bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multidisciplinary Nutrition Management Based on Enhanced Recovery after Surgery Protocols in Patients Undergoing Percutaneous Endoscopic Interlaminar Discectomy: A Randomized Controlled Clinical Trial
Authors: Chen Jiali , Zhang Xinyu , Ning Ning , Li Peifang , Zhang Yueer 
Published: November 2020

Abstract
Background Few studies reported the impact of nutrition management based on Enhanced Recovery after Surgery (ERAS) protocols in spinal surgery. The aim of this study was to examine the association of multidisciplinary nutrition management in percutaneous endoscopic interlaminar discectomy (PEID) with patients’ subjective feelings and postoperative recovery.Methods A randomized controlled clinical trial was conducted from August to November in 2017. A total of 101 patients undergoing PEID were randomized into two groups: a control group (50 patients experiencing traditional nutrition management) and an intervention group (51 patients experiencing multidisciplinary nutrition management). Fasting time, subjective feelings, satisfaction and postoperative recovery were evaluated in all patients.Results In all, 96 patients completed the study: 48 in each group. Our findings revealed that patients in intervention group had weaker preoperative hunger (p＝0.036), preoperative thirst (p＜0.001) and postoperative thirst (p＝0.006), higher satisfaction about nutrition management (p＝0.001), shorter pre and post-operative fasting liquids and solids time, and shorter first passage of flatus (p＝0.005) than those of patients in control group.Conclusion Multidisciplinary nutrition management can promote patients’ subjective feelings and postoperative gastric recovery.Trial registration: Current Controlled Trials ChiCTR-IOQ-17011742, June/22/2017.
Evaluation of PRKAA2 Genetic Variation on Metformin Efficacy as an Initial Therapy Among Drug-Naïve Patients With Type II Diabetes Mellitus
Authors: Virginia Dita , Wahyuningsih Mae , Nugrahaningsih Dwi 
Published: November 2020

Abstract
Background: Metformin is the most popular oral antidiabetic agent, which is recommended as initial monotherapy. AMPK is the pivotal target of metformin molecular mechanisms. AMPK subunit a2 (encoded by PRKAA2) is a gene contributable to increase type 2 diabetes mellitus (T2DM) risk. This study aimed to evaluate PRKAA2 rs2796498, rs2746342, and rs980799 genetic variations on metformin efficacy.Methods: This study enrolled 191 newly diagnosed Indonesia T2DM patients in primary health care. Patients who received metformin as monotherapy for at least 3 months were included for genotyping. Genotyping was performed using the Taqman assay.Results: Baseline characteristics showed that BMI was higher among AA than GG+AG (p=0.04). Patients with TT genotype showed a higher FBG and HbA1c than GG+GT (p=0.02 and p=0.02, respectively). There was no significant difference in allele and genotype frequencies between responders and non-responders group in PRKAA2 rs2796498, rs9803799, and rs2746342. However, among PRKAA2 rs2796498, AG carrier had 0.32 times of responding in metformin efficacy after adjusting BMI, WC, blood pressure, lipid profiles, and eGFR. Dominant model of rs2796498 showed a significant association (OR=0.34, 95%CI=0.13 – 0.90) to metformin efficacy. Conclusions: Our findings suggest that PRKAA2 rs2796498 genetic variation may affect metformin efficacy, especially AG carrier, in drug-naïve T2DM patients.
Metabolic Response of Larix Olgensis A. Henry to Polyethylene Glycol-simulated Drought Stress
Authors: Zhang Lei , Yan ShanShan , Zhang Sufang , Yan Pingyu , Wang Junhui , Zhang Hanguo 
Published: November 2020

Abstract
BackgroundDrought stress in trees limits their growth, survival, and productivity, and it negatively affects the afforestation survival rate. Molecular responses to drought stress have been extensively studied in broad-leaved species, but studies on coniferous species are limited.ResultsOur study focused on the molecular responses to drought stress in a coniferous species, Larix olgensis A. Henry. Drought stress was simulated in one-year-old seedlings using 25% polyethylene glycol 6000. The drought stress response in these seedlings was assessed by analyzing select biochemical parameters, along with gene expression and metabolite profiles. The soluble protein content, peroxidase activity, and malondialdehyde content of L. olgensis were significantly changed during drought stress. Quantitative gene expression analysis identified a total of 8172 differentially expressed genes in seedlings processed after 24 h, 48 h, and 96 h of drought stress treatment. Compared with the gene expression profile of the untreated control, the number of up-regulated genes was higher than that of down-regulated genes, indicating that L. olgensis mainly responded to drought stress through positive regulation. Metabolite analysis of the control and stress-treated samples showed that under drought stress, the increased abundance of linoleic acid was the highest among up-regulated metabolites, which also included some saccharides. A combined analysis of the transcriptome and metabolome revealed that genes dominating the differential expression profile were involved in glutathione metabolism, galactose metabolism, and starch and sucrose metabolism. Moreover, the relative abundance of specific metabolites of these pathways was also altered. Thus, our results indicated that L. olgensis prevented free radical-induced damage through glutathione metabolism and responded to drought through sugar accumulation.ConclusionsThe soluble protein content, peroxidase activity, and malondialdehyde content of L. olgensis were significantly changed during drought stress. A total of 8172 differentially expressed genes in seedlings processed after drought stress treatment. A combined analysis of the transcriptome and metabolome revealed that genes dominating the differential expression profile were involved in glutathione metabolism, galactose metabolism, and starch and sucrose metabolism. Our results indicated that L. olgensis prevented free radical-induced damage through glutathione metabolism and responded to drought through sugar accumulation.
Alpha Oscillatory Activity Associated with Impaired Visual Search in Cerebral Visual Impairment
Authors: Bennett Christopher , Bauer Corinna , Bex Peter , Bottari Davide , MERABET LOTFI 
Published: November 2020

Abstract
Cerebral (cortical) visual impairment (CVI) is associated with perinatal damage to retrochiasmatic pathways and cerebral structures. Individuals with CVI often present with impairments in visual spatial processing and attention. However, the neural correlates associated with these higher order perceptual deficits remain unknown. In this study, we investigated visual search performance using a novel virtual reality based task combined with electroencephalography (EEG) and time frequency decomposition of recorded oscillatory activity. We found that CVI participants showed impaired visual search performance (indexed by both decreased success rates and increased reaction times) compared to age matched controls. Furthermore, analysis of captured EEG activity revealed that posterior alpha desynchronization (typically associated with coordinating neural activity in perceptual and cognitive tasks) was greatly impaired in CVI compared to control participants. Finally, exploratory analysis suggested a potential association between amplitude of oscillations in the alpha range and morphometric anatomical measures. Specifically, less alpha desynchronization following stimulus onset was correlated with decreased volume of specific thalamic nuclei. These results suggest that in the setting of early neurological damage to retrochiasmatic visual pathways, alpha desynchronization remains greatly impaired and may be related to deficits in visual spatial processing and attention commonly observed in this population.
Predicting Ventilator-Associated Pneumonia with Machine Learning
Authors: Giang Christine , Calvert Jacob , Barnes Gina , Siefkas Anna , Green-Saxena Abigail , Hoffman Jana , Mao Qingqing , Das Ritankar 
Published: November 2020

Abstract
Objective Ventilator-associated pneumonia (VAP) is the most common and fatal nosocomial infection in intensive care units (ICUs). Existing methods for identifying VAP display low accuracy, and their use may delay antimicrobial therapy. ​VAP diagnostics derived from machine learning methods that utilize electronic health record data have not yet been explored. The objective of this study is to compare the performance of a variety of machine learning models trained to predict whether VAP will be diagnosed during the patient stay.Methods A retrospective study examined data from 6,129 adult ICU encounters lasting at least 48 hours following the initiation of mechanical ventilation. The gold standard was the presence of a diagnostic code for VAP. Five different machine learning models were trained to predict VAP 48 hours after initiation of mechanical ventilation. Model performance was evaluated with regard to area under the receiver operating characteristic curve (AUROC) on a 10% hold-out test set. Feature importance was measured in terms of Shapley values.Results The highest performing model achieved an AUROC value of 0.827. The most important features for the best-performing model were the length of time on mechanical ventilation, presence of antibiotics, sputum test frequency, and most recent Glasgow Coma Scale assessment.Discussion Supervised machine learning using patient electronic health record data is promising for VAP diagnosis and warrants further validation. Conclusion This tool has the potential to aid the timely diagnosis of VAP.
Improved Confidence Intervals for Fixed Term Survival Probabilities in a Small Two-Arm Trial
Authors: Qian Chen , Pan Jianmin , McClain Craig , Rai Shesh 
Published: November 2020

Abstract
BackgroundThe confidence interval for survival probability at a fixed time point provides valuable information on how the subject performs in terms of survival rate. However, in a two-arm trial when the sample size in each group is small or when the distribution of events that occurred within the group is skewed, the confidence interval might become very unstable, and thus may not provide accurate information for estimating survival rate. In addition, when there are other covariates available in the dataset, it is important to select those significant variables and include them in the model. On the other hand, researchers such as physicians who pay more attention to the final result often analyze the treatment group and control group separately, which may lead to inaccurate prediction. MethodsIn this study, two treatment groups are combined, and the group indicator variable is considered as a covariate and is included in the model for computation. Yuan and Rai’s adjusted effective sample size methods are further extended along with Cox proportional hazard model, Weibull model, and log-logistic model to compute predicted fixed-term overall survival probabilities and corresponding confidence intervals with other covariates adjusted. Simulations are conducted to obtain coverage probability. ResultsIn a single model, Wilson-Peto provides better confidence intervals than Kaplan-Meier, especially in the middle and later stages. In addition, AC-Peto produces better coverage probability at all time points. In a multivariate model, the log-logistic method provides both better confidence intervals and coverage probability than Cox regression model at all stages.ConclusionsThis paper provides a guideline on how one should correctly analyze survival data with the most appropriate method. Depending on the dataset, it is important to consider methods other than traditional Kaplan-Meier and Cox regression models when evaluating survival outcomes.
The Heterogeneity of Reversion to Normoglycemia According to Prediabetes Type is not Explained by Lifestyle Factors.
Authors: Giráldez-García Carolina , Soriano Lucia Cea , Albadalejo Romana , Franch-Nadal Josep , Mata-Cases Manel , Díez-Espino Javier , Artola Sara , Serrano Rosario , Regidor Enrique 
Published: November 2020

Abstract
Background: Healthy lifestyle interventions and drug therapies are proven to have a positive preventative influence on normal glucose regulation in prediabetes. However, little is known on the specific role that these factors play on reversion to normal glycemia according to type of prediabetesMethods: We used data from the Observational prospective cohort study. The Cohort study in Primary Health Care on the Evolution of Patients with Prediabetes from 2012-2015. A total of 1184 individuals aged 30 to 74 years old were included and classified based on the ADA in three mutually exclusive groups using either fasting plasma glucose (FPG) levels (from 100-125 mg/dl, FPG group), HbA1c (5.7%–6.4%, HbA1c group) or both impaired parameters group. Information on lifestyle factors and biochemical parameters were collected at baseline Reversion to normal glucose regulation was calculated at third year of follow-up. Relationship of lifestyle factor and type of prediabetes with reversion were estimated using odds ratios (ORs) with 95% confidence intervals (95% CIs) adjusting by different groups of confounders.Results: Proportion of reversion rates were 31% for FPG group, 31% for HbA1c group and 7.9% for both altered parameters group, respectively. Optimal life style factors such as BMI<25 kg/m2[OR (95% CI): 1.90 (1.20-3.01)], high adherence to Mediterranean diet 1.78 (1.21-2.63) and absence of abdominal obesity 1.70 (1.19-2.43) were the strongest predictors for reversion to normal glucose. However, those did not modify the ORs of reversion to normal glucose. Taking as reference those with both impaired parameters, subjects with FPG impairment (FP group) had an OR of 4.87 (3.10-7.65) and 3.72 (2.39-5.78) for HbA1c group. These estimates remained almost the same after further adjustment for biochemical parameters and lifestyle factors (4.55(2.84-7.28) and 3.09 (1.92- 4.97), respectively).Conclusions: Optimal lifestyle factors showed to be a positive predictor for reversion to normal glucose regulation however, the differences of reversion risk according type of prediabetes are not explained by lifestyle factors.
FoxO1, a Potential Therapeutic Target, Regulates Mitochondrial Dysfunction and Pyroptosis in LPS-Induced Human Cervical Cancer Cells
Authors: Wang Huizhi , Ma Zhi , Gao Fanshu , Jiang Wei , Li Yang , Li Shuping 
Published: November 2020

Abstract
Background: Chronic inflammation plays an important role in the development of cervical cancer. Studies have demonstrated that transcription factors forkhead box protein O1 (FoxO1) have been reported to play important roles in various cancers. Aim: The purpose of this study was to investigate the effect of FoxO1 gene on lipopolysaccharide (LPS)-induced inflammation and intracellular pyroptosis in the development and progression of human cervical cancer cells (SiHa).Methods: In this study, FoxO1 expression was examined using real-time polymerase chain reaction (PCR), western blotting and immunohistochemical staining. SiHa cells migration and proliferation was detected using the transwell assay and 3H‑TdR assay. Mitochondrial function was assessed based on reactive oxygen species (ROS) generation and changes in the mitochondrial membrane potential (ΔΨm). Results: Our study demonstrated that LPS inhibited FoxO1 gene expression, and the silence of FoxO1 gene caused the accumulation of ROS, decreases in the ΔΨm and mitochondrial morphology change). However, either overexpression of FoxO1 or metformin could reverse the LPS-induced mitochondrial dysfunction, cell pyroptosis, migration and proliferation.Conclusions: Our study indicated that FoxO1 as a potential therapeutic target to cure against LPS-induced human cervical cancer in a mitochondria-dependent manner.
Demand for Family Planning Satisfied With Modern Methods in Urban Malawi: CHAID Analysis to Identify Predictors and Women Underserved With Family Planning Services
Authors: Alhassan Nurudeen , Madise Nyovani Janet 
Published: November 2020

Abstract
BackgroundFamily planning progress under the SDGs is measured with a novel indicator, demand for family planning satisfied with modern methods (mDFPS), which provides a better indication of modern contraceptive coverage than unmet need and contraceptive prevalence rate. Yet, few studies have examined the predictors of mDFPS and the sub-groups of women with unsatisfied mDFPS in urban Saharan Africa. The objective of this study was to examine the predictors of mDFPS in urban Malawi and to identify the sub-groups of urban women underserved with modern contraceptives.MethodsThe study analysed data from the 2015-16 Malawi Demographic and Health survey. The sample comprised of 2,917 women in urban Malawi who had a demand for family planning services. We used a Chi-square (χ2) Automatic Interaction Detector (CHAID) model to address the study objectives.ResultsThe results show that the number of children a woman had was the most significant predictor of mDFPS. Women with one or more children, who were of Chewa, Lomwe or Tumbuka ethnic origin, and who resided in the central region had the highest mDFPS (87%). On the other hand, women with no children, and who were not exposed to FP information on television had the lowest mDFPS (41%). Among women in union, ethnicity was the best predictor of mDFPS. Ngoni, Yao and other ethnic minority women in union who were aged 15-19 and 40 years and above, and who were Catholic, SDA/Baptist or Muslim had the lowest mDFPS (36%).ConclusionThis study demonstrates significant intra-urban disparities in demand for FP satisfied with modern contraceptives in Malawi. There is the need for policy makers and reproductive health practitioners to recognise these disparities and to prioritise the underserved groups identified in this study.
The Relationship Between Long-term, Low-dose Macrolide Therapy and Acute Exacerbation in Idiopathic Bronchiectasis Classified by High-resolution Computed Tomography
Authors: SAITO ZENYA , Yoshida Masahiro , Nishioka Saiko , Tamura Kentaro , Tamura Nobumasa , Kuwano Kazuyoshi 
Published: November 2020

Abstract
Background: High-resolution computed tomography (HRCT) and long-term, low-dose macrolide therapy has been established as a diagnostic method and treatment for bronchiectasis. HRCT correlates with clinical symptoms, respiratory function and quality of life in bronchiectasis. However, whether it will lead to reduction of macrolide therapy effects is unknown. We investigated the relationship between the efficacy of macrolide therapy and severity assessment performed by HRCT in idiopathic bronchiectasis.Methods: Ninety-nine patients with idiopathic bronchiectasis were selected. Acute exacerbation (AE) incidence was set as a comparison factor for the treatment effect. First, patients were divided into the severe and non-severe group based on HRCT. The severe group was defined to have abnormal findings in three or more lobes and in both lungs and the non-severe group as having two or fewer lobes or one side of the lung. Next, each group was divided into subgroups with and without macrolide therapy. Finally, the relationship between macrolide therapy and the AE incidence in each subgroup was compared.Results: Among the 99 idiopathic patients, 50 and 49 were included in the non-severe and severe groups, respectively. In the non-severe group, the subgroup with macrolide therapy had significantly less AE than the subgroup without macrolide (odds ratio [OR] = 0.10, P < 0.036). No significant difference was found in the severe group (OR = 0.70, P = 0.57).Conclusions: HRCT may be useful in predicting the effect of long-term, low-dose macrolide therapy for idiopathic bronchiectasis.
Inter-day Test-retest Reproducibility of the CAT, CCQ, HADS&nbsp;and EQ-5D&nbsp;in Patients With Severe and Very Severe COPD&nbsp;
Authors: Hansen Henrik , Beyer Nina , Frølich Anne , Godtfredsen Nina , Bieler Theresa 
Published: November 2020

Abstract
BackgroundIn patients with COPD the COPD Assessment Test (CAT), Clinical COPD Questionnaire (CCQ), Hospital Anxiety and Depression Scale (HADS) and EuroQol 5D (EQ-5D) are widely used patient reported outcome measures (PROMs) of respiratory symptoms, anxiety, depression and quality of life. Despite established responsiveness and minimal important change (MIC), reproducibility and especially important agreement parameters remain unreported in these frequently used PROMs. The aim of this study was to investigate the inter-day test-retest reliability and agreement of the CAT, CCQ, HADS and EQ-5D in patients with severe and very severe COPD (FEV1 <50%) eligible for hospital-based pulmonary rehabilitation.Patients and MethodsFifty patients (22 females, mean [SD] age 67 [9] yrs.; FEV1 32[9] %; 6-minute walk distance 347 [102] meters; CAT 21 [6] points; BMI: 26 [6] kg/m2) completed the questionnaires (CAT, CCQ, HADS, EQ-5D) in combination with functional performance test instructed by one assessor on test-day one (T1) and by another assessor 7-10 days later on test-day two (T2).ResultsThe inter-day test-retest reliability ICC was 0.88 (LL95CI: 0.80) for CAT; 0.69 (LL95CI: 0.46) for CCQ; 0.86 (LL95CI: 0.75) and 0.90 (LL95CI: 0.82) for HADS-anxiety (A) and depression (D) and 0.87 (LL95CI: 0.76) for EQ-5D-VAS. The corresponding agreements within a single measurement (standard error of measurement, SEM) and for repeated measurement errors (smallest real difference, SRD) were respectively 2.1 and 2.9 points for CAT; 0.5 and 0.7 points for CCQ total; 1.3 and 1.9 points for HADS-A; 0.9 and 1.3 points for HADS-D) and 6.8 and 9.7 VAS-score for EQ-5D respectively. Ceiling/flooring effect was present in <5% for all questionnaires. ConclusionIn patients with severe and very severe COPD the CAT, CCQ, HADS and EQ-5D questionnaires presented moderate to excellent inter-day test-retest reliability and acceptable agreement e.g. SEM and SRD below the established MIC on group level except for the CCQ questionnaire. No floor or ceiling effect of relevance was documented for the questionnaires.
Frequency and Factors associated with Thyroid Dysfunction- A Descriptive Cross-Sectional Study from a Tertiary Care Center in Afghanistan
Authors: Lakanwall Mohammad Naeem , Ahmed Sibtain Ahmed , Azizi Shabnam , Jalal Jamshid , Haidary Ahmed Maseh , Hanifi Ahmed Nasir , Gowani Ambreen 
Published: November 2020

Abstract
Objective: Endocrinopathies are a commonly occurring entity, particularly those of the thyroid gland, however there is death of scientific literature from Afghanistan, a country with very limited health care facilities and resources. This is the first study aimed to describe the frequency of occurrence and factor associated with thyroid dysfunction in Afghan population. The aim of this study is to estimate the frequency and to identify factors associated with thyroid dysfunction among individuals coming to a tertiary care facility in Kabul, Afghanistan.Methods: A cross-sectional study was conducted from July to Sep 2018 at the Department of Clinical Pathology, French Medical Institute for Mothers and Children (FMIC), Kabul, Afghanistan. Blood samples were obtained, serum TSH levels were analyzed, and the patients were divided into three diagnostic categories according to their serum TSH concentrations: 1) Hypothyroidism 2) Hyperthyroidism 3) normal.Results: A total of 127 individuals were included in the final analysis. Majority study participants (77%) were females. A large number of the participants (92%) did not have family history of thyroid dysfunction. (74%) participants in the study had normal TSH levels classified as normal thyroid function, (14%) had lower TSH levels and (12%) higher TSH levels (Table 1) classified as hyper and hypothyroid respectively.Conclusion: The findings of the current study showed a high frequency of thyroid dysfunctions from a single center. Further large scale studies are needed to find out the prevalence and document this entity for better health outcomes in the country.