bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sarcopenia Modifies the Associations of NAFLD&nbsp;With All-cause and Cardiovascular Mortality Among Elderly Individuals
Authors: Sun Xingxing , Liu Zhelong , Chen Fuqiong , Du Tingting 
Published: January 2021

Abstract
Background: The contribution of nonalcoholic fatty liver disease (NAFLD) to all-cause and cardiovascular mortality remains controversial. Sarcopenia, a measure of muscle mass and function, may identify which persons are most at risk for adverse effects of NAFLD. We aimed to test the hypothesis that sarcopenia modiﬁes the associations between NAFLD and all-cause and cardiovascular mortality. Methods: A total of 2,446 elderly individuals (≥60 years) from the third National Health and Nutrition Examination Survey were enrolled. Their mortality data were linked to death certificates in the National Death Index. Sarcopenia was defined as having low skeletal muscle mass together with slow gait speed, which captures both muscle mass and muscle function. Ultrasound tests were used for the assessment of hepatic steatosis. Results: During follow-up (median 16.8 years), 1530 elderly subjects died from any cause, of which 379 were cardiovascular-related. All-cause and cardiovascular mortality rates were 4.31 and 1.07 per 100 person-years, respectively. In a multivariate model, using participants without NAFLD and sarcopenia as the reference group, individuals with both NAFLD and sarcopenia had 1.69 times (95% CI, 1.23-2.31) and 2.17 times (95% CI, 1.33-3.54) higher risks of all-cause and cardiovascular mortality, respectively. However, NAFLD persons without sarcopenia had hazard ratios for all-cause and cardiovascular mortality similar to those of the reference group.Conclusions: Sarcopenia modiﬁed the associations of NAFLD with all-cause and cardiovascular mortality. Sarcopenia may identify elderly adults who are at the highest risk for adverse outcomes associated with NAFLD.
Data Utilisation and Factors Influencing the Performance of the Health Management Information System in Tanzania
Authors: Mboera Leonard , Rumisha Susan , Mbata Doris , Mremi Irene , Lyimo Emanuel , Joachim Catherine 
Published: January 2021

Abstract
Background: Health Management Information System (HMIS) is a set of data regularly collected at health care facilities, aimed to meet the needs of statistics on health services. This study aimed to determine the utilisation of HMIS data and factors influencing the performance of health system at the district and primary health care facility levels in Tanzania. Methods: This cross-sectional study was carried out in 11 districts and involved 115 health care facilities in Tanzania. Data were collected using a standard questionnaire and an observational checklist. The collected data was cleaned, summarized into proportions and graphical presentation using STATA version 13 software. Results: This study involved 115 health facilities in 11 districts. A total of 93 health facility workers and 13 district officials were interviewed. About two-thirds (60%) of the facility respondents reported to use the HMIS data they collect. Data were mainly used for comparing performance in terms of services coverage (53%), monitoring of disease trends over time (50%), and providing evidence for community health education and promotion programme (55%). The majority (41.4%) of the facility’s personnel had not received any training on data management related to HMIS in the past 12 months. Only five out of 13 district respondents reported to routinely analyse HMIS data. Patient load was described to frequently affect staff performance on data collection and management. Less than half (42%) of the health facilities (HFs) had received supervisory visits from the district office. Nine district respondents reported to systematically receive feedback on the quality of their reports on monthly and quarterly bases from higher authorities. More than half (n=7) of district respondents reported that those responsible for HMIS activities are also responsible for other equally important activities. Conclusion: Poor data utilisation was common in most of the districts and health facilities in Tanzania. Inadequate human and financial resources, inadequate training, lack of supervision, and lack of standard operating procedures were the major challenges affecting the HMIS performance in Tanzania.
Molecular Parameters and Intrinsic Viscosity of Nettle Seed (Urtica Pilulifera) Gum as a Function of Temperature
Authors: Zamani Zahra , Razavi Seyed Mohammad Ali 
Published: January 2021

Abstract
This research focused to determine some molecular properties of Nettle seed gum (NSG), as one of novel and natural source of hydrocolloids, at various temperatures (10, 25, 40, 55, and 70°C) in the dilute region. The results displayed that among the models studied, the Higiro 2 model with highest R2 and lowest RMSE values was the most proper model for determining the intrinsic viscosity of the NSG. According to this model, the intrinsic viscosity value of NSG was obtained in the range of 0.15–0.21 dl/g. It was also revealed that, as the temperature raised, the intrinsic viscosity of NSG declined. The shape factor of NSG at 40°C was spherical, however, with increasing the temperature from 40°C to 70°C, it was changed to an ellipsoidal shape. Berry number and master curve slope revealed that NSG solution at all temperatures was within the dilute regime and that no molecular entanglements were present. The parameter b values acquired for NSG at the intended temperatures showed that the molecular conformation of NSG was random coil. The activation energy and chain flexibility parameter calculated for NSG at the studied temperatures were 0.488×107 J/kgmol and 587.2, respectively.
A National Hiv Clinical Mentorship Program: Enabling Zambia to Accelerate Towards the Controlling the Hiv Epidemic
Authors: Boyd Mary Adetinuke , Fwoloshi Sombo , Minchella Peter A. , Simpungwe James , Siansalama Terence , Barradas Danielle T. , Shah Minesh , Mulenga Lloyd , Agolory Simon 
Published: January 2021

Abstract
Background
Although Zambia has increased the proportion of people living with HIV (PLHIV) who are on antiretroviral therapy (ART) in recent years, progress toward HIV epidemic control remains inconsistent. Some districts are still failing to meet the UNAIDS 90/90/90 targets where 90% of PLHIV should know their status, 90% of those who know their status should be receiving sustained ART, and 90% of those on ART should have documented viral load suppression (VLS) by 2020. Providing consistently excellent HIV services at all ART health facilities is critical for achieving the UNAIDS 90/90/90 targets and controlling the HIV epidemic in Zambia. Zambia Ministry of Health (MoH), in collaboration with the U.S. Centers for Disease Control and Prevention (CDC), aimed to achieve these targets through establishing a national HIV clinical mentorship program in which government-employed mentors were assigned to specific facilities with a mandate to identify and ameliorate programmatic challenges.
Methods
Mentors were hired, trained and deployed to individual facilities in four provinces to mentor staff on quality HIV clinical and program management. The pre-mentorship period was July 2018–September 2018 and the post-mentorship period was July 2019–September 2019.
Results
Review of key programmatic indicators from the pre and post-deployment periods revealed HIV testing yield improved from 4.2–6.8% (P < 0.001) as fewer HIV tests were needed despite the number of PLHIV being identified and placed on ART increasing from 492,613 to 521,775, and VLS increased from 84.8–90.1% (p < 0.001).
Conclusions
Key considerations in the establishment of an HIV clinical mentorship program include having a government-led process of regular site level data review and continuous clinical mentorship underpinned by quality improvement methodology.
PTX3 secreted by human adipose-derived stem cells promotes dopaminergic neuron repair in Parkinson's disease via inhibiting apoptosis
Authors: Lian Changlin , Huang Qiongzhen , Zhong Xiangyang , He Zhenyan , Liu Boyang , Zeng Huijun , Xu Ningbo , Yang Zhao , Liao Chenxin , Fu Zhao , Guo Hongbo 
Published: January 2021

Abstract
Background

Adipose-derived human mesenchymal stem cells (hADSCs) transplantation has recently emerged as a promising method in the treatment of Parkinson's disease (PD), however, the mechanism underlying has not been fully illustrated.
Methods

In this study, the therapeutic effects of the striatum stereotaxic injected hADSCs in 6-OHDA-induced mouse model were evaluated. Furthermore, an in vitro model of PD was constructed using tissue-organized brain slices. And the therapeutic effect was evaluated by co-culture of hADSCs and 6-OHDA-constructed brain slice. Within the analysis of hADSCs' exocrine proteins through RNA-seq, Human protein cytokine arrays and label-free quantitative proteomics, key extracellular factors were identified in hADSCs secretion environment.The degeneration of DA neurons and apoptosis were measured in PD samples in vivo and vitro models, and the beneficial effects were evaluated through quantitative reverse transcription polymerase chain reaction (qRT-PCR), western blot,Fluoro-Jade C, Tunel assay and immunofluorescence analysis.
Results

In this study, we discovered that hADSCs protected the dopaminergic (DA) neurons in vivo and vitro models.we identified Pentraxin3 (PTX3) as a key extracellular factor in hADSCs secretion environment. Moreover, we found that human recombinant Pentraxin3 (rhPTX3) treatment could rescue the physiological behaviour of the PD mice in-vivo, as well as prevent DA neurons from death and increase the neuronal terminals in the Ventral tegmental area (VTA) + substantia nigra pars compacta (SNc) and striatum (STR) on the PD brain slices in-vitro. Furthermore, within testing on the pro-apoptotic markers of PD mice brain following the treatment of rhPTX3, we found that rhPTX3 can prevent the apoptosis and the degeneration of DA neurons.
Conclusions

Overall, the current study investigated that PTX3, a hADSCs secreted protein, played a potential role in protecting the DA neurons from apoptosis and degeneration in PD progression as well as improving the motor performances in PD mice to give a possible mechanism of how hADSCs works in the cell replacement therapy in PD. Importantly, our study also provided potential translational implications for the development of PTX3-based therapeutics in PD.
Orexin-A Alleviates Astrocytic Apoptosis and Inflammation via Inhibiting OX1R-mediated NF-κB and MAPK Signaling Pathways in Cerebral Ischemia/reperfusion Injury
Authors: Xu Dandan , Kong Tingting , Shao Ziqi , Zhang Rumin , Zhang Shengnan , Kong Qingxia , Chen Jing , Cheng Baohua , Wang Chunmei 
Published: January 2021

Abstract
Background: Orexin-A (OXA) is a neuropeptide with neuroprotective effect by reducing cerebral ischemia/reperfusion injury (CIRI). Inflammation and apoptosis mediated by astrocyte activation are the key pathological mechanisms for CIRI. We thus attempted to confirm neuroprotective effects of OXA on astrocytic inflammation and apoptosis in CIRI and clarify the relative mechanisms. Methods: A middle cerebral artery occlusion and reperfusion (MCAO/R) rat model and U251 glioma cells model subjected to oxygen glucose deprivation and reperfusion (OGD/R) were established, with or without OXA treatment. Neurological deficit score was determined, and cerebral infarct volume was evaluated by 2,3,5-triphenyltetrazolium chloride (TTC) staining. Western Blot was used to detect the expressions of NF-κB p65, p-ERK, p-p38, GFAP, OX1R, IL-1β, TNF-α, IL-6, iNOS, Bcl-2, Bax, CytC, cleaved caspase-9 and cleaved caspase-3 in vivo and vitro. Pro-inflammatory cytokines in cell supernatant IL-1β, TNF-α and IL-6 were determined by ELISA. Hoechst 33342 staining was used to detect the apoptosis of astrocyte. Immunofluorescent staining was performed to assess the nuclear translocation of p65 and the expression of GFAP. Results: The results showed that OXA significantly improved neurological deficit score and decreased the volume of infarct area in brain. OXA decreased inflammatory mediators, inhibited astrocyte activation and nuclear translocation of NF-κB and phosphorylation of MAPK/ERK and MAPK/p38. Besides, OXA suppressed apoptosis via upregulating the ratio of Bcl-2/Bax and downregulating cytochrome C, cleaved-caspase-9 and cleaved caspase-3. Conclusions: Overall, it was concluded that OXA exerts neuroprotective effect during CIRI through attenuating astrocytes apoptosis, astrocytes activation and pro-inflammatory cytokines production, by Inhibiting OX1R-mediated NF-κB, MAPK/ERK and MAPK/p38 signaling pathways. The progress in our study are helpful to elucidate the molecular mechanisms of OXA neuroprotection, which could lead to the development of new treatment strategies for ischemic stroke.
GnRH Agonist Ovulation Trigger in Patients Undergoing Controlled Ovarian Hyperstimulation for IVF with Stop GnRH-agonist Combined With Multidose GnRH-antagonist Protocol.
Authors: Orvieto Raoul , Nahum Ravit , Frei Judith , Zandman Orit , Frenkel Yulia , Haas Jigal 
Published: January 2021

Abstract
Backround: Recently, the Stop GnRH agonist protocol has been used successfully in poor responder patients , those with poor embryos quality and those with elevated peak serum progesterone levels. The aim of the present study was to evaluate, whether GnRH-agonist trigger in patients undergoing the Stop protocol combined , will result in an optimal response/trigger, as reflected by post trigger LH >15 mIU/mL Methods: A retrospective cohort study. All consecutive women admitted to our IVF unit from February 2020 through November 2020 who reached the ovum pick-up stage. Patients triggered with GnRH-ag alone, or combined with hCG for final oocyte maturation were included in the study. LH levels were measured 12 hours post trigger.Results: Five out of the 32 patients (15.6%) demonstrated suboptimal response as reflected by LH levels <15 IU/L 12 hrs post GnRH-agonist trigger. Moreover, while no differences were observed in oocytes recovery rate, maturity or embryos quality between the different study groups, those achieving a suboptimal response to the GnRH-agonist trigger (post trigger LH <15 mIU/mL) demonstrated significantly higher number of follicles and peak estradiol levels at the day of trigger.Conclusions: The Stop GnRH-agonist combined with GnRH-antagonist protocol, enables the substitution of HCG with GnRH-ag for final oocyte maturation. However, caution should be taken in high responders, where the dual trigger with small doses of hCG (1000-1500IU) should be considered, aiming to avoid suboptimal response (post trigger LH levels <15IU/L).
Exploring the Linkage Between Financial Development and Economic Growth: the ARDL Bounds Testing approach
Authors: Kashem Mohammad Abul , Rahman Mohammad Mafizur 
Published: January 2021

Abstract
This study investigates the cointegration, short and long run dynamics and causal links between financial development and economic growth in Bangladesh for the period 1973 to 2015. We applied the Autoregressive Distributed Lag (ARDL) Bounds Testing approach and the Granger causality test. The ARDL bounds tests and other cross-checking test confirmed the long run cointegration between economic growth and financial development indicators in Bangladesh. The two financial development indicators, growth in broad money to gross domestic product (GDP) ratio and growth in total deposit liabilities to GDP ratio appeared to have time variant impact on economic growth: the former having significant positive impact in the short- run but negative impact in the long- run, while the latter has significant negative impact in the short- run but positive impact in the long- run. The Granger causality analysis indicated a bidirectional, co-evolutionary process between financial development and economic growth.
A mixed-methods evaluation of the uptake of novel differentiated ART delivery models in a national sample of health facilities in Uganda
Authors: Zakumumpa Henry , Makobu Kimani , Wilbrod Ntawiha , Maniple Everd 
Published: January 2021

Abstract
INTRODUCTIONSince 2017, Uganda has been implementing differentiated antiretroviral therapy services (DARTS) to improve the quality of HIV care and health-system efficiencies. The Ministry of Health endorsed five models. The community-based models include Community Client-Led Drug Delivery (CCLAD) and Community Drug Distribution Points (CDDPs), with facility-based models being either Fast Track Drug Refill (FTDR), Facility Based Group (FBG) or Facility-Based Individual Management (FBIM). It is unclear what the uptake of DARTS is since roll-out in 2017. We set out to assess the extent of uptake of DARTS models and to describe barriers to uptake of either facility-based or community-based models.METHODSBetween August and December 2019, we conducted a mixed-methods study entailing a cross-sectional health facility survey (n=116) and in-depth interviews (n=18) with ART clinic managers in ten case-study facilities as well as six focus group discussions (56 participants) with patients enrolled in DARTS models. Facilities were selected based on the 10 geographic sub-regions of Uganda. Statistical analyses were performed in STATA (v13) while qualitative data were analyzed by thematic approach. The qualitative arm of our study was dominant.RESULTSMost facilities 63 (57%) commenced implementation of DARTS in 2018. The most implemented facility-based model was Fast Track Drug Refill (FTDR) implemented in 100 (86%) of health facilities. Community Client-Led ART Delivery (CCLAD) was the most popular community model implemented in more than a half of facilities (63/116 or 54%). Community Drug Distribution Points (CDDP) model had the lowest uptake and was implemented in only 33 (24.88%) facilities. Overall, there has been a higher uptake of facility-based models. Barriers to enrollment in community-based models include; HIV-related stigma and a fear of breach of confidentiality of HIV status, low enrollment of adult males in community models. Health-system constraints include insufficient training of health workers in DARTS and inadequate funding to facilities for implementing community-based models.CONCLUSIONTo the best of our knowledge this is the first study reporting national DARTS coverage in Uganda. There is need to devise stigma-reduction interventions to enhance uptake of community models and increased donor and government funding for community models to maximize DARTS potential for achieving health-system efficiencies.
Sacral incidence to pubis: a novel and alternative morphologic radiological parameter to pelvic incidence in assessing spinopelvic sagittal alignment
Authors: Takahashi Yasuhito , Watanabe Kei , Okamoto Masashi , Hatsushikano Shun , Hasegawa Kazuhiro , Endo Naoto 
Published: January 2021

Abstract
Background: Although pelvic incidence (PI) is a key morphologic parameter in assessing spinopelvic sagittal alignment, accurate measurements of PI become difficult in patients with severe hip dislocation or femoral head deformities. This study aimed to investigate the reliability of our novel morphologic parameters and the correlations with established sagittal spinopelvic parameters. Methods: One hundred healthy volunteers (25 male and 75 female), with an average age of 38.9 years, were analysed. Whole-body alignment in the standing position was measured using a slot-scanning X-ray imager. We measured the established spinopelvic sagittal parameters and a novel parameter: the sacral incidence to pubis (SIP). The correlation coefficient of each parameter, regression equation of PI using SIP, and regression equation of lumbar lordosis (LL) using PI or SIP were obtained. The intraclass correlation coefficient (ICC) was calculated as an evaluation of the measurement reliability. Results: Reliability analysis showed high intra- and inter-rater agreements in all the spinopelvic parameters, with ICCs > 0.9. The SIP and pelvic inclination angle (PIA) demonstrated strong correlation with PI ( R = 0.96) and pelvic tilt (PT) ( R = 0.92). PI could be predicted according to the regression equation: PI = –9.92 + 0.905 * SIP ( R = 0.9596, p < 0.0001). The ideal LL could be predicted using the following equation using PI and age: ideal LL = 32.33 + 0.623 * PI – 0.280 * age ( R = 0.6033, p < 0.001) and using SIP and age: ideal LL = 24.29 + 0.609 * SIP – 0.309 * age ( R = 0.6177, p < 0.001). Conclusion: Both SIP and PIA were reliable parameters for determining the morphology and orientation of the pelvis, respectively. Ideal LL was accurately predicted using the SIP with equal accuracy as the PI. Our findings will assist clinicians in the assessment of spinopelvic sagittal alignment.
Intervention fidelity and its determinants of focused antenatal care package implementation, in South Wollo, Northeast Ethiopia.
Authors: Tessema Asressie Molla , Gebeyehu Abebaw , Mekonnen Solomon , Alemu Kassahun , Tigabu Zemene 
Published: January 2021

Abstract
Background: Focused antenatal care is directed at sustaining maternal health and improving fetal wellbeing to ensure birth of a healthy neonate. Failure to implement focused antenatal care can result in inability to reduce maternal and perinatal morbidity and mortality in low income countries. Due to evidence-practice gaps, however, thousands of maternal, fetal and neonatal lives are still lost every day, mostly from preventable causes. This study aimed to assess focused antenatal care package’s intervention fidelity and its determinant factors in South Wollo Zone, Northeast Ethiopia. Methods: A cross-sectional study design was employed and a total of 898 women who gave birth in the last six months prior to data collection were included. Also 16 health extension workers, working in ten selected health posts, were included. Interviews and self-administered questionnaires were used to collect data from mothers and health extension workers. Ten (10) health posts were audited to assess availability and functionality of drugs and supplies to provide focused antenatal care. Mothers were asked whether or not the required level of care was provided. Health extension workers were provided with self-administered questionnaires to assess socio-demographic characteristics, reception of training, facilitation strategies for the implementation of focused antenatal care and ability to classify danger signs. Multilevel linear regression analysis was performed to identify individual and organizational level’s factors influencing focused antenatal care package intervention fidelity. Results: Overall weighted average focused antenatal care package intervention fidelity (implemented as intended/planned) was 49.8% (95% CI: 47.7 – 51.8), which means the average number of focused antenatal care package interventions women received is 49.8%. Health extension workers implemented 55.1% and skilled providers (nurses, midwives, health officers or medical doctors) 44.9% of focused antenatal care package interventions. Overall antenatal care coverage, irrespective of frequency (at least one visit), was 752/898 women (83.7%; 95% CI: 81.3–86.1); 263/752 women (35.0%; 95% CI: 31.6 – 38.4) received at least four antenatal visits and only 46/752 women (6.1%; 95% CI: 4.4 - 7.8) received all recommended components of focused antenatal care. Previous pregnancy-related problems, paternal education and implementation of facilitation strategies were found to be significant factors enhancing focused antenatal care package intervention fidelity.Conclusion: Focused antenatal care package intervention fidelity in the study area was low; this may imply that the current level of maternal, perinatal and neonatal mortality might be partly due to the low level of focused antenatal care intervention fidelity. Improving implementation of facilitation strategies is highly required to contribute to the reduction of those mortalities.