bluuebunny/crossref_metadata_2025_split huggingface dataset:
What lies beneath? Above ground and sediment carbon storage in mangroves along a sea to shore gradient in Lindi, Tanzania
Authors: Cleyndert Georgia de Jong , Cuni-Sanchez Aida , Seki Hamidu A , Shirima Deo D , Munishi Pantaleo K.T. , Burgess Neil , Marchant Robert 
Published: May 2020

Abstract
Background: Mangrove forests have gained recognition for their potential role in climate change mitigation due to the carbon sequestration of the productive ecosystems and storage in the sediments that are trapped by the mangrove tree roots and pneumatophores. Africa hosts about 19% of the world’s mangroves, yet there are relatively few studies that have examined the carbon stocks of African mangroves, and the studies available report great differences among sites and amongst the different pools of carbon stocks, particularly between the above ground carbon stored in trees (AGC) and organic carbon stored within the sediment - ‘soil organic carbon (SOC)’. We investigate if AGC and SOC carbon stocks differ with increasing seaward distance for estuarine mangroves in Tanzania and, how our results compare to those reported elsewhere across Africa.Results: AGC ranged between 10.9-54.9 Mg C ha-1. Stem density, basal area, mean diameter and mean height increased with increasing seaward distance, but percentage of small stems (5.0-9.9 cm diameter) decreased. SOC for 0-1m depth ranged from 153.7-483.6, with a mean of 301.7 Mg C ha-1. SOC was significantly negatively correlated with seaward distance. Overall, our estimates of AGC are similar to those reported elsewhere in Tanzania but our estimates of SOC are higher as we sampled at a greater depth. There are important methodological differences in previous studies in Africa. Conclusion:This study indicates that seaward distance has an important effect on both AGC and SOC stocks in the Lindi region of Tanzania and there is the need to standardise methodological approaches to make results easily comparable across sites. The high SOC value is likely to be much greater if the full extent of the sediment system is assessed and so if Tanzania and other African nations are to fully benefit from carbon offsetting schemes, it is essential that the contribution of mangrove sediment carbon is considered.
Growth differentiation factor 15 is associated with cardiovascular outcomes in patients with coronary artery disease
Authors: Li Man , Duan Lei , Cai Yulun , Li Huiying , Hao Benchuan , Chen Jianqiao , Liu Hongbin 
Published: May 2020

Abstract
Background: Growth differentiation factor-15 (GDF-15) is a marker of inflammation, oxidative stress and it is associated with adverse prognosis in cardiovascular disease. The aim of the present cohort study is to investigate the prognostic value of GDF-15 in patients with coronary artery disease (CAD) during long-term follow up.Method: A total of 3641 consecutive patients with CAD were prospectively enrolled into the study and followed up for all cause death and major adverse cardiovascular events (MACEs) up to 6.4 years. Plasma GDF-15 was measured and clinical data and long-term events were registered. The patients were subsequently divided into three groups by the levels of GDF-15 and the association of GDF-15 level with MACEs was evaluated.Result: After a median follow-up at 6.4 years later, 775 patients (event rate of 21%) had developed MACEs and 275 patients died (event rate of 7.55%). Kaplan–Meier analysis indicated that the patients with GDF-15 > 1800 ng/L were significantly associated with an increased risk of MACEs and all cause death. After adjustment for potential confounders, GDF-15 > 1800 ng/L. were independently associated with the composite of major adverse cardiovascular events (MACEs) (HR 1.74; 95% CI: 1.44–2.02; p<0.001) and all-cause death (HR 2.04; 95% CI 1.57– 2.61; p<0.001). For MACEs a significant increase of receiver operator characteristic curve (ROC)curve was seen after addition of GDF-15 to a clinical model 0.628(95% CI 0.605–0.651; p <0.001).For long-term all-cause death a significant increase of ROC curve was seen after addition of GDF-15 to a clinical model 0.817(95% CI 0.787–0.846; p<0.001).Conclusions: In the setting of CAD, GDF-15 is associated with long-term all-cause death, MACEs and provides incremental prognostic value beyond traditional risks factors.
Cross-sectional study of prevalence and determinants of uncontrolled Hypertension among South African adult residents of Mkhondo municipality
Authors: Masilela Charity , Pierce Brendon , Adeniyi Oladele Vincent , Benjeddou Mongi 
Published: May 2020

Abstract
Background: Achieving the blood pressure treatment target in individuals with hypertension is a serious global health challenge. Furthermore, the actual burden of uncontrolled hypertension is poorly understood especially in the developing countries. Therefore, this study comprehensively examined the rate and factors associated with uncontrolled hypertension in individuals receiving care at the primary healthcare facilities in the rural areas of Mkhondo Municipality in the Mpumalanga Province, South Africa.Methods: In this cross-sectional study, individuals attending care for hypertension were recruited from January 2019 to June 2019 at three primary healthcare centres, namely, Piet Retief hospital, Mkhondo town clinic and Thandukukhanya community health centre. Uncontrolled hypertension was defined as systolic blood pressure ≥ 140mmHg and diastolic blood pressure ≥ 90mmHg in accordance with the South African Hypertension Society guideline (2014). Multivariate logistic regression (Forward LR method) analysis was used to identify the significant determinants of uncontrolled hypertension.Results: The majority of the participants were; 55 years old and above (69.0%), Zulus (81.2%), non-smokers (84.19%) and had been diagnosed with hypertension for more than a year prior to the study (72.64%). The overall prevalence of uncontrolled hypertension was 56.83% (n=187) with no significant difference between sexes, 57.38% males versus 56.88% females, respectively. In the multivariate logistic regression model analysis after adjusting for confounding variables, obesity (AOR=2.90; 95% CI 1.66-5.05), physical activity (AOR=4.79; 95% CI 2.15-10.65) and HDL-C (AOR=5.66; 95% CI 3.33-9.60) were the significant and independent determinants of uncontrolled hypertension in the cohort.ConclusionThe high rate of uncontrolled hypertension in the study setting, can be largely attributed to obesity, physical activity and dyslipidaemia. Treatment will require the collaborative efforts of individuals, clinicians and health authorities. All these determinants should be addressed decisively so as to achieve the treatment blood pressure targets in the study population.
What are the Most Important Problems in Functioning Among Patients with Shoulder Pain? An Analysis of the Patient-Specific Functional Scale
Authors: Røe Yngve , Rysstad Tarjei , Tveter Anne Therese , Sandbakk Torill Bjugan , Jæger Marit , Grotle Margreth 
Published: May 2020

Abstract
Background Shoulder pain is a common and often persistent health condition with substantial impact on daily functioning. The primary aim of the present study was to identify important functional problems among patients with shoulder pain, using the Patient-Specific Functional Scale (PSFS). A secondary aim was to investigate differences between primary- and secondary care patients.Methods The study had a cross-sectional design and included patients seeking care for shoulder pain in a primary- and a secondary outpatient clinic. Background variables, pain, physical activity level and the PSFS, were registered with a questionnaire package. Meaningful concepts from the PSFS responses were extracted and linked to the International Classification of Functioning, Disability and Health (ICF), according to the refined linking rules. Frequency for the ICF categories was estimated for primary- and secondary care, separately. Differences between primary and secondary care were investigated by calculating confidence intervals for the sample proportions, at ICF chapter level.Results Of the total 177 patients, 84 were recruited from primary care and 93 from secondary care. The primary care sample reported functional problems linked to 226 ICF categories, while 337 in secondary care. Of the linked ICF categories 87.7% belonged to the Activities and Participation component of the ICF. Seventeen categories were identified in > 3% of the patients, of those the most frequent were: Recreation and leisure (d920), Lifting and carrying objects (d430)’, Doing housework (d640), Hand and arm use (d445) and Remunerative employment (d850). Categories included in the ICF chapters Self-care (d5) and Domestic life (d6) were significantly more frequent in the secondary care sample, while there was a trend that b7 Neuromusculoskeletal and movement-related functions were more frequent in primary care.Conclusion The present findings indicate that patients with shoulder pain report a wide range of functional problems, from basic functions related to mobility to more complex functions related to work and leisure activities. This study also discovered differences in the report of functional problems between primary and secondary care patients. The large variation in the experiences between patients supports the use of an individualised measure to support assessment of functioning among shoulder patients.Trial registration Not applicable
Intraoperative Three-Dimensional Imaging in Ankle Syndesmotic Reduction.
Authors: Beck Markus , Brunk Manuela , Wichelhaus Alice , Mittlmeier Thomas , Rotter Robert 
Published: May 2020

Abstract
PurposeInjuries of the distal syndesmosis in ankle fractures are traditionally treated with a temporary adjusting screw fixation. Conventional fluoroscopic and X-ray examinations cannot reliably diagnose malpositions of the fixed tibiofibular syndesmosis. Postoperative computer tomography allows a reliable control of the transfixed region. The aim of the study was to clarify whether an intraoperative 3D image intensifier examination can detect malpositions of the syndesmosis already intraoperatively and whether the examination has an influence on the postoperative revision rate.MethodsIn 200 patients with tibiofibular syndesmosis injuries, an intraoperative 3D scan was performed after reduction of the distal tibiofibular syndesmosis and placement of the adjusting screw. Postoperative computer tomography of both ankle joints was performed in all patients.Results15% of all intraoperative 3D scans (30 patients) showed a finding requiring correction in the area of the ankle fork. In 7% of the cases, a malposition of the fibula in the tibial incisura requiring correction was found. Further corrections were necessary due to the extent and position of the osteosynthesis material (7%) and for the removal of joint bodies (1%). Postoperative computer tomographies of the ankle joints showed no deformities requiring revision.ConclusionAn intraoperative 3D scan allows a reliable assessment of the injured ankle region and reduces the postoperative revision rate. This makes a postoperative routine CT examination of the ankle joint dispensable.
Clinicians’ Experience of Providing Care: A Rapid Review
Authors: Iqbal Maha Pervaz , Manias Elizabeth , Mimmo Laurel , Mears Stephen , Jack Briony , Hay Liz , Harrison Reema 
Published: May 2020

Abstract
Background Health care services internationally are refocussing care delivery towards patient centred, integrated care that utilises effective, efficient and innovative models of care to optimise patient outcomes and system sustainability. Whilst significant efforts have been made to examine and enhance patient experience, to date little has progressed in relation to provider experience. This review aims to explore this knowledge gap by capturing evidence of clinician experience, and how this experience is defined and measured in the context of health system change and innovation. Methods: A rapid review of published and grey literature review was conducted utilising a rapid evidence assessment methodology. 79 studies retrieved from the literature were included in the review. 14 articles were identified from the grey literature search and one article obtained via hand searching. In total, 94 articles were included in the review. This study was commissioned by and co-designed with the New South Wales, Ministry of Health. Results: Clinician experience of delivering health care is inconsistently defined in the literature, with identified articles lacking clarity regarding distinctions between experience, engagement and work-related outcomes such as job satisfaction. Clinician experience was commonly explored using qualitative research that focused on experiences of discrete health care activities or events in which a change was occurring. Such research enabled exploration of complex experiences. In these contexts, clinician experience was captured in terms of self-reported information that clinicians provided about the health care activity or event, their perceptions of its value, the lived impacts they experienced, and the specific behaviours they displayed in relation to the activity or event. Moreover, clinician’s experience has been identified to have a paucity of measurement tools. Conclusion: Literature to date has not examined clinician experience in a holistic sense. In order to achieve the goals identified in relation to value-based care, further work is needed to conceptualise clinician experience and understand the nature of measurement tools required to assess this. In health system application, a broader ‘clinician pulse’ style assessment may be valuable to understand the experience of clinical work on a continuum rather than in the context of episodes of change/care.
Spatiotemporal Variability and Trends in Rainfall and Temperature in Alwero Watershed, Western Ethiopia
Authors: ALEMAYEHU ARRAGAW , Maru Molla , Bewket Woldeamlak , Assen Mohammed 
Published: May 2020

Abstract
Background Climate analysis at relevant time scales is important for water resources management, agricultural planning, flood risk assessment, ecological modeling and climate change adaptation. This study analyses spatiotemporal variability and trends in rainfall and temperature in Alwero watershed, western Ethiopia. The study is based on gridded monthly rainfall and maximum and minimum temperature data series at a resolution of 4 × 4 km which were obtained from the National Meteorological Agency of Ethiopia for the period 1983–2016. The study area is represented by 558 points (each point representing 4 × 4 km area).Results Mean annual rainfall of the watershed is > 1600 mm. Annual, June-September (Kiremt), March-May (Belg) rainfall totals exhibit low inter-annual variability. Annual and October-February (Bega) rainfall show statistically significant increasing trends at p = 0.01 level. May and November rainfall show statistically significant increasing trends at p = 0.01 level. March shows statistically significant decreasing trend at p = 0.1 level. The mean annual temperature of the watershed is 25 0C with standard deviation of 0.31 0C and coefficient of variation of 0.01 0C. Mean annual minimum and maximum temperatures show statistically non-significant decreasing trends. Bega season experienced statistically significant deceasing trend in the maximum temperature at p = 0.01 level. The year-to-year variability in the mean annual minimum and maximum temperatures showed that the 2000s is cooler than the preceding decades. Unlike our expectations, annual and seasonal rainfall totals showed increasing trends while maximum and minimum temperatures showed decreasing trends.Conclusions Our results suggest that local level investigations such as this one is important in developing context-specific climate change adaptation and agricultural planning, instead of coarse-scale national level analysis guiding local level decisions.
The correlation of intraoperative hypotension and postoperative cognitive impairment: a meta-analysis of randomized controlled trials
Authors: Feng Xiaojin , Hu Jialing , Hua Fuzhou , Zhang Jing , Zhang Lieliang , Xu Guohai 
Published: May 2020

Abstract
Background There is no consensus on whether intraoperative hypotension is associated with postoperative cognitive impairment. Hence, we performed a meta-analysis to evaluate the correlation of intraoperative hypotension and the incidence of postoperative delirium (POD) or postoperative cognitive dysfunction (POCD).Methods We searched PubMed, Embase, and Cochrane library databases to find randomized controlled trials (RCTs) in which reported the relationship of intraoperative hypotension and POD or POCD. The retrieval time is up to January 2020, without language restrictions. Quality assessment of the eligible studies was conducted by two researchers independently using the Cochrane evaluation system.Results Five RCTs were included. For the incidence of POD, there are two studies with 99 participants in the low-blood pressure (LP) group and 94 participants in the high-blood pressure (HP) group. For the incidence of POCD, there are four studies with 360 participants in the LP group and 341 participants in the HP group, with a study contains both POD and POCD. No significant difference between the LP and the HP group was observed in the incidence of POD (RR = 3.30, 95% CI 0.80 to 13.54, P = 0.10), or POCD (RR = 1.26, 95% CI 0.76 to 2.08, P = 0.37). Furthermore, it also demonstrated that intraoperative hypotension prolonged the length of ICU stay, but did not increased the mortality, the length of hospital stay, and mechanical ventilation (MV) time.Conclusions There is no significant correlation between intraoperative hypotension and the incidence of POD or POCD.
The effect of the fraction of inspired oxygen during alveolar recruitment on absorption atelectasis in laparoscopic surgery: A randomized, controlled trial
Authors: Kim Bo Rim , Lee Seohee , Bae Hansu , Lee Minkyoo , Bahk Jae-Hyon , Yoon Susie 
Published: May 2020

Abstract
Background
The intraoperative alveolar recruitment maneuver (ARM) efficiently treats atelectasis, but the effect of Fio2 during ARM on atelectasis is uncertain. Here, we investigated this effect.
Methods
Patients undergoing elective laparoscopic surgery in the Trendelenburg position were randomized to low- (Fio2 0.4; n = 44) and high-Fio2 (Fio2 1.0, n = 46) groups. ARMs were performed 1-min post tracheal intubation and post changes between supine and Trendelenburg positions during surgery. Intraoperative Fio2 was set at 0.4 for both groups. Modified lung ultrasound (LUS) scores were calculated to assess lung aeration after inducing anesthesia and at surgery completion. The primary outcome was modified LUS score at the end of the surgery, and secondary outcomes were the intra- and postoperative Pao2 to Fio2 ratio and postoperative pulmonary complications.
Results
Both groups presented similar modified LUS scores before capnoperitoneum and ARM (P = 0.747). However, the postoperative modified LUS score was significantly lower in the low- than in the high-Fio2 group (7.0 ± 4.1 vs 11.7 ± 4.2, mean difference 4.7, 95% CI 2.96–6.44, P < 0.001). Significant atelectasis postoperatively was more common in the high-Fio2 group (relative risk 1.77, 95% CI 1.27‒2.47, P < 0.001). Intra- and postoperative Pao2 to Fio2 were similar and no postoperative pulmonary complications occurred. Atelectasis occurred more frequently when ARM was performed with high than with low Fio2. High-Fio2 did not benefit oxygenation.
Conclusions
In patients undergoing laparoscopic surgery in the Trendelenburg position, absorption atelectasis occurred more frequently when the ARM was performed with high rather than low Fio2. No oxygenation benefit was observed in the high-Fio2 group.
Trial registration:
ClinicalTrials.gov, NCT03943433. Registered 7 May 2019, https://clinicaltrials.gov/ct2/show/NCT03943433
Quality of sleep and associated factors among people living with HIV/AIDS on follow up at Ethiopian Zewditu Memorial Hospital,2018
Authors: Mengistu Nebiyu , Azale Telake , Yimer Solomon , Fikreyesus Mahilet , Melaku Elsa , Shumye Seid 
Published: May 2020

Abstract
Background
Sleep disturbance is a common complaint in people living with HIV/AIDS. Those individuals with it are less likely to adhere to their antiretroviral therapy regimens, have decreased quality of life, have decreased work productivity as well as it may increase the risk for psychiatric disorders, cardiovascular morbidity and disease progression. However, it is not well studied in Ethiopia.
Methods
An institution based cross-sectional study was utilized among 408 participants selected by systematic sampling technique. The Pittsburgh Sleep Quality Index questionnaire was used to measure sleep quality. Binary and multivariable logistic regression models were fitted. Odds ratios (OR) with the corresponding 95% confidence interval (95%CI)) was computed to assess the strength of association. P-value < 0.05 was considered as statistically significant.
Results
The magnitude of poor sleep quality was 55.6%. Being female [AOR = 3.40, 95% CI: (1.80, 6.41)], depression [AOR = 3.52, 95% CI: (1.95, 6.32)], CD4count ≤ 200 cells/mm3 [AOR = 3.18,95%CI: (1.65,6.13)], duration of HIV/AIDS diagnosis [AOR = 3.43,95% CI: (1.61,7.29)], current use of tobacco [AOR = 5.69, 95% CI: (2.04,15.9)] and chat or caffeinated drinks [AOR = 2.65, 95% CI: (1.06,6.64)] and poor sleep hygiene [AOR = 3.55, 95% CI: (1.85, 6.78)] were significantly associated with poor sleep quality.
Conclusions
More than half of the study participants were found to have poor sleep quality. Routine screening of sleep condition among people living with HIV/AIDS and early intervention based on the findings is suggested.
Effects of enriched environment and probiotics on the intestinal mucosal barrier and the brain-gut axis in rats with colorectal cancer
Authors: Liu Dun , Xian-Yi Wu , Si-Ting Huang 
Published: May 2020

Abstract
Background

Enriched environment is a paradigm where animals are introduced to novel, complex, and stimulating surroundings that can protect the intestinal mucosal barrier and regulate the expression of brain-gut peptides. Probiotics can effectively protect the intestinal mucosal barrier and regulate brain-gut axis activity in colorectal cancer patients. This study assessed the effects of probiotics, enriched environment, and joint intervention on the intestinal mucosal barrier and brain-gut axis in rats with colorectal cancer.
Methods

We used a rat model of 1,2-dimethylhydrazine-induced colorectal cancer. Rats were housed in four different conditions for 2 weeks: enriched environment, probiotic,joint condition and normal condition. Each rat was weighed, and the intestinal mucosa and plasma levels of tumor TNF-α, IL-6, IL-10, ghrelin, CRF, occludin, BT, SIgA and the morphology of the intestinal mucosa were measured.
Results

enriched environment was beneficial regarding bacteria translation, plasma and intestinal mucosa levels of cytokines, plasma CRF levels, villi length and width of intestinal mucosa and hypothalamus ghrelin compared to probiotic (P < 0.05). There were no statistical differences between the enriched environment and the other groups regarding occludin, SIgA, muscle thickness or intestinal mucosa ghrelin (P > 0.05).
Conclusions

The effect of enriched environment was better than probiotic, especially in the intestinal mucosal immune and biological barrier in rats with colorectal cancer. However, the combination of the two was not as effective as enriched environment. In future studies, we can investigate the role of environment and probiotics in SIgA, intestinal mucosal mechanical barrier and body weight by extending the intervention time and enlarging the sample size.