bluuebunny/crossref_metadata_2025_split huggingface dataset:
A novel predictive model based on inflammatory markers to assess the prognosis of patients with HBV-related acute-on-chronic liver failure：a retrospective cohort study
Authors: Qiang Li , Qin Jiao , Sun Changfeng , Sheng Yunjian , Chen Wen , Qiu Bangdong , Chen Xin , Chen Yuanfang , Liu Fei , wu gang 
Published: April 2020

Abstract
Background: Systemic inflammatory response is closely related to the development and prognosis of liver failure. This study aimed to establish a new model combing the inflammatory markers including neutrophil/lymphocyte ratio (NLR) and red blood cell distribution width (RDW) with several hematological testing indicators to assess the prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF). Methods: A derivation cohort with 421 patients and a validation cohort with 156 patients were recruited from three hospitals. Retrospectively collecting their clinical data and laboratory testing indicators. Medcalc-15.10 software was employed for Data analyses.Results: Multivariate analysis indicated that RDW, NLR, INR, TBIL and Cr were risk factors for 90-day mortality in patients with HBV-ACLF. The risk assessment model isCOXRNTIC=0.053×RDW+0.027×NLR+0.003×TBIL+0.317×INR+0.003×Cr (RNTIC) with a cut-off value of 3.08 (sensitivity: 77.89%, specificity: 86.04%). The area under the receiver operating characteristics curve (AUC) of the RNTIC was 0.873 [95%CI(0.837–0.903)], better than the predictive value of MELD score [0.732, 95%CI(0.687–0.774)], MELD-Na [0.714, 95%CI(0.668-0.757)], CTP[0.703, 95%CI(0.657-0.747)]. In the validation cohort, RNTIC also performed a better prediction value than MELD score, MELD-Na and CTP with the AUC of [0.845, 95%CI(0.778-0.898)], [0.768, 95%CI (0.694-0.832)], [0.759, 95%CI(0.684-0.824)] and [0.718, 95%CI(0.641-0.787)] respectively. Conclusions: The inflammatory markers RDW and NLR could be used as independent predictors of 90-day mortality in patients with HBV-ACLF. Compared with MELD score, RNTIC had a more powerful predictive value for prognosis of patients with HBV-ACLF.
Communication mediums used by clients and health professionals in accessing and providing healthcare in low resource settings: A descriptive cross-sectional study
Authors: Dongyele Mathias , Ansong Daniel , Osei Francis Adjei , Newton Sam , New Evans Xorse Amusu , New Nicholas Karikari Mensah , New Alfred Kwame Owusu , New Bright Atta Dunkwa , Frimpong Samuel Odoom , Bonney Joseph , Adjei Duncan , Amusu Anne , Akowuah Emmanuel Kofi , Lartey Kelvin , Appiah Christopher Seth Yaw 
Published: April 2020

Abstract
Background: There exist continuing challenges with communication media used during health service provision. These challenges relate to clients and health institution, intra and inter-health institution communications. This study reviewed the existing healthcare communication media from the perspectives of clients and health professionals at a tertiary hospital in Ghana.
Method: cross-sectional design was employed with a multilevel sampling method to select a total of 651 participants consisting of 304 clients, 303 health workers and 44 hospital directorate managers for the study. A well-structured survey questionnaire was used to collect data from respondents.
Results: Two thirds of the hospital staff (66.4%) used a blend of social media and direct means (face-to-face medium) to communicate among themselves. The majority (89.8%) of the staff communicated with management through meetings sections. Nearly all healthcare providers (97.4%) communicated with clients through direct means (face-to-face medium). Almost all forms of communication between the hospital management members and the general public was done through letters and official memos.
Conclusions: The study revealed blended forms of communication media used by health providers and health service consumers. Delayed information flow and poor feedbacks contributed to the dissatisfaction levels associated with the traditional communication media platforms used.
A survey of the working status of family medicine physicians in clinics and hospitals in Korea
Authors: Shin Hyun-Young 
Published: April 2020

Abstract
Background In the approximately 35 years since family medicine was established in South Korea, family medicine physicians have sought to expand their expertise to cover clinical fields beyond primary medicine. This study examines their working status and compares the working conditions of family medicine physicians in clinics and hospitals in Korea. Methods We conducted an online survey with 4,057 family medicine physicians in Korea in 2016. The results were analyzed using descriptive statistics. Results Of the respondents, 572 doctors were working in clinics and 441 in hospitals. In the analysis of treatment pattern by doctors, the rate of chronic disease management was 84.7% in clinics and 93.4% in hospitals ( p < 0.001), and the rate of diseases covered by national insurance was 74.8% in clinics and 76.9% in hospitals ( p = 0.005). Among physicians younger than 40 years, the rate of chronic disease management and diseases covered by national insurance were 64.6% and 68.0% in clinics and 93.6% and 78.5% in hospitals, retrospectively. Conclusions Family medicine physicians working in hospitals have higher rates of chronic disease management and diseases covered by national insurance. This discrepancy of treatment pattern became larger for doctors younger than 40 years. More in-depth studies of the treatment pattern and its tendencies between family medicine physicians in clinics and hospitals are needed in the future.
Decomposing the educational inequalities in the factors associated with severe acute malnutrition among under-five children in Low- and Middle-Income Countries
Authors: Fagbamigbe Adeniyi Francis , Kandala Ngianga-Bakwin , Uthman Olalekan A. 
Published: April 2020

Abstract
Background: Low- and Middle-Income Countries (LMIC) have remained plagued with the burden of severe acute malnutrition (SAM). The decomposition of the educational inequalities in SAM across individual, neighbourhood and national level characteristics in LMIC has not been explored. This study aims to decompose educational-related inequalities in the development of SAM among under-five children in LMIC and identify the risk factors that contribute to the inequalities.
Methods: We pooled successive secondary data from the Demographic and Health Survey conducted between 2010 and 2018 in 51 LMIC. We analysed data of 532,680 under-five children nested within 55,823 neighbourhoods. Severe acute malnutrition was the outcome variable while the literacy status of mothers was the main exposure variable. The explanatory variables cut across the individual-, household- and neighbourhood-level factors of the mother-child pair. Oaxaca-Blinder decomposition method was used at p=0.05.
Results: The proportion of children whose mothers were not educated ranged from 0.1 % in Armenia and Kyrgyz to as much as 86.1 % in Niger. The overall prevalence of SAM in the group of children whose mothers had no education was 5.8 % compared with 4.2 % among those whose mothers were educated, this varied within each country. Fourteen countries (Cameroon(p<0.001), Chad(p<0.001), Comoro(p=0.047), Burkina Faso(p<0.001), Ethiopia(p<0.001), India(p<0.001), Kenya(p<0.001), Mozambique(p=0.012), Namibia(p=0.001), Nigeria(p<0.001), Pakistan(p<0.001), Senegal(p=0.003), Togo(p=0.013), and Timor Leste(p<0.001) had statistically significant pro-illiterate inequality while no country showed statistically significant pro-literate inequality. We found significant differences in SAM prevalence across child’s age (p<0.001), child’s sex(p<0.001), maternal age(p=0.001), household wealth quintile(p=0.001), mother’s access to media(p=0.001), birth weight(p<0.001) and neighbourhood socioeconomic status disadvantage(p<0.001). On the average, neighbourhood socioeconomic status disadvantage, location of residence were the most important factors in most countries. Other contributors to the explanation of educational inequalities are birth weight, maternal age and toilet type.
Conclusions: SAM is prevalent in most LMIC with wide educational inequalities explained by individual, household and community-level factors. Promotion of women education should be strengthened as better education among women will close the gaps and reduce the burden of SAM generally. We recommend further studies of other determinate causes of inequalities in severe acute malnutrition in LMIC.
Submicromolar copper (II) ions stimulate transretinal signaling in the isolated retina from wild type but not fromCav2.3-deficient mice
Authors: Lüke Jan Niklas , Neumaier Felix , Alpdogan Serdar , Hescheler Jürgen , Schneider Toni , Albanna Walid , Akhtar-Schäfer Isha 
Published: April 2020

Abstract
Background: So far, only indirect evidence exists for the pharmacoresistant R-type voltage-gated Ca2+ channel (VGCC) to be involved in transretinal signaling by triggering GABA-release onto ON-bipolar neurons. This release of inhibitory neurotransmitters was deduced from the sensitivity of the b-wave to stimulation by Ni2+, Zn2+ and Cu2+. To further confirm the interpretation of these findings, we compared the effects of Cu2+ application and chelation (using kainic acid, KA) on the neural retina from wild type and Cav2.3-deficient mice. Furthermore, the immediately effect of KA on the ERG b-wave modulation was assessed.Methods: Transretinal signaling was recorded as an ERG from the superfused murine retina isolated from wildtype and Cav2.3-deficient miceResults: In mice, the stimulating effect of 100 nM CuCl2 is absent in the retinae from Cav2.3-deficient mice, but prominent in Cav2.3-competent mice. Application of up to 3 mM tricine does not affect the murine b-wave in both genotypes, most likely because of chelating amino acids present in the murine nutrient solution. Application of 27 µM KA significantly increased the b-wave amplitude in wild type and Cav2.3 (-|-) mice. This effect can most likely be explained by the stimulation of endogenous KA-receptors described in horizontal, OFF-bipolar, amacrine or ganglion cells, which could not be fully blocked in the present study.Conclusion: Cu2+ dependent modulation of transretinal signaling only occurs in the murine retina from Cav2.3 competent mice, supporting the ideas derived from previous work in the bovine retina that R-type Ca2+ channels are involved in shaping transretinal responses during light perception.
How do older adults understand and manage distress? A qualitative study
Authors: Moult Alice , Kingstone Tom , Chew-Graham Carolyn 
Published: April 2020

Abstract

Background Distress is an expected emotional response to a negative life event. Experiences common in later life may trigger distress such as bereavement or loss of physical mobility. Distress is considered to be distinct to anxiety and/or depression and is not diagnostically labelled as a mental health problem. Older adults will often manage their own distress. Previous literature has focused on how younger adults self-manage mental health problems, however little research has explored the self-management strategies used by older people. There is a need to clarify the role of primary care in the context of distressed older adults who may consult healthcare services. This study seeks to address these gaps through qualitative methods. Methods This study was approved by Keele University’s ethical review panel. Older adults who self-identified as distressed were recruited from community groups in North Staffordshire, England. Data were generated through semi-structured interviews and analysed thematically using constant comparison methods. A patient and public involvement and engagement group contributed to development of the research questions and methods, and offered their perspectives on the findings. Results Data saturation was achieved after 18 interviews. Key themes were: experiences of distress, actions taken, help-seeking from healthcare services and perceptions of treatments offered in primary care. Various forms of loss contributed to participants’ distress. Participants initiated their own self-management strategies which included: pursuing independent activities, seeking social support and attending community groups and church. Five participants reported having consulted a GP when distressed but described a lack of acceptable treatments offered. Conclusions To support older adults who are distressed, healthcare professionals in primary care should consider exploring how patients currently manage their mood problems, provide a broad range of information about potential management options and consider sign-posting older adults to community resources.
Methotrexate impaired in-vivo matured mouse oocyte quality and the possible mechanisms
Authors: Tian Ning , Lv Dan-yu , Yu Ji , Ma Wan-yun 
Published: April 2020

Abstract
Background: Methotrexate (MTX) is an antifolate agent which is widely used in clinic for treating malignancies, rheumatoid arthritis and ectopic pregnancy. As reported, MTX has side effects on gastrointestinal system, nervous system and reproductive system, while its potential damages on oocyte quality are still unclear. It is known that oocyte quality is essential for healthy conception and the forthcoming embryo development. Thus, this work studied the effects of MTX on the oocyte quality. Results: We established MTX model mice by single treatment with 5 mg/Kg MTX. Both morphological and molecular biology studies were performed to assess the in-vivo matured oocytes quality and to analyze the related mechanisms. The in-vivo matured oocytes from MTX-treated mice had poor in-vitro fertilization ability, and the resulting embryo formation rates and blastocyst quality were lower than the control group. We found that the in-vivo matured MTX-treated mouse oocytes displayed abnormal transcript expressions for genes of key enzymes in the folate cycles. MTX increased the rate of abnormal chromosome alignment and affected the regulation of chromosome separation via disrupting the spindle morphology and reducing the mRNA expressions of MAD2 and Sgo1. MTX reduced the DNA methylation levels in the in-vivo matured oocytes, and further studies showed that MTX altered the expressions of DNMT1 and DNMT 3b, and may also affect the levels of the methyl donor and its metabolite. Conclusions: MTX impaired the in-vivo matured mouse oocyte quality by disturbing folate metabolism and affecting chromosome stability and methylation modification.
Associations of CXCL1 gene 5’UTR variations with ovarian cancer
Authors: Guo Man , Xu Chao , Chen Yan-Zhe , Sun Qi-Wen , Zhao Xin-Ying , Liu Xin , Yang Yi , Hu Yi-Yan , Li Fei-Feng , Liu Shu-Lin 
Published: April 2020

Abstract
Background: There are about 2.4 hundred thousand new cases and 1.5 hundred thousand deaths of ovarian cancer (OC) annually in the world. Chronic inflammation is a risk factor for OC. C-X-C motif chemokine ligand 1 (CXCL1) defects may facilitate inflammation and transactivate EGFR in ovarian cancer, but the precise haplotypes associated with the potential diseases remained largely unknown. In this work, we characterized CXCL1 gene variations to elucidate their possible associations with OC.
Methods: We analyzed the CXCL1 gene for 300 OC patients with 400 healthy participants as controls. The statistical analyses and Hardy-Weinberg equilibrium tests of the patients and control populations were conducted using the SPSS software (version 19.0) and Plink (version 1.9).
Results: The variants rs11547681, rs201090116, rs199791199, rs181868085, rs4074 and rs1814092 within or near the CXCL1 gene were characterized. The genetic heterozygosity of rs11547681 and rs4074 was very high. Statistical analysis showed that the variant rs11547681 in the gene was closely associated with the risk of OC in the Chinese Han population, although this variant was not associated with FIGO stages or pathological grades of the patients.
Conclusions: Rs11547681 in CXCL1 gene was associated with the risk of OC in the Chinese Han population.
Undesirable Perioperative Anesthesia Outcomes at Two National Referral Hospitals, a cross sectional study in Eritrea
Authors: Andemeskel Yonatan Mehari , Elsholz Traudl , Gebreyohannes Ghidey , Tesfamariam Eyasu H. 
Published: April 2020

Abstract
Background: Perioperative undesirable anesthesia outcomes are common among patients undergoing surgery. They may affect body systems and lead into more serious intraoperative and postoperative problems. This research is conducted in the Eritrean National Referral Hospitals with the aim of assessing the prevalence of undesirable anesthesia outcomes during the perioperative period. Method: A cross sectional study design was applied on 470 patient who underwent different types of surgeries with in a three month period. Patients were interviewed 24 hours after operation using the Leiden preoperative care patient satisfaction questionnaire (LPPSq). This study reports one component of a large study conducted. The dimension “Discomfort and needs” of the LPPSq was considered and the measurement of that dimension are presented in this report. Items of the dimension were standardized and measured using a five point Likert scale from “Not at all” to “Extremely”. Multivariable logistic regression was used to look for the association of the outcomes with the types of surgery and types of anesthesia using SPSS (Version 22). Statistical significance level was set at p< 0.05. Results: The prevalence of undesirable anesthesia outcomes were computed in two manners; prevalence of those with ‘at least a little bit’ outcomes which was computed to see the total occurrence of these outcomes and prevalence of those having ‘more than moderate’ outcomes to see the severe experience of these outcomes. Prevalence of the predominant undesirable outcome, post-operative pain, for ‘at least a little bit’ and ‘more than moderate’ were 82.6% and 43.6% respectively. The rest post-operative undesirable outcomes were less frequently reported. Conclusion: Postoperative pain was found to be the most prevalent undesirable outcome. Enhancement of the proper assessment and management of postoperative pain through the development and implementation of specific pain management modalities is needed. Local guidelines should also be available in these settings for the treatment of acute postoperative pain or other outcomes. Keywords: Leiden preoperative care patient satisfaction questionnaire (LPPSq), Perioperative care, Surgery, Undesirable anesthesia outcomes.
Cell-division pattern and phylogenetic analyses of a new ciliate genus Parasincirra n. g. (Protista, Ciliophora, Hypotrichia), with report of a new soil species, P. sinica n. sp. found from northwest China
Authors: Shao Chen , Ma Jiyang , Zhao Yan , Zhang Tengyue , Al-Rasheid Khaled A.S. , Song Weibo 
Published: April 2020

Abstract
Background: Ciliated protists, a huge assemblage of unicellular eukaryotes, are extremely diverse and play important roles in ecosystem in almost all kinds of habitats. Even though there is a growing recognition that those organisms associate with many ecological or environmental processes, their biodiversity, due to many reasons, is poorly understood and many biotopes (e.g. the soil in desert area in Asia) remain largely unknown or unconsidered. Here we document an undescribed form found in sludge soil in a halt-desert inland in China and the taxonomic/ morphogenetic surveys indicate that it represents a new genus and new species, Parasincirra sinica n. g., n. sp. which is supported also by molecular data.Results: This new, monotypic genus Parasincirra n. g. is defined by having three frontal cirri, an amphisiellid median cirral row about as long as the adoral zone, one short frontoventral cirral row, cirrus III/2 and transverse cirri present, buccal and caudal cirri absent, one right and one left marginal row and three dorsal kineties. The main morphogenetic features of the new taxon are: (1) frontoventral-transverse cirral anlagen II to VI are formed in primary mode; (2) the amphisiellid median cirral row is formed by anlagen V and VI, while the frontoventral row is generated from anlage IV; (3) cirral streaks IV to VI generate one transverse cirrus each; (4) frontoventral-transverse cirral anlage II generates one or two cirri, while the posterior one will be absorbed in late stages, that is, no buccal cirrus is formed; (5) the posterior part of the parental adoral zone of membranelles is renewed; (6) dorsal morphogenesis follows a typical Gonostomum-pattern; and (7) the macronuclear nodules fuse to form a single mass. Based on the SSU rDNA information, analyses of the phylogenetic relationship inferred from Bayesian inference and maximum likelihood analyses were unable to outline the exact position of this new form among some other species of related genera which are generally assigned in the family Amphisiellidae Jankowski, 1979. The morphological/ morphogenetical differences between the new genus/species and Uroleptoides Wenzel, 1953/ Parabistichella Jiang et al., 2013, as well as other amphisiellids, clearly support the validity of the establishment of this new genus Parasincirra.
Spatial variation in the frequency of knockdown resistance genotypes in Florida Aedes aegypti populations
Authors: Mundis Stephanie Jane , Estep Alden S. , Waits Christy M. , Ryan Sadie J. 
Published: April 2020

Abstract
Background The development of insecticide resistance in disease-vectoring mosquito species can lead to vector control failure and disease resurgence. However, insecticide applications remain an essential public health intervention. In Florida, insecticide resistance in Aedes aegypti , an anthropophilic mosquito species capable of transmitting dengue, chikungunya, and Zika virus, is a major concern. Understanding the location, scale, and driving factors of insecticide resistance can enhance the ability of vector control organizations to target populations effectively. Methods We used previously collected data on frequencies of mutations that confer resistance to commonly used pyrethroid insecticides in Aedes aegypti specimens from 62 sites distributed across 18 counties in Florida. To determine the scale of clustering for the most resistant variant, we used a Ripley’s K function. We also used a spatial scanning statistic technique to identify the locations of clusters where higher than expected frequencies of susceptible or resistant mosquitoes occurred. We then tested for associations between landscape, demographic, and insecticide-use factors using a beta regression modelling approach and evaluated the effect of spatial lag and spatial error terms on overall explanatory power of these models. Results The scale at which maximum clustering of the most resistant variant occurs is approximately 20 kilometers. We identified statistically significant clusters of genotypes associated with resistancein several coastal cities, although some of these clusters were near significant clusters of susceptible mosquitoes, indicating selection pressures vary at the local scale. Vegetation density, distance from roads, and pyrethroid-use by vector control districts were consistently significant predictors of knockdown resistance genotype frequency in the top-performing beta regression models, although pyrethroid-use surprisingly had a negatively associated with resistance. The incorporation of spatial lags resulted in improvements to the fit and explanatory power of the models, indicating an underlying diffusion process likely explains some of the spatial patterns observed. Conclusions The genetic mutations that confer resistance to pyrethroids in Aedes aegpyti mosquitoes in Florida exhibit spatial autocorrelation and patterns that can be partially explained by landscape and insecticide-use factors. Further work at local scales should be able to identify the mechanisms by which these variables influence selection for alleles associated with resistance.