bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nutritional status and associated factors among high school adolescents in Debre Tabor Town, South Gondar Zone, Northcentral Ethiopia
Authors: Zemene Melkamu Aderajew , Engidaw Melaku Tadege , Gebremariam Alemayehu Digssie , Asnakew Desalegn Tesfa , Tiruneh Sofonyas Abebaw 
Published: November 2019

AbstractBackgroundAdolescents are among the nutritionally vulnerable group due to their nutritional demand for pubertal spurt. At this age, adequate nutrition, nutritional education, and counseling are very important to halt the consequence and its impact on this segment of the population. So, the aim of this study was to assess the prevalence and its associated factors of nutritional status among high school adolescents aged 10–19 years in Debre Tabor Town, South Gondar Zone, and North central Ethiopia.MethodsA cross-sectional study was conducted from September to October 2017. A total of 349 high school adolescents were selected by using simple random sampling. Data were collected through face to face interview and physical measurement. The data were entered into Epi info version 7 software and then exported into SPSS version 20 software for further analysis. Ap-value < 0.2 was used to select independent variables for multivariable logistic regression. A p-value ≤0.05 was used to declare the statistical significance. Also, odd ratios were calculated with a 95% of the confidence interval to check the existence of the association.ResultA total of 327 adolescents participated in this study with the overall response rate of 93.69%. The magnitude of stunting and thinness was 15% (95% CI: 11, 19) and 4.9% (95% CI: 2.4, 7.4) respectively. Sex (AOR: 2.24, 95% CI: 1.15, 4.36), residency (AOR: 2.48, 95% CI: 1.28, 4.82), and family size (AOR: 3.41, 95% CI: 1.65, 7.05) were the associated factors for stunting. Residence (AOR: 3.67, 95% CI: 1.16, 11.56), and living away from the family (AOR: 4.37, 95% CI: 1.20, 15.95) were the associated factors for the development of thinness.ConclusionStunting is a mild public health problem but not thinness. Sociodemographic variables were the determinant factors for the development of stunting and thinness. To halt this, integrated adolescent related school and nutrition services is very important with adequate and quality food access to adolescents. In addition to this the government shall have to increase the access of education.
Influence of breast reconstruction on technical aspects of echocardiographic image acquisition compared with physician-assessed image quality
Authors: Duarte Ow Joaquin , Hemu Mohamad , Yakupovich Anel , Bhatt Parva , Gaddam Hannah , Prabhu Nicole , Fughhi Ibtihaj , Cobleigh Melody , Tracy Melissa , Fogg Louis , Okwuosa Tochukwu 
Published: November 2019

Abstract

Introduction
Assessment of cardiac function after treatment for breast cancer relies on interval evaluation of ventricular function through echocardiography. Women who undergo mastectomy more frequently choose to undergo breast reconstruction with implant. This could impede assessment of cardiac function in those with left-sided implant. We aimed to examine whether left-sided breast reconstruction with tissue expanders (TE) affect echo image acquisition and quality, possibly affecting clinical decision-making.

Methods
A retrospective case-control study was conducted in 190 female breast cancer patients who had undergone breast reconstruction with TE at an urban academic center. Echocardiographic technical assessment and image quality were respectively classified as excellent/good or adequate/technically difficult by technicians; and excellent/good or adequate/poor by 2 board-certified cardiologist readers. Likelihood ratio was used to test multivariate associations between image quality and left-sided TE.

Results
We identified 32 women (81.3% white; mean age 48 years) with left-sided/bilateral TE, and 158 right-sided/no TE (76.6% white, mean age 57 years). In multivariable analyses, we found a statistically significant difference in technician-assessed difficulty in image acquisition between cases and controls (p = 0.01); but no differences in physician-assessed image quality between cases and controls (p = 0.09, Pearson’s r = 0.467).

Conclusions
Left-sided breast TE appears to affect the technical difficulty of echo image acquisition, but not physician-assessed echo image quality. This likely means that echo technicians absorb most of the impediments associated with imaging patients with breast TE such that the presence of TE has no bearing on downstream clinical decision-making associated with echo image quality.
Clinical features and outcomes of prolonged mechanical ventilation: a single-center retrospective observational study
Authors: Nagata Isao , Takei Tetsuhiro , Hatakeyama Junji , Toh Masafumi , Yamada Hiroyuki , Fujisawa Michiko 
Published: November 2019

Abstract

Background
Information on epidemiology of prolonged mechanical ventilation (PMV) patients in the acute care setting in Japan is totally lacking. We aimed to investigate clinical features, impact, and long-term outcomes of PMV patients.

Methods
This was a retrospective observational study conducted in a tertiary care hospital. Adult patients who were admitted to our intensive care unit (ICU) from April 2009 to March 2014 and required mechanical ventilation (MV) for ≥ 2 days were included. PMV was defined as having MV for ≥ 21 consecutive days.

Results
Among 1282 MV patients, 93 (7.3%) required PMV, and median duration of MV was 37.0 days. Compared with the non-PMV patients, PMV patients had longer total ICU and high care unit (HCU) stay (34.0 vs. 7.0 days, p < 0.001), longer hospital stay (74.0 vs. 35.0 days, p < 0.001), and higher hospital mortality (54.8 vs. 21.4%, p < 0.001). In multivariable logistic regression analysis, emergency ICU admission and steroid use during MV were associated with PMV. The Kaplan–Meier curves for MV withdrawal and ICU/HCU discharge were almost identical. Among PMV patients, 52 (55.9%) died, 29 (31.2%) were successfully liberated from MV during hospitalization, and 12 (12.9%) still required MV at discharge.

Conclusion
In this investigation, 7.3% of the patients with MV required PMV. Most PMV patients were liberated from MV during hospitalization, while occupying critical care beds for an extended period. A nationwide survey is required to further elucidate the overall picture of PMV patients and to discuss whether specialized weaning centers to treat PMV patients are required in Japan.
The effects of hemodynamic management using the trend of the perfusion index and pulse pressure variation on tissue perfusion: a randomized pilot study
Authors: Godai Kohei , Matsunaga Akira , Kanmura Yuichi 
Published: November 2019

AbstractBackgroundIntraoperative hemodynamic management is challenging because precise assessment of the adequacy of the intravascular volume is difficult during surgery. Perfusion index (PI) has been shown to reflect changes in peripheral circulation perfusion. Pulse pressure variation (PPV) reflects the preload responsiveness. The hypothesis of this study was that hemodynamic management using the trend of the PI and PPV would improve tissue perfusion.MethodsThis was a prospective, randomized, parallel design, single-blind, single-center pilot study. Patients undergoing elective open gynecological surgery requiring a direct arterial line were included. The patients were randomly allocated to two groups. The intervention group received hemodynamic management using the trend of the PI and PPV in an effort to improve tissue perfusion. The control group received hemodynamic management at the discretion of the anesthesia care provider. The primary outcome was the peak lactate level during surgery. The secondary outcomes were the duration of hypotension, intraoperative fluid balance, intraoperative urine output, and postoperative complication rate. Statistical analysis was performed using Student’sttest and Fisher’s exact test. APvalue of < 0.05 was considered statistically significant.ResultsAlthough the intervention significantly decreased the duration of hypotension and intraoperative fluid balance, the peak lactate level was not different between the intervention group and the control group. Intraoperative urine output and postoperative complication rate were not different between the groups.ConclusionHemodynamic management using the trend of the PI and PPV does not improve tissue perfusion in patients undergoing open gynecological surgery.Trial registrationThis trial was prospectively registered on a publicly accessible database (UMIN Clinical Trials Registry ID: UMIN 000026957. Registered 12 April 2017,https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000030916).
Fully automating fine-optics manufacture - why so tough, and what are we doing?
Authors: Walker David Douglas , McCluskey Thomas Leo , Yu Guoyu , Petrovic Sanja , Li Hongyu 
Published: November 2019

Abstract
Precision and ultra-precision surfaces are crucial for many products – quality optics, joint & cranial implants, turbine blades, and industrial moulds & dies, to name a few. Automation in this context is distinct from standard procedures in industry, where the identical sequence of operations can be repeated over and over again. Ultraprecision tolerances may be tens to hundreds of times tighter, and this is compounded by the hundreds of diverse substrate materials in use. Even with modern computer numerically controlled (CNC) machines, skilled craftspeople are needed to plan a process-chain for a new material or geometry. Processes working at these tight tolerances, fall short of being fully-deterministic, so repeated process-metrology iterations are required. Surface-correction loops may be automated, but expert assessment should be performed at each step to check for unexpected anomalies. The ultimate goal of importing a part, processing autonomously, and delivering a finished part to an “optical” specification with no human intervention, is still a long way off. This paper describes the challenge and why it is important. It then melds together process-monitoring, psychology, artificial intelligence and robotics, to take a far-sighted view of how the ultimate goal can be realised.
Use of a steerable microcatheter during superselective angiography: impact on radiation exposure and procedural efficiency
Authors: Hoffmann Jason C. , Minkin Jonathan , Primiano Nicholas , Yun Jung , Eweka Abieyuwa 
Published: November 2019

Abstract

Background/purpose
To study steerable microcatheter (SM) use in moderate and highly difficult vessel selection compared to conventional pre-shaped microcatheter (CM) use.

Material and methods
An IRB approved, single institution analysis of 40 complex angiographic procedures with and without superselective microcatheter use during an eight-month period in 2017 was performed. Target vessels were deemed moderate or highly difficult to select based on vessel size, tortuosity, and/or angulation during non-selective initial angiography. Data collected included type of microcatheter used (SM or CM), number of microcatheters and microwires used, procedure time, radiation exposure index (dose area product/DAP), target vessel location, and time to target vessel selection (TTVS; time from device placement to vessel selection). Comparison between the SM and CM groups was performed using Wilcoxon test.

Results
A SM (SwiftNinja, Merit Medical, South Jordan, UT, USA) was used to select 46 vessels in 20 patients. One or more CMs were used in 20 patients to select 34 vessels. Median TTVS, number of microwires used, total procedure time, and DAP (microGray.m2) were 12 vs. 462.5 s (p < 0.0001), 0 vs. 2 (p < 0.001), and 26,948 vs. 30,904 (p = 0.15) in the SM vs. CM groups, respectively. When adjusted for body mass index (BMI) using a linear model for radiation exposure, patients in the SM group had lower radiation exposure than those in the CM group (p = 0.05).

Conclusions
Utilization of a steerable microcatheter, without or with a guidewire, leads to easier and faster target vessel selection with shorter procedure times in complex vessel anatomy.
A putative N-BAR-domain protein is crucially required for the development of hyphae tip appressorium-like structure and its plant infection in Magnaporthe oryzae
Authors: Lin Lili , Chen Xiaomin , Shabbir Ammarah , Chen Si , Chen Xuewen , Wang Zonghua , Norvienyeku Justice 
Published: November 2019

Abstract
Membrane remodeling modulates many biological processes. The binding of peripheral proteins to lipid membranes results in membrane invaginations and protrusions, which regulate essential intra-cellular membrane and extra-cellular trafficking events. Proteins that bind and re-shape bio-membranes have been identified and extensively investigated. The Bin/Amphiphysin/Rvs (BAR) domain proteins are crescent-shape and play a conserved role in tubulation and sculpturing of cell membranes. We deployed targeted gene replacement technique to functionally characterize two hypothetical proteins (MoBar-A and MoBar-B) containing unitary N-BAR domain in Magnaporthe oryzae. The results obtained from phenotypic examinations showed that MoBAR-A deletion exerted a significant reduction in the growth of the defective ∆Mobar-A strain. Also, MoBAR-A disruption exclusively compromised hyphae-mediated infection. Additionally, the targeted replacement of MoBAR-A suppressed the expression of genes associated with the formation of hyphae tip appressorium-like structure in M. oryzae. Furthermore, single as well as combined deletion of MoBAR-A and MoBAR-B down-regulated the expression of nine different membrane-associated genes. From these results, we inferred that MoBAR-A plays a key and unique role in the pathogenesis of M. oryzae through direct or indirect regulation of the development of appressorium-like structures developed by hyphae tip. Taken together, these results provide unique insights into the direct contribution of the N-BAR domain proteins to morphological, reproduction, and infectious development of M. oryzae.
Assessment of left ventricular systolic and diastolic functions in severely malnourished children
Authors: Bebars Gihan M. , Askalany Hany T. 
Published: November 2019

Abstract

Background
Malnourished children endure many changes in body composition and lose heart and skeletal muscle mass. Diastolic dysfunction is one of the major causes of heart failure with preserved ejection fraction.

Aim
To assess left ventricular systolic and diastolic functions in children with severe acute malnutrition using tissue Doppler imaging technique and to evaluate the effect of nutritional rehabilitation.

Patients and Methods
A follow-up case-control study conducted on 60 severely malnourished children (WHZ < -3SD) and 120 age and sex-matched healthy children as a control group. Tissue Doppler imaging (TDI) was done for all included malnourished children at admission and for control to measure left ventricular systolic and diastolic functions. Nutritional rehabilitation was done according to WHO protocol and tissue doppler was repeated after rehabilitation when (WHZ > -2SD) to detect any changes in systolic or diastolic functions.

Results
Systolic function was normal in malnourished children and control. Grade I diastolic dysfunction was detected in 40% and grade II in 30% of severely malnourished children in comparison to 100% normal diastolic function in control group. No correlations between diastolic dysfunction and either anthropometric measurements, electrolyte disturbances or Hb% in malnourished children before nutritional rehabilitation. Mortality from sepsis with associated ventricular dysfunction grade II documented in 3.3% of malnourished children. After nutritional rehabilitation diastolic function improved significantly as 65.6% of children attained normal diastolic function, 31% grade1 and 3.4% grade II. Positive correlations between diastolic function and WAZ, HAZ, WHZ and MUAC after rehabilitation.

Conclusion
Severe acute malnutrition affects diastolic function in children which is reversible in most of these cases with rehabilitation. TDI is an easy and practical method for detection and follow-up of ventricular function in malnourished children.
Role of annexin A2 and osteopontin for early diagnosis of hepatocellular carcinoma in hepatitis C virus patients
Authors: Hanno Abd El-Fattah F. , Abd El-Aziz Fatma M. , Deghady Akram A. , El-Kholy Ehab H. , Aborawy Aborawy I. 
Published: November 2019

Abstract

Background
Liver cancer is the fifth most common cancer and the second most frequent cause of cancer-related death globally. Early stages of hepatocellular carcinoma (0&A) can be treated with curative procedures. The aim of this work was to evaluate the role of annexin A2 and osteopontin for early diagnosis of hepatocellular carcinoma in hepatitis C virus patients.

Methods
The study was carried out on 80 patients classified into two groups. Group A had 40 chronic hepatitis C patients without hepatocellular carcinoma, while group B had 40 chronic hepatitis C patients with early hepatocellular carcinoma (stages; 0&A). All patients were subjected to thorough history taking, clinical examination, liver function tests, renal function tests, serum alpha-fetoprotein, serum osteopontin, and serum annexin A2.

Results
Serum alpha-fetoprotein was found to be statistically significantly higher in patients with the hepatocellular carcinoma group than the chronic hepatitis C group. The ROC curve for alpha-fetoprotein for detection of HCC was significant, its diagnostic performance was 0.818* (p < 0.001*), and the cutoff point for predicting the probability for HCC was 6.0 (ng/ml) with sensitivity of 77.50%, specificity of 82.50%, positive predictive value of 81.60%, negative predictive value of 78.6%, and accuracy of 80%. Serum osteopontin was found to be statistically significantly higher in patients from the hepatocellular carcinoma group than the chronic hepatitis C group. The ROC curve for osteopontin was significant, its diagnostic performance was 0.739* (p < 0.001*), the cutoff point was 13.2 (ng/ml) with sensitivity of 65.0%, specificity of 90.0%, positive predictive value of 86.70%, negative predictive value of 72.0%, and accuracy of 77.0%. Serum annexin A2 was found to be statistically significantly higher in patients from the hepatocellular carcinoma group than the chronic hepatitis C group. The ROC curve for annexin A2 was significant, its diagnostic performance was 0.927* (p < 0.001*), the cutoff point was 10.1(ng/ml) with sensitivity of 85.0%, specificity of 85.0%, positive predictive value of 85.0%, negative predictive value of 85.0%, and accuracy of 85.0%.

Conclusions
Osteopontin had better specificity but lower sensitivity than serum alpha-fetoprotein for early diagnosis of hepatocellular carcinoma. Annexin A2 had better diagnostic sensitivity and specificity than alpha-fetoprotein for early diagnosis of hepatocellular carcinoma.
Problems posed by the Werther effect as a ‘net effect’: a comment on recent scholarly work on the effects of 13 Reasons Why
Authors: Arendt Florian , Romer Daniel 
Published: November 2019

SummaryRecent research estimated that an additional 195 suicides among 10- to 17-year-old youths occurred following the release of the television series 13 Reasons Why. There is an underrecognised aspect in this line of research that this effect represents a net effect based on different possible underlying patterns (e.g. +195/−0 or +395/−200).
Opioid Epidemic or Pain Crisis? Using the Virginia All Payer Claims Database to Describe Opioid Medication Prescribing Patterns and Potential Harms for Patients With Cancer
Authors: LeBaron Virginia T. , Camacho Fabian , Balkrishnan Rajesh , Yao Nengliang (Aaron) , Gilson Aaron M. 
Published: November 2019

PURPOSE: A key challenge regarding the current opioid epidemic is understanding how concerns regarding opioid-related harms affect access to pain management, an essential element of cancer care. In certain regions of the United States where disproportionately high cancer mortality and opioid fatality rates coexist (such as southwest Virginia in central Appalachia), this dilemma is particularly pronounced. METHODS: This longitudinal, exploratory, secondary analysis used the Commonwealth of Virginia All Payer Claims Database to describe prescription opioid medication (POM) prescribing patterns and potential harms for adult patients with cancer living in rural southwest Virginia between 2011 and 2015. Descriptive and inferential statistical analyses were conducted at the patient, prescriber, and prescription levels to identify patterns and predictors of POM prescribing and potential harms. To explore geographic patterns, choropleth and heat maps were created. RESULTS: Of the total sample of patients with cancer (n = 4,324), less than 25% were prescribed a Controlled Substance Schedule II POM at least three times in any study year. More than 60% of patients never received a Controlled Substance Schedule II POM prescription. Six hundred fifty-two patients (15.1%) experienced 1,599 hospitalizations for any reason; 10 or fewer patients were admitted for 11 opioid use disorder–related hospitalizations. The main findings suggest potential undertreatment of cancer-related pain; no difference in risk for opioid-related hospitalization on the basis of frequency of POM prescriptions; and geographic disparities where opioid overdoses are occurring versus where POM prescription use is highest. CONCLUSION: These findings have significant opioid policy and practice implications related to the need for cancer-specific prescribing guidelines, how to optimally allocate health delivery services, and the urgent need to improve data interoperability and access related to POMs.
IGFBP-1 in Cardiometabolic Pathophysiology—Insights From Loss-of-Function and Gain-of-Function Studies in Male Mice
Authors: Haywood Natalie J , Slater Thomas A , Drozd Michael , Warmke Nele , Matthews Connor , Cordell Paul A , Smith Jessica , Rainford Jethro , Cheema Harneet , Maher Caitlyn , Bridge Katherine I , Yuldasheva Nadira Y , Cubbon Richard M , Kearney Mark T , Wheatcroft Stephen B 
Published: November 2019

Abstract
We have previously reported that overexpression of human insulin-like growth factor binding protein (IGFBP)-1 in mice leads to vascular insulin sensitization, increased nitric oxide bioavailability, reduced atherosclerosis, and enhanced vascular repair, and in the setting of obesity improves glucose tolerance. Human studies suggest that low levels of IGFBP-1 are permissive for the development of diabetes and cardiovascular disease. Here we seek to determine whether loss of IGFBP-1 plays a causal role in the predisposition to cardiometabolic disease. Metabolic phenotyping was performed in transgenic mice with homozygous knockout of IGFBP-1. This included glucose, insulin, and insulin-like growth factor I tolerance testing under normal diet and high-fat feeding conditions. Vascular phenotyping was then performed in the same mice using vasomotor aortic ring studies, flow cytometry, vascular wire injury, and angiogenesis assays. These were complemented with vascular phenotyping of IGFBP-1 overexpressing mice. Metabolic phenotype was similar in IGFBP-1 knockout and wild-type mice subjected to obesity. Deletion of IGFBP-1 inhibited endothelial regeneration following injury, suggesting that IGFBP-1 is required for effective vascular repair. Developmental angiogenesis was unaltered by deletion or overexpression of IGFBP-1. Recovery of perfusion following hind limb ischemia was unchanged in mice lacking or overexpressing IGFBP-1; however, overexpression of IGFBP-1 stimulated hindlimb perfusion and angiogenesis in insulin-resistant mice. These findings provide new insights into the role of IGFBP-1 in metabolic and vascular pathophysiology. Irrespective of whether loss of IGFBP-1 plays a causal role in the development of cardiometabolic disorders, increasing IGFBP-1 levels appears effective in promoting neovascularization in response to ischemia.