bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antioxidants and oxidative damage markers response to visceral fat loss in obese female subjects.
Authors: Gariballa Salah , Alkaabi Juma , Yasin Javed , Essa Awad Al 
Published: November 2019

Abstract
Objective

Visceral obesity and related diabetes is reaching epidemic proportions in the United Arab Emirates (UAE). Inflammation and oxidative damage are possible mechanisms linking visceral obesity to diabetes and other related complications. We have recently reported that levels of oxidative stress and inflammatory markers increase with increasing waist circumference (WC) in obese female subjects. The aim of this study was to measure antioxidants and oxidative damage markers response to visceral fat loss.

Results

Overall 293 females who received structured dietary education for obesity management were included in the study. Over a follow-up period of 427±223 days, obese subjects had a mean (±SD) of 13±5 education sessions. At the end of the follow up period we found decreased visceral fat, inflammatory and oxidative damage markers and increased antioxidant enzymes and vitamins, however, no significant differences were found between obese subjects who lost visceral fat compared to those who gained visceral fat. Both increased fruits and vegetables and decreased calorie intake had significant independent positive effects on WC decrease [odd ratio (95% CI): 1.04 (1.01, 1.08); p=0.045 and 1.0 (1.0, 1.01); p=0.048 respectively].
Improving Practice of Institutional Delivery in Southern Ethiopia
Authors: Kassa Dejene , Tadele Henok , Tadesse Birkneh Tilahun , Alemayehu Akalewold , Abuka Teshome , Woldegebriel Fistum , Ethiopia Hawassa University , Mengesha Selamawit , Haji Yusuf 
Published: November 2019

Abstract
Background Institutional delivery service utilization is one of the key and proven interventions to reduce maternal death. It ensures safe birth, reduces both actual and potential complications, and decreases maternal and newborn death. However, a significant proportion of deliveries in developing countries including Ethiopia occurs at home and is not attended by skilled birth attendants. This study aimed at determining the prevalence of home delivery and associated factors in three districts in Sidama Zone.Methods A cross sectional survey was conducted from 15th- 20th October 2018. A multi-stage sampling design was employed to select 507 women who gave birth 12 months preceding the survey. Quantitative data were collected by using structured, interviewer administered questionnaires. Univariate and multivariate logistic regression models were run to assess factors associated with home delivery. Measures of association between factors and the outcome variable were reported using 95% confidence intervals (CIs) and adjusted odds ratios (aORs).Results The response rate was 495(97.6%). The overall prevalence of home delivery was 113 (28%) with 95%CI (19%, 27%). Maternal rural residence, aOR=7.45(95%CI: 2.23-24.83); illiteracy of mothers, aOR=8.78 (95% CI: 2.33-33.01); those who completed grades 1-4, aOR =3.81(95% CI: 1.16-12.49); mothers who did not know the expected date of delivery, aOR=2.12 (95% CI: 1.21-3.71); mother being merchant, aOR=3.01(95%CI:1.44-6.3) and paternal illiteracy, aOR=3.27, (95% CI: 1.20-8.88) were predictors of home birth.Conclusion The prevalence of skilled birth attendance in the study area has improved from the EDHS 2016 report of 26%. Uneducated, rural and merchant mothers were more likely to deliver at home. Interventions targeting rural and uneducated mothers might help to increase skilled birth attendance in the region.
High Dose and Low Dose Oxytocin Regimen as Determinants of Successful Induction: A multicenter comparative study
Authors: TESEMMA MELESE GEZAHEGN , Sori Demisew Amenu , Gemeda Desta Hiko 
Published: November 2019

Abstract
Background Induction of labor by Oxytocin is a routine obstetric procedure. However, little is known regarding the optimal dose of oxytocin so as to bring successful induction. This study is aimed at comparing the effect of high dose versus low dose oxytocin regimen on success of induction.Methods Hospital based comparative cross-sectional study was conducted in four selected hospitals in Ethiopia from October 1, 2017 to May 30, 2018. A total of 216 pregnant women who undergo induction of labor at gestational age of 37 weeks and above were included. Data was entered into Epi-data version 3.1 and then exported to SPSS version 20 for cleaning and analysis. Chi-square test and logistic regression were done to look for determinants of successful induction. The result is presented using 95% confidence interval of crude and adjusted odds ratios. P-value < 0.05 was used to declare statistical significance.Result Mean “Induction to delivery time” was 5.9 hours and 6.3 hours for participants who received high dose Oxytocin and low dose Oxytocin respectively. Higher successful induction (72.2% versus 61.1%) and lower Cesarean Section rate (27.8% vs. 38.9) was observed among participants who received low dose Oxytocin compared to high dose. Favourable bishop score [AOR 4.0 95% CI 1.9, 8.5], elective induction [AOR 0.2 95% CI 0.1, 0.4], performing artificial rupture of membrane [AOR 10.1 95% CI 3.2, 32.2], neonatal birth weight of < 4Kg [AOR 4.3, 95% CI 1.6, 11.6] and being parous [AOR 2.1 95% CI 1.1, 4.0] were significantly associated with success of induction. Conclusions : In this study, oxytocin regimen didn’t show significant association with success of induction. But, high dose oxytocin regimen is significantly associated with slightly shorter induction to delivery time. Favourable bishop score, emergency induction, performing artificial rupture of membrane and delivery to non-macrosomic neonate are positive determinants of successful induction. Thus, we recommend ripening cervix when condition allows, estimating fetal weight and performing artificial rupture of membrane. We also recommend researchers to conduct more strong research that controls confounders to see the real effect of different oxytocin regimen on induction success.
A case report of asymptomatic long-segmental aortic dissection diagnosed by transthoracic echocardiography
Authors: Wang Jiwei , Lai Bin , Yao Cai , Wu Yongbing , Liu Yanna 
Published: November 2019

Abstract
Background: Aortic dissection (AD) is a life-threatening disease with high mortality rate. Severe pain in chest, back or abdomen is the most common symptom. Painless, but with a variety of other symptoms, also happened in some AD patients. Asymptomatic AD is exceptionally rare and often under-recognized. Case presentation: A 51-year-old man presented to cardiovascular department accompanied with an exaggerated low DBP and widened PP when measuring routine BP. Blood pressure was 124/36 mmHg (PP 88mmHg) in his right arm and 108/32 mmHg (PP 76mmHg) in his left arm. Transthoracic echocardiography was scheduled and showed that dissection intimal flaps are visualized in the aortic root, aortic arch and descending aorta. Subsequent CT angiography (CTA) was performed and demonstrated that a long-segmental AD occurred from aortic root to left common iliac artery. The patient underwent replacement of the aortic root, ascending aorta, and aortic arch with endovascular stent-graft placement into the descending aorta. At three months of follow-up, he was asymptomatic and with no signs of target organ damage. Conclusions: A careful TTE scan is particularly important for asymptomatic AD patient because it most likely as a routine imaging technique used for cardiovascular evaluation. If miss-diagnosed and under-recognized by clinician, untreated patients with prolonged dissection will become highly susceptible to an aortic rupture or ischemia to organs and leads to mortality.
Clients’ satisfaction with malaria in pregnancy preventive services in Anambra State, Nigeria
Authors: Obagha Chijioke Emmanuel , Ajayi IkwOluwakpo , Abdullahi Gobir A. , Umeokonkwo Chukwuma David 
Published: November 2019

Abstract
Background: Burden of Malaria in pregnancy (MIP) is still high despite deployment of proven cost-effective interventions. Considerable progress has been made on improving antenatal attendance but MIP preventive services utilization remains low. Factors responsible for this include dissatisfaction with the services provided. We assessed clients’ satisfaction with malaria in pregnancy services delivered at antenatal clinics (ANC) in Anambra State Nigeria. Method: We conducted a cross-sectional study among 284 pregnant women attending ANC using a three-stage sampling technique. Pre-tested semi-structured interviewer-administered questionnaire was used to collect information on socio-demographics, knowledge of malaria in pregnancy services and satisfaction with services. Responses to questions on satisfaction was on a 5-point Likert scale. A cut off of ≥75% of composite score was used to classify respondents as satisfied. For knowledge, every correct answer was scored 1 and incorrect 0; ≥75% of the composite score was graded as good knowledge. Chi square and logistic regression were used to test for association between client satisfaction and independent variables. Results: The mean age of participants is 28 years±4.4 years. Overall 62.2% were satisfied with quality of MIP preventive services, but 64.8% and 57.8% were not satisfied with cost of healthcare and interpersonal relationship with the health workers (HWs). Majority of the of respondents (88.73%) had poor knowledge of MIP preventive services. Type of facility (Adjusted odds ratio [aOR] = 2.11; 95%CI: 1.20-3.71) and knowledge (aOR: 0.41; 95%CI: 0.18 – 0.90) were independently associated with satisfaction with interpersonal relationship respectively. Type of facility (aOR: 0.47; 95%CI: 0.27-0.80) and employment status (aOR: 3.07; 95%CI: 1.39 -6.74) were also independently associated with satisfaction with cost of healthcare domain. Conclusion: A fair proportion of respondents were satisfied with the MIP services provided even though most were unsatisfied with the cost of assessing care and interpersonal relationship with health workers. To achieve satisfaction with services, the state government should subsidize the cost of services and encourage HWs to build good relationships with their clients especially at public secondary health facilities.
Metagenomic Next-generation Sequencing of Cerebrospinal Fluid for the Diagnosis of Central Nervous System Infections: A Multicentre Cohort Study
Authors: Fan Siyuan , Wang Xiaojuan , Hu Yafang , Shi Jingping , Zou Yueli , Zhao Weili , Qiao Xiaodong , Wang Chunjuan , Chin Jerome H. , Liu Lei , Qin Lingzhi , Wang Shengnan , Li Hongfang , Yue Wei , Zhang Weihe , Li Xiaohua , Ge Ying , Wu Honglong , Chen Weijun , Li Yongjun , Li Shiying , Wu Yihan , Zhou Gaoya , Liu Zheng , Piao Yushun , Zhang Jianzhao , Ren Changhong , Cui Li , Liu Caiyun , Ren Haitao , Zhao Yanhuan , Feng Shuo , Jiang Haishan , Wang Jiawei , Bu Hui , Guo Shougang , Peng Bin , Cui Liying , Li Wei , Guan Hongzhi 
Published: November 2019

Abstract
Background: Infectious encephalitis and meningitis are often treated empirically without identification of the causative pathogen, even if comprehensive conventional diagnostic technologies are applied. Metagenomic next-generation sequencing (mNGS) is a high throughput technology that enables the detection of pathogens independent of prior clinical or laboratory information.Methods: The present study was a multicentre prospective evaluation of mNGS of cerebrospinal fluid (CSF) for the diagnosis of suspected central nervous system infections in China, where routine PCR was not widely used. Results: A total of 276 patients were enrolled in this study between Jan 1, 2017 and Jan 1, 2018. Identification of an aetiologic pathogen in CSF by mNGS was achieved in 101 patients (36.6%). mNGS detected 11 bacterial species, 7 viral species, 2 fungal species, and 2 parasitic species. The leading positive detections were Mycobacterium tuberculosis (14), Listeria monocytogenes (8), Brucella (7), varicella-zoster virus (17), herpes simplex virus 1 (12), Epstein-Barr virus (12), and Cryptococcus neoformans (7). False positives occurred in 12 (4.3%) patients with bacterial infections known to be widespread in hospital environments. False negatives occurred in 16 (5.8%) patients and included bacterial, viral and fungal aetiologies. Conclusions: This study shows that mNGS of CSF is a powerful diagnostic method to identify the pathogen for many central nervous system infections. The result of mNGS should be interpreted with clinical information sometimes.
A comparative study of laminoplasty with short segment transpedicular screw fixation versus laminoplasty with anterior fusion in treating extensional cervical spinal cord injury without radio graphic abnormality in adults
Authors: Zhang Bi , Zhou Zhenhai , Yu Honggui , Pan Zhimin , Zhou Rongping , Wan Wenbing , Chen Lu , Zeng Zhaoxun , Cao Kai 
Published: November 2019

Abstract
Background: Cervical spinal cord injury(CSCI) without major fracture or dislocation is often described as cervical SCI without radiographic abnormality (SCIWORA). Majority of this injury could be without radiographic abnormality but with disrupted anterior longitudinal ligament or intervertebral disc unless examined by MRI. The optimal surgical management of this cervical spinal cord injury remains controversial. This study is to evaluate the clinical advantages of laminoplasty combined with short-segment transpedicular screw fixation for managing this issue. Methods: SCIWORA patients were collected into two groups according to different surgical methods. Patients in group A received laminoplasty combined with transpedicular screw fixation, and patients in group B received anterior cervical fusion combined with laminoplasty. All cervical spine were assessed by X-ray, CT, MRI preoperatively and postoperatively to evaluate the decompression range, bonegraft fusion and instruments location. ASIA grade and JOA score were recorded to assess the neurological function recovery. Complications, surgery time, intraoperative blood loss and hospital stay were compared between two groups. Mean follow-up was at least 2 years. Results: In this study, Forty eight patients were in group A and 54 ones were in group B. All cases were decompressed fully and obtained fusion 6-month postoperatively. The ASIA grade was improved postoperatively, but no significantly different between two groups (p=0.907). The JOA was 6.12±1.76 preoperatively and improved to 11.98±2.98 postoperatively with the 53.13% neurofunction recovery rate in group A, with no significantly different compared with group B(vs 6.63±2.45, p=0.235; vs 12.62±3.59, p=0.303; vs 57.76%, p=0.590)respectively. Total 18 complications occurred but the occurrence was significant lower in group A(p=0.020). The average surgery time was 2.2±0.32 hours, intraoperative blood loss was 304±56ml and hospital stay was 8.2±3.1 days, significantly decreased compared with group B(vs 3.1±0.29, p=0.000; vs 388±61ml, p=0.000; vs 12±2.8days, p=0.000)respectively. Conclusions: Cervical laminoplasty combined with short-segment transpedicular screw fixation is a reliable option to treat SCIWORA patients with CSS. The advantages include achieving sufficient cervical decompression, maintaining cervical stability and avoiding extra anterior cervical fusion which increases surgery time, intraoperative blood loss, postoperative complications and hospital stay.
Topping-off surgery vs posterior lumbar interbody fusion for degenerative lumbar disease: a finite element analysis
Authors: Fan Yunpeng , Zhu Liulong 
Published: November 2019

Abstract
Background Adjacent segment disease (ASD) is a common complication after posterior lumbar interbody fusion (PLIF). Recently, a topping-off surgery (non-fusion with Coflex) has been developed to reduce the risk of ASD, yet whether and how the topping-off surgery can relieve ASD remains unclear. The purpose of this study was to explore the biomechanical effect of PLIF and Coflex on the adjacent segments via finite element (FE) analysis and discuss the efficacy of Coflex in preventing ASD.Methods A FE model of L3-5 segments was generated from the CT of a healthy volunteer via three commercially available software. Coflex and PLIF devices were modeled and implanted with the segment model in the FE software. In the FE model, a pre-compressive load of 500 N, which was equal to two thirds of the human body mass, was applied to the top surface of the L3. In addition, four types of moments (anteﬂexion, rear protraction, bending and axial rotation) set as 10 Nm were successively applied to the FE model combined with this pre-compressive load. Then the range of motion (ROM), the torsional rigidity and the maximum von Mises equivalent stress on L3-L4 disc and the implant were analyzed.Results Both Coflex and PLIF reduced ROM. However, no significant difference was found in the maximum von Mises equivalent stress of adjacent segment disc between the two devices. Interestingly enough, both systems increased the torsional rigidity at the adjacent lumbar segment, and PLIF had a more significant increase. The Coflex implant had a larger maximum von Mises equivalent stress.Conclusions Both Coflex and PLIF reduced ROM at L3-L4, and thus improved the lumbar stability. Under the same load, both devices had almost the same maximum von Mises equivalent stress as the normal model on the adjacent intervertebral disc. But it is worthy to notice the torsional rigidity of PLIF was higher than that of Coflex. It indicated that the lumbar treated with PLIF would undertake a larger load to reach ROM of Coflex. Therefore, we presumed that ADS was related to higher torsional rigidity.
Changes in Inflammatory Cytokines, Antioxidants and Liver Stiffness after Chelation Therapy in Individuals with Chronic Lead Poisoning
Authors: Teerasarntipan Tongluk , Chaiteerakij Roongruedee , Prueksapanich Piyapan , Werawatganon Duangporn 
Published: November 2019

Abstract
Background Chronic exposure to lead accumulates mainly in the liver. In vivo studies showed that lead toxicities are related to alterations of the inflammatory response. We aimed to evaluate the association between lead poisoning and liver fibrosis as well as the change in degree of liver fibrosis, levels of inflammatory mediators and glutathione (GSH) after chelation therapy.Methods Workers from a battery factory who were exposed to lead for > 12 months and had blood lead level (BLL) > 70 µg/dL were enrolled (n=86) into the study. They received chelation therapy with intravenous CaNa2EDTA for 2 days followed by oral D-penicillamine for 90 days. Primary outcome was the change in the degree of liver fibrosis, which was presented as liver stiffness (LS), measured by FibroScan®. Secondary outcomes were the change in the levels of serum GSH and inflammatory mediators such as tumor necrotic factor-alpha (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6) after chelation therapy.Results Of the 86 participants, there was a positive correlation between duration of lead exposure and LS (r=0.249, p=0.021). To avoid the confounder effect of obesity-related steatosis, only 70 individuals who had controlled attenuation parameters < 296 dB/m, BMI ≤ 25 kg/m2 and normal waist circumference were included in the interventional analysis. After chelation, the mean LS significantly decreased from 5.4 ± 0.9 to 4.8 ± 1.4 kPa (p=0.001). Similarly, all of the inflammatory cytokines studied significantly decreased after chelation (p<0.001); TNF-α dropped from 371.6 ± 211.3 to 215.8 ± 142.7; the levels of IL-1β dropped from 29.8 ± 1.7 to 25.9 ± 4.3 and the levels of IL-6 dropped from 46.8 ± 10.2 to 35.0 ± 11.9. On the other hand, the mean GSH level significantly increased from 3.3 ± 3.3 to 13.1 ± 3.7 (p<0.001) after chelation therapy.Conclusions Our findings suggest that long-term exposure of lead may cause liver fibrosis. Lead poisoning induces chronic inflammatory response and oxidative stress. Treatment by chelation decreases inflammation and replenishes antioxidants, and potentially reduces the degree of LS.
Comparison of bedside index for severity in acute pancreatitis(BISAP) and modified CT severity index(MCTSI) for predicting the severity of hyperlipidemic acute pancreatitis(HLAP)
Authors: Nie Lan , Cheng Yi , Yao Fei , Wu Ru Shuo , Li Ming , Zhang Junjun , Wu Ming qing , Long Hui , Fang Ming Xiang 
Published: November 2019

Abstract
Background: In recent years,the incidence of hyperlipidemic acute pancreatitis(HLAP) is rapidly increasing.It is important for Clinical worker to identify the severity at early stage of HLAP. AIMS: The goal of this paper was to compare bedside index for severity in acute pancreatitis(BISAP) and modified CT severity index(MCTSI) for predicting the severity and local complications of HLAP.Methods: We collected 167 patients with HLAP, including 133 cases of Mild acute pancreatitis(MAP), 34 cases of Moderately severe acute pancreatitis(MSAP) and Severe acute pancreatitis(SAP). The study retrospectively analyzed the clinical characteristics of two groups(MAP group,MSAP and SAP group) of patients.Correlation analysis was demonstrated by Spearman,s test. In addition,the accuracy was investigated through the study of the receiver operating characteristic(ROC) curve to predict the severity of HLAP by BISAP and MCTSI score.Results:There are significantly statistical differences(P<0.05) in Triglycerides(TG), Total cholesterols(TC),Hospitalization days,Fatty liver,and Local complications between two groups,While no statistical differences in Gender, Age,Serum amylase,Alanine aminotransferase(ALT),Aspertate aminotransferase(AST),Hypertension,Type2 diabetes,and Hyperuricemia. Positive relevance was established between BISAP and TG with r of 0.55. The Area Under the Curve(AUC) of BISAP and MCTSI in predicting the severity of HLAP respectively were0.89、0.78，sensitivity were 73.5%、79.4%, specificity were95.5%、60.2%, positive predictive value(PPV) were 80.6%、33.8%, negative predictive value(NPV) were 93.4%、92.0%.In predictionig local complications,the AUC respectively were 0.73、0.87, sensitivity were 37.5%、90.1%, specificity were 93.2%、78.6%, PPV were 77.4%、72.5%, NPV were 70.6%、93.1%.Conclusion: BISAP score has a meaningful prognostic value for predicting the severity of HLAP and higher AUC than MCTSI.In particular,there are significant association between BISAP and TG.Keywords:Hyperlipidemic acute pancreatitis；Triglycerides;BISAP score；MCTSI score; Severe acute pancreatitis