bluuebunny/crossref_metadata_2025 huggingface dataset:
Pyrotinib Combined with Vinorelbine in Patients with Previously Treated HER2-Positive Metastatic Breast Cancer: A Multicenter, Single-Arm, Prospective Study
Authors: Jiang Kuikui , Hong Ruoxi , Xia Wen , Lu Qianyi , Li Liang , Huang Jianhao , Shi Yanxia , Yuan Zhongyu , Zheng Qiufan , An Xin , Xue Cong , Huang Jiajia , Bi Xiwen , Chen Meiting , Zhang Jingmin , Xu Fei , Wang Shusen
Published: October 2023

Purpose This study aims to evaluate the efficacy and safety of a new combination treatment of vinorelbine and pyrotinib in human epidermal growth factor receptor 2 (HER2)–positive metastatic breast cancer (MBC) and provide higher level evidence for clinical practice.Materials and Methods This was a prospective, single-arm, phase 2 trial conducted at three institutions in China. Patients with HER2-positive MBC, who had previously been treated with trastuzumab plus a taxane or trastuzumab plus pertuzumab combined with a chemotherapeutic agent, were enrolled between March 2020 and December 2021. All patients received pyrotinib 400 mg orally once daily plus vinorelbine 25 mg/m2 intravenously or 60-80 mg/m2 orally on day 1 and day 8 of 21-day cycle. The primary endpoint was progression-free survival (PFS), and the secondary endpoints included the objective response rate (ORR), disease control rate (DCR), overall survival, and safety.Results A total of 39 patients were enrolled. All patients had been pretreated with trastuzumab and 23.1% (n=9) of them had accepted trastuzumab plus pertuzumab. The median follow-up time was 16.3 months (95% confidence interval [CI], 5.3 to 27.2), and the median PFS was 6.4 months (95% CI, 4.0 to 8.8). The ORR was 43.6% (95% CI, 27.8% to 60.4%) and the DCR was 84.6% (95% CI, 69.5% to 94.1%). The median PFS of patients with versus without prior pertuzumab treatment was 4.6 and 8.3 months (p=0.017). The most common grade 3/4 adverse events were diarrhea (28.2%), neutrophil count decreased (15.4%), white blood cell count decreased (7.7%), vomiting (5.1%), and anemia (2.6%).Conclusion Pyrotinib plus vinorelbine showed promising efficacy and tolerable toxicity as second-line treatment in patients with HER2-positive MBC.
Short $\mathrm{SL}_2$-structures on simple Lie algebras
Authors: Stasenko Roman Olegovich
Published: October 2023

In Vinberg's works certain non-Abelian gradings of simple Lie algebras were introduced and investigated, namely, short $\mathrm{SO}_3$- and $\mathrm{SL}_3$-structures. We investigate a different kind of these, short $\mathrm{SL}_2$-structures. The main results refer to the one-to-one correspondence between such structures and certain special Jordan algebras.
Bibliography: 8 titles.
Collocation approximation by deep neural ReLU networks for parametric and stochastic PDEs with lognormal inputs
Authors: Dinh Dung
Published: October 2023

We find the convergence rates of the collocation approximation by deep ReLU neural networks of solutions to elliptic PDEs with lognormal inputs, parametrized by $\boldsymbol{y}$ in the noncompact set ${\mathbb R}^\infty$. The approximation error is measured in the norm of the Bochner space $L_2({\mathbb R}^\infty, V, \gamma)$, where $\gamma$ is the infinite tensor-product
standard Gaussian probability measure on ${\mathbb R}^\infty$ and $V$ is the energy space. We also obtain similar dimension-independent results in the case when the lognormal inputs are parametrized by ${\mathbb R}^M$ of very large dimension $M$, and the approximation error is measured in the $\sqrt{g_M}$-weighted uniform norm of the Bochner space $L_\infty^{\sqrt{g}}({\mathbb R}^M, V)$, where $g_M$ is the density function of the standard Gaussian probability measure on ${\mathbb R}^M$.
Bibliography: 62 titles.
Satisfaction With Abortion Training in an Abortion-Restrictive State
Authors: Du Angela , Smith Rachel M. , Rivlin Katherine
Published: October 2023

Background With increasingly disparate patient access to abortion care and resident access to abortion training opportunities following the Dobbs v Jackson Women’s Health Organization decision, educators must better understand how legal restrictions affect obstetrics and gynecology (OB/GYN) resident training experiences and residents’ desire to provide abortions.

Objective To characterize how resident perceptions of abortion restrictions affect satisfaction with training and intent to provide abortion.

Methods We recruited OB/GYN residents training in Ohio, a state restrictive to abortion, to complete surveys capturing training experiences between 2019 and 2020. Logistic regression models were used to estimate associations between perception of the legal climate on training and satisfaction with training and intent to provide abortions. To provide additional context to survey responses, we reviewed open-ended responses to the effect of the legal climate on training.

Results Of 343 eligible residents, 88 (26%) responded from 13 of 15 programs (87% of programs). Most (73%) felt that the legal climate affected their training, and these respondents were more likely to be unsatisfied with their training (adjusted odds ratio [aOR] 16.6; 95% CI 2.83-97.22). We found no association between perception of legal climate on training and intent to provide abortions. In open-ended responses, most residents described a desire for more abortion training and barriers to patient care. Some highlighted the positives of training in a restrictive environment, which allowed for an improved understanding of the skills required for patient advocacy.

Conclusions Many residents felt that the legal climate in Ohio affected their abortion training, a perception that was associated with decreased satisfaction with training.
The Development of an Innovative Crowdsourced Resident Procedure Team Model to Improve Bedside Procedural Proficiency in the Inpatient Setting
Authors: Ilagan-Ying Ysabel C. , Cotter Robert , Su Chang , Rodwin Benjamin A. , Huston John C.
Published: October 2023

Background Bedside procedures are a necessary skill for many residents. Practice changes, including the discontinuation of a minimum number of procedures required by the American Board of Internal Medicine, may have resulted in decreased incentive for residents to seek procedural opportunities.

Objective To improve residents’ procedural output and confidence in abdominal paracentesis, arterial and central venous line placement, nasogastric intubation, and ultrasound-guided peripheral intravenous catheter insertions (USPIV).

Methods A novel Resident Procedure Team (RPT) model was created using crowdsourced proficient (having completed ≥5 procedures) near-peers in combination with peer-led USPIV simulation workshops to increase the number of supervising residents available. Procedure logs and the number of residents who became qualified to perform and supervise procedures were tracked from July 2018 to June 2022 and compared before and after the implementation of the RPT in July 2020.

Results Implementing the novel RPT model significantly increased the number of procedures performed (1875 procedures post-RPT vs 1292 pre-RPT; P=.02). Abdominal paracentesis increased from 411 to 482 (17.3%), central venous line placement increased from 344 to 401 (16.6%), USPIV increased from 318 to 389 (22.3%), arterial line placement increased from 189 to 360 (90.5%), and nasogastric intubation increased from 30 to 243 (710.0%). Resident confidence levels increased significantly after RPT-led USPIV workshops (P<.05 for all).

Conclusions Implementation of a novel, crowdsourced, resident-led procedure team and peer-led USPIV workshops helped increase the number of procedures performed by residents.
Association between interleukin-12 +1188A/C polymorphism and the risk of tuberculosis: a meta-analysis
Authors: Wang Pengcheng , Liao Jiadan
Published: October 2023

Background: The role of interleukin-12(IL-12) gene +1188A/C polymorphism has been indicated in the progression of tuberculosis(TB). Nevertheless, the outcomes remain controversial.

Objectives: This meta-analysis focused on examining the association between IL-12 +1188A/C polymorphism and TB.

Methods: EMBASE and PubMed databases were searched to identify relevant studies for retrospective analysis. Then, a random- or fixed-effects model was utilized to calculate the combined odds ratios (ORs) as well as corresponding 95% confidenceintervals (CIs).

Results: A total of 9 related articles were discovered. The result of meta-analysis showed that IL-12 +1188A/C polymorphism did not show significant correlation with TB risk among the total population (C vs A: OR =0.66, 95% CI=0.41-1.05; AC vs AA: OR = 1.28, 95% CI =0.90-1.82; CC vs AA: OR =0.95, 95% CI=0.80-1.14; recessive model: OR =1.00, 95% CI = 0.75-1.34; dominant model: OR =1.07, 95% CI =0.94-1.21). As discovered from subgroup analyses based on race and HWE, this polymorphism did not show relationship with TB risk.

Conclusion: The present findings indicated that IL-12 +1188A/C polymorphism was not related to the risk of TB.

Keywords: IL-12; tuberculosis; meta-analysis.
Omicron (B.1.1.529): constellation of unusual mutations in SARS-CoV-2
Authors: Kashyap Abhishek , Banerjee Indrajit
Published: October 2023

NIL
Antibody response to pneumococcal conjugate vaccine 10 among Nigerian children under 5 years
Authors: A Udah Chidinma , U Iregbu Francis , E Ekanem Emmanuel
Published: October 2023

Introduction: Invasive pneumococcal diseases have been a major contributor to childhood mortality, particularly in the developingworld and pneumococcal vaccines were introduced to reduce the burden. The Pneumococcal Conjugate Vaccine 10 (PCV 10) was incorporated into the Nigerian National Programme on Immunization (NPI) in 2014 to reduce the incidence of childhood pneumococcal infections. This study was done to determine the immunogenicity of the vaccine in our clime.

Methodology: This cross-sectional study was carried out between September 2019 and January 2020 at the Children Outpatient Clinic of the Federal Medical Center, Owerri, Nigeria. Two hundred and forty five children between the ages of 20 weeks and 59 months, who had received three doses of Pneumococcal Conjugate Vaccine 10 (PCV 10) at 6, 10 and 14 weeks according to the NPI schedule, were recruited into the study. The anti-pneumococcal PCV 10 IgG concentration was determined using Human Anti-Pneumococcal CPS 10 IgG vaccine ELISA Kit ®. Simple proportions, means and median (as appropriate) were used to analyse the data. Kruskal Wallis test and Spearman’s correlation were done to test association. Significance was set as p< 0.05.

Results: The mean anti-pneumococcal IgG concentration was 11.01±1.23 IU/ml and all the study participants formed protective levels of anti-pneumococcal IgG. There was a slight positive correlation between antibody response and age (r=0.13, p=0.04), and the antibody response was slightly more in males than females.

Conclusion: All the children under the age of five years who had received PCV 10 at 6, 10 and 14 weeks of age, who participated in this study formed protective levels of antibodies to the vaccine. Antibody levels increased slightly with age. The PCV 10 currently used in the Nigerian programme is sufficiently antigenic and a downward trend in pneumococcal diseases should soon be noticeable.

Keywords: Pneumococcal conjugate vaccine; antibody; children; Nigeria.
Expression of miR-152 in cervical cancer and its influence on cisplatin resistance
Authors: Wu Jun , Chi Xiaoping , Yang Qian , Li Jinxiao
Published: October 2023

Background: Cervical cancer has a high mortality rate.

Aim: We aimed to study the expression of micro ribonucleic acid 152 (miR-152) in cervical cancer and its influence on cisplatin(DDP) resistance.

Methodology: Cervical cancer Hela cells were divided into control, DDP, DDP + mimic nc and DDP + miR-152 mimic groups.

Results: DDP, DDP + mimic nc and DDP + miR-152 mimic groups had lower cell survival rate, smaller number of single clones and cells penetrating the membrane, and higher apoptosis rate and miR-152 expression than those of the control group (P<0.05). Compared with DDP and DDP + mimic nc groups, the cell survival rate, number of single clones and number of cells penetrating the membrane significantly decreased, while the apoptosis rate and miR-152 expression increased in the DDP + miR-152 mimic group (P<0.05). ERBB3 was a downstream target gene of miR-152. Hela cells transfected with miR-152 mimic had lower protein expressions of Snail, ERBB3, Akt2, p-Akt and c-myc than those of NC cells (P<0.05).

Conclusion: MiR-152 suppresses the proliferation, migration and infiltration of cervical cancer cells and reduces their resistanceto DDP chemotherapy by inhibiting the expressions of proteins in the ERBB3/Akt/c-myc and ERBB3/Akt/Snail pathways.

Keywords: miR-152; cervical cancer; cisplatin; drug resistance.
Boosting COVID-19 vaccine inoculation and booster shots: a systematic review and meta-analysis of factors that influence coronavirus vaccine uptake in practice
Authors: Adusei-Mensah Frank , Michael Isiozor Nzechukwu , Lekpa Kingdom David , Jeff Oduro Kennedy , John Okolie Chukwuma
Published: October 2023

Introduction: Vaccines alone do not control pandemics, but vaccinations. The hope of COVID-19 pandemic control is hinged on vaccinations and other public health measures. This systematic review/meta-analysis (SR/MA) investigated the factors that inform coronavirus vaccine uptake globally in an attempt to improve COVID-19 immunization.

Method: The PRISMA 2020 methodology was used for this review. A total of 2902 articles were identified from electronic databases and other sources. After screening, 33 articles were included in the review and quantitative meta-analysis. Comprehensive meta-analysis software version 3 was used for the meta-analysis.

Results: We observed that vaccine effectiveness, side effects and the proportion of acquaintances vaccinated significantly influencedrespondents’ COVID-19 immunization decision. Also, associations of vaccine effectiveness, smaller risks to serious side effects, free and voluntary vaccinations and fewer vaccine doses, and longer duration to wanning were observed. We also observed variations in vaccine hesitancy trends in studies carried out in Asia, Europe, America, and Africa.

Conclusion: Wanning and acquaintance’s vaccination status as factors to vaccination are insights the present paper is bringing to the limelight. Health promotion and COVID-19 vaccination planning are crucial for enhancing vaccine uptake.

Keywords: Vaccination; vaccine hesitancy; coronavirus; pandemic; herd immunity; immunization.
Overexpression of C19orf48 correlates with poor prognosis in breast cancer
Authors: Guo Jia , Hui Beina , Gong Tuotuo , Zhao Xu , Li Jing
Published: October 2023

As one of the most commonly diagnosed cancers in women around the world, breast cancer has been detailed studied. This study aimed to identify the expression of c19orf48 in several kinds of cancers including liver, lung and breast cancers etc. The driving factors behind it were analysed and it found that the amplification of c19orf48 may relate with the elevated expression. At the same time, the correlation between the expression of it and the survival time in breast cancer patients was explored. It was found that the c19orf48 expression at transcriptional level elevated in breast cancer tissue samples compared with the normal. It was inferred that the c19orf48 play its oncogenic role in development of breast cancer by involving in cell-cycle related biological process. In conclusion, c19orf48 may be a useful and predictive biomarker for the prognosis of breast cancer patients. To the best of our knowledge, this is the first report describing the expression of c19orf48, the potential driving factor led to this and its effect.

Keywords: Breast cancer; c19orf48; Predictive biomarker.
Prediction of recurrence of early gastric carcinoma after endoscopic submucosal dissection
Authors: Xu Hongjing , Yang Xiaojun , Lu Ying , Wang Shiming
Published: October 2023

Background: The aim of this retrospective study was to predict the post-endoscopic submucosal dissection (ESD) recurrence risk of early gastric carcinoma (EGC) using a nomogram model, and to provide valuable evidence for preventing the recurrence.

Methods: The patients with EGC receiving ESD between March 2010 and February 2018 were enrolled. They were followed up once every three months after ESD. At the end of follow-up, they were assigned into recurrence and non-recurrence groups. The independent risk factors for post-ESD recurrence were identified using Cox regression analysis. A nomogram prediction model was established, and its predictive efficiency was assessed by plotting receiver operating characteristic (ROC) curve.

Results: Helicobacter pylori (HP) infection, number of positive lymph nodes >3 and a large amount of intraoperative hemorrhage were risk factors for post-ESD recurrence. According to multivariate Cox regression analysis, HP infection and number of positive lymph nodes >3 were independent predictors. The nomogram model had a good fitting effect, and the area under ROC curve was 0.933 (95% confidence interval: 0.919-0.947), suggesting a high predictive efficiency.

Conclusion: Positive lymph nodes and HP infection are closely correlated with the recurrence risk after ESD in EGC patients. The established model is a quantitative tool for predicting recurrence to improve the prognosis.

Keywords: Endoscopy; gastric carcinoma; nomogram model; recurrence; submucosal dissection.
Advice for smokers in smoking cessation clinic: a review
Authors: Yu Xuechan , Wang Meihua , Cen Jie , Ye Mianzhi , Li Sha , Wang Younuo , Su Qingwen , Chen Hui , Xu Ruyi , Zhang Shuya , Wang Shanshan , Yu Yiming , Deng Zaichun , Chen Zhongbo
Published: October 2023

Background: Tobacco dependence has become a global public health concern. We chose to investigate the modifiable factors and motivations during the period of smoking cessation based on the mechanism of nicotine addiction.

Methods: We selected emotion, sleep, alcohol, caffeine beverages, mental activities after dinner, exercise and CYP2A6 genotype as influencing factors, and provided corresponding recommendations for smokers based on these factors. Based on these characteristics, we reviewed literature and summarized the relationship between these factors and nicotine dependence or smoking.

Results: Different emotion, sleep deficiency, caffeine intake, alcohol consumption, mental activities after dinner, physical exercises and CYP2A6 genotype have an effect on daily smoking and nicotine dependence.

Conclusion: These suggestions related literature-derived factors may increase the success rate of smoking cessation.

Keywords: Tobacco dependence; smoking cessation; risk factors; advice; addiction.
Effects of right stellate ganglion block combined with topical anesthesia on heart rate variability in awake patients receiving tracheal intubation
Authors: Bai Liping , Hao Weihong , Zhang Chunmin , Guan Zhiming
Published: October 2023

Objective: General anesthesia is commonly performed with tracheal intubation. We aimed to evaluate the effects of right stellateganglion block combined with topical anesthesia on the heart rate variability in awake patients receiving tracheal intubation.

Methods: A total of 120 eligible patients were equally divided into observation and control groups using a random number table. The observation group underwent right stellate ganglion block combined with topical anesthesia. The excellent and good rate of anesthesia, indicators of vital signs and heart rate variability, incidence rate of adverse reactions, success rate and time consumption of tracheal intubation, postoperative resuscitation and cognitive function score of the two groups were compared.

Results: The systolic pressure, diastolic pressure and heart rate significantly increased in both groups during tracheal intubationcompared with those before tracheal intubation, which they were lower in the observation group than those in the control group during tracheal intubation (P<0.05). Low-frequency power, ratio of low-frequency power to high-frequency power and heart rate variability index significantly decreased in both groups during tracheal intubation compared with those before tracheal intubation (P<0.05).

Conclusion: Right stellate ganglion block combined with topical anesthesia can work well for awake patients during trachealintubation.

Keywords: Anesthetics, topical; block; heart rate; intubation, intratracheal; stellate ganglion.
Visual outcome after small incision cataract surgery of patients in a Kenyan Hospital contributors
Authors: Kipkemboi Rono Julius , Nirghin Urvashni
Published: October 2023

Background: The visual outcome and the effect of cataract surgery on existent and surgically induced refractive errors are a concern of interest that the eye care expert must deal with.

Objectives: The aim of the study was to investigate the visual outcome after small incision cataract surgery of patients in a Kenyan hospital.

Methods: A descriptive retrospective study covering 3 years (2015 to 2017). Total of 1104 files of patients aged > 50 years who had undergone small incision cataract surgery at Sabatia eye hospital were purposively selected. Information on demographics, clinical aspects and outcome was collected using a ministry of health structured form. Statistical package for social sciences version 24 was used to analyse the data.

Results: Of the 1104 patients, 55% (n=606) were females. The mean age of patients was 70.6 ± 9.8 years. Most patients were from the hospital neighbourhood. Visual acuity improved by 38.9%, 28.9%, 19.8% and 11.5% in patients aged 50-59, 60-69, 70-79, and 80-89 years old, respectively.

Conclusion: Small incision cataract surgery improved visual acuity in all patients’ groups, but the outcome is influenced by age, refractive error particularly astigmatism.

Keywords: Small incision cataract surgery; visual outcome; refractive errors.
Exploring the barriers and facilitators towards physical activity among church members in Lagos, Nigeria: a qualitative study
Authors: Ololade Odukoya Oluwakemi , Olukemi Odediran Omoladun , R Rogers Charles , Ogunsola Folasade , S Okuyemi Kolawole
Published: October 2023

Background: Physical inactivity is substantially linked to the rise in the global burden of non-communicable diseases. Faithbasedorganizations are recognized as potential partners for sustainable health interventions.

Objective: This study aims to explore the facilitators and barriers towards physical activity among adult church members in Lagos, Nigeria.

Methods: Sixteen focus group discussions (n-163) were conducted among adult male and female church members in twelve Anglican churches. The discussions were audio-taped, transcribed verbatim and analysed along with the field notes for themes using sequential approach with the aid of the Dedoose® software.

Results: Individual facilitators of PA included self-discipline, and personal habits. Individual barriers were laziness, ill-health, fear of injury and pre-existing health conditions. Organizational facilitators included biblical verses promoting PA, while deterring factors were lack of safe spaces for PA and poor knowledge among church leadership. The community-level facilitators included pro-physical activity cultural practices, while the prevailing practice hiring house-helps, high costs of gym membership and gender norms discouraging men from participating in household chores served as deterring community-level factors. Environmental facilitators were the availability of safe spaces for PA while deterring factors were city living and high traffic density.

Conclusion: Several multi-level factors influence physical activity among church members. While it is pertinent to address personalfactors, family and community factors also promote PA, therefore, group-level interventions may be warranted. Strategies that address the socio-cultural norms that serve as barriers to PA should also be included in the design of church-based PA programmes.

Keywords: Physical activity; faith-based organization; determinants.
Clinical roles of autophagy-related proteins Beclin-1 and mTOR in smoking and non-smoking patients with oral leukoplakia
Authors: Zhang Ping , Zhou Peng , Yao Min
Published: October 2023

Background: To study the expressions of autophagy-related proteins Beclin-1 and mammalian target of rapamycin (mTOR) insmoking and non-smoking patients with oral leukoplakia (OLK).

Methods: A total of 240 patients diagnosed as OLK from January 2017 to December 2017 were enrolled. Beclin-1 and mTORexpressions were detected by immunohistochemistry. Their clinical data were collected. The correlations of smoking with Beclin-1 and mTOR expressions as well as clinical factors were explored by Spearman’s analysis.

Results: There were significant differences in gender ratio, age, lesion location, severity and malignancy between smoking andnon-smoking OLK patients (P<0.05). The positive expression rate of Beclin-1 in OLK patients with simple hyperplasia andabnormal hyperplasia in the smoking group was significantly lower than that of the non-smoking group (P<0.05). In the abnormalhyperplasia group, the number of cigarettes daily was significantly positively correlated with mTOR expression (r=0.843, P=0.042). After the simple hyperplasia group was included, there was a positive correlation between smoking age and positive expression rate of mTOR (r=0.942, P=0.012). For number of cigarettes and smoking age, the positive expression rates of Beclin-1 and mTOR showed significant negative correlations (r=-0.952, P=0.003, r=-0.953, P=0.002).

Conclusion: Autophagy-related proteins Beclin-1 and mTOR may be involved in the smoking-induced pathogenesis of OLK.

Keywords: Smoking; oral leukoplakia; autophagy; Beclin-1; mammalian target of rapamycin.
Factors influencing clinical pregnancy outcome of in vitro fertilization/ intracytoplasmic sperm injection in older women
Authors: Gao Jinyu , Liu Zhaohua , Zhong Yao , Li Nannan , Tang Tingting
Published: October 2023

Objective: To analyse the factors influencing clinical pregnancy outcome of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) in older women, and to establish a risk prediction model.

Methods: A total of 425 patients receiving IVF/ICSI from March 2018 to March 2020 were divided into pregnancy group (n=194) and non-pregnancy group (n=231). The factors affecting the outcomes of IVF/ICSI were explored by univariate and multivariate logistic regression analyses. A nomogram prediction model was constructed.

Results: The two groups had significantly different age, body mass index, dysmenorrhea, parity, times of full-term births, history of cesarean section, basal follicle stimulating hormone, basal antral follicle count (AFC), number of high-quality embryos, and basal estradiol, luteinizing hormone and endometrial thickness on the day of human chorionic gonadotropin (HCG) administration (P<0.05). Age ≥40 years old, dysmenorrhea, history of cesarean section, basal AFC<9, number of high-quality embryos <4, and endometrial thickness on the day of HCG administration <11 mm led to IVF/ICSI failure. The established model exhibited high calibration and discrimination degrees in predicting the outcome of IVF/ICSI.

Conclusion: The risk prediction model for the pregnancy outcome of IVF/ICSI in older women helps evaluate the fertility probability and risk, providing references for formulating reasonable assisted reproduction plans.

Keywords: Older pregnant woman; in vitro fertilization/intracytoplasmic sperm injection; pregnancy outcome; risk factor; nomogram prediction model.
Prevalence, influencing factors, and outcomes of emergency caesarean section in public hospitals situated in the urban state of Lagos, Nigeria
Authors: Banke-Thomas Aduragbemi , Ke-on Avoka Cephas , Ogunyemi Olakunmi
Published: October 2023

Background: Caesarean section (CS) performed in an emergency can be life-saving for both the pregnant woman and her baby. In Nigeria, CS rates have been estimated to be 2.7% nationally, with the highest regional rate of 7.0% reported in the South-West of the country. Our objective in this facility-based retrospective cross-sectional study was to describe patterns and assess factors, obstetric indications, and outcomes of emergency CS in Lagos, Nigeria.

Methods: Socio-demographic, travel, and obstetric data of pregnant women were extracted from case notes. Travel data was inputted in Google Maps to extract travel time from the pregnant women’ home to the hospital. Univariate, bivariate and multivariable logistic regression analyses were conducted.

Results: Of the 3,134 included pregnant women, 1,923 (61%) delivered via emergency CS. The odds of an emergency CS were significantly higher among women who were booked (OR=1.97, 95%CI 1.64–2.35), presented with obstructed labour (OR=2.59, 95%CI 1.68–3.99), pre-eclampsia/eclampsia (OR=1.67, 95%CI 1.08–2.56), multiple gestations (OR=2.71, 95%CI 1.72–4.28) and travelled from suburban areas (OR=1.43, 95%CI 1.15–1.78). There was an increasing dose-effect response between travel time to the hospital and emergency CS.

Conclusion: Optimisation of CS rates requires a multi-pronged approach during pregnancy and childbirth, with particular emphasis on supporting pregnant women living in the suburbs.

Keywords: Caesarean section; emergency obstetric care; prevalence; factors; urban; Nigeria.
Experiences of female clients in the assisted reproductive technology process in Nigeria
Authors: V Ezeome Ijeoma , O Akintola Simisola , S Jegede Ayodele
Published: October 2023

Background: Though assisted reproductive technology (ART) has been a source of hope for many infertile couples, it is knownto be associated with physical, social, psychological, and ethical challenges in different settings.

Objective: The study objective was to explore the experiences of female clients who accessed services in ART clinics in Nigeria.

Methods: An exploratory qualitative design, using snowballing technique was employed. It involved in-depth interviews of eightwomen who had gone through the assisted conception process, using an interview guide. Data collection was from November 2019 to January 2020.

Results: The age range of the participants was 30 – 52 years with a mean of 41.88 years. Majority of the clients presented at advanced age to their ART providers because of lack of funds and ignorance. Other challenges were suboptimal risk disclosure, high cost of services, feelings of shame and stigmatization during and after the process.

Conclusion: Cost of ART remain unaffordable to most Nigerians hence the need for government subsidization and in-corporation of ART services into the National Health Insurance Scheme. Additionally, lack of adequate information disclosure, shared decision-making and gendered suffering are areas of great concern among the study participants. A national regulatory guideline will ensure uniform international standard of care.

Keywords: Experience; clients; assisted reproductive technology.
Clinical study on combined "lanzhou prescription" for the treatment of "syndrome of heat-toxin congestion and excessiveness" in children with acute aplastic anemias
Authors: Yu Niancheng , Huang Hong , Wu Fang
Published: October 2023

Purpose: The clinical efficacy of "Lanzhou prescription" plus or minus combined with western medicine in the treatment of children with acute aplastic anemia, ‘excessive accumulation of heat toxin’, was comprehensively and objectively evaluated.

Methods: Sixty children diagnosed with acute aplastic anemia, ‘excessive accumulation of heat toxin’ were divided into observation group (lanzhou prescription plus or minus combined with immunosuppressive therapy) and control group (immunosuppressive therapy alone). The relief degree of clinical symptoms and signs and the change of laboratory indicators were taken as the evaluation criteria.

Results: (1) After treatment, the results of remission rate of two groups treated by western medicine shows that the remission rate of the observation group was significantly higher than the control group (P< 0.05). (2) the ‘cure rate’ of the observation group treated for 6 months was significantly higher than treated for 3 months (P<0.05). (3) After treated for 6 months, the indexes of CD34+ cells and FOXP3+ regulatory cells in bone marrow of observation group increased, while the CD8+ cells and B cells decreased significantly, and the indexes of CD3+ cells, CD4+ cells and NK cells decreased somewhat(P<0.05).

Conclusion: Compared with immunosuppressive therapy, lanzhou prescription plus or minus combined with immunosuppressive therapy can alleviate the clinical symptoms and signs of children more effectively, obviously improve the Traditional Chinese Medicine symptoms of children, and help bone marrow hematopoietic stem cells gradually restore hematopoietic function.

Keywords: Acute aplastic anemia in children; Lanzhou prescription; Traditional Chinese medicine combined with Western medicine; Clinical research.
Early perinatal outcomes of babies born to adolescent mothers at two maternity hospitals in Mogadishu, Somalia
Authors: Orey Fartun , Ndeezi Grace , Mugalu Jamiir , Mohamud Luul , Nabukeera-Barungi Nicolette
Published: October 2023

Background: Adolescent motherhood remains a major problem in developing countries. We set out to describe the perinatal outcomes of infants born to adolescent mothers and to determine factors associated with birth asphyxia among these infants in Mogadishu, Somalia.

Methods: This cross-sectional study involved adolescent mothers who presented in labor. Sociodemographic and medical data was collected and mother-infant pairs were followed up at 24hrs. Poor perinatal outcomes were: low birth weight, birth asphyxia, death or hospitalization after 24 hours. Data was entered into Epi data 3.1 and analysed using STATA version 12.0.

Results: Of the 270 adolescents, mean age was 17.7 years (±1.19), 89% were married, 94% were unemployed and 54% had not received formal education. Of the 270 babies born, 70 (25.9%) had poor perinatal outcomes which included; 35 (12.9%) died; of whom 30 (11.1%) were stillbirths. Thirty-two infants (13.3%) had birth asphyxia and 18 (6.7%) had low birth weight. Prolonged labor (p-value=<0.001) and preterm birth (p-value=0.023) were significantly associated with birth asphyxia while living in Mogadishu was protective (p- value=0.018).

Conclusions: About one in four adolescent mother’s babies had poor perinatal outcomes. Prolonged labor and preterm delivery and were associated with birth asphyxia while residing closer to the facilities was protective.

Keywords: Adolescent mother; early perinatal outcome; poor perinata.
Job satisfaction among rehabilitation professionals employed in public health facilities in KwaZulu-Natal
Authors: N Makholwa , B Tlou , TP Dlungwane
Published: October 2023

Background: Job satisfaction is essential in stimulating productivity and efficiency in the health sector. Dissatisfied employees are likely to leave, which places an added burden considering the shortage of health workers. Rehabilitation professionals form a critical component of the public health workforce.

Objective: The aim of the study was to document the level of job satisfaction and factors associated with job satisfaction among rehabilitation professionals employed in public health facilities in KwaZulu-Natal.

Methods: A cross-sectional survey was conducted. A self-administered questionnaire was utilized. A Chi-square test and logistic regression were used to assess associations and to identify factors associated with job satisfaction. A p-value less than 0.05 was deemed statistically significant.

Results: Most participants (59%) reported a low level of overall job satisfaction. The participants were dissatisfied about not getting recognition for work related to their specific professions (61.3 %) and not being considered for career advancement (74.3 %). In addition, inadequate financial rewards (87.2%) and benefits (71.3%) were also linked to low job satisfaction.

Conclusion: Participants displayed a low level of job satisfaction. Rehabilitation services should be prioritized, and appropriate recognition should be granted to rehabilitation professionals in order to enhance job satisfaction.

Keywords: Job satisfaction; rehabilitation professionals; public health facilities.
Health-related quality of life associated with different cervical cancer therapies received by patients in two Nigerian tertiary hospitals
Authors: Samaila Aliyu , A Biambo Aminu , Usman Nuruddeen , M Aliyu Usman , Abdullahi Adamu , O Adibe Maxwell
Published: October 2023

Background: There are important consequences from cervical cancer (CC) disease and its treatment among survivors, especiallythe impact on quality of life (QoL).

Objective: To evaluate the health-related QoL associated with different CC therapies received by patients in two Nigerian tertiaryhospitals.

Methods: This study employed a prospective longitudinal design. It was conducted at Usmanu Danfodiyo University TeachingHospital, Sokoto and Ahmadu Bello University Teaching Hospital Zaria, North-Western Nigeria. Data of all the 157 eligible CCpatients were collected at baseline and after therapy. Data analysis was done with appropriate descriptive and inferential statisticsusing SPSS V. 20 for windows. P<0.05 was considered statistically significant.

Results: Chemotherapy (CT) was the major therapy option received by 78(49.7%) of the patients. Patients who received chemoradiation therapy (CRT) and adjuvant chemotherapy (CTS) had the highest increase in mean overall health-related QoL of 0.138(t=8.456, p<0.001) and 0.138 (t=6.489, p<0.001) higher than their respective baseline scores. Patients who received CT had theleast increase in mean overall health-related QoL of 0.095 (t=4.574, p<0.001) from baseline.

Conclusion: Chemoradiation therapy and adjuvant chemotherapy were associated with highest increase in mean overallhealth-related QoL. Chemotherapy was associated with the least increase in mean overall health-related QoL.

Keywords: Cervical cancer; quality of life; therapies.
The effect of the Covid-19 pandemic on Tuberculosis (TB) case notification in Ogun State, Nigeria
Authors: J Daniel Olusoji , O Bamidele Janet , D Alabi Adekunle , A Tijani Musibau , A Akinleye Callistus , S Oritogun Kolawole , O Soyinka Festus , A Adejumo Olusola
Published: October 2023

Introduction: COVID-19 pandemic has resulted in disruptions in delivery of Tuberculosis services especially, in resource-limited settings. Provisional data by the WHO from 84 countries indicates that about 1.4 million fewer people received care for tuberculosis in 2020 than in 2019. This study assessed the effect of COVID-19 pandemic on tuberculosis case notification rates in Ogun state, Nigeria

Methods: A retrospective review of presumptive TB and diagnosed TB cases that were notified in 2019 and 2020. Analysis was done using Epi-info version 7.2.3.1. Level of statistical significance was p < 0.05

Results: A total of 3102 and 3326 confirmed cases were reported in 2019 and 2020 respectively with an increase of 7.2%. There was significant decline in total number of cases notified in Q2, 2020 compared to 2019 (p=0.001) with a significant increase in proportion of TB cases notified by private facilities from 11.65% in 2019 to 20.27% in 2020.

Conclusion: Total TB cases notified in Ogun state increased during the covid-19 pandemic. There was significant decline in TB cases during the lockdown but an increase in proportion of TB cases notified by private facilities demonstrating that private facilities can withstand disruptions to TB case notifications due to the Covid-19 pandemic.

Keywords: Tuberculosis; COVID-19; case notification; private-public mix; private sector.
Clinical value of CVP+VIVC in predicting fluid resuscitation in patients with septic shock
Authors: Zhang Haitao , Liu Chang , Cao Aiping , Hang Qiong
Published: October 2023

Objective: To explore the clinical value of central venous pressure (CVP) + inferior vena cava respiratory variability (VIVC) in fluid resuscitation in spontaneously breathing patients with septic shock.

Methods: In retrospective observational study, during October 2019 to December 2021, 145 patients with septic shock treated in our hospital were enrolled by the method of observational study. According to the change rate of cardiac output (△ CO) ≥15% or △ CO<15% after 30 minutes, they were assigned into volume-responsive and volume-unresponsive group depending early fluid resuscitation in sepsis. The clinical value of combination of CVP and VIVC in predicting fluid resuscitation in patients with septic shock was compared.

Results: The CVP of the study group was higher at 12h and 24h after fluid resuscitation, and the VIVC level of the study group at 6h, 12h and 24h after fluid resuscitation was higher (P<0.05). Pearson correlation analysis indicated that CVP, and VIVC levels were noticeably correlated with fluid resuscitation in patients with septic shock (P<0.05). The area under curve (AUC) of receiver operating characteristic curve (ROC) of CVP for predicting fluid resuscitation in septic shock patients was 0.694 and the cut-off value was 0.932, the sensitivity was 46.9%, and the specificity was 87.5%. VIVC predicted fluid resuscitation in septic shock patients with an AUC of 0.776, which was a cut-off value of 0.688, a sensitivity of 50.0%, and a specificity of 90.0%. Combination of CVP and VIVC predicted fluid resuscitation in septic shock patients with an AUC of 0.948, which was a cut-off value of 1.420, a sensitivity of 90.6%, and a specificity of 87.5%.

Conclusion: Combination of CVP and VIVC may have a good effect on the evaluation of volume responsiveness in patients with septic shock, which is better than single CVP and VIVC. Combination of CVP and VIVC can be adopted to predict fluid responsiveness volume responsiveness in septic shock patients, which is of great significance for guiding clinical fluid responsiveness therapy.

Keywords: Septic shock; fluid resuscitation; CVP; VIVC.
Treatment of tibial traumatic osteomyelitis with negative pressure closure drainage combined with open bone grafting or bone migration and its effect on the levels of CRP, TNF-α and IL-6 in the serum
Authors: Wang Xinqiang , Wu Liangbang , Zhang Yuehong , Hou Zhenhai , Zheng Longbao , Gu Zenghui
Published: October 2023

Objective: To observe the effect of negative pressure closure drainage combined with open bone grafting or bone migration inthe treatment of tibial traumatic osteomyelitis.

Methods: Eighty-six (86) cases of tibial traumatic osteomyelitis admitted to Hospital of the Chinese people's Liberation Armyfrom September 2017 to September 2018 were randomly divided into control group and observation group, forty-three (43)cases each. Debridement, open bone grafting or bone migration was given to the control group.The observation group was treated with negative pressure closed drainage on the basis of the control group. In addition, the serumcomponents such as CRP, TNF-α, IL-6 of the control group and observation group were detected respectively after surgery.

Results: Observation group granulation cover wound, fracture healing time was shorter than the control group, fracture healingrate was better than the control group, the difference has statistical significance (P<0.05). By comparing serum CRP, TNF-α,IL-6 levels before and after treatment in the two groups, it was found that the observation group was lower than the controlgroup (P<0.05, respectively). Serum CRP, TNF-α, IL-6 levels were significantly (P<0.05).

Conclusion: The treatment of tibial traumatic osteomyelitis with negative pressure closure drainage combined with open bonegrafting or bone displacement has a good effect on fracture healing and is worth popularizing.

Keywords: Bone removal; CRP; IL-6; Negative pressure closure drainage; Tibia; TNF-α; Traumatic osteomyelitis.
A feasibility study of 70 kV double low-dose coronary imaging technique in abdomen-fatty patients using dual-source CT
Authors: Chen Lei , Ge Shang , Chen Yuan , Zhang Ting-Ting , Zhang Ting-Ting , Zhu Zhao-Huan
Published: October 2023

Objective: To investigate the aplication of low contrast agent concentration and low tube voltage in coronary CTA on patientswith high BMI (26kg/m228kg/m2).

Methods: 60 patients with high BMI (26kg/m228kg/m2) wererandomly divided into two groups: double low group A (n=30, tube voltage = 70 KV), double low group B (n=30, tube voltage= 70 KV), processed by SAFIRE iterative reconstruction with 270 mgI/ml contrast agent. Conventional group a (n=30, tubevoltage = 120 KV), conventional group b (n=30, tube voltage = 120 KV), with filtered back projection (FBP) and 370 mg I/mlcontrast agent. the image excellent index (FOM), the effective radiation dose (ED), mean CT value, signal-to-noise ratio (SNR),and contrast-to-noise ratio(CNR) between corresponding groups were compared.

Result: There was no significant difference in subjective scores of coronary artery image quality between the two high BMIsubgroups (P>0.05).The ED of group A (1.103±0.101 mSv) was significantly lower than that of group a (4.663±0.412 mSv)(P<0.001).There was no significant difference in mean CT value, SNR and CNR between the two subgroups (P>0.05).The imageexcellent index (FOM) of group A was higher than that of group a (P<0.05).The total iodine content and iodine injectionrate in group A were lower than those in group a (P<0.001).The difference of subjective scores of coronary artery image qualitybetween the two ultra-high subgroups was significant. The mean CT value, SNR and CNR of group B were lower than those ofgroup b (P<0.05). The images of 14 patients in group B could not meet the diagnosis demand.

Conclusion: It is feasible to reduce the tube voltage to 70KV in patients with abdominal BMI with high BMI (26Kg/m228Kg/m2), under the same conditions, the70KV can not meet the daily diagnosis requirement.

Keywords: Radiation dose; tomography; coronary artery; iterative reconstruction; contrast agent; abdominal obesity.
Correlates of somatic symptom disorder among internally displaced persons in Ogoja displacement settlements, Nigeria: a cross-sectional study
Authors: Maurice-Joel Ugbe Ugbe , Babatunde Esu Ekpereonne , Chiezey Onwusaka Obiageli , Muji Bisongedam Marvin , Libuo-Beshel Nji Elizabeth , Ajah Efut Joseph , Irom Ekpo Ofem , Ubi Okoi Faith
Published: October 2023

Background: Experiences of displacement have been associated with the prevalence of mental health disorders owing to certainfactors.

Objectives: This study aimed to identify the correlates of Somatic Symptom Disorder (SSD) among internally displaced adultsin Ogoja displacement settlements, Nigeria.

Methods: This was a cross-sectional study of 335 respondents. SSD was assessed using the SOM-SCL section of the CommonMental Disorder Questionnaire while a semi-structured questionnaire was used to collect data on sociodemographic and displacement-related factors. Data were analysed using descriptive statistics, Chi-square, and multivariable logistic regression.

Result: The prevalence of somatoform disorder was 59.1%. Factors found to be significant in each bivariate Chi-square analysiswere modelled for the mental disorder. The multivariate analysis revealed that being married (AOR=2.80; p=0.020) prolongeddisplacement (AOR=3.29; p=0.003), discrimination (AOR=2.25; p=0.010), disease outbreak (AOR=1.92; p=0.030), loss ofloved ones (AOR=1.34; p=0.028), overcrowded households (AOR=2.30; p=0.008), and fear of reprisals (AOR=2.05; p=0.026)were significantly associated with somatoform disorder.

Conclusion: The findings suggest that the high prevalence of the studied outcome is related to several stressors and eventsamong Internally displaced persons. Evidence-based mental health support efforts by different bodies in creating and routinelyarranging mental health clinical interventions for this population is recommended.

Keywords: Somatoform; somatic symptom disorder; internally displaced adults.