bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating the African food supply against the nutrient intake goals set for preventing diet-related non-communicable diseases: 1990 to 2017 trend analysis
Authors: Gebremedhin Samson , Bekele Tilahun 
Published: January 2021

Background
Population intake goals intended to prevent diet-related non-communicable diseases (NCDs) have been defined for multiple nutrients. Yet, little is known whether the existing food supply in Africa is in conformity with these goals or not. We evaluated the African food balances against the recommendations for macronutrients, free sugars, types of fatty acids, cholesterol and fruits and vegetables over 1990 to 2017, and provided regional, sub-regional and country-level estimates.

Methods
The per capita supply of 95 food commodities for 45 African countries (1990–2017) was accessed from the FAOSTAT database and converted into calories, carbohydrate, fat, protein, free sugars, cholesterol, saturated (SFA), monounsaturated (MUFA), and polyunsaturated (PUFA) fatty acids contents using the Food Data Central database. The supply of fruits and vegetables was also computed.

Results
In Africa the energy supply increased by 16.6% from 2,685 in 1990 to 3,132 kcal/person/day in 2017. However, the energy contribution of carbohydrate, fat and protein remained constant and almost within acceptable range around 73, 10 and 9%, respectively. In 2017, calories from fats surpassed the 20% limit in upper-middle- or high-income and Southern Africa countries. Energy from SFA remained within range (<10%) but that of PUFA was below the minimum desirable level of 6% in 28 countries. Over the period, energy from free sugars remained constant around 7% but the figure exceeded the limit of 10% in upper-middle- or high-income countries (14.7%) and in Southern (14.8%) and Northern (10.5%) sub-regions. Between 1990 and 2017 the availability of dietary cholesterol per person surged by 14% but was below the upper limit of 300 mg/day. The supply of fruits and vegetables increased by 27.5% from 279 to 356 g/capita/day; yet, with the exception of Northern Africa, the figure remained below the target of 400 g/capita/day in all sub-regions.

Conclusion
According to this population level data, in Africa most population intake goals are within acceptable range. Yet, the supply of fruits and vegetables and PUFAs are suboptimal and the increasing energy contributions of free sugars and fats are emerging concerns in specific sub-regions.
Auditive beta stimulation as a countermeasure against driver fatigue
Authors: Moessinger Michèle , Stürmer Ralf , Mühlensiep Markus 
Published: January 2021

Objective
Fatigue in road traffic can occur after long driving times or during night-time driving and can lead to a dangerous decrease in vigilance or microsleep. As a countermeasure, the effectiveness of brain stimulation by means of frequency-modified music is investigated. Small frequency shifts between two different sounds simultaneously perceived by both ears (e.g. 400 and 418 Hz) stimulate the brain to increase activity in the stimulated range (e.g. 18 Hz).

Methods
The effects of acoustic brain entrainment (ABE) in the EEG beta range (12–20 Hz) were compared to placebo during day and night driving (n = 40 each) in 80 subjects. The effects were examined at the subjective (Karolinska Sleepiness Scale, KSS), physiological (EEG) and performance level (test battery for attention testing, TAP). The test drive took place on the motorway. Sequence of events with measurement times: Preparation in the laboratory (60 min; TAP & KSS), driving (90 min day/ 180 min night; KSS every 30 min), beta/placebo stimulation while driving (20 min), rest (20 min; TAP & KSS), driving (60 min; KSS every 30 min), end of driving (40 min; TAP & KSS). EEG was recorded continuously (Fz, Cz, Pz, C3, C4) and analyzed for 10 min time windows.

Results
The subjective fatigue rating in the KSS decreased significantly after ABE compared to placebo. This was still significant about 100 minutes after stimulation. The ABE led to a significant increase in EEG beta activity compared to placebo. This was still significant about 80 minutes after stimulation. Furthermore, the ABE led to a significant decrease in theta activity compared to placebo. This was still significant about 70 minutes after stimulation and was more pronounced during daytime driving. Faster reaction times were observed for the ABE compared to the placebo condition during day and night driving. The faster reaction times were partly significant for the ABE still 80 minutes after stimulation.

Conclusion
Positive effects of ABE during driving could be demonstrated on the subjective, physiological and performance level. The effect was more pronounced during the day than at night. No negative side effects of Beta Stimulation were observed. The stimulation in the beta frequency range led to an increase of beta activity in the EEG.
Verification-phase tests show low reliability and add little value in determining V̇O2max in young trained adults
Authors: Wagner Jonathan , Niemeyer Max , Infanger Denis , Hinrichs Timo , Guerra Clement , Klenk Christopher , Königstein Karsten , Cajochen Christian , Schmidt-Trucksäss Arno , Knaier Raphael 
Published: January 2021

ObjectiveThis study compared the robustness of aV˙O2-plateau definition and a verification-phase protocol to day-to-day and diurnal variations in determining the trueV˙O2max. Further, the additional value of a verification-phase was investigated.MethodsEighteen adults performed six cardiorespiratory fitness tests at six different times of the day (diurnal variation) as well as a seventh test at the same time the sixth test took place (day-to-day variation). A verification-phase was performed immediately after each test, with a stepwise increase in intensity to 50%, 70%, and 105% of the peak power output.ResultsParticipants meanV˙O2peakwas 56 ± 8 mL/kg/min. Gwet’s AC1values (95% confidence intervals) for the day-to-day and diurnal variations were 0.64 (0.22, 1.00) and 0.71 (0.42, 0.99) forV˙O2-plateau and for the verification-phase 0.69 (0.31, 1.00) and 0.07 (−0.38, 0.52), respectively. In 66% of the tests, performing the verification-phase added no value, while, in 32% and 2%, it added uncertain value and certain value, respectively, in the determination ofV˙O2max.ConclusionCompared toV˙O2-plateau the verification-phase shows lower reliability, increases costs and only adds certain value in 2% of cases.
The efficacy and safety of prokinetics in critically ill adults receiving gastric feeding tubes: A systematic review and meta-analysis
Authors: Peng Rong , Li Hailong , Yang Lijun , Zeng Linan , Yi Qiusha , Xu Peipei , Pan Xiangcheng , Zhang Lingli 
Published: January 2021

Background
Intolerance to gastric feeding tubes is common among critically ill adults and may increase morbidity. Administration of prokinetics in the ICU is common. However, the efficacy and safety of prokinetics are unclear in critically ill adults with gastric feeding tubes. We conducted a systematic review to determine the efficacy and safety of prokinetics for improving gastric feeding tube tolerance in critically ill adults.

Methods
Randomized controlled trials (RCTs) were identified by systematically searching the Medline, Cochrane and Embase databases. Two independent reviewers extracted the relevant data and assessed the quality of the studies. We calculated pooled relative risks (RRs) for dichotomous outcomes and the mean differences (MDs) for continuous outcomes with the corresponding 95% confidence intervals (CIs). We assessed the risk of bias using the Cochrane risk-of-bias tool and used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology to rate the quality of the evidence.

Results
Fifteen RCTs met the inclusion criteria. A total of 10 RCTs involving 846 participants were eligible for the quantitative analysis. Most studies (10 of 13, 76.92%) showed that prokinetics had beneficial effects on feeding intolerance in critically ill adults. In critically ill adults receiving gastric feeding, prokinetic agents may reduce the ICU length of stay (MD -2.03, 95% CI -3.96, -0.10; P = 0.04; low certainty) and the hospital length of stay (MD -3.21, 95% CI -5.35, -1.06; P = 0.003; low certainty). However, prokinetics failed to improve the outcomes of reported adverse events and all-cause mortality.

Conclusion
As a class of drugs, prokinetics may improve tolerance to gastric feeding to some extent in critically ill adults. However, the certainty of the evidence suggesting that prokinetics reduce the ICU or hospital length of stay is low. Prokinetics did not significantly decrease the risks of reported adverse events or all-cause mortality among critically ill adults.
Sleep deprivation did not enhance the success rate of chloral hydrate sedation for non-invasive procedural sedation in pediatric patients
Authors: Cui Yu , Guo Langtao , Mu Qixia , Cheng Qin , Kang Lu , He Yani , Tang Min , Wu Qunying 
Published: January 2021

Study objective
In Asian countries, oral chloral hydrate is the most commonly used sedative for non-invasive procedures. Theoretically, mild sleep deprivation could be considered as one of assisted techniques. However, there is no consensus on sleep deprivation facilitating the sedation during non-painful procedures in children. The aim of our study is to analyze the clinical data of children undergoing non-invasive procedural sedation retrospectively and to evaluate the association between mild sleep deprivation and sedative effects in non-invasive procedures.

Measurements
Consecutive patients undergoing chloral hydrate sedation for non-invasive procedures between December 1, 2019 to June 30, 2020 were included in this study. The propensity score analysis with 1: 1 ratio was used to match the baseline variables between patients with sleep deprivation and non-sleep deprivation. The primary outcome was the failure rate of sedation with the initial dose. The secondary outcomes included the failure rate of sedation after supplementation of chloral hydrate, the incidence of major and minor adverse events, initial and supplemental dose of chloral hydrate, and the length of sedation time.

Main results
Of the 7789 patients undergoing chloral hydrate sedation, 6352 were treated with sleep deprivation and 1437 with non-sleep deprivation. After propensity score matching, 1437 pairs were produced. The failure rate of sedation with initial chlorate hydrate was not significantly different in two groups (8.6% [123/1437] vs. 10.6% [152/1437], p = 0.08), nor were the failure rates with supplemental chlorate hydrate (0.8% [12/1437] vs. 0.9% [13/1437], p = 1) and the length of sedation time (58 [45, 75] vs. 58 [45, 75] min; p = 0.93).

Conclusions
The current results do not support sleep deprivation have a beneficial effect in reducing the pediatric chloral hydrate sedation failure rate. The routine use of sleep deprivation for pediatric sedation is unnecessary.
Short-term effect of anti-VEGF for chronic central serous chorioretinopathy according to the presence of choroidal neovascularization using optical coherence tomography angiography
Authors: Song Yong-Yeon , Yu Hwa-Young , Baek Seung-Kook , Lee Young-Hoon , Lee Min-Woo 
Published: January 2021

Purpose
To analyze the short-term therapeutic efficacy of intravitreal injection of bevacizumab (IVB) for chronic central serous chorioretinopathy (CSC) according to the presence of choroidal neovascularization (CNV) using optical coherence tomography angiography (OCTA).

Methods
A retrospective chart review was perfomed on cases of CSC with CNV (Group 1: n = 31) and an age-matched cases of CSC without CNV (Group 2: n = 30). The response to IVB was evaluated by changes in best-corrected visual acuity (BCVA), central macular thickness (CMT), choroidal thickness (CT), and pachyvessel diameter. Univariate and multivariate linear regression analyses were performed to identify factors associated with the visual outcome of chronic CSC with CNV after IVB.

Results
At baseline, the CT values differed significantly between Groups 1 and 2 (371.55 ± 67.09 vs. 417.33 ± 71.32 μm, p = 0.01). In Group 1, BCVA improved significantly (p < 0.001), and CMT (p < 0.001), CT (p = 0.001) and pachyvessel diameter (p = 0.045) decreased significantly, after IVB. In Group 2, only pachyvessel diameter (p = 0.001) was significantly smaller after IVB. Univariate analysis showed that the initial CT (B = 0.002, p = 0.026) and pachyvessel diameter (B = 0.002, p = 0.001) significantly affected visual outcome. In multivariate analysis, the initial pachyvessel diameter exhibited significant results (B = 0.002, p = 0.001).

Conclusions
IVB showed less effective short-term outcomes in chronic CSC patients without CNV than in patients with CNV. In chronic CSC with CNV, the short-term visual outcome after IVB was better in patients with a thinner choroid and smaller pachyvessels.
Epidemiological aspect of renal failure in the Internal Medicine department of HUEH from May 2018 to December 2018
Authors: FLORIAL Edisond , THERMIDOR Srane-Lorette , MEDOR John Mirvens , SIMEON Charlin 
Published: January 2021

Introduction

Renal failure either acute or chronic is a global public health problem. In developed countries, this condition occurs mainly in the elderly. The World Health Organization (WHO) has made preventing chronic disease a vital investment. The incidence of RF, long underestimated, increases with the age of the patient. Estimated at eight per million in children, it increases to 949 in octogenarians. In the registers of the Internal Medicine department of the HUEH, the country's reference center, kidney failure is very common after cardiac and gastric pathologies. The aim of this study will be to describe the epidemiological aspects of renal failure cases by studying quantitative and qualitative variables.

Methodology
This is a retrospective quantitative study conducted on sample patients in the Internal Medicine Department of the Hospital of the State University of Haiti (HUEH). The study was conducted on 39 patients admitted and registered in the internal medicine department of the HUEH during the period from May 2018 to December 2018 for the concept of renal failure.

Result
A total of 39 patients with 17 women (44%) and 22 men (56%).The mean age of the patients is 48.66 years, the main length of hospitalization is 21.7 days. Chronic renal failure (CRF) is the dominant diagnosis 27 cases (69.23%) compared to acute renal failure (ARF), 7 cases (17.95%), end-stage chronic renal failure (ESRF) 4 cases (10.26%) and severe chronic renal failure (SCRF) 1 case (2.56%). For patient outcome, discontinuation was 16 patients (41.03%), exeated was 15 patients (38.46%), Death was 7 patients (17.95%), transferred was 1 patient (2.56%). The department of origin was not mentioned for 20 patients (51.28%), the dominant department is the West or 11 patients (28.21%).
Multimodal Imaging Brain Markers in Early Adolescence Are Linked with a Physically Active Lifestyle
Authors: Salvan Piergiorgio , Wassenaar Thomas , Wheatley Catherine , Beale Nicholas , Cottaar Michiel , Papp Daniel , Bastiani Matteo , Fitzgibbon Sean , Duff Euguene , Andersson Jesper , Winkler Anderson M. , Douaud Gwenaëlle , Nichols Thomas E. , Smith Stephen , Dawes Helen , Johansen-Berg Heidi 
Published: January 2021

The World Health Organization promotes physical exercise and a healthy lifestyle as means to improve youth development. However, relationships between physical lifestyle and human brain development are not fully understood. Here, we asked whether a human brain–physical latent mode of covariation underpins the relationship between physical activity, fitness, and physical health measures with multimodal neuroimaging markers. In 50 12-year old school pupils (26 females), we acquired multimodal whole-brain MRI, characterizing brain structure, microstructure, function, myelin content, and blood perfusion. We also acquired physical variables measuring objective fitness levels, 7 d physical activity, body mass index, heart rate, and blood pressure. Using canonical correlation analysis, we unravel a latent mode of brain–physical covariation, independent of demographics, school, or socioeconomic status. We show that MRI metrics with greater involvement in this mode also showed spatially extended patterns across the brain. Specifically, global patterns of greater gray matter perfusion, volume, cortical surface area, greater white matter extra-neurite density, and resting state networks activity covaried positively with measures reflecting a physically active phenotype (high fit, low sedentary individuals). Showing that a physically active lifestyle is linked with systems-level brain MRI metrics, these results suggest widespread associations relating to several biological processes. These results support the notion of close brain-body relationships and underline the importance of investigating modifiable lifestyle factors not only for physical health but also for brain health early in adolescence.SIGNIFICANCE STATEMENTAn active lifestyle is key for healthy development. In this work, we answer the following question: How do brain neuroimaging markers relate with young adolescents' level of physical activity, fitness, and physical health? Combining advanced whole-brain multimodal MRI metrics with computational approaches, we show a robust relationship between physically active lifestyles and spatially extended, multimodal brain imaging-derived phenotypes. Suggesting a wider effect on brain neuroimaging metrics than previously thought, this work underlies the importance of studying physical lifestyle, as well as other brain–body relationships in an effort to foster brain health at this crucial stage in development.
Vitamin D status and pathway genes in five European autoimmune Addison’s disease cohorts
Authors: Penna-Martinez Marissa , Meyer Gesine , Wolff Anette Boe , Skinningsrud Beate , Betterle Corrado , Falorni Alberto , Ollier William , Undlien Dag , Husebye Eystein , Pearce Simon , Mitchell Anna L , Badenhoop Klaus 
Published: January 2021

Objective
While vitamin D regulates immune cells, little is known about it in autoimmune Addison’s disease (AAD). We investigated the vitamin D status in AAD patients from five European populations to assess its deficiency. In addition, we studied two case-control cohorts for vitamin D metabolism and pathway genes.

Design
Cross-sectional study.

Methods
A total of 1028 patients with AAD from Germany (n = 239), Italy (n = 328), Norway (n = 378), UK (n = 44) and Poland (n = 39) and 679 controls from Germany (n = 301) and Norway (n = 378) were studied for 25(OH)D3 (primary objective). Secondary objectives (1,25(OH)2D3 and pathway genes) were examined in case-controls from Germany and Norway correlating 25(OH)D3 and single nucleotide polymorphisms within genes encoding the vitamin D receptor (VDR), 1-α-hydroxylase (CYP27B1), 25-hydroxylase (CYP2R1), 24-hydroxylase (CYP24A1) and vitamin D binding protein (GC/DBP).

Results
Vitamin D deficiency (25(OH)D3 10–20 ng/mL) was highly prevalent in AAD patients (34–57%), 5–22% were severely deficient (<10 ng/mL), 28–38% insufficient (20–30 ng/mL) and only 7–14% sufficient (>30 ng/mL). Lower 25(OH)D3 and 1,25(OH)2D3 levels were observed both in Norwegian and German AAD (P = 0.03/0.003 and P = 1 × 10-5/< 1 × 10-7, respectively) the former was associated with CYP2R1 (rs1553006) genotype G. Whereas controls achieved sufficient median 25(OH)D3 in summers (21.4 to 21.9 ng/mL), AAD patients remained largely deficient (18.0 to 21.2 ng/mL) and synthesize less 1,25(OH)2D3.

Conclusion
Vitamin D deficiency and insufficiency are highly prevalent in AAD patients. The vitamin D status of AAD may be influenced by genetic factors and suggests individual vitamin D requirements throughout the year.
Corticotroph tumor progression after bilateral adrenalectomy (Nelson’s syndrome): systematic review and expert consensus recommendations
Authors: Reincke Martin , Albani Adriana , Assie Guillaume , Bancos Irina , Brue Thierry , Buchfelder Michael , Chabre Olivier , Ceccato Filippo , Daniele Andrea , Detomas Mario , Di Dalmazi Guido , Elenkova Atanaska , Findling James , Grossman Ashley B , Gomez-Sanchez Celso E , Heaney Anthony P , Honegger Juergen , Karavitaki Niki , Lacroix Andre , Laws Edward R , Losa Marco , Murakami Masanori , Newell-Price John , Pecori Giraldi Francesca , Pérez‐Rivas Luis G , Pivonello Rosario , Rainey William E , Sbiera Silviu , Schopohl Jochen , Stratakis Constantine A , Theodoropoulou Marily , van Rossum Elisabeth F C , Valassi Elena , Zacharieva Sabina , Rubinstein German , Ritzel Katrin 
Published: January 2021

Background
Corticotroph tumor progression (CTP) leading to Nelson’s syndrome (NS) is a severe and difficult-to-treat complication subsequent to bilateral adrenalectomy (BADX) for Cushing’s disease. Its characteristics are not well described, and consensus recommendations for diagnosis and treatment are missing.

Methods
A systematic literature search was performed focusing on clinical studies and case series (≥5 patients). Definition, cumulative incidence, treatment and long-term outcomes of CTP/NS after BADX were analyzed using descriptive statistics. The results were presented and discussed at an interdisciplinary consensus workshop attended by international pituitary experts in Munich on October 28, 2018.

Results
Data covered definition and cumulative incidence (34 studies, 1275 patients), surgical outcome (12 studies, 187 patients), outcome of radiation therapy (21 studies, 273 patients), and medical therapy (15 studies, 72 patients).

Conclusions
We endorse the definition of CTP-BADX/NS as radiological progression or new detection of a pituitary tumor on thin-section MRI. We recommend surveillance by MRI after 3 months and every 12 months for the first 3 years after BADX. Subsequently, we suggest clinical evaluation every 12 months and MRI at increasing intervals every 2–4 years (depending on ACTH and clinical parameters). We recommend pituitary surgery as first-line therapy in patients with CTP-BADX/NS. Surgery should be performed before extrasellar expansion of the tumor to obtain complete and long-term remission. Conventional radiotherapy or stereotactic radiosurgery should be utilized as second-line treatment for remnant tumor tissue showing extrasellar extension