bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of level of asthma control and related factors in children attending pediatric respiratory clinics in Addis Ababa, Ethiopia
Authors: Aschalew Amare , Kebed Rahel Argaw , Demie Takele Gezahegn , Weldetsadik Abate Yeshidinber 
Published: February 2022

Abstract
Background
Asthma is a common airways disease with significant morbidity and mortality in all ages. Studies of pediatric asthma control and its determinants yielded variable results across settings. However, there is paucity of data on asthma control and its factors in Ethiopian children. We aimed to assess the level of asthma control and the related factors in children attending pediatric respiratory clinics at three tertiary hospitals in Addis Ababa.

Methods
We conducted a cross-sectional study from March 1 to August 30, 2020 using standardized questionnaires and review of patient’s charts. Data was analyzed using SPSS software for window version 26.

Results
A total of 105 children (56.2% male) were included in the study. The mean age (± SD) and age at Asthma diagnosis (± SD) were 6 (± 3.3) and 4 (± 2.8) respectively. Uncontrolled asthma was present in 33 (31%) of children. Comorbidities (Atopic dermatitis and allergic Rhinitis (AOR = 4.56; 95% CI 1.1–18.70; P = 0.035), poor adherence to controller medications (AOR = 3.23; 95% CI 1.20–10.20; P = 0.045), inappropriate inhaler technique (AOR = 3.48; 95% CI 1.18–10.3; P = 0.024), and lack of specialized care (AOR = 4.72; 95% CI 1.13–19.80; P = 0.034) were significantly associated with suboptimal asthma control.

Conclusion
One-third of children attending pediatric respiratory clinics in Addis Ababa had uncontrolled Asthma. Treatment of comorbidities, training of appropriate inhaler techniques, optimal adherence to controllers, and proper organization of clinics should be emphasized to improve asthma control among children.
Rigid ureteroscopic lithotripsy in the lateral decubitus position for upper urinary tract stones
Authors: Zhang Jinqing , Li Binbin , Li Gang , Yang Zengshi , Ye Ning , Liu Yihao , Zhuo Hongbing , Hong Jingfan 
Published: February 2022

Abstract
Background
The current study aimed to assess a novel ureteroscopic technique developed for treating upper urinary calculi based on a specially designed lateral decubitus body position that could avoid stone loss by adjusting to the effects of gravity.

Methods
This retrospective study examined patients with upper urinary calculi who were surgically treated from November 2008 to January 2020, using a new body position and a rigid ureteroscope. Clinical outcomes, stone-free rates, operative times and complications were evaluated, and factors that could influence treatment success were determined.

Results
In total, 1080 patients were included, and 1145 operations were performed. The maximum calculus diameters were 11.22 ± 5.01 mm. Operative times were 48.60 ± 27.44 min. A total of 1042 cases were successfully treated, with a stone-free rate of 91.00%. Multivariate analysis showed that female sex (OR = 2.135, 95% CI 1.332–3.422, P = 0.002), thin scope standby (OR = 1.643, 95% CI 1.074–2.514, P = 0.022), laser lithotripsy (OR = 5.087, 95% CI 2.400–10.785, P = 0.000) and stone size (OR = 0.946, 95% CI 0.912–0.981, P = 0.003) were independently associated with stone-free outcomes. In total, 2 ureteral perforations, 2 ureteric avulsions and 4 urosepsis cases were observed, but were all cured without sequelae.

Conclusions
Ureteroscopic lithotripsy in the lateral decubitus position is a safe and effective technique for treating upper urinary tract calculi, especially upper ureteral calculi.
Perceived stress and study-related behavior and experience patterns of medical students: a cross-sectional study
Authors: Afshar Kambiz , Wiese Birgitt , Stiel Stephanie , Schneider Nils , Engel Bettina 
Published: February 2022

Abstract
Background
Distress and burnout are common in physicians. Both may already arise during medical training and persist throughout residency. An analysis of needs is necessary in order to develop target group specific curricular concepts at medical faculties. Aim of this study was to assess the perceived stress of medical students, to explore study-related behavior and experience patterns, and to investigate associated factors.

Methods
We conducted a cross-sectional survey of medical students at the Hannover Medical School. The web-based questionnaire consisted of 74 items and included two standardized instruments: the “Work-related Behavior and Experience Patterns” (Arbeitsbezogene Verhaltens- und Erlebensmuster, AVEM) and the “Perceived Medical School Stress” scale (PMSS). Students were asked to state their self-perceived actual stress level on a scale from 0% (no stress at all) to 100% (maximum stress). We performed a classification and regression tree (CART) analysis to identify factors that can discriminate between the four different AVEM patterns.

Results
Five hundred ninety-one medical students (female 75.8%, response rate: 34.0%) participated in the survey. The mean sum score of the PMSS was 37.2 (SD 8.3; median score 37, min.-max. = 18–65). Overall, 68.5% of the students showed a risk pattern (risk pattern A “overexertion”: 38.9%; risk pattern B “burnout”: 29.6%). Pattern G “healthy” was shown in 8.3% and pattern S “protection” in 23.1% of the students. Multilevel analysis revealed that the self-perceived stress level and the PMSS sum score were the most important predictors for the AVEM pattern assignment. Furthermore, academic year, gender, and financial dependency were relevant influencing factors: students in higher academic years with no financial support had a higher probability to be in risk pattern B whereas male students in the first academic year tended to be in pattern G.

Conclusions
The PMSS sum score could objectify medical students’ high self-perceived stress level. The majority of participating students showed a risky study-related behavior and experience pattern. Medical faculties should be aware of the still existing and relevant problem of stress and burnout among medical students. Our results lay the groundwork for an evaluation and further development of medical curricula at the own faculty.
Greater trochanter morphology and association with patient demographics, surgical factors, and post-operative stem position: a retrospective assessment of 150 cementless THRs in 135 dogs
Authors: Silveira Catrina J. , Barnes Katherine H. , Kerwin Sharon C. , Saunders W. Brian 
Published: February 2022

AbstractBackgroundTotal hip replacement (THR) in the gold standard surgical treatment for the canine hip. While it has been shown that greater trochanter morphology affects post-operative cementless stem position in humans, trochanter morphology and the effect on cementless stem position has not been extensively evaluated in dogs. The objective of this study was to classify greater trochanter morphology and identify potential associations between trochanter morphology and patient demographics, femoral canal geometry, surgical time, technique modifications, and post-operative stem position in client-owned dogs undergoing cementless THR.ResultsIn this retrospective study, medical records and radiographs of 135 dogs undergoing 150 cementless total hip replacements from 2013 to 2020 were included. Trochanters were classified in the frontal plane using an ordinal grading system adapted from human THR. A Grade I trochanter denoted a trochanter positioned lateral to the periosteal surface of the lateral femoral cortex, whereas a Grade IV trochanter denoted a trochanter positioned medial to the anatomic axis of the femur. Associations between trochanter grade and other variables were examined using ANOVA, Kruskall-Wallis, or chi-squared tests. Significance was assumed atP ≤ .05.Trochanters were classified as follows: Grade I (44/150, 29.3%), Grade II (56/150, 37.4%), Grade III (44/150, 29.3%), Grade IV (6/150, 4.0%). Grade IV trochanters had lower anatomic lateral distal femoral angle (aLDFA; 91.0 ± 6.2°), angle of inclination (117.7 ± 10.5°), and canal flare index (1.53 ± 0.27). When compared to all groups, Grade IV trochanters were associated with longer surgical times (Grade IV: 227.0 ± 34.2 min; all grades: 183.2 ± 32.9 min) and technique modifications (Grade IV: 83.3%; all grades: 18%). Grade I trochanters had stems placed in valgus (− 1.8 ± 2.33°), whereas Grade II (0.52 ± 2.36°), III (0.77 ± 2.58°), and IV (0.67 ± 2.73°) trochanters exhibited varus stems. Depth of stem insertion was greater (11.2 ± 4.2 mm) for Grade IV trochanters.ConclusionsTrochanter grade was associated with post-operative stem alignment and translation in the frontal plane. Grade IV trochanters were associated with altered femoral geometry, increased surgical time, technique modifications, and stem insertion depth. Pre-operative greater trochanter classification may prove useful in identifying cases requiring prolonged surgical times or technique modifications.
Sensitive and selective detection of Mucin1 in pancreatic cancer using hybridization chain reaction with the assistance of Fe3O4@polydopamine nanocomposites
Authors: Dong Qing , Jia Xiuna , Wang Yuling , Wang Hao , Liu Qiong , Li Dan , Wang Jin , Wang Erkang 
Published: February 2022

AbstractPancreatic cancer is characterized as the worst for diagnosis lacking symptoms at the early stage, which results in a low overall survival rate. The frequently used techniques for pancreatic cancer diagnosis rely on imaging and biopsy, which have limitations in requiring experienced personnel to operate the expensive instruments and analyze the results. Therefore, there is a high demand to develop alternative tools or methods to detect pancreatic cancer. Herein, we propose a new strategy to enhance the detection sensitivity of pancreatic cancer cells both in biofluids and on tissues by combining the unique property of dopamine coated Fe3O4 nanoparticles (Fe3O4@DOP NPs) to specifically quench and separate free 6-carboxyfluorescein (FAM) labeled DNA (H1-FAM/H2-FAM), and the key feature of hybridization chain reaction (HCR) amplification. We have determined the limit of detection (LOD) to be 21 ~ 41 cells/mL for three different pancreatic cancer cell lines. It was also discovered that the fluorescence intensity of pancreatic cancer cells was significantly higher than that of HPDE-C7 and HepG-2 cells (control cell lines), which express lower MUC1 protein. Moreover, the HCR amplification system was used to identify the cancer cells on pancreatic tissue, which indicated the versatility of our strategy in clinical application. Therefore, the presented detection strategy shows good sensitivity, specificity and has great potential for the diagnosis of pancreatic cancer.
Graphical Abstract
Design of a chimaeric antigen and its use in the detection of IgG antibodies against rubella virus
Authors: Xing Wenyue , Li Li , Zhang Jingnan , Ma Chunli , Xue Xin , Ye Shumei , Xue Huiting , Hu Ruiping , Ma Yanhua , Yuan Hong 
Published: February 2022

Abstract
Background
Rubella virus (RV) is the causative agent of rubella or German measles. Although most infections cause only mild self-limited measles-like illness, the infection in pregnant women can cause severe foetal malformation or even miscarriage, especially in the first 3 months of pregnancy. Therefore, it is of great practical significance to establish a simple and sensitive RV detection method.

Methods
The partial epitopes of the E1 and E2 proteins from Rubella Virus were selected as the target sites, the sequence of the selected antigenic sites of the E1 and E2 were linked by a linker. The expression plasmid P6T was constructed by inserting the gene into PET-32A + with a histidine Tag. The P6 protein was induced and expressed in Escherichia coli L21 (DE3) and purified by nickel column affinity. The protein P6 antigen was identified by Western blotting analysis, and an anti-P6 antibody ELISA was established to test known serum samples to evaluate the capability of this method.

Results
After purification, the concentration and purity of the protein P6 were 0.283 mg/mL and more than 80%, respectively. Western blotting analysis showed that the protein P6 could react with rubella virus positive serum. By ELISA, 36 negative sera and 58 positive sera were detected. The coincidence rate, specificity and sensitivity of the ELISA were 86.2%, 88.89% and 84.48%, respectively. The P6 ELISA with a kappa coefficient of 0.715, P < 0.05, indicated excellent consistency.

Conclusions
The protein P6 with excellent antigenicity obtained from prokaryotic expression followed by chromatography purification could prove useful for early diagnosis of RV infection.
Healthcare worker perspectives on mother’s insufficient milk supply in Malawi
Authors: Piccolo Olivia , Kinshella Mai-Lei Woo , Salimu Sangwani , Vidler Marianne , Banda Mwai , Dube Queen , Kawaza Kondwani , Goldfarb David M. , Nyondo-Mipando Alinane Linda 
Published: February 2022

Abstract
Background
Human milk insufficiency is a significant barrier to implementing breastfeeding, and it is identified as a prevalent concern in 60–90% of mothers in low-and-middle-income countries. Breastmilk insufficiency can lead to hypoglycemia, hypernatremia, nutritional deficiencies, and failure to thrive in newborns and infants. Studies investigating the impact of breastfeeding interventions to improve milk production highlight inconsistencies between healthcare workers and mothers perceived support, as well as gaps in practical knowledge and training. The aim of this study was to determine perceptions surrounding human milk insufficiency from Malawian healthcare workers.

Methods
This study is a secondary analysis of 39 interviews with healthcare workers from one tertiary and three district hospitals in Malawi employing content analysis. Interviewed healthcare workers included nurses, clinical officers, midwives, and medical doctors. An inclusive coding framework was developed to identify themes related to human milk insufficiency, which were analyzed using an iterative process with NVivo12 software. Researchers focused on themes emerging from perceptions and reasons given by healthcare workers for human milk insufficiency.

Results
Inability to produce adequate breastmilk was identified as a prevalent obstacle mothers face in the early postpartum period in both district and tertiary facilities in Malawi. The main reasons given by participants for human milk insufficiency were mothers’ perceived normalcy of milk insufficiency, maternal stress, maternal malnutrition, and traditional beliefs around food and eating. Three focused solutions were offered by participants to improve mother’s milk production – improving education for mothers and training for healthcare providers on interventions to improve mother’s milk production, increasing breastfeeding frequency, and ensuring adequate maternal nutrition pre- and post-partum.

Conclusion
Health care workers perspectives shed light on the complexity of causes and solutions for human milk insufficiency in Malawi. This research highlights that a respectful professional relationship between health care workers and mothers is an essential bridge to improving communication, detecting human milk insufficiency early, and implementing appropriate interventions. The results of this study may help to inform research, clinical practice, and education in Malawi to improve human milk production.
Altered gut microbiota composition with antibiotic treatment impairs functional recovery after traumatic peripheral nerve crush injury in mice: effects of probiotics with butyrate producing bacteria
Authors: Rodenhouse Andrew , Talukder M. A. Hassan , Lee Jung Il , Govindappa Prem Kumar , O’Brien Mary , Manto Kristen M. , Lloyd Kelsey , Wandling Grant D. , Wright Justin R. , Chen See Jeremy R. , Anderson Samantha L. , Lamendella Regina , Hegarty John P. , Elfar John C. 
Published: February 2022

Abstract
Objective
Antibiotics (ABX) are widely used for life-threatening infections and also for routine surgical operations. Compelling evidence suggests that ABX-induced alterations of gut microbiota composition, termed dysbiosis, are linked with diverse disease states including neurological and neurodegenerative conditions. To combat the consequences of dysbiosis, probiotics (PBX) are widely used. ABX-induced dysbiosis is reported to impair neurological function after spinal cord injury. Traumatic peripheral nerve injury (TPNI) results in profound neurologic impairment and permanent disability. It is unknown whether ABX treatment-induced dysbiosis has any impact on TPNI-induced functional recovery, and if so, what role medical-grade PBX could have on TPNI recovery.

Results
In this study, ABX-induced dysbiosis and PBX-induced microbiota enrichment models were used to explore the potential role of gut microbiome in TPNI. Stool analysis with 16S ribosomal RNA (rRNA) gene sequencing confirmed ABX-induced dysbiosis and revealed that ABX-induced changes could be partially restored by PBX administration with an abundance of butyrate producing bacteria. Pre-injury ABX significantly impaired, but pre-injury PBX significantly improved post-TPNI functional recovery. Importantly, post-injury PBX protected against pre-injury ABX-induced functional impairment. These findings demonstrate that reestablishment of gut microbiota composition with butyrate producing PBX during ABX-induced dysbiosis could be a useful adjuvant therapy for TPNI.
Mindfulness practice correlates with reduced exam-induced stress and improved exam performance in preclinical medical students with the “acting with awareness”, “non-judging” and “non-reacting” facets of mindfulness particularly associated with improved exam performance
Authors: Hearn Jasmine Heath , Stocker Claire J. 
Published: February 2022

Abstract
Background
Medical students demonstrate higher levels of psychological distress compared with the general population and other student groups, especially at exam times. Mindfulness interventions show promise in stress reduction for this group, and in the reduction of cortisol, an established clinical marker of the body’s stress response. This study investigated the relationship of mindfulness to exam-induced stress, salivary cortisol and exam performance in undergraduate medical students.

Methods
A controlled pre-post analysis design with within-groups comparisons. 67 medical students completed the five facet mindfulness questionnaire (FFMQ) and provided saliva samples, from which cortisol was extracted, during group work (control/baseline) and immediately prior to end of year 2 examinations (experimental). Academic performance data was extracted for comparison with measures.

Results
Exam-induced salivary cortisol concentration showed a significant negative relation with exam performance. Total FFMQ score showed a significant positive relation with exam performance and a significant negative relation with exam-induced salivary cortisol. The specific mindfulness facets of acting with awareness, non-judging and non-reacting also showed a positive correlation with exam performance.

Conclusions
This study suggests that there exists an important relationship between mindfulness and the physiological biomarker of stress, cortisol, and this manifests into improved assessment outcomes potentially through healthier, more adaptive coping and stress management strategies. In particular, this study identifies the acting with awareness, non-judging and non-reacting facets of mindfulness to be significantly associated with exam performance suggesting that these may be important facets for clinical educators to target when helping students with mindfulness practice.
VeilGraph: incremental graph stream processing
Authors: Coimbra Miguel E. , Esteves Sérgio , Francisco Alexandre P. , Veiga Luís 
Published: February 2022

AbstractGraphs are found in a plethora of domains, including online social networks, the World Wide Web and the study of epidemics, to name a few. With the advent of greater volumes of information and the need for continuously updated results under temporal constraints, it is necessary to explore alternative approaches that further enable performance improvements. In the scope of stream processing over graphs, we research the trade-offs between result accuracy and the speedup of approximate computation techniques. The relationships between the frequency of graph algorithm execution, the update rate and the type of update play an important role in applying these techniques. Herein we present VeilGraph, through which we conducted our research. We showcase an innovative model for approximate graph processing implemented in . We analyse the feasibility of our model and evaluate it with the case study of the PageRank algorithm, the most famous measure of vertex centrality used to rank websites in search engine results. Our experiments show that VeilGraph can often reduce latency closely to half (speedup of 2.0×), while achieving result quality above 95% when compared to results of the traditional version of PageRank executing in with (i.e. without any summarization or approximation techniques). In some cases, depending on the workload, speedups against reach up to 3.0x (i.e. yielding a reduction of up to 66% in latency). We have found VeilGraph implementation on Flink to be scalable, as it is able to improve performance up to 10X speedups, when more resources are employed (16 workers), achieving better speedups with scale for larger graphs, which are the most relevant.
Suture tape reinforcement of hamstring tendon graft reduces postoperative knee laxity after primary ACL reconstruction
Authors: von Essen Christoffer , Sarakatsianos Vasileios , Cristiani Riccardo , Stålman Anders 
Published: February 2022

Abstract
Purpose
To evaluate and compare subjective and objective knee outcomes following hamstring tendon (HT) and quadriceps tendon (QT) anterior cruciate ligament reconstruction (ACLR) with or without suture tape (ST) reinforcement. It was hypothesized that the addition of an intra-articular synthetic augmentation with a ST would reduce postoperative knee laxity and graft ruptures after ACLR.

Methods
A 1:1 matched-cohort comparison of patients who underwent HT and QT autograft ACLR with or without ST reinforcement was performed. Patients with ST reinforcement were consecutively assigned to the study groups until a number of 20 in each group was achieved. Medical records were reviewed for demographic characteristics and additional injuries. Laxity measurements with KT-1000, strength measurements and physical examination findings were collected both preoperatively and at 6 months and patient reported outcome (PRO) scores were collected both preoperatively and at 12 months, and comparison was made HT vs HT + ST and QT vs QT + ST. Reoperations and re-ruptures were recorded during the 24-month follow-up period.

Results
Overall, 80 patients who underwent ACLR were included. Patients with HT + ST had significant less laxity postoperatively compared to HT at 6 months, 1.9 vs 0.8 mm, p < 0.05. No differences were found between the QT and QT + ST group. At 6 weeks patients treated with ST, both QT and HT, had a significant deficit in flexion compared to those without ST. However, this resolved at 6 months. There were no significant differences between HT + ST vs HT, or QT + ST vs QT, regarding postoperative PROs or strength measurements. Furthermore, the incidence of subsequent surgery and graft rupture was not significantly different between the groups.

Conclusion
ACLR with HT + ST reduces laxity at 6 months compared to ACLR without ST, a difference not seen when ACLR was performed using QT with or without ST. No other differences were seen between the two techniques comparing subjective and objective findings.

Level of evidence
Level III.