bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of vitamin D supplementation on the glycemic control of pre-diabetic Qatari patients in a randomized control trial.
Authors: Thani Mohammed Al , Sadoun Eman , Sofroniou Angeliki , Jayyousi Amin , Baagar Khaled Ahmed Mohamed , Hammaq Abdulla Al , Vinodson Benjamin , Akram Hammad , Bhatti Zaid Shakoor , Nasser Heba Samir , Leventakou Vasiliki 
Published: July 2019

Abstract
Background: Vitamin D deficiency is associated with indicators of pre-diabetes including, insulin resistance, β-cell dysfunction and elevated plasma glucose with controversial findings from current trials. This study aims to investigate the long-term effect of vitamin D on glucose metabolism and insulin sensitivity in pre-diabetic and highly vitamin-deficient subjects. Methods: 132 participants were randomized to 30,000 IU vitamin D weekly for 6 months. Participants underwent oral glucose tolerance test (OGTT) at 3-month intervals to determine the change in plasma glucose concentration at 2h after 75g OGTT (2hPCG). Secondary measurements included glycated hemoglobin, fasting plasma glucose and insulin, post-prandial insulin, indices of insulin sensitivity (HOMA-IR, Matsuda Index), β-cell function (HOMA-β, glucose and insulin area under the curve (AUC), disposition and insulinogenic indices), and lipid profile. Results: A total of 57 (vitamin D) and 75 (placebo) subjects completed the study. Mean baseline serum 25(OH) D levels were 17.0 ng/ml and 14.9 ng/ml for placebo and vitamin D group, respectively. No significant differences were observed for 2hPC glucose or insulin sensitivity indices between groups. HOMA-β significantly decreased in the vitamin D group, while area under curve for glucose and insulin showed a significant reduction in β-cell function in both groups. Additionally, HOMA-β was found to be significantly different between control and treatment group and significance persisted after adjusting for confounding factors. Conclusion: Vitamin D supplementation in a pre-diabetic and severely vitamin-deficient population had no effect on glucose tolerance or insulin sensitivity. The observed reduction in β-cell function in both placebo and vitamin D groups could be attributed to factors other than supplementation. Trial registration: The trial was registered at www.clinicaltrials.gov with number: NCT02098980.
Gadolinium oxide nanoparticles enhance the cytotoxicity of chemotherapeutic drugs by blocking autophagic flux in cancer cells
Authors: Zhang Tianyu , Zhong Cheng , Xie Zhixiong 
Published: July 2019

Abstract
During chemotherapy, drugs can damage cancer cells’ DNA and cytomembrane structure, and then induce cell death. However, autophagy can increase the chemotherapy resistance of cancer cells, reducing the effect of chemotherapy. We found that gadolinium oxide nanoparticles (Gd2O3 NPs), which have great potential for use as a contrast agent in magnetic resonance imaging, could block the late stage of autophagic flux in a dose-dependent manner and then cause autophagosome accumulation in HeLa cells. When co-treated with 8 μg/mL Gd2O3 NPs and 5 μg/mL cisplatin, the number of dead cancer cells increased by about 20% compared with cisplatin alone. We observed the same phenomenon in cisplatin-resistant COC1/DDP cells. Thus, Gd2O3 NPs have significant potential for use in both cancer diagnosis and therapy.
Maternal satisfaction on delivery care services and associated factors among mothers who gave birth in the University of Gondar teaching and referral hospital, northwest Ethiopia
Authors: Firdie Andualem , Maru Alemnew , Deriye Abdulahi , Assefa Amare , Bedassa Abdi , Bekele Anteneh , Alemayehu Amanuel , Abebe Zegeye , Gizaw Zemichael 
Published: July 2019

Abstract
Introduction

Maternal satisfaction on delivery services is an important indicator for assessment of the quality of care. Quality of delivery care increases the likelihood of timely and appropriate treatment and good outcomes. The use of delivery services and outcomes are the result not only of the provision of care but also of women’s experience of that care. Therefore, investigating women’s experience or satisfaction on delivery care is of paramount importance to enhance the services utilization.

Methods

An institution-based cross-sectional study design was used. Data were collected using structured and pretested questionnaire from 403 mothers who were recruited by simple random sampling technique. Multivariable binary logistic regression analysis was used to identify variables associated with maternal satisfaction on delivery services on the basis of adjusted odds ratio (AOR) with 95% confidence interval (CI) and a p-value less than 0.05.

Results

The current study found that the overall satisfaction of mothers on delivery services was found to be 65.5%. Specifically, 78.2%, 65.5%, 64.3%, 49.9% and 44.7% of the mothers who gave birth at the University of Gondar teaching and referral hospital were satisfied on physicians’ communication, healthcare services, physicians’ attitude, privacy and sanitation condition of the health institution respectively. Maternal satisfaction was statistically associated with maternal education (diploma and above education) [AOR = 0.29, 95% CI = (0.13, 0.66)], maternal education (secondary and/or primary education) [AOR = 0.42, 95% CI = (0.20, 0.90)], antenatal care (ANC) follow-up in the current pregnancy [AOR = 4.47, 95% CI = (1.77, 11.27)] and short waiting time [AOR =1.85, 95% CI = (1.19, 2.88)].

Conclusion

This study revealed that the overall satisfaction of mothers on delivery service was found to be suboptimal. Physicians’ communication, healthcare services and physicians’ attitude were areas where the highest proportion of mothers satisfied. On the other hand, the highest proportion of mothers was dissatisfied on sanitation condition. Educational status, ANC follow-up and waiting time were found to be statistically associated with maternal satisfaction on delivery services.
Microscopic features of small bowel mucosa of patients with Crohn’s disease
Authors: cui yun , Lu Shi-yuan , Xu Jie , Peng Yan-shen , Miao Qi , wang xiao-qing , Chen Xiao-yu , Ran Zhi-hua 
Published: July 2019

Abstract
Background Double-balloon enteroscopy enables performing numerous small bowel biopsies for pathologic analysis. However, most histopathological characteristics of Crohn’s disease are non-specific characteristics. We aimed to explore the small bowel mucosal histopathologic characters of Crohn’s disease and identify some disease-specific changes.
Methods We included 253 patients without tumors and grouped them into Crohn’s disease, suspected Crohn’s disease, and non-Crohn’s disease groups. These patients underwent double-balloon endoscopy examination and small bowel biopsy at Renji Hospital, Shanghai. All histopathological sections were reviewed, and >20 histopathological parameters were assessed. Immunohistochemistry was conducted when necessary.
Results There were different forms of granulomatous lymphangitis on the small bowel mucosa in Crohn’s disease. They showed as various macrophages or epithelioid cells in the lumina of lymphatics or in the center of the villi with or without evident obstruction. These features were only observed in Crohn’s disease patients. Furthermore, they were correlated with granuloma and lymphangiectasia. Additionally, 15 other features showed significant differences among the three groups, and Crohn’s disease patients showed an average of almost seven histopathological characteristics.
Conclusions We described the detailed morphologies of granulomatous lymphangitis on the small bowel mucosa and recommend it as a useful histopathological feature for the diagnosis of Crohn’s disease. In terms of specificity and sensitivity, it was superior to non-caseating epithelioid granuloma.
Low risk patients with acute atrial fibrillation and elevated high-sensitivity troponin do not have increased incidence of pathological stress test: a prospective cohort study
Authors: Thelin Johan , Gerward Sofia , Melander Olle 
Published: July 2019

Abstract
Background

Many patients with atrial fibrillation (AF) or atrial flutter (AFL) and rapid ventricular response (RVR) have elevated high-sensitivity troponin T (hsTnT) values. Elevated hsTnT is an independent risk marker for cardiovascular events and mortality. The aim was to examine if AF/AFL patients with RVR and elevated hsTnT have an increased incidence of pathological cardiac stress tests, indicating need of further evaluation for coronary artery disease (CAD).

Methods

We prospectively included 90 AF/AFL patients without known heart failure and CAD presenting with AF/AFL and RVR. Half of the patients had elevated hsTnT (cases) and half had levels below the 99th percentile (controls). All patients were discharged in sinus rhythm. After approximately one week in sinus rhythm a new hsTnT was analysed and the patients performed a bicycle exercise stress test within the 30 day follow-up. The primary endpoint was a pathological stress test confirmed by a pathological SPECT myocardial perfusion imaging or a coronary angiography.

Results

None of the controls reached the primary endpoint. Two patients (4%) out of the 45 cases reached the primary endpoint (p= 0.49 vs controls), but only one was found to have significant CAD at subsequent coronary angiography.

Conclusions

Patients with paroxysmal AF/AFL, without history of CAD and heart failure, who present with a RVR and minor hsTnT elevations do not have an increased incidence of pathological stress test compared to patients with hsTnT values below the 99th percentile. Our results do not support the need of performing stress tests in this population.
Matching actual treatment with patient administration-route-preference improves analgesic response among acute-low-back-pain patients
Authors: Shani Adi , Granot Michal , Mochalov Gleb , Raviv Bennidor , Rahamimov Nimrod 
Published: July 2019

Abstract
Background

Accommodating a patient's treatment preference has been reported to promote greater responsiveness and better clinical outcomes. The effect of administration-route-preference (ARP) on the individual analgesic response has not been extensively examined to date. This study aimed to explore whether ARP-matched treatment i.e. individualized intramuscular (IM) or oral (PO) analgesic administration according to patient choice, would increase the analgesic effect.

Methods

38 patients with acute-low-back-pain (aLBP) presenting at the emergency room, reported their ARP for analgesics, and, regardless of their initial desire, were randomly assigned to receive either PO or IM diclofenac. Pain intensity was self-reported using the numeric pain score (NPS) before and during the first hour after drug administration.

Results

Both groups receiving PO or IM administration reported similar initial pain, (NPS 8.63±1.5 and 8.74±1.6 respectively (and magnitude of pain reduction. However, patients who received the drug in their desired route (oral or injection) had a significantly greater reduction in pain levels (4.05±2.8) as compared with patients who received the undesired route (2.08±1.8) p<0.05.

Conclusions

These findings support the hypothesis that individualized ARP-matching treatment in aLBP improves therapeutic outcomes, potentially by triggering an additive analgesic placebo reaction above the direct pharmacological effect alone.
Perceptions and vocational tendency of undergraduate clinical medical students in China to general practice：A cross-sectional study
Authors: Ren wen , Qiu Yan , Liu Ying , Fang Xiangming , Wu Yan , Yan qinqin , jiang zhengzhi , ren Jingjing , Wang Yongchen 
Published: July 2019

Abstract
Background Undergraduate education determines the overall quality of general practitioners in the future, however, there were lack of standard objectives and teaching content of general practice in the academic sessions in China. This paper explore on the perception of general practice and vocational tendency of undergraduate clinical medical students.
Methods A questionnaire was sent to clinical medical students from those 5 universities at the first semester by Wenjuanxing software. 30 valid questionnaires in each grade of each university were selected. Main outcome included the general information, cognizance of general medicine and attitude to be general practitioners.
Results Among the 750 medical students, 87.9% thought it was necessary to developing this course and 54.5% thought it should be a required subject in the undergraduate years. Multimode teaching (74.1%) was the favorite teaching mode. The percentage of clinical medical students willing to be general practitioners was only 34.9%, the most important reason for medical students willing or unwilling to be general practitioners was both career prospect. In those who eager to be general practitioners 63.2% were unwilling to work in the community health service center. In logistic regression analysis, the grade (Odds Ratio [OR] = 1.55, 95% Confidence Interval [CI]: 1.20-2.0), the place of birth (OR = 0.82; 95% CI: 0.72-0.94), and the universities (OR = 1.24, 95% CI: 1.10-1.41) were significantly associated with the willingness of becoming general practitioners (P<0.05). The students who thought it was worth to developing general practice course were more prefer to be general practitioner, and students from schools who had made it a compulsory course.
Conclusions
In order to improve the perceptibility about general practice and attract more medical students to be general practitioners, the government should establish a perfect educational system, explore new teaching patterns and offer a bright career future.
Relationship between KCNQ1 gene polymorphisms and type 2 diabetes in the population of northwestern China and a meta-Analysis
Authors: Xu Jing , Zhang Wei , Song Wei , Cui Jiaqi , Tian Yanni , Chen Huan , Huang Pan , Yang Shujun , Wang Lu , He Xin , Wang Lin , Cui Wei , Shi Bingyin 
Published: July 2019

Abstract
Aims

The purpose of this study was to explore the correlation between Potassium Voltage-Gated Channel Subfamily Q Member 1 (KCNQ1) gene polymorphisms and the risk of type 2 diabetes mellitus (T2DM) and its clinical indicators in the population of northwestern China, and conducted a meta-analysis on two polymorphic loci that have been studied frequently and controversial.

Methods

A case control study was conducted, involving 508 patients and 503 healthy individuals in the population of northwest China, and evaluated the associations using the χ2 test, Fisher's exact test, T test, and genetic model analyses.

Results

We discovered that rs2237895 rs2283228, rs163184, and rs163177 were associated with susceptibility to T2DM. Rs231362 rs231356, rs8181588 were related to the risk of T2DM after stratification. The results of meta-analysis also confirmed that rs2237895 and rs2283228 were strongly correlated with T2DM risk, especially in the East Asian population.

Conclusions

This study provides evidence for the correlation between KCNQ1 gene polymorphisms and T2DM in the population of northwestern China.
Assessing the variability and predictability of adipokines (adiponectin, leptin and resistin and their ratios) in non-obese and obese women with polycystic ovary syndrome
Authors: Obirikorang Christian , Owiredu William K.B.A. , Adu-Afram Sandra , Acheampong Emmanuel , Asamoah Evans Adu , Antwi-Boasiakoh Enoch Kwabena , Owiredu Eddie-Williams 
Published: July 2019

Abstract
Objectives

To assess the variability in adiponectin, leptin, and resistin between ovulatory women, and non-obese and obese women with polycystic ovary syndrome (PCOS). The study also explores the ratios of the adipokines and evaluated their predictability for PCOS.

Results

The PCOS group presented with lower adiponectin [13.0(10.49-16.59) vs 18.42(15.72-19.92) µg/ml, p<0.0001], adiponectin: leptin ratio [0.60(0.35-0.88) vs 1.19(0.92-1.37), p<0.0001], and adiponectin: resistin ratio [0.30(0.21-0.43) vs 0.42(0.32-0.62), p<0.0001] but a higher leptin [20.02(14.54-26.80) vs 16.17(14.51-18.36) ng/ml, p<0.0001] and leptin: resistin ratio [0.53(0.37-0.82) vs 0.40(0.27-0.48), p<0.0001] compared to the ovulatory group. The obese PCOS group presented with lower adiponectin [11.04(5.66-13.25) vs 14.18(11.04-18.02) µg/ml, p<0.0001 and 18.42(15.72-19.92) µg/ml, p<0.0001], adiponectin: leptin ratio [0.36(0.27-0.44) vs 0.78(0.61-1.16), p<0.0001 and 1.19(0.92-1.37), p<0.0001], and adiponectin: resistin ratio [0.24(0.17-0.38) vs 0.40(0.23-0.58), p<0.0001 and 0.42(0.32-0.62), p<0.0001] but a higher leptin [26.80(14.28-32.09) vs 17.95(14.86-21.26) ng/ml, p<0.05 and 16.17(14.51-18.36) ng/ml, p<0.0001] and leptin: resistin ratio [0.63(0.46-1.03) vs 0.41(0.30-0.61), p<0.0001 and 0.40(0.27-0.48), p<0.0001] compared to the non-obese PCOS and ovulatory control group, respectively. Adiponectin: leptin ratio presented with the best discriminatory power in predicting PCOS (AUC=0.83) followed by adiponectin alone (AUC=0.79), and leptin: resistin ratio and leptin alone (both AUC=0.69). Resistin alone presented with the poorest discriminatory power (AUC=0.48).
Predictors of Health Care Seeking Pace Among Newly-Diagnosed Pulmonary Tuberculosis Patients In Cebu City, Philippines: A Cross-Sectional Study
Authors: DUAVIS1 MARK JOHNUEL MATABILAS 
Published: July 2019

Abstract
Background

Tuberculosis remains a major public health dilemma in the Philippines. While free and effective TB diagnosis and treatment have been made available since 1996, a number of patients still delay accessing them re­sulting to increased TB mortality and community transmission. This study is aimed at determining the significant variables that can predict a TB patient’s pace in seeking appropriate health care.

Methods

A descriptive, correlational cross-sectional survey was done to 127 newly-diagnosed TB patients from 10 government-owned TB DOTS facilities in Cebu City. Participants were categorically grouped into Prompt Health Seekers and Delayed Health Seekers using a norm-referenced median dichotomy. Descriptive and inferential analysis utilized included Chi-square Test, Pearson’s Correlation and Discriminant Analysis.

Results

A mean health care seeking delay of 59 days (median=49) was recorded. Most of the participants experienced unexplained cough which they perceived as only slightly dangerous. 38% of them reported not knowing any symptom related to TB while 39% were not aware of the free public TB services. Most patients have made 2-3 prior health recourses, mostly through self-medication, before finally contacting a DOTS facility. Marital status (p=0.004), the number of symptoms experienced (p=0.000), first symptom experienced (p=0.016), perceived dangerousness of all symptoms experienced (p=0.009), perceived dangerousness of the first symptom experienced (p=0.001), perceived social stigma (p=0.035) and, perceived social support (p=0.002) were found to be significantly associated with the patients’ health care seeking pace. Extending to multivariate analysis, five independent variables namely marital status (p=0.037), number of symptoms experienced (p=0.018), perceived dangerousness of all the symptoms experienced (p=0.028), perceived social stigma (p=0.026) and, perceived social support (p=0.001) can significantly predict the patients’ health care seeking pace.

Conclusion

A considerable health care seeking delay of 59 days was documented, especially among those with lower perception of social support, higher perception of social stigma and those who do not currently have partners. Patients who experienced more symptoms and those who view these symptoms as less dangerous were, however, likely to seek immediate health care. Reducing health care seeking delays through intensified health information campaigns, strengthening social support systems and reducing social stigma is recommended.
Tachysystole and risk of cesarean section after labor induction using misoprostol: a cohort study
Authors: Sichitiu Joanna , Vial Yvan , Panchaud Alice , Baud David , Desseauve David 
Published: July 2019

Abstract
Background
In western countries, induction of labor is a common obstetrical intervention. Uterine tachysystole frequently manifests after cervical ripening by misoprostol vaginal inserts. Currently, there is insufficient evidence regarding the clinical impact of tachysystole during induction of labor. Therefore, the objective of the current study is to examine if tachysystole is associated with an increased risk of cesarean section following induction of labor by misoprostol vaginal inserts.

Methods
We conducted a retrospective cohort study of 446 women over 37 weeks of gestation admitted for labor induction by misoprostol vaginal inserts between May 2016 and May 2017. Fetal heart rate and uterine activity tracings were assessed for tachysystole, defined as ≥ 6 contractions per 10 minutes, averaged over a 30-minute window. Univariate analysis was performed by using t-test and Chi-square, comparing demographics, pregnancy characteristics, intrapartum monitoring, mode of delivery, neonatal outcomes (Apgar score < 7 at 5 minutes, umbilical cord artery pH < 7.10, neonatal intensive care unit admission) and maternal outcomes, with regard to the presence of tachysystole. The association between tachysystole and cesarean section was evaluated after adjusting for potential confounders by a modified Poisson regression model, expressed as an adjusted risk ratio and 95% confidence intervals.

Results
A total of 140 women (31.4%) presented with tachysystole. The median duration of tachysystole was 2 hours 12 minutes. The rate of cesarean section was 25.0% (N=35) among patients with tachysystole and 19.6% (N=60) for those without tachysystole. Presence of tachysystole during induction of labor with misoprostol vaginal inserts was not associated with cesarean section (adjusted risk ratio,1.0; 95% confidence interval, 0.7 to 1.4). Neonatal and maternal outcomes were similar between mothers who did and did not experience tachysystole.

Conclusions
This study illustrates that tachysystole is not associated with an increased risk of cesarean section after induction of labor by misoprostol vaginal inserts. The impact of excessive uterine activity on the fetal wellbeing defined by the frequency of uterine contraction alone is probably insufficient. Further research on the development of accurate measures of uterine contractility is necessary to better understand its effect on fetal well-being.
Mapping maternal and newborn healthcare access in West African Countries
Authors: Ononokpono Dorothy , Baffour Bernard , Richardson Alice 
Published: July 2019

Abstract
Background: The Sustainable Development Goal (SDG) three emphasizes the need to improve maternal and newborn health, and reduce global maternal mortality ratio to less than 70 per 100 000 live births by 2030. Achieving the SDG goal 3.1 target will require evidence based data on concealed inequities in the distribution of maternal and child health outcomes and their linkage to healthcare access. The objectives of this study were to estimate the number of women of reproductive age, pregnancies and live births at subnational level using high resolution maps and to quantify the number of pregnancies within user-defined distances or travel times of a health facility in three poor resource West African countries: Mali, Guinea and Liberia.
Methods: The maternal and newborn health outcomes were estimated and mapped for the purpose of visualization using geospatial analytic tools. Buffer analysis was then performed to assess the proximity of pregnancies to health facilities with the aim of identifying pregnancies with inadequate access (beyond 50km) to a health facility.
Results: Results showed wide variations in the distribution of maternal and newborn health outcomes across the countries of interest and districts of each of the countries. There was also clustering of health outcomes and health facilities at the urban capital cities of Bamako, Conakry, and Greater Monrovia.
Conclusion: To bridge the gap in inequity in healthcare access, and improve maternal and newborn health in the study countries, there is need for equitable distribution of human resources and infrastructure within and across the various districts.