bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and Determinants of Home Delivery in Eastern Africa: Further Analysis of Countries Recent Demographic and Health Survey Data
Authors: Regassa Lemma Demissie , Tola Assefa , Weldesenbet Adisu Birhanu , Tusa Biruk Shalmeno 
Published: February 2021

Abstract
Background: Despite the high proportion of maternal mortality ratio in East African countries primarily attributed to home delivery, overall magnitude of home delivery and its determinants remains unclear. Therefore, the current study aimed to determine magnitude of home delivery and its determinant factors in East Africa using Demographic and Health Survey (DHS) data.Methods: We pooled the DHS survey data of the 11 East African countries, and a total weighted sample of 125,786 women were included in the study. Generalized Linear Mixed Models (GLMM) was fitted to identify factors associated with home delivery. Variables with Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI), and p-value < 0.05 in the final GLMM model were reported to declare significantly associated factors with home delivery.Result: The weighted prevalence of home delivery was 23.79% [95% CI: 23.55 – 24.02] among women in East Africa countries. Home delivery was highest among Ethiopian women (72.5%) whereas, it was lowest among women from Mozambique (2.8%). In GMM, respondent’s age group, marital status, educational status, place of residence, living country, wealth index, media exposure and total children ever born were shown significantly associated with the home delivery in the East Africa countiesConclusion: Home delivery was varied between countries of East African zone. The home delivery was significantly increased among women aged 20-34 years, higher number of ever born children, rural residence, never married or formerly married participants. To the contrast home delivery was decreased with higher educational level, media exposure, and higher wealth index. Wide range interventions to decrease home delivery should focus on addressing inequities associated with maternal education, family wealth, increased access to media, as well as narrowing the gap between the rural and the urban areas, poor and rich families, and married and unmarried mothers.
Astrocytic YAP Protects the Optic Nerve and Retina in an Experimental Autoimmune Encephalomyelitis Model Through TGF-β Signaling
Authors: Wu qian , Miao Xuemeng , Zhang Jingjing , Xiang Ludan , Li Xiuchun , Bao Xiaomei , dong Haoru , Du Siyu , Wang Wei , Xu Xingxing , Zhang xu , Shen Xiya , Yang Danlu , Wang Xiwu , Miao shuangda , fang yuanyuan , Wang hui , hu lixin , Fan Yiren , pan xuyi , Wang Ying , huang zhihui 
Published: February 2021

Abstract
BackgroundOptic neuritis, inflammation of the optic nerve (ON), is one of the main symptoms in multiple sclerosis (MS) and leads to visual disability. Astrocytes are pivotal regulators of neuroinflammation in MS. However, it remains unclear that the detailed roles and mechanisms of astrocytes in the neuroinflammation and demyelination in optic neuritis of MS. MethodsTo assess the role of YAP in ON and retina in response to experimental autoimmune encephalomyelitis (EAE), mice that conditionally knockout (CKO) YAP in astrocytes, namely YAP GFAP -CKO mice, were successfully generated. Immunostaining, Nissl staining, Hematoxylin-Eosin (HE) staining, TUNEL staining, luxol fast blue (LFB) staining, electron microscopy (EM), qRT-PCR and gene set enrichment analysis (GSEA) and gene set variation analysis (GSVA) by RNA sequencing were used to examine the roles of YAP pathway in EAE based on these conditional knockout mice. Inhibitors including SRI-011381 [an agonist of transforming growth factor-β (TGF-β) pathway] and XMU-MP-1 (an inhibitor of Hippo kinase MST1/2 to activate YAP) were used to further explore the molecular mechanism of YAP in ON and retina of EAE mice. Additionally, microglia and retinal ganglion cells (RGCs) counts, and demyelination and astrocytes were assessed by immunohistological staining. ResultsWe found that yes-associated protein (YAP) was significantly upregulated and activated in the astrocytes of ON in EAE. Conditional knockout YAP in astrocytes caused more severe inflammatory infiltration and demyelination in ON, and damage of the RGCs in EAE mice. Moreover, YAP deletion in astrocytes promoted the activation of astrocytes and microglia, but inhibited the proliferation of astrocytes of ON in EAE mice. Mechanically, TGF-β signaling pathway was significantly down-regulated after YAP deletion in astrocytes . Additionally, both qPCR and immunofluorescence assays confirmed the reduction of TGF-β 1 in YAP knockout ON astrocytes of EAE mice. Interestingly, SRI-011381 partially rescued the deficits in ON and retina of YAP knockout EAE mice. Finally, activation of YAP pathway relieved the neuroinflammation and demyelination in optic neuritis of EAE mice. ConclusionsThese results suggest astrocytic YAP may prevent the neuroinflammatory infiltration and demyelination through upregulation of TGF-β signaling and provide targets for the development of therapeutic strategies tailored for optic neuritis in MS.
Norovirus outbreaks in long-term care facilities. Catalonia, 2017-2018
Authors: Parrón Ignacio , Barrabeig Irene , Alseda Miquel , Rius Cristina , Cornejo-Sánchez Thais , Jané Mireia , Pérez Cristina , Guix Susanna , Domínguez Àngela , Group Working 
Published: February 2021

Abstract
Norovirus is the leading cause of outbreaks of acute viral gastroenteritis. We carried out this study to investigate outbreaks in long-term care facilities reported in 2017 and 2018 in Catalonia (Spain). The characteristics of the centres, exposed persons and the genogroups responsible were analyzed. Viral loads were estimated. The attack rate (AR), rate ratios (RR) or the odds ratio (OR) and its 95% confidence intervals were calculated. The mean cycle thresholds (Cq) were compared using the t-test for independent means. We included 30 outbreaks (4,631 exposed people). The global AR was 25.9%. The RR of residents vs. staff was 2.28 (95%CI 2.0-2.6). In residents with total or severe dependence the attack rate was 85.16% and in residents with moderate and low dependence or independent was 69.13% (RR 1.23, 95% CI 1.05–1.45). ARs were higher in smaller centres than in larger ones (34.4% vs 19.5%; RR 1.76 (95%CI 1.60–1.94). GII was responsible for 70% of outbreaks and 78.5% of identifications. No association was found between the genogroup and presenting symptoms (OR 0.96; 95% CI 0.41 to 2.26). Viral loads were higher in symptomatic than in asymptomatic patients (p = 0.001). Because norovirus was detected in asymptomatic persons, control measures should be applied not only to people with symptoms but to all persons in LTCF where norovirus outbreaks occur.
Ag2O/GO/TiO2 Composite Nanostructure: an efficient heterogeneous catalyst for one pot synthesis of Bis (dihydropyrimidinone) and tetrahydro-4H-chromenes derivatives
Authors: Zadeh Fatemeh Samandi , Mohammadi Mohammad Kazem , Raeiatzadeh Ayeh , Hasanzadeh Neda 
Published: February 2021

Abstract
The simple and efficient synthesis reaction was used for preparing Bis (dihydropyrimidinone) derivatives through Biginelli condensation reaction of terephthalic aldehyde, 1, 3-dicarbonyl compounds and (thio) urea or guanidine and tetrahydro-4H-chromenes via one pot condensation of aromatic aldehydes, malononitrile and dimedone with Ag2O/GO/TiO2 composite nanostructures as a catalyst. The structural functionalities and morphological observations of catalyst were obtained using characterization techniques of field emission scanning electron microscopy (FESEM), X-ray diffraction (XRD), Fourier transfer infrared (FT-IR) spectroscopy and transmission electron microscope (TEM). The structures of Bis (dihydropyrimidinone) and tetrahydro-4H-chromenes confirmed by FT- IR, NMR and mass spectroscopy. Excellent yields of the products, simple reaction process and simple work-up are attractive features of these effective synthesis methods.
Resilience and Its Relationship With Occupational Stress and Professional Quality of Life Among Nurses in COVID-19 Isolation Wards
Authors: Mostafazadeh Ali , Ghorbani-Sani Somayyeh , Seyed-Mohammadi Najmadin , Ghader-jola Kazhal , Habibpour Zeinab 
Published: February 2021

Abstract
Background: Nurses’ direct and continuous contact with patients afflicted by coronavirus disease 2019 (COVID-19) causes them stress due to fear over affliction and reduces their professional quality of life (PQOL). Resilience has potential protective effects against different stressors. This study aimed to assess resilience and its relationship with occupational stress (OS) and PQOL among nurses in COVID-19 isolation wards.Methods: This descriptive-analytical study was conducted in 2020. Participants were nurses in the COVID-19 isolation wards of healthcare centers affiliated to Khoy University of Medical Sciences, Khoy, Iran. In total, 158 eligible nurses were recruited through a census. Data were collected using a researcher-made demographic questionnaire, the short version of the Connor-Davidson Resilience Scale, the Nursing Stress Scale, and the PQOL Scale. Data analysis was performed using the SPSS software (v. 16.) and through the independent-sample t test, one-way analysis of variance, Pearson’s correlation analysis, and linear regression analysis.Results: The total mean scores of resilience and OS were 26.19±6.2 (in the possible range of 0–40) and 73.3±14.5 (in the possible range of 34–136), respectively. The mean scores of the compassion satisfaction, job burnout, and secondary traumatic stress dimensions of PQOL were respectively 38.02±8.16, 30.84±5.45, and 27.66±6.13, (all in the possible range of 10–50). Most participants experienced moderate OS (57.9%). The mean scores of participants’ resilience and OS had no significant relationship with their demographic characteristics (P > 0.05). Resilience had significant negative relationship with OS (r = –0.376, P < 0.001) and significant positive relationship with the compassion satisfaction dimension of PQOL (r = 0.373; P < 0.001). Resilience was also a significant predictor of OS and the compassion satisfaction dimension of PQOL (P < 0.001).Conclusion: Nurses’ OS can be reduced through resilience-promoting strategies such as development of their social support network, improvement of their optimism, and provision of resilient role models and quality resilience-related education.
Exosomal Proteomic Signatures Correlate With Drug Resistance and Carboplatin Treatment Outcome in a Spontaneous Model of Canine Osteosarcoma
Authors: Weinman Marcus A , Ramsey Stephen A , Leeper Haley J , Brady Jacqueline V , Schlueter Andrew , Stanisheuski Stanislau , Maier Claudia S , Miller Tasha , Ruby Carl , Bracha Shay 
Published: February 2021

Abstract
BackgroundOsteosarcoma patients often experience poor outcomes despite chemotherapy treatment, likely due in part to various mechanisms of tumor cell innate and/or acquired drug resistance. Exosomes, microvesicles secreted by cells, have been shown to play a role in drug resistance, but a comprehensive protein signature relating to osteosarcoma carboplatin resistance has not been fully characterized. MethodsIn this study, cell lysates and exosomes from two derivatives (HMPOS-2.5R and HMPOS-10R) of the HMPOS osteosarcoma cell line generated by repeated carboplatin treatment and recovery, were characterized proteomically by mass spectrometry. Protein cargos of circulating serum exosomes from dogs with naturally occurring osteosarcoma, were also assessed by mass spectrometry, to identify biomarkers that discriminate between good and poor responders to carboplatin therapy. ResultsBoth cell lysates and exosomes exhibited distinct protein signatures related to drug resistance. Furthermore, exosomes from the resistant HMPOS-2.5R cell line were found to transfer drug resistance to drug-sensitive HMPOS cells. The comparison of serum exosomes from dogs with a favorable disease-free interval [DFI] of >300 days, and dogs with <100 days DFI revealed a proteomic signature that could discriminate between the two cohorts with high accuracy. Furthermore, when the patient’s exosomes were compared to exosomes isolated from carboplatin resistant cell lines, several putative biomarkers were found to be shared. Conclusions﻿The findings of this study highlight the significance of exosomes in the potential transfer of drug resistance, and the discovery of novel biomarkers for the development of liquid biopsies to better guide personalized chemotherapy treatment.
Characteristics of T lymphocyte subsets and their apparent effect on infection in patients with chronic kidney disease
Authors: Zhang Yali , Ji Ying , Yu Lei , Zhao Ye , Liu Guoping , Dong Lina 
Published: February 2021

Abstract
Background

Chronic kidney disease (CKD) is associated with Immune deficiency. T lymphocytes are significant components of the adaptive immune system. Previous studies have found dysfunction of T lymphocytes in patients with CKD,but the changing trend of the absolute number of T lymphocytes and the relationship with infection has been still unclear in CKD.
Methods

We collected 447 patients with CKD, tested the absolute counts of T lymphocyte subsets, explored the relationship between the absolute count of T lymphocytes and renal function, and explored these impacts on infection.
Results

absolute counts of T lymphocyte gradually decrease as CKD progresses. The patients with infection demonstrated fewer T lymphocyte cells compared with non-infected patients. CD4+ (cluster of differentiation 4) T lymphocytes are closely related to infection and CD4+ T < 469 cells/µl has a certain value in predicting infection in patients with CKD.
Conclusion

With the gradual decline of renal function in CKD patients, the level of T lymphocytes gradually decreased and the risk of infection gradually increased. The CD4+T absolute count has a specific predictive power for infection in patients with chronic kidney disease. Our results suggest a new feasible strategy for preventing infections in CKD patients.
Primary Colonic Lymphoma: Report of Two Cases and a Literature Review
Authors: Chen Li , Chen Engeng , Jin Dongai , song zhangfa 
Published: February 2021

Abstract
Introduction: Primary colonic lymphoma is a highly rare malignant tumor. There is no standard treatment method for this disease. We report two cases of primary lymphoma of the colon successfully treated with chemotherapy and surgery respectively.Case Presentation: In the first case, a 61-year-old female presented with the symptoms of abdominal pain for more than one month. The patient was diagnosed with a colonic tumor. However, immunohistochemical examinations conﬁrmed the initial diagnosis of colonic lymphoma. The patient underwent laparoscopic assisted right hemicolectomy and followed by postoperative adjuvant chemotherapy with CHOP regimen (cyclophosphamide, doxorubicin, vincristine, and prednisone), combined with targeted therapy of rituximab. In the second case, a 78-year-old male presented with complaints abdominal distention for more than one year. Diffuse Large B-cell Lymphoma was definitely diagnosed by immunohistochemical examinations. And this patient treated by the systemic chemotherapy with R- CHOP regimen.Conclusions: Primary colonic lymphoma is a rare type of NHL. The clinical treatment is not standardized unlike many other types of lymphomas. Maybe it is mainly based on the symptoms to determine whether surgery or systemic chemotherapy. Rituximab is effective in some patients which may play an important role in the treatment of unresectable or asymptomatic colonic lymphoma.
A Correlation Study Between Non-alcoholic Fatty Liver Disease and Serum Triglyceride Level After an Oral Fat Tolerance Test
Authors: Hou Xiaoyu , Guan Yunpeng , Tang Yong , Song An , Zhao Jiajun , Ren Luping , Chen Shuchun , Wei Limin , Ma Huijuan , Song Guangyao 
Published: February 2021

Abstract
Background: Non-alcoholic fatty liver disease (NAFLD) has become one of the most common chronic liver diseases worldwide. High postprandial serum lipid concentrations have been reported in patients with metabolic syndrome. Meanwhile, postprandial triglyceride (TG) was found to be a potential replacement when fasting TG is not available. We aimed to investigate the relationship between postprandial TG concentration during oral fat tolerance testing (OFTT) and NAFLD. Methods : A total of 472 Chinese adults, aged 25 to 65 years enrolled in this study. All the participants underwent OFTT. Serum triglyceride and other lipid concentrations were measured, and their relationships with NAFLD were analyzed. Results: Of the 472 participants, 155 were diagnosed with NAFLD. The fasting and postprandial TG concentrations of the participants with NAFLD were higher than those of healthy participants (P<0.05). The TG concentrations of the healthy participants peaked 4 h postprandially, whereas those of the participants with NAFLD peaked 6 h postprandially and had higher peak values. Postprandial triglyceride concentration showed significant association with higher risk of NAFLD.Conclusions: Higher postprandial TG concentration is positively related to higher risk of NAFLD, and postprandial TG concnetrations of NAFLD patients were higher than healthy individuals with a delayed peak time. Hence, 4h postprandial TG maybe a potential indicator for NAFLD.Trial registration number: ChiCTR1800019514
Clinical Feature and Prognostic Factors for Repeatedly Recurrent Spinal Chondrosarcoma: A Retrospective Study of 49 Patients in One Single Institution.
Authors: Zhang Yue , Xu Yuduo , Miao Wenzhi , Wei Haifeng 
Published: February 2021

Abstract
Background: To investigate the clinical feature in prognostic prediction of repeatedly recurrent spinal chondrosarcoma (RRSC). The purpose of this study was to illustrate the clinical parameters of RRSC and to discuss the prognostic factors by statistical analysis.Methods: Univariate and multivariate analyses were performed to investigate independent prognostic factors for recurrence and death of patients with RRSC. Recurrence-free survival (RFS) and overall survival (OS) were estimated by Kaplan-Meier curve, and differences were analyzed by log-rank test. Factors with P < 0.1 extracted by univariate analysis were subjected to multivariate analysis by Cox regression analysis. P < 0.05 were considered statistically significant.Results: Included in this study were 49 patients with RRSC who were followed up by a mean of 31.7 months (median, 25 months; range, 5-93 months). Local recurrence was detected in 33 patients, with death in 28 patients. The final statistical analysis indicated that wide surgical margin (> 4 mm) was the most favorable prognostic factor for both recurrence-free survival (RFS) and overall survival (OS). Meanwhile, fewer number of recurrences (NOR) was in favor of RFS, and lower pathological grade was a significant favorable prognostic factor for OS.Conclusion: Wide surgical margin should be considered in predicting the prognosis of RRSC, including RFS as well as OS. NOR was significant prognostic indicator for RFS, and pathological grading was significantly associated with OS.
Forensic Pathological Analysis of Death Due to Pulmonary Thromboembolism: a Retrospective Study Based on 145 Cases
Authors: Chen Ziyuan , Wang Pengfei , Zhang Mengzhou , Wen Shuheng , Cheng Hao , Wang Ning , Wu Mingzhe , Li Bingxuan , Guo Xiangshen , Zhang Yujian , Guan Dawei , Wang Linlin , Zhao Rui 
Published: February 2021

Abstract
Pulmonary thromboembolism (PTE) is a common cause of sudden unexpected death in forensic practice following deep vein thrombosis (DVT). It remains easy to overlook the special procedure used for the detection of PTE during autopsies; therefore, the relationship between PTE and the associated risk factors is in need of analysis. In the present study, 145 fatal cases of PTE found during autopsies performed from 2004 to 2019 at the Center of Forensic Investigation of China Medical University were retrospectively evaluated; the demographic data, risk factors, original location of DVT, and time interval from the formation of DVT to PTE were analyzed. In addition, the difference in lung-to-heart weight ratio between the PTE and disease-free accident groups was calculated with matching for gender and age. The 40–59 age group accounted for more than half of the total cases (51.03%). Immobilization, trauma or fracture (especially of the pelvis, femur, tibia, or fibula), surgery, pregnancy and cesarean section, mental disorders and the use of antipsychotics were the top 5 high-risk factors for fatal PTE. Among the victims, 92.9% (130/140) died within 60 days of the first exposure to risk factors. Most DVT were formed and shed in lower limb veins, especially popliteal veins and their branches, which caused 87.6% of the thrombi distributed in bilateral pulmonary arteries. No significant difference in the lung-to-heart weight ratio was found between the PTE and control groups. The present study provides valuable information for the prevention and treatment of thrombosis during clinical events and may also be important for alerting forensic examiners to conduct special PTE detection in cases with potential risk factors.
Shared clinical decision-making experiences in nursing: A qualitative study
Authors: Chung Fen-Fang , Lin Shu-Chuan , Lee Yu-Hsia , Wang Pao-Yu , Wu Hon-Yen , Lin Mei-Hsiang 
Published: February 2021

Abstract
Background

Shared decision making (SDM) is a patient-centred nursing concept that emphasises the autonomy of the patient. It is a co-operative process of exchanging information, communication and response, and treatment decisions made between medical staff and patients. In this study, we explored the experience of clinical nursing staff participating in SDM.
Methods

We adopted a qualitative research method. Semi-structured interviews were conducted with 21 nurses at a medical centre in northern Taiwan. The data obtained from interview recordings were transferred to verbatim manuscripts. Content analysis was used to analyse and summarise the data.
Results

Clinical nursing staff should have basic professional skills, communication and response skills, respect and cultural sensitivity, the ability to form a co-operative team, the ability to search for and integrate empirical data, and the basic ability to edit media to participate in SDM.
Conclusions

The results of this study describe the experiences of clinical nursing staff participating in SDM, which can be used as a reference for nursing education and nursing administrative supervisors to plan and enhance professional nursing SDM in nursing education.
Non-Intubated Uniportal Subxiphoid&nbsp;Thoracoscopic Extended Thymectomy for Thymoma Associated with Myasthenia Gravis
Authors: Zhong Jian , Sun Yang , Liu Zhengcheng 
Published: February 2021

Abstract
Background: To describe a technique of non-intubated uniportal subxiphoid thoracoscopic extended thymectomy.Methods: Data were collected retrospectively. A single 3-cm transverse incision was made below the xiphoid process. This method for extended thymectomy entails adoption of uniportal subxiphoid VATS combined with use of non-intubated anaesthesia for thymoma associated with myasthenia gravis.Results: 10 consecutive patients underwent this procedure successfully. Mean operative time was 102.5 minutes. Conversion to intubated ventilation or thoracotomy was not required. Mean chest tube duration was 3.5 days. Mean postoperative hospital stay was 4.7 days. Histologic examination showed early-stage thymomas. Complications were rare. Quantitative MG scores decreased during follow-up. Conclusions: Patients were uneventfully discharged with fast recovery. This technique may merge the potential benefits of a subxiphoid incision and the non-intubated anesthesia protocol.