bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of C-reactive protein levels on headache frequency. The HUNT Study 2006-2008
Authors: Hagen Knut , Stovner Lars Jacob , Nilsen Kristian Bernhard , Kristoffersen Espen Saxhaug , Winsvold Bendik Slagsvold 
Published: October 2019

Abstract
Background Increased high sensitivity C- reactive protein (hs-CRP) levels have been found in many earlier studies on migraine, and recently also in persons with migraine and insomnia. The aim of this study was to see whether these findings could be reproduced in a large-scale population-based study.
Methods A total of 50,807 (54%) out of 94,194 invited aged ≥ 20 years or older participated in the third wave of the Nord-Trøndelag Health Study study performed in 2006-2008. Among these, 38,807 (41%) had valid measures of hs-CRP and answered questions on headache and insomnia. Elevated hs-CRP was defined as >3.0 mg/L. The cross-sectional association with headache was estimated by multivariate analyses using multiple logistic regression. The precision of the odds ratio (OR) was assessed with 95% confidence interval (CI).
Results In the fully adjusted model, elevated hs-CRP was associated with migraine (OR 1.14, 95% CI 1.04-1.25) and migraine with aura (OR 1.15, 95% CI 1.03-1.29). The association was strongest among individuals with headache ≥ 15 days/month for any headache (OR 1.26, 95% CI 1.08-1.48), migraine (OR 1.62, 95% CI 1.21-2.17), and migraine with aura (OR 1.84, 95% CI 1.27-2.67). No clear relationship was found between elevated hs-CRP and headache less than 7 days/month or with insomnia.
Conclusions Cross-sectional data from this large-scale population-based study showed that elevated hs-CRP was associated with headache ≥ 7 days/month, especially evident for migraine with aura.
Understanding Family Caregivers’ Needs to Support Relatives with Advanced Disease at Home: An Ethnographic Study in Rural Portugal
Authors: Teixeira Maria Joao Cardoso , Abreu Wilson , Costa Nilza , Maddocks Matthew 
Published: October 2019

Abstract
Background: Family caregivers play an important role supporting their relatives with advanced progressive disease to live at home. There is limited research to understand family caregiver needs over time, particularly outside of high-income settings. The aim of this study was to explore family caregivers’ experiences of caring for a relative living with advanced progressive disease at home, and their perceptions of met and unmet care needs over time.
Methods: An ethnographic study comprising observations and interviews. A purposive sample of 10 family caregivers and 10 relatives was recruited within a rural area in the north of Portugal. Data were collected between 2014-16 using serial participant observations (n=33) and in-depth interviews (n=11). Thematic content analysis was used to analyse the data.
Results: Five overarching themes were yielded: (1) provision of care towards independence and prevention of complications; (2) perceived and (3) unknown caregiver needs; (4) caregivers’ physical and emotional impairments; and (5) balancing limited time. An imbalance towards any one of these aspects may lead to reduced capability and performance of the family caregiver, with increased risk of complications for their relative. However, with balance, family caregivers embraced their role over time.
Conclusions: These findings enhance understanding around the needs of family caregivers, which are optimally met when professionals and family caregivers work together with a collaborative approach over time. Patients and their families should be seen as equal partners. Family-focused care would enhance nursing practice in this context and this research can inform nursing training and educational programs.
Relation between carotid vulnerable plaques and peripheral leukocyte: A case-control study of comparison utilizing multi-parametric CEUS
Authors: Luo Xianghong , Li Wanbin , Bai Yun , Du Lianfang , Wu Rong , Li Zhaojun 
Published: October 2019

Abstract
Background: This study evaluates carotid vulnerable plaques using contrast-enhanced ultrasound (CEUS) and explores the relationship between vulnerable plaques and leukocytes.Methods: Sixty-two symptomatic and 54 asymptomatic patients underwent CEUS. The images were analyzed using time-intensity and fitting curves, and peak (PTIC), mean (MTIC), peak (PFC), sharpness (SFC), and area under the curve (AUCFC) were obtained. The relations between CEUS parameters and leukocytes were analyzed.Results: In the symptomatic group, total leukocytes and neutrophils were higher, while lymphocyte was decreased; PTIC, MTIC, PFC, SFC,, and AUCFC were significantly higher; MTIC and AUCFC were negatively correlated with lymphocytes, and MTIC was positively correlated with neutrophils. Classification and regression tree analysis showed that MTIC at a cutoff of 20.8 and AUCFC at a cutoff of 8.8 resulted in a predictive of acute cerebral infarction, accuracy of 84.3%, sensitivity of 87.1%, and specificity of 81.5%.Conclusions: The variation in the perivascular leucocyte is significantly related to intraplaque inflammatory activities, CEUS is a feasible monitor of intraplaque neovascularization, so CEUS combined with perivascular leucocyte could be helpful as a warning for vulnerable plaques.
Reducing preterm mortality in eastern Uganda: The impact of introducing low-cost bubble CPAP on neonates &lt;1500g
Authors: Okello Francis , Egiru Emmanuel , Ikiror Juliet , Acom Linda , Loe Kate SM , Olupot-Olupot Peter , Burgoine Kathy 
Published: October 2019

Abstract
Background:
Complications of prematurity are the leading cause of deaths in children under the age of five.The predominant reason for these preterm deaths is respiratory distress syndrome (RDS). In low-income countries (LICs) there are limited treatment options for RDS. Due to their simplicity and affordability, low-cost bubble continuous positive airway pressure (bCPAP) devices have been introduced in neonatal units in LICs to treat RDS. This study is the first observational study from a LIC to compare outcomes of very-low-birth-weight (VLBW) neonates in pre- and post-CPAP periods.

Methods:
This was a retrospective study of VLBW neonates (weight <1500 grams) in Mbale Regional Referral Hospital Neonatal Unit (MRRH-NNU), a government hospital in eastern Uganda. It aimed to measure the outcome of VLBW neonates in two distinct study periods: A 14-month period beginning at the opening of MRRH-NNU and covering the period until bCPAP was introduced (pre-bCPAP) and an 18-month period following the introduction of bCPAP (post-bCPAP). After the introduction of bCPAP, it was applied to preterm neonates with RDS when clinically indicated and if a device was available. Clinical features and outcomes of all neonates <1500g were compared before and after the introduction of bCPAP.

Results:
The admission records of 377 VLBW neonates <1500g were obtained. 158 were admitted in the pre-bCPAP period and 219 in the post-bCPAP period. The mortality rate in the pre- bCPAP period was 39.2% (62/158) compared with 26.5% (58/219, P =0.012) in the post-bCPAP period. Overall, there was a 44% reduction in mortality (OR 0.56, 95%CI 0.36-0.86, P = 0.01).There were no differences in birthweight, sex, presence of signs of respiratory distress or apnoea between the two groups.

Conclusion:
Specialized and resource-appropriate neonatal care, that appropriately addresses the challenges of healthcare provision in LICs, has the potential to reduce neonatal deaths.The use of a low-cost bCPAP to treat RDS in VLBW neonates resulted in a significant improvement in their survival in a neonatal unit in eastern Uganda. Since RDS is one of the leading causes of neonatal mortality, it is possible that this relatively simple and affordable intervention could have a huge impact on global neonatal mortality.
Challenges With Study Fidelity When Conducting Household Surveys: Reports From The Field
Authors: Folayan Morenike , Alade Michael A , Ozeigbe Elizabeth O 
Published: October 2019

Abstract
Objectives: The aim of the study was to identify reasons for protocol deviations during conduct of large epidemiological surveys despite training of field workers, validating clinicians, and providing field supervisory support. Enquiries focused on breaches of recruitment procedures, privacy, confidentiality, and informed consent. The case study was a household survey conducted in Ile-Ife, Nigeria.

Results: The study reveals that despite training of field workers, providing supervisory support, and conducting validation exercises, protocol deviation still occurred. Measures to improve internal research validity during the conduct of surveys can minimise but not eliminate protocol deviations. Individual and environmental factors increase the risk for protocol deviation. Individual factors include personal bias against adherence to elements of the protocols, and pressure to meet personal recruitment targets to maximise remuneration. These pressures increase the risk of breaching study participants’ recruitment process. Environmental pressures resulted from low research literacy that made it possible for field workers not to consent participants and for participants not to prioritise privacy. The use of electronic data collection enhanced data security. A key recommendation from the study was that improved field supervision will reduce the risk for protocol violation.
A nationwide survey of the opinions of paediatricians regarding the management of neonates born to women with group B Streptococcus in Japanese maternity homes
Authors: yamaguchi kotomi , Ohashi Kazutomo 
Published: October 2019

Abstract
Objective: The Japanese Midwifery Association (JMA) guidelines allow midwives to manage group B Streptococcus (GBS)-positive women during pregnancy and labour at maternity homes. However, no guidelines exist to manage neonates born to GBS-positive women in Japan. We aimed to investigate the opinions of paediatricians regarding optimal management strategies for neonates born to GBS-positive women in maternity homes. A questionnaire was sent to paediatricians at 396 Japanese perinatal medical centres. We examined opinions regarding examinations and routine clinical tests for neonates born to GBS-positive women in maternity homes.
Results: Of 235 paediatricians, only 11.2% considered that paediatric examinations were unnecessary for neonates born to GBS-positive women in maternity homes. Moreover, 20.5%, 13.2%, and 11.1% of paediatricians considered culture test of the nasal cavity, serum C-reactive protein level analysis, and blood cell count analysis, respectively, necessary for neonates born to GBS-positive pregnant women with intrapartum antibiotic prophylaxis (IAP), whereas 36.3%, 56.2%, and 40.6% of paediatricians considered these tests necessary in cases without IAP. The JMA guidelines had low penetration rates among paediatricians in Japan. To manage neonates born to GBS-positive women in maternity homes, midwives should engage with commissioned paediatricians in more detail and develop appropriate strategies to increase awareness and cooperation.
Prestroke statins use reduces oxidized low density lipoprotein levels and improves clinical outcomes in patients with atrial fibrillation related acute ischemic stroke
Authors: he lanying , Xu Ronghua , Wang Jian , Zhang LIli , Zhang Lijuan , Zhao Wang , Dong Weiwei 
Published: October 2019

Abstract
Background: Atrial fibrillation (AF) is a common cause of cerebral infarction, which could lead to endothelial dysfunction, increased reactive oxygen species (ROS) and oxidized low density lipoprotein (Ox-LDL).AF is associated with higher mortality and more severe neurologic disability. Statins may exert neuroprotective effects that are independent of LDL-C lowering. The purpose of our study was to investigate whether prestroke statins use could reduce plasma Ox-LDL levels and improve clinical outcomes in patients with AF-related acute ischemic stroke (AIS).
Methods: This was a multicenter prospective study that involved four medical centers, 242 AIS patients with AF were identified, who underwent a comprehensive clinical investigation and a 72h-Holter electrocardiogram monitoring. All patients were divided into two groups: prestroke statins use and n o prestroke statins use groups , who were followed up for 3 months. Plasma Ox-LDL levels were measured using enzyme-linked immunosorbent assay (ELISA) on admission and at 3 months. The outcome was death, major disability (modified Rankin Scale score≥3), and composite outcome (death/major disability) at 3 months after AIS.
Results: 136 patients were in no prestroke statins use group, and 106 in prestroke statins use group . Plasma Ox-LDL levels were significantly lower in prestroke statins use than in no prestroke statins use on admission and at 3 months (P<0.001). Plasma Ox-LDL levels on admission were associated with 3-month mortality [adjusted odds ratio (OR), 1.05; 95% confidence interval(CI), 0.99-1.12; P=0.047]. In fully adjusted models, prestroke statins use was associated with reduced 3-month mortality [adjusted OR, 0.38; 95% CI, 0.16–0.91; P=0.031)], major disability (adjusted OR, 0.38; 95%CI, 0.15–0.99; P=0.047), and composite outcome (adjusted OR, 0.31; 95% CI,0.17–0.74; P=0.009).
Conclusions: Prestroke statins use can reduce plasma Ox-LDL levels and improve clinical outcomes in patients with AF-related AIS.
Magnitude of metabolic syndrome and its associated factors among patients with type 2 diabetes mellitus in Ayder comprehensive specialized hospital, Tigray, Ethiopia, 2019: a cross sectional study
Authors: Gebremeskel Gebreamlak Gebremedhn , Berhe Kalayou Kidanu , Belay Desta Siyoum , Kidanu Berihu Hailu , Negash Assefa Iyasu , Gebreslasse Kfle Tekulu , Tadesse Degena Bahrey , Birhanu Mulugeta Molla 
Published: October 2019

Abstract
Abstract
Objective : The objective of this study was to assess magnitude of metabolic syndrome and its associated factors among type 2 diabetes mellitus patients in Ayder comprehensive specialized hospital. A hospital based cross sectional study design was used. Binary logistic regression model was used.
Result : A total of 419 respondents (208 males and 211 females) were enrolled; the mean age was 56.39 (SD 10.18), 51.1% of the respondents had metabolic syndrome according to international diabetes federation. Sex and age were statistically associated with metabolic syndrome with [AOR (95% CI) = 1.93(1.057, 3.533) and 1.04 (1.012, 1.072)] respectively. Regular physical exercise, overweight and obesity were statistically associated with metabolic syndrome with [AOR (95% CI) =1.84 (1.002, 3.362), 2.68 (1.518, 4.747) and 3.55 (1.254, 10.074)] respectively. To conclude, Magnitude of metabolic syndrome was high. The associated factors for metabolic syndrome are physical inactivity, inadequate intake of fruits, family history, overweight, and obesity.
Key words : Ethiopia, Associated Factors, Magnitude, Metabolic syndrome
Determinants and Seasonality of Major Structural Birth Defects Among Newborns Delivered at Primary and Referral Hospital of East and West Gojjam Zones, North West Ethiopia 2017- 2018: Case- Control Study
Authors: Tsehay Binalfew , Shitie Desalegn , Lake Akilog , Abebaw Erimiyas , Taye Amisalu , Essa Enatinesh 
Published: October 2019

Abstract
Objective: Although infant mortality because of birth defect has increased in both developed and developing countries, had not got attention like other health issues at national, regional, or local levels. Documenting the risk factors that influence the occurrence of birth defects and its seasonality will help to inform the community and to develop preventive strategies for the country.
Results: Factors associated with higher likelihood of a major structural birth defects included maternal age; neonates born from women living in urban; and in Dega; history of fever during pregnancy; intake of herbal medicine; and drinking alcohol. Counselling for pregnancy preparation and folic acid supplementation was found protective for the likelihood of birth defect.
Key words: Birth defect, maternal illness, maternal medication use, environmental exposure
Patient Satisfaction with Clinical Laboratory Services and Associated Factors among Adult Patients Attending Outpatient Departments at Debre Markos Referral Hospital, Northwest Ethiopia
Authors: Alelign Asmamaw , Belay Yihalem Abebe 
Published: October 2019

Abstract
Abstract
Objectives : There is limited evidence on patient satisfaction with clinical laboratory services in Northwest Ethiopia. This study aimed to assess patient satisfaction with clinical laboratory services and associated factors among adult patients attending outpatient departments at Debre Markos hospital, Northwest Ethiopia. Cross-sectional study was conducted among 391 patients from April 09-16, 2019 using interviewer-administered questionnaire. Systematic random sampling technique was used. Data were entered into Epi-Data software version 4.2, and analyzed using SPSS 23. Binary logistic regression analysis was employed. Variables having p-value < 0.05 were considered as statistically significant.
Results: Overall level of patient satisfaction towards clinical laboratory services was 48.3%. Patients with no occasion of missing laboratory results [AOR: 2.10; 95% CI (1.13, 3.83)], had diplomas and above educational level [AOR: 0.38; 95% CI (0.15, 0.96)], and who reported no place in the laboratory to put personal things [AOR: 0.37; 95% CI (0.21, 0.54)] were significant factors. Hospital administration and laboratory department in Debre Markos hospital should strengthen their effort to improve patient satisfaction focusing on educational status of patients, missing laboratory results, and the availability of places to put personal things in the blood drawing room.
Key words: Debre Markos hospital; Patient satisfaction; Laboratory services
Multi-drug Resistant Extended Spectrum Beta-Lactamase Producing E. coli and Salmonella on Raw Vegetable Salads Served at Hotels and Restaurants in Bharatpur, Nepal
Authors: Sapkota Sanjeep , Adhikari Sanjib , Pandey Asmita , Khadka Sujan , Adhikari Madhuri , Kandel Hemraj , Pathak Sandhya , Pandey Asmita 
Published: October 2019

Abstract
Antimicrobial resistance among bacteria present in ready-to-eat foods like vegetable salads is an emerging concern today. The current study was undertaken to investigate the presence of multi-drug resistant extended-spectrum β-lactamase (ESBL) producing E. coli and Salmonella spp. in raw vegetable salads served at hotels and restaurants in Bharatpur. A total of 216 salad samples were collected from three different grades of hotels/restaurants and examined for the presence of E. coli and Salmonella spp. in Microbiology laboratory of Birendra Multiple Campus by conventional microbiological techniques. Out of 216 samples, 66 samples (35.2%) showed presence of Salmonella spp. whereas E. coli was recovered from 29(13.4%) samples of which 3 samples harbored E. coli O157: H7. Antibiotic susceptibility testing revealed that 9(13.6%) Salmonella and 4(13.8%) E. coli isolates were multi-drug resistant. Total ESBL producers reported were 5(7.57%) Salmonella and 4(13.8%) E. coli . The study also assessed a significant association between occurrence of E. coli and Salmonella with grades of hotels/restaurants, personal hygiene and literacy rate of chefs and with type of cleaning materials used to wash knives and chopping boards (p<0.05). The findings suggest immediate need of attention by concerned authorities to prevent emergence and transmission of food-borne pathogens and antimicrobial resistance.
Febrile neutropenia management in pediatric cancer patients at Ethiopian Tertiary Care Teaching Hospital
Authors: Bedewi Husnia , Berihun Malede , Mulu Atalay , Assefa Tamrat 
Published: October 2019

Abstract
Objective This study aimed at assessing the management practice of febrile neutropenia (FN) in pediatric cancer patients at Tikur Anbessa Specialized Hospital (TASH), Ethiopia by reviewing patients’ charts from 135 participants retrospectively. Data was entered into Epi-info 7 and exported to SPSS 20 for analysis. Results Empiric antibiotics therapy (EAT) was given to all patients in which ceftriaxone with gentamycin constituted of 71.9% followed by ceftriaxone monotherapy. EATs were converted to others in 20 (14.8%) and 2(1.5%) patients for the first and second times respectively, mainly based on poor clinical response without conducting culture and sensitivity tests. These tests were done only for 13 (9.6%) participants and growth was seen in 5 patients; and definitive therapy was given for 2 patients. ANC value was above 500 cell/mm3 in 80.7% of patients and 98.5% of study participants were afebrile after completion FN treatment. Most of them (70.4%) were treated for FN and 7 of patients died due to all case mortality. The hospital should not rely mainly only on ceftriaxone with gentamycin as EAT and also should do culture and sensitivity test to optimize therapy based on susceptibility result before conversion and modification of therapy in management of FN.
Transcriptome Analysis Reveals Mechanism Underlying the Differential Intestinal Functionality of Laying Hens in the Late Phase and Peak Phase of Production
Authors: Wang Weiwei , Wang Jing , Zhang Haijun , Wu Shugeng , Qi Guanghai 
Published: October 2019

Abstract
Background The compromised performance of laying hens in the late phase of production relative to the peak production was thought to be associated with the impairment of intestinal functionality, which plays essential roles in contributing to their overall health and production performance. In the present study, RNA sequencing was used to investigate differences in the expression profile of intestinal functionality-related genes and associated pathways between layers in the late phase and peak phase of production. Results A total of 104 upregulated genes with 190 downregulated genes were identified in the ileum of layers in the late phase of production compared to those at peak production. These upregulated genes were found to be enriched in little KEGG pathway, however, the downregulated genes were enriched in the pathways of PPAR signaling pathway, oxidative phosphorylation and glutathione metabolism. Besides, these downregulated genes were mapped to several GO clusters in relation to lipid metabolism, electron transport of respiratory chain, and oxidation resistance. Similarly, there were lower activities of total superoxide dismutase, glutathione S-transferase and Na+/K+-ATPase, and reductions of total antioxidant capacity and ATP level, along with an elevation in malondialdehyde content in the ileum of layers in the late phase of production as compared with those at peak production. Conclusions The intestine of layers in the late phase of production were predominantly characterized by a disorder of lipid metabolism, concurrent with impairments of energy production and antioxidant property. This study uncovers the mechanism underlying differences between the intestinal functionality of layers in the late phase and peak phase of production, thereby providing potential targets for the genetic control or dietary modulation of intestinal hypofunction of layers in the late phase of production.