bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of sickle cell disease with nutritional status among under-five children and mediating role of hemoglobin level: secondary analysis of data from 2018 Nigeria Demographic and Health Survey
Authors: Islam Mohammad Redwanul , Moinuddin Md. , Ahmed Ayeda , Rahman Syed Moshfiqur 
Published: August 2020

Abstract
Background: Malnutrition continues to affect under-five children in Africa to an overwhelming proportion. The situation is further compounded by the burden of sickle cell disease (SCD). However, association of SCD with stunting, wasting, and underweight in a nationally representative sample of under-five children remains unexplored. We aimed to describe prevalence of undernutrition by sickle cell status, to evaluate its association with growth faltering ascertained with anthropometric indices, and to explore mediating role of hemoglobin.Methods: We availed data from the 2018 Nigeria Demographic and Health Survey (DHS) and the sample comprised 11233 children aged 6–59 months who were successfully genotyped for SCD. The DHS employed a two-stage stratified sampling strategy. SickleSCAN rapid diagnostic test was used for SCD genotyping. Z-scores of length/height-for-age (HAZ), weight-for-height (WHZ), and weight-for-age (WAZ) were computed against the 2006 World Health Organization Child Growth Standards. We fitted logistic regression models to evaluate association of SCD with stunting, wasting, and underweight. Mediation analysis was performed to capture the indirect effect of, and proportion of total effect mediated through hemoglobin level in SCD-anthropometric indices association.Results: Prevalences of stunting, wasting, and underweight among children with SCD were 55.4% (54.5–56.4), 9.1% (8.6–9.7), and 38.9% (38.0-39.8), respectively. The odds of stunting were 2.39 times higher (adjusted odds ratio (aOR) 2.39, 95% CI: 1.26–4.54) among sickle children than those with normal hemoglobin. SCD was also significantly associated with underweight (aOR 2.64, 95% CI: 1.25–5.98), but not with wasting (aOR 1.60, 95% CI: 0.85–3.02). Hemoglobin level significantly mediated SCD-HAZ (adjusted indirect effect (aIE) -0.328, 95% CI: -0.387, -0.270), SCD-WHZ (aIE − 0.080, 95% CI: -0.114, -0.050), and WAZ (aIE − 0.245, 95% CI: -0.291, -0.200) associations. The extent of mediation was highest for SCD-HAZ association (adjusted proportion mediated 0.928, 95% CI: 0.535–2.770).Conclusion: We presented compelling evidence of the negative impact of SCD on nutritional status of under-five children. Integration of a nutrition-oriented approach into a definitive SCD care package and its nation-wide implementation could bring promising results by mitigating the nutritional vulnerability of children with SCD.
Dietary protein is the strong predictor of coronary artery disease; a data mining approach
Authors: Soflaei Sara Saffar , Shamsara Elham , Sahranavard Toktam , Esmaily Habibollah , Moohebati Mohsen , Shabani Niloofar , Asadi Zahra , Tajfard Mohammad , Ferns Gordon A , Mobarhan Majid Ghayour 
Published: August 2020

Abstract
Backgrounds and aims: Coronary artery disease (CAD) is the major cause of mortality and morbidity globally. Diet is known to contribute to CAD risk, and the dietary intake of specific macro- or micro-nutrients might be potential predictors of CAD risk. Machine learning methods may be helpful in the analysis of the contribution of several parameters in dietary including macro- and micro-nutrients to CAD risk. Here we aimed to determine the most important dietary factors for predicting CAD.Methods: Total 273 cases with more than 50% obstruction in at least one coronary artery and 443 healthy controls who completed a food frequency questionnaire (FFQ) were entered into the study. All dietary intakes were adjusted for energy intake. QUEST method was applied to determine the diagnosis pattern of CAD.Results: Total 34 dietary variables obtained from FFQ were entered the study that 23 of these variables were significantly associated with CAD according to t-test. Out of 23 dietary input variables adjusted protein, manganese, biotin, zinc and cholesterol remained in the model. According to our tree, only protein intake could identify the patients with coronary artery stenosis according to angiography from healthy participant up to 80%. Manganese dietary intake was the second important variable after protein. The accuracy of the tree was 84.36% for training dataset and 82.94% for testing dataset.Conclusion: Among different macro- and micro-nutrients in the dietary, a combination of protein, manganese, biotin, zinc and cholesterol could predict the presence of CAD.
Outcomes of proximal femoral locking-plate fixation for pathological fractures of the proximal femur
Authors: Riansuwan Kongkhet , Jivasomboonkul Somkiat , Phimolsarnti Rapin , Chandhanayingyong Chandhanarat , Asavamongkolkul Apichat 
Published: August 2020

Abstract
Background

Intramedullary nailing of long bones is a common technique for management of existing or impending pathological fracture of the proximal femur. This fixation has been shown to be biomechanically superior to the locking-plate system. However, serious complications, including pulmonary embolism, have been reported in patients treated with intramedullary nailing with or without reaming. The purpose of this report was to study the treatment outcomes of proximal femoral locking-plate fixation of pathological fractures of the proximal femur relative to clinical results, implant failure, and surgical complications.
Methods

From 2007 to 2018, 17 patients (18 femurs) with a diagnosis of impending or existing pathological fracture of the proximal femur were treated with proximal femoral locking-plate fixation. Data collected included operative duration, estimated blood loss, ambulatory status, hardware failure events, and postoperative complications.
Results

Of the 18 femurs that were included, 13 were existing pathological fractures and 5 were impending fractures. The mean age of patients was 53.7 years (range: 28–89), and 12 of them were female. The mean follow-up was 11.3 months (range: 1–67). Ten of 17 patients (62.5%) had progressive lung disease from pulmonary metastasis or from lung primary. No patient developed oxygen desaturation or cardiac arrest during the intraoperative or postoperative period. Thirteen of 17 patients (76.5%) could walk with or without an assistive device at the time of final follow-up. Two patients required close postoperative monitoring in the ICU due to poor preoperative status, and both of those patients died within one month after surgery from other medical problems. No hardware failure occurred.
Conclusion

For pathological fracture of the proximal femur, proximal femoral locking-plate fixation is a treatment option that results in fewer perioperative and postoperative cardiopulmonary events and surgical complications. Most patients can ambulate with or without an assistive device at the final follow-up.
Adrenomedullin-CALCRL Axis Controls Relapse-Initiating Drug Tolerant Acute Myeloid Leukemia Cells
Authors: Larrue Clément , Guiraud Nathan , Dubois Marine , Mouchel Pierre-Luc , Farge Thomas , Gotanègre Mathilde , Bosc Claudie , Saland Estelle , Nicolau-Travers Marie-Laure , Sabatier Marie , Serhan Nizar , Sahal Ambrine , Boet Emeline , Mouche Sarah , Heydt Quentin , Aroua Nesrine , Stuani Lucille , Kaoma Tony , Angenendt Linus , Mikesch Jan-Henrik , Schliemann Christoph , Vergez Francois , Tamburini Jerome , Récher Christian , Sarry Jean-Emmanuel 
Published: August 2020

Abstract
Drug tolerant leukemic cell subpopulations may explain frequent relapses in acute myeloid leukemia (AML), suggesting that these Relapse-Initiating Cells (RICs) persistent after chemotherapy represent bona fide targets to prevent drug resistance and relapse. We uncovered that the G-protein coupled receptor CALCRL is expressed in leukemic stem cells (LSCs) and RICs, and that the overexpression of CALCRL and/or of its ligand adrenomedullin (ADM) correlates to adverse outcome in AML. CALCRL knockdown impairs leukemic growth, decreases LSC frequency and sensitizes to cytarabine in patient-derived xenograft (PDX) models. Mechanistically, the ADM-CALCRL axis drives cell cycle, DNA integrity and mitochondrial OxPHOS function of AML blasts dependent on E2F1 and BCL2. Finally, CALCRL depletion reduces LSC frequency of RICs post-chemotherapy in vivo. In summary, our data highlight a critical role of ADM-CALCRL in post-chemotherapy persistence of these cells, and disclose a promising therapeutic target to prevent relapse in AML.
Host-Response Subphenotypic Classification with A Parsimonious Model Offers Prognostic Information in Patients with Acute Respiratory Failure: A Prospective Cohort Study.
Authors: Drohan Callie M. , Nouraie S. Mehdi , Bain William , Shah Faraaz A. , Evankovich John , Zhang Yingze , Morris Alison , McVerry Bryan J. , Kitsios Georgios D. 
Published: August 2020

Abstract
Background: Recent research in patients with ARDS has consistently shown the presence of two distinct subphenotypes of host-responses (hyper- and hypo-inflammatory) with markedly different outcomes and responses to therapies. However, inherent uncertainty in reaching the diagnosis of ARDS creates considerable biological and clinical overlap with other broadly-defined syndromes of acute respiratory failure, such as patients with risk factors (e.g. sepsis or pneumonia) for ARDS (at-risk for ARDS [ARFA]) or patients with decompensated congestive heart failure (CHF). Limited data are available for the presence of subphenotypes in such broader critically-ill populations. Methods: We enrolled mechanically-ventilated patients with acute respiratory failure (ARDS, ARFA, and CHF) and measured 11 plasma biomarkers at baseline. We applied latent class analysis (LCA) methods to determine optimal subphenotypic classifications in this inclusive patient cohort by considering clinical variables and biomarkers. We then derived a parsimonious logistic regression model for subphenotype predictions and compared clinical outcomes between subphenotypes.Results: We included 334 patients (123 [37%] ARDS, 177 [53%] ARFA, 34 [10%] CHF) in a derivation cohort and 36 patients in a temporally-independent validation cohort. A two-class LCA model was found to be optimal, classifying 29% of patients in the hyper-inflammatory subphenotype, consistent with prior findings. A 4-variable parsimonious model (angiopoietin-2, soluble tumor necrosis factor receptor-1, procalcitonin and bicarbonate) for subphenotype prediction offered excellent classification (area under the curve = 0.98) compared to LCA classifications. For both LCA- and regression model classifications, hyper-inflammatory patients had higher severity of illness by Sequential Organ Failure Assessment scores, fewer ventilator-free days and higher 30- and 90-day mortality (all p<0.01) compared to the hypo-inflammatory group. Subphenotype predictions in the validation cohort revealed consistent trends for clinical outcomes and higher levels of inflammatory biomarkers in the hyper-inflammatory group (22%). Conclusions: Host-response subphenotypes are observable in broader and heterogeneous patient populations beyond just patients with ARDS, and subphenotypic classifications offer prognostic information on clinical outcomes. Accurate subphenotyping is possible with the use of a simple predictive model to improve clinical applicability.
Acute Skeletal Muscle Wasting and Dysfunction Predict Physical Disability at Hospital Discharge in Patients With Critical Illness
Authors: Mayer Kirby P. , Bastin Melissa L. Thompson , Montgomery-Yates Ashley A. , Pastva Amy M. , Dupont-Versteegden Esther E. , Parry Selina M. , Morris Peter E 
Published: August 2020

Abstract
Background: Patients surviving critical illness develop muscle weakness and impairments in physical function, however, the relationship between early skeletal muscle dysfunction and physical function at hospital discharge remains unclear. The primary purpose of this study was to determine if changes in muscle size, strength and power assessed in the intensive care unit (ICU) predict physical function at hospital discharge. Methods: Study design is a single-center, prospective, observational study in patients admitted to the medicine or cardiothoracic ICU with diagnosis of sepsis or acute respiratory failure. Rectus femoris (RF) and tibialis anterior (TA) muscle ultrasound images were obtained day one of ICU admission, repeated serially and assessed for muscle cross-sectional area (CSA), layer thickness (mT), and echointensity (EI). Muscle strength, as measured by Medical Research Council-sum score, and muscle power (lower-extremity leg-press) were assessed prior to ICU discharge. Physical function was assessed with performance on 5-times sit-to-stand (5STS) at hospital discharge.Results: Forty-one patients with median age of 61 years (IQR 55-68), 56% male, and sequential organ failure assessment score of 8.1 ± 4.8 were enrolled. RF muscle CSA decreased significantly a median percent change of 18.5% from day 1 to 7 (F = 26.6, p = 0.0253). RF EI increased at a mean percent change of 10.5 ± 21% in the first 7 days (F = 3.28, p = 0.081). At hospital discharge 25.7% of patients (9/35) met criteria for ICU-acquired weakness. Change in RF EI in first 7 days of ICU admission and muscle power measured prior to ICU were strong predictors of ICU-AW at hospital discharge (AUC = 0.912). Muscle power at ICU discharge, age and ICU length of stay were predictive of performance on 5STS at hospital discharge.Conclusion: ICU-assessed muscle dysfunction is a predictor of physical disability at hospital discharge in patients surviving critical illness.
Ca2+-Activated Mitochondrial Biogenesis and Functions Improve Stem Cell Fate in Rg3-Treated Human Mesenchymal Stem Cells
Authors: Hong Taeui , Kim Moon Young , Ly Dat Da , Park Su Jung , Eom Young Woo , Park Kyu-Sang , Baik Soon Koo 
Published: August 2020

Abstract
Although mitochondrial functions are essential for cell survival, their critical roles in stem cell fate, including proliferation, differentiation, and senescence, remain elusive. Ginsenoside Rg3 exhibits various biological activities and reportedly increases mitochondrial biogenesis and respiration. Herein, we observed that Rg3 increased proliferation and suppressed senescence of human bone marrow-derived mesenchymal stem cells. Osteogenic, but not adipogenic, differentiation was facilitated by Rg3 treatment. Rg3 suppressed reactive oxygen species production and upregulated mitochondrial biogenesis and antioxidant enzymes, including superoxide dismutase. Consistently, Rg3 strongly augmented basal and ATP synthesis-linked respiration with high spare respiratory capacity. Rg3 treatment elevated cytosolic Ca2+ concentration contributing to mitochondrial activation. Reduction of intracellular or extracellular Ca2+ levels strongly inhibited Rg3-induced activation of mitochondrial respiration and biogenesis. Taken together, Rg3 enhances capabilities of mitochondrial and antioxidant functions mainly through a Ca2+-dependent pathway, which improves the proliferation and differentiation potentials and prevents the senescence of human mesenchymal stem cells.
Prevalence and Risk Factors of Burden Among Caregivers of Older Patients in the Emergency Department The Caregiver Burden of Acutely Presenting Older Patients
Authors: Zaalberg Tessel , Barten Dennis , Heugten Caroline van , Klijnsma Petra , Knarren Lieve , Hiemstra Ytje , Kurvers Roel , Lekx Anita , Mooijaart Simon , Janssen-Heijnen Maryska 
Published: August 2020

Abstract
BACKGROUND

The number of older individuals that live independently at home is rising. These older individuals often rely on caregivers who typically have a similar age and health status. Therefore, caregivers may experience a high burden. We determined the prevalence and risk factors of burden among caregivers of older patients in the emergency department (ED).
Methods

a prospective observational cohort study of primary caregivers of patients aged ≥ 70 years visiting the ED of a Dutch teaching hospital. Structured interviews were conducted with patients and their caregivers. Caregiver burden was measured using the caregiver strain index (CSI). Additionally, data from medical records were extracted to determine potential risk factors. Univariate and multivariate regression analyses were conducted to identify independent determinants for burden.
RESULTS

A primary caregiver was reported by 200 of 628 included ED patients. The mean age of patients with a caregiver was 82 (SD 6.7) years and the mean age of the caregivers was 66 (SD 12.4) years. Seventy-eight caregivers (39%) experienced a high burden. Multivariate analysis showed a significant association between high caregiver burden and patients with cognitive impairment or dependency for instrumental activities of daily living (IADL) and more self-reported hours of care per day.
CONCLUSION

Almost 40% of older patients in the ED have a caregiver who experiences a high burden. Formal assessment in the ED may help provide adequate care to the patients and their caregivers.
Stimulation-Induced Differential Redistributions of Clathrin and Clathrin-Coated Vesicles in Axons Compared to Soma/Dendrites
Authors: Tao-Cheng Jung-Hwa 
Published: August 2020

Abstract
Clathrin-mediated endocytosis plays an important role in the recycling of synaptic vesicle in presynaptic terminals, and in the recycling of transmitter receptors in neuronal soma/dendrites. The present study uses electron microscopy (EM) and immunogold EM to document the different categories of clathrin-coated vesicles (CCV) and pits (CCP) in axons compared to soma/dendrites, and the depolarization-induced redistribution of clathrin in these two polarized compartments of the neuron. The size of CCVs in presynaptic terminals (~40 nm; similar to the size of synaptic vesicles) is considerably smaller than the size of CCVs in soma/dendrites (~90 nm). Furthermore, neuronal stimulation induces an increase in the number of CCV/CCP in presynaptic terminals, but a decrease in soma/dendrites. Immunogold labeling of clathrin revealed that in presynaptic terminals under resting conditions, the majority of clathrin molecules are unassembled and concentrated outside of synaptic vesicle clusters. Upon depolarization with high K+, label for clathrin became scattered among de-clustered synaptic vesicles and moved closer to the presynaptic active zone. In contrast to axons, clathrin-labeled CCVs and CCPs were prominent in soma/dendrites under resting conditions, and became inconspicuous upon depolarization with high K+. Thus, EM examination suggests that the regulation and mechanism of clathrin-mediated endocytosis differ between axon and dendrite, and that clathrrin redistributes differently in these two neuronal compartments upon depolarization.
Health Surveillance Indicators: What is Available in European Data Sets for Policy Evaluation?
Authors: Stanley Isobel , Neumann-Podczaska Agnieszka , Wieczorowska-Tobis Katarzyna , Mensink Gert B.M. , Rosas Lina Garnica , Do Stefanie , Omar Karim Abu , Woods Catherine , Ahrens Wolfgang , Hebestreit Antje , Murrin Celine 
Published: August 2020

Abstract
Background: Policies targeting diets and physical activity have been proposed as mechanisms for the prevention and control non communicable diseases in Europe. While these actions have the potential to improve health at a population level, the impact of these policies in Europe is currently unknown. The aim of this study, as part of the wider Policy Evaluation Network, is to catalogue the data currently available for policy evaluation in Europe to inform the development of surveillance instruments. The catalogues will also provide an opportunity for key stakeholders to view the available EU indicators that can be employed to evaluate policies which influence diet, physical activity and sedentary behaviour. Methods: A suite of key indicators was agreed by PEN members and over 30 EU experts during a workshop in September 2019. Next, variables in existing EU monitoring systems were suggested by workshop participants for the measurement of each key indicator. The mapping process involved an evaluation of how suitable the suggested variables were as measures for the indicators. This was done using a Likert scale (matched, somewhat matched, less matched, not matched). Results: The suite of key indicators included both behaviour outcome indicators and upstream indicators relating to diet (n=72) and physical activity and sedentary behaviour (n=67). 72% of diet indicators and 86% of physical activity and sedentary behaviour indicators were matched to at least one variable in an existing EU monitoring system. The majority of indicator-measure pairs were categorised as ‘matched’ on the Likert scale. Conclusions: While there are gaps in the measurement of policy level indicators in domains such as inequality, funding and resources and governance, the majority of key policy indicators were mapped to measures in existing systems. Therefore, much of the data for evaluation of policies is readily available.
Day-to-Day Pattern of Work and Leisure Time Physical Behaviours: Are Low Socioeconomic Status Adults Couch Potatoes or Work Warriors?
Authors: Rasmussen Charlotte Lund , Dumuid Dorothea , Hron Karel , Gupta Nidhi , Jørgensen Marie Birk , Nabe-Nielsen Kirsten , Holtermann Andreas 
Published: August 2020

Abstract
BackgroundMost studies on day-to-day patterns of physical behaviours (i.e. physical activities and sedentary behaviour) are based on adult populations of high socioeconomic status (SES) and without differentiating between work and leisure time. Thus, we aimed to characterise the day-to-day leisure time physical behaviours patterns among low SES adults and investigate if a day of the week, workday, work duration, and work physical behaviours influence these leisure-time patterns.MethodsThis cross-sectional study included 1012 adults from typical low SES occupations (e.g. manufacturing, cleaning and transportation). The participants wore accelerometers for 1-7 days to measure daily physical behaviours during work and leisure time, expressed as 3-part time-use compositions consisting of time spent 1) sedentary, 2) standing or 3) being active (i.e. walking, running, stair climbing, or cycling). Multivariate multilevel log-ratio models were used to regress leisure time-use composition on day-of-week and the interaction between day-of-week and (1) type of day, (i.e., work/non-work), (3) work duration, and (4) work time-use composition. Models were adjusted for sex, age, BMI, and smoking-status. ResultsOver the course of a week, the workers were primarily sedentary during leisure time, while spending most work time standing or being active. Leisure time physical behaviours were associated with type of day (p < 0.005, more sedentary on workdays vs. non-workdays), day-of-week (p < 0.005, more sedentary on Friday, Saturday and Sunday), standing work (p < 0.005, more sedentary and less active leisure time on Sunday), active work (p < 0.005, less sedentary and more active leisure time on Sunday), and work duration (p < 0.005, less active leisure time on Friday). ConclusionsOur findings suggest that while low SES adults’ leisure time is mostly sedentary, their work time is predominantly standing or active. Leisure time was spent more sedentary on workdays compared to non-workdays, indicating that work factors influenced day-to-day leisure time behaviours. Accordingly, work physical behaviours and work duration were differently associated with leisure time physical behaviours. Our findings support the value of considering the influence of work factors when planning strategies aiming to increase health-enhancing leisure time activities among low SES adults.