bluuebunny/crossref_metadata_2025_split huggingface dataset:
TIA and minor stroke: A qualitative study of long-term impact and experiences of follow-up care
Authors: Turner Grace M , McMullan Christel , Atkins Lou , Foy Robbie , Mant Jonathan , Calvert Melanie 
Published: October 2019

Abstract
Background Transient ischaemic attack (TIA) and minor stroke are often considered transient events; however, many patients experience residual problems and reduced quality of life. Current follow-up healthcare focuses on stroke prevention and care for other long-term problems is not routinely provided. We aimed to explore patient and healthcare provider (HCP) experiences of residual problems post-TIA/minor stroke, the impact of TIA/minor stroke on patients’ lives, and current follow-up care and sources of support. Methods This qualitative study recruited participants from three TIA clinics, seven general practices and one community care trust in the West Midlands, England. Semi-structured interviews were conducted with 12 TIA/minor stroke patients and 24 HCPs from primary, secondary and community care with framework analysis. Results A diverse range of residual problems were reported post-TIA/minor stroke, including psychological, cognitive and physical impairments. Consultants and general practitioners generally lacked awareness of these long-term problems; however, there was better recognition among nurses and allied HCPs. Residual problems significantly affected patients’ lives, including return to work, social activities, and relationships with family and friends. Follow-up care was variable and medically focused. While HCPs prioritised medical investigations and stroke prevention medication, patients emphasised the importance of understanding their diagnosis, individualised support regarding stroke risk, and addressing residual problems. Conclusion HCPs could better communicate lay information about TIA/minor stroke diagnosis and secondary stroke prevention, and improve their identification of and response to important residual impairments affecting patients.
Nutrition knowledge and Attitude in Medical Students of Tabriz University of Medical Sciences in 2017-2018
Authors: Dolatkhah Neda , Aghamohammadi Dawood , Khalili Azizeh Farshbaf , Hajifaraji Majid , Hashemian Maryam , Esmaeili Sepideh 
Published: November 2019

Abstract
Objectives : In this cross-sectional study among 220 medical students we aimed to determine the nutritional knowledge and attitude of medical students through clinical training courses (externship and internship) of Tabriz University of Medical Sciences, Iran. A nutritional knowledge questionnaire included 51 questions was used to determine the correct, perceived and accuracy of knowledge of the participant in different aspects of nutrition sciences. Nutritional knowledge was calculated as percentage of correct responses. The nutrition attitude questionnaire included 30 questions. Both questionnaires were confirmed in terms of the validity and reliability for assessing nutritional knowledge and attitude in this sample of Iranian medical students.
Results: The mean score of correct knowledge was not significantly different among externs and interns (68.20±7.50% and 67.87±6.04% respectively, p=0.729). Results showed that most of the participants (49.61% of externs and 57.14% of inters) had a poor nutritional knowledge, significantly varied by age (p=0.035). The mean attitude index of the subjects was not significantly different among externs and interns (106.37±13.66 and 108.16±13.35 out of 145 respectively, p=0.337). Most students (92.7%) had a very appropriate attitude toward nutrition, significantly varied by sex (p=0.010). These findings indicate that there are multiple deficiencies in nutrition knowledge of medical students.
Impact of Early Chimerism Status on Clinical Outcome in Children with Acute Lymphoblastic Leukaemia after Haematopoietic Stem Cell Transplantation
Authors: Lejman Monika , Zaucha-Prażmo Agnieszka , Zawitkowska Joanna , Mroczkowska Aleksandra , Grabowski Dominik , Kowalczyk Jerzy Roman , Drabko Katarzyna 
Published: October 2019

Abstract
Background: The significance of very early chimerism assessment before day +28, which is considered the moment of engraftment, is still unclear. In this retrospective study, we evaluated the clinical impact of very early chimerism on the clinical outcome after allogeneic haematopoietic stem cell transplantation (allo-HSCT) in children with acute lymphoblastic leukaemia (ALL).
Methods: The study group included 38 boys and 18 girls. Very early chimerism was evaluated on days +7, +14, +21 and +28 after the transplant. Short tandem repeat polymerase chain reaction (STR PCR) was used to analyse chimerism.
Results: Overall survival (OS) and event-free survival (EFS) were 84% and 80%, respectively. The OS in the group of 24 patients with complete donor chimerism on day +14 was 83%, and it did not differ statistically compared to the 32 patients with mixed chimerism on day +14 (OS was 84%). In our cohort of patients, the matched unrelated donor, male of donor, number of transplanted cells above 4.47 x 106 kg and no serotherapy with ATG were statistically related to a higher level of donor chimerism. The immunophenotypes of disease, age of patient at time HSCT, recipient sex, stem cell source (peripheral blood/bone marrow) and conditioning regimen had no impact on early chimerism. Acute graft versus host disease grades II-IV was diagnosed in 23 patients who presented with donor chimerism levels above 60% on day 7.
Conclusion: The data presented in this study provide valuable insight into the analysis of very early chimerism in children with ALL treated with HSCT.
Digital Postpartum Hemorrhage Management Device (DPHMD)
Authors: Tekela Derartu Dereje , Asmare Abeba Getachew , Gebremariam Birhan Meskelu , Assegahegn Christian Adamu , Wami Kidst Dejene , Nemomssa Hundessa Daba , Simegn Gizeaddis Lamesgin 
Published: October 2019

Abstract
Background

Primary postpartum hemorrhage (PPH) is an obstetric emergency caused by excessive blood loss that occurs most commonly after the placenta is delivered. PPH can lead to volume depletion, hypovolemic shock, anemia, and it is the leading cause of maternal mortality worldwide. With 470 deaths per 100,000 live births, the maternal mortality ratio in Ethiopia is one of the highest in the world. It is estimated that 94% of births occur at home in Ethiopia and that 10% of maternal deaths are attributed to PPH. Currently, physicians use visual estimation to calculate blood loss and provide fluid during delivery. This traditional method is subjective and generally inaccurate.Method

In this project, after delivery blood loss measurement system integrated with fluid delivery and vital sign monitoring method is proposed. The collection and measurement system collects blood loss after delivery and measures the amount of blood loss. The management system continuously monitors the mother’s heart rate and blood pressure. These vital sign values are integrated with the measured blood loss to estimate the amount of IV fluid required to be delivered for the mother. The rate of IV fluid delivery is regulated by a flow rate sensor and solenoid valve.Results

The prototype was built and undergone through different tests and iterations. The proposed device was tested for accuracy, cost effectiveness and ease to use. 91.28% accuracy has been achieved and the prototype was built with less than 210 USD.Conclusion

The proposed design allows physicians, especially those in low resource setting, to estimate blood loss and deliver fluid accurately. This helps to reduce maternal mortality rate that may occur due to postpartum hemorrhage.
Prevalence and genotyping of Toxoplasma gondii in stray cats in Mashhad area, Iran.
Authors: Khodaverdi Majid , Razmi Gholamreza 
Published: October 2019

Abstract
Background: Cats as a definitive host have an important role in the epidemiology of toxoplasmosis in humans and animals. The aim of the study was to determine the frequency of Toxoplasma gondii infection and isolate and identify the genotypes of T. gondii in stray cats in Mashhad suburb.
Methods: From April 2016 to August 2017, 175 fecal samples from stray cats and 31 brain samples from cats killed in driving accidents were collected. The fecal samples were examined by fecal flotation technique and T. gondii-specific PCR. The brain samples were investigated by T. gondii-specific PCR and consequently examined by mice bioassay. The DNA of T. gondii isolated was genotyped using SAG1, SAG2, SAG3, BTUB and GRA6 as PCR-restriction fragment length polymorphism (PCR-RFLP) markers.
Results: In the present study, Toxoplasma-like oocysts were microscopically observed in 2.2% (4/175) fecal samples. The presence of Toxoplasma oocysts was confirmed in one microscopy-positive sample by PCR. In addition, T. gondii DNA was detected in 4% (7/175) microscopy-negative samples using PCR. T. gondii was isolated from one brain PCR-positive sample by mice bioassay. The isolate was avirulent and many T. gondii cysts were observed in mice brain. The isolate was successfully genotyped by PCR-RLFP analysis .The isolated genotyped was type II. Beside, eight Toxoplasma-positive fecal samples contained insufficient DNA and only amplified at SAG-3 locus in PCR. These samples were also showed type II pattern at this locus.
Conclusions: Parasitological and molecular results showed low frequency of Toxoplasma infection in the stray cats, and identified the genotype of T. gondii isolate as type II, for the first time in Mashhad area, Khorasan Razavi Province.
Seasonal variations in the occurrence of acute appendicitis and their relationship with the presence of fecaliths in children
Authors: Hsu Yao-Jen , Fu Yu-Wei , Chin Taiwai 
Published: October 2019

Abstract
Background
Acute appendicitis (AA) is the most common surgical condition in children. Although a higher incidence of AA in summer has been reported, the reason for this observation remains unclear. The purpose of this study was to compare the clinical findings of AA patients who underwent appendectomies during the summer months with those who underwent the procedure during the non-summer months.
Methods
The clinical data of 171 patients who underwent appendectomy from January 2013 to December 2016 were reviewed. The patients were divided into a summer group (from May to October) and a non-summer group (from November to April) based on the month when appendectomy was performed. All patients were under 18 years of age at the time of surgery. The medical records including laboratory data, computed tomography scans, pathology reports and operative notes were reviewed.
Results
The number of patients with AA was higher in the summer group than in the non-summer group (101 vs. 70 patients). No significant differences in the laboratory results between the two groups of patients were observed. The percentage of AA patients who presented with a fecalith was significantly lower in the summer group (33.6%) than in the non-summer group (55.7%). No significant differences in the incidence of appendiceal perforations and abscesses, as well as postoperative complications were observed between the two groups.
Conclusions
The percentage of AA patients with fecaliths in summer was lower than that in the non-summer months. The increase in the number of AA patients in summer may be due to the increased occurrence of lymphoid hyperplasia, which may be correlated with the yearly outbreak of enterovirus infection during this period.
In vitro and in situ study on characterizationand mechanismofthe intestinal absorptionof 2,3,5,4'-tetrahydroxy-stilbene-2-O-β-D-glucoside
Authors: Wang Cheng , Zhou Yimeng , Gong Xiaohong , Zheng Li , Li Yunxia 
Published: October 2019

Abstract
Background: 2,3,5,4'-tetrahydroxystilbence-2-O-β-D-glucoside(TSG) is a polyhydroxyphenolic compound, which exhibited a broad spectrum of pharmacological activities, such asanti-inflammatory, anti-depression, anti-oxidation and anti-atherosclerosis.However, the compound had poor bioavailability and the underlying absorption mechanisms had not been studied. Therefore, the purpose of this study was to investigate the intestinal absorption mechanism of TSG.
Methods:This study used Caco-2 cell monolayer model and single-passintestinal perfusion modelto explore the gastrointestinal absorption mechanisms of TSG. The effects of basic parameters such as drug concentration, time and pH on the intestinal absorption of TSG were analyzed by high performance liquid chromatography.The absorption susceptibility of TSG to three inhibitors, P-gp inhibitors verapamil hydrochloride and quinidine, and MRP2 inhibitor probenecid were also assessed.
Results: TSG was poorly absorbed in the intestines and the absorption of TSG in stomach is much higher than that in intestine. Both in vitro andin situ experiments showed that the absorption of TSG was saturated with increasing concentration and it was better absorbed in a weakly acidic environment pH 6.4. Moreover, TSG interacts with P-gp and MRP2, and TSG was not only the substrate of the P-gp and MRP2, but also affected the expression of P-gp and MRP2.
Conclusions: It wasconcluded that the gastrointestinalabsorption mechanisms ofTSG involved processes passive transport and the participation ofefflux transporters.
Intratumoral reciprocal expression of monocarboxylate transporter 4 and glypican-3 in hepatocellular carcinomas
Authors: Yorita Kenji , Ohno Akinobu , Nishida Takahiro , Kondo Kazuhiro , Ohtomo Toshihiko , Kataoka Hiroaki 
Published: October 2019

Abstract
Objective: We previously reported the identification of monocarboxylate transporter 4 (MCT4) and glypican-3 (GPC3) as prognostic factors for hepatocellular carcinoma (HCC), which are now considered significant poor prognostic factors for the disease. This study aimed to clarify the detailed interaction of these two factors in HCC t o improve our understanding of aggressive HCC phenotype s. A total of 225 Japanese patients with HCC from our previous study were subjected to immunohistochemical analyses.
Results: The number of MCT4-positive (MCT4+) HCC cases was 47 (21%), and most MCT4+ HCC showed high GPC3 expression (94%, 44/47 cases). In 44 MCT4+/GPC3+ HCC cases, intratumoral heterogeneity of GPC3 or MCT4 expression was further evaluated. We observed reciprocal (inverse), synergistic, mixed reciprocal and synergistic, or irrelevant interaction of MCT4 and GPC3 expression in 29 (66%), 5 (11%), 1 (2%), and 9 cases (21%), respectively. The cases exhibiting reciprocal expression of both markers tended to have cirrhosis without a history of neoadjuvant therapy. In summary, although MCT4+ HCC cases are mostly GPC3+, intratumoral expression patterns of MCT4 and GPC3 are frequently reciprocal each other, suggesting that dual targeting of MCT4 and GPC3 may achieve a better antitumor effect for MCT4+ HCC cases.
Frequency Electromagnetic field effects on Gram-Positive and Gram-Negative Bacteria
Authors: Bayatiani Mohamad Reza , seif fatemeh , Arjomandzadegan mohamad , moradabadi alireza , parvin arash 
Published: October 2019

Abstract
Abstract

Objective: The effects of electromagnetic waves on the growth of living organisms and the determination of the threshold of these radiations have remained elusive. Therefore, in this research, we have investigated the growth rate of gram-positive (Staphylococcus aureus) and gram-negative (Escherichia coli) bacteria that had been exposed to the different frequencies of electromagnetic fields.
Results: The more frequency increased the slower bacteria grew; however, in gram-positive bacteria such as S. aureus, this effect was seen less. The effect of the 1mT electromagnetic field in the growth of S. aureus was significant between the two groups, nonetheless, in the 2mT electromagnetic field, the effect was not significant between the two groups at different frequencies. Noteworthy, no significant change was observed by increasing the frequency in S. aureus exposed bacteria in comparison to the control group. The study of bacterial growth in terms of frequency in both case and control groups showed an increasing trend. Increasing the frequency from 50 Hz to 150Hz, significantly, enhanced the rate of bacterial growth. On the whole, the magnetic field had an increment effect on the growth of bacteria; in fact, this effect was greater on the gram-negative than on the gram-positive bacteria.
Comparative Randomized Multicenter Study Of Plastic Vs. Self-expanding Metal Stents In The Endoscopic Ultrasound-guided Drainage Of Walled-off Pancreatic Necrosis
Authors: gornals joan b , Perez-Miranda Manuel , Vazquez-Sequeiros Enrique , Vila Juan , Esteban Jose M , Gonzalez-Huix Ferran , Guarner-Argente Carlos , Sanchez-Yague Andres , Teran Alvaro , Bas-Cutrina Francesc , Serna Carlos De La , De Paredes Ana Garcia Garcia , Ballester Raquel , Velasquez-Rodriguez Julio , Salord Silvia , Tebe Cristian , Hereu Pilar , Videla Sebastia 
Published: November 2019

Abstract
Background: It seems that the appearance of lumen-apposing metal stents (LAMS), are displacing the role of plastic stents in the therapy of pancreatic fluid collection as walled-off necrosis (WON). To date there is no quality of evidence to recommend LAMS as the standard treatment in management of WON. The theoretical benefit of LAMS over PLASTIC stents, need to be proved.Methods/design: This is a multicenter prospective study, superiority, randomized controlled clinical trial by parallel groups, without masking. One hundred fourteen patients with WON will be Endoscopic ultrasound (EUS)-guided transmural drained in 9 tertiary hospitals in Spain and will be randomized to the LAMS or PLASTIC stent group. The primary endpoint is to assess the short-term (4 weeks) clinical success determined by the reduction of the collection (to <50% or < 5cm in size), along with clinical improvement. Secondary endpoints: the long-term (4 months) clinical success (total resolution or 5cm); the procedure’s duration, the level of difficulty, safety and recurrences.Discussion: The PROMETHEUS trial has been designed to response if LAMS are superior over PLASTIC stents in the EUS-guided transmural drainage of WON. Trial registration: ClinicalTrials.gov, NCT03100578. Registered on April 4, 2017. https://clinicaltrials.gov/ct2/home
Associations between early childhood caries and malnutrition and anemia: A global perspective
Authors: Folayan Morenike , Tantawi Maha El , Schroth Robert J , Vukovic Ana , Kemoli Authur , Gaffar Balgis O , Obiyan Mary 
Published: October 2019

Abstract
Background To determine the relationship between country-level prevalence of early childhood caries (ECC), malnutrition and anemia in infants and preschool children.Methods Matched country level ECC, malnutrition and anemia prevalence information were generated from databases covering the period from 2000 to 2017. Multivariate general linear models were developed to assess the relationship between outcome variables (prevalence of stunting, wasting, overweight, and anemia) and the explanatory variable (ECC prevalence) adjusted for Gross National Income per capita. The adjusted regression coefficients (B) and partial eta squared were computed.Results The mean (standard deviation (SD)) ECC prevalence for 0-2 year-olds was 23.8 (14.8)% and 57.3 (22.4)% for 3-5 year-olds. The mean (SD) prevalence of wasting was 6.3 (4.8)%, overweight was 7.2 (4.9)%, stunting was 24.3 (13.5)%, and anemia was 37.8 (18.1)%. For 0-2-year-olds, the strongest and only significant association observed was between the prevalence of ECC and overweight (η2= 0.21): one percent higher ECC prevalence was associated with 0.12% higher prevalence of overweight (B= 0.12, P= 0.03). In 3-5-year-olds, the strongest and only significant association was observed between the prevalence of ECC and anemia (η2= 0.08): one percent higher prevalence of ECC was associated with 0.14% lower prevalence of anemia (B= -0.14, P= 0.048).Conclusion There were age-related disparities in the relationship between country-level prevalence of ECC, malnutrition and anemia. The relationship between ECC and overweight may be due to intake of sugars. The relationship between ECC and anemia needs further investigations.
Tracing cross species transmission of Mycobacterium bovis at the wildlife/livestock interface in South Africa
Authors: Sichewo Petronillah Rudo , Hlokwe Tiny M. , Etter Eric M.C. , Michel Anita L. 
Published: October 2019

Abstract
Background Bovine tuberculosis (bTB) affects cattle and wildlife in South Africa with the African buffalo ( Syncerus caffer ) as the principal maintenance host. The presence of a wildlife maintenance host at the wildlife/livestock interface acting as spill-over host makes it much more challenging to control and eradicate bTB in cattle. Spoligotyping and mycobacteria interspersed repetitive unit-variable number of tandem repeat (MIRU-VNTR) genotyping methods were performed to investigate the genetic diversity of Mycobacterium bovis ( M. bovis ) isolates from cattle and wildlife, their distribution and transmission at the wildlife/livestock interface in northern Kwa-Zulu Natal (KZN), South Africa. Results SB0130 was identified as the dominant spoligotype pattern at this wildlife/livestock interface, while VNTR typing revealed a total of 29 VNTR profiles (strains) in the KZN province signifying high genetic variability. The detection of 5 VNTR profiles shared between cattle and buffalo suggests M. bovis transmission between species. MIRU-VNTR confirmed co-infection in one cow with three strains of M. bovis that differed at a single locus, with 2 being shared with buffalo, implying pathogen introduction from most probably unrelated wildlife sources. Conclusion Our findings highlight inter and intra species transmission of bTB at the wildlife/livestock interface and the need for the implementation of adequate bTB control measures to mitigate the spread of the pathogen responsible for economic losses and a public health threat.
Formation of ultralong DH regions through genomic rearrangement
Authors: Smider Brevin A. , Smider Vaughn 
Published: October 2019

Abstract
Background: Cow antibodies are very unusual in having exceptionally long CDR H3 regions. The genetic basis for this length largely derives from long heavy chain diversity (DH) regions, with a single “ultralong” DH, IGHD8-2, encoding over fifty amino acids. Most bovine IGHD regions are homologous but have several nucleotide repeating units that diversify their lengths. Genomically, most DH regions exist in three clusters that appear to have formed from DNA duplication events. However, the relationship between the genomic arrangement and long CDR lengths is unclear. Results: The DH cluster containing IGHD8-2 underwent a rearrangement and deletion event in relation to the other clusters in the region corresponding to IGHD8-2, with possible fusion of two DH regions and expansion of short repeats to form the ultralong IGHD8-2 gene. Conclusions: Length heterogeneity within DH regions is a unique evolutionary genomic mechanism to create immune diversity, including formation of ultralong CDR H3 regions.