bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of liver damage on blood-borne variables and pulmonary hemodynamic responses to hypoxia and hyperoxia in anesthetized rats
Authors: Sepehrinezhad Ali , Dehghanian Amirreza , Rafati Ali , Ketabchi Farzaneh 
Published: January 2020

Abstract
Background
Liver disorders may be associated with normal pulmonary hemodynamic, hepatopulmonary syndrome (HPS), or portopulmonary hypertension (POPH). In this study, we aimed to investigate the effect of the severity of liver dysfunctions on blood-borne variables, and pulmonary hemodynamic during repeated ventilation with hyperoxic and hypoxic gases.

Methods
Female Sprague Dawley rats were assigned into four groups of Sham (n = 7), portal vein ligation (PPVL, n = 7), common bile duct ligation (CBDL, n = 7), and combination of them (CBDL+ PPVL, n = 7). Twenty-eight days later, right ventricular systolic pressure (RVSP) and systemic blood pressure were recorded in anesthetized animals subjected to repeated maneuvers of hyperoxia (O2 50%) and hypoxia (O2 10%). Besides, we assessed blood parameters and liver histology.

Results
Liver histology score, liver enzymes, WBC and plasma malondialdehyde in the CBDL+PPVL group were higher than those in the CBDL group. Also, the plasma platelet level in the CBDL+PPVL group was lower than those in the other groups. On the other hand, the serum estradiol in the CBDL group was higher than that in the CBDL+PPVL group. All the above parameters in the PPVL group were similar to those in the Sham group. During ventilation with hyperoxia gas, RVSP in the CBDL+PPVL group was higher than the ones in the other groups, and in the CBDL group, it was more than those in the PPVL and Sham groups. Hypoxic pulmonary vasoconstriction (HPV) was not detected in both CBDL+PPVL and CBDL groups, whereas, it retained in the PPVL group.

Conclusion
Severe liver damage increases RVSP in the CBDL+PPVL group linked to the high level of ROS, low levels of serum estradiol and platelets or a combination of them. Furthermore, the high RVSP at the noted group could present a reliable animal model for POPH in female rats.
Value of the Barthel scale in prognostic prediction for patients with cerebral infarction
Authors: Li Qun-Xi , Zhao Xiao-Jing , Wang Yan , Wang Da-Li , Zhang Jiang , Liu Tie-Jun , Peng Yan-Bo , Fan Hai-Yan , Zheng Fu-Xia 
Published: January 2020

Abstract
Background
This study aims to evaluate the ADL(activity of daily living) of patients with acute cerebral infarction through BI scoring, in order to observe its predictive value in the prognosis of these patients.

Methods
According to the inclusion and exclusion criteria, patients with acute anterior circulation cerebral infarction were included in the present study. Then, the BI scoring was analyzed through five grades, in order to further investigate the dose-response relationship between BI scoring and mortality risk in patients with cerebral infarction. The receiver operating characteristic (ROC) curves for BI-scored patients were drawn, and the predictive authenticity of the Barthel scale in prognostic prediction for patients with cerebral infarction was estimated.

Results
The difference in BI scores between the survival group and death group were statistically significant (t = 10.029, P < 0.05), in which the score was lower in the death group than in the survival group. According to the linear trend ×2-test, the decrease in BI score indicates an increase in mortality risk in patients with cerebral infarction. The area under the curve (AUC) of the ROC curve was 0.794 with a P–value of < 0.05.

Conclusion
BI scoring is a highly valuable scoring system for the prognostic prediction of patients with acute cerebral infarction.
ABC-tool reinvented: development of a disease-specific ‘Assessment of Burden of Chronic Conditions (ABCC)-tool’ for multiple chronic conditions
Authors: Boudewijns Esther A. , Claessens Danny , van Schayck Onno C. P. , Keijsers Lotte C. E. M. , Salomé Philippe L. , in ‘t Veen Johannes C. C. M. , Bilo Henk J. G. , Gidding-Slok Annerika H. M. 
Published: January 2020

Abstract
Background
Numerous instruments have been developed to assess patient reported outcomes; most approaches however focus on a single condition. With the increasing prevalence of multimorbidity, this might no longer be appropriate. Moreover, a more comprehensive approach that facilitates shared decision making and stimulates self-management is most likely more valuable for clinical practice than a questionnaire alone. This study aims to transform the Assessment of Burden of Chronic Obstructive Pulmonary Disease (COPD) (ABC)-tool into the Assessment of Burden of Chronic Conditions (ABCC)-tool for COPD, asthma, and diabetes mellitus type 2 (DM2). The tool consists of a scale, a visualisation of the outcomes, and treatment advice.

Methods
Requirements for the tool were formulated. Questionnaires were developed based on a literature study of existing questionnaires, clinical guidelines, interviews with patients and healthcare providers, and input from an expert group. Cut-off points and treatment advice were determined to display the results and to provide practical recommendations.

Results
The ABCC-scale consists of a generic questionnaire and disease-specific questionnaires, which can be combined into a single individualized questionnaire for each patient. Results are displayed in one balloon chart, and each domain includes practical recommendations.

Conclusions
The ABCC-tool is expected to facilitate conversations between a patient and a healthcare provider, and to help formulate treatment plans and care plans with personalised goals. By facilitating an integrated approach, this instrument can be applied in a variety of circumstances and disease combinations.
Ultrasonography in assessing suspected bone fractures: a cross-sectional survey amongst German general practitioners
Authors: Schmid Gordian Lukas , Kühnast Beatrice , Heise Marcus , Deutsch Tobias , Frese Thomas 
Published: January 2020

AbstractBackgroundOver the last two decades, ultrasonography (US) has been shown to be an accurate tool for the diagnosis of suspected bone fractures; however, the integration of this application of US into routine care and outpatient settings needs to be explored. In this study, we surveyed German general practitioners (GPs) to assess their knowledge, attitudes, and utilization of US for the diagnosis of suspected fractures.MethodsNotification of the study, a self-designed questionnaire, and a reminder were mailed to 600 randomly selected GPs in Saxony and Saxony-Anhalt.ResultsThe response rate was 47.7% (n = 286), and respondents did not differ from the population of all GPs in respect to sex and practice type. Among GPs surveyed, 48.6% used an US device in their practice. On average, GPs diagnosed six patients with suspected fractures per month, yet only 39.3% knew about the possibility of ultrasonographic fracture diagnosis, and only 4.3% of GPs using US applied it for this purpose. Among participants, 71.9% believed that US is inferior to conventional X-rays for the diagnosis of bony injuries. Users of US were better informed of and more commonly used US for fracture diagnosis compared to non-users.ConclusionThe need to rule out possible fractures frequently arises in general practice, and US devices are broadly available. Further efforts are needed to improve the knowledge and attitudes of GPs regarding the accuracy of US for fracture diagnosis. Multicenter controlled trials could explore the safety, usefulness, and effectiveness of this still seldom used diagnostic approach for suspected fractures.
Twenty-five years on: revisiting Bosnia and Herzegovina after implementation of a family medicine development program
Authors: Hodgetts Geoffrey , Brown Glenn , Batić-Mujanović Olivera , Gavran Larisa , Jatić Zaim , Račić Maja , Tešanović Gordana , Zahilić Amra , Martin Mary , Birtwhistle Richard 
Published: January 2020

Abstract
Background
The wars that ravaged the former Socialist Federal Republic of Yugoslavia in the 1990’s resulted in the near destruction of the healthcare system, including education of medical students and the training of specialist physicians. In the latter stages of the war, inspired by Family Medicine programs in countries such as Canada, plans to rebuild a new system founded on a strong primary care model emerged. Over the next fifteen years, the Queen’s University Family Medicine Development Program in Bosnia and Herzegovina played an instrumental role in rebuilding the primary care system through educational initiatives at the undergraduate, residency, Masters, PhD, and continuing professional development levels. Changes were supported by new laws and regulations to insure sustainability. This study revisited Bosnia and Herzegovina (B-H) 8-years after the end of the program to explore the impact of initiatives through understanding the perspectives and experiences of individuals at all levels of the primary care system from students, deans of medical schools, Family Medicine residents, practicing physicians, Health Center Directors and Association Leaders.

Methods
Qualitative exploratory design using purposeful sampling. Semi-structured interviews and focus groups with key informants were conducted in English or with an interpreter as needed and audiotaped. Transcripts and field notes were analyzed using an interpretative phenomenological approach to identify major themes and subthemes.

Results
Overall, 118 participants were interviewed. Three major themes and 9 subthemes were identified including (1) The Development of Family Medicine Education, (subthemes: establishment of departments of family medicine, undergraduate medical curriculum change), (2) Family Medicine as a Discipline (Family Medicine specialization, academic development, and Family Medicine Associations), and (3) Health Care System Issues (continuity of care, comprehensiveness of care, practice organization and health human resources).

Conclusions
Despite the impact of years of war and the challenges of a complex and unstable postwar environment, initiatives introduced by the Queen’s Program succeeded in establishing sustainable changes, allowing Family Medicine in B-H to continue to adapt without abandoning its strong foundations. Despite the success of the program, the undervaluing of Primary Care from a human resource and health finance perspective presents ongoing threats to the system.
RETRACTED ARTICLE: Approaching treatment for immunological rejection of living-donor liver transplantation in rats
Authors: Feng Yanhu , Han Zhijian , Feng Zedong , Wang Bofang , Cheng Huijuan , Yang Luxi , Li Yangbing , Gu Baohong , Li Xuemei , Li Yahao , Li Yumin , Wang Chen , Chen Hao 
Published: January 2020

Abstract
Background
The anti-immunological rejection therapy for small-for-size syndrome (SFSS) after live donor liver transplantation (LDLT) play a central role in keeping graft survival. The hepatocyte number and grafts function has undergone real-time changes with the proliferation and apoptosis of the grafts after reperfusion. Lacking an accurate and effective treatment regiments or indicators to guide the use of immunosuppressive drugs in SFS liver transplantation has made immunotherapy after SFS liver transplantation an urgent problem to be solved. Herein, we established small-for-size (SFS) and normal size liver transplantation model in rats to explore the effective indicators in guiding immunotherapy, to find an effective way for overcoming SFSS.

Methods
Lewis rats (donors) and BN rats (recipients) were used to mimic allograft liver transplantation and treated with tacrolimus. Local graft immune response was analyzed through haematoxylin and eosin and immunohistochemistry. Flow cytometry was used to assess the overall immune status of recipient. The pharmacokinetics mechanism of immunosuppressive drugs was explored through detecting CYP3A2 expression at mRNA level and protein levels.

Results
The results showed the local immune reaction of SFS grafts and systemic immune responses of recipient were significantly increased compared with those in normal size grafts and their recipient at four days after liver transplantation. Regression equation was used to regulate the tacrolimus dose which not only controlled tacrolimus serum concentration effectively but alleviated liver damage and improved survival rate.

Conclusions
This study showed that AST level and tacrolimus serum concentrations are effective indicators in guiding immunotherapy. Regression equation (TD = − 0.494TC-0.0035AST + 260.487) based on AST and tacrolimus serum concentration can be used as a reference for adjustment of immunotherapy after SFS liver transplantation, which is applicable in clinical practice.
A new grounded theory model of sexual adjustment to HIV: facilitators of sexual adjustment and recommendations for clinical practice
Authors: Huntingdon Ben , Sharpe Louise , de Wit John , Duracinsky Martin , Juraskova Ilona 
Published: January 2020

AbstractBackgroundLife expectancy of people living with HIV (PLWH) is increasing. Effective biomedical prevention methods (treatment as prevention and preexposure prophylaxis) are being widely implemented in high-income nations. Therefore, research into quality of life, including sexual adjustment, is of increasing importance to HIV care. Yet, sexual adjustment of PLWH has been neglected in past research. We propose a new model of sexual adjustment to HIV which explores the dynamic process, facilitators and barriers characterising sexual life of PLWH overtime.MethodThirty PLWH (19 male, 11 female) recruited from two HIV treatment centres as well as community groups, completed semi-structured interviews which were audio-recorded and transcribed verbatim for analysis using grounded theory.ResultsThe model of sexual adjustment to HIV is the first to establish how undue fears of transmission of HIV during sex and/or fear of rejection by sexual partners determine initial sexual behaviour after diagnosis and also sexual adjustment over time. Within the model, sexual adjustment to HIV is facilitated by factors which assist PLWH to overcome such fears, including: partner acceptance, peer, community and health professional support, and accurate knowledge of risk of transmission including of undetectable viral load and pre-exposure prophylaxis. Adjustment is inhibited when undue fears of transmission and of rejection persist long term, resulting in maladaptive behaviours to cope with such fears including avoidance of sex and problematic drug and alcohol use.ConclusionThis model offers clear directions for promoting sexual adjustment to HIV. Health professionals should: (a) assess and intervene for sexual quality of life (not just risk) among PLWH; (b) be aware that serosorting facilitates adjustment in the short to medium term, but may interfere with adjustment long-term, (c) promote opportunities for positive connection between PLWH, and (d) intervene directly with PLWH and HIV negative sexual partners to promote accurate risk of transmission knowledge, including how this applies to their own sexual practices, and whether they are experiencing undue fear of transmission over time.
Prevalence of diarrhoea and associated risk factors among children under five years old in Pader District, northern Uganda
Authors: Omona Stephen , Malinga Geoffrey M. , Opoke Robert , Openy Geoffrey , Opiro Robert 
Published: January 2020

Abstract
Background
Diarrhoea remains a major cause of morbidity and mortality in children under 5 years in sub-Saharan Africa. Of the three East African countries, Uganda has the worst mortality rate in children < 5 years, with 22% of these deaths attributed to diarrhoea. For proper planning and implementation of control, an understanding of the prevalence and determinants of the disease is crucial. This study assessed the prevalence of diarrhoea and related risk factors among children < 5 years in Pajule Subcounty, Pader District in northern Uganda.

Methods
A cross-sectional survey was conducted in April 2018, covering 244 randomly selected households having children < 5 years old in the study area. A semi-structured questionnaire was used to interview the households about diarrhoeal history in their children in the last 2 weeks preceding the survey, and on the risk factors predisposing children to diarrhoeal infections. Bivariate and multivariate logistic regression analyses with a 95% confidence interval and p < 0.05 was used to identify the risk factors associated with childhood diarrhoeal disease.

Results
We found a prevalence of diarrhoea of 29.1% [95% CI (23.7–35.0)] among children < 5 years in Pajule Subcounty during the 2 weeks preceding the survey. Use of unprotected water sources, age of child caretaker, child weaning time and family size had significant associations with diarrhoeal morbidity.

Conclusion
The prevalence of childhood diarrhoea among children < 5 years of age in rural settings of Pajule Subcounty was higher than the Ugandan national average. Use of unprotected water sources, age of child caretaker, child weaning time and family size were identified as predictors of diarrhoeal occurrence. These findings underscore the need for improving access to clean water and providing community health education as the best methods for fighting childhood diarrhoea in the study area.
Childhood neurodegeneration associated with a specific UBTF variant: a new case report and review of the literature
Authors: Bastos Filipa , Quinodoz Mathieu , Addor Marie-Claude , Royer-Bertrand Beryl , Fodstad Heidi , Rivolta Carlo , Poloni Claudia , Superti-Furga Andrea , Roulet-Perez Eliane , Lebon Sebastien 
Published: January 2020

AbstractBackgroundA new monogenic neurodegenerative disease affecting ribosomal metabolism has recently been identified in association with a monoallelicUBTFputative gain of function variant (NM_001076683.1:c.628G>A, hg19). Phenotype is consistent among these probands with progressive motor, cognitive, and behavioural regression in early to middle childhood.Case presentationWe report on a child with this monoallelicUBTFvariant who presented with progressive disease including regression, episodes of subacute deterioration during febrile illnesses and a remarkable EEG pattern with a transient pattern of semi-periodic slow waves.ConclusionsThis case further supports the phenotype-genotype correlation of neurodegeneration associated withUBTFc.628G>A. Moreover, it brings new insights into the clinical features and EEG that could possibly serve as diagnostic markers of this otherwise nonspecific phenotype.
Midwives’ engagement in smoking- and alcohol-prevention in prenatal care before and after the introduction of practice guidelines in Switzerland: comparison of survey findings from 2008 and 2018
Authors: Lemola Sakari , Gkiouleka Anna , Urfer-Maurer Natalie , Grob Alexander , Tritten Schwarz Katharina , Meyer-Leu Yvonne 
Published: January 2020

AbstractBackgroundEvidence suggests that cigarette smoking and alcohol consumption during pregnancy negatively impacts fetal health. Health agencies across countries have developed specific guidelines for health professionals in perinatal care to strengthen their role in smoking and alcohol use prevention. One such example is the “Guideline on Screening and Counselling for prevention of cigarette smoking and alcohol consumption before, during, and after pregnancy” introduced by the Swiss Midwives Association in 2011. The current study assesses the changes in midwives’ engagement in smoking and alcohol use prevention before (2008) and after the introduction of the Guideline (2018). Further, the current study examines differences across regions (German vs. French speaking regions), graduation years (before and after the introduction of the Guideline) and different work settings (hospital vs. self-employed).MethodsSurvey data were collected in 2008 (n = 366) and in 2018 (n = 459). Differences in how midwives engaged in smoking and alcohol use prevention between 2008 and 2018 were assessed with chi-square tests, as were differences across German and French speaking regions, graduation years (before and after the introduction of the Guideline) and across different work settings (working in hospitals or as self-employed).ResultsAn increase in midwives’ awareness of the risks of consuming even small quantities of cigarettes and alcohol for the unborn child between 2008 and 2018 is evident. Explaining the risks to pregnant women who smoke or use alcohol remained the most frequently reported prevention strategy. However, engagement with more extensive smoking and alcohol use preventive strategies across the whole course of pregnancy, such as assisting women in the elaboration of a plan to stop smoking/alcohol use, remained limited.ConclusionsSeven years after its introduction, the effectiveness of the Guideline in increasing midwives’ engagement in smoking and alcohol use prevention appears limited despite midwives’ increased awareness.
Perinatal outcomes of infants with congenital limb malformations: an observational study from a tertiary referral center in Central Europe
Authors: Farr Alex , Wachutka Eva , Bettelheim Dieter , Windsperger Karin , Farr Sebastian 
Published: January 2020

Abstract
Background
Congenital limb malformations are rare, and their perinatal outcomes are not well described. This study analyzed the perinatal outcomes of infants with congenital limb malformations.

Methods
All infants with congenital limb malformations who underwent prenatal assessment and delivery at our tertiary referral center from 2004 through 2017 were retrospectively identified. Neonatal outcome parameters were assessed, and the predictors of worse perinatal outcomes were determined.

Results
One hundred twenty-four cases of congenital limb malformations were identified, of which 104 (83.9%) were analyzed. The upper limb was affected in 15 patients (14.4%), the lower limb in 49 (47.1%), and both limbs in 40 (38.5%) patients. A fetal syndrome was identified in 66 patients (63.5%); clubfoot and longitudinal reduction defects were the most frequent malformations. In total, 38 patients (36.5%) underwent termination, seven (6.7%) had stillbirth, and 59 (56.7%) had live-born delivery. Rates of preterm delivery and transfer to the Neonatal Intensive Care Unit were 42.4 and 25.4%, respectively. Localization of the malformation was a determinant of perinatal outcome (P = .006) and preterm delivery (P = .046).

Conclusions
Congenital limb malformations frequently occur bilaterally and are associated with poor perinatal outcomes, including high rates of stillbirth and preterm delivery. Multidisciplinary care and referral to a perinatal center are warranted.