bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Relevance of Vitamins and Carotenoids With Liver Steatosis and Fibrosis Detected by Transient Elastography in Adults
Authors: Liu Xiaohui , Shen Hong , Chen Mingfeng , Shao Jun 
Published: November 2021

Background: Vitamins and carotenoids may be involved in the pathogenesis of non-alcoholic fatty liver disease (NAFLD). Previously related publications mainly focused on vitamin D and vitamin E, and studies on other vitamins and carotenoids and NAFLD are scarce.Methods: This study aimed to explore the clinical relevance of vitamin A, B vitamins (vitamin B1, vitamin B2, niacin, vitamin B6, folate, vitamin B12, and choline), vitamin C and carotenoids (α-carotene, β-carotene, β-cryptoxanthin, lycopene, lutein + zeaxanthin) with liver steatosis and fibrosis in the 2017–2018 NHANES (N = 4,352). Liver steatosis and fibrosis were detected by transient elastography. Logistic regression, linear regression and restricted cubic splines were adopted to explore the non-linear dose-response relationships.Results: Higher intakes of vitamin C [0.68 (0.50–0.93)] and β-carotene [0.71 (0.54–0.93)] were inversely associated with liver steatosis. Higher levels of serum vitamin C [0.45 (0.32–0.62)] were inversely associated with liver fibrosis, while higher intakes of choline [1.43 (1.04–1.98)] and α-carotene [1.67 (1.01–2.74)] were positively associated with liver fibrosis. In addition, marginally inverse association between lutein + zeaxanthin and liver steatosis and positive association between vitamin B12 and liver fibrosis were found. In linear regression, the above-mentioned associations between vitamin C, β-carotene, and lutein + zeaxanthin and liver steatosis, and serum vitamin C, choline, α-carotene, and vitamin B12 and liver fibrosis were also found. The above-mentioned associations were mainly linear, while the relationship between β-carotene and liver steatosis might be non-linear.Conclusion: Vitamin C, α-carotene, β-carotene, lutein + zeaxanthin, choline and vitamin B12 may be associated with liver steatosis and fibrosis.
Variation of Neonatal Outcomes and Care Practices for Preterm Infants <34 Weeks' Gestation in Different Regions of China: A Cohort Study
Authors: Bai Ruimiao , Jiang Siyuan , Guo Jinzhen , Jiang Shanyu , Lee Shoo K. , Li Zhankui , Cao Yun 
Published: November 2021

Background: To compare outcomes and care practices of preterm infants born at &lt;34 weeks' gestation in the different regions of China from 2015 to 2018.Methods: This cohort study enrolled all infants born at &lt;34 weeks and admitted to 25 tertiary neonatal intensive care units across China from May 1st, 2015, to April 30th, 2018. The participating hospitals were categorized into three groups according to their distinct geographic locations: eastern China, central China, and western China. Multilevel mixed-effects logistic regression models were used to assess the independent association between neonatal outcomes and regions.Results: A total of 27,532 infants at &lt;34 weeks' gestation were enrolled in our study. Overall, 14,178 (51.5%) infants were from 12 hospitals in eastern China, 8,069 (29.3%) from 9 hospitals in central China, and 5,285 (19.2%) from 4 hospitals in western China. Infants in eastern China had the lowest rates of mortality or any morbidity (23.3%), overall mortality (7.6%), in-hospital mortality (3.7%), and discharge against medical advice (DAMA, 6.3%), compared with central (27.8, 11.3, 5.0, and 10.6%, respectively) and western China (37.4, 19.4, 7.7, and 19.4%, respectively). Multilevel mixed-effects logistic regression showed that infants in western China were exposed to the highest risks of mortality or any morbidity, overall mortality, in-hospital mortality, and DAMA. Significant variations of care practices existed in three regions. Infants in central China had the longest duration of the first course of invasive ventilation, the lowest rate of continuous positive airway pressure within 24 h after birth, the lowest rate of breast milk feeding, the latest initiation of feeds, and the longest duration of total parenteral nutrition among the three regions.Conclusions: We identified marked disparities in outcomes and clinical care practices of preterm infants born at &lt;34 weeks' gestation in different regions of China. Targeted quality improvement efforts are needed to improve the outcomes of premature infants in different regions of China.
Use of Eculizumab in Pediatric Patients With Transplant Associated Thrombotic Microangiopathy
Authors: Gomez-Ganda Laura , Benitez-Carabante Maria Isabel , Fernandez-Polo Aurora , Muñoz-Lopez Marina , Renedo-Miro Berta , Ariceta Gema , Diaz De Heredia Cristina 
Published: November 2021

Background: Transplant-associated thrombotic microangiopathy (TA-TMA) is a serious complication of hematopoietic stem cell transplantation (HSCT) associated with high morbidity and mortality. High-risk TA-TMA (hrTA-TMA) is characterized by multifactorial endothelial damage caused by environmental stressors, dysregulation of the complement system, and genetic predisposition. Complement inhibitors have significantly decreased mortality and are the current treatment of choice. In this article, we describe our experience with the use of eculizumab in pediatric patients diagnosed with hrT-TMA after HSCT.Method: Retrospective study of pediatric patients with hrTA-TMA treated with eculizumab between January 2016 and December 2020.Results: Four pediatric patients aged 1, 12, 14, and 17 years at the time of HSCT were diagnosed with hrTA-TMA and treated with eculizumab during the study. At diagnosis, they all had renal impairment with proteinuria, and hypertension under treatment with at least two antihypertensive drugs. The patient who presented multisystemic involvement died instead of treatment. The three patients with exclusive renal involvement achieved TA-TMA resolution after treatment with eculizumab for 65, 52, and 40.6 weeks and were able to stop treatment. The two patients with follow-up data one year after eculizumab withdrawal sustained a favorable response. Eculizumab was well tolerated, and with adequate vaccination and antibiotic prophylaxis, did not increase the risk of infection.Conclusions: Eculizumab appears to be both safe and effective for the treatment of hrTA-TMA in patients with renal impairment. Early diagnosis and initiation of treatment may improve response. Eculizumab withdrawal can be contemplated in patients who achieve laboratory and clinical resolution of TA-TMA.
The Early Diagnosis of Scrub Typhus by Metagenomic Next-Generation Sequencing
Authors: Liu Xianghong , Zhang Ye , Zhang Jun , Lou Zheng , Xia Han , Lu Zhijuan 
Published: November 2021

Introduction: Scrub typhus is a mite-borne infection widespread in Southeast Asia, with clinical symptoms such as fever, chills, skin rash, eschar at the bite site, and other signs of acute febrile illness. The Rickettsia pathogen (Orientia tsutsugamushi) is always difficult to be diagnosed at an early stage by traditional clinical diagnostic methods, especially for patients without typical eschar. This greatly increases the mortality of patients with scrub typhus. A new approach should be introduced to improve its clinical diagnosis.Methods: During May 2018 to March 2021, 13 samples from 10 patients with suspected scrub typhus were collected. Metagenomic next-generation sequencing (mNGS) and other diagnostic methods (including serology using Weil–Felix reaction and indirect immunofluorescence test (IIFT) for scrub typhus and respiratory tract profile IgM as well as culture for routine bacteria) were used to identify the pathogens in this study.Results: The results of mNGS were all positive, with mapped reads of O. tsutsugamushi ranging from 1 to 460. Eight patients (80%) were diagnosed as scrub typhus. The other two were diagnosed as suspected scrub typhus due to the limited number of reads of the pathogen (one and two, respectively). According to clinical evidences, nine of the 10 patients were finally diagnosed as scrub typhus, except for patient 9 (suspected scrub typhus by mNGS with one specific reads of the pathogen) diagnosed as acute exacerbation of chronic obstructive pulmonary disease. For the five scrub typhus patients without typical eschar, mNGS gave all positive results (4–460 specific reads). For other methods, only Weil–Felix reaction of one patient detected the pathogen. In addition, the respiratory tract profile (IgM) detected various pathogens, but all were confirmed to be false positive.Conclusions: mNGS performed better than conventional clinical methods to early diagnose scrub typhus. This approach can be routinely carried out for early and precise diagnosis in clinical infections, especially for those hard to be identified by traditional diagnostic methods.
Determinan Kelaparan di Indonesia Tahun 2015-2019
Authors: Mone Daniel M V , Utami Efri Diah 
Published: November 2021

Sustainable Development Goals (SDGs) adalah sebuah perencana aksi berskala global yang disepakati oleh para pemimpin dunia, termasuk Indonesia dengan tujuan mendorong pembangunan sosial, ekonomi dan lingkungan hidup. Salah satu dari 17 tujuan SDGs adalah mengakhiri kelaparan. Berdasarkan data yang dirilis Badan Pusat Statistik, salah satu pendekatan untuk mengukur tingkat kelaparan adalah proporsi penduduk dengan asupan kalori minimum di bawah 1400 kkal/kapita/hari. Proporsi penduduk dengan asupan kalori minimum di bawah 1400 kkal/kapita/hari di Indonesia masih cukup tinggi dan terus mengalami peningkatan dari tahun 2017 hingga 2019. Penelitian ini bertujuan untuk menganalisis bagaimana gambaran umum dari tingkat kelaparan dan variabel-variabel yang diduga mempengaruhinya, serta bagaimana pengaruh variabel-variabel tersebut terhadap tingkat kelaparan di Indonesia tahun 2015-2019. Hasil dari penelitian ini dapat digunakan untuk merumuskan kebijakan-kebijakan guna penuntasan kelaparan di Indonesia. Metode analisis yang digunakan adalah regresi data panel dengan menggunakan fixed effect model yang diestimasi dengan metode Seemingly Unrelated Regression (SUR). Hasil dari penelitian ini menunjukkan bahwa variabel yang berpengaruh signifikan terhadap tingkat kelaparan adalah pengeluaran makanan dan harga beras, sedangkan jumlah penduduk miskin dan pendapatan perkapita tidak berpengaruh signifikan.
High-temperature post-annealing to improve Jc
-B-T properties of MgB2 thin film synthesized via hybrid deposition combining thermal evaporation of magnesium and sputtering of boron
Authors: Iwanaka Takumu , Kusunoki Toshiaki , Kotaki Hiroshi , Kodama Motomune , Tanaka Hideki , Matsumoto Akiyoshi , Horii Shigeru , Kawayama Iwao , Doi Toshiya 
Published: November 2021

Abstract
A new in situ process for depositing MgB2 film is being developed in the present study as a candidate method to facilitate the mass production of MgB2-thin-film superconducting tapes. Here, a MgB2 film was synthesized on a heated copper substrate via “hybrid deposition,” comprising thermal evaporation of magnesium and sputtering of boron. High-temperature post-annealing was performed to increase the critical current density (J

c
) of the MgB2 thin films obtained via hybrid deposition. The J

c
of the MgB2 film deposited at 360 °C by hybrid deposition and post-annealed at 430 °C was drastically improved to 1100 A mm−2 at 20 K under 4 T, 79 000 A mm−2 at 15 K under 3 T, and 59 000 A mm−2 at 10 K under 5 T under a magnetic field parallel to the film. It was expected that the incorporation of hybrid deposition in processing using a reel-to-reel machine would facilitate the synthesis of high-J

c
, long MgB2-thin-film superconducting wires.
Onda sinusoidal en el electrocardiograma
Authors: Hernández-Somerson Mario Andrés 
Published: November 2021

Mujer de 58 años, con cuadro de una semana de evolución consistente en astenia progresiva, disnea con esfuerzos medianos y en últimas 48 horas somnolencia marcada. No refiere antecedentes de importancia.
A su ingreso con Tensión arterial en 90/60, frecuencia cardíaca: 50 por minuto, frecuencia respiratoria 14 por minuto y afebril. Se observa con signos de deshidratación grado II y estuporosa. Se toma glucometría en 95 mg/dL y electrocardiograma (figura 1) con evidencia ausencia de onda P con R-R regular y ensanchamiento del complejo QRS (130 mseg), con intervalo QT corregido prolongado (460 mseg) y trastorno inespecífico de la repolarización. Se inicia manejo hídrico, oxigenoterapia, monitoreo electrocardiográfico y se toman paraclínicos. Se realiza electrocardiograma de control a los 10 minutos que muestra la presencia de una onda sinusoidal (figura 2).
Ante la sospecha de hiperpotasemia, se inicia gluconato de calcio intravenoso al 10%, 10 cc cada 10 minutos hasta reversión de la onda sinusoidal (figura 3) , en total requirió 40 cc. Se reciben niveles de potasio en 8.6 meq/L, creatinina en 10 mg/dl y nitrógeno ureico en 110 mg/dL. Se complementa manejo farmacológico para hiperpotasemia y se interconsulta al servicio de nefrología para inicio de terapia de reemplazo renal urgente.
Intervalos biológicos de referencia del perfil lipídico
Authors: Galvis Yeisson , Barona Acevedo Jacqueline , Cardona Arias Jaiberth Antonio 
Published: November 2021

Introducción: la clasificación de la concentración de cualquier analito como patológico o no implica que el valor de la medición sea comparado con valores de individuos similares, para lo cual es necesario obtener Intervalos Biológicos de Referencia (IBR). Los IBR del perfil lipídico adoptados por los laboratorios clínicos son principalmente los propuestos por las casas comerciales y los obtenidos por los paneles de expertos. Sumado a las limitadas publicaciones sobre los IBR del perfil lipídico para nuestra población, es oportuno precisar que variables como el sexo y la edad pueden estar relacionadas con modificaciones en el metabolismo lipídico.

Objetivo: estimar los intervalos biológicos de referencia del perfil lipídico en una población atendida en un laboratorio de Medellín.
Métodos: Estudio descriptivo transversal en 81 individuos sanos; los IBR se estimaron a partir del estadístico X±[Zα/2*(DE/√n)], confianza del 95% y precisión del 5%. En el análisis bivariado se utilizó Anova y la prueba t Student. Todo fue realizado en SPSS 21.0®. En los IBR de hombres y mujeres solo se hallaron diferencias en el colesterol total y los índices colesterol total/cHDL y triglicéridos/cHDL. Analizando los grupos etarios, se hallaron diferencias en los triglicéridos y el cVLDL siendo menor en los adultos jóvenes en comparación con los adultos medios y mayores; para el índice triglicéridos/cHDL se halló diferencia entre los adultos jóvenes y mayores.

Conclusión: este estudio permitió determinar los IBR del perfil lipídico, los cuales son importantes para el diseño de estrategias de prevención primaria para dislipidemias en la población estudiada.
La aplicación del conocimiento
Authors: Torres Duque Carlos A , Pareja Zabala Maria José 
Published: November 2021

Muy importante y bien documentado su Editorial, “La aplicación del conocimiento” (1), en el cual analiza un estudio publicado recientemente en New England Journal of Medicine sobre el uso de oxígeno en pacientes con EPOC e hipoxemia moderada (2) y su dudosa aplicabilidad a grandes alturas, y hace énfasis en la necesidad de investigar localmente acerca de problemas cotidianos en salud. El ejemplo es muy apropiado puesto que los criterios de oxigenoterapia a largo plazo (OLP) en pacientes con EPOC fueron definidos a nivel del mar y cerca del 20% de la población colombiana reside por encima de los 2.500 metros. Al respecto, aportamos la siguiente información:

1.	Una de las clasificaciones de altitud más recomendadas (3) define grandes alturas como aquéllas situadas entre 2.500 y 3.500 metros sobre el nivel del mar. Bogotá, a 2.640 metros, es la ciudad más poblada del mundo situada a gran altura (México D.F. está a 2.240 m).

2.	El estudio sobre valores normales de gases arteriales en adultos sanos en Bogotá (n=374) (4), en preparación para publicación, muestra que una saturación de oxígeno entre 89 y 93%, definida como hipoxemia moderada en el estudio analizado en su Editorial (1, 2), está en rangos de normalidad para la altitud de Bogotá.

3.	Como usted lo plantea (1), se desconoce si los criterios de OLP en EPOC definidos a nivel del mar son apropiados a gran altura. Basados en el estudio sobre gases arteriales normales en Bogotá (4) y en la observación de que un grupo significativo de pacientes con EPOC, residentes a esta altura, con presión arterial de oxígeno entre 50 y 55 mmHg no exhiben signos de hipoxia crónica, particularmente hipertensión pulmonar, planteamos un estudio experimental multicéntrico, coordinado desde la Fundación Neumológica Colombiana, para evaluar si se puede hacer un ajuste (punto de corte más bajo) de los criterios de OLP a gran altura (≥ 2.500 - ≤ 3.500 m). El estudio fue aprobado a comienzos de 2016 por COLCIENCIAS (335972553295) y se encuentra registrado en Clinical Trials (www.clinicaltrials.gov) (NCT03020212). Tendrá una duración de 36 meses y se espera que a comienzos de la siguiente década se tengan resultados que den respuesta a la pregunta planteada en su Editorial.

4.	Como información relacionada, un análisis colaborativo (BOLD, PLATINO, EPISCAN y PREPOCOL) recientemente publicado, comprueba que no hay asociación entre altitud y prevalencia de EPOC (5) como lo había sugerido el estudio PREPOCOL previamente.
Frecuencia de la potencial interacción entre trimetoprim/sulfametoxazol y espironolactona por riesgo de hiperkalemia en pacientes colombianos
Authors: Machado-Alba Jorge Enrique , Machado-Duque Manuel Enrique , Gaviria-Mendoza Andres , Restrepo-López Juan Sebastian , Benítez-Mejia Juan Felipe 
Published: November 2021

Introducción: Se ha descrito el riesgo aumentado de muerte súbita y hospitalización por hiperkalemia en pacientes que consumen ahorradores de potasio y sulfonamidas, por lo que se buscó determinar la frecuencia de la potencial interacción entre espironolactona y trimetoprim-sulfametoxazol en pacientes mayores de 60 años de Colombia.
Métodos: Estudio observacional, de una base de datos de 3,6 millones de personas se seleccionaron pacientes mayores de 60 años que recibieron espironolactona de manera ambulatoria por al menos 3 meses consecutivos y pacientes con prescripción de trimetoprim-sulfametoxazol entre el 01/08/2014 y 31/07/2015. Posteriormente, se identificaron aquellos con la co-prescripción durante un mismo mes. Se incluyeron variables de sociodemográficas, uso concomitante de inhibidores de sistema renina angiotensina, diuréticos e inotrópicos.
Resultados: Durante el año de estudio, se encontraron 8941 pacientes mayores de 60 años con prescripción continua de espironolactona y 8028 pacientes con trimetoprim-sulfametoxazol. Su coprescripción fue detectada en 77 pacientes, con una incidencia acumulada de 0,86 casos por 100 pacientes-espironolactona/año. La edad promedio de estos pacientes fue de 79,1±14 años, un 57,1% fueron hombres y la ciudad con más presentación de casos fue Cali (13,0% del total). El 68,8% de los casos tuvieron además comedicación con losartan y 62,3% con furosemida.
Conclusiones: La interacción entre espironolactona y trimetoprim-sulfametoxazol en una población Colombiana es relativamente poco frecuente, sin embargo debido a los riesgos a los que se expone el paciente anciano es relevante por sus implicaciones en morbilidad y mortalidad, requiriendo ser conocida y monitoreada por el médico prescriptor.
Hastanemizde son bir yıl içerisinde yapılan acil ve elektif sezaryen doğum sonuçlarının değerlendirilmesi
Authors: KİREMİTLİ Sevil , KİREMİTLİ Tunay , YILMAZ Nesrin 
Published: November 2021

Amaç: Acil ve elektif şartlarda yapılan sezaryenler arasında obstetrik-fetal sonuçlar ve komplikasyonlar açısından fark olup olmadığını araştırmaktır.
Gereç ve Yöntemler: Çalışmamıza 1 Ocak 2020-31 Mart 2021 tarihleri arasında Erzincan Binali Yıldırım Üniversitesi Kadın Hastalıkları ve Doğum Kliniğinde sezaryen doğum yapan 459 hasta dahil edildi. Elektif sezaryen grubuna, hasta ve doğum ekibince sezaryen tarihi önceden planlanmış 221, acil sezaryen grubuna ise sezaryeni planlanmadan acil alınan 238 hasta dahil edildi. Hasta bilgilerine retrospektif dosya taraması yapılarak ulaşıldı. İki grup arasında yaş, doğum haftası, doğum kilosu, sezaryen endikasyonu, laboratuvar bulguları, maternal ve perinatal komplikasyonlar ve yenidoğan yoğun bakım ünitesine(YYBÜ) yatış sayıları karşılaştırıldı.
Bulgular: Elektif sezaryen grubunda en sık sezaryen endikasyonu geçirilmiş sezaryen (%85,5) iken acil sezaryen grubunda en sık endikasyonlar geçirilmiş sezaryen (%27,3) ve fetal distressti (%23,9). Elektif sezaryen grubunda yetersiz antenatal bakım alan hasta 16 (%7,2) iken, acil sezaryen grubunda bu sayı 40 (%16,9)’dı ve fark istatistiksel olarak anlamlıydı (p=0,03). 5’inci dakika apgar skorunun 7’nin altında olması, YYBÜ’nde 24 saatten fazla yatış ve mekonyumlu amniyon mayi görülmesi acil sezaryen grubunda daha fazla izlendi (p
Gebelerde düşük molekül ağırlıklı heparin kullanımının sistemik immün-inflamasyon indeksi üzerine etkisi
Authors: OLUKLU Deniz , GÖNCÜ AYHAN Şule , KEVEN Mehmet , SAHİN Dilek 
Published: November 2021

Amaç Gebelerde Düşük Molekül Ağırlıklı Heparin (DMAH) kullanımı sonrası inflamasyon belirteçlerinin değişiminin saptanması amaçlanmıştır.
Gereç ve Yöntemler Gebeliğinde DMAH kullanan 57 hastanın DMAH kullanımı öncesi ve bir ay sonrası hemogram tetkikindeki parametreler kullanılarak hesaplanan, NLO (Nötrofil Lenfosit Oranı), TLO (Trombosit Lenfosit Oranı), LMO (Lenfosit Monosit Oranı) ve SII (Sistemik İmmün-inflamasyon İndeks) (Nötrofil x Trombosit / Lenfosit) karşılaştırıldı.
Bulgular DMAH kullanımı sonrasında OEDG (Ortalama eritrosit dağılım genişliği), OTH (ortalama trombosit hacmi), OTDG (Ortalama trombosit dağılım genişliği), NLO ve SII anlamlı olarak artarken; platekrit, LMO anlamlı olarak azalmış olarak saptandı (p
ULTRASONOGRAPHIC EVALUATION OF CARPAL TUNNEL IN PREGNANT WOMEN WITH DIABETES MELLITUS
Authors: GÖNCÜ AYHAN Şule , SAHİN Dilek 
Published: November 2021

Objective: To determine the ultrasonography (USG) values of median nerve cross-sectional area (MN-CSA) in pregnant women with and without diabetes mellitus (DM) to confirm carpal tunnel syndrome (CTS).
Methods: We prospectively studied pregnant women who have been diagnosed with pregestational type 1 and type 2 DM or gestational DM (GDM) due to positive GDM screening tests. One-step GDM screening (2 h - 75 g oral glucose tolerance test (OGTT)) was used at 24–28 weeks of gestation and diagnosis of GDM. MN was identified at the level of distal wrist crease in transverse sections with USG and maximal MN-CSA was calculated then, asked the patient complaints about her hand (paraesthesia, pain, numbness). The DM group was compared to the control group according to age, week of pregnancy, weight gain during pregnancy, MN-CSA, and presence of compliments.
Results: There were 107 DM pregnant women and 113 controls in the study group. The median value of MN-CSA was higher in the DM group than in the control group (p< 0,001). There was no difference between groups in terms of DM subgroups and insulin requirement. Hand pain is significantly frequent in the DM group than in controls. There has been a positive correlation between weight gain during pregnancy and MN-CSA (p =0,011; r=0,245).
Conclusion: USG can be a first-line diagnostic test for CTS in the diabetic pregnant population, as recommended for the general population before. Both pregnancy and DM are stated as risk factors for CTS, these patients must be evaluated more carefully about this issue and proper advices should be given to improve their life quality.