bluuebunny/crossref_metadata_2025_split huggingface dataset:
Seroprevalence of Brucella Infection and Associated Factors among Pregnant Women Receiving Antenatal Care around Human, Wildlife and Livestock Interface in Ngorongoro Ecosystem, Northern Tanzania. A Cross Sectional Study
Authors: Makala Robert , Majigo Mtebe Venance , Bwire George M. , Kibwana Upendo , Mirambo Mariam M. , Joachim Agricola 
Published: August 2019

Abstract
Background
Brucellosis is a zoonotic disease transmitted to human through contact with infected animals, animal products or consumption of infected dairy products. Infection during pregnancy is of special interest due to associated adverse pregnancy outcome. This study determined the sero-prevalence and factors associated with Brucella infection among pregnant women around human-wildlife-livestock interface area in Ngorongoro Ecosystem, Northern Tanzania.
Methods
Pregnant women receiving antenatal care were invited to participate in a cross sectional study between April and May 2018. A structured questionnaire was used to collect socio-demographic and obstetric characteristics in addition to behavior and practices related to human brucellosis. Presence of serum immunoglobulin against Brucella was determined using Rose Bengal Plate Test. The positive samples were further assayed for presence of IgG and IgM using Enzyme-Linked Immunosorbent assay. Data were analyzed using Statistical Package for Social Sciences version 20.
Results
The overall Sero-prevalence of Brucella infection was 10.9%. Of 34 sero-positive individuals, 27(79.4%) had IgG antibodies while 8(23.5%) had IgM antibodies indicating 2.6% (8/313) recent infection. Regular contact with manure (OR 3.59, 95% CI 1.19 – 10.80, p = 0.023), consumption of raw milk (OR 3.58, 95% CI 1.12–11.39, p = 0.031), raw meat (OR 3.07, 95% CI 1.28 – 7.35, p = 0.012) and raw blood (OR 3.16, 95% CI 1.25–7.95, p = 0.015), increased the odds of being infected with Brucella. Majority of social-demographic and obstetric factors were not associated with the occurrence of brucellosis
Conclusion
Brucellosis is highly prevalent in areas with interactions of humans; livestock and wildlife. The risk of infection increased with regular contact with manure and consumption of raw foodstuff. These findings emphasize the need for interventional strategies to reduce risk of exposure and improve early detection of infection in pregnant women.
Age-dependent impact of breast cancer risk perception on mammography screening behavior in Brazilian women
Authors: Alves Saionara Açucena Vieira , Weller Mathias 
Published: August 2019

Abstract
Background: Previous studies suggest that education and income affect Brazilian women’s breast cancer prevention behavior. The present study focused on the impact of perceived risk on mammography screening behavior. Methods: Information regarding socioeconomic variables and risk perception was obtained from 396 healthy women aged 40 - 79 years. Absolute and comparative perceived risk was measured on a seven-point Likert scale. Perceived numeric risk was measured on a percentage scale A Breast Cancer Risk Assessment Tool of five-year and lifetime risk of developing invasive breast cancer was used to estimate real risk. Regression analysis was applied to determine odds ratios (OR) and confidence intervals (95%CI) of independent variables. Results: Women without family history, aged 40 - 49 years and ≥ 50 years, had a 5.777 (95%CI: 2.261- 14.764) and 9.239 (95%CI: 4.028- 21.194) higher chance, respectively, of having low perceived absolute risk (p = 0.000). Regression modelling revealed that women aged between 40 and 49 years with low perceived absolute risk and low educational level, performed regular mammography screening about 2.7 (OR = 0.377; 95%CI: 0.143-0.989; p = 0.037 and OR = 0.368; 95%CI: 0.100-1.360; p = 0.040) times less often, compared to those ones with high risk perception and high educational level. Education was the only significant variable for women aged ≥ 50 years (p = 0.021): Women with low educational level underwent annual and biannual mammography about 3.5 (OR = 0.289; 95%CI: 0.035- 2.363) and 23.3 (OR = 0.043; 95%CI: 0.004- 0.420) times less often, respectively, than did women with high education level. Overestimation of numeric and comparative perceived risk, respectively, indicated a negative association with participation in mammography screening (p = 0.021; p = 0.017). Conclusions: Perception of absolute risk depended on family history. The effect of risk perception on mammography screening was age group-dependent, particularly for women aged 40 - 49 years, whereas for women aged ≥ 50 years, educational level had a more prominent effect. Overestimation of risk was not positively associated with increased adherence on mammography screening.
Prevalence and pre-disposing factors associated to gastro intestinal protozoan infections among diarrheal children under 5 years in kisii county, kenya.
Authors: Ondara Caleb Okeri , Nyachong’i Benson Omweri , Orucho Vincent Obino 
Published: August 2019

Abstract
ABSTRACT.

Objectives: Mortality and morbidity due to diarrheal diseases among children below the age of five has been increasing especially in the developing countries. This infection has not got attention like other health issues at national or regional levels. Documenting the risk prevalence and factors that influence the occurrence of the diarrheal diseases help to inform the and to develop preventive strategies for the county of study and the country at large.

Results: There was high prevalence of gastro intestinal protozoan infection with 34(28.3%) children infected with either Entamoeba histolytica, Giardia lamblia or both (co infections). Female children were 2.1 times less likely to be infected with gastro intestinal protozoa than their male counterparts, though not statistic ally different (P=0.392).

Keywords: Gastro intestinal protozoans, diarrhea, children under 5 years
Effects of lutein supplementation on inflammatory biomarkers and metabolic risk factors in adults with central obesity: study protocol for a randomized controlled study
Authors: Zhou Juan , Zhao Dan , Wang Ning , Zeng Zhiwei , Wang Changyi , Hao Liping , Peng Xiaolin 
Published: August 2019

Abstract
Introduction: The prevalence of central obesity is sustained growth and visceral fat is associated with increased production of inflammatory factors and metabolic risk factors. Lutein might retard the development of the metabolic disease through the antioxidant and anti-inflammatory properties. Furthermore, epidemiological studies associate higher dietary intakes and serum levels of lutein with decreased adiposity. However, few of the randomized controlled trails (RCT) have showed the effects of lutein supplementation on inflammatory biomarkers and metabolic risk factors, especially in adults with central obesity. Methods and analysis: This study will be conducted as a double-blinded, and parallel placebo-controlled clinical trial in which 120 central obesity people aged 18-60 years old and willing to provide informed consent will be randomly assigned to intervention and placebo group in a 1:1 ratio according to gender, age and waist circumstance. The intervention group will receive daily lutein 10 mg supplementation for 12 weeks to explore the effect of lutein supplementation on serum lutein, glycemic and lipid profiles, inflammatory factors and body composition. Two population (intention-to-treat population and per-protocol population) will be used in the data analyses. Discussion: Our findings from this trial will contribute to the knowledge of the association between lutein supplementation and inflammatory biomarkers, metabolic risk factors in people with central obesity, which will offer us a possibility for the prevention of inflammatory diseases. Trail registration: Chinese Clinical Trial Registry, ChiCTR1800018098. Registered on 30 August 2018. Keywords: Lutein supplementation, central obesity, inflammatory biomarkers, metabolic risk factors.
Evaluation of the Safety and Tolerability of a Nutritional Formulation in Patients with Angelman Syndrome (FANS): Study Protocol for a Randomized Controlled Trial
Authors: Herber Donna L. , Weeber Edwin J. , D’Agostino Dominic P. , Duis Jessica 
Published: August 2019

Abstract
Background Ketogenic and low glycemic index diets are effective in treating drug resistant seizures in children with Angelman syndrome. Cognition, mobility, sleep, and gastrointestinal health are intrinsically linked to seizure activity and overall quality of life. Ketogenic and low glycemic diets restrict carbohydrate consumption and stabilize blood glucose levels. The ketogenic diet induces ketosis, a metabolic state where ketone bodies are preferentially used for fuel. The use of exogenous ketones in promoting ketosis in Angelman syndrome has not been previously studied. The study formulation evaluated herein contains the exogenous ketone beta-hydroxybutyrate to rapidly shift the body towards ketosis, resulting in enhanced metabolic efficiency. Methods This is a 16 week, randomized, double blind, placebo-controlled crossover study to assess the safety and tolerability of a nutritional formula containing exogenous ketones. It also examines the potential for exogenous ketones to improve the patient’s nutritional status which can impact the physiologic, symptomatic, and health outcomes liabilities of living with Angelman syndrome. Discussion This manuscript outlines the rationale for a study designed to be the first to provide data on nutritional approaches for patients with Angelman syndrome using exogenous ketones. Trial Registration: ClinicalTrials.gov, identifier: NCT03644693; Registered on 23 August 2018. Last Updated on 23 August 2018.
DIVERTICULAR DISEASE IN THE YOUNG AGE GROUP – CLINICAL COURSE AND MANAGEMENT
Authors: Omar Islam , Alsaati Hani , Aljabri Raneem , Kalaji Hala , Mallala Abeer 
Published: August 2019

Abstract
Diverticular disease is a common disease which is classically described in the elderly. However, recently its incidence in young patients is being reported more frequently. It has a wide spectrum of presentations ranging from asymptomatic diverticulosis to life-threatening forms. Classically, the diverticular disease in the young was considered a more virulent form with a higher recurrence rate necessitating more surgical interventions however, this old notion has been recently challenged. The aim is to study the clinical course of diverticular disease in the young age group < 50 years to evaluate the differences related to the predisposing risk factors, presentation, severity, complications, recurrence rate, and the management.
Methods:
A retrospective study of the patients admitted with diverticular disease in King Hamad University Hospital from 2016 to 2019. Patients were divided into 2 groups; group I (Young, <50) and group II (Old, ≥ 5). A comparison was held between the two groups according to the proposed risk factors, predictors of severity, the clinical, and the way of management. Different variables were analyzed using the appropriate statistical tests. Statistical significance was taken as P < 0.05.
Results 134 patients were included; 76 (56.7%) males and 58 (43.3%) females. The median age was 59.5 (Min. – Max.) (25 – 89), Mean ± SD.58.2 ± 13.5. 115 (85.8%) patients presented with diverticulitis and 19 (14.2%) with diverticular bleeding.
There was male predominance in the young group, p = 0.006. The old group showed a higher prevalence of DM, HTN and dyslipidemia, p= < 0.001 for all. Moreover, the old group showed lower haemoglobin and vitamin D levels with higher steroids intake, p = < 0.001, 0.001 and 0.004 respectively. There was no significant difference related to disease severity, management setting, antibiotics prescription, guided drainage, laparoscopic lavage or the need for surgery. However, recurrence was significantly higher in the young group, p= 0.046.
Conclusion: Diverticular disease in the young age group under 50 is more predominant in males with a higher rate of recurrence. However, it is not a severe form of the disease and can be managed the same way as in the elderly.
The impact of nurse staffing levels and nurse’s education on patient mortality in medical and surgical wards: an observational multicentre study.
Authors: Haegdorens Filip , Bogaert Peter Van , De Meester Koen , Monsieurs Koen 
Published: August 2019

Abstract
BACKGROUND
Growing evidence indicates that improved nurse staffing in acute hospitals is associated with lower hospital mortality. Current research is limited to studies using hospital level data or without proper adjustment for confounders which makes the translation to practice difficult.

METHOD
In this observational study we analysed retrospectively the control group of a stepped wedge randomised controlled trial concerning 14 medical and 14 surgical wards in seven Belgian hospitals. All patients admitted to these wards during the control period were included in this study. Pregnant patients or children below 17 years of age were excluded. In all patients, we collected age, crude ward mortality, unexpected death, cardiac arrest with Cardiopulmonary Resuscitation (CPR), and unplanned admission to the Intensive Care Unit (ICU). A composite mortality measure was constructed including unexpected death and death up to 72 hours after cardiac arrest with CPR or unplanned ICU admission.

Every four months we obtained, from 30 consecutive patient admissions across all wards, the Charlson comorbidity index. The amount of nursing hours per patient days (NHPPD) were calculated every day for 15 days, once every four months. Data were aggregated to the ward level resulting in 68 estimates across wards and time. Linear mixed models were used since they are most appropriate in case of clustered and repeated measures data.

RESULTS
The unexpected death rate was 1.80 per 1000 patients. Up to 0.76 per 1000 patients died after CPR and 0.62 per 1000 patients died after unplanned admission to the ICU. The mean composite mortality was 3.18 per 1000 patients. The mean NHPPD and proportion of bachelor hours were respectively 2.48 and 0.59. We found a negative association between the nursing hours per patient day and the composite mortality rate adjusted for possible confounders (B= -2.771, p=0.002). The proportion of Bachelor hours was negatively correlated with the composite mortality rate in the same analysis (B= -8.845, p=0.023). Using the regression equation, we calculated theoretically optimal NHPPDs.

CONCLUSIONS
This study confirms the association between higher nurse staffing levels and lower patient mortality controlled for relevant confounders.
Association between anemia and frailty in 13,175 community-dwelling older adults in China
Authors: Ruan Ye , Guo Yanfei , Kowal Paul , Lu Ye , Liu Chazhen , Sun Shuangyuan , Huang Zhezhou , Zheng Yang , Wang Wenjing , Li Gan , Shi Yan , Wu Fan 
Published: August 2019

Abstract
Background

Anemia and frailty contribute to poor health outcomes in older adults; however, most current research in lower income countries has concentrated on anemia or frailty alone rather than in combination. The aim of the present study was to investigate the association between anemia and frailty in community-dwelling adults aged 50 years and older in China.

Methods

The study population was sourced from the 2007/10 SAGE China Wave 1. Anemia was defined as hemoglobin less than 13g/dL for men and less than 12g/dL for women. A frailty index (FI) was compiled to assess frailty. The association between anemia and frailty was evaluated using a 2-level hierarchical logistic model.

Results

The prevalence of anemia was 31.0% (95%CI: 28.4%, 33.8%) and frailty 14.7% (95%CI: 13.5%, 16.0%). In the univariate regression model, presence of anemia was significantly associated with frailty (OR=1.62, 95% CI: 1.39, 1.90) and the effect remained consistent after adjusting for various potential confounding factors including age, sex, education, household wealth, residence, smoking, alcohol drinking (adjusted OR =1.31, 95% CI:1.09, 1.57). In the linear model, each 1 g/dL increase in hemoglobin concentration was associated with 4% decrease in the odds of frailty after adjusting for several confounding variables (adjusted OR =0.96, 95% CI: 0.93, 0.99).

Conclusion

Anemia and low hemoglobin concentrations were significantly associated with frailty. Therefore, health care professionals caring for older adults should increase screening, assessment of causes and treatment of anemia as one method of avoiding, delaying or even reversing frailty.
Association of vitamin D and FGF23 with serum Ferritin in hypoparathyroid thalassemia, a case control study
Authors: Saki Forough , salehifar azita , Kassaee Seyed Reza , omrani Gholamhossein Ranjbar 
Published: August 2019

Abstract
Background:FGF23 controls serum l,25(OH)2D3 levels and phosphate homeostasis. This study evaluates the effects of Ferritin on intact PTH, FGF23 and l,25(OH)2D3 in patients with major thalassemia. It evaluates FGF23 changes in patients with hypoparathyroidism to clarify the interaction between FGF23 and PTH in the absence of proper PTH function in human.
Methods:In this case-control study,25 patients with major-beta thalassemia with hypoparathyroidism and their age- and gender-matched patients with major-beta thalassemia having normal parathyroid function were enrolled. Biochemical studies assessed serum calcium, albumin phosphorus, alkaline phosphatase, PTH, FGF23, 25(OH)D, 1,25(OH)2D3, Ferritin and Fractional excretion of phosphorous.
Results:FGF23 was higher in the patients with hypoparathyroidism compared to controls(p=0.002). Fractional excretion of phosphorous was lower in patients with hypoparathyroidism, despite of high FGF23(p=0.001). There was a correlation between serum1,25(OH)2D3 and FGF23 with ferritin in the controls(P=<0.001and P=<0.001,respectively).
Conclusions: The present study suggested that rise in FGF23 in patients with thalassemia, may be due to either stimulating effect of PTH and 1,25(OH)2D3 on FGF23 production, or might be direct stimulating effect of ferritin. It seems that in hypoparathyroid patients with insufficient PTH action, the FGF23 is not able to exert its full function in reducing serum phosphorus level by its phosphaturic action.
Investigation of the Voltage Dependent Surface States and Their Relaxation Time of the Al/CdZnO/p-Si (MIS) Structure Via Admittance Method
Authors: ERBİLEN TANRIKULU Esra 
Published: August 2019

The voltage dependent surface states/traps (Nss) and their relaxation time () of the Al/CdZnO/p-Si (MIS) structure were investigated with admittance method using C-V-f and G/-V-f measurements in the frequency range of 5 kHz-1 MHz. Both the values of C and G/ were found as strong function of voltage and frequency and they increase with decreasing frequency almost for each voltage. The obtained higher values of C and G at the low frequencies are due to the presence of Nss located between CdZnO/p-Si interfaces. At low frequencies, the relaxation time of the charges at the traps is larger than the period (≥T) of the applied ac signal, so they can contribute to the measured C and G/ values. In addition, the presence of Nss causes a peak at the extracted parallel conductance (Gp/) versus Lnf curves of the structure. Thus, both the values of Nss and  were calculated from the peak value and its position, respectively. The values of Nss and  ranged from 1.65x1013 eV-1 cm-2, 31.4 s at 1.7 V and 1.39x1013 eV-1 cm-2, 9.18 s at 3 V, respectively. These values are very suitable for these structures at room temperature.
Chemical Mediators’ Expression Associated with the Modulation of Pain in Rheumatoid Arthritis
Authors: Cortes-Altamirano José Luis , Morraz-Varela Abril , Reyes-Long Samuel , Gutierrez Marwin , Bandala Cindy , Clavijo-Cornejo Denise , Alfaro-Rodriguez Alfonso 
Published: August 2019

Background:
The management of pain in patients with rheumatoid arthritis (RA) is a
complex subject due to the autoimmune nature of the pathology. Studies have shown that chemical
mediators play a fundamental role in the determination, susceptibility and modulation of pain at
different levels of the central and peripheral nervous system, resulting in interesting novel molecular
targets to mitigate pain in patients with RA. However, due to the complexity of pain physiology in
RA cand the many chemical mediators, the results of several studies are controversial.

Objective:
The aim of this study was to identify the chemical mediators that are able to modulate
pain in RA.

Method:
In this review, a search was conducted on PubMed, ProQuest, EBSCO, and the Science
Citation index for studies that evaluated the expression of chemical mediators on the modulation of
pain in RA.

Results:
Few studies have highlighted the importance of the expression of some chemical mediators
that modulate pain in patients with rheumatoid arthritis. The expression of TRPV1, ASIC-3, and
TDV8 encode ionic channels in RA and modulates pain, likewise, the transcription factors in RA,
such as TNFα, TGF-β1, IL-6, IL-10, IFN-γ, IL-1b, mTOR, p21, caspase 3, EDNRB, CGRPCALCB,
CGRP-CALCA, and TAC1 are also directly involved in pain perception.

Conclusion:
The expression of all chemical mediators is directly related to RA and the modulation
of pain by a complex intra and extracellular signaling pathway, however, transcription factors are
involved in modulating acute pain, while the ionic channels are involved in chronic pain in RA.
Risk Factors, Mechanisms and Treatments of Thromboangiitis Obliterans: An Overview of Recent Research
Authors: Li Meng-di , Wang Yi-fan , Yang Mei-wen , Hong Fen-fang , Yang Shu-long 
Published: August 2019

Background::Thromboangiitis obliterans (TAO) is a nonatherosclerotic thromboticocclusive vasculitis that affects the vessels of the small and medium-sized extremities. No explicit etiology or pathogenesis of TAO has been proven, and more effective treatments are needed.Objective: :The study aimed to summarize and present an overview of recent advances regarding the risk factors, mechanisms and treatments of TAO and to organize the related information in figures to provide a comparatively complete reference.Methods::We searched PubMed for English-language literature about TAO without article type limits, including articles about the risk factors, pathological mechanisms and treatments of TAO in the last 10 years with essential supplements (references over ranges and English abstracts of Russian literature).Results::After screening content of works of literature, 99 references were evaluated. We found that risk factors of TAO include smoking, gene factors and periodontal diseases. The underlying mechanism of TAO involves oxidative stress, immunity, hemodynamic changes, inflammation and so on. Moreover, similarities in genetic factors and cigarette relevance existed between periodontal diseases and TAO, so further study of relationship was required. For TAO treatment, medicine, endovascular intervention and revascularization surgery, autologous cell therapy and novel therapies were also mentioned. Besides, a hypothesis that infection triggers autoimmunity in TAO could be speculated, in which TLR4 plays a key role.Conclusions::1. A hypothesis is put forward that infections can trigger autoimmunity in TAO development, in which TLR4, as a key agent, can activate immune signaling pathways and induce autoimmune cytokines expression. 2. It is suggested to reconsider the association between periodontal diseases and TAO, as they share the same high-risk population. Controlling periodontal disease severity in TAO studies may provide new clues. 3. For TAO treatment, endovascular intervention and autologous cell therapy both showed promising long-term therapeutic effectiveness, in which autologous cell therapy is becoming more popular, although more clinical comparisons are needed.