bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Status of Emergency Obstetric and Newborn Care in Post-Conflict Eastern DRC: A Facility-Level Cross-Sectional Study.
Authors: MIZERERO Serge-André Uwunva , Wilunda Calistus , Musumari Patou Masika , Ono-Kihara Masako , Mubungu Gerrye , Masahiro Kihara , Nakayama Takeo 
Published: December 2020

Abstract
Background Pregnancy-related mortality remains persistently higher in post-conflict areas. Part of the blame lies with continued disruption to vital care provision, especially emergency obstetric and newborn care (EmONC). In such settings, assessment of EmONC is essential for informed interventions needed to improve maternal and neonatal survival. In the North Kivu Province (NKP), the epicentre of armed conflict in eastern Democratic Republic of the Congo (DRC) between 2006-2013, the post-conflict status of EmONC is unknown. We assessed the availability, use, and quality of EmONC in 3 health zones (HZs) of the NKP.Method A cross-sectional survey of all 42 public facilities designated to provide EmONC in 3 HZs (Goma, Karisimbi, and Rutshuru), purposively selected based on their relative proximity to previous conflicts and their respective locations encompassing the entire economic landscape of the province, was conducted in 2017. Interviews, reviews of maternity ward records, and observations were used to assess the accessibility, use, and quality of EmONC against WHO standards.Results The 3 HZs fell short of WHO standards. Only three referral facilities (two faith-based facilities in Goma and the MSF-run referral hospital of Rutshuru) met the criteria for comprehensive EmONC, i.e., 1.5 EmONC facilities per 500,000 population. None of the health centres qualified as basic EmONC, nor could offer obstetric and neonatal care services 24 hours, 7 days a week (24/7). Assisted vaginal delivery was the least performed signal function, followed by parenteral administration of anticonvulsants, mostly due to policy restrictions and lack of demand. Moreover, none of the HZs could achieve a direct-obstetric case facility rate of at most 1% and, the met need for EmONC was as low as 6.5% and 5.4% in Goma and Rutshuru, respectively. However, the proportion of births by caesarean section in EmONC facilities met the minimum standard in both HZs. Overall, the intrapartum and very early neonatal death rate was 1.5%.Conclusion This study provides grounds for the development of coordinated and evidence-based programming, involving local and external stakeholders, as part of the post-conflict effort to improve maternal and neonatal health in the NKP. Particular attention to basic EmONC is required, focusing on strengthening human resources, equipment, supply chains, and referral capacity, on the one hand, and on tackling residual insecurity that might hinder 24/7 staff availability, on the other.
The Potential Diagnostic and Predictive Role of HbA1c in Diabetic, Septic Patients - a Retrospective Single Center Study
Authors: Juhász Imre , Juhász Janka , Lőrincz Hajnalka , Seres Ildikó , Végh Lilla , Ujfalusi Szilvia , Harangi Mariann , Szabó Zoltán , Paragh György 
Published: December 2020

Abstract
Background: Diabetes mellitus is a major risk factor of sepsis. The potential role of hemoglobin A1c (HbA1c) in diabetic, septic patients has not yet been studied. Results: In our retrospective study we included diabetic, septic patients - in whom the diagnosis of sepsis was based on the Systemic Inflammatory Response Syndrome (SIRS) criteria (112 patients, SIRS group) - who had HbA1c levels measured either in the previous 30 days (SIRS 30d subgroup – 39 patients) or within 24 hours after their Emergency Department admission (SIRS 24h subgroup – 73 patients). We later selected those patients from the SIRS group, whose Sequential Organ Failure Assessment (SOFA) score was ≥ 2 (55 patients, SOFA group) and these patients were also divided based on the time of HbA1c measurement (SOFA 30d subgroup – 21 patients and SOFA 24h subgroup – 34 patients). We analyzed the relationship between laboratory parameters, length of hospital stay and HbA1c. We found a significant positive correlation between glucose and HbA1c, significant negative correlations between white blood cell count (WBC) and glucose, WBC and HbA1c levels in the SIRS 24h and SOFA 24h subgroups. Furthermore there was a significant positive correlation between length of hospital stay and HbA1c in the SOFA 24h subgroup. No significant correlations were found in the SIRS 30d and SOFA 30d subgroups. Conclusions: Based on our results normal WBC with elevated HbA1c might be considered a positive SIRS criterium in diabetic, SIRS 24h patients. Besides this potential diagnostic role, HbA1c might also be an additional prognostic biomarker in diabetic, SOFA 24h patients.
White Matter Changes, Duration of Hypertension, and Age Are Associated With Cerebral Microbleeds in Hypertensive Patients of Different Stages
Authors: Liang Changhu , Wang Jing , Liu Cheng , Guo Lingfei 
Published: December 2020

Abstract
Purpose We aimed to investigate risk factors for the presence and number of cerebral microbleeds (CMBs) in patients with different hypertension stages, with an emphasis on the relationship between white matter changes (WMCs) and CMBs.Materials and methods Since 2016, participants aged 40 years or more have been evaluated for the presence of CMBs using enhanced 3D multi-echo GE T2*-weighted angiography (ESWAN) sequences. The Mann-Whitney U test and Pearson χ2 test were used to compare the clinical characteristics between the CMB and no-CMB groups of patients. Furthermore, we used Spearman’s rank correlation analyses to examine the association between the degree of CMB severity and other important factors.Results CMBs were detected in 110 (36.7%) of 300 participants. Among patients with stage 2 hypertension, the majority also had CMBs. CMBs were positively correlated with age, hypertension stage, duration of hypertension, WMCs, and silent cerebral infarction. Patients with grade 3 WMCs were significantly more likely to have CMBs than those without WMCs; this association was true for patients with both stage 1 and stage 2 hypertension. In patients with stage 1 or stage 2 hypertension lasting longer than 20 years, the majority had CMBs.Conclusions CMBs detected in hypertensive patients are more likely to occur in deep structures, and the grade of WMCs and duration of hypertension are more closely associated with the CMB degree than with age.Synopsis: The grade of WMCs and duration of hypertension are more closely associated with the CMB degree than with age.
Factors Influencing Prognosis of Patients with Intra-Abdominal Infection and Its Value in Assessing Prognosis
Authors: Pan Jianfei , Zhu Quanwei , Wu Xiao , Zhang Xiaoqian , Xu Jun , Pan Linlin , Mao Xiang 
Published: December 2020

Abstract
Background: To explore the distribution of pathogenic bacteria in patients with intra-abdominal infection, to clarify the independent factors that affect the prognosis of patients with intra-abdominal infection and its evaluation value for prognosis. Methods The pathogens, underlying diseases and related clinical data of patients with intra-abdominal infection from January 2012 to December 2019 in our hospital were retrospectively collected and the APACHE II score was calculated. The patients were divided into survival group and death group according to the prognosis, and the index between the two groups were compared. Spearman correlation analysis was used to evaluate the correlation between each index and prognosis, multivariate Logistic regression analysis was used to screen the independent prognostic factors. Results 282 patients were included in the study, including 183 males and 99 females, aged 56.99 ± 15.34 years. The survival group was 218cases, the death group was 64 cases, the total intra-abdominal infection mortality was 22.70%. There were significant differences between the two groups in age, serum albumin level, APACHE II score, basic cardiovascular disease and diabetes mellitus (P <0.05). Spearman correlation analysis showed that ALB level was negatively correlated with prognosis, age and APACHE II score were positively correlated with prognosis. Logistic regression analysis showed that age, ALB level and APACHE II score were independent prognostic factors. The area under the curve of the age, ALB level, APACHE II score and these three combined to assess the prognosis were 0.624, 0.698, 0.807 and 0.842 respectively. the sensitivity was 56.30%, 57.80%, 79.70% and 89.10% respectively, and the specificity was 69.30%, 75.20%, 68.80% and 65.10%, respectively. The formula of age combined ALB level and APACHE II score was Y= X1-3.6X2+6.5X3 (X1 was the age, X2 was the ALB level and X3 was the APACHE II score), Y was positively correlated with poor prognosis, and the optimal cutoff value was Y = 40.96. Conclusions Age, ALB level and APACHE II score are independent factors which influencing the prognosis of patients with intra-abdominal infection, and the combination of age, ALB level and APACHE II score can better assess the prognosis of patients with intra-abdominal infection.
Dysphagia Rehabilitation Following Acquired Brain Injury, Including Cerebral Palsy, Across The Lifespan: A Scoping Review Protocol
Authors: Halfpenny Rhiannon , Stewart Alexandra , Kelly Paula , Conway Eleanor , Smith Christina 
Published: December 2020

Abstract
Background: Swallowing impairment (dysphagia) following brain injury can lead to life-threatening complications such as dehydration, aspiration pneumonia and acute choking episodes. In adult therapeutic practice, there is research and clinical evidence to support the use of swallowing exercises to improve swallowing physiology in dysphagia, however, use of these exercises in treating children with dysphagia is largely unexplored. Fundamental questions remain regarding the feasibility and effectiveness of using swallowing exercises with children. This review aims to outline the published literature on exercise-based treatment methods used in the rehabilitation of dysphagia secondary to an acquired brain injury across the lifespan. This will allow the range and effects of interventions utilised to be mapped alongside differential practices between adult and child populations to be formally documented, providing the potential for discussions with clinicians about which interventions might be appropriate for further trial in paediatrics.Methods: This study will use a scoping review framework to identify and systematically review the existing literature using the Joanna Briggs Institute (JBI) and Preferred Reporting Items for Systematic Reviews (PRISMA) scoping review guidelines. Electronic databases (Medline, PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Allied and Complementary Medicine Database (AMED) and Cochrane Database of Systematic Reviews), grey literature and the reference lists of key texts will be searched. Information about the rehabilitation design, dosage and intensity of exercise programmes used as well as demographic information such as the age of participants and aetiology of dysphagia will be extracted. The number of articles in each area and the type of data source will be presented in written and visual format. Comparison between literature in adult and child populations will be discussed. Discussion: If therapy protocols from the adult literature are to be developed for use in paediatrics, it is important to have a clear understanding of the scope and effectiveness of interventions described in both adults and children. This review is unique as it directly compares dysphagia rehabilitation in adults with that of a paediatric population in order to formally identify and discuss the therapeutic gaps in child dysphagia rehabilitation. The results will inform the next stage of research, looking into current UK based Speech and Language Therapy practices when working with children with an acquired dysphagia. Systematic review registration: Not registered.
Inverse Relationship Between Serum Cystatin C and Sudomotor Function Detected by SUDOSCAN in Chinese Patients With Type 2 Diabetes Mellitus
Authors: Guo Qingyu , Lu Bin , Wang Liping , Guo Zhanhong , Song Wenjing , Zang Pu , Gu Ping , Li Ling , Shao Jiaqing 
Published: December 2020

Abstract
Background and aims:To explore the relationship between serum cystatin C and sudomotor function produced by the SUDOSCAN in subjects with type 2 diabetes mellitus.Methods:The research incorporated 917 Chinese individuals with type 2 diabetes mellitus from May 2017 to May 2019. All patients underwent SUDOSCAN and examined cystatin C. SUDOSCAN was evaluated with electrochemical skin conductance in hands (HESC) and feet (FESC), asymmetry ratio in hands (HASYM) and feet (FASYM). Average FESC <60 µS was defined as sudomotor dysfunction. 917 patients were classified into 791 diabetic patients without sudomotor dysfunction, and 126 diabetic patients complicated with sudomotor dysfunction. The difference of cystatin C between two groups was compared firstly, the difference of SUDOSCAN metrics among tertiles of serum cystatin C was also compared. The spearman and multiple linear regression analyses were applied to analyze the association between serum cystatin C and SUDOSCAN metrics. Results:The total prevalence of sudomotor dysfunction was 13.74%. Patients with sudomotor dysfunction had a higher level of cystatin C (P<0.001). With increasing tertiles of serum cystatin C, ESC declined, ASYM elevated, and the prevalence of sudomotor dysfunction increased (P<0.001).The spearman analysis performed an association between serum cystatin C and SUDOSCAN metrics including HESC (r=-0.143, P<0.001), FESC(r=-0.178, P<0.001), HASYM (r=0.169, P<0.001), FASYM (r=0.174, P<0.001). Multivariate regression linear analyses demonstrated cystatin C was independently linked with HESC (B=-14.657, P<0.001) and FESC (B=-10.015, P=0.022) levels after controlling for potential confounders. Conclusions:Serum cystatin C is inversely linked with sudomotor function detected by SUDOSCAN in Chinese patients with type 2 diabetes mellitus.
Effect of sodium-glucose co-transporter-2 inhibitors on the levels of serum asprosin in patients with newly diagnosed type 2 diabetes mellitus
Authors: Jiang Aijun , Feng Zhanrong , Yuan Lu , Zhang Ying , Li Qian , She Yuqing 
Published: December 2020

Abstract
BackgroundAsprosin, a novel adipokine which raises glucose levels and stimulates appetite, has been proved to be pathologically increased in populations predisposed to type 2 diabetes mellitus (T2DM), obesity and cardiovascular diseases. The mechanisms of sodium-glucose co-transporter-2 (SGLT2) inhibitors for hypoglycemic effect and cardiovascular protection have not been fully clarified. Therefore, we conducted this study to assess change in the levels of serum asprosin after treatment with SGLT2 inhibitors in patients with newly diagnosed T2DM.MethodsThis study was a randomized, double-blind, placebo-controlled trial. A total of 29 participants with newly diagnosed T2DM with body mass index (BMI) ≥ 23.0 kg/m² and haemoglobin A1c (HbA1c) levels of 58 ~ 85 mmol/mol (7.5%~10%) were randomized to SGLT2 inhibitors dapagliflozin 10 mg/d (n = 19) or placebo (n = 10) treatment for 24 weeks. We analyzed asprosin concentrations by an enzyme-linked immunosorbent assay. In addition, body weight, BMI, HbA1c, fasting plasma glucose (FPG), and lipid levels were measured at baseline and at 24 weeks.ResultsAt 24 weeks, participants with SGLT2 inhibitors treatment exhibited lower the levels of serum asprosin (22.87 vs 45.06 ng/ml in the placebo group; P < 0.001) after adjusting for baseline values. The levels of body weight, BMI, HbA1c, FPG and triglyceride (TG) were decreased, while high density lipoprotein-cholesterol (HDL-C) was increased after SGLT2 inhibitors dapagliflozin treatment compared with placebo (P < 0.05 for all). Low density lipoprotein-cholesterol (LDL-C) and total cholesterol (TC) levels were unchanged in SGLT2 inhibitors group and placebo group. No statistical correlation was found between the levels of serum asprosin and body weight, BMI, HbA1c, FPG, and lipid levels during the SGLT2 inhibitor dapagliflozin treatment.ConclusionsThis study shows that SGLT2 inhibitors can decrease the levels of serum asprosin in patients with newly diagnosed T2DM, which may be involved in SGLT2 inhibitors mechanisms of improving glucose levels and reducing cardiovascular diseases risk factors.Trial registrationISRCTN, ISRCTN2013L01573. Registered 29 august 2013. http://www.icmje.org/search/?q=ISRCTN+2013L01573ISRCTN, ISRCTN2014L00001.Registered 4 January http://www.icmje.org/search/?q=ISRCTN+2014L00001
Messenger RNA levels of enzymes involved in glycerolipid synthesis in the brain of the mouse and its alterations in Agpat2-/- and db/db mice
Authors: Gonzalez-Hodar Lila , Agarwal Anil K. , Cortés Víctor 
Published: December 2020

Abstract
Background and Aims:

Expression of genes encoding enzymes involved in glycerolipid and monoacylglycerol pathways in specific brain regions is poorly known and their alterations in insulin resistance (IR) and type 2 diabetes (T2D) remain unreported. We determined the mRNA levels of enzymes involved in glycerolipid synthesis in specific regions of the mouse brain and their changes in two models of severe IR, the lipodystrophic Agpat2−/− and the obese Leprdb/db mice.
Methods

Cerebral cortex, hypothalamus, hippocampus and cerebellum were dissected from adult Agpat2−/− mice, Leprdb/db mice and their respective wild type littermates. Total RNA was isolated and the relative mRNA abundance of enzymes was determined by RT-qPCR.
Results

GPAT1, AGPAT1-4, LIPIN1/2, DGAT1/2 and MOGAT1 mRNAs were detected in all studied brain regions, whereas GPAT2, LIPIN3 and MOGAT2 were undetectable. Abundance of GPAT1, AGPAT1, AGPAT2, AGPAT4, LIPIN1, and MOGAT1, was higher in the hypothalamus. AGPAT3 and DGAT1 were higher in cortex and cerebellum, and LIPIN2 and DGAT2 were higher in cortex and hippocampus. In Agpat2−/− mice, LIPIN1 levels were increased in all the brain regions. By contrast, GPAT1 and AGPAT4 in hypothalamus, AGPAT3 in hippocampus and hypothalamus, and MOGAT1 in cortex, hypothalamus and cerebellum were lower in Agpat2−/− mice. Leprdb/db mice showed fewer and milder changes, with increased levels of GPAT1 and LIPIN1 in cerebellum, and AGPAT3 in hypothalamus.
Conclusions

Enzymes involved in glycerolipids synthesis are differentially expressed across regions of the mouse brain and IR and T2D determine altered gene expression of these enzymes in the mouse brain.
Short-term effectiveness of safety decompression via double percutaneous lumbar foraminoplasty and percutaneous endoscopic lumbar decompression for lateral lumbar spinal canal stenosis: a prospective cohort study
Authors: Wang Yu , Deng Mingyan , Wu Hao , Wu Ye , Guo Chuan , Zhang Dongfeng , Kong Qingquan 
Published: December 2020

Abstract
Purpose This prospective cohort study reports on a modified technique, namely precise safety decompression via double percutaneous lumbar foraminoplasty (DPLF) and percutaneous endoscopic lumbar decompression (PELD) for lateral lumbar spinal canal (LLSC) stenosis, and its short-term clinical outcomes.Methods The study analyzed 69 patients with single-level LLSC stenosis simultaneously occurring in both zones 1 and 2 (defined as retrodiscal space and upper bony lateral recess respectively by new LLSC classification) who underwent DPLF–PELD from November 2018 to April 2019. Clinical outcomes were evaluated according to preoperative, three months postoperatively, and last follow-up, via leg pain/low back pain (LBP) visual analog scale (VAS) scores, Oswestry disability index (ODI) scores, and the Macnab criteria. The postoperative MRI and CT were used to confirm the complete decompression, and flexion-extension x-rays at the last follow-up were used to observe lumbar stability.Results All patients successfully underwent DPLF–PELD, and the stenosis was completely decompressed, confirmed by postoperative MRI and CT. The mean follow-up duration was 13 months (range: 8–17 months). The mean preoperative leg pain VAS score is 7.05 ± 1.04 (range 5–9), which decreased to 1.03 ± 0.79(range: 0–3) at three months postoperatively and to 0.75 ± 0.63 (range: 0–2) by the last follow-up visit(p < 0.05). The mean preoperative ODI was 69.8 ± 9.05 (range: 52–85), which decreased to 20.3 ± 5.52 (range: 10–35) at the third month postoperatively and to 19.6 ± 5.21 (range: 10–34) by the final follow-up visit(p < 0.05). The satisfactory (excellent or good) results were 94.2%. There was one patient with aggravated symptoms, which were relieved after an open surgery. Two patients had a dural tear, and two patients suffered postoperative LBP. No recurrence or segmental instability was observed at the final follow-up.Conclusion DPLF–PELD could be a good alternative for the treatment of LLSC stenosis patients whose stenosis occurred in both zones 1 and 2.Trial registration Chinese Clinical Trial Registry (ChiCTR1800019551). Registered 18 November 2018.
Prevalence of heavy episodic drinking and associated factors among adults residing in Arba Minch health and demographic surveillance site: a cross sectional study
Authors: Gutema Befikadu Tariku , Chuka Adefris , Ayele Gistane , Tariku Eshetu Zerhun , Aschalew Zeleke , Baharu Alazar , Degefa Nega , Gurara Mekdes Kondale 
Published: December 2020

Abstract
Background: Alcohol consumption is associated with different types of illnesses; particularly heavy episodic drinking is one of the risk factors for the disease burden of alcohol intake. The aim of the study was to assess the prevalence of heavy episodic drinking and associated factors in Arba Minch Health and Demographic Surveillance Site (HDSS).Methods: A community-based cross-sectional study was conducted in 2017 among adult residents of Arba Minch HDSS. Using Arba Minch HDSS database, 3368 individuals were selected by simple random sampling techniques. From WHO STEPS instruments, step one was applied for this study. Variables with a p-value of less than 0.10 for bivariate analysis entered into a multivariable logistic regression model to outline the independent predictors of the heavy episodic drinking. To assess the presence of an association between dependent and independent variables, a p-value of less than 0.05 was considered.Results: The prevalence of heavy episodic drinking was 13.7% (95% CI: 12.6–14.9). The study has shown that heavy episodic drinking was significantly associated with occupation (daily laborer [AOR=0.49; 95% C.I: 0.29–0.85] and housewives [AOR=0.63; 95% C.I: 0.45–0.88] compared with farmers), wealth index (2nd quintiles [AOR =0.55; 95% C.I: 0.41–0.74) and 3rd quintiles [AOR = 0.66; 95% C.I: 0.46–0.93] compared with 1st quintiles), and climatic zone (midland [AOR=1.80;95% CI: 1.11–2.93), highland [AOR=1.95;95% CI: 1.19–3.18] compared with lowland). In addition, tobacco use [AOR=4.28;95% CI: 3.38–5.43], and khat use [AOR=4.75; 95% CI: 2.66–8.50) were also associated with heavy episodic drinking among the study participants. Conclusions: More than one in ten adults reported heavy episodic drinking in the study area. Intervention programs that aim to prevent heavy episodic drinking should be designed appropriately for individuals from lower wealth status, and for highlander.