bluuebunny/crossref_metadata_2025_split huggingface dataset:
The utility of red cell distribution width to predict mortality of septic patients in a tertiary hospital of Nepal.
Authors: Ghimire Rajan , Shakya Yogendra Man , Shrestha Tirtha Man , Neupane Ram Prasad 
Published: April 2020

Abstract
Background: Sepsis is a common problem encountered in the emergency room which needs to be intervened early. Predicting prognosis is always a difficult task in busy emergency rooms using present scores, which has several variables to calculate. Red cell distribution width (RDW) is an easy, cheap, and efficacious score to predict the severity and mortality of patients with sepsis. Methods: This prospective analytical study was conducted in the emergency room of Tribhuvan University Teaching Hospital among the patients age ≥16 years and with a clinical diagnosis of sepsis using qSOFA score. 148 patients were analyzed in the study by using a non-probability purposive sampling method. Results: RDW has fair efficacy to predict the mortality in sepsis (Area under the Curve of 0.734; 95% C. I= 0.649-0.818; p-value=0.000) as APACHE II (AUC of 0.728; 95% C. I= 0.637 to 0.819; p-value=0.000) or SOFA (AUC of 0.680, 95% C.I =0.591-0.770; p-value=0.001). Youden Index was maximum (37%) at RDW value 14.75, which has a sensitivity of 83% (positive likelihood ratio=1.81) and specificity of 54% (negative likelihood ratio=0.32). Out of 44 patients with septic shock 16 died (36.4 %) and among 104 patients without septic shock, 24 died (22.9%) which had the odds ratio of 0.713 (p=0.555, 95% C. I= 0.231-2.194). Overall mortality was 27.02% (n=40). RDW group analysis showed no mortality in RDW <13.1 group, 3.6% mortality in 13.1 to 14 RDW group, 22.0% mortality in 14 to >15.6 RDW group and 45.9% mortality in >15.6 RDW group. Significant mortality difference was seen in 14 to >15.6 and >15.6 RDW subgroups with a p-value of 0.003 and 0.008 respectively. Conclusion: Area under the curve value for RDW is fair enough to use it as a good prognostic score to predict the mortality of patients with sepsis in the emergency room. Keywords: red cell distribution width, sepsis, emergency care, mortality
Vaginal repaired cesarean section diverticulum is beneficial in women with two prior cesarean sections
Authors: Wang Yizhi , Li Jiarui , New Husheng Wang , Wang Xipeng 
Published: April 2020

Abstract
Background: The aim of this study was to evaluate the effect of vaginal repair in patients with cesarean section diverticulum (CSD) who had one or two previous cesarean sections (CSs). Methods : From January 2012 to December 2014, 248 women with CSD underwent vaginal repair surgery in Shanghai First Maternity and Infant Hospital. These included 193 women with one previous cesarean section and 55 women with two previous cesarean sections. Excision and suture of CSD was performed through a vaginal approach. The duration of menstruation, the length, width and depth of the CSD and thickness of the remaining muscular layer (TRM) were evaluated before and after surgery by transvaginal three-dimensional (3D) color Doppler ultrasound. Results: A total of 221 (89.11%) women were followed-up for more than 3 months, and 168 (67.74%) women were followed-up for more than 6 months. There were significant differences in the average duration of menstruation (7.77±2.05 and 8.02±2.06 days VS 13.99±3.71 days), the average size of CSD (5.54*9.19*5.60 and 5.75*9.04*6.18 mm VS 7.99*12.43*6.62 mm) and the TRM (7.61±2.52 and 7.60±3.00 mm VS 2.51±1.02 mm) after surgery compared with those figures before surgery. The results of this study reveal that vaginal repair could shorten the duration of menstruation and improve anatomical defects (P< 0.05). Moreover, there was no significant difference in the effect of clinical repair between women with one or two previous cesarean sections (P> 0.05). Conclusion: In CSD patients, the clinical effectiveness of vaginal repair was equivalent between women with one or two previous cesarean sections.
The prevalence of cryptococcal antigen (CrAg) and benefits of pre-emptive antifungal treatment among HIV-infected persons with CD4+ T-cell counts &lt; 200 cells/μL: Evidence based on a meta-analysis
Authors: Li Yao , Huang Xiaojie , Chen Hui , Qin Yuanyuan , Hou Jianhua , Li Aixin , Wu Hao , Yan Xiaofeng , Chen Yaokai 
Published: April 2020

Abstract
Background: Current WHO guidelines (2018) recommend screening for cryptococcal antigen (CrAg) in HIV-infected persons with CD4<100 cells/μL, followed by pre-emptive antifungal therapy among CrAg positive (CrAg+) persons, to prevent Cryptococcal meningitis related deaths. The strategy may also be considered for those persons with a CD4 count of<200 cells/uL according the WHO guidelines. However, there remains little evidence for doing so in those HIV-infected persons with this CD4 cell count. Objective: We aimed to assess the necessity of CrAg screening and the efficacy of pre-emptive antifungal therapy in CrAg+ persons with CD4<200 cells/µL. Methods: We conducted a meta-analysis using data obtained from randomized controlled studies (RCTs) and cohort studies found in Pubmed, Web of Science, Cochrane Library and EMBASE/MEDLINE . Results: The pooled prevalence of CrAg positivity in HIV-infected persons with CD4<200 cells/µL was 5% (95%CI: 3-6). The incidence of CM in CrAg+ persons was 7- fold (7%, 95%CI: 4-10) that of CrAg negative (CrAg-) persons (1%, 95%CI: 0-1). Among CrAg+ persons who did not receive any treatment or only received placebo, the incidence of CM was 9% (95%CI: 5-13), whereas the incidence of CM among those who received antifungal therapy was 2% (95%CI: 0-3), a highly statistically significant reduction of 78% (RR: 6.03, 95%CI: 2.74-13.24, p <0.00001). Conclusions: In our meta-analysis, the incidence of CM in CrAg+ persons were significantly higher than in CrAg- persons with CD4<200 cells/µL. Furthermore, the incidence of CM was significantly reduced by pre-emptive antifungal therapy in CrAg+ persons with CD4<200 cells/µL.
Clinical pictures, treatments and resource use of norovirus gastroenteritis in long-term care facilities: A survey with a chart review in Japan
Authors: Fujiki Saori , Ishizaki Tatsuro , Nakayama Takeo 
Published: April 2020

Abstract
Background Outbreaks of norovirus infection can have detrimental impacts on long-term care facilities. This study investigated the incidence, clinical picture, treatment, resource use, and costs of norovirus gastroenteritis in long-term care facilities. Methods Nineteen facilities in Osaka and Kyoto, Japan participated in questionnaire surveys conducted between 2009 and 2011 regarding the incidence of norovirus gastroenteritis. From clinical charts, the characteristics, symptoms, and treatment of infected residents were analyzed. Total drug cost per infected resident was calculated by multiplying the unit price for each drug by the daily dose and the number of days administered and summing the costs for each drug (USD 1 = JPY 100). Results Over the 3-year period, 8 outbreaks of norovirus gastroenteritis occurred in 6 facilities. The mean clinical course of 107 infected residents in five facilities that granted permission to examine patients’ medical records was 4 days, with all but one resident presenting with vomiting and/or diarrhea, and 84 (79%) also presenting with associated symptoms. Of 107 infected residents, 72 (67%) were isolated. The proportion of infected residents isolated varied from 50% to 100% depending on the facility. Of the infected residents, 81 (76%) received some type of medication, the most common being infusion (67 patients, 63%) and antibiotics (30 patients, 28%). The median total cost of all drugs administered was USD 4.4, and the median drug cost per infected resident per day was USD 2.0. Total drug cost over the entire treatment period was the highest for antibiotics, at USD 8.6. Conclusion Clinical course was similar to those of norovirus cases examined at other facilities. The majority of infected residents received some type of medication. Although the economic burden was not large, not a few infected residents were given antibiotics, which are ineffective for norovirus.
Missed Opportunities for Family Planning Counselling among HIV-Positive Women Receiving HIV Care in Uganda
Authors: Author) JULIET NABIRYE(Former Corresponding , Author) Joseph KB Matovu(New Corresponding , Bwanika John Baptist , Makumbi Fredrick , Wanyenze Rhoda K. 
Published: April 2020

Abstract
Introduction

HIV-positive women who are still in the reproductive years need adequate sexual and reproductive health information to make informed reproductive health choices. However, many HIV-positive women who interface with the health system continue to miss out on this information. We sought to: a) determine the proportion of HIV-positive women enrolled in HIV care who missed family planning (FP) counselling; and b) assess if any association existed between FP counseling and current use of modern contraception to inform programming.

Methods

Data were drawn from a quantitative national cross-sectional survey of 5,198 HIV-positive women receiving HIV care at 245 HIV clinics in Uganda; conducted between August and November 2016. Family planning counseling was defined as receipt of FP information by an HIV-positive woman during ANC, at the time of delivery or at the PNC visit. Analyses on receipt of FP counseling were done on 2,760 HIV-positive women aged 15-49 years who were not currently pregnant and did not intend to have children in the future. We used a modified Poisson regression model to determine the Prevalence Ratio (PR) as a measure of association between receipt of any FP counseling and current use of modern contraception, controlling for potential confounders. Analyses were performed using STATA statistical software, version 14.1.

Results

Overall, 2,104 (76.2%) HIV-positive women reported that they received FP counseling at any of the three critical time-points. Of the 24% ( n =656) who did not, 37.9% missed FP counseling at ANC; 41% missed FP counseling during delivery; while 54% missed FP counseling at the post-natal care visit. HIV-positive women who received any FP counseling were significantly more likely to report current use of modern contraception than those who did not (adjusted PR [adj. PR] = 1.21; 95% Confidence Interval [CI]: 1.10, 1.33).

Conclusion

Nearly one-quarter of HIV-positive women did not receive any form of FP counseling when they interfaced with the healthcare system. This presents a missed opportunity for prevention of unintended pregnancies, and suggests a need for the integration of FP counseling into HIV care at all critical time-points.
Urinary angiotensinogen as a surrogate marker predicting the antiproteinuric effects of angiotensin receptor blockers in patients with overt proteinuria
Authors: Jeon Junseok , Kim Do Hee , Jang Hye Ryoun , Lee Jung Eun , Huh Wooseong , Kim Hye-Young , Kim Dae Joong , Kim Yoon-Goo 
Published: April 2020

Abstract
Background: Although urinary angiotensinogen (AGT) and renin reflect intrarenal renin-angiotensin system activity and are enhanced in proteinuric chronic kidney disease, the clinical value of urinary AGT and renin levels during antiproteinuric treatment has yet to be determined. We investigated the clinical usefulness of initial urinary AGT or renin to determine the antiproteinuric effects of angiotensin receptor blockers (ARBs). Methods: This multicenter, prospective, single-arm study included 205 patients with overt proteinuria (urinary protein/creatinine ratio [uPCR] ≥ 1 mg/mg) enrolled between April 2009 and December 2011. All patients were treated with valsartan. The urinary AGT/creatinine ratio (uAGT/Cr) was measured at the baseline and 24 weeks, and the renin/creatinine ratio (uR/Cr) was measured at the baseline. Fifty-six patients were followed-up for 5 years. Results: The mean age was 47.6 years and 51.2% were male. The mean uPCR was 2.32 mg/mg and the mean eGFR was 63.2 mL/min/1.73m 2 . Natural logarithms (ln) (uAGT/Cr), ln(uR/Cr), and diabetes mellitus were associated with proteinuria decrement (decrease in uPCR ≥ 1 mg/mg). Ln(uAGT/Cr) was an independent predictor for proteinuria decrement (OR 1.372, 95% CI, 1.068–1.762, P = 0.013). Among the 56 patients followed-up for 5 years, Δln(uAGT/Cr) at 24 weeks was an independent predictor for uPCR < 1 mg/mg at 5 years (OR 0.379, 95% CI, 0.20–0.715, P = 0.003). Conclusions: Our study demonstrates the potential role of both baseline urinary AGT and changes in urinary AGT during the initial 24 weeks as surrogate markers predicting the antiproteinuric effects of ARBs in patients with overt proteinuria.
The loss of photosynthesis pathway and genomic locations of the lost plastid genes in a holoparasitic plant Aeginetia indica
Authors: Chen Jingfang , Yu Runxian , Dai Jinhong , Liu Ying , Zhou Renchao 
Published: April 2020

Abstract
Background: With three origins of holoparasitism, Orobanchaceae provides an ideal system to study the evolution of holoparasitic lifestyle in plants. The evolution of holoparasitism can be revealed by plastid genome degradation and coordinated changes in the nuclear genome, since holoparasitic plants lost the capability of photosynthesis. Among the three clades with holoparasitic plants in Orobanchaceae, only Clade VI has no available plastid genome sequences for holoparasitic plants. In this study, we sequenced the plastome and transcriptome of Aeginetia indica , a holoparasitic plant in Clade VI of Orobanchaceae, to study its plastome evolution and the corresponding changes in the nuclear genome as a response of the loss of photosynthetic function.
Results: The plastome of A. indica is reduced to 86,212 bp in size, and almost all photosynthesis-related genes were lost. Massive fragments of the lost plastid genes were transferred into the mitochondrial and/or nuclear genomes. These fragments could not be detected in its transcriptomes, suggesting that they were non-functional. Most protein coding genes in the plastome showed the signal of relaxation of purifying selection. Plastome and transcriptome analyses indicated that the photosynthesis pathway is completely lost, and that the porphyrin and chlorophyll metabolism pathway is partially retained, although chlorophyll synthesis is not possible.
Conclusions: Our study suggests the loss of photosynthesis-related functions in A. indica in both the nuclear and plastid genomes. The lost plastid genes are transferred into its nuclear and/or mitochondrial genomes, and exist in very small fragments with no expression and are thus non-functional. The Aeginetia indica plastome also provides a resource for comparative studies on the repeated evolution of holoparasitism in Orobanchaceae.
Green Coffee Extract Modifies Body Weight, Serum Lipids and TNF-α in High-Fat Diet-Induced Obese Rats
Authors: Ilmiawati Cimi , Fitri Fajar , Rofinda Zelly Dia , Reza Mohamad 
Published: April 2020

Abstract
Objective: Currently, there are many efforts to find functional nutrients for obesity management, and the green coffee extract is a potential candidate. This study aimed to examine the effect of the green coffee extract on body weight, serum lipids, and TNF-α level in obese rats.
Results: Administration of green coffee extract to high-fat diet-induced male Wistar rats (Rattus norvegicus) reduced body weight, total serum cholesterol, and triglyceride at the dose of 10, 20, and 40 mg/kg BW/day; lowered LDL-cholesterol at the treatment of 20 mg/kg BW/day (p<0.05). The effective dose to decrease serum TNF-α level was 40 mg/kg BW/day, while the effective dose to improve the lipid profile was 10 mg/kg BW/day. These results supported the potential use of green coffee extract as a functional nutrient in the management of obesity
Making researchers responsible: Attributions of responsibility and ambiguous notions of culture in research codes of conduct
Authors: Valkenburg Govert , Dix Guus , Tijdink Joeri , de Rijcke Sarah 
Published: April 2020

Abstract
Background: Research codes of conduct offer guidance to researchers with respect to which values should be realized in research practices, how these values are to be realized, and what the respective responsibilities of the individual and the institution are in this. However, the question how the division between individual and institutional responsibilities is to be made, has hitherto received little attention. Therefore, we conduct an analysis of research codes of conduct, and investigate how responsibilities are positioned as individual or institutional ones and how the boundary between those two is shaped.
Method: We selected 12 institutional, national and international codes of conduct that apply to medical research in the Netherlands, and performed a close-reading content analysis of these codes of conduct. We first identify dominant themes, and then investigate how responsibility is attributed to individuals and institutions.
Results: We observe that in many cases, the attribution of the responsibility to either the individual or the institution is not entirely clear and that the notion of culture appears as a residual category for such attributions. This notion of responsible research cultures is deemed important as something that mediates between the individual and institutional level, but at the same time largely lacks substantiation.
Conclusions: While many attributions of individual and institutional responsibility are clear, the exact boundary between individual and institutional responsibility is often problematic. We suggest two possible avenues for improvement in codes of conduct: either clearly attribute responsibilities to individuals or institutions and depend less less on the notion of culture, or make culture a more explicit concern and articulate what it is and how it could be fostered.
An immunoinformatic approach driven by experimental proteomics: in silico design of a subunit candidate vaccine targeting secretory proteins of Leishmania donovani amastigotes
Authors: Khan Md Anik Ashfaq , Ami Jenifar Quaiyum , Faisal Khaledul , Chowdhury Rajashree , Ghosh Prakash , Hossain Faria , Wahed Ahmed Abd El , Mondal Dinesh 
Published: April 2020

Abstract
Background Visceral leishmaniasis (VL) caused by dimorphic Leishmania species is a parasitic disease with high socioeconomic burden in endemic areas worldwide. Sustaining control of VL in terms of proper and prevailing immunity development is a global necessity amid unavailability of a prophylactic vaccine. Screening of experimental proteome of the human disease propagating form of Leishmania donovani (amastigote) can be more pragmatic for in silico mining of novel vaccine candidates. Methods By using an immunoinformatic approach, CD4+ and CD8+ T cell-specific epitopes from experimentally reported L. donovani proteins having secretory potential and increased abundance in amastigotes were screened. A chimera linked with a Toll-like receptor 4 (TLR4) peptide adjuvant was constructed and evaluated for physicochemical characteristics, binding interaction with TLR4 in simulated physiological condition and the trend of immune response following hypothetical immunization. Results Selected epitopes from physiologically important L. donovani proteins were found mostly conserved in L. infantum , covering theoretically more than 98% of the global population. The multi-epitope chimeric vaccine was predicted as stable, antigenic and non-allergenic. Structural analysis of vaccine-TLR4 receptor docked complex and its molecular dynamics simulation suggest sufficiently stable binding interface along with prospect of non-canonical receptor activation. Simulation dynamics of immune response following hypothetical immunization indicate active and memory B as well as CD4+ T cell generation potential, and likely chance of a more Th1 polarized response. Conclusions The methodological approach and results from this study could facilitate more informed screening and selection of candidate antigenic proteins for entry into vaccine production pipeline in future to control human VL.
Effects of Kinesio Tape on kinesiophobia, balance and functional performance of athletes with post anterior cruciate ligament reconstruction: A Pilot Trial
Authors: Gholami Milad , Kamali Fahimeh , Mirzaei Maryam , Motealleh Alireza , Shamsi MohammadBagher 
Published: April 2020

Abstract
Background : This study aimed to investigate the effects of Kinesio Taping on Kinesiophobia (fear of re-injury), balance and functional performance in athletes after anterior cruciate ligament reconstruction.
Methods: This randomized, placebo-controlled clinical trial was performed on 20 athletes with anterior cruciate ligament reconstruction (mean age 32.35 ± 6.25 years) at the time of return to sport. The participants were selected using purposive sampling approach and they were randomly assigned to kinesio tape group (n=10) or placebo kinesio tape group (n=10).
While subjects under taped, the following outcomes were measured at baseline, ten minutes after the intervention, and two days later. Kinesiophobia, balance, strength, functional / agility performance was assessed by Tampa Scale, Y balance test (YBT), single leg hops and 10-yard extremity functional test, respectively. Data were analyzed using the repeated measure analysis of variance (RMANOVA) in the SPSS v.23.
Results: Two days after Kinesio taping, the difference between the scores obtained in the first and the second measurements for all variables in the kinesio tape group was not significantly different rather than placebo kinesio tape group (all P> 0.05). The difference between scores of the third and the first measurements of all variables was also not significantly different in the kinesio tape group compared to the placebo kinesio tape group (all P> 0.05).
In the kinesio tape and placebo kinesio tape groups, RMANOVA indicated that the differences in all variables scores were significant over time (P < 0.001), Sidak post-hoc test indicated that the differences between the first and the second measurements, as well as between the first and the third measurements were significant (P < 0.001).
Conclusion: This study gives no support for any beneficial effect of kinesio taping on reduction of kinesiophobi or improvement of balance score and functional performance in athletes with post anterior cruciate ligament reconstruction.
Trial registration: This study was registered in the Iranian Clinical Trial Center with the code IRCT20190130042556N1, https://www.irct.ir/trial/37312, registered 12 February 2019.