bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gastrointestinal Bleeding in Patients Admitted to Cardiology: risk factors and a new risk score
Authors: Zhang Ming , Liu Demin , Wang Qian , Geng Xue , Hou Qian , Gu Guoqiang , Xie Ruiqin , Cui Wei 
Published: April 2020

Abstract
Background: Although the early use of a risk stratification score in gastrointestinal bleeding(GIB) is recommended, there has been no risk score for GIB in patients admitted to cardiology so far.Objective:To describe the risk factors of GIB and develop a new risk score model in patients admitted to cardiology. Methods: A total of 633 inpatients with GIB from January 2014 to December 2018 were recruited, 4,231 inpatients with non-GIB recruited as the control group. Multivariate logistic regression was used to describe the risk factors of GIB,A new risk score model was developed in the derivation cohort. Accuracy to predict GIB was assessed by the area under the receiver operating characteristic (AUROC) curve in the validation cohort.Results: Male, coronary heart disease, hypertension, stroke, systolic blood pressure, hematocrit, plasma albumin and alanine aminotransferase(ALT) were associated with GIB . The model had a high predictive accuracy (AUROC 0.816; 95%CI, 0.792-0.839), which was supported by the validation cohort (AUROC 0.841; 95% CI, 0.807~0.874). Besides,the prediction of the model better than HAS-BLED score(AUROC 0.557; 95%CI, 0.513~0.602) and CRUSADE score(AUROC 0.791; 95%CI, 0.757~0.825), respectively. Among the inpatients with a score 0-3, 4-7, and ≥8 points, the incidence of GIB, the proportion of inpatients requiring suspended red blood cells transfusion, length of stay and in-hospital mortality all increased gradually(P< 0.001). Conclusions: Male, coronary heart disease, hypertension, stroke, systolic blood pressure, hematocrit, plasma albumin and ALT are associated with GIB. The new risk score model is an accurate risk score that predicts GIB in patients admitted to cardiology.
Oral health related quality of life and satisfaction with dental condition of school age children with dental pain in Ibadan, Nigeria
Authors: Lawal Folake , Oke Gbemisola Aderemi 
Published: April 2020

Abstract
Background: Pain of dental origin is a major reason why school age children seek dental care in low resource settings but how it affects their oral health related quality of life and satisfaction with dental condition remains under researched. The aim of the study was to determine the impact of dental pain on oral health related quality of life as well as its association with satisfaction with dental condition of school age children in Ibadan, Nigeria. Methods: This cross-sectional study was conducted among 1006 pupils aged 9-12 years who attended randomly selected primary schools in Ibadan, Nigeria. An interviewer administered questionnaire, Child–Oral Impact on Daily Performances inventory (C-OIDP) in addition to oral examination was used to obtain data. Analysis was done with SPSS version 23 and p value < 0.05 was considered significant. Results: The prevalence of self-reported dental pain was 10.2%. The mean C-OIDP score was 2.6 (±7.2) overall and 9.8 (±12.4) for pupils with pain. There was higher impact on oral health related quality of life of respondents who reported dental pain than those who did not (Mean Rank = 749.54 vs 475.4, U = 21162, Z = -12.724, p < 0.001) compared to those with and without clinically assessed pain (Mean Rank = 541.21 vs 502.97, U = 6416, Z = - 0.692, p = 0.489). Those who reported dental pain were more dissatisfied with their dental condition (OR = 7.7, CI = 5.0 – 12.0, P < 0.001) compared to those with clinically assessed dental pain (OR = 1.3, CI = 0.4 – 4.9, p = 0.687). Children with self-reported dental pain and who were dissatisfied with their dental condition reported highest odds of impairment in maintaining social contact (OR = 6.5, CI =0.7 - 58.3, p = 0.093). Conclusion:Self-reported dental pain significantly impacted the quality of life of the pupils and caused dissatisfaction with dental condition when compared to clinically assessed pain.
Medical Cost and Healthcare Utilization of Amyotrophic Lateral Sclerosis in China: A Study Based on Hospital Data from 2015 to 2018
Authors: Song Han , Liu Jianchao , Cao Zipeng , Luo Wenjing , Chen Jingyuan 
Published: April 2020

Abstract
Background: Amyotrophic Lateral Sclerosis (ALS), a specific neurodegenerative disease, imposed increased economic and utilizations burden on the healthcare system, especially with the progress of the diseases severity. However, the economic burden on Chinese ALS patients remained unclear. This study therefore was aimed to investigate medical cost and healthcare utilization for Chinese ALS patients.Methods: Longitudinal health data of over 20 million individuals, including military personnel and civilians, was collected from all Chinese military hospitals. We identified 480 patients with a first major diagnosis for ALS from 2015 to 2018, while matched 400 controlled patients on age, gender, ethnic group, geographic region, length of stay, year of diagnosis and comorbidity. Their medical cost and healthcare utilizations were then measured 1 year before, and 1 year after ALS diagnosis. Results: The median annual medical cost of ALS patients was about two-fold higher, 17,087 CNY during the index year than 1 year before, 7,859 CNY. The highest increase in utilizations may account for medical costs on ALS patients, which was represented by hospitalizations (Odd Ratio (OR)=4.26, 95% Confidence Interval (CI) 3.52, 5.15), Electromyography (EMG) (OR=4.14, 95% CI 2.37, 7.22), Nerve Conduction Velocity (NCV) (OR=3.26, 95% CI 2.23, 4.77).Conclusions: This study is the first one reporting direct economic burden on Chinese ALS patients. Efforts should be made to develop cost-effective diagnostic tools in order that sources of medical cost were more effectively allocated, and this disease was detected earlier.
Ethnomedicinal Knowledge of Pwo People in Northern Thailand
Authors: Pongamornkul Wittaya , Muangyen Nattee , Phookaphin Benjaporn , Panyadee Prateep , Inta Angkhana 
Published: April 2020

Abstract
Background: Northern Thailand is the home of many ethnic groups who possess great knowledge of ethnomedicine, so it is the location with the highest number of ethnobotanical studies in Thailand. However, the Pwo have never been included in. Therefore, this study is the first ethnobotanical study of Pwo people. Methods: In this study, 50 Pwo informants from 8 villages in Omkoi district were interviewed about their ethnomedicinal knowledge. They were asked about the vernacular name(s) and uses of plant species found in their villages and nearby forests. Results : A total of 122 ethnomedicinal species with 930 use-reports were recorded. Leaves were the most preferred plant part and decoction was the most preferred preparation method. Herbs were the most favored life form of ethnomedicinal plants used by Pwo people. Asteraceae, Fabaceae, and Zingiberaceae were the three most dominant plant families, which contributed 22% of the total species. Most plants with high Use value (UV) values were common species which also found and reported in other ethnobotanical studies however, the exception was Garcinia pedunculata Roxb. ex Buch.-Ham. Although only a single individual was found in nearby forests, but it was commonly used by Pwo people in the studied sites. The five ailments with high recorded IAR included: injuries, muscular-skeletal system, pain, respiratory systems, and digestive systems. These ailments were directly related to the life-style of Pwo people. Conclusion : The comparison between the species found in this study and a study of Sgaw Karen in a nearby area showed that their knowledge differed from each other in both species and their uses despite their close proximity. The results emphasize the importance and the need of ethnobotanical studies although in the areas where many studied have been carried out. The more understanding of the traditional knowledge would increase our chance of understanding and identification of medicinal properties of plants. The results would lead to the discovery and development of new pharmaceutical substances to improve human life quality.
Lymph node ratio is an independent prognostic factor for patients with Siewert type II adenocarcinoma of esophagogastric junction: results from a 10-year follow-up study
Authors: Zhang Yuling , Liu Ditian , Chen Chunfa , Zeng De 
Published: April 2020

Abstract
Background

Emerging evidences suggest that lymph node ratio (LNR), the number of metastatic lymph node (LN) to the total number of dissected lymph nodes (NDLN), may predict survival in multiple types of solid tumor. However, the prognostic role of LNR in adenocarcinoma of the esophagogastric junction (AEG) remains uninvestigated. The study is intended to determine the prognostic value of LNR in the patients with Siewert type II AEG.

Methods

A total of 342 patients with Siewert type II AEG who underwent R0 resection were enrolled in this study. The optimal cut-off of LNR was stratified into tertiles using X-tile software. The log-rank test was used to evaluate the survival differences, and multivariate Cox regression analysis were performed to determine the independent prognostic variables.

Results

The optimal cut-off of LNR were classified as LNR = 0, LNR between 0.01 and 0.40 and LNR > 0.41. Patients with high LNR had a shorter 5- and 10-year disease-specific survival (DSS) rate (8.5%, 1.4%) compared with those with moderate LNR (20.4%, 4.9%) and low LNR (58.0%, 27.5%) ( P < 0.001). Multivariate Cox regression analysis indicated that LNR was an independent factor for DSS after adjusting for confounding variables ( P < 0.05). Furthermore, after stratification by NDLN between NDLN < 15 group and NDLN ≥ 15 group, the LNR remained a significant predictor for DSS ( P < 0.05).

Conclusions

LNR is an independent predictor for DSS in patients with Siewert type II AEG regardless of NDLN. Patients with higher LNR have significantly shorter DSS.
A Propensity Score Matching study on the effect of OnabotulinumtoxinA alone versus Short-Term Psychodynamic Psychotherapy plus drug-of-choice as preventive therapy in Chronic Migraine: effects and predictive factors.
Authors: Alessiani Michele , Petolicchio Barbara , Sanctis Rita De , Giambattista Romina Di , Puma Marta , Franzese Ciro , Gilliéron Edmond , Viganò Alessandro , Piero Vittorio Di 
Published: April 2020

Abstract
Background: Chronic migraine (CM) is an ensemble disorder in which pain, comorbidities, and medication overuse headache (MOH) interact to determine the degree of disability. No data support the choice of a monotherapy rather than a multidisciplinary preventive approach. The aim of this study is testing the superiority of multidisciplinary approach, i.e. Short-term Psychodynamic Psychotherapy (STPP) plus drug of choice, vs. monotherapy, i.e. OnabotulinumtoxinA. Methods: We consecutively recorded data from CM patients who underwent STPP or OnaBoNT-A, with a 3-month follow-up schedule. Headache days and analgesics intake were monitored as primary outcome measures to determine the benefit. Propensity score matching (PSM) was used to eliminate discrepancies between groups. Discriminant function analysis was used to pinpoint predictive factors associated to the clinical response. Results: 96 patients with CM (64% with MOH) were treated with STPP and 54 (59% with MOH) with OnaBoNT-A. At baseline, OnaBoNT-A patients had more failed preventive therapies, more years of illness and chronicity, and were older, while STPP patients were more depressed and had an higher HIT-6 (p<0.001). Both STPP and OnaBoNT-A patients showed a significant reduction of headache days (STPP: -14 vs. OnaBoNT-A:-14.3) and analgesics intake (STPP: -12,3 vs. OnaBoNT-A -13.5 pills/month), respectively. MOH diminished more in STPP, adherence was higher in OnaBoNT-A. Results were confirmed after that PSM balanced the two groups for all these variables that resulted different (but age). DFA predicts responders in pooled and OnaBoNT-A group. Conclusions: OnaBoNT-A monotherapy produced similar results of a multidisciplinary approach with psychotherapy plus medication. STPP provided a better short term response but short- and long-term adherence was higher in OnaBoNT-A.
Epidemiology and risk factors of rectal colonization of carbapenemase-producing Enterobacteriaceae among high-risk patients from ICU and HSCT wards in a university hospital
Authors: Yan Li , Sun Jide , Xu Xiuyu , Huang Shifeng 
Published: April 2020

Abstract
Background: Nosocomial infections caused by carbapenemase-producing Enterobacterieceae (CPE) constitute a major global health concern and are associated with increased morbidity and mortality. Rectal colonization with CPE is a risk factor for bacterial translocation leading to subsequent endogenous CPE infections. This prospective observational study was aimed to investigate the prevalence and epidemiology of rectal colonization of CPE, the carbapenemase genotypes, and to identify the independent risk factors for the acquisition of CPE colonization in high-risk patients from ICU and HSCT wards in a university hospital in China. Methods: In a prospective cohort study, 150 fecal samples from rectal swabs were consecutively obtained for inpatients from the ICU and HSCT wards from November 2018 to May 2019, and screening test for CPE was conducted by using home-made trypsin soybean broth (TSB) selective media and MacConkey agar. Antimicrobial susceptibility was determined by the broth microdilution method and carbapenemase genes were characterized by both the GeneXpert Carba-R and PCR for blaKPC, blaNDM, blaIMP, blaVIM and blaOXA. In order to further investigate the risk factors and clinical outcomes of CPE colonization, a prospective case-control study was also performed.Results: 26 suspected CPE strains, including 17 Klebsiella pneumoniae, 6 Escherichia coli, 1 Citrobacter freundii, 1 Enterobacter Kobe, and 1 Raoultella ornithinolytica, were identified in 25 non-duplicated fecal samples from 25 patients, with a carriage rate of 16.67% (25/150). Through GeneXpert Carba-R and subsequent PCR and sequencing, all the suspected CPE isolates were identified to be positive for the carbapenemase genes, of which 17 were blaKPC-carriers, and another 9 were blaNDM-producers. Multivariate analysis indicated that urinary system diseases, operation of bronchoscopy, and combined use of antibiotics were independent risk factors for acquiring CPE colonization in high-risk patients from the ICU and HSCT wards. Conclusions: This study revealed a high prevalence of rectal CPE colonization in high-risk patients from ICU and HSCT wards, and a predominant colonization of the KPC-producing K. pneumoniae strains. Stricter infection control measures are urgently needed to limit the dissemination of CPE strains, especially in patients who were afflicted by urinary system diseases, have underwent bronchoscopy, and were previously exposed to combined antibiotic use.
A case series of children with adenovirus pneumonia: three-year experiences in a tertiary PICU
Authors: Shi Jingyi , Zhou Yiping , Wang Fei , Wang Chunxia , Miao Huijie , Sun Ting , Shan Yijun , Cui Yun , Zhang Yucai 
Published: April 2020

Abstract
Objective: Describe the outcome of adenovirus pneumonia in a pediatric intensive care unit (PICU) over a 3-year period, to identify the risk factors that may be associated with worse outcome. Design: A retrospective observational study was performed in a tertiary university PICU from July 2016 to June 2019. Setting: The PICU of children’s hospital in Shanghai. Patients: Sixty-seven children over 29 days to 14 years old with adenovirus pneumonia who were admitted to PICU with acute hypoxemic respiratory failure were included in this study. Measurements and Main Results: The primary outcome was hospital mortality, and secondary outcomes were hospital and PICU length of stay (LOS), and risk factors of worse outcome. Of 67 children with severe adenovirus pneumonia, the hospital mortality was 16.42 % (11/67) and 28-day mortality was 14.93 % (10/67). Median Pediatric Risk of Mortality III (PRISM III) score at admission was 13 (interquartile range[IQR], 10-15). Median PICU LOS stay was 11days (8-18d) and hospital LOS was 22 days (16-31d). Among children with extracorporeal membrane oxygenation (n=9), 6 cases survived and 3 cases died. The patients who need renal replacement therapy, neuromuscular blockade, parenteral nutrition, and packed red blood cell perfusion had higher hospital mortality ( p = 0.000, p = 0.041, p = 0.000, p = 0.012, respectively). Multivariate logistic analysis indicated that liver dysfunction and co-infection & nosocomial infection were associated with high risk of mortality. Conclusions: The hospital mortality of adenovirus pneumonia in our PICU was 16.42%. Patients complicated liver dysfunction and co-infection & nosocomial infection were associated with poor outcome.
The roles of vicariance and isolation by distance in shaping biotic diversification across an ancient archipelago: evidence from a Seychelles caecilian amphibian
Authors: Maddock Simon T , Nussbaum Ronald A , Day Julia J , IV Leigh Latta , Miller Mark , Fisk Debra L , Wilkinson Mark , Rocha Sara , Gower David , Pfrender Michael E 
Published: April 2020

Abstract
Background: Island systems offer excellent opportunities for studying the evolutionary histories of species by virtue of their restricted size and easily identifiable barriers to gene flow. However, most studies investigating evolutionary patterns and processes shaping biotic diversification have focused on more recent (emergent) rather than ancient oceanic archipelagos. Here, we focus on the granitic islands of the Seychelles, which are unusual among island systems because they have been isolated for a long time and are home to a radiation of caecilian amphibians that have been separated from their extant sister lineage for ca. 65 Ma. We selected the most widespread Seychelles caecilian species, Hypogeophis rostratus , to investigate morphological and genetic (mitochondrial and nuclear) variation across the archipelago (782 samples from nine islands) to identify patterns and test processes that shaped their evolutionary history within the Seychelles. Results: Overall a signal of strong geographic structuring with distinct northern- and southern-island clusters were identified across all datasets. We suggest that these distinct groups have been isolated for ca. 1.2 Ma years without subsequent migration between them. Populations from the somewhat geographically isolated island of Frégate showed contrasting relationships to other islands based on genetic and morphological data, clustering alternatively with northern-island (genetic) and southern-island (morphological) populations. Conclusions: Although variation in H. rostratus across the Seychelles is explained more by isolation-by-distance than by adaptation, the genetic-morphological incongruence for affinities of Frégate H. rostratus might be caused by local ecological adaptation over-riding the signal from their vicariant history. Our findings highlight the need to investigate fine-scale geographic structuring to uncover underlying diversity and to better understand evolutionary processes on ancient, continental islands.
Predictability and controlling factors of overpressure in the North Alpine Foreland Basin, SE Germany: An interdisciplinary post-drill analysis of the Geretsried GEN-1 Deep Geothermal Well
Authors: Drews Michael Christian , Hofstetter Peter , Zosseder Kai , Shipilin Vladimir , Stollhofen Harald 
Published: April 2020

Abstract
Drilling- and velocity-based well analyses and 3D basin modelling were combined to test the predictability and controlling factors of overpressure in the North Alpine Foreland Basin in SE Germany. More specifically, the techniques were tested in the sub-regional context of the deep geothermal well Geretsried GEN-1 (TVD = 4852 m), located in the south of Munich. A 3D basin model based on a total of 20 wells was calibrated to the pressure distribution of four petroleum wells and tested against the Geretsried GEN-1 well. The results demonstrate that overpressure in the North Alpine Foreland Basin in SE Germany can be predicted from a simple 3D basin model calibrated to a minimum number of wells. Thereby, disequilibrium compaction likely acts as the main overpressure mechanism in the study area, underpinned by significantly higher sedimentation rates at overpressured locations. 3D basin modelling also confirms the role of Upper Cretaceous shales, which, if present, serve as an important pressure barrier between the under- to normally pressured Jurassic and overpressured Cenozoic basin fill. In addition, overpressure magnitudes of the Chattian might be higher than previously expected. The results of this study have great impact on future drilling campaigns in the North Alpine Foreland Basin in SE Germany. Minimized non-productive time and drilling cost, improved well planning and increased safety are amongst the most important benefits of accurate pore pressure and overpressure prediction. The newly derived insights on the mechanisms of overpressure will greatly influence future geomechanical and tectonic studies, since pore pressure is driving rock strength and principal stress magnitudes. Finally, the study is a great example for the importance of an interdisciplinary approach and the incorporation of geological conditions, when investigating drilling-related problems.
Cottonseed oil alleviates ischemic stroke injury by inhibiting the inflammatory activation of microglia and astrocyte
Authors: Liu Min , Xu Zhipeng , Wang Long , Zhang Lixia , Liu Yi , Cao Jiangbei , Fu Qiang , Liu Yanhong , Li Hao , Lou Jingsheng , Hou Wugang , Mi WeiDong , Ma Yulong 
Published: April 2020

Abstract
Background: Ischemic stroke is the second leading cause of death globally. The narrow time window for administering effective thrombolytic therapy motivates the search for alternative prevention strategies. Microglia and astrocyte activation-mediated inflammation play a pivotal role in ischemic stroke injury. Cottonseed oil (CSO) has been shown to exert anti-inflammatory effects against peripheral tissue injury, although CSO is mostly used as a solvent for lipid-soluble drugs. However, the role of CSO in neuroprotection against stroke has not been previously reported.Methods: We treated adult male rats with CSO (1.3 ml/kg, subcutaneous injection, once every other day for 3 weeks) and then constructed a middle cerebral artery occlusion (MCAO) model followed by 24 hours of reperfusion. Then we measured the neurological scores, infarction volume, neuronal injury and brain edema; we also measured the levels of pro-inflammatory cytokines (IL-1β, IL-6, TNF-α), degree of microglial and astrocytic activation, protein expression levels of Toll-like receptor 4 (TLR4), NF-κB and C3d, and the presence of A1 type astrocytes and A2 type astrocytes.Results: We found that CSO treatment significantly improved the neurological deficit, reduced infarction volume, and alleviated neuronal injuries, blood–brain barrier (BBB) disruption and brain edema. Additionally, CSO treatment significantly reduced microglial and astrocytic activation, inhibited TLR4 and NF-κB protein expression, and reduced the release of IL-1β, IL-6, and TNF-α. Finally, CSO treatment significantly decreased the number of C3d/glial fibrillary acidic protein (GFAP)-positive cells and C3d protein expression, and increased the number of S100A10/GFAP-positive cells.Conclusion: Our results first found that CSO treatment alleviated ischemic stroke injury by inhibiting TLR4/NF-κB pathway-mediated microglial and astrocytic activation and inflammation, and by reducing A1 phenotype neurotoxic astrocyte activation, suggesting that CSO could be a new strategy in the prevention of ischemic stroke.