bluuebunny/crossref_metadata_2025_split huggingface dataset:
“Kunika women are always sick”: Views from community focus groups on short birth interval (kunika) in Bauchi State, Northern Nigeria
Authors: Ansari Umaira , Pimentel Juan , Omer Khalid , Gidado Yagana , Baba Muhd Chadi , Andersson Neil , Cockcroft Anne 
Published: May 2020

Abstract
Background In Northern Nigeria, short birth interval is common. The word kunika in the Hausa language describes a woman becoming pregnant before weaning her last child. A sizeable literature confirms an association between short birth interval and adverse perinatal and maternal health outcomes. Yet there are few reported studies about how people view short birth interval and its consequences. In support of culturally safe child spacing in Bauchi State, in North East Nigeria, we explored local perspectives about kunika and its consequences. Methods A qualitative descriptive study included 12 gender-segregated focus groups facilitated by local men and women in six communities from the Toro Local Government Area in Bauchi State. Facilitators conducted the groups in the Hausa language and translated the reports of the discussions into English. After an inductive thematic analysis, the local research team reviewed and agreed the themes in a member-checking exercise.Results Some 49 women and 48 men participated in the 12 focus groups, with an average of eight people in each group. All participants were married with ages ranging from 15-45 years. They explained their understanding of kunika, often in terms of pregnancy while breastfeeding. They described many disadvantages of kunika, including health complications for the mother and children, economic consequences, and adverse impact on men’s health and family dynamics. The groups concluded that some people still practise kunika, either intentionally (for example, in order to increase family size or because of competition between co-wives) or unintentionally (for example, because of frequent unprotected sex), and explained the roles of men and women in this. Conclusion Men and women in our study had a clear understanding of the concept of kunika. They recognized many adverse consequences of kunika beyond the narrow health concerns reported in quantitative studies. Their highlighted impacts of kunika on men’s wellbeing can inform initiatives promoting the role of men in addressing kunika.
Low serum albumin, aspartate aminotransferase, and body mass are risk factors for frailty in elderly people with diabetes – a cross-sectional study
Authors: Yanase Toshihiko , Yanagita Ikumi , Fujihara Yuya , Iwaya Chikayo , Kitajima Yuichi , Tajima Misuzu , Honda Masanao , Teruya Yuji , Asakawa Hideko , Ito Tomoko , Eda Terumi , Yamaguchi Noriko , Kayashima Yumi , Yoshimoto Mihoko , Harada Mayumi , Yoshimoto Shoji , Aida Eiji , Nawata Hajime , Muta Kazuo 
Published: May 2020

Abstract
Background: Frailty is broadly characterized by vulnerability and decline in physical, mental and social activities and is more common in elderly patients with type 2 diabetes mellitus (T2DM). Frailty is closely associated with nutrition, muscle strength, inflammation, and hormones etc. In hormones, dehydroepiandrosterone sulfate (DHEA-S) and cortisol are suggested to be such candidates affecting frailty. Little investigation has been performed using a wider range of measures of frailty to clarify risk factors for frailty including the above two hormones. Methods: We performed a cross-sectional study to investigate the risk factors for frailty in elderly T2DM patients (n=148; ≥65 years), using a broad assessment, the clinical frailty scale. We compared parameters between the non-frail and frail groups using the unpaired t and Mann-Whitney U tests. The Jonckheere-Therpstra test was used to identify relationships with the severity of frailty and risk factors were identified using binary regression analysis.Results: Simple regression analysis identified a number of significant risk factors for frailty, including DHEAS <70 µg/dL and cortisol/DHEA-S ratio ≥0.2. Multiple regression analysis showed that low albumin (<4.0 g/dl) (odds ratio [OR]=5.79, p<0.001), low aspartate aminotransferase (AST) activity (<25 IU/L) (OR=4.34, p=0.009), and low body mass (BM) (<53 kg) (OR=3.85, p=0.012) were independent risk factors for frailty. A significant decrease in DHEA-S and a significant increase in the cortisol/DHEA-S ratio occurred alongside increases in the severity of frailty. DHEA-S concentration positively correlated with both serum albumin and BM.Conclusions: Hypoalbuminemia, low AST, and low BM are independent risk factors for frailty in elderly T2DM patients, strongly implying relative malnutrition in these frail patients. DHEA-S may be important for the maintenance of liver function and BM. A decrease in DHEA-S and an increase in the cortisol/DHEAS ratio may be involved in the mechanism of the effect of malnutrition in elderly T2DM patients. trial registration number: UMIN (number 000031357)
Health-related quality of life and associated factors in patients with myocardial infarction after returning to work: a cross-sectional study
Authors: Chen Changying , Du Ruofei , Wang Panpan , Wang Tao , Ma Lixia , Larcher Leon 
Published: May 2020

Abstract
Background: Return to work following myocardial infarction (MI) represents an important indicator of recovery. However, MI can cause patients to feel pressure, loneliness and inferiority during work and even detachment from employment after returning to work, which may affect their quality of life. The aims of this study were to identify the influencing factors of Health-related quality of life (HRQoL) in patients with MI after returning to work and explore the correlations between these factors and HRQoL.Method: This was a cross-sectional study. All participants were recruited from tertiary hospitals in China from October 2017 to March 2018. The general data questionnaire, Short-Form Health Survey-8 (SF-8), Health Promoting Lifestyle ProfileⅡ (HPLPⅡ), Medical Coping Modes Questionnaire (MCMQ) and Social Supporting Rating Scale (SSRS) were used to assess 326 patients with myocardial infarction returned to work after discharge. Multiple linear regression analysis was performed to explore factors related to HRQoL in patients with MI after returning to work.Results: The sample consisted of 326 patients. The mean total score of quality of life was 28.03±2.554. According to the multiple linear regression analysis, next factors were associated with better HRQoL: younger age (B=−0.354, P=0.039), higher income (B=0.513, P=0.000), less co-morbidity (B=−0.440, P=0.000), the longer time taken to return to work (B=0.235, P=0.003), fewer stents installed (B=−0.359, P=0.003), participation in cardiac rehabilitation (CR) (B=−1.777, P=0.000), complete CR (B=−1.409, P=0.000), better health behaviors such as more health responsibility (B=0.172, P=0.000) and exercise (B=0.165, P=0.000), better nutrition (B=0.178, P=0.000) and self-realization (B=0.165, P=0.000), stress response (B=0.172, P=0.000), more social support such as more objective support (B=0.175, P=0.000), subjective support (B=0.167, P=0.000) and better utilization of social support (B=0.189, P=0.028), positive copping strategies such as more coping (B=0.133, P=0.000) and less yield (B=−0.165, P=0.000).Conclusions: HRQoL of MI patients after returning to work is not satisfactory. Health behavior, coping strategies, social support are factors which can affect HRQoL. A comprehensive and targeted guide may be a way to improve HRQoL and to assist patients' successful return to society.
Global Fund Financing and Human Resources for Health Investments in the Eastern Mediterranean Region
Authors: Okunogbe Adeyemi , Bowser Diana , Gedik Gulin , Naseri Saha , Abu-Agla Ayat , Safi Najibullah 
Published: May 2020

Abstract
Background: Despite the large investments in donor-related health activities in areas of the globe prone to tension and conflict, few studies have examined in detail the role of these donor investments in human resources for health (HRH). Methods: We used a mixed-methods research methodology comprising both quantitative and qualitative analysis to analyze the Enhanced Financial Reporting System of the Global Fund to Fight AIDS, Tuberculosis and Malaria budget and expenditure data from 2003-2017 for 13 countries in the Eastern Mediterranean Region (EMR). We analysed additional detailed budgetary data over the period 2013-2017 for a sub-set of these countries. Two country-case studies were conducted in Afghanistan and Sudan for a more in-depth understanding of the HRH-related activities that occurred as a result of Global Fund grants. Results: The results show that US$2.2 billion Global Fund dollars had been budgeted and US$1.6 billion were expended over the period 2003-2017 in 13 Eastern Mediterranean countries. The average expenditures for human resources for health (training and human resources) as a percentage of total expenditure is 28%. Additional detailed budgetary data analysis shows a more conservative investment in HRH with 13% of total budgets allocated to “direct” HRH activities such as salaries, training costs, and technical assistance. HRH-related activities supported by the Global Fund in Afghanistan and Sudan were similar, including pre-service and in-services training, hiring of program coordinators and staff, and top-ups for clinical staff. Conclusions: HRH remains a key issue in strengthening the health systems of low- and middle-income countries. While this study suggests that Global Fund’s HRH investments in the EMR are not lagging behind the global average, there appears to be a need to further scale up these investments considering this region’s unique HRH challenges.
Central venous pressure measurement is associated with improved outcomes in septic patients: an analysis of the MIMIC-III database
Authors: Chen Hui , Zhu Zhu , Zhao Chenyan , Guo Yanxia , Chen Dongyu , Wei Yao , Jin Jun 
Published: May 2020

Abstract
Purpose: Measurement of central venous pressure (CVP) can be a useful clinical tool. However, the formal utility of CVP measurement in preventing mortality in septic patients has never been proven. Methods: The Medical Information Mart for Intensive Care III (MIMIC-III) database was searched to identify septic patients with and without CVP measurements. The primary outcome was 28-day mortality. Multivariate regression was used to elucidate the relationship between CVP measurement and 28-day mortality, and propensity score matching (PSM) and an inverse probability of treatment weighing (IPTW) were employed to validate our findings. Results: A total of 10275 patients were included in our study, of which 4516 patients (44%) underwent CVP measurement within 24 h of intensive care unit (ICU) admission. The risk of 28-day mortality was reduced in the CVP group (OR 0.60 (95% CI 0.51-0.70; p<0.001)). Patients in the CVP group received more fluid on day 1, and had a shorter duration of mechanical ventilation and vasopressor use, and the reduction in serum lactate was greater than that in the no CVP group. The mediating effect of serum lactate reduction was significant for the whole cohort (p=0.04 for the average causal mediation effect (ACME)) and patients in the CVP group with an initial CVP level below 8 mmHg (p=0.04 for the ACME). Conclusion: CVP measurement was associated with decreased risk-adjusted 28-day mortality among patients with sepsis and was proportionally mediated through serum lactate reduction.
Effects of red and blue light on leaf anatomy, CO2 assimilation, and the photosynthetic electron transport capacity of sweet pepper (Capsicum annuum L.) seedlings
Authors: Li Yan , Xin Guofeng , Liu Chang , Shi Qinghua , Yang Fengjuan , Wei Min 
Published: May 2020

Abstract
Background: The red (R) and blue (B) light wavelengths are known to influence many plant physiological processes during growth and development, particularly photosynthesis. To understand how R and B light influences plant photomorphogenesis and photosynthesis, we investigated changes in leaf anatomy, chlorophyll fluorescence and photosynthetic parameters, and ribulose-1, 5-bisphosphate carboxylase/oxygenase (Rubisco) and Calvin cycle-related enzymes expression and their activities in sweet pepper ( Capsicum annuum L.) seedlings exposed to four light qualities: monochromatic white (W, control), R, B, and mixed R and B (RB) light with the same photosynthetic photon flux density (PPFD) of 300 μmol/m 2 ·s . Results: The results revealed that seedlings grown under R light had lower biomass accumulation, CO 2 assimilation, and photosystem II (PSII) electron transportation compared to plants grown under other treatments. These changes are probably due to inactivation of the photosystem (PS). Biomass accumulation and CO 2 assimilation were significantly enriched in B- and RB-grown plants, especially the latter treatment. Their leaves were also thicker, and photosynthetic electron transport capacity, as well as the photosynthetic rate were enhanced. The up-regulation of the expression and activities of Rubisco , fructose-1, 6-bisphosphatase (FBPase) and glyceraldehyde-phosphate dehydrogenase (GAPDH), which involved in the Calvin cycle and are probably the main enzymatic factors contributing to RuBP (ribulose-1, 5-bisphosphate) synthesis, were also increased. Conclusions: Mixed R and B light altered plant photomorphogenesis and photosynthesis, mainly through its effects on leaf anatomy, photosynthetic electron transportation, and the expression and activities of key Calvin cycle enzymes.
Threshold changeable secret image sharing using bivariate polynomial
Authors: LIU YANXIAO , Wu Ping , Sun Qindong , Zhou Zhili 
Published: May 2020

Abstract
In secret image sharing (SIS) scheme, a confidential image is encrypted into multiple shadows, any group of shadows that reaches the threshold, otherwise nothing can be reconstructed at all. Most existing SIS schemes have a fixed threshold, however in this work, we consider more complicated cases that the threshold may be adjusted due to the changeable security environment. In this paper, we construct a $(k\leftrightarrow h,n)$ threshold changeable SIS (TCSIS) scheme using bivariate polynomial, which has $h-k+1$ possible thresholds $k,k+1,...,h$. During image reconstruction, each participant can update the his shadow according to the current threshold $T$ only based on his initial shadow. Comparing with previous TCSIS schemes, the proposed scheme achieves unconditional security, and can overcome the information disclosure problem caused by homomorphism.
Improvement of a Delayed Swallowing Reflex Following Treatment for Advanced Head and Neck Cancer
Authors: Ohkoshi Akira , Kato Kengo , Ogawa Takenori , Nakanome Ayako , Ishii Ryo , Katori Yukio 
Published: May 2020

Abstract
Background: The latency of the swallowing reflex is an important factor causing dysphagia in head and neck cancer patients. Although there are many reports comparing voluntary swallowing function before and after treatment, few studies have focused on the latency of the swallowing reflex, which is a risk factor for pneumonia due to silent aspiration. The aim of this retrospective study was to clarify the changes in the latency of the swallowing reflex before and after treatment. Methods: The latency of the swallowing reflex was quantified using the time from the injection of 1 ml of distilled water into the pharynx through a nasal catheter to the onset of swallowing. Results: The latency time of the swallowing reflex was significantly decreased 3 months after treatment compared to before treatment. A significant reduction was also observed in patients with pharyngeal cancer who underwent chemoradiation therapy. Conclusions: This retrospective study showed that a delayed swallowing reflex improved with treatment in advanced head and neck cancer patients.
A comparison among PCNL, Miniperc and Ultraminiperc for lower calyceal stones between 1 and 2 cm : A prospective, comparative, multicenter and randomised study.
Authors: Bozzini Giorgio , Aydogan Tahsin B , Müller Alexander , Sighinolfi Maria Chiara , Besana Umberto , Calori Alberto , Lorenzo Berti , Govorov Alexander , Pushkar Dmitry Y , Pini Giovannalberto , Pastore Antonio Luigi , Romero-Otero Javier , Rocco Bernardo , Buizza Carlo 
Published: May 2020

Abstract
Background Conventional Percutaneous Lithotripsy (PCNL) has been an effective, successful and easy approach for especially >1 cm sized calyceal stones however risks of complications and nephron loss are inevitable. Our aim is to compare the efficacy and safety of PCNL, MiniPerc(MP) and UltraMiniPerc(UMP) for lower calyceal stones between 1 and 2 cm with a multicenter prospective randomized study.Methods Between January 2015 and June 2018, 132 consecutive patients with single lower calyceal stone were enrolled. Patients were randomized in three groups; A: PCNL; B: MP; C: UMP. 44 patients for the Group A, 47 for Group B and 41 for Group C. Exclusion criterias were the presence of coagulation impairments, age of <18 or >75, presence of infection or serious comorbidities. Patients were controlled with computerized tomography scan after 3 months. A negative CT or an asymptomatic patient with stone fragments < 3 mm size were the criteria to assess the stone-free status. Patient characteristics, stone free rates (SFR)s, complications and re-treatment rates were analyzed.Results The mean stone size were 16.38, 17.82 and 15.23mm respectively in Group A, B and C(p=0.34). The overall SFR was significantly higher in Group A (86.3%) and B (82.9%) as compared to Group C (78%)(p<0.05). The re-treatment rate was significantly higher in Group C (12.1%) and complication rates was higher in Group A (13.6%) as compared to others(p<0.05). The hospitalization was significantly shorter in Group C compared to Group A(p=0.04).Conclusions PCNL and MP showed higher efficacy than UMP to obtain a better SFR. Auxiliary and re-treatment rates were higher in UMP. On the other hand for such this kind of stones PCNL had more complications. Overall evaluation favors MP as a better indication in stones 1-2 cm size.
Global profiles of a cetylated proteins in the brains of scrapie agents 139A- and ME7-infected mice collected at mid-early, mid-late and terminal stage
Authors: Shi qi , Chen Dong-Dong , Adalaiti Maimaitiming , Xiao Kang , Gao Li-Ping , Yang Xue-Hua , Wu Yue-Zhang , Chen Cao , Dong Xiaoping 
Published: May 2020

Abstract
BackgroundAcetylation is a reversible post-translational modification in eukaryotic and prokaryotic cells, actively participating in the regulation for biological functions and in the pathogenesis of diseases.MethodsThe acetylated proteins from the cortex regions of scrapie agents 139A- and ME7-infected mice collected at mid-early (80 days post-infection, dpi), mid-late (120 dpi) and terminal stage (180 dpi) were extracted. The global profiles of the brain acetylated proteins were assayed with proteomic mass spectrometry. The acetylated peptides whose levels were >1.5-fold higher or lower than that of age-matched normal controls were considered as differentially expressed acetylated peptides (DEAPs).ResultsA total of 1,485 acetylated peptides were identified. 118, 42 and 51 DEAPs were in the brains of 139A-80 dpi, 120 dpi and 180 dpi, while 390, 227 and 75 DEAPs were in those of ME7-80 dpi, 120 dpi and 180 dpi, respectively. Overwhelming majority of the DEAPs in mid-early stage was down-regulated, while more portions of DEAPs in mid-late and late stage were up-regulated. Approximately 22.1% (328/1485) acetylated peptides were mitochondrial associated, which were mapped to 74 different proteins. Among them, 44 (59.5%) proteins showed differentially expressed at least at one tested time-point. KEEG pathways analysis identified 39, 13, 10 and 55, 25, 18 pathways in the samples of 80, 120 and 180 dpi of 139A- and ME7-infected mice as significantly changed (P<0.05), respectively. Six pathways were commonly involved in all tested samples, including carbon metabolism, metabolic pathways, biosynthesis of amino acids, glycolysis/gluconeogenesis, pyruvate metabolism and citrate cycle (TCA cycle). Moreover, dozens of steps in TAC cycle were affected via down-regulated acetylation for the relevant enzymes in the mid-early stage, while many steps were affected in the mid-late stage via up-regulated acetylation. In the late stage, the affected steps focused on up-regulated acetylation for succinate dehydrogenase, fumarate hydratase and malate dehydrogenase.ConclusionCollectively, Our data here illustrated a picture of global acetylation for brain proteins during prion infection, showing remarkably inhibiting acetylation in the early stage and relatively enhanced acetylation in the late stage.
The use of information and communication technologies in Latin American dentists: A Cross-Sectional Study from Ecuador
Authors: Cherrez-Ojeda Ivan , Vera-Paz Carlos A. , Vanegas Emanuel , Gallardo Juan Carlos , Felix Miguel , Espinoza-Fuentes Fernando , Chedraui Peter , Gavilanes Danilo , Mata Valeria 
Published: May 2020

Abstract
Background: The use of information and communication technologies (ICTs) provide the tools for enabling fast and reliable real-time communications, as well as the transfer of information between dental professionals and their patients. However, little is known about the frequency and preference of ICTs among Latin-American dentists. Our study aims to fill this gap by assessing different aspects related to ICTs, mainly the frequency of use, perceptions, and barriers among Ecuadorian dentists.
Methods: An anonymous, cross-sectional survey-based study was conducted among 342 Ecuadorian dentists. The final questionnaire included 13 items related to the frequency of use, perceptions, and barriers of ICTs. Bivariate analysis was performed by using chi-squared testing to explore the association between the independent variables and the intended use of ICTs, as well as to characterize the perceptions and barriers related to ICTs.
Results: In general, most participants reported the use of ICTs to communicate with colleagues (99.7%), and patients (96.2%), while only 63.5% reported using ICTs to obtain academic information in their daily practice. WhatsApp was rated as the most used ICT for communicating with colleagues and patients. A majority of participants considered that ICTs can be useful for facilitating continuing dental education (92.1%), searching new work opportunities (91.5%), promoting health (90.1%), working with colleagues and other health professionals (91.2%), promoting their professional services (90.6%), and for resolving clinical cases (87.7%). On the subject of barriers, privacy and security concerns about personal and/or patient information was the biggest concern among dentists (65%), followed by lack of time to learn how to use and/or use ICTs (48%), lack of mobile internet access (28.1%), and lack of internet access at work (24.9%).
Conclusion: In our study, we found that Ecuadorian dentists had a high usage rate of ICTs, mainly for communicating with other colleagues and patients, while the academic use of technology remains a comparatively underused application. Most participants had a positive perception towards ICTs, while privacy and security concerns were identified as the main barrier. Older age was associated with a less favourable perception as well as an increased likelihood of reporting barriers related to the use of technology.