bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health-related quality of life among cervical cancer survivors at a tertiary hospital in Kumasi, Ghana
Authors: Antwi Kwabena Amo , Agambire Ramatu , Konney Thomas Opkoti , Nartey Yvonne , Kubi Adu-Appiah , Nguah Samuel Blay , Dassah Edward T. , Akakpo Patrick K. , Opoku Baafour K. , Ankobea Frank , Tawia Augustine , Nti Maxwell K. , Djokoto Rex Mawuli , Peprah Amponsah , Ansah Mavis Bobie , Johnston Carolyn 
Published: January 2021

Abstract
Background: Cervical cancer survivors often experience significant diminution in health-related quality of life (HRQoL). We aimed to investigate the overall HRQoL, determine the role of the stage of disease and type of treatment received on HRQoL, and evaluate predictors of HROoL among cervical cancer survivors in Kumasi, Ghana. Methods: A hospital-based cross-sectional study was conducted in 153 cervical cancer patients who completed curative treatment between January 2004 and December 2018 at Komfo Anokye Teaching Hospital. The European Organization for Research and Treatment of Cancer core questionnaire (EORTC QLQ C-30) supplemented with the cervical cancer-specific (EORTC QLQ-CX24) module was used. The Kruskal-Wallis test was used to determine the effect of the stage of cervical cancer and the type of treatment received on mean scores of the different domains of HRQoL. Multivariate logistic regression was performed to identify predictors of HRQoL. P < 0.05 was considered statistically significant. Results: The mean global health score (GHS) was 79.7 (+/-16.2), and it differed significantly with International Federation of Gynaecology and Obstetrics (FIGO) stage, with 84.1 76.2, and 79.9, for stages I, II and III respectively (p=0.012). Financial burden was higher in participants with FIGO stage II compared to stage I disease (45.4 vs 20.8, p=0.012.). The mean GHS scores for surgery, chemoradiation and radiation only were 85.2, 75.9, and 82.1 respectively (p=0.027). Compared to participants who were treated with Chemoradiation, those treated with surgery had lower financial difficulties (12.1 vs 41.6 , p=0.019), better body image (95.7vs 79.5, p =0.039) and better symptom experience (5.9 vs 12.0, p =0.043).The likelihood that survivors’ GHS is affected is decreased with illiteracy (AOR = 0.30, 95% CI=0.09–1.00), and increased with complaints of pain (AOR=5.50, 95%CI=1.68-18.29), loss of appetite (AOR=13.24, 95% CI=2.71– 64.67) and diminution in body image perception (AOR = 6.04, 95% CI=1.67–21.83). Conclusion: Cervical cancer survivors in Kumasi, Ghana have overall satisfactory HRQoL. Surgical treatment is associated with improved HRQoL and less financial burden. Efforts to enhance HRQoL should also be focused on maximizing survivors’ body image and managing pain and loss of appetite. Educating women about expected impacts on their quality of life, and strategies to manage and mitigate these impacts, is essential.
Deploying unsupervised clustering analysis to derive clinical phenotypes and risk factors associated with mortality risk in 2,022 critically ill patients with COVID-19 in Spain
Authors: Rodríguez Alejandro , Botella Manuel Ruiz , Matín-Loeches Ignacio , Herrera María Jiménez , Solé-Violan Jordi , Gómez Josep , Bodí María , Trefler Sandra , Papiol Elisabeth , Díaz Emili , Suberviola Borja , Vallverdú Montserrat , Mayor-Vázquez Eric , Moreno Antonio Albaya , Berlanga Alfonso Canabal , Sánchez Miguel , Ortíz María del Valle , Ballesteros Juan Carlos , Iglesias Lorena Martín , Marín-Corral Judith , Ramos Esther López , Valverde Virgina Hidalgo , Tello Loreto Vidaur , Chinesta Susana Sancho , de Molina Francisco Javier González , García Sandra Herrero , Perez Carmen Carolina Sena , Laderas Juan Carlos Pozo , García Raquel Rodríguez , Estella Angel , Ferrer Ricard 
Published: January 2021

Abstract
Background: The identification of factors associated with Intensive Care Unit (ICU) mortality and derived clinical phenotypes in COVID-19 patients could help for a more tailored approach to clinical decision-making that improves prognostic outcomes. Methods: Prospective, multicenter, observational study of critically ill patients with confirmed COVID-19 disease and acute respiratory failure admitted from 63 Intensive Care Units(ICU) in Spain. The objective was to utilize an unsupervised clustering analysis to derive clinical COVID-19 phenotypes and to analyze patient’s factors associated with mortality risk. Patient features including demographics and clinical data at ICU admission were analyzed. Generalized linear models were used to determine ICU morality risk factors. The prognostic models were validated and their performance was measured using accuracy test, sensitivity, specificity and ROC curves. Results: The database included a total of 2,022 patients (mean age 64[IQR5-71] years, 1423(70.4%) male, median APACHE II score (13[IQR10-17]) and SOFA score (5[IQR3-7]) points. The ICU mortality rate was 32.6%. Of the 3 derived phenotypes, the A(mild) phenotype (537;26.7%) included older age (<65 years), fewer abnormal laboratory values and less development of complications, B (moderate) phenotype (623,30.8%) had similar characteristics of A phenotype but were more likely to present shock. The C(severe) phenotype was the most common (857;42.5%) and was characterized by the interplay of older age (>65 years), high severity of illness and a higher likelihood of development shock. Crude ICU mortality was 20.3%, 25% and 45.4% for A, B and C phenotype respectively. The ICU mortality risk factors and model performance differed between whole population and phenotype classifications.Conclusion: The presented machine learning model identified three clinical phenotypes that significantly correlated with host-response patterns and ICU mortality. Different risk factors across the whole population and clinical phenotypes were observed which may limit the application of a “one-size-fits-all” model in practice.
Chemical Hybridization of Sulfasalazine and Dihydroartemisinin&nbsp;Promotes Brain Tumor Cell Death&nbsp;
Authors: Ackermann Annemarie , Çapcı Aysun , Buchfelder Michael , Tsogoeva Svetlana , Savaskan Nicolai 
Published: January 2021

Abstract
Gliomas are primary brain tumors with still poor prognosis for the patients despite a combination of cytoreduction via surgery followed by a radio-chemotherapy. One strategy to find effective treatment is to combine two different compounds to add or at best potentiate their impact on malignant cells. Here, we report on the effects of a newly synthesized covalently bound hybrid of sulfasalazine (SAS) and dihydroartemisinin (DHA) called AC254. In previous studies both SAS and DHA have already proved to have anti-tumor properties themselves and to have sensitizing respectively potentiating effects on other treatments against malignant tumors. We investigated the impact of sole SAS and DHA, their 1:1 combination and as a chemical linked hybrid (AC254) on rodent and human glioma cells. In our study SAS showed no or only a mild effect on glioma whereas DHA led to a significant reduction of cell viability in a dose-dependent manner. Next we compared the efficacy of the hybrid AC254 to the combinational treatment of its parent compounds SAS and DHA. The hybrid was highly efficient in combating glioma cells compared to single treatment strategies regarding cell viability and cell death. Interestingly, AC254 showed a remarkable advantage over the combinatorial treatment of both parent substances in most used concentrations. In addition to its reduction in cell viability and induction of cell death the hybrid AC254 displayed changes in cell cycle and reduction of cell migration. Taken together, these results demonstrate that clinically established compounds as SAS and DHA can be potentiated in their anti-cancer effects by chemical hybridization. Thus, this concept provides the opportunity to provide new chemotherapeutic drugs.
The Influence of an All-Female Healthcare Environment on Mentorship and Empowerment of Female Healthcare Professionals
Authors: Munabi Naikhoba , Auslander Allyn , Xepoleas Meredith D. , Bunker Libby D. , Vangsness Kella L. , Koualla Sara , Magee Kathy S. , Magee William P. , Yao Caroline A. 
Published: January 2021

Abstract
Background: Low- and middle-income countries (LMICs) have the greatest need for additional healthcare providers, and women outside the workforce help address the need. Women in healthcare historically need more mentorship and leadership training to advance their careers. This study evaluates how women working together on a medical team influences mentorship, leadership and empowerment. Methods: An all-female volunteer team participating in a cleft surgery mission in Oujda, Morocco were surveyed before and after the mission. Responses were analyzed according to country of origin, national gender equality ranking, volunteer role, and prior mentorship experiences. Statistical analysis with student’s t-test or chi-squared were performed with significance defined as p<0.05. Results: 95 female volunteers from 23 countries participated and 85% completed surveys. Volunteers from HICs (32%) and LMICs (68%) had similar mission roles (p=0.58) and duration of volunteerism (p=0.69). Experience as a mission volunteer (p=0.47), team leader (p=0.28), and educator (p=0.18) were equivalent between cohorts. 73% of women had previously received mentorship but 98% wanted more. 75% had previously mentored others, but 97% wanted to be mentors. Over 90% of past mentor-mentee relationships were between women. 73% of volunteers who had no prior mentorship found their first mentor during the mission. All participants found a long-term peer relationship and felt motivated to mentor women at home. All volunteers felt empowered and enjoyed the mission. Over 95% were inspired to pursue leadership positions, advance professionally, and work with other women at home. Conclusion: Our results found that this population of female healthcare professionals in HICs and LMICs overwhelmingly desired more mentorship than is felt to be available. An all-female healthcare environment appears to provide opportunities for mentorship and create lasting motivation to teach, lead, and advance professionally. Increasing the visibility of female professionals may effectively empower women in healthcare.
Paraventricular hypothalamic nucleus are essential for arousal promotion and maintenance
Authors: Huang Zhi-Li , Chen Chang-Rui , Zhong Yu-Heng , Jiang Shan , Xu Wei , Wang Zan , Xiao Lei , Qu Wei-Min 
Published: January 2021

Abstract
Adequate wakefulness is fundamental for proper daytime functioning. Clinical observations indicate that the paramedian region of the hypothalamus is a critical node for controlling wakefulness. However, the specific nucleus and neural circuitry for this function remain unknown. Here, we found that inhibition of PVHvglut2 neurons induced 3-h increase of NREM sleep. Chemogenetic activation of PVHvglut2 neurons potently induced 9-h wakefulness, and PVHCRH neuronal activation also exerted wakefulness. Photostimulation of PVHvglut2→parabrachial complex/ventral lateral septum circuits immediately drove transitions from NREM to wakefulness. Furthermore, using in vivo fiber photometry or multichannel electrophysiological recordings in mice, we find arousal-dependent increases in population activity of PVHvglut2 neurons. Most importantly, ablation of PVHvglut2 neurons dramatically led mice to hypersomnia-like behaviors. These results demonstrate that PVHvglut2 neurons are essential for physiologic arousal in the hypothalamus.
Determinants of the Practice of Exclusive Breastfeeding in Guinea: Evidence from 2018 Guinean Demographic and Health Survey
Authors: Soumah Anne Marie , Baldé Mamadou Diouldé , Tassembedo Mahamadi , OUEDRAOGO Ousmane , Garanet Franck , Ouédraogo Adja Mariam , Yara Aminata , Koulibaly Mamady , Camara Ibrahima , Kouanda Seni 
Published: January 2021

Abstract
Background: Exclusive breastfeeding is recognized as one of the key interventions with proven effectiveness in reducing child morbidity and mortality and malnutrition. However, with the current trend in breastfeeding rates in Guinea, the World Health Assembly target of at least 50% by 2025 is likely to be compromised.The objective of this study was to identify the individual and contextual determinants of the practice of Exclusive Breastfeeding in Guinea.Method: We conducted a secondary analysis of data from the 2018 Guinea Demographic and Health Survey (DHS). The study population consisted of women who gave birth between the ages of 15 and 49. Our sample consisted of women who had their last birth six (06) months prior to collection. The enumeration areas were our second level. A multilevel logistic regression was performed using Stata version 15.1 software. Three statistical models were implemented: The final model was obtained using the bottom-up step-by-step method. The intra-class correlation coefficient was calculated.Results: On the 851 women included in our study, 33% reported having exclusively breastfed during the first 6 months of life of their children. After a multivariate analysis, the variables associated with exclusive breastfeeding are : children aged 2-3 months (OR = 0.53 CI95% = [0.36-0.79]) and children aged 4-5 months (OR = 0.23 IC95% = [0.14-0.36] and p= 0.0000), women in the Faranah area (OR = 2.69 IC95% = [1.21-5.94] and p= 0. 014) and those in Mamou (OR = 2.27 IC95% = [1.00-5.94] and p= 0.049), women who gave birth in a health facility (OR = 1.94 IC95% = [1.34-2.80] and p= 0.0000) and women living in polygamous households (OR = 0.68 IC95% = [0.48-0.98] and p= 0.042).Conclusion: The practice of exclusive breastfeeding remains low in Guinea. For the achievement of Sustainable Development Goals, particularly the improvement of exclusive breastfeeding practices, the individual and contextual determinants identified in this study should be taken into consideration in policies and programmes.
Treatment and Outcomes in Differentiated Thyroid Cancer: A Retrospective Exploration in Three UK Centres That Provide Different Advice on Low Iodine Diets
Authors: England Clare , Ingarfield-Herbert Kate , Beasley Matthew , Moss Laura , Vinjamuri Sobhan , Haupt-Schott Ingrid , McKane Gail , Hunt Linda , Herbert Georgia , Leary Sam , Ness Andy , Atkinson Charlotte 
Published: January 2021

Abstract
Background International guidelines on the treatment of differentiated thyroid cancers promote low iodine diets (LID) before radioiodine remnant ablation. Evidence that the LID ultimately improves treatment success is inconsistent. This study aimed to determine if there is a difference in ablation success rates according to provision of advice to follow a LID.Methods Retrospective study of patients with differentiated thyroid cancer treated with total thyroidectomy and radioiodine remnant ablation between 01/01/2015 and 31/12/2016 in 3 centres advising: no LID (C1: n=108); LID for 1-week before (C2: n=50); LID for 2-weeks before and 48 hours (C3: n=59) after RRA. Response to treatment was determined by adapted American Thyroid Association Dynamic Risk Stratification Score, stratified as excellent, indeterminate, or incomplete response.Results In total, 217 patients were included in the analysis. We found differences in preparation for radioiodine remnant ablation and in the assessment of outcomes between centres. Furthermore, although there was little difference in staging between centres there was a difference in the percentage of patients receiving 1.1GBq vs higher administered activities (15% in C1, 22% in C2 and 44% in C3, p<0.001). An excellent response was recorded for 49% in C1, 48% in C2 and 36% in C3 (p=0.61). With C1 as reference group, the odds ratios (OR) for an excellent response were C2 OR: 0.96 (95% CI 0.46,2.00) and C3 OR: 0.62 (95% CI 0.29,1.30), p=0.40.Conclusions We found no evidence that advice to follow a low iodine diet for 1 or 2 weeks before radioiodine remnant ablation impacts on ablation success but differences between centres means the results should be regarded as exploratory. There is no immediate need to change practice regarding the LID, but a prospective multi-centre study with a more homogenous approach to patient management or a randomised controlled trial will provide more definitive recommendations.
Barriers and Facilitators to Antiretroviral Therapy in Northern Tanzania in the Era of Test and Treat
Authors: Mudasiru Omobola , Hemono Rebecca , Mnyippembe Agatha , Hassan Kassim , Njau Prosper , McCoy Sandra 
Published: January 2021

Abstract
Background Tanzania adopted WHO’s universal test and treat policy in 2016, recommending antiretroviral therapy (ART) for all people living with HIV (PLHIV). However, many individuals continue to confront challenges initiating or continuing ART. The study aims to understand how barriers and facilitators to ART have evolved since Test and Treat policy in Tanzania.Between March and June 2018, 25 semi-structured in-depth interviews were conducted among PLHIV who were out of care, including PLHIV who never initiated ART and PLHIV who were formerly in care and discontinued ART. Participants were 18-years-old or older, identified from clinic databases at three health facilities and through home-based care providers. Data were coded and interpreted using content analysis and the socio-ecological framework.Results Low HIV literacy, poor quality of health messaging and comprehension, stigma, structural factors, and poverty were identified as main barriers to care. HIV literacy appeared higher among those formerly in care and some misconceptions about ART differed whether or not participants had previously initiated treatment. Participants expressed desire for more information about their health and treatment, including more engagement with their healthcare providers. Conclusions Our results are consistent with the barriers and facilitators to care reported prior to the implementation of the Test and Treat policy. Despite universal access to care, limited progress has been made in addressing the underlying challenges that PLHIV confront in initiating and continuing ART. Efforts such as increase in HIV literacy, improve health messaging, and strengthen healthcare provider-to-patient communication will facilitate access to care. The policy implication of these findings is that the landscape for barriers to ART has not changed drastically, efforts towards engagement to care need to be further refined and tailored to facilitate access to care.
Survival Analysis in The Presence of a Cure Fraction Using Data of Dialysis Patients: A Bayesian Approach
Authors: Rafati Shideh , Baneshi Mohammad Reza , Hassani Laleh , Bahrampour Abbas 
Published: January 2021

Abstract
Background: The aim of this study was to evaluate the goodness of fit of Bayesian mixture and non-mixture cure models to find the factors affecting dialysis patient’s survival time where a significant proportion of the population has a long-term survival.Study Design: A retrospective cohort study. Methods: The data of 252 dialysis patients were used among whom 35 cases died. Since in this study a part of the population had long-term survival, Bayesian cure models were used and evaluated using DIC index. The data were analyzed by R and Openbugs Softwares. Results: Of the 252 dialysis patients, 136(54%) were males and the mean (SD) age was 53.39 (18.09) years. The patient’s follow-up time mean (SD) was 10.93(7.82) years. The 10 and 20-year survival rate of these patients were 87% and 73%, respectively. The findings show that the best fitting belonged to the Bayesian Non-mixture Cure Model (BNCM) with Dagum distribution. The variables of age, Body Mass Index, dialysis duration, frequency of dialysis, age of onset of dialysis, and occupation affected patients' survival based on BNCM with Dagum distribution.Conclusions: The results demonstrated that the BNCM with Dagum distribution can be a good selection model to analyze survival data, where there is the possibility of a fraction of cure.
Exposure to Air Pollution and Renal Function - An Underestimated Threat?
Authors: Kuźma Łukasz , Małyszko Jolanta , Gajewska Hanna Bachórzewska- , Dobrzycki Sławomir 
Published: January 2021

Abstract
Introduction: Air pollution contributes to the premature death of approximately 428,000 citizens of Europe every year. The adverse effects of air pollution can be observed not only in respiratory, circulatory, and nervous systems but also in renal function.Aim: Our goal was to investigate the hypothesis indicating that we can observe the long-term and also short-term impact of air pollution on kidney function.Methods: We reviewed medical notes of patients hospitalized at Medical University of Bialystok, Poland between 2007-2016. We used linear, log-linear, and logistic regression models to assess the association between renal function and NO2, SO2, and PMs. Results are reported as beta (β) coefficients and odds ratios (OR) for an increase in interquartile range (IQR) concentration with 95% confidence intervals (95%CI). Results: 3,554 patients were included into the final analysis. The median age was 66 (IQR 15) and men were in the majority (53.2%, N=1891). Chronic kidney disease (CKD) was diagnosed in 21.5% (N=764). The long-term increase in annual average concertation of PM2.5 (OR for IQR increase=1.07; 95% CI 1.01 – 1.15, P=0.037) and NO2 (OR for IQR increase=1.05;95% CI 1.01 – 1.10, P=0.047) resulted in an increased number of patients with CKD. In short-term observation the IQR increase in weekly PM2.5 concentration was associated with a 2% reduction in eGFR (OR=0.98, 95%CI 0.97 – 0.99, P=0.03)Conclusions: The effects of air pollution on renal function were observed. Long- and short–term exposure to elevated air pollution levels was associated with a decrease in eGFR. The main pollutant affecting the kidneys was PM2.5.
Generation of Two Multipotent Mesenchymal Progenitor Cell Lines Capable of Osteogenic, Mature Osteocyte, Adipogenic, and Chondrogenic Differentiation
Authors: Prideaux Matthew , Wright Christian , Noonan Megan , Yi Xin , Clinkenbeard Erica , Mevel Elsa , Wheeler Jonathan , Wijenayaka Asiri , Gronthos Stan , Sankar Uma , Byers Sharon , White Kenneth , Atkins Gerald , Thompson William 
Published: January 2021

Abstract
Mesenchymal progenitors differentiate into several tissues including bone, cartilage, and adipose. Targeting these cells in vivo is challenging, making mesenchymal progenitor cell lines valuable tools to study tissue development. Mesenchymal stem cells (MSCs) can be isolated from humans and animals; however, obtaining homogenous, responsive cells in a reproducible fashion is challenging. As such, we developed two mesenchymal progenitor cell (MPC) lines, MPC1 and MPC2, generated from bone marrow of male C57BL/6 mice. These cells were immortalized using the temperature sensitive large T-antigen, allowing for thermal control of proliferation and differentiation. Both MPC1 and MPC2 cells are capable of osteogenic, adipogenic, and chondrogenic differentiation. Under osteogenic conditions, both lines formed mineralized nodules, and stained for alizarin red and alkaline phosphatase, while expressing osteogenic genes including Sost, Fgf23, and Dmp1. Sost and Dmp1 mRNA levels were drastically reduced with parathyroid hormone, thus recapitulating in vivo responses. MPC cells secreted intact (iFGF23) and C-terminal (cFGF23) forms of the endocrine hormone FGF23, which was upregulated by 1,25 dihydroxy vitamin D (1,25D). Both lines also rapidly entered the adipogenic lineage, expressing adipose markers after 4 days in adipogenic media. MPC cells were also capable of chondrogenic differentiation, displaying increased expression of cartilage genes including aggrecan, Sox9, and Comp. With the ability to differentiate into multiple mesenchymal lineages and mimic in vivo responses of key regulatory genes/proteins, MPC cells are a valuable model to study factors that regulate mesenchymal lineage allocation as well as the mechanisms that dictate transcription, protein modification, and secretion of these factors.