bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dexmedetomidine provides better hemodynamic stability than fentanyl without impairing microcirculation during isoflurane anesthesia in bitches with pyometra submitted to ovariohysterectomy
Authors: Nagashima Julio Ken , Gonçalves Lucas Alaião , Pereira Marco Aurélio Amador , Talib Mariana Semião Francisco , Oliveira Clair Motos de , Ambrósio Aline Magalhães , Fantoni Denise T. 
Published: August 2019

Abstract
Microcirculatory disorders are one of the most common systemic alterations in septic patients, which can occur even in the presence of normal macro-hemodynamic parameters. Several anesthetic protocols have been indicated for sepsis. A drug frequently used in critically ill human patients is dexmedetomidine, a potent and selective alpha 2-agonist with sedative, analgesic and muscle relaxant properties that promotes blood pressure increase and peripheral vasoconstriction. The objective of the present study was to compare dexmedetomidine and fentanyl constant rate infusions in septic dogs using microcirculatory, hemodynamic and metabolic parameters. Thirty-three bitches with pyometra submitted to therapeutic ovariohysterectomy (OHE) and triaged with the quick SOFA score were included in the study. The animals were randomized into two groups treated with either dexmedetomidine (3 μg/kg/h) or fentanyl (5 μg/kg/h) constant rate infusions during isoflurane anesthesia and under mechanical ventilation. Hemodynamic, microcirculatory, ventilatory and metabolic parameters were recorded before, during and after anesthesia. The data were submitted to a normality test, then groups were compared using the unpaired Wilcoxon test or the t student test when necessary. All microcirculatory parameters were not significantly different between groups. Dexmedetomidine constant rate infusion provided superior blood pressure values and lactate clearance results, suggesting that it did not impair peripheral oxygen transport and organ perfusion, and both groups had similar clinical outcomes such as mortality and occurrence of hypotension and bradyarrhythmias. Similar values of microcirculatory parameters and higher blood pressure demonstrated that dexmedetomidine does not compromise microcirculation compared to fentanyl, it improves macro-hemodynamics instead.
Morbidity profile and prevalence of diabetes and high blood pressure among truck drivers in three regions of India
Authors: Randhawa Sonali , Dogra Vishal , Bambrah Hardeep Singh , Hegde Shailendra , Sudke Ajit Kisanrao , Phanse Vishal 
Published: August 2019

Abstract
Background Truck drivers in India are one of the groups experiencing a disproportionate health burden. Understanding the distribution of health morbidities is essential to plan and mitigate the risk of premature mortality among this subgroup. We aim to describe the health morbidities and prevalence of diabetes and high blood pressure among truck drivers in three regions of India.Method We used routinely collected data from a community-based healthcare program for truck drivers. Electronic medical health records (July 2018 to February 2019) of truck drivers were accessed and analyzed. We study the sociodemographic, health risk and morbidity profile of the truck drivers with an emphasis on diabetes, and high blood pressure status in East, West, and South, regions of India. Significance level was fixed at 95% and results with p-values less than 0.05 were considered significant.Results We identified 15725 truck drivers, of which nearly two-thirds 10247 (65%) were from the south region alone. Majority of truck drivers were male and middle-aged (median age 44 years). Over two-third (>62%) truck drivers in all regions were tobacco users. Half of the truck drivers reported smoking in the South (53%) compared to smokeless tobacco use in the West (53%) and East (41%) regions. Alcohol use alone and both alcohol and tobacco use were significantly lower in the West compared to the East and South regions. A significant number of truck drivers were either overweight 3485 (22%) or obese 6772 (49%). The prevalence of obesity among truck drivers ranged 55% in the South and 47% in the East compared to 32% in the West region. Of all truck drivers, 6991 (44%) had non-communicable diseases; 3350 (21%) had musculoskeletal conditions, and 1954 (12%) were suffering from communicable diseases. The prevalence of diabetes differed significantly in the three regions (p<0.05). Nearly half of the truck drivers (7326/15725) 47% had high blood pressure (≥ 140/90 mm Hg) and regional differences were not significant.Conclusion Truck drivers in India suffer from multiple health and lifestyle-related diseases. Early identification of high risk and tailored behavioral and occupational interventions are needed urgently.
Prevalence and associated factors of diarrhea among under-five children in Debre Berhan Town, Ethiopia 2018: A cross sectional study
Authors: Shine Sisay , Muhamud Sindew , Adnew Solomon , Demelash Alebachew 
Published: August 2019

Abstract
Introduction Diarrhea is responsible for 525,000 under five children deaths and 1.7 billion cases in the world and the second leading cause of death among under-five children. It is the major public health problem in developing countries like Ethiopia. The main aim of this study was to assess the prevalence and associated factors of diarrhea among under-five children in Debre Berhan Town, Ethiopia.Methods Community based cross-sectional study design was done among 420 children in Debre Behan Town. Multi-stage sampling technique was used to select the study participants. Data were collected by using pre-tested and structured questionnaire. Odds ratios with 95% confidence intervals were used to assess level of significance.Results The two week prevalence of diarrhea among under-five children was 16.4%. Age of children with 7-11 month years old (AOR: 4.2, 95%CI: 1.2 – 15.3), being the second children (AOR: 3.9, 95%CI: 1.8 – 8.5), not vaccinated against Rota virus (AOR: 10.3, 95%CI: 3.2 – 91.3) and feeding children by using hand (AOR: 2.5, 95%CI: 1.1 - 6.1) were significant predictors of under five children diarrhea.Conclusions This study revealed that the two weeks’ period prevalence of under-five diarrhea was relatively high. Age of children, vaccination against Rota virus and feeding children by using hand were associated with under-five children diarrhea. Education program on the important of vaccination against Rota virus and critical point of hand washing is recommended.
Morbid anatomy of patients with mycobacterial infections, a cross sectional autopsy study at a tertiary Hospital in a high disease burden setting
Authors: Wamala Dan , Kallenius Gunilla , Joloba Moses 
Published: August 2019

Abstract
Background Tuberculosis is a major cause of morbidity and mortality globally. Infections caused by different mycobacteria can be clinically indistinguishable but the differences in their pathological features and mortality are unclear. Methods To evaluate the contribution of different mycobacterial pathogens to lethal mycobacterial disease and assess subsequent pathological features, we performed autopsies of 49 patients with suspected TB. Autopsy specimens were examined histologically and cultured for mycobacteria. We identified Mycobacterium tuberculosis (Mtb) isolates and non-tuberculous mycobacteria (NTM), and further genotyped the Mtb isolates. Results Mtb isolates were found in 37 patients and NTM in 12 patients. All patients had signs of caseous pneumonia and 42 patients (86%) had disease involving more than half of the lungs. Two-thirds of the patients with TB or NTM had extrapulmonary engagement in addition to pulmonary pathology. Gross pathology and histopathology were similar in TB patients and patients with NTM, except that patients with NTM had a significantly reduced tendency to cause pleural effusions. Of the Mtb isolates 55% were of the Uganda genotype, which is the predominant Mtb genotype in Uganda. This genotype was significantly more frequent in the younger patients. Conclusion In this autopsy study of patients with presumptive TB a majority of culture positive cases were caused by Mtb. In 25% of patients NTM were identified, and histopathology was similar in TB and NTM patients, although NTM patients had significantly less pleural effusions. These results suggest that NTM contribute to mortality, and that their identification is important because of the special clinical and therapeutic implications associated with NTM infections.
Low seroprevalence of Toxoplasma gondii IgG and IgM antibodies in pregnant women of northern Durango, Mexico
Authors: Campos Rolando Adair Facio , Esqu Cosme Alvarado , Olivas Edgar 
Published: August 2019

Abstract
Toxoplasmosis is caused by intracellular parasite Toxoplasma gondii (T. gondii) a zoonotic disease that infects almost all warm-blooded animals, including humans. In addition, T. gondii infection can result in serious and life-threatening consequences for the developing fetus or newborn, including spontaneous abortion, congenital blindness, hydrocephalus, mental retardation, and even death. The aim of this research was to estimate the frequency of seropositivity to IgM and IgG antibodies against T. gondii in pregnant women attended in the health services of the “Lagunera” region of Durango State in the period of January 2018 - October 2018. A cross-sectional study was conducted on 434 pregnant women who used the health services of Durango State. Serum was analyzed for T. gondii infection by detecting IgG and IgM anti-T. gondii antibodies using commercial kits through the immunological technique of ELISA. In addition, a standardized questionnaire was applied to evaluate risk factors and sociodemographic characteristics of the participants. From 434 participants, 4 were detected with IgG antibodies (0.92%) and none of these had a positive result to IgM antibodies (0%). Dry meat consumption (OR = 13.5; 95% CI 0.94 – 192.58; p= 0.055) and other types of meat consumption (OR = 15.61; 95% CI 1.08 – 224.05; p= 0.043) were associated factors to infection. The results showed a lower seroprevalence of antibodies against T. gondii than any other study reported before. In addition, our results indicate the majority of the population studied is at risk of having a primary T. gondii infection.
Horizontal gene transfer contributes to virulence and antibiotic resistance of Vibrio harveyi 345 based on complete genome sequence analysis
Authors: Feng Juan , Deng Yiqin , Xu Haidong , Su Youlu , Liu Songlin , Xu Liwen , Guo Zhixun , Wu Jinjun , Cheng Changhong 
Published: August 2019

Abstract
Background Horizontal gene transfer (HGT), which is affected by environmental pollution and climate change, promotes genetic communication, changing bacterial pathogenicity and drug resistance. However, few studies have been conducted on the effect of HGT on the high pathogenicity and drug resistance of the opportunistic pathogen Vibrio harveyi.Results V. harveyi 345 that was multidrug resistant and infected Epinephelus oanceolutus was isolated from a diseased organism in Shenzhen, Southern China, an important and contaminated aquaculture area. Analysis of the entire genome sequence predicted 5,678 genes including 487 virulence genes contributing to bacterial pathogenesis and 25 antibiotic-resistance genes (ARGs) contributing to antimicrobial resistance. Five ARGs ( tetm , tetb , qnrs , dfra17 , and sul2 ) and one virulence gene (CU052_28670) on the pAQU-type plasmid p345-185, provided direct evidence for HGT. Comparative genome analysis of 31 V. harveyi strains indicated that 217 genes and 7 gene families, including a class C beta-lactamase gene, a virulence-associated protein D gene, and an OmpA family protein gene were specific to strain V. harveyi 345. These genes could contribute to HGT or be horizontally transferred from other bacteria to enhance the virulence or antibiotic resistance of 345. Mobile genetic elements in 71 genomic islands encoding virulence factors for three type III secretion proteins and 13 type VI secretion system proteins, and two incomplete prophage sequences were detected that could be HGT transfer tools. Evaluation of the complete genome of V. harveyi 345 and comparative genomics indicated genomic exchange, especially exchange of pathogenic genes and drug-resistance genes by HGT contributing to pathogenicity and drug resistance. Climate change and continued environmental deterioration are expected to accelerate the HGT of V. harveyi , increasing its pathogenicity and drug resistance.Conclusion This study provides timely information for further analysis of V. harveyi pathogenesis and antimicrobial resistance and developing pollution control measurements for coastal areas.
A high number of diseases and consultations: a warning signal for GPs when following up a multimorbid patient
Authors: Aujoulat Paul , NABBE Patrice , LALANDE Sophie , GOFF Delphine LE , DERRIENIC Jeremy , VIALA Jeanlin , FONSECA Jerome , GATINEAU Florence , RESTE Jean Yves LE 
Published: August 2019

Abstract
Background: the European General Practitioners Research Network (EGPRN) designed and validated a comprehensive definition of multimorbidity using a systematic literature review and qualitative research throughout Europe. Detecting risk factors for decompensation would be an interesting challenge for family physicians (FPs) in the management of multimorbid patients. The purpose of the survey was to assess which items belonging to the EGPRN multimorbidity definition could help to identify patients at risk of decompensation in a cohort pilot study over a 24-month follow-up among primary care outpatients.

Method : 131 patients meeting the multimorbidity definition were included using two inclusion periods between 2014 and 2015. Over a 24-month follow-up, the « decompensation » or « nothing to report » status was collected. A logistic regression, following a Cox model, was then performed
to identify risk factors for decompensation.

Results : After 24 months of follow-up, 120 patients were analyzed. 3 clusters were identified. 44 patients, representing 36.6 % of the population, were still alive and had not been hospitalized for a period exceeding 6 days. Two variables were significantly linked to decompensation: the number of visits to the FP per year (HR 1.06, IC 95 %, 1,03-1,10, p-value <0,001) and the total number of diseases (HR 1,12, IC 95 %, 1,013-1,33, p-value = 0,039).

Conclusion: FPs should be aware that a high number of consultations and a high total number of diseases are linked to severe outcomes such as death or unplanned hospitalization. A large-scale cohort in primary care seems feasible to confirm these results.
QALY-Time: Experts’ view on the use of the quality-adjusted life year in cost-effectiveness analysis in palliative care
Authors: Wichmann Anne B. , Goltstein Lia C.M.J. , Obihara Ndidi J. , Berendsen Madeleine R. , Houdenhoven Mark van , Morrison R. Sean , Johnston Bridget M. , Engels Yvonne 
Published: August 2019

Abstract
Background. The Quality-Adjusted Life Year (QALY) is internationally recognized as standard metric of health outcomes in cost-effectiveness analyses (CEAs) in healthcare. The ongoing debate concerning the appropriateness of its use for decision-making in palliative care has been recently mapped in a review. Aim. To report on and draw conclusions from two expert meetings that reflected on earlier mapped issues in order to reach consensus, and to advise on the QALY’s future use in palliative care. Methods. A nominal group approach was used. In order to facilitate group decision making, three statements regarding the use of the QALY in palliative care were discussed in a structured way. Two groups of international policymakers, healthcare professionals and researchers participated. Data were analysed qualitatively using inductive coding. Findings. 1) Most experts agreed that the recommended measurement tool for the QALYs ‘Q’ component, the EuroQol-5D (EQ-5D), is inappropriate for palliative care. A more sensitive tool, which might be based on the capabilities approach, could be used or developed. 2) Valuation of time should be incorporated in the ‘Q’ part, leaving the linear clock time in the ‘LY’ component. 3) Most experts agreed that the QALY, in its current shape, is not suitable for palliative care. Discussion. 1) Although the EQ-5D does not suffice, a generic tool is needed for the QALY. As long as no suitable alternative is available, other tools can be used besides or serve as basis for the EQ-5D because of issues in conceptual overlap. 2) Future research should further investigate the valuation of time issue, and how best to integrate it in the ‘Q’ component. 3) A generic outcome measure of effectiveness is essential to justly allocate healthcare resources. However, experts emphasized, the QALY is and should be one of multiple criteria for choices in the healthcare insurance package.
Base on metabolomics:analysis of the internal causes of nutrient changes in Leymus chinensis at different harvest stage
Authors: Wang wei , Ge Gentu , Zhou Tian rong , Chang Chun , Yin Qiang , Jia Yushan 
Published: August 2019

Abstract
Background Leymus chinensis is one of most valuable forage on the native grassland for its higher nutrition content. But the local farmer often gained the worse Leymus chinensis hay due to the unfavourable harvest stage, the nutrition of Leymus chinensis was decreasing from jointing stage to solid stage fro its growth characteristics, and the results showed that the crude protein (CP) decreased and the fiber content increased which will caused the nutrition of forage reduced. However, the reason for the nutrient changes in Leymus chinensis has not yet explained at the metabolic level. Results In this research, the Leymus chinensis was harvested at two growth stage(jointing stage and solid stage).Metabolomics was used to analyze the expression changes of metabolites in the whole plant of Leymus chinensis at different harvest stage, and the metabolites were analyzed based on LC-MS/MS untargeted metabolomics. A total of 55 metabolic pathways and 119 metabolites were related to the nutritional change in Leymus chinensis. Most of the metabolites are involved in metabolic processes, including amino acid metabolism, carbohydrate metabolism and acid metabolism biosynthesis. Under the action of EBF1/2 and EIN3, cysteine participates in the ubiquitin-mediated protein degradation pathway. In solid stage, the increasing content of cysteine directly promotes the ubiquitin-mediated protein degradation rate, which is manifested reduce the synthesis of crude protein (CP) in Leymus chinensis, resulting in the decreasing of Leymus chinensis nutrient quality. Carbohydrate metabolism provides raw materials for the synthesis of hemicellulose, leading to the increasing of hemicellulose. In addition, phenylalanine provides the necessary conditions for the synthesis of lignin. These are the internal factors that lead to the decline of quality of Leymus chinensis. Conclusions This study analyzed the elucidate the relationship between the reduction in the nutritional value of Leymus chinensis and complex biological processes by the metabolomic,This study will provides a theoretical basis for producing high-quality Leymus chinensis hay and sets the stage for further research.
Adverse maternal outcomes of pregnancy induced hypertension among pregnant women in Tigray Regional State, Ethiopia: a prospective cohort study
Authors: Berhe Abadi Kidanemariam , ILESANMI Abiodun O. , AIMAKHU Christopher O. , Mulugeta Afework 
Published: August 2019

Abstract
Objective The objective of this study was to assess the effect of pregnancy-induced hypertension on adverse maternal outcomes in Tigray Regional State, Ethiopia. A prospective cohort study was conducted on a total sample of 782 pregnant women attending antenatal care in hospitals of Tigray regional state, Ethiopia. Data were collected using interviewer-administered questionnaire and review of their medical records from February 1, 2018, to February 30, 2019. Data analysis was performed using Stata version 14.0.Results The overall adverse maternal outcome was 67.7% among women with pregnancy-induced hypertension and 25.1% among normotensive women. Specifically women with pregnancy-induced hypertension were at higher risk of developing Antepartum hemorrhage (Adjusted RR=1.4(1.1,2.5)), postpartum hemorrhage (RR=2.6(1.3,4.9)), induction of labor (RR=5.9(4.0,8.7)) and delivering by cesarean section (RR=2.1(1.6,2.8)) compared to normotensive women.
Self- Care Practices and Associated Factors among Adult Diabetic Patients in Public Hospitals of Dire Dawa Administration, Eastern Ethiopia
Authors: Getie Asmare , Geda Biftu , Alemayhu Tadesse , Bante Agenehu , Aschalew Zeleke , Alemu Biresaw wassihun 
Published: August 2019

Abstract
Background Diabetes is a huge growing problem, and causes high and escalating costs to the society. To prevent serious morbidity and mortality, diabetes treatment requires commitment to demanding self-care behaviors in multiple domains. Even though the majority of diabetic treatment in lines with good self-care practice, the number of research’s conducted on self-care practice is not adequate and some domains, like foot care practice were not addressed. The aim of this study was to assess self- care practices and its associated factors among adult diabetic patients in Dire Dawa public hospitals of Eastern, Ethiopia.METHODS Cross-sectional study was conducted among 513 diabetic patients. Study participants were selected through systematic random sampling. Data was collected from Feb, 01 to March 01, 2018. Patients were interviewed using a structured questionnaire. Data were entered into Epi-data version 3.3.1 and exported to SPSS version 22.0 for analysis. Bivariate and multivariable logistic regression with crude and adjusted odds ratios along with the 95% confidence interval was computed and interpreted accordingly. A P-value of <0.05 was considered to declare a result as statistically significant.RESULT The result of the study showed that 55.9%,(95% CI: 51.4, 60.3) of participants had good self-care practices. There were statistical association between good diabetes knowledge (AOR= 2.14, 95% CI:1.37, 3.35), family support system (AOR= 2.69, 95% CI:1.56, 4.62), treatment satisfaction (AOR= 2.07, 95% CI:1.18, 3.62), diabetes education (AOR= 2.21, 95% CI: 1.35, 3.63), high economic status (AOR= 1.89, 95% CI: 1.01, 3.48), having glucometer,(AOR=2.69, 95% CI:1.57, 4.63),higher educational status (AOR= 2.68, 95% CI: 1.31, 5.49), and duration of disease greater than 10 years AOR=2.70, 95% CI: 1.17, 6.26) with good self-care practice.Conclusion In this study a substantial number of the patients had poor self-care practices especially dietary practice and self-monitoring of blood glucose which have critical roles in controlling diabetes. Provision of diabetes self-care education and counseling especially on importance of self-monitoring of blood glucose, and dietary practice should be considered by responsible bodies.