bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spatial Distributions and Determinants of High-risk Fertility Behavior among Women in Ethiopia: Further Analysis from 2016 Ethiopia Demographic Health Survey
Authors: Tessema Zemenu Tadesse , Tamirat Koku Sisay 
Published: March 2020

Abstract
Background: High-risk fertility behavior associated with numerous unfavorable child and maternal health outcomes such as chronic undernutrition, anemia, and child mortality. Although different studies have been conducted to assess the magnitude and effects of high-risk fertility behaviors, there are limited shreds of evidence about the geographical distributions and determinants in Ethiopia. Therefore, this study aimed to assess the spatial distributions and determinants of high-risk fertility behavior among reproductive-age women in Ethiopia. Method: This study was based on secondary data analysis from the 2016 Ethiopia Demography and Health Survey. Information about 11,022 women who gave birth five years preceding the survey were extracted from the kid’s record (KR) file. For the spatial analysis ArcGIS 10.6 and Sat ScanTM 9.6, were used and for multilevel analysis, STATA 14.1 was used. Mixed effect Multivariable multilevel logistic regression model was fitted to identify determinants of high-risk fertility behavior.Result: More than three fourth (76.5%) with 95%CI (75.1 to 77.1) women had high-risk fertility behavior. From the spatial analysis, high-risk fertility behavior in Ethiopia geographically varies, the eastern and northern parts of the country such as Somalia and Tigray had an increased risk of fertility behavior. Primary education (AOR=0.71, 95% CI: 0.63 to 0.80) and secondary (AOR=0.73; 95% CI: 0.60 to 0.89), not ever used contraceptive (AOR=1.25, 95%CI: 1.12 1.40), unwanted pregnancy (AOR=1.40, 95%CI: 1.23 1.59), no ANC visit (AOR=1.19, 95%CI: 1.05 1.35), rural-dwelling (AOR=1.26, 95%CI: 1.04 1.51), regions of Ethiopia [Somalia (AOR=1.70,95%CI:1.24 2.32) and Amhara (AOR=0.72,95%CI:0.53 0.96)] were determinants of high risk fertility behavior.Conclusion: High-risk fertility behavior was significantly higher and geographical variations also noticed and the eastern and northern parts of the country were the hot spot areas. Education, rural residence, unwanted pregnancies, No ANC visit, and contraceptive use were determinants of high-risk fertility behavior. This suggests that areas with high-risk fertilities need special interventions to avert related complications.
Identification and Validation of an Individualized Autophagy-Clinical Prognostic Index in Gastric Cancer Patients
Authors: Jieping Qiu , Qiu Jieping , Sun Mengyu , Wang Yaoqun , Chen Bo 
Published: March 2020

Abstract
Background: The purpose of this study is to perform bioinformatics analysis of autophagy-related genes in gastric cancer, and to construct a multi-gene joint signature for predicting the prognosis of gastric cancer.Methods: GO and KEGG analysis were applied for differentially expressed autophagy-related genes in gastric cancer, and PPI network was constructed in Cytoscpae software. In order to optimize the prognosis evaluation system of gastric cancer, we established a prognosis model integrating autophagy-related genes. We used single factor Cox proportional risk regression analysis to screen genes related to prognosis from 222 autophagy-related genes in The Atlas Cancer Genome (TCGA) gastric cancer cohort. Then, the generated genes were applied to the Least Absolute Shrinkage and Selection Operator (LASSO). Finally, the selected genes were further included in the multivariate Cox proportional hazard regression analysis to establish the prognosis model. According to the median risk score, patients were divided into high-risk group and low-risk group, and survival analysis was conducted to evaluate the prognostic value of risk score. Finally, by combining clinical features and prognostic gene signatures, a nomogram was established to predict individual survival probability.Results: GO analysis showed that the 38 differently expressed autophagy-related genes was enriched in cell growth, neuron death, and regulation of cell growth. KEGG analysis showed that the 38 differently expressed autophagy-related genes were related to platinum drug resistance, apoptosis and p53 signaling pathway. The risk score was constructed based on 4 genes (GRID2, ATG4D,GABARAPL2, CXCR4), and gastric cancer patients were significantly divided into high-risk and low-risk groups according to overall survival. In multivariate Cox regression analysis, risk score was still an independent prognostic factor (HR = 1.922, 95% CI = 1.573-2.349, P < 0.001). Cumulative curve showed that the survival time of patients with low-risk score was significantly longer than that of patients with high-risk score (P < 0.001). The external data GSE62254 proved that nomograph had a great ability to evaluate the prognosis of individual gastric cancer patients.Conclusions: This study provides a potential prognostic marker for predicting the prognosis of GC patients and the molecular biology of GC autophagy.
Politicking with Health Care and Its Implications for the Attainment of Universal Health Coverage
Authors: Odii Aloysius , Ogbozor Pamela , Orjiakor Charles , Agwu Prince , Onwujekwe Obinna 
Published: March 2020

Abstract
Background Primary Health Centres (PHCs) are acknowledged key to the achievement of Universal Health Coverage (UHC) owing to their closeness to the grass-root and the constant patronage by low- and middle-income class citizens. An impediment to the efficiency of PHCs is the nature of politics on-going in its operation beginning from its physical construction, employment of staff, among others. This study provides evidence of politicking marring the efficiency of PHCs as well as possible solutions to the issue. Method The study was carried out in eight purposively selected PHC facilities drawn from three local government areas in Enugu State, southeast Nigeria. Data were collected using in-depth interviews (IDIs) and focus group discussions (FGDs). The IDIs involved sixteen participants that cut across frontline health workers, heads and supervisors of health units at the local governments, and chairpersons of the health facility committees (HFCCs). In addition, four FGDs were held with male and female service users of the facilities. Findings It was discovered that certain powerful community members influenced the locations of PHCs, even when the general community is disfavoured by such decision. Powerful group of persons equally influence the recruitment and sanctioning of healthcare staff. The consequences include weak patronage of the facilities and poor healthcare delivery. Of the several solutions, obtaining localised support from powerful persons in the community to enforce fairness featured strongly. Conclusions The politics around primary healthcare is a threat to the achievement of UHC, since it discourages patronage and encourages inefficiency of healthcare staff. To overcome this, there is the need to facilitate genuine participation of community members and implementing local actions and policies in the facilitation of PHCs, and also, rapidly addressing the excesses of powerful groups and individuals. Key words: Primary Health Centre; Politicking; Universal Health Coverage; Power; Politics
Leaky gut potentially leads to bacterial/endotoxin translocation in a rat model of non-ischemic acute kidney injury
Authors: Li Jiangtao , Moturi Krishna Rekha , Wang Lirui , Zhang Kun , Yu Ying , Liu Xi , Zhang Yingying , Yu Chen 
Published: March 2020

Abstract
Background: Emerging evidence indicates that there is a causal relationship between acute kidney injury (AKI) and gut barrier disruption. The aim of our study was to determine whether the translocation of gut-derived bacteria/endotoxin develops in non-ischemic AKI, and, if so, what is the mechanism behind it? Methods: SPF male Sprague-Dawley rats were randomly subjected to bilateral nephrectomy (BNx) or sham-operation and observed for 24 hours. Gut permeability was evaluated in vivo and in vitro. Serum endotoxin and bacterial loads in liver and mesenteric lymph nodes (MLN) were measured. The expression of the key tight junctions (TJs) in ileum, including zonula occluden-1(ZO-1), occludin and claudin-1 were evaluated by Western blot and immunohistochemical staining. The structure of TJs was observed using transmission electron microscopy. Apoptotic changes of ileal mucosa were evaluated by TUNEL staining and ELISA. Results: Non-ischemic AKI rats (rats subjected to BNx) demonstrated marked blunting and shortening of the gut villi. The gut mucosal permeability was increased in non-ischemic AKI rats, evidenced by the elevated serum levels of D-lactate and the increased amount of FITC-Dextran which passed through the ileum wall. Serum endotoxin was significantly elevated in non-ischemic AKI rats. Non-ischemic AKI rats had relatively higher bacterial loads in liver and MLN than sham-operated rats. For non-ischemic AKI rats, apoptosis of ileal mucosa was significantly accelerated. Neither the protein expression and the distribution pattern, nor the structure of the TJs was altered in non-ischemic AKI rats. Conclusion: Non-ischemic AKI results in profound gut barrier disruption and thus favors the subsequent episode of bacterial/endotoxin translocation. In this non-ischemic AKI model, the translocation of bacterial/endotoxin was not most likely due to a TJs mediated paracellular pathway.
Co-culture with leukemia cells decreases proliferation and increases chemoprotective capacity of normal mesenchymal stromal cells
Authors: Hou Ruixia , Yang Wanfang , Zhang Yaofang , Chen Xiuhua , Ren Fanggang , Xu Jing , Tan Yanhong , Xu Zhifang , Chang Jianmei , Wang Hongwei 
Published: March 2020

Abstract
Background Bone marrow mesenchymal stromal cells (BM-MSCs) are essential structural and functional components of the BM microenvironment and play an important role in acute myeloid leukemia (AML) pathogenesis. BM-MSCs isolated from AML patients (AML-MSCs) show distinct signatures from normal BM-MSCs. However, the exact abnormalities of AML-MSCs and the origin of these abnormalities are still unknown.Methods In this study, we evaluated the proliferative activity of AML-MSCs, and the influence of leukemia cells (LCs) on BM-MSCs. These two cell types were co-cultured using an in vitro co-culture system, and the biological functions of AML-MSCs, healthy donor derived MSCs (HD-MSCs), and LC-treated HD-MSCs (LCtrHD-MSCs) were compared by flow cytometry, and CCK-8 and chemotaxis assays. Student t-test (between two groups) and one-way ANOVA (more than 2 groups) were used to compare differences. Pearson correlation coefficients were used to assess correlations between two factors.Results AML-MSCs display a significant proliferative deficiency, which correlates with primary leukemic blast cell counts but not with patients’ age. Inhibition of BM-MSC proliferation could be induced by leukemia cells through direct contact. Co-cultured leukemia cells also increase expression of several inflammatory cytokines, and chemokines in BM-MSCs. Furthermore, LCtrHD-MSCs reduced apoptosis, and increased migration and chemoresistance in co-cultured AML cells, comparable with AML-MSCs.Conclusions Our results showed that leukemia cells can induce healthy donor derived BM-MSCs to exhibit AML-MSC-like characteristics and indicated that AML-MSC abnormalities may be partly induced by leukemia cells.
The value of TI-RADS combined with superb micro-vascular imagine in distinguishing benign and malignant thyroid nodules:a meta-analysis
Authors: Wang Cong , Hou Xiukun 
Published: March 2020

Abstract
This meta-analysis aimed to evaluate the value of thyroid imaging report and data system (TI-RADS) combined with superb micro-vascular imagine technique(SMI) in distinguishing benign and malignant thyroid nodules. We searched PubMed, Web of Science, Google Scholar, Cochrane Library, EBSCO, and CBM databases from inception through January 1st, 2015 without language restrictions. Meta-analysis was conducted using STATA version 14.0 and Meta-Disc version 1.4 softwares. We calculated the summary statistics for sensitivity(Sen), specificity(Spe), and receiver operating characteristic (SROC) curve. Six studies that met all inclusion criteria were included in this meta-analysis. A total of 408 thyroid malignant nodules and 496 thyroid benign nodules were assessed. All thyroid nodules were histologically confirmed after SMI. The pooled Sen and Spe of TI-RADS were 0.80(95%CI=0.71-0.87) and 0.82(95%CI=0.75-0.87); The pooled Sen and Spe of TI-RADS combined with SMI were 0.88 (95%CI=0.80-0.91) and 0.89 (95%CI=0.85-0.92). The areas under the SROC curve of TI-RADS and TI-RADS combined with SMI were 0.8874(SE=0.0165) and 0.9415(SE=0.0102), between which there was significant difference(Z=2.789; SE=0.0194; p =0.0053). Our meta-analysis indicates that TI-RADS combined with SMI may have high diagnostic accuracy, and is more effective than single TI-RADS in distinguishing benign and malignant thyroid nodules.
Obstetric Fistula: a retrospective study of 413 cases in Haut-Katanga Province, Democratic Republic of Congo
Authors: Nsambi Joseph B. , Mukuku Olivier , Kakudji Prosper L. , Andrianne Robert , Kakoma Jean-Baptiste S.Z. 
Published: March 2020

Abstract
Background: In developing countries, fistulae are generally caused by long obstructed labors. Obstetric fistula (OF) is a severe condition which can have devastating consequences for a woman’s life.This study aims to describe the socio-demographic and delivery characteristics of patients with OF in Haut-Katanga province in the Democratic Republic of Congo.Methods: This is a prospective descriptive study of 413 patients with OF in Haut-Katanga province during the period from September 2009 to December 2018.Results: At fistula occurrence, 53.3% of patients were younger than 20 years (mean age: 21.3 ± 6.7 years) and 65.8% were primiparous. More than half had primary education and 39.7% were illiterate; 70.2% of the patients were separated or divorced. Fistula developed after delivery at home in 239 (57.9%) of 413 women. A total of 393 (95.2%) women developed fistula after vaginal delivery. A total of 387 (93.7%) of the 413 women reported that the fetus did not survive the labor during which fistula developed. 92.3% had a vesico-vaginal fistula and the mean age of fistula was 6.5 years. Surgical repair was successful in 82.9%.Conclusion: Obstructed labor remains the most important cause of OF in Haut-Katanga. It is important to prevent OF arising from obstructive causes. The surgical treatment of OF will depend upon the type, size and location of fistula.
BRCA detection rate in an Italian cohort of luminal early-onset and triple-negative breast cancer patients without family history: when biology overcomes genealogy.
Authors: Toss Angela , Molinaro Eleonora , Venturelli Marta , Domati Federica , Marcheselli Luigi , Piana Simonetta , Barbieri Elena , Grandi Giovanni , Piombino Claudia , Marchi Isabella , Tenedini Elena , Tagliafico Enrico , Tazzioli Giovanni , Cortesi Laura 
Published: March 2020

Abstract
BACKGROUND: NCCN Guidelines recommend BRCA genetic testing in individuals with a probability >5% of being a carrier. This analysis aimed to evaluate the rate of BRCA mutations in triple-negative breast cancer (TNBC) patients diagnosed ≤60 years and luminal-like breast cancer (BC) patients diagnosed ≤35 without breast and/or ovarian family history. METHODS: 159 TNBC patients diagnosed ≤60 years and 109 luminal-like BC patients diagnosed ≤35 years without family history were retrospectively identified. Mutation prevalence and clinical-pathological characteristics associated with mutational status were evaluated. RESULTS: In TNBC patients, BRCA mutation prevalence was 22.6% (21.4% BRCA1 and 1.2% BRCA2). BRCA1-related TNBC patients were younger (p <0.001). Mutation prevalence was 64.2% ≤30 years, 31.8% in patients aged 31-40, 16.1% for those aged 41-50 and 7.9% for those between 51 and 60 years of age. A total of 40% of patients with estrogen receptor (ER) 1-9% were BRCA1 carriers. BRCA detection rate in early-onset BCs was 6.4% (1.8% BRCA1 and 4.6% BRCA2). Mutation prevalence was 0% 0-25 years, 9% 26-30 years and 6% 31-35 years. BRCA2-positive luminal-like early-onset BCs were more likely associated with low progesterone receptor (PR) expression (p = 0.049). CONCLUSIONS: BRCA genetic testing is recommended in TNBC diagnosed ≤ 60 years, regardless of cancer family history, histotype and by using immunohistochemical staining <10% of nuclei for both ER and/PR as a cut-off. In luminal-like early-onset BC patients, a lower BRCA detection rate was observed, suggesting a role for other predisposing genes.
Challenges of clinical chemistry analyzers utilization in public hospitals of selected zones of Oromia region, Ethiopia
Authors: Belete Rebuma Benti , Cheneke Waqtola Gebisa , Getachew Aklilu Mamo , Abdu Ahmedmemewer Seid 
Published: March 2020

Abstract
Background: The modern practice of clinical chemistry relies ever more heavily on automation. Their utilization in clinical laboratories of developing countries is greatly affected by many factors. Thus, identifying the different challenges relating to clinical chemistry automation utilization faced by laboratories is important to work on and resolve. Method: Cross-sectional study was conducted in 15 public hospitals found in Southwest Shoa, Jimma, Ilubabor and Buno-Bedele zones of Oromia region, Ethiopia from January 28 to March 15, 2019. Sixty eight key informants and ninety three laboratorians who were working in the clinical chemistry section were included in the study. Data were collected by self-administered questionnaires, indepth interviews and observation. The quantitative data were analyzed by simple descriptive statistics using SPSS 25.0 whereas qualitative data were analyzed manually. Results: There were 14 different models of clinical chemistry analyzers. More than two-thirds of analyzers were out-of-service. In another way, only 14 (15.1%) of the laboratorians had received user training of clinical chemistry analyzers. Majority of the laboratories were suffered from clinical chemistry reagents shortage. There were also inappropriate procurement processes of the clinical chemistry analyzers, misuse and underuse of clinical chemistry tests. Conclusion: The survey and interviews specified six major challenges that seriously obstruct utilization of clinical chemistry analyzers. Keywords: Challenges; analyzers utilization; clinical chemistry analyzers; automation.
Changes of Three kinds of miRNAs, MALAT1 and PI3K/AKT/mTOR signaling pathway Protein Levels in Her-2 Positive Breast Cancer in neoadjuvant chemotherapy and their relationship with prognosis- -A small sample study report
Authors: Hongcan Zhao , xiping zhang 
Published: March 2020

Abstract
Objective To investigate the roles of three kinds of miRNAs (MiR-99a, MiR-455 and MiR-143), Lnc MALAT1 and related proteins of PI3K/AKT/mTOR signaling pathway in neoadjuvant chemotherapy of patients with Her-2 positive breast cancer (BC) and analysed their related mechanisms. Method The frozen tumor tissue and serum samples before and after neoadjuvant chemotherapy of 14 cases patients with Her-2 positive BC who received neoadjuvant chemotherapy were collected. The relative expressions level of MiR-99a, MiR-455, MiR-143, MALAT1 and related proteins of PI3K/AKT/mTOR signaling pathway in tumor tissue and a part of serum samples were detected by qRT-PCR or western blot. Results MiR-99a level was negatively correlated with RFS and OS before and after chemotherapy. MiR-99a and MiR-455 levels after chemotherapy was negatively correlated with OS. The serum MALAT1 level was negatively correlated with RFS and OS in chemosensitivity group before and after chemotherapy. In chemotherapy resistance group, p-AKT level before chemotherapy was negatively correlated with T stage, p-mTOR level after chemotherapy was positively correlated with lymph node stage and negatively correlated with RFS and OS, PTEN level was negatively correlated with clinical TNM stage. Conclusion Serum MALAT1 and MiR-99a, MiR-455, MiR-143, p-AKT, p-mTOR and PTEN of tumor tissues in Her-2 positive BC patients can be used as markers to judge neoadjuvant chemotherapy sensitivity in Her-2 positive BC. Chemotherapy resistance is may be related to PI3K/AKT/mTOR signaling pathway.
The Tunica vaginalis testis metastasis as the first clinical manifestation of pancreatic adenocarcinoma: a case report and and literature review
Authors: zhang yongrui , guo kaimin , ma dongkai , gao baoshan , an wei , fu yaowen 
Published: March 2020

Abstract
Background: Metastases from pancreas or ampullary malignancies are common, but spread to the testicle and paratesticular tissue is exceedingly rare. To our knowledge, few than 30 cases have been previously reported in the literature. More rarely, it is to be found with tunica vaginalis testis metastasis without involvement of testicle and epididymis. Case presentation: A 65-year-male with complaints of left painless scrotal swellings for over 1 week was referred to the Department of Urology . Scrotal ultrasound demonstrated a left sided hydrocele with paratesticular masses.The chest computed tomography showed lung metastases and left enlarged supraclavicular lymph node. The preoperative diagnosis was left testicular tumor with lung metastasis.Then, a left radical orchidectomy was performed with high ligation of the spermatic cord and postoperative histopathology showed that it was suggestive of metastatic tumors. Abdominal computed tomography revealed the presence of a tumor in the tail of the pancreas. Tumor markers cancer antigen CA 19-9 were elevated almost 6-fold levels. The outcome of this patient was unsatisfactory and died 3 months later. Conclusions: This case highlighted that metastatic carcinoma from the pancreas must be considered in the differential diagnosis of scrotal enlargement. Older patient age is suggestive of a secondary testicular tumor. In addition, careful clinical and radiological examination has become the imaging modality.