bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of efforts to prevent maternal deaths due to obstetric hemorrhage on trends in epidemiology and management of severe postpartum hemorrhage in Japan: a nationwide retrospective study
Authors: Ueda Akihiko , Nakakita Baku , Chigusa Yoshitsugu , Mogami Haruta , Ohtera Shosuke , Kato Genta , Mandai Masaki , Kondoh Eiji 
Published: June 2022

Abstract
Background
The Japan Society of Obstetrics and Gynecology and the Japan Association of Obstetricians and Gynecologists have issued the guidelines and recommendations on postpartum hemorrhage since 2010 and have been conducted widespread educational activities from 2012. The aim of this study was to investigate the impact of these efforts by the Societies to prevent maternal deaths due to obstetric hemorrhage on trends in epidemiology and management of severe postpartum hemorrhage in Japan.

Methods
A national retrospective cohort study was conducted using the national database of health insurance claims for the period 2012 and 2018. The subjects were all insured women who received a blood transfusion for postpartum hemorrhage. The primary endpoints of this study were hysterectomy and maternal mortality. The etiology of hemorrhage, treatment facility, type of procedure, and blood transfusion volume were tabulated.

Results
Women with postpartum hemorrhage that underwent transfusion increased from 3.5 to 5.5 per 1000 deliveries between 2012 and 2018. The most common cause of postpartum hemorrhage was atonic hemorrhage. After insurance coverage in 2013, the intrauterine balloon tamponade use increased to 20.3% of postpartum hemorrhages treated with transfusion in 2018, while the proportion of hysterectomy was decreased from 7.6% (2013–2015) to 6.4% (2016–2018) (p < 0.0001). The proportion of postpartum hemorrhage in maternal deaths decreased from 21.1% (2013–2015) to 14.1% (2016–2018) per all maternal deaths cases (p = 0.14). Cases with postpartum hemorrhage managed in large referral hospitals was increased (65.9% in 2012 to 70.4% in 2018) during the study period (p < 0.0001).

Conclusions
The efforts by the Societies to prevent maternal mortality due to obstetric hemorrhage resulted in a significant decrease in the frequency of hysterectomies and a downward trend in maternal mortality due to obstetric hemorrhage.
Tumor and peritumor radiomics analysis based on contrast-enhanced CT for predicting early and late recurrence of hepatocellular carcinoma after liver resection
Authors: Li Nu , Wan Xiaoting , Zhang Hong , Zhang Zitian , Guo Yan , Hong Duo 
Published: June 2022

Abstract
Background
In China, liver resection has been proven to be one of the most important strategies for hepatocellular carcinoma patients, but the recurrence rate is high. This study sought to investigate the prognostic value of pretreatment tumor and peritumor contrast-enhanced CT radiomics features for early and late recurrence of BCLC stage 0-B hepatocellular carcinoma after liver resection.

Methods
This study involved 329 hepatocellular carcinoma patients after liver resection. A radiomics model was built by using Lasso-Cox regression model. Association between radiomics model and recurrence-free survival was explored by using Harrell’s concordance index (C-Index) and receiver operating characteristic (ROC) curves. Then, we combined the radiomics model and clinical factors to establish a nomogram whose calibration and discriminatory ability were revealed.

Results
Ten significant tumor and peritumor features were screened to build the radiomics model whose C-indices were 0.743 [95% CI, 0.707 to 0.778] and 0.69 [95% CI, 0.629 to 0.751] in the training and validation cohorts. Moreover, the discriminative accuracy of the radiomics model improved with peritumor features entry. The C-indices of the combined model were 0.773 [95% CI, 0.739 to 0.806] and 0.727 [95% CI, 0.667 to 0.787] in the training and validation cohorts, outperforming the radiomics model.

Conclusions
The tumor and peritumor contrast-enhanced CT radiomic signature is a quantitative imaging biomarker that could improve the prediction of early and late recurrence after liver resection for hepatocellular carcinoma patients when used in addition to clinical predictors.
Investigation of BRCAness associated miRNA-gene axes in breast cancer: cell-free miR-182-5p as a potential expression signature of BRCAness
Authors: Darbeheshti Farzaneh , Kadkhoda Sepideh , Keshavarz-Fathi Mahsa , Razi Sepideh , Bahramy Afshin , Mansoori Yaser , Rezaei Nima 
Published: June 2022

AbstractThe concept of the ‘BRCAness’ phenotype implies the properties that some sporadic breast cancers (BC) share withBRCA1/2-mutation carriers with hereditary BC. Breast tumors with BRCAness have deficiencies in homologous recombination repair (HRR), likeBRCA1/2-mutation carriers, and consequently could benefit from poly-(ADP)-ribose polymerase (PARP) inhibitors and DNA-damaging chemotherapy. Triple-negative breast cancers (TNBC) show a higher frequency of BRCAness than the other BC subtypes. Therefore, looking for BRCAness-related biomarkers could improve personalized management of TNBC patients. microRNAs (miRNAs) play a pivotal role in onco-transcriptomic profiles of tumor cells besides their suitable features as molecular biomarkers. The current study aims to evaluate the expression level of some critical miRNAs-mRNA axes in HRR pathway in tumors and plasma samples from BC patients. The expression levels of three multi-target miRNAs, including miR-182-5p, miR-146a-5p, and miR-498, as well as six downstream HRR-related protein-coding genes, have been investigated in the breast tumors and paired adjacent normal tissues by Real-time PCR. In the next step, based on the results derived from the previous step, we examined the level of cell-free miR-182-5p in the blood plasma samples from the patients. Our results highlight the difference between TNBC and non-TNBC tumor subgroups regarding the dysregulation of the key miRNA/mRNA axes involved in the HRR pathway. Also, for the first time, we show that the level of cell-free miR-182-5p in plasma samples from BC patients could be a clue for screening BC patients eligible for receiving PARP inhibitors through a personalized manner. Altogether, some sporadic BC patients, especially sporadic TNBC, have epigenetically dysregulated HRR pathway that could be identified and benefit from BRCAness-specific therapeutic agents.
Effectiveness of crisis resolution home treatment for the management of acute psychiatric crises in Southern Switzerland: a natural experiment based on geography
Authors: Soldini Emiliano , Alippi Maddalena , Zufferey Maria Caiata , Lisi Angela , Lucchini Mario , Albanese Emiliano , Colombo Raffaella Ada , Rossa Simona , Bolla Emilio , Mellacqua Zefiro Benedetto , Larghi Giuseppina , Cordasco Severino , Kawohl Wolfram , Crivelli Luca , Traber Rafael 
Published: June 2022

Abstract
Background
Crisis Resolution Home Treatment (CRHT) is an alternative to inpatient treatment for acute psychiatric crises management. However, evidence on CRHT effectiveness is still limited. In the Canton of Ticino (Southern Switzerland), in 2016 the regional public psychiatric hospital replaced one acute ward with a CRHT. The current study was designed within this evaluation setting to assess the effectiveness of CRHT compared to standard inpatient treatment.

Methods
CRHT was offered to patients aged 18 to 65 with an acute psychiatric crisis that would have required hospitalization. We used a natural experiment based on geography, where intervention and control groups were formed according to the place of residence. Primary endpoints were reduction of psychiatric symptoms at discharge measured using the Health of the Nation Outcome Scales, treatment duration in days, and rate and length of readmissions during a two-year follow-up period after discharge. Safety during the treatment period was measured with the number of serious adverse events (suicide/suicide attempts, major self-harm episodes, acute alcohol/drug intoxications, aggressions to caregivers or family members). We used linear, log-linear and logistic regression models with propensity scores for the main analysis.

Results
We enrolled 321 patients; 67 were excluded because the treatment period was too short and 17 because they were transferred before the end of the treatment. Two hundred thirty-seven patients were available for data analysis, 93 in the intervention group and 144 in the control group. No serious adverse event was observed during the treatment period in both groups. Reduction of psychiatric symptoms at discharge (p-value = 0.359), readmission rates (p-value = 0.563) and length of readmissions (p-value = 0.770) during the two-year follow-up period did not differ significantly between the two groups. Treatment duration was significantly higher in the treatment group (+ 29.6% on average, p-value = 0.002).

Conclusions
CRHT was comparable to standard hospitalization in terms of psychiatric symptoms reduction, readmission rates and length of readmissions, but it was also characterized by a longer first treatment period. However, observational evidence following the study indicated that CRHT duration constantly lowered over time since its introduction in 2016 and became comparable to hospitalization, showing therefore to be an effective alternative also in terms of treatment length.

Trial registration
ISRCTN38472626 (17/11/2020, retrospectively registered).
Spatio-temporal evolution and trend prediction of the incidence of Class B notifiable infectious diseases in China: a sample of statistical data from 2007 to 2020
Authors: Wang Ruo-Nan , Zhang Yue-Chi , Yu Bo-Tao , He Yan-Ting , Li Bei , Zhang Yi-Li 
Published: June 2022

Abstract
Background
With the accelerated global integration and the impact of climatic, ecological and social environmental changes, China will continue to face the challenge of the outbreak and spread of emerging infectious diseases and traditional ones. This study aims to explore the spatial and temporal evolutionary characteristics of the incidence of Class B notifiable infectious diseases in China from 2007 to 2020, and to forecast the trend of it as well. Hopefully, it will provide a reference for the formulation of infectious disease prevention and control strategies.

Methods
Data on the incidence rates of Class B notifiable infectious diseases in 31 provinces, municipalities and autonomous regions of China from 2007 to 2020 were collected for the prediction of the spatio-temporal evolution and spatial correlation as well as the incidence of Class B notifiable infectious diseases in China based on global spatial autocorrelation and Autoregressive Integrated Moving Average (ARIMA).

Results
From 2007 to 2020, the national incidence rate of Class B notifiable infectious diseases (from 272.37 per 100,000 in 2007 to 190.35 per 100,000 in 2020) decreases year by year, and the spatial distribution shows an “east-central-west” stepwise increase. From 2007 to 2020, the spatial clustering of the incidence of Class B notifiable infectious diseases is significant and increasing year by year (Moran’s I index values range from 0.189 to 0.332, p < 0.05). The forecasted incidence rates of Class B notifiable infectious diseases nationwide from 2021 to 2024 (205.26/100,000, 199.95/100,000, 194.74/100,000 and 189.62/100,000) as well as the forecasted values for most regions show a downward trend, with only some regions (Guangdong, Hunan, Hainan, Tibet, Guangxi and Guizhou) showing an increasing trend year by year.

Conclusions
The current study found that since there were significant regional disparities in the prevention and control of infectious diseases in China between 2007 and 2020, the reduction of the incidence of Class B notifiable infectious diseases requires the joint efforts of the surrounding provinces. Besides, special attention should be paid to provinces with an increasing trend in the incidence of Class B notifiable infectious diseases to prevent the re-emergence of certain traditional infectious diseases in a particular province or even the whole country, as well as the outbreak and spread of emerging infectious diseases.
Preoperative and postoperative nomograms for predicting early recurrence of hepatocellular carcinoma without macrovascular invasion after curative resection
Authors: Zhang Yanfang , Lei Xuezhong , Xu Liangliang , Lv Xiaoju , Xu Mingqing , Tang Hong 
Published: June 2022

Abstract
Background
Postoperative early recurrence (ER) is a major obstacle to long-term survival after curative liver resection (LR) in patients with hepatocellular carcinoma (HCC). This study aimed to establish preoperative and postoperative nomograms to predict ER in HCC without macrovascular invasion.

Methods
Patients who underwent curative LR for HCC between January 2012 and December 2016 were divided into training and internal prospective validation cohorts. Nomograms were constructed based on independent risk factors derived from the multivariate logistic regression analyses in the training cohort. The predictive performances of the nomograms were validated using the internal prospective validation cohort.

Results
In total, 698 patients fulfilled the eligibility criteria. Among them, 265 of 482 patients (55.0%) in the training cohort and 120 of 216 (55.6%) patients in the validation cohort developed ER. The preoperative risk factors associated with ER were age, alpha-fetoprotein, tumor diameter, and tumor number, and the postoperative risk factors associated with ER were age, tumor diameter, tumor number, microvascular invasion, and differentiation. The pre- and postoperative nomograms based on these factors showed good accuracy, with concordance indices of 0.712 and 0.850 in the training cohort, respectively, and 0.754 and 0.857 in the validation cohort, respectively. The calibration curves showed optimal agreement between the predictions by the nomograms and actual observations. The area under the receiver operating characteristic curves of the pre- and postoperative nomograms were 0.721 and 0.848 in the training cohort, respectively, and 0.754 and 0.844 in the validation cohort, respectively.

Conclusions
The nomograms constructed in this study showed good performance in predicting ER for HCC without macrovascular invasion before and after surgery. These nomograms would be helpful for doctors when determining treatments and selecting patients for regular surveillance or administration of adjuvant therapies.
Analysing root roughness and smear layer relationship by comparing contemporary dental curettes with conventional dental curettes: a randomised controlled trial
Authors: Riaz Sania , Ahmed Shahbaz , Shabbir Sumaiya , Khan Ziaur Rahman , Zaidi Syed Jaffar Abbas , Naeem Meshal Muhammad , Farooqui Waqas Ahmed 
Published: June 2022

Abstract
Background
Root debridement procedures for the treatment of periodontal diseases, produces root surface irregularities and smear layer on the root surface that can adversely affect the healing of periodontal tissues. The objective of the present study was to evaluate the surface texture of root after hand instrumentation with Gracey curette, After Five curette, and Mini Five curette.

Methods
A randomised, controlled clinical trial was conducted with 120 participants clinically diagnosed with chronic periodontitis. Participants were equally randomised into four groups, with parallel treatment assignment of scaling and root planning using Gracey Curettes, After five and Mini five curette, and a control group with no instrumentation. Mobile teeth of these patients were then extracted atraumatically and analysed under a Scanning Electron Microscope and graded for "Roughness and Loss of Tooth substance index" and "Smear layer index." Cross Tabulation was made between the test groups (Control, Gracey Curette, After five, and Mini Five) versus "Roughness and Loss of Tooth substance Index" and "Smear Layer Index." A Chi-square test with Bonferroni correction was used to determine the graded distribution among the groups.

Results
In the control group, 73.3% of the teeth showed grade 1 roughness. In the Gracey group, 56.7% showed grade 2 roughness; in the After 5 group, 70% showed grade 3 roughness; in the Mini 5 group, 76.7% showed grade 3 roughness. A significant association was found between roughness scores and the use of individual instruments. Regarding smear layer formation, 46.7% of teeth showed a grade 4 smear layer in the control group. 50% of teeth showed grade 2 smear layer thickness in the Gracey group. In the After 5 group, 73.3% of teeth showed a grade 1 smear layer, while in the Mini 5 group, 80.0% showed a grade 1 smear layer. The use of individual instruments was significantly associated with the smear layer scores.

Conclusion
Gracey curettes produced relatively smoother root surfaces with less smear layer formation than After Five and Mini Five curettes, which produced relatively more roughened root surfaces with thicker smear layer formation.

Trial registration

ID: ClinicalTrials.gov Identifier: NCT04216966 Date of Registration: January 3, 2020.
Barriers and facilitators to attending and being physically active during recreation time among women incarcerated
Authors: Camplain Ricky , Williamson Heather J. , Pinn Travis A. , Shuman Sara , Robinson Bethany M. , Evans Maribeth , Luna Crystal 
Published: June 2022

Abstract
Background
Most women incarcerated in jail are not physically active and do not attend recreation time (rec-time), a time dedicated to being physically active, outside. The purpose of this study was to determine barriers and facilitators to attending and being physically active during rec-time among women incarcerated in jail.

Methods
We recruited and distributed a cross-sectional questionnaire to 100 women incarcerated at the Coconino County Detention Facility (CCDF) in Flagstaff, Arizona from March to July 2020. Women were asked about their experience with rec-time at CCDF, including if they had ever attended, how often they attended, if they exercised at rec-time, activities they participated in, and facilitators, barriers, and benefits to attend rec-time.

Results
Among 99 women who completed the questionnaire, 89% had ever attended rec-time. Most women identified environmental- and health-related facilitators to attending rec-time including enjoying natural light (74%), getting fresh air (83%), a change in environment (62%), and to move around and exercise (72%). Many women indicated environmental-, equipment-, clothing, and motivation-related barriers to attending rec-time. Specifically, women believed there was a lack of equipment (56%) and limited access to proper footwear (49%).

Conclusions
As health and environment are important facilitators and barriers to being physically active among women incarcerated in jail, it is important to identify appropriate environmental and policy interventions to increase the use of rec-time and physical activity. If a correctional facility does not offer rec-time or a similar alternative, one should be established, accessible, and welcoming.
Investigating pharmacy students’ therapeutic decision-making with respect to antimicrobial stewardship cases
Authors: Nasr Ziad G. , Alhaj Moustafa Diala , Dahmani Sara , Wilby Kyle J. 
Published: June 2022

Abstract
Background
Antimicrobial stewardship programs (ASPs) play a big role in minimizing antimicrobial resistance. Pharmacists are essential members of the health care team and in order for them to fulfill roles on ASP teams and become antimicrobial stewards, they must be prepared adequately by pharmacy schools prior to entry into actual practice. Although programming has been implemented into entry-to-practice programs worldwide, little is known about how students interpret antimicrobial stewardship (AMS) data and arrive at clinical decisions. We aimed to explore students’ cognitive processes and determine how they formulate therapeutic decisions when presented with AMS cases.

Methods
This was a qualitative study conducted using a case study approach, in which a sample (n=20) of pharmacy students was recruited to interpret AMS cases. Semi-structured 1-on-1 interviews were arranged with each participant. A think-aloud procedure with verbal protocol analysis was adopted to determine students’ decision-making processes. Thematic analysis was used to interpret themes from the interview data.

Results
Two themes were interpreted from the data: students’ focus and students’ approach to case interpretation. Students’ focus relates to external factors students consider when interpreting AMS case data and use to make and justify therapeutic decisions including patient-centered factors, drug-related factors, AMS interventions, and pharmacist’s role. Students’ clinical reasoning describes the approach that students use to interpret the data and the decision-making processes they employ to arrive at a clinical decision including a systematic approach versus non-systematic approach.

Conclusions
Students vary in their focus and the cognitive strategies used to interpret AMS cases. Findings support the notion that clinical reasoning and decision-making should be explicitly taught in pharmacy curricula, in order to help students become aware of their own cognitive processes and decision-making abilities.
The knowledge, barriers and opportunities to improve nutrition and physical activity amongst young people attending an Australian youth mental health service: a mixed-methods study
Authors: Mawer Tamieka , Kent Katherine , Williams Andrew D. , McGowan Courtney J. , Murray Sandra , Bird Marie-Louise , Hardcastle Sibella , Bridgman Heather 
Published: June 2022

Abstract
Background
Mental illnesses are the leading cause of disability in young people, and lifestyle interventions in young people at risk of mental illness remain a priority. Opportunities to improve nutrition and physical activity among young people through youth mental health services remain unclear. This study aimed to determine the knowledge and behaviors towards nutrition and physical activity, the barriers and enablers to improving behaviors, and the preferred providers and sources of information for nutrition and physical activity among a sample of young people attending a youth mental health service.

Methods
A mixed-method study was conducted in regional Tasmania, Australia in a sample of young people (15–25 years) attending a youth mental health service (headspace). A quantitative survey (n = 48) determined young people’s nutrition and physical activity knowledge, behaviors, barriers and enablers to achieving recommendations, and their preferred providers and sources of information. Structured interviews and a focus group further explored these concepts (n = 8), including the role of the mental health service as a provider of this support.

Results
The majority of participants did not meet national recommendations for nutrition and physical activity, despite possessing a high level of knowledge regarding their importance for mental health. Improving mental health was a common enabling factor for participants choosing to alter diet and physical activity habits, but also the leading barrier for participating in physical activity. Young people wanted to receive information from reputable health providers, ideally through social media sources. headspace was seen as an important potential provider of this information.

Conclusions
Our results indicate that there is a clear need to improve diet and physical activity habits to enhance mental and physical health outcomes in this at-risk group, and youth mental health services could provide further interventions to support their clients. Specialized staff (e.g. dietitians and exercise physiologists) may provide additional benefits alongside existing mental health care support.