bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors influencing desired number of children among Ethiopian women: Application of count regression models.
Authors: Molla Habitu Liyew , Muluneh Essey Kebede 
Published: December 2019

Abstract
Background: Desired family size, the number of children wanted in one’s lifetime, is one of the major factors influencing the population dynamics. Knowledge of factors influencing the desired family size is crucial in regulating the population growth. This study assesses the desired family size and its determinants among Ethiopian women. Methods: The study was based on the 2016 Ethiopian Demographic and Health Survey (EDHS) data. A total of 13,941 women with complete information were considered in the study. Count regression models, a family of generalized linear models, were used to identify determinant factors for the desired number of children among women in Ethiopia. Results: Results showed that the average number of children per women was 4.5. The highest average was recorded in Somali region (10.58) and the lowest in Addis Ababa city administration (3.56). The random intercept negative binomial regression model was found to be the most appropriate model for the data. Women’s age, household head, contraception using, wealth index, women’s education, religion, marital status, husband’s work, family size and age at first marriage were significantly associated with the desired number of children by women at reproductive age. The study also showed that there was significant regional variation in desired number of children among Ethiopian women. Conclusions: Variables such as women’s age and family size were positively associated with the desired number of children by women at reproductive age while age at first marriage, contraception using, wealth index and women’s education were negatively associated with the desired number of children by women. Women who attained higher level of education preferred small family size compared to women with no formal education. Desire for children was high among mothers from rural areas, women in the poorest economic level and woman having no work. Keywords: Desired number of children, statistical weight, EDHS, Count regression models, multilevel analysis.
Up-regulating autophagy by targeting the mTOR-4EBP1 pathway: a possible mechanism for improving cardiac function in mice with experimental dilated cardiomyopathy
Authors: Jin Bo , Shi Haiming , Jun Zhu , Wu Bangwei , Geshang Quzhen 
Published: December 2019

Abstract
Background: Autophagy plays a crucial role in the pathological process of cardiovascular diseases. However, little is known about the pathological mechanism underlying autophagy regulation in dilated cardiomyopathy (DCM).Methods: We explored whether up-regulating autophagy could improve cardiac function in mice with experimental DCM through the mTOR-4EBP1 pathway. Animal model of DCM was established in BALB/c mice by immunization with porcine cardiac myosin. Both up- or down-regulation of autophagy were studied by administration of rapamycin or 3-MA in parallel. Morphology, Western blotting, and echocardiography were applied to confirm the pathological mechanisms.Results: Autophagy was activated and autophagosomes were significantly increased in the rapamycin group. The collagen volume fraction (CVF) was decreased in the rapamycin group compared with the DCM group (9.21 ± 0.82 % vs 14.38 ± 1.24 %, P<0.01). The expression of p-mTOR and p-4EBP1 were significantly decreased in rapamycin-induced autophagy activation, while the levels were increased by down-regulating autophagy with 3-MA. In the rapamycin group, the LVEF and FS were significantly increased compared with the DCM group (54.12 ± 6.48 % vs 45.29 ± 6.68 %, P<0.01; 26.89 ± 4.04 % vs 22.17 ± 2.82 %, P<0.05). As the inhibitor of autophagy, 3-MA aggravated the progress of maladaptive cardiac remodeling and declined cardiac function in DCM mice.Conclusions: The study indicated a possible mechanism for improving cardiac function in mice with experimental DCM by up-regulating autophagy via the mTOR-4EBP1 pathway, which could be a promising therapeutic strategy for DCM.
Confirmatory Factor Analysis of Adverse Childhood Experiences (ACEs) among a Community-Based Sample of Parents and Adolescents
Authors: Afifi Tracie , Salmon Samantha , Davila Isabel Garcés , Struck Shannon , Fortier Janique , Taillieu Tamara , Stewart-Tufescu Ashley , Asmundson Gordon J.G. , Sareen Jitender , MacMillan Harriet L. 
Published: December 2019

Abstract
Background Despite increased understanding of Adverse Childhood Experiences (ACEs), very little advancement has been made in how ACEs are defined and conceptualized. The current objectives were to determine: 1) the factor structure of the original ACEs and possible expanded ACEs, and 2) the association of all individual ACEs and the confirmed factors with poor self-rated mental and physical health.Methods Data were obtained from the Well-Being and Experiences Study, survey data of adolescents aged 14 to 17 years (n = 1002) and their parents (n = 1000) in Manitoba, Canada collected from 2017 to 2018. Statistical methods included confirmatory factor analysis (CFA) and logistic regression models.Results The study findings indicated a two-factor solution for both the adolescent and parent sample, confirming the categorization of the child maltreatment and household challenges ACEs. All original and expanded ACEs loaded on one of these two factors and all individual ACEs were associated with poor self-rated mental and/or physical health (Adjusted Odds Ratios ranged from 1.16-3.25 among parents and 1.12-8.02 among adolescents). Additionally, both factors were associated with poor mental and physical health.Conclusions Findings confirm a two-factor structure (i.e., child maltreatment and peer victimization and household challenges) and indicate that the ACEs list should include original ACEs (i.e., physical abuse, sexual abuse, emotional abuse, emotional neglect, physical neglect, exposure to intimate partner violence (IPV), household substance use, household mental health problems, parental separation or divorce, parental problems with police) and expanded ACEs (i.e., spanking, peer victimization, household gambling problems, foster care placement or child protective organization (CPO) contact, poverty, and neighborhood safety).
The state of child nutrition in Ethiopia: an umbrella review of systematic review and meta-analysis reports
Authors: Mohammed Shimels Hussien , Habtewold Tesfa Dejenie , Arero Amanuel Godana , Esmaillzadeh Ahmad 
Published: December 2019

Abstract
Background Various systematic review and meta-analysis (SRM) studies were done on nutritional statuses of children in Ethiopia, but no summary of the findings was done on the topic. Thus, this umbrella review was done to summarize the evidence from SRM studies on the magnitude and determinants of malnutrition and poor feeding practices among under-5 children in Ethiopia. Methods PubMed, Embase, Scopus, Web of Sciences, and Google Scholar were searched for SRM studies on the magnitude and risk factors of malnutrition and child feeding practice indicators in Ethiopia. The methodological quality of the included studies was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR) tool. The estimates of the included SRM studies on the prevalence and determinants of stunting, wasting, underweight, and poor child feeding practices were pooled and summarized with random-effects meta-analysis models. Result We included nine SRM studies, containing a total of 214,458 under-5 children from 255 observation studies. The summary estimates of prevalence of stunting, underweight, and wasting were 42% (95%CI=37-46%), 33% (95%CI=27-39%), and 15% (95%CI=12-19%). The proportion of children who met the recommendations for timely initiation of breastfeeding, exclusive breastfeeding during the first 6 months, and timely initiation of complementary feeding were 65%, 60%, and 62%, respectively. The proportion of children who met the recommendations for dietary diversity and meal frequency were 20%, and 56.0%, respectively. Only 10% of children fulfilled the minimum criteria of acceptable diet. There was a strong relationship between poor feeding practices and the state of malnutrition, and both conditions were related to various health, socio-economic, and environmental factors. Conclusion Child malnutrition and poor feeding practices are highly prevalent and of significant public health concern in Ethiopia. Only few children are getting proper complementary feeding. Multi-sectoral efforts are needed to improve children’s feeding practices and reduce the high burden of malnutrition in the country.
Influence of trends in hospital volume over time on patient outcomes for high-risk surgery
Authors: Payet Cécile , Polazzi Stéphanie , Lifante Jean-Christophe , Cotte Eddy , Grinberg Daniel , Carty Matthew J , Sanchez Stéphane , Rabilloud Muriel , Duclos Antoine 
Published: December 2019

Abstract
Background The more frequent a hospital performs a procedure, the better the outcome of the procedure; however, the mechanisms of this volume-outcome relationship have not been deeply elucidated to date. We aimed to determine whether patient outcomes improve in hospitals with a significantly increased volume of high-risk surgery over time and whether a learning effect existed at the individual hospital level. Methods We included all patients who underwent one of ten digestive, cardiovascular and orthopaedic procedures between 2010 and 2014 from the French nationwide hospitals database. For each procedure, we identified three groups of hospitals according to volume trend (increased, decreased, or no change). In-hospital mortality, reoperation, and unplanned hospital readmission within 30 days were compared between groups using Cox regressions, taking into account clustering of patients within hospitals and potential confounders. Learning effect was investigated by considering the interaction between hospital groups and procedure year. Results Over 5 years, 759,928 patients from 694 hospitals were analysed. Patients’ mortality in hospitals with procedure volume increase or decrease over time did not clearly differ from those in hospitals with unchanged volume across the studied procedures (e.g., Hazard Ratios [95%] of 1.04 [0.93-1.17] and 1.08 [0.97-1.21] respectively for colectomy). Furthermore, patient outcomes did not improve or deteriorate in hospitals with increased or decreased volume of procedures over time (e.g., 1.01 [0.95-1.08] and 0.99 [0.92-1.05] respectively for colectomy). Conclusions Trend in hospital volume over time does not appear to influence patient outcomes, which puts the relevance of the "practice-makes-perfect" dogma in question.
Factors influencing the sustained utilization of child welfare services among children 18 to 59 months in a low-income rural community.
Authors: Konlan Kennedy Diema , Amoah Roberta Mensima , Doat Abdul Razak , Japiong Milipaak , Abdulai Juliana Asibi 
Published: December 2019

Abstract
ABSTRACT
Background: Despite substantial progress in reducing child mortality, concerted efforts remain necessary to avoid preventable deaths in children under-5 years and to accelerate progress in improving child survival further. The patronage of child welfare services therefore remains paramount to the attainment of these goals. This study identified the factors that influence the patronage of child welfare services in a rural community in the Ho West District of the Volta region.
Methodology: The study employed a quantitative descriptive cross-sectional design. Systematic sampling method was used to select 310 caregivers of children less than 60 months in the catchment area of the Abutia kloe sub district. Questionnaire was used to collect data from study respondents. The data was entered into a Microsoft Excel Spreadsheet and cleaned and subsequently exported to SPSS (version 22.0) for the data analysis. Data was analysed into simple descriptive statistics
Results: The results showed that a significant number of respondents (44.2%) had defaulted at a point during the continued growth monitoring process. The reasons for the default included children had completed major immunization (72.3%), children had started school (57.4%), and poor staff attitude (3.2%). Noteworthy, It depicts that majority of mothers have an idea about the purpose of Growth chart (68%). It is also worth noting that 86.5% of mothers are able to access a Child Welfare Clinic in less than thirty minutes. In addition, the results pointed out that there is a strong association between the level of caregivers’ education and CWC attendance with a chi-square test of 3 and a P-value less than 0.05.
Conclusion: Healthcare providers should intensify education on the need to continue growth monitoring up to 59 months even after the completion of major immunization. This goal can be attained if growth monitoring is incorporated into school health activities while policy implementers ensure the full implementation.
Modified Therapy Concepts for Fragility Fractures of the Pelvis after additional MRI
Authors: Graul Isabel , Marintschev Ivan , Hackenbroch Carsten , Palm Hans-Georg , Friemert Benedikt , Lang Patricia 
Published: December 2019

Abstract
Background Fractures of the pelvic ring in elderly patients have increased in frequency over time. These injuries are associated with a high morbidity and have a socio-economic impact. The diagnostic procedures and their influence of therapy decisions are still controversial.Methods In a retrospective study, we investigate the value of additional MRI examination on therapy decision of fragility fractures of the pelvis. The evaluation of all patients with pelvic fractures without adequate trauma and with performed CT and MRI from 2010 to 2017 was conducted at three large German hospitals. The imaging procedure took place within a maximum interval of 4 weeks. After evaluation of the imaging, the resulting therapeutic consequences either based on CT alone or on CT and MRI were reviewed by experienced pelvic surgeons. Furthermore, a measurement of Hounsfield units as an indicator of reduced bone density was recorded in the L5 vertebra.Results Of 754 patients with pelvic injuries, 67 (age 80 +/- 9.7 years, f: m 54:13) could be included in the study. The detection of vertical fractures in CT (n = 40 unilateral, n = 11 bilateral) could be increased by the additional MRI (n = 44 unilateral, n = 23 bilateral). A horizontal fracture component was identified in CT in 9.0% (n = 6) vs. MRI in 25.4% (n = 17) of the cases. An anterior pelvic ring injury was detected in 71.6% (n = 44; 4x bilateral) in CT, in 80.6% in MRI (n = 50, 4 bilateral). Additive MRI imaging increased the decision rate for surgical therapy from 20.9% (n = 14) to 31.3% (n = 21). In 90.0% of the patients (n = 60) a reduced bone density in the L5 vertebra was measured.Conclusions The results of this study further support the value of bone marrow detection by MRI diagnostics (or dual source CT which showed promising initial results) for the detection of pelvic ring fractures. For the first time, the study identifies an additional therapeutic consequence by an increased rate of surgical procedures.
Feasibility and behavioral effects of prolonged static and dynamic standing as compared to sitting in older adults with type 2 diabetes mellitus
Authors: Marusic Uros , Muller Martijn , Alexander Neil , Bohnen Nicolaas 
Published: December 2019

Abstract
Background: Physical inactivity is prevalent in older adults with type 2 diabetes mellitus (T2DM) and may exacerbate their clinical symptoms. The aim of this study was to examine the feasibility of 4-hour regular versus more dynamic standing sessions while performing routine desktop activities as a non-exercise physical activity intervention in older adults with T2DM to increase non-exercise activity.Methods: Twelve older adult patients with T2DM (3 female; age 71 ± 4 years; BMI 34 ± 5 kg/m2) completed three sessions (baseline sitting followed by "static" or "dynamic" desktop standing sessions). Participants stood behind a regular height-adjustable desk in the "static" standing session. An upright dynamic standing desk, which provides cues to make small weight-shifting movements, was used for the "dynamic" standing session. Oxygen consumption, cognitive performance, as well as net standing duration, total movement activity, and musculoskeletal discomfort were assessed during all three sessions.Results: All participants were able to complete all sessions. Oxygen consumption and overall movements progressively increased from sitting to static and dynamic standing, respectively (p<0.001). The duration of breaks during standing (p=0.024) and rate of total musculoskeletal discomfort development (p=0.043) were lower in the dynamic standing compared to static standing sessions. There was no evidence of executive cognitive worsening during either standing session compared to sitting.Conclusions: Prolonged 4-hour standing as a simple non-exercise physical intervention is feasible in older adults with T2DM and may have metabolic (VO2 consumption) benefits. Increasing movement during desktop standing may offer incremental benefits compared to regular standing. Prolonged desktop standing might provide an effective intervention in T2DM older participants to target sedentariness.
Correlation between Peripheral Blood Neutrophil-lymphocyte Ratio and CD34 Expression in Prostate Cancer
Authors: Wang Yiyang , Dong Xiaofei , Qu Zhaokui , Peng Kang , Sun Xiaolei , Chen Renfu 
Published: December 2019

Abstract
Backgrounds The association of neutrophil-lymphocyte ratio (NLR) and CD34 expression level with PSA level, Gleason score, and clinical stage was investigated in patients with prostate cancer. The correlation between NLR and CD34 expression was also investigated to provide evidence supporting the use of NLR for predicting the prognosis of prostate cancer patients. Methods Clinical data of 75 patients diagnosed with prostate cancer by prostate aspiration biopsy were retrospectively analyzed. The correlation between NLR, CD34 expression, and clinicopathological characteristics was analyzed using the χ2 test and one-way analysis of variance. The correlation between NLR and CD34 was determined using the Pearson coefficient. Disease free survival was estimated by Kaplan-Meier analysis. Results Both NLR and CD34 expression were significantly positively correlated with PSA, Gleason score, and clinical stage (P<0.05 both). Patients in the NLRHigh/CD34High group were characterized by high PSA level and Gleason score and late clinical stage. NLR was positively correlated with CD34 expression (r=0.529, P<0.001). Conclusions Pretreatment NLR was a valuable marker of prognosis in prostate cancer. NLR is positively correlated with CD34 expression.
Strategy using a new antigenic test for rapid diagnosis of Streptococcus pneumoniae infection in respiratory samples from children consulting at hospital
Authors: Haddar Cyrille H , J Johan MD , Carricajo Anne , Verhoeven Paul O , Grattard Florence , Mory Olivier , Begaud Evelyne , Germani Yves , Cantais Aymeric , Pozzetto Bruno 
Published: December 2019

Abstract
Background. Despite vaccination programs, Streptococcus pneumoniae remains among the main microorganisms involved in bacterial pneumonia, notably in terms of severity. The prognosis of pneumococcal infections is conditioned in part by the precocity of the diagnosis. The aim of this study was to evaluate the impact of a Rapid Diagnostic Test (RDT) targeting cell wall polysaccharide of Streptococcus pneumoniae and performed directly in respiratory samples, on the strategy of diagnosis of respiratory pneumococcal infections in children. Results. Upper-respiratory tract samples from 196 children consulting at hospital for respiratory infection were tested for detecting S. pneumoniae using a newly-designed RDT (PneumoResp, Biospeedia), a semi-quantitative culture and two PCR assays. If positive on fluidized undiluted specimen, the RDT was repeated on 1:100-diluted sample. The RDT was found highly specific when tested on non- S. pneumoniae strains. By comparison to culture and PCR assays, the RDT on undiluted secretions exhibited a sensitivity (Se) and negative predictive value (NPV) of more than 98%. By comparison to criteria of S. pneumoniae pneumonia combining typical symptoms, X-ray image, and culture ≥ 10 7 CFU/ml, the Se and NPV of RDT on diluted specimens were 100% in both cases. Conclusions. In case of negative result, the excellent NPV of RDT on undiluted secretions allows excluding S. pneumoniae pneumonia. In case of positive result, the excellent sensitivity of RDT on diluted secretions for the diagnosis of S. pneumoniae pneumonia allows proposing a suitable antimicrobial treatment at day 0.
Prevention and Control of Tuberculosis Relying on a Tuberculosis Dynamic Model Based on the Cases of American
Authors: Wu Yan , Li Yong 
Published: December 2019

Abstract
Background: Tuberculosis (TB) which is a preventable and curable disease, is claimed as the second largest number of fatalities and there are 9,029 cases of American in 2018. Many researches have done many study to control TB and had evident e_ects, but TB is also a serious problem for human being. So the study is always improving. Methods: In the paper, we propose a new dynamic model to study the transmission dynamic and prevalence of TB, then use global di_erential evolution and local sequential quadratic programming (DESQP) optimization algorithm to estimate parameters of the model. Next, we use Latin hypercube sampling (LHS) to sample and partial rank correlation coe_cients (PRCC) to analyze the inuence of parameters on the basic reproduction number (R0) and the total infectious (including the diagnosed, undiagnosed and incomplete treatment infectious), respectively. Results: With the PRCC and p-value of the parameters, we _nd how the factors a_ect the outbreaks of TB. Chemoprophylaxis, treatment and vaccination have positive e_ects, relatively, the vaccine expiry date, diagnostic techniques and the contact ratio have negative e_ects. Especially, chemoprophylaxis is the most sensitive factors controlling TB. Conclusion: With results, we give some suggestions to control the prevalence of TB, such as prolonging the duration of the vaccine by researching new and better vaccines to prevent TB, persuading people infected with TB in the latent stage to use chemoprophylaxis to treat and do not contact with the infected and instructing people take care of themselves and be treated in time when they are infected with TB. By doing these, we can e_ectively control and prevent the prevalence of TB according to the epidemiological characteristics of tuberculosis transmission.