bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spatial distribution and Determinants of Optimal ANC visit among pregnant women in Ethiopia: Further analysis of 2016 Ethiopia demographic Health Survey
Authors: Tadesse Zemenu Tessema , Animut Yaregal 
Published: February 2020

Abstract
Background: Antenatal care (ANC) is essential to improve maternal and newborn health and wellbeing. Antenatal care coverage is improving in Africa since over two-thirds of pregnant women have at least one ANC contact. However, to realize the complete life-saving potential that ANC guarantees for mothers and babies, at least four visits providing essential evidence-based interventions are required. . Therefore, this study was conducted to identify determinants of an optimal ANC visit and its spatial distribution in Ethiopia. Methods: This study is a secondary data analysis of the 2016 Ethiopian Demographic and Health Survey (EDHS).A total of 8,025 women who had a live birth in the five years preceding the survey were included in this study. STATA 14 software and ArcGIS10.7 software were used for analysis. The generalized estimating equation (GEE) model was fitted to identify factors associated with an optimal ANC visit. Crude and Adjusted odds ratio with a 95% CI computed to assess the strength of association between explanatory and outcome variables. Results: This study revealed that rural residence (AOR=0.59, 95%CI: 0.45-0.77),male partners educational status[secondary school (AOR=1.33, 95%CI: 1.05-1.67)], distance to the health institutions[not a big problem (AOR=1.21, 95%CI: 1.04-1.39)], community-level literacy(AOR=1.07, 95%CI: 1.03-1.12), and community level service utilization(AOR=2.67,95%CI:2.21-3.24) were significantly associated with optimal ANC visits. From the spatial analysis result, an Optimal ANC visit was observed in Addis Ababa, Tigray, Harari, and Dire Dawa regions whereas areas with no optimal ANC visit were Afar, Amhara, Oromia Benishangul, SNNP, and Somalia regions. Conclusion: Living in peripheral regions of the country and in rural areas, lower educational status of male partners and distance to health institutions were prohibiting factors for an adequate number of visits. In this study, community-level literacy and community level service utilizations were were also affect womens’ ANC utilization which implies community-level interventions should be considered for improving antenatal care utilization and better health outcomes. The government should give special attention to the regions like Afar, Amhara, Oromia, Benishangul, SNNP, and Somalia which had low optimal ANC visits. Keywords: Optimal Antenatal Care Visit, Determinant, Spatial distribution, Ethiopia
Cardiac Surgical Outcome Prediction by Blood Pressure Variability Indices Poincaré plot and Coefficient of Variation: an Observational Study
Authors: K Senthil Packiasabapathy , Prasad Varesh , Rangasamy Valluvan , Popok David , Xu Xinling , Novack Victor , Subramaniam Balachundhar 
Published: February 2020

Abstract
Background
Recent literature suggests a significant association between blood pressure variability (BPV) and postoperative outcomes after cardiac surgery. However, its outcome prediction ability remains unclear. Current prediction models use static preoperative patient factors. We explored the ability of Poincaré plots and coefficient of variation (CV) by measuring intraoperative BPV in predicting adverse outcomes.
Methods
In this retrospective, observational, cohort study, 3687 adult patients (> 18 years) undergoing cardiac surgery requiring cardio-pulmonary bypass from 2008 to 2014 were included. Blood pressure variability was computed by Poincare plots and CV. Standard descriptors (SD) SD1, SD2 were measured with Poincare plots by ellipse fitting technique. The outcomes analyzed were the 30-day mortality and postoperative renal failure. Logistic regression models adjusted for preoperative and surgical factors were constructed to evaluate the association between BPV parameters and outcomes. C-statistics were used to analyse the predictive ability.
Results
Analysis found that, 99 (2.7%) patients died within 30 days and 105 (2.8%) patients suffered from in-hospital renal failure. Logistic regression models including BPV parameters (standard descriptors from Poincare plots and CV) performed poorly in predicting postoperative 30-day mortality and renal failure [Concordance(C)-Statistic around 0.5]. They did not add any significant value to the standard STS risk score [C-statistic: STS alone 0.7, STS + BPV parmeters 0.7].
Conclusions
In conclusion, BP variability computed from Poincare plots and CV were not predictive of mortality and renal failure in cardiac surgical patients. Patient comorbid conditions and other preoperative factors are still the gold standard for outcome prediction. Future directions include analysis of dynamic parameters such as complexity of physiological signals in identifying high risk patients and tailoring management accordingly.
Physiological and transcriptomic analyses reveal the mechanisms underlying the salt tolerance of Zoysia japonica Steud.
Authors: Wang Jingjing , An Cong , Guo Hailin , Yang Xiangyang , Chen Jingbo , Zong Junqin , Li Jianjian , Liu Jianxiu 
Published: February 2020

Abstract
Background: Areas with saline soils are sparsely populated and have fragile ecosystems, which severely restricts the sustainable development of local economies. Zoysia grasses are recognized as excellent warm-season turfgrasses worldwide, with high salt tolerance and superior growth in saline-alkali soils. However, the mechanism underlying the salt tolerance of Zoysia species remains unknown. Results: The phenotypic and physiological responses of two contrasting materials, Zoysia japonica Steud. Z004 (salt sensitive) and Z011 (salt tolerant) in response to salt stress were studied. The results show that Z011 was more salt tolerant than was Z004, with the former presenting greater K+/Na+ ratios in both its leaves and roots. To study the molecular mechanisms underlying salt tolerance further, we compared the transcriptomes of the two materials at different time points (0 h, 1 h, 24 h, and 72 h) and from different tissues (leaves and roots) under salt treatment. The 24-h time point and the roots might make significant contributions to the salt tolerance. Moreover, GO and KEGG analyses of different comparisons revealed that the key DEGs participating in the salt-stress response belonged to the hormone pathway, various TF families and the DUF family. Conclusions: Z011 may have improved salt tolerance by reducing Na+ transport from the roots to the leaves, increasing K+ absorption in the roots and reducing K+ secretion from the leaves to maintain a significantly greater K+/Na+ ratio. Twenty-four hours might be a relatively important time point for the salt-stress response of zoysiagrass. The auxin signal transduction family, ABA signal transduction family, WRKY TF family and bHLH TF family may be the most important families in Zoysia salt-stress regulation. This study provides fundamental information concerning the salt-stress response of Zoysia and improves the understanding of molecular mechanisms in salt-tolerant plants.
Resection of retrohepatic inferior vena cava without reconstruction in ex vivo liver resection and autotransplantation: a retrospective study
Authors: Yang Xianwei , Wang Tao , Kong Junjie , Huang Bin , Wang Wentao 
Published: February 2020

Abstract
Background: Retrohepatic inferior vena cava (RIVC) resection without reconstruction in ex vivo liver resection and autotransplantation (ERAT) for advanced alveolar echinococcosis (HAE) is unclear.
Methods: Depending on the presence of a rich collateral circulation and stable blood volume in ERAT, we chose not to rebuild the RIVC. Then, we chose an appropriate revascularization technique for the hepatic and renal veins. Finally, all ERAT procedures were completed, and short- and long-term outcomes were observed.
Results: Between February 2014 and August 2018, 5 advanced HAE patients who underwent ERAT required the described technique. One patient died of circulatory failure 1 day after surgery. Another four patients, with a median follow-up duration of 18 months (range, 10-25 months), demonstrated normal liver and kidney function, no thrombosis and no HAE recurrence.
Conclusions: Through the long-term results of ERAT, the pros and cons of not reconstructing the RIVC need to be re-examined. In cases with a rich collateral circulation, the RIVC can be reconstructed. However, in cases requiring the resection of multiple organs, RIVC reconstruction is prudential.
Healthcare Access and Adverse Family Impact among U.S. Children ages 0-5 years by Prematurity Status
Authors: Lindly Olivia J. , Crossman Morgan K. , Shui Amy M. , Kuo Dennis Z. , Earl Kristen M. , Kleven Amber R. , Perrin James M. , Kuhlthau Karen A. 
Published: February 2020

Abstract
Background: Many children and their families are affected by premature birth. Yet, little is known about their healthcare access and adverse family impact during early childhood. This study aimed to (1) examine differences in healthcare access and adverse family impact among young children by prematurity status and (2) determine associations of healthcare access with adverse family impact among young children born prematurely. Methods: This was a secondary analysis of cross-sectional 2016 and 2017 National Survey of Children’s Health data. The sample included 19,482 U.S. children ages 0-5 years including 242 very low birthweight (VLBW) and 2,205 low birthweight and/or preterm (LBW/PTB) children. Prematurity status was defined by VLBW (i.e., <1,500 grams at birth) and LBW/PTB (i.e., 1,500-2,499 grams at birth and/or born at <37 weeks with or without LBW). Healthcare access measures were adequate health insurance, access to medical home, and developmental screening receipt. Adverse family impact measures were ≥$1,000 in annual out-of-pocket medical costs, having a parent cut-back or stop work, parental aggravation, maternal health not excellent, and paternal health not excellent. The relative risk of each healthcare access and adverse family impact measure was computed by prematurity status. Propensity weighted models were fit to estimate the average treatment effect of each healthcare access measure on each adverse family impact measure among children born prematurely (i.e., VLBW or LBW/PTB). Results: Bivariate analysis results showed that VLBW and/or LBW/PTB children generally fared worse than other children in terms of medical home, having a parent cut-back or stop working, parental aggravation, and paternal health. Multivariable analysis results only showed, however, that VLBW children had a significantly higher risk than other children of having a parent cut-back or stop work. Adequate health insurance and medical home were each associated with reduced adjusted relative risk of ≥$1,000 in annual out-of-pocket costs, having a parent cut-back or stop work, and parental aggravation among children born prematurely. Conclusions: This study’s findings demonstrate better healthcare access is associated with reduced adverse family impact among U.S. children ages 0-5 years born prematurely. Population health initiatives should target children born prematurely and their families.
Clinical characteristics and risk factors of 47 cases with ruptured neuroblastoma in children
Authors: Qin Hong , Author) Shen Yang(Former Corresponding , Cai Siyu , Ren Qinghua , Han Wei , Yang Wei , Cheng Haiyan , Ma Xiaoli , Author) Huanmin Wang(New Corresponding 
Published: February 2020

Abstract
Backgroud: Neuroblastoma (NB) tumor rupture is a rare oncology emergency with poor prognosis. We aimed to evaluate clinical characteristics and risk factors for ruptured NB. Methods: A retrospective study was conducted on 47 confirmed ruptured NB patients in Beijing Children's Hospital between January 2009 and January 2019. To identify tumor rupture risk factors within high-risk NB, we included 93 consecutive nonruptured high-risk NB patients from January 2017 to January 2019. Results: Median age at presentation was 29 months (adrenal and retroperitoneum origin) for 47 ruptured NB patients. Spontaneous tumor rupture occurred in 22 cases; 18 developed tumor rupture during or after the first chemotherapy cycle, and 7 developed after core needle biopsy. Five patients died of tumor rupture, and 17 patients’ parents refused further anti-tumor therapy. Among 25 remaining patients, 6 survived without disease, 5 remained under treatment with stable disease, and 14 died. According to multivariate logistic regression analysis, the maximum diameter of primary tumor > 13.20 cm and MYCN gene amplification were independent risk factors for tumor rupture within high-risk NB. Conclusions: Tumor rupture is an uncommon, life-threatening presentation among NB patients; these patients are most likely to have poor outcomes due to tumor recurrence or rapid progression. Several treatment modalities, including symptomatic support therapy and chemotherapy, are important for saving lives and creating the respective required conditions for subsequent NB risk-based treatment.
Standardised neonatal parenteral nutrition formulations – Australasian Neonatal Parenteral Nutrition Consensus update 2017
Authors: Bolisetty Srinivas , Osborn David , Schindler Tim , Sinn John , Deshpande Girish , Wong Chee Sing , Jacobs Susan , Phad Nilkant , Pharande Pramod , Tobiansky Rodney , Luig Melissa , Trivedi Amit , McIntosh Joanne , Jozsa Eszter , Opie Gillian , Downe Lyn , Anderson Chad , Bhatia Vineesh , Kumar Prasanna , Malinen Katri , Birch Pita , Simmer Karen , McLeod Gemma , Suzanne Quader , Rajadurai Victor Samuel , Hewson Michael , Nair Arun , Williams Megan , Xiao Jing , Ravindranathan Hari , Broadbent Roland , Lui Kei 
Published: February 2020

Abstract
Background: The first consensus standardised neonatal parenteral nutrition formulations were implemented in many neonatal units in Australia in 2012. The current update involving 49 units from Australia, New Zealand, Singapore, Malaysia and India was conducted between September 2015 and December 2017 with the aim to review and update the 2012 formulations and guidelines. Methods: A systematic review of available evidence for each parenteral nutrient was undertaken and new standardised formulations and guidelines were developed. Results: Five existing preterm Amino acid-Dextrose formulations have been modified and two new concentrated Amino acid-Dextrose formulations added to optimise amino acid and nutrient intake according to gestation. Organic phosphate has replaced inorganic phosphate allowing for an increase in calcium and phosphate content, and acetate reduced. Lipid emulsions are unchanged, with both SMOFlipid (Fresenius Kabi, Australia) and ClinOleic (Baxter Healthcare, Australia) preparations included. The physicochemical compatibility and stability of all formulations have been tested and confirmed. Guidelines to standardise the parenteral nutrition clinical practice across facilities have also been developed. Conclusions: The 2017 PN formulations and guidelines developed by the 2017 Neonatal Parenteral Nutrition Consensus Group offer concise and practical instructions to clinicians on how to implement current and up-to-date evidence based PN to the NICU population.
Altered regional gray matter volume in Chinese female patients with bulimia nervosa
Authors: Li Xiao , Liu Xiaowei , Wang Yu , Li Lingfei , Zheng Linli , Liu Yaya , Ma Jing , Zhang Lan 
Published: February 2020

Abstract
Background The bulimia nervosa (BN) is one of the psychiatric disorders, which pathophysiology is not clear currently. Recent studies have concentrated on brain structural and functional changes in BN patients. However, findings have been inconsistent.The aim of this study was to explore the relationships between brain structural alterations and clinical features in Chinese female patients with BN. Method A total of 34 female patients with BN and 34 matched healthy controls (HC) underwent a T1-weighted magnetic resonance imaging (MRI) scanning. VBM analysis was carried out by using SPM8 ( http://www.fil.ion.ucl.ac.uk/spm/software/spm8/ ) to explore the alterations of regional Grey Matter Volume (GMV). The correlation analysis was performed using Statistical Package for the Social Sciences (SPSS) . Results The BN group showed reduced regional grey matter volume of the left medial superior frontal gyrus (SFGmed.L), the right superior temporal gyrus (STG.R), the right median cingulate and paracingulate gyri (DCG.R), the left median cingulate and paracingulate gyri (DCG.L) and the left dorsolateral superior frontal gyrus (SFGdor.L) compared to HC. There was no significantly regional grey matter volume increase in BN patients. The brain areas that GMV altered were uncorrelated with BMI and duration of illness (p>0.05). There was a significantly negtive correlation between age and GMV in the SFGmed.L (P<0.005, r=-0.516), the DCG.R (P<0.005, r=-0.556), the DCG.L (P<0.05, r=-0.576) and the SFGdor.L (P<0.005,r=-0.576). The self-esteem and self-evaluation of BN patients were uncorrelated with the structural alterations of GMV. Conclusions The results show altered regional GMV in females with bulimia nervosa in several brain areas, but it difficult to differentiate whether the GMV changes are the results of BN pathology or the consequences of binge-eating and compensatory behaviour. The structural alterations might be associated with impairments of inhibitory control and body dissatisfaction in BN patients, as well as mood disorder comorbidity.
IDentification of patients in need of general and specialised PALLiative care (ID-PALL©): item generation, content and face validity of a new interprofessional screening instrument.
Authors: Lüthi Fabienne Teike , Bernard Mathieu , Beauverd Michel , Gamondi Claudia , Ramelet Anne-Sylvie , Borasio Gian Domenico 
Published: February 2020

Abstract
Background Early identification of patients requiring palliative care is a major public health concern. A growing number of instruments exist to help professionals to identify these patients, however, thus far, none have been thoroughly assessed for criterion validity. In addition, no currently available instruments differentiate between patients in need of general vs. specialised palliative care, and most are primarily intended for use by physicians. This study aims to develop and rigorously validate a new interprofessional instrument allowing identification of patients in need of general vs specialised palliative care. Methods The instrument development involved four steps: i) literature review to determine the concept to measure; ii) generation of a set of items; iii) review of the initial set of items by experts to establish the content validity; iv) administration of the items to a sample of the target population to establish face validity. We conducted a Delphi process with experts in palliative care to accomplish step 3 and sent a questionnaire to nurses and physicians non-specialised in palliative care to achieve step 4. The study was conducted in the French and Italian-speaking regions of Switzerland. An interdisciplinary committee of clinical experts supervised all steps. Results The literature review confirmed the necessity of distinguishing between general and specialised palliative care needs and of adapting clinical recommendations to these different needs. Thirty-six nurses and physicians participated in the Delphi process and 28 were involved in the face validity assessment. The Delphi process resulted in two lists: a 7-item list to identify patients in need of general PC and an 8-item list for specialised PC needs. The content and face validity were deemed to be acceptable by both the expert and the target populations. Conclusion This instrument makes a significant contribution to the identification of patients with palliative care needs as it has been designed to differentiate between general and specialised palliative care needs. Moreover, diagnostic data is not fundamental to the use of the instrument, thus facilitating its use by healthcare professionals other than physicians, in particular nurses. Internal and criterion validity assessments are ongoing and essential before wider dissemination of the instrument.
Determinants and aetiologies of postpartum pyrexia; a retrospective analysis in a tertiary health facility in the Littoral Region of Cameroon.
Authors: Ngunyi Yannick Lechedem , Halle-Ekane Gregory , Tendongfor Nicholas , Mbivnjo Etheldreda Leinyuy , Mbarga Armel Evouna , Nembulefack Derick , Abonge Clifford Lo-oh , Egbe Thomas Obinchemti 
Published: February 2020

Abstract
Background

Postpartum febrile morbidity is relatively common, occurring in approximately 5–7% of births. Differentiating between potentially serious and benign causes of postpartum pyrexia (PP) is fundamental in curbing the mortality rate from sinister causes such as sepsis. The paucity of data on PP in Cameroon makes it difficult to access its actual burden. This study was aimed at determining the prevalence, risk factors and aetiologies of PP at a tertiary hospital in Douala, Cameroon.

Methods

This was a 2 – year hospital – based retrospective cohort study carried out at the Douala General Hospital (DGH), during which medical records of all postpartum admissions between January 1 st 2017 and December 31st 2018 were reviewed. The review consisted of collecting data on socio-demographic characteristics, clinical profile, investigations and final diagnoses. The collected data was analysed in SPSS 23.0. Chi-squared test was used to test the association between variables and a logistic regression analysis was fitted to identify risk factors associated to PP.

Results

A total of 1520 postpartum files were reviewed. The prevalence of PP was 8.82%. The most frequent causes of PP were: malaria (46.7%), urinary tract infections (18.7%), puerperal sepsis (17.9%) and pneumonia (8.7%). E. coli was the most (49.3%) cultured germ isolated in positive cultures. Onset of PP was more common (85%) within the first 3 days postpartum and malaria (60%) was the leading aetiology within this period. Five or more vaginal examinations prior to delivery (OR 59.151, 95% CI: 21.463-163.019; p<0.001), perineal tears (OR 45.157, 95% CI: 2.266-899.722; p<0.001), and duration of labour >18hours (OR 26.760, 95% CI: 7.100-100.862; p<0.001) were the most significant risk factors associated with PP.

Conclusion

Approximately 1 in every 12 postpartum cases in the DGH presents with PP . Malaria was the leading cause of PP at DGH especially for cases registered within 3 days postpartum. The risk factors identified were mostly associated to perinatal events, such as frequent vaginal examinations, perineal tears and prolonged labour. Efforts towards preventing identified risk factors thus becomes paramount in order to curb this high rate of PP in the DGH.