bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic Validity of the American Joint Committee on Cancer Eighth Edition Staging System for Well-Differentiated Pancreatic Neuroendocrine Tumors: A Retrospective Multinational Multicenter Study
Authors: Wang Hebin , Ding Ding , Qin Tingting , Liu Jun , Zhang Hang , Zhao Junfang , Wu Chien-Hui , Javed Ammar , Wolfgang Christopher , Guo Shiwei , Chen Qinmin , Zhao Weihong , Shi Wei , Zhu Feng , Guo Xingjun , Li Xu , Peng Feng , He Ruizhi , Xu Simiao , Jin Jikuan , Wu Yi , Nuer Abula , Edil Barish , Tien Yu-Wen , Jin Gang , Zheng Lei , He Jin , Liu Jianhua , Liu Yahui , Wang Min , Qin Renyi 
Published: October 2020

Abstract
Background:There is no widely-accepted staging system for pancreatic neuroendocrine tumors (pNETs). The aim of this study was to validate the American Joint Committee on Cancer (AJCC) 8th edition staging system for well-differentiated (G1/G2) pNETs.Methods:A multicenter dataset (n=1086) was used to evaluate the application of the AJCC 7th and 8th, the European Neuroendocrine Tumor Society (ENETS), and the modified ENETS (mENETS) staging systems for well-differentiated pNETs.Results:The proportion of patients with stage III tumors was extremely low (1.1%) according to the AJCC 7th staging system. For the ENETS staging system, patients with stage IIIA disease had worse estimated mean survival than patients with stage IIIB disease (78.9 vs. 107.3 months). When comparing with patients in stage I, the AJCC 7th, ENETS, and mENETS staging systems showed good performance in discriminating between stages; however, there was no significant difference in some stages when the reference was defined as the earlier stage. When the reference was defined as stage I or the earlier stage, there was a significant inter-stage difference in the AJCC 8th staging system.Conclusions:The AJCC 8th staging system is more suitable for pNETs than other TNM staging systems and may be adopted in clinical practice.
The Interaction Relationship Between The Diversification of Health Care Support Activities and The Health Care Services Outreach: Evidence from Microfinance Institutions in Vietnam
Authors: Ha Duong Van , Ha Van Duong , Ha Pham Trong Khang 
Published: October 2020

Abstract
Background: One of the main ways to strengthen the health-system capacity by the intersectoral approaches is to promote social health by linking microfinance with healthcare support activities. The aim of the study was to discover the interaction relationship between the diversification of health care support activities and the health care services outreach of formal microfinance institutions (MFIs) in Vietnam. This study proposes policy measures that could be implemented by the policy makers, managers of MFIs to diversify the health care support activities and to promote the health care services outreach.Methods: This study used the panel data regression method from 2010 to 2019 of all formal MFIs in Vietnam, the study found out the interaction relationship between the diversification of health care support activities and the health care services outreach of formal MFIs in Vietnam.Results: The results showed that number of branches and the health care services outreach had positive relationships with the diversification of health care support activities; productivity had a negative impact on the diversification of health care support activities. The diversification of health care support activities, and productivity had positive relationships with the health care services outreach; number of branches had a negative impact on the health care services outreach. At the same time, this study found bidirectional interactions and the causal relationship between the diversification of health care support activities and the health care services outreach of formal MFIs in Vietnam.Conclusions: This study found bidirectional interactions and the causal relationship between the diversification of health care support activities and the health care services outreach. The study results encourage and provide opportunities to diversify the health care support activities and to promote the health care services outreach of formal MFIs in Vietnam.
Optimized and Non-Optimized Personal Protective Equipment use During the COVID-19 Pandemic in Thailand: A National Cross-Sectional Survey in a Resource-Limited Setting
Authors: Moolasart Visal , Manosuthi Weerawat , Thienthong Varaporn , Jaemsak Uajai , Pantool Pimonamorn , Chottanapund Suthat 
Published: October 2020

Abstract
Background: Coronavirus disease (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-COV2). COVID-19 is highly contagious, potentially fatal, and a global public health concern. Combining optimized personal protective equipment (PPE) use and hand hygiene is the best strategy for preventing COVID-19 in health care workers (HCWs).Methods: We conducted a national cross-sectional survey of HCWs in the infection control program in Thailand between May 5, 2020 and May 15, 2020. The primary objective was the prevalence of optimized PPE use amongst HCWs. The secondary objective was identification of the independent predictors of optimized PPE use. Results: Seven hundred and fifty-six HCWs responded. Five HCWs were excluded because of non responsible of care team, and 751 were included in the final analysis. The prevalence of optimized PPE use was 22 % (168/751), 78% (583/751) were non-optimized PPE use, 35% (263/751) over-used PPE, and 43% (320/751) under-used PPE. In univariate analysis, optimized PPE use was significantly associated with age, education level, knowledge of appropriate negative pressure room selection and knowledge of apparently milder symptom severity in children than adults. In multivariate analysis, independent predictors of optimized PPE use were knowledge of appropriate negative pressure room selection (aOR=1.95, 95% CI=1.18-3.22) , the difference in symptom severity between children and adults (aOR=0.55, 95% CI=0.37-0.81) and education level (aOR=1.54, 95% CI=1.04-2.27).Conclusion: The prevalence of optimized PPE use amongst HCWs was 22 %. Independent predictors of optimized PPE use were COVID-19 knowledge-based factors and education level.Continued education is advised among Thai HCWs.
Gynaecological health burden among women in the Niger Delta region of Nigeria: A hospital based analysis
Authors: Onyije Felix Monday , Azubuike Ngokere Ajuluchukwu , Ebi Ligha Aloysius , Ovie Avwioro Godwin , Osaro Mgbere 
Published: October 2020

Abstract
BackgroundIncreasingly, residents of the Niger Delta region of Nigeria are reporting health impacts that they believe are linked to environmental pollutions relating to oil and gas activities. Hence, this study aimed to assess the gynaecological health burden among women in the Niger Delta region receiving medical care at the Rivers State University Teaching Hospital (RSUTH) in Port Harcourt, Nigeria. MethodsData used for this study (n=697) were obtained from the RSUTH, Port Harcourt, Nigeria and covered the period between 2010 and 2014. The data were generated from patients who had partial or total hysterectomy or diagnosed of gynaecological lesion between 2010 and 2014. We extracted from the records, age, type of lesions and the origin of the tissue. Data obtained from this study were subjected to both descriptive and inferential statistics. All tests performed were two-tailed, with a probability value of .05 used as the statistical significance level. All statistical analyses were conducted using SAS 9.4 version (SAS Institute, Cary, NC, USA). ResultsThe distribution of the gynaecological lesions differed significantly (p<0.001) by year of diagnosis, developmental stage, age category and types of lesion. Leiomyoma was the highest number of lesions identified (56.0%, n=390), followed by ovarian cyst (10.0%, n=70) and retained product of conception (8.0%, n=56). Women of age group 30-39 years and 40-49 years had the highest number of lesions during the period with a range of 21-71% and 17-34 %, respectively.ConclusionThe preponderance and characteristics of gynaecological lesions in our study sample point to the potential public health consequences, and strong need for creation of awareness campaigns and mass health screenings in the Niger Delta region of Nigeria.
Parkinson Mice Show Functional and Molecular Changes in the Gut Long before Motoric Disease Onset
Authors: Gries Manuela , Christmann Anne , Schulte Steven , Weyland Maximilian , Rommel Stephanie , Martin Monika , Baller Marko , Röth Ralph , Schmitteckert Stefanie , Unger Marcus , Liu Yang , Sommer Frederik , Mühlhaus Timo , Schroda Michael , Timmermans Jean-Pierre , Pintelon Isabel , Rappold Gudrun A. , Britschgi Markus , Lashuel Hilal , Menger Michael D. , Laschke Matthias W. , Niesler Beate , Schäfer Karl-Herbert 
Published: October 2020

Abstract
Background:There is increasing evidence that Parkinson’s disease (PD) might start in the gut, thus involving and compromising also the enteric nervous system (ENS). At the clinical onset of the disease the majority of dopaminergic neurons in the midbrain is already destroyed, so that the lack of early biomarkers for the disease represents a major challenge for developing timely treatment interventions. Here, we use a transgenic A30P-α-synuclein-overexpressing PD mouse model to identify appropriate candidate markers in the gut before hallmark symptoms begin to manifest. Methods:Based on a gait analysis we defined 2-month-old A30P mice as pre-symptomatic (psA30P), since they are not showing any motoric impairments of the skeletal neuromuscular system. Mice at this particular age were further used to analyze functional and molecular alterations in both, the gastrointestinal tract and the ENS, to identify early pathological changes. We examined gastrointestinal motility, molecular composition of the ENS, as well as the expression of regulating miRNAs. Moreover, we applied A30P-α-synuclein challenges in vitro to simulate PD in the ENS. Results:A retarded gut motility and early molecular dysregulations were found in the myenteric plexus of psA30P mice. We found that i.e. neurofilament light chain, vesicle-associated membrane protein 2 and calbindin 2, together with the miRNAs that regulate them, are significantly altered in the psA30P, thus representing potential biomarkers for early PD. Many of the dysregulated miRNAs found in the psA30P mice are reported to be changed in PD patients as well, either in blood, cerebrospinal fluid or brain tissue. Interestingly, the in vitro approaches delivered similar changes in the ENS cultures as seen in the transgenic animals, thus confirming the data from the mouse model. Conclusions:These findings provide an interesting and novel approach for the identification of appropriate biomarkers in men.
Association between Unmet Needs for Informal support and Diabetes-related Distress among People Living with Type 2 Diabetes in Vietnam: A Cross-sectional Study
Authors: Khong Diep Thi , Xuan Bai Nguyen , Duc Cuong Le , Gammeltoft Tine , Søndergaard Jens , Meyrowitsch Dan Wolf , Bygbjerg Ib Christian , Nielsen Jannie 
Published: October 2020

Abstract
Background: Diabetes-related distress (DRD) in people with type 2 diabetes (T2D) is associated with reduced quality of life. Lower levels of DRD were found in people who received informal support. The prevalence of T2D in Vietnam is rapidly increasing. Yet, the prevalence of DRD and its association with informal social support have not been investigated. The present investigate the prevalence of DRD and its association with unmet needs for informal support in people with T2D in Vietnam. Methods: A total of 806 people, age ³40 years, diagnosed with T2D in Thai Binh, Vietnam, completed a questionnaire-based cross-sectional survey. DRD was self-reported, based on the Problem Areas In Diabetes scale 5 (PAID 5). We assessed 6 types of unmet needs for informal support from family/friends/community including: (i) Transport and company when visiting health facilities; (ii) Reminders to take medication; (iii) Purchase and preparation of food; (iv) Reminders to engage in physical exercise; (v) Emotional support; and (vi) Financial support. Multivariable logistic regression was used to model DRD as an outcome of each type of unmet need for informal support, and as an outcome of the number of unmet needs for informal support, adjusted for three sets of covariates. Results: The prevalence of DRD in people with T2D was 50.0%. Odds for DRD were higher among those who had unmet needs for emotional support and financial support as compared to those with met needs (OR=2.59, CI95%: 1.19-5.63 and OR= 1.63, CI95%: 1.10 -2.40, respectively). People who had more than one type of unmet need was not a higher risk of DRD as compared to those with only one type of unmet need. Conclusions: Half of the people with T2D had DRD. DRD was associated with unmet needs for emotional and financial support. The findings suggest that in order to prevent or reverse DRD, family members and others providing informal support should be included in health programs and interventions targeting people with T2D in Vietnam and similar settings.
Effect of Postpartum Depression on Exclusive Breast-Feeding Practices in Sub-Saharan Africa Countries: Systematic Review and Meta-analysis
Authors: Handiso Demelash Woldeyohannes , Ifa Yohannes Tekalegn , Sahiledengle Biniyam Sahiledengle , Makango Dejene Ermias , Wontamo Tekele Ejajo , Mwanri Lillian Mwanri 
Published: October 2020

Abstract
Background: Postpartum depression (PPD) is a serious mood disorder that affects behavioural, physical and mental health of women and newborn after childbirth. Although a wide range of research have been conducted on maternal and infant health outcomes, the effect of postpartum depression on exclusive breastfeeding practices remains ambiguous, and needs addressing. The aim of this study was to assess the effect of postpartum depression on exclusive breast feeding practices in sub-Saharan African countries.Methods: PubMed, Google Scholar, Science Direct and Cochrane Library were systematically searched for relevant articles published between 2001 and 2020. STATA version 14 was used to calculate the pooled odd ratio with 95% confidence intervals (95% CI). The DerSimonian and Laird random effects meta-analysis was used to measure the effect of postpartum depression on exclusive breast feeding practices. The heterogeneity and publication bias were assessed by using I2 test statistics and Egger’s test, respectively. This review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis.Result: A total of 1482 published articles and Grey literatures were retrieved from different databases. Additional articles were from the reference list of identified reports and articles. After assessment of obtained articles, studies not meeting the inclusion criteria were excluded. Twenty six studies involving 30021 population met the inclusion criteria were included in this review. In sub Saharan Africa the overall estimated level of postpartum depression was 18.6% (95% CI: 13.8, 23.4). This review found that postpartum depression had no significant effect on exclusive breast feeding practices (OR = 0.46, 95% CI: 0.18, 1.14). Conclusion: In Sub Saharan Africa, the prevalence of postpartum depression was higher than WHO report of 2018. This review reveled that maternal postpartum depression has no significant effect on exclusive breast feeding practices. Thus, the investigators strongly recommend the researchers to conduct primary studies using strong study design in sub-Saharan Africa.
“I came to escort someone”: Men’s experiences of antenatal care services in Urban Ghana. A qualitative study
Authors: Ampim Gloria Abena , Blystad Astrid , Kpoor Albert , Haukanes Haldis 
Published: October 2020

Abstract
BackgroundMale involvement in maternal healthcare has been widely recognized as important for positive health outcomes for expectant mothers and their unborn babies, but few studies have explored men’s experiences of maternal health services. The purpose of this paper is to explore men’s involvement in antenatal care in urban Ghana and to discuss how men navigate their roles in a space that has been constructed as feminine. The study draws upon theories of gender, place and space.MethodsA qualitative exploratory study using semi-structured interviews, focus group discussion and observation was conducted in Accra, Ghana. Expectant fathers and health workers were interviewed and observation was conducted at a selected public hospital in Accra. ResultsThe findings suggest that the few men who attend antenatal care with their expecting partners get involved to a limited extent in activities at the clinic. Beyond a few who take an active role, most men stay on the outskirts of the hospital grounds, and rarely participate in the consultation with their partner and nurse-midwife. Men still view their presence as important, both to acquire knowledge, and as a source of emotional, financial and physical support for their partners. On the health workers’ side, the study found that there was no clear agenda for engaging men at the clinic, and nurses / midwives felt the lack of staff who could engage more directly with the men. ConclusionThe study indicates that most expecting fathers feel too shy and uncomfortable to locate themselves in the female space that makes up antenatal care / maternity wards. Health workers do not feel they have the necessary resources to involve men in a fruitful way. Thus, men do not engage in the activity as hoped but remain on the outskirts of the maternity clinic. However, if men continue to negotiate their involvement at the clinic and become more assertive in their roles, the maternity clinic as a female space could, with time, be transformed into a space where both expecting mothers and fathers can be active and engaged to the benefit of all.
Leeches as the intermediate host for strigeid trematodes – genetic diversity and taxonomy of the genera Australapatemon Sudarikov, 1959 and Cotylurus Szidat, 1928
Authors: Pyrka Ewa , Kanarek Gerard , Zaleśny Grzegorz , Hildebrand Joanna 
Published: October 2020

Abstract
BackgroundLeeches (Hirudinida) play a significant role as intermediate hosts in the circulation of trematodes in the aquatic environment. However, the species richness, molecular diversity and phylogeny of larval stages of Strigeidae trematodes (tetracotyle) occurring in this group of aquatic invertebrates remain poorly understood. In the present work, on the basis of recently obtained sequences of several molecular markers we analysed several aspects of the ecology, taxonomy and phylogeny of the genera Australapatemon and Cotylurus, which utilise leeches as intermediate hosts.MethodsFrom April 2017 to September 2018, 153 leeches were collected from several sampling stations in small rivers with slow-flowing waters and related drainage canals located in three regions of Poland. The distinctive forms of tetracotyle metacercariae collected from leeches supplemented with adult Strigeidae specimens sampled from a wide range of water birds were analysed using the 28S rDNA partial gene, ITS2 region and the COI fragment.ResultsAmong investigated leeches, metacercariae of the tetracotyle type were detected in the parenchyma and musculature of 62 specimens (prevalence 40.5%) with a mean intensity reaching 19.9 ind. The taxonomic generic affiliation of metacercariae derived from leeches revealed the occurrence of two Strigeidae genera: Australapatemon Sudarikov, 1959 and Cotylurus Szidat, 1928. Phylogenetic reconstructions based on the partial 28S rRNA gene, ITS2 region and partial COI gene confirmed the separation of the Australapatemon and Cotylurus clades. Unfortunately, regarding currently available molecular data and our results, it is not possible to precisely define the taxonomic position of the recently sequenced tetracotyle of Australapatemon. On the other hand, on the basis of the obtained sequences, supplemented with previously published data, the metacercariae of Cotylurus detected in leeches were identified as two species: C. strigeoides Dubois, 1958 and C. syrius Dubois, 1934. This is the first record of C. syrius from the intermediate host.ConclusionsThe results suggest the separation of ecological niches and life cycles between C. cornutus (Rudolphi, 1808) and C. strigeoides/C. syrius with potential serious evolutionary consequences for a wide range of host–parasite relationships. Moreover, phylogenetic analyses corroborated the polyphyletic character of C. syrius, the unclear status of C. cornutus and the separate position of Cotylurs raabei Bezubik, 1958 within Cotylurus. The data demonstrate the inconsistent and confusing taxonomic status of the sequenced tetracotyle of Australapatemon, resulting, in our opinion, from the limited availability of fully reliable, comparative sequences of related taxa in GenBank.
Neutrophil-to-Lymphocyte Ratio is Associated With Increased Cerebral Blood Flow Velocity in Acute Bacterial Meningitis
Authors: Giede-Jeppe Antje , Atay Selim , Koehn Julia , Mrochen Anne , Luecking Hannes , Hoelter Philip , Volbers Bastian , Huttner Hagen B. , Hueske Lena M. , Bobinger Tobias 
Published: October 2020

Abstract
ObjectiveIn community-acquired bacterial meningitis(CABM) intracranial vascular alterations are devastating complications which are triggered by neuroinflammation and result in worse clinical outcome. The neutrophil-to-lymphocyte ratio(NLR) represents a reliable parameter of the inflammatory response. So far, in CABM-patients the association between NLR and elevated cerebral blood flow velocity(CBFv) remains unclear.MethodsThis study included all (CABM)-patients admitted to a German tertiary center between 2006-2016. Patient demographics, in-hospital measures and neuroradiological data were retrieved from institutional databases. CBFv was assessed by transcranial Doppler sonography transcranial doppler(TCD). Patients’, radiological and laboratory characteristics were compared between patients with/without elevated CBFv. Multivariate-analysis investigated parameters independently associated with elevated CBFv. Receiver operating characteristic(ROC-)curve analysis was undertaken to identify the best cut-off for NLR to discriminate between increased CBFv.Results108 patients with CABM were identified. 27.8%(30/108) showed elevated CBFv. These patients had a worse clinical status on admission(Glasgow Coma Scale:12[9-14vs.14[11-15]; p=0.005) and required more often intensive care (30/30[100%]vs.63/78[80.8%];p=0.01).The causative pathogen was S. pneumoniae in 70%. These patients developed more often cerebrovascular complications with delayed cerebral ischemia(DCI) within hospital stay(p=0.031). A significantly higher admission-NLR was observed in patients with elevated CBFv(median[IQR]:elevated CBFv:24.0[20.4-30.2]vs. normal CBFv:13.5[8.4-19.5];p<0.001). After adjusting for significant parameters in univariate testing, NLR on admission was significantly associated with increased CBFv(Odds ratio[95%CI]:1.042[1.003-1.084];p=0.036). ROC-analysis identified a NLR of 20.9 as best cut-off value to discriminate between elevated CBFv(area under the curve=0.713, p<0.0001,Youden's Index=0.441;elevated CBFv:NLR>20.9 19/34[55.9%]vs.NLR<20.9 11/74[14.9%];p<0.001).ConclusionsIntracranial vascular complications are common among CABM-patients and are a risk factor for unfavorable outcome at discharge. NLR is independently associated with elevated CBFv.