bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Clinical Outcomes Between Ticagrelor and Clopidogrel in Acute Coronary Syndrome: an Updated Meta-Analysis
Authors: Sun Mengyi , Cui Weichen , Li Linping 
Published: October 2021

Abstract
Background: Ticagrelor is currently recommended for patients with acute coronary syndrome (ACS). However, recent studies have yielded controversial results. Objective: To compare the clinical outcomes of ticagrelor and clopidogrel in ACS patients.Methods: Three electronic databases were queried until April 1, 2021. Major adverse cardiovascular event (MACE) was the primary efficacy endpoint. The secondary efficacy endpoints included stroke, stent thrombosis (ST), cardiovascular (CV) death, all-cause death, and myocardial infarction (MI). The safety endpoints were (major and minor) bleeding. Odds ratios (ORs) and 95% confidence intervals (CIs) and were calculated to represent the estimated effect sizes.Results: Nine clinical trials and 18 observational studies with 269,935 ACS patients were included. No significant difference was detected in MACE (OR 0.76, 95% CI 0.54-1.06, p = 0.11, I² = 66.74%), but ticagrelor introduced a higher risk of bleeding (1.49, 1.14-1.94, 0.00, 63.97%) and minor bleeding (1.57, 1.08-2.30, 0.02, 59.09%) in clinical trials. The secondary efficacy endpoints differed between clinical trials and observational studies. Subgroup analysis demonstrated that ticagrelor showed better therapeutic effects in patients underwent PCI (0.38, 0.23-0.63, 0.00, 0) than those intended for PCI (1.02, 0.70-1.49, 0.93, 68.99%). Meanwhile ticagrelor showed different therapeutic effects on ACS patients of different ethnicities and from different countries.Conclusion:This meta-analysis demonstrated that ticagrelor is not superior to clopidogrel in MACE but is associated with a higher risk of bleeding in ACS patients. Different PCI strategies, ethnicities, and countries may be the factors that contribute to different therapeutic efficacy of ticagrelor.
Mothers’ health care seeking behavior and associated factors for common childhood illnesses in Ethiopia: a systematic review and meta-analysis
Authors: Sume Bickes Wube , Alamneh Yoseph Merkeb , Adane Fentahun 
Published: October 2021

Abstract
Background: Even though healthcare-seeking interventions potentially reduce child mortality from easily treatable diseases, significant numbers of children die without ever reaching a health facility or due to delays in seeking care in Ethiopia. Though there was fragmented evidence on the proportion of mothers' healthcare-seeking behavior and associated factors for common childhood illnesses in Ethiopia, the national level is unknown. Therefore, this systematic review and meta-analysis estimated the pooled proportion of mothers' healthcare-seeking behavior and associated factors in Ethiopia from 2008–2019.
Methods: We systematically searched the databases: PubMed/MEDLINE, Google Scholar, and Science Direct for studies conducted in Ethiopia on mothers’ health care seeking behavior since 2008. We have included observational studies, which were published between 2008 and 2019. The report was compiled according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The quality of included studies was scored based on the Newcastle Ottawa quality assessment scale adapted for cross-sectional studies. The data were extracted in Microsoft excel and analyzed using Stata version 14.1 software. We employed a random-effects model to estimate the pooled proportion of mothers' healthcare-seeking behavior in Ethiopia. The presence of statistical heterogeneity within the included studies was evaluated using the I-squared statistic. We used Egger’s regression test to identify evidence of publication bias. The pooled proportion with a 95% confidence interval (CI) was presented using tables and forest plots.
Result: We screened a total of 581 articles. Of these, 14 studies were included in the final systematic review and meta-analysis. In Ethiopia, the pooled proportion of mothers' health care seeking behavior was 50.24% (95% CI: 37.13, 63.35%). Less than 5 kilometers from a health facility (OR, 2.07; 95% CI: 1.50, 2.87), mothers who were aware of common childhood illnesses (OR =2.06; 95% CI: 1.45, 2.91, mothers who had educational levels of primary school and above (OR = 1.82;95% CI: 1.36, 2.43), caregivers at a higher wealth index category (OR = 2.01; 95% CI: 1.33. 3.24) were significantly associated with health care seeking behavior of mothers/caregivers.
Conclusion: Overall, in Ethiopia healthcare-seeking behavior of mothers/caregivers for common childhood illnesses is low. Awareness, perceived illness severity, distance from a health care facility, and mothers/caregivers’ level of education were predictors of mothers' healthcare-seeking behavior. Accordingly, increasing the proximity of health facilities and educate mothers/caregivers about the importance of healthcare-seeking behavior were recommended to improve healthcare-seeking behavior.
Exclusive Breastfeeding Practice And Associated Factors Among Employed And Unemployed Mothers In Ethiopia: Comparative Cross Sectional Study Using EDHS 2016
Authors: Minamo Desta Markos 
Published: October 2021

Abstract
Introduction Contrary to the recommendation, children under the age of 6 months be exclusively breastfed, many infants are also fed with other liquids such as water, non-milk liquids, and other milks before 6 months. Because of level of education and proportion of employed women in Ethiopia has been increasing gradually. Consequently the practice of exclusive breastfeeding became very lower. The main objective of this study was to assess the magnitude and factors associated with the practice of exclusive breastfeeding among employed and unemployed mothers in Ethiopia, using dataset from EDHS 2016. METHOD Data was extracted from Ethiopia Demographic and Health Survey (EDHS-2016). A total of 1089 mothers with infants aged 0 to 6 months in the data set were included in the analysis. Descriptive analysis, chi-square and binary logistic regression models were used. RESULT This study has demonstrated a 64.7%, 95%CI(58.9-70.5) and 75.4%, 95%CI(72.378.2) prevalence of EBF practices among employed and unemployed mothers respectively in the 24h preceding the survey. Other factors associated with EBF practice included being unemployed mother, larger to normal birth weight; infant aged 0-3 month old, infant being male, have radio in the house, infant being wanted, delivery by non CS mode and presence of ANC follow up during pregnancy were found to be significantly associated with exclusive breastfeeding practice. Conclusion the prevalence of exclusive breast feeding practice among employed mothers was significantly lower than that of unemployed mothers. Thus, Having in consideration the impact of appropriate infant and young children feeding practice on children’s nutritional status and mortality rate, policy makers still need to give more emphasis on promotion of exclusive breastfeeding through creating an enabling environment targeting the extension of postnatal maternity leave up to the first six month.
Evaluation of Left Ventricular Systolic Function in Patients With Systemic Lupus Erythematosus Using Ultrasonic Layer-specific Strain Technology and Its Association With Cardiovascular Events: a Long-term Follow-up Study
Authors: Zhang Hebin , Yang Cunxin , Gao Feng , Hu Shanting , Ma Hui 
Published: October 2021

Abstract
Background: Systemic lupus erythematosus (SLE) is a multisystem, autoimmune disease with potential cardiovascular involvement. Layer-specific strain (LSS) analysis is a new method that allows early detection of subtle LV systolic dysfunction. The aim of this study was to evaluate left ventricular (LV) systolic function in patients with SLE using conventional echocardiographic measurements and longitudinal strain (LS) and circumferential strain (CS) by LSS. Furthermore, the association between echocardiographic parameters and the occurrence of cardiovascular events was assessed. Methods: A total of 162 patients with SLE (the SLE group) who underwent a dedicated multidisciplinary assessment, including echocardiography, were analyzed at the time of their first visits. The control group consisted of 68 age- and sex-matched healthy subjects. LS and CS on endocardial, mid-myocardial, and epicardial layers at 17 cardiac segments were measured. Transmural strain gradient was calculated as the differences in systolic strain between the endocardial and epicardial layers.Results: Compared with control subjects, patients with SLE had significantly lower LV ejection fraction, LS, and CS values in all layers (P<0.05); LV LS and CS gradient were all lower than control subjects(P<0.05). During a median follow-up period of 83 months (interquartile range: 64-95 months), 59 patients (36.4%) developed cardiovascular events. Using multivariate Cox regression analysis, we found that LV endocardial LS (hazard ratio, 1.022;95% CI,0.992-1.046; P=0.037) and CS (hazard ratio, 1.052;95% CI, 1.028-1.046; P<0.001) demonstrated independent associations with cardiovascular events; whereas LV ejection fraction was not significantly associated with cardiovascular events. The Kaplan-Meier survival curves showed that patients with SLE with lower LV endocardial LS and CS (based on the cutoff values of -21.5% and -29.0%, respectively) experienced higher cumulative rates of cardiovascular events compared with those with higher LV endocardial LS and CS. Conclusions: In patients with SLE, LV systolic function measured by LV endocardial LS and CS were significantly lower than that of the control group and were associated with cardiovascular events, potentially representing a new technology to improve risk stratification in these patients.
Evaluation of anthropogenic nexus on groundwater quality through integration of hydrogeochemical processes and water quality index at Nacharam watershed of greater Hyderabad, India
Authors: Kurakalva Rama Mohan , Guddeti Sravya Sai , Nath Anjana , Vemana Eswara Venkata Ravi Kishore 
Published: October 2021

Abstract
Anthropogenic activities such as the rapid leap of industrialization and urbanization constitute a significant concern in megacities and have become a key source of groundwater contamination. Twenty-five (25) groundwater samples were collected from tube wells and handpumps from Nacharam watershed, greater Hyderabad. The water samples were analyzed for 13 physicochemical parameters and major dissolved ions using the standard methods. WQI has been computed using a weighted arithmetic index method and integrated with GIS to identify the hotspots of contamination and their spatial distribution. The analytical data plotted on the Piper diagram showed that dominance of Ca-Mg-Cl (52%) type followed by Na-Cl type of water is dominant in 44% of samples might be resulting due to increase in anthropogenic activities such as discharge of waste water from industries. Results reveal that 96% of the samples exceed the F - concentrations compared with WHO permissible limits suggested unfit for drinking. WQI values indicate that 56% of samples fall in the poor category, 28% belong to very poor water, and 4% are unsuitable for drinking. These findings will provide valuable information to policymakers and stakeholders on the proper management and supply of potable water that reduces human health concerns .
Assessment of a Comparative Bayesian-Enhanced Population-Based Decision Model for COVID-19 Critical Care Prediction in Dominican Republic Social Security Affiliates
Authors: Baez Amado Alejandro , Lopez Oscar , Martinez Maria del Pilar , Ramirez-Slaibe Pedro , Martinez Leticia , Castellanos Pedro Luis 
Published: October 2021

Abstract
Introduction: The novel coronavirus disease 2019 is a major health concern worldwide. The objective was to develop a Bayesian model to predict critical outcomes in patients with COVID-19. Methods: Sensitivity and specificity were obtained from previous meta-analysis. Using the IVC-COV2 index as pretest probability, likelihood ratios were integrated in a Fagan nomogram for posttest probabilities, generating IVC-COV2 + NEWS and CURB-65 scores values. Absolute and Relative Diagnostic Gains (ADG, RDG) were calculated. Results: The IVC-COV2 index was derived from a population of 1,055,746 individuals and based on mortality divided into high (71.97%) Intermediate (26.11%) and low (1.91%) risk groups. Integrating the IVC-COV2 intermediate + NEWS≥5 and CURB-65 >2 score models found that the Number Needed to Diagnose demonstrated a slight improvement for the CURB-65 model [2.00 (2) vs 2.71(3)]. When comparing diagnostic gains, no statistical differences were found on the IVC-CoV2 NEWS model compared to the CURB-65 model in both LR+ (P=0.62) and LR- (P=0.95). Conclusion: This mathematical model proposed that the combination of a IVC-COV2 Intermediate score plus NEWS or CURB-65 scores yields superior results and a greater predictive value for severity of illness. To our knowledge this is the first population-based/mathematical model for COVID-19 Critical Care decision making.
Prepubertal Stress Following Mild Maternal Immune System Activation Damages Prefrontal White MatterStructure and Related Molecules in Adult Mice Offspring
Authors: Namvarpour Zahra , Ranaei Elahe , Amini Abdollah , Roudafshani Zahra , Fahanik-Babaeid Javad 
Published: October 2021

Abstract
Mild maternal immune activation (MIA) by inflammatory agents such as lipopolysaccharide (LPS) and prepubertal stress (PS) may individually and collectively affect the central nervous system (CNS) during adulthood. Here, we intend to assess the effects of mild MIA, alone or combined with PS, on prefrontal white matter structure and its related molecules in adult mice offspring. Pregnant mice received either a mild intraperitoneal (IP) dose of LPS (50 μg/kg) on gestational day 17 (GD17) or normal saline. Their pups were exposed to stress from postnatal days (PD) 30 to PD38 or no stress during prepubertal development. We randomly chose 56-day-old male offspring (n=2 offspring per mother) from each group and isolated their prefrontal areas according to relevant protocols. The tissue samples were prepared for structural, histological, and molecular examinations. According to the results, the LPS+stress group had evidence of increased damage in the white matter structures compared to the control, stress, and LPS groups (p<.05). The LPS+stress group also had significant downregulation of the genes involved in white matter formation (Sox10, Olig1, myelin regulatory factor (Aprato et al), and Wnt) compared to the control, stress, and LPS groups (p<.05).In conclusion, although each manipulation individually resulted in small changes in myelination, their combined effects were more pronounced. These changes were parallel to abnormal expression levels of the molecular factors that contribute to myelination.
Applying PSS, mLE, SALI and GALI Methods for Exploring Order and Chaos in Two and Three Dimensional Hamiltonian Systems with Quartic Coupling
Authors: ghamari Mohammed El , Chatar Walid , Kharbach Jouad , Benkhali Mohamed , Masrour Rachid , Rezzouk Abdellah , Ouazzani-Jamil Mohammed 
Published: October 2021

Abstract
In this article, the complex nonlinear dynamics and chaos control have been examined in Hamiltonians systems with quartic coupling through the generalized three-dimensional (3D) Yang-Mills Hamiltonian system with four control parameters. We provide sufficient conditions on the four control parameters of the system which guarantee the 3D integrability in the Liouvillian sense. Therefore, we get a classification of the 3D Yang-Mills Hamiltonian system in sense of integrability and non-integrability. The integrable cases are identified and the detailed calculations of their associated first integrals of motion are given. The nature of the behavior orbits could be distinguished in a fast and efficient way by using a set of reliable methods based on the so-called the evolution of deviation vectors related to the studied orbit. This set of methods includes the Poincaré surface of section (PSS), the maximum Lyapunov exponent (mLE), the Smaller Alignment Index (SALI), the Generalized Alignment Index (GALI). In this view, the chaotic behavior will be explored and the order-chaos transition could be evaluated both in 2D and 3D, when any control parameters on which the system depends vary. Finally, the efficiency and rapidity of these proposed methods are proven by using several numerical illustrative paradigms for identifying whether the system is in chaos or order state.
Daily probiotics: benefits and reasonable application
Authors: Shulpekova Yu. O. , Rusyaev V. Yu. 
Published: October 2021

This article reviewed the mechanisms of action of probiotics and the possible effects of individual strains on the general wellbeing if they are taken daily.The content and activity of bacteria in food products should be regulated by special guidelines. The balanced nutrition allows us to get healthy strains in a natural way. Daily consumption of certain strains as part of functional food products is promising for the prevention of obesity, type 2 diabetes mellitus, non-alcoholic fatty liver disease, functional intestinal disorders, colon cancer, cardiovascular diseases and depression. The issues of safety of novel probiotic strains newly introduced in clinical practice require careful consideration. Synbiotics can comprise probiotic strains of bacteria (Lactobacillus acidophilus La-14, Lactobacillus rhamnosus Lr-32, Bifidobacterium lactis Bl-04) with tolerance to acid, pepsin and bile salts, as well as the prebiotic inulin and vitamins B1, B2, B6 and B12 contributing to survival of beneficial bacteria. L. acidophilus is a common probiotic that occurs in the natural environment and food products, no cases of antibiotic resistance of this species have been established. Strains Lactobacillus acidophilus La-14, Lactobacillus rhamnosus Lr-32, Bifidobacterium lactis Bl-04 have a high adhesion capacity, strong inhibitory effects on intestinal pathogens, including fungi, anti-inflammatory effects, help to eliminate oxalates. As can be seen from the above, the use of probiotics and synbiotics is one of the most promising preventive fields of medicine.
Dietary therapeutic and preventive food products in complex therapy of gastroinal tract diseases associated with Helicobacter pylori
Authors: Pilat T. L. , Kuzmina L. P. , Bezrukavnikova L. M. , Kolyaskina M. M. , Korosteleva M. M. , Ismatullaeva S. S. , Khanferyan R. A. 
Published: October 2021

Introduction. The paper presents modern literature and clinical research data on the efficacy and safety of dietary therapeutic and prophylactic foods in the complex therapy of diseases associated with Helicobacter pylori. Aim. To assess the efficacy and safety of the use of dietary therapeutic and prophylactic food products in the complex therapy of diseases of the gastrointestinal tract associated with Helicobacter pylori. Materials and methods. To evaluate the efficacy of dietary therapeutic and prophylactic food products such as Vegetable Puree Soup with Herbs and Oatmeal, Oatmeal Porridge with Herbs and Flax Seed, Protein-Sea Buckthorn Cocktail (LEOVIT Nutrio LLC), the main group of patients with gastrointestinal diseases (n = 41) was formed, which was further divided into four subgroups. Each of three subgroups received one specialty food product, and the fourth subgroup received all three products. Changes in complete blood count were evaluated using Sysmex XT-2000i analyzer, those in proteinograms – using SAS1, SAS2 protein fraction analyser and those in metabolic liver disorders, lipid profile and glucose level – using Konelab PRIME 30i (Thermo Fisher Scientific) analyzer. All parameters were studied three times: before use, 14 and 60 days after use of the products. Results and discussion. After 14 days, complaints of lack of appetite decreased in the main group, discomfort in the epigastrium, feeling of heaviness and nausea decreased. After 60 days, 100% of patients reported no heartburn, belching, nausea, pain, rumbling in the abdomen, appetite and stool returned to normal. There was a marked significant (p < 0.05) decrease in the level of alpha-1 globulin against the background of an increase in albumin, a decrease in the concentration of CRP and ESR, the levels of leukocytes and neutrophils in all subgroups of the main group after 60 days. Conclusions. The investigated products are safe, no adverse reactions were noted, including the phenomena of intolerance and allergies, and are recommended for use in dis[1]eases of the gastrointestinal tract associated with Helicobacter pylori.
Degradation of tetracycline using nanoparticles of zero-valent iron and copper
Authors: Ayoub Mohamed 
Published: October 2021

Abstract
Tetracycline (TC) is one of the most persistent pharmaceuticals in the ecosystem. Advanced oxidation processes (AOPs) are suitable and effective technology for treating wastewater contaminated with antibiotics such as TC. In this manner, Fenton-like reaction is effective for wastewater treatment from toxicity and non-biodegradable organic pollutants using bimetallic nanoparticles. This study aims to verify the effect of AOPs using ZVI/Cu bimetallic nanoparticles on removing the TC antibiotic via a Fenton-like reaction, and what is necessary to evaluate the factors that influence the reaction, i.e. pH, ZVI/Cu dose, stirring intensity, H2O2 concentration, and initial TC dosage. The obtained results indicated that the TC removal reached up to 82.3% with an initial TC dose of 8 μg/L. In addition, the TC degradation process is more effective in an acidic medium than in an alkaline medium. Furthermore, the TC removal reached up to 85.1% with a ZVI/Cu dose of 1.2 g/L. On the other hand, the optimum mixing intensity value was 200 rpm, and the optimum H2O2 dose was 2 g/L according to the conditions of the present study.