bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Retrospective Study of the Clinical Phenotype and Predictors of Survival in non-Caucasian Hispanic Patients with Amyotrophic Lateral Sclerosis.
Authors: Sánchez-Martínez Claudia Marisol , Choreño-Parra José Alberto , Nuñez-Orozco Lilia , Placencia-Álvarez Noel Isaías , Alvis-Cataño Laura Marcela , Guadarrama-Ortiz Parmenides 
Published: October 2019

Abstract
Background. Little is known about the clinical phenotype of amyotrophic lateral sclerosis (ALS) in non-Caucasian populations. Here, we aimed to describe the clinical characteristics, prognostic factors and survival of Mexican patients with ALS.
Methods. We conducted a retrospective study by reviewing the medical records of patients with ALS that attended and were regularly followed at a third level hospital in Mexico City from 2000 to 2015. We calculated absolute and relative frequencies of the clinical characteristics from all the participants. We also estimated correlation coefficients between clinical features and overall survival. Additionally, survival rates were compared for all participants grouped according to different clinical features using the Kaplan-Meier method and the log-rank test.
Results. We enrolled 45 ALS patients, 53.33% had spinal-onset ALS and 46.66% presented bulbar ALS. The male/female ratio was 0.8. The mean age at onset of symptoms was 58.11 years. Mean survival time from onset was 64.73 ± 34.83 months. Cumulative survival rate after 5 years of disease onset was 44.44%. Age at onset and age at diagnosis inversely correlated with overall survival time. Also, we found that bulbar-onset, short diagnostic delay, percutaneous endoscopic gastrostomy, mechanical ventilation, and lower total cholesterol serum levels were associated with short survival.
Conclusions. The clinical characteristics of Mexican ALS patients differ from the disease phenotype observed in Caucasians. Nonetheless, the predictive value of certain well-recognized prognostic factors remains consistent in our population. The current study provides relevant information for a better understanding of prognostic factors in ALS patients from Mexico and other Latin American countries.
Sensory processing of women diagnosed with genito-pelvic pain/penetration disorder: a research proposal
Authors: Labuschagne Elsie , Niekerk Matty van 
Published: October 2019

Abstract
Objectives: The study objectives are to describe the sensory processing patterns of women diagnosed with genito-pelvic pain/penetration disorder (GPPPD), to explore the level of anxiety when both GPPPD and sensory processing disorder (SPD) are present and to investigate participants’ experience of participating in a sensory-based home programme.
Methods: A descriptive two-phased study design will be used. Phase one is a quantitative, cross sectional non-experimental descriptive study, using the Adolescent/Adult Sensory History (ASH) and Hospital Anxiety and Depression Scales (HADS) to obtain data from purposive sampling.
Phase two is an exploratory qualitative study involving participants who were identified with SPD in phase one. They will participate in a sensory-based home programme and their experience thereof will be established during semi-structured interviews.
Outcomes: Descriptive studies are known to be useful in planning health services and to develop hypotheses for future testing. This study could improve practitioners’ understanding of GPPPD and SPD and make alternative, non-invasive, non-pharmacological treatment options available to better assist these patients. The study could further clarify the role of the occupational therapist in sexuality. Exploring participants’ anxiety has important implications for treatment protocols in occupational therapy and assisting in describing the signs and symptoms of GPPPD.
A randomised controlled trial exploring the impact of a dedicated Health and Social Care Professionals team in the Emergency Department on the quality, safety, clinical and cost-effectiveness of care for older adults: Study Protocol
Authors: Cassarino Marica , Robinson Katie , O’Shaughnessy Íde , Smalle Eimear , White Stephen , Devlin Collette , Quinn Rosie , Trépel Dominic , Boland Fiona , Ward Marie E. , McNamara Rosa , O’Connor Margaret , McCarthy Gerard , Ryan Damien , Galvin Rose 
Published: October 2019

Abstract
Background : Older people are frequent Emergency Department (ED) users who present with complex issues that are linked to poorer health outcomes post-index visit, often have increased ED length of stay and tend to have raised healthcare costs. Encouraging evidence suggests that ED teams involving health and social care professionals (HSCPs) can contribute to enhanced patient flow and improved patient experience by improving care decision-making and thus promoting timely and effective care. However, the evidence supporting the impact of HSCPs teams assessing and intervening with older adults in the ED is limited and identifies important methodological limitations, highlighting the need for more robust and comprehensive investigations of this model of care. This study aims to evaluate the impact of a dedicated ED-based HSCP team on the quality, safety, clinical and cost-effectiveness of care of older adults when compared to usual care.
Methods : The study is a single-site randomised controlled trial whereby patients aged ≥65 years who present to the ED of a large Irish hospital will be randomised to the experimental group (ED-based HSCP assessment and intervention) or the control group (usual ED care). The recruitment target is 320 participants. The HSCP team will provide a comprehensive functional assessment as well as interventions to promote a safe discharge for the patient. The primary outcome is ED length of stay (from arrival to discharge). Secondary outcomes include: rates of hospital admissions from the ED, ED re-visits, unplanned hospital admissions and healthcare utilisation at 30-days, four and six-month follow-up; patient functional status and quality of life (at baseline and follow-up); patient satisfaction; costs-effectiveness in terms of costs associated with ED-based HSCP compared to usual care; and perceptions on implementation by ED staff members.
Discussion : This is the first randomised controlled trial testing the impact of HSCPs working in teams in the ED on the quality, safety, clinical and cost-effectiveness of care for older patients. The findings of the study will provide important information on the effectiveness of this model of care for future implementation.
Trial registration : ClinicalTrials.gov, NCT03739515; registered on 12 th November 2018. Protocol version 1. URL: https://clinicaltrials.gov/ct2/show/NCT03739515
Determinants of effective organizational capacity training: lessons from a training programme on health workforce development with participants from three African Countries
Authors: Amde Woldekidan Kifle , Marchal Bruno , Sanders David , Lehmann Uta 
Published: October 2019

Abstract
Background
Health systems in sub-Saharan Africa face multifaceted capacity challenges to fulfil their mandates of service provision and governance of their resources. Four academic institutions in Africa implemented a World Health Organisation-funded collaborative project encompassing training, curriculum development, and partnership to strengthen national leadership and training capacity for health workforce development. This paper looks into the training component of the project, a blended Masters programme in public health that sought to improve the capacity of personnel involved in teaching or management/development of human resources for health. The paper aims to explore factors influencing contribution of training to organisational capacity development.

Methods
We chose a case study design. Semi-structured interviews were held with 18 trainees that were enrolled in the training programme, and who were affiliated to health ministries or public health training institutions. We gathered additional data through document reviews, observation, and interviews with 14 key informants associated with the programme and/or working in the collaborating institutions. The evidence gathered were analysed thematically.

Results
Thirteen of the eighteen training participants stayed in the target institutions and contributed to improved capacity of their institutions in the fields of management, policy, planning, research, training, or curriculum development. Five left for private and international agencies due to dissatisfaction with payment, work conditions, or career prospect.

Factors that were associated with the training, trainees, and the institutional and broader context, determine contribution of training to organisational capacity development. These include relevance of newly acquired knowledge and skills set of trainees to the role/position they assume in the organisation; recognition of trainees by employing organisations in terms of promotion or assignment of challenging tasks; and motivation and retention of trained staff.

Conclusion
Training, even if relevant and applicable, makes no more than a ‘latent’ contribution, one which is activated and realised through alignment of clusters of interacting contextual and relational factors related to the target institutions and trained personnel. While not predictable, implementers need to focus more deliberately on the likely interaction and best possible alignments between training relevance, student selection for potential to contribute, recognition and career advancement potential.
The First Study of Successful Pregnancies in Chinese patients with Phenylketonuria
Authors: Lin Wang , Fang Ye , Hui Zou , Kundi Wang , Zhihua Chen , Qin Hui , Bingjuan Han , Chun He , Xiaowen Li , Shen Ming 
Published: October 2019

Abstract
Background
Since the inception of newborn screening programs in China in the 1990s, pregnancy among patients with inherited, metabolic disorders has become more common. This study explores the management and outcomes of planned, full-term pregnancies in patients with phenylketonuria (PKU).
Method
Married patients with PKU from 2012 to 2017 were enrolled to receive prenatal counseling and regular health assessments. Study-related assessments included the timing of Phe-restricted diets, maternal weight gain, gestational age, pregnancy complications, and blood Phe concentrations (both pre-conception and during pregnancy), obstetrical data, and offspring outcomes(e.g.anthropomorphic measurements and developmental quotients [DQs]).
Results
A total of six offspring were successfully delivered. The mean±SD (range) age of the mother at delivery was 26.3±4.7 (range:21.1-32.5) years. The mean duration of Phe control before pregnancy was 5.5±1.3(range:3.1-6.5) months. During pregnancy, the proportion of blood Phe concentrations within the clinically-recommended target range (120–360μmol/L) ranged from 63.2-83.5%. Low birth weight (<2500g) offspring occurred in two women who experienced suboptimal metabolic control. In addition, offspring DQ was related to the proportion of blood Phe levels per trimester that were within the recommended range (r=0.886, p=0.016).
Conclusion
This is the first report of women in China with PKU who successfully gave birth to clinically healthy babies. Infant outcomes were related to maternal blood Phe management prior to and during pregnancy. In maternal PKU patients with poor compliance todietary treatment, sapropterin dihydrochloride（6R-BH 4 ）may be an option to improve the management of blood Phe levels.
Cost-effectiveness of two long-lasting insecticidal nets delivery models in mass campaign in rural Mozambique
Authors: Arroz Jorge , Candrinho Baltazar , Mendis Chandana , Lopez Melanie , Martins Maria do Rosário Oliveira 
Published: October 2019

Abstract
Objective The aim is to compare the cost-effectiveness of two long-lasting insecticidal nets (LLINs) delivery models (standard vs new) in universal coverage (UC) campaigns in rural Mozambique. Results The total financial cost of delivering LLINs was US$ 231,237.30 and US$ 174,790.14 in the intervention (302,648 LLINs were delivered) and control districts (219,613 LLINs were delivered), respectively. The average cost-effectiveness ratio (ACER) per LLIN delivered and ACER per household (HH) achieving UC was lower in the intervention districts. The incremental cost-effectiveness ratio (ICER) per LLIN and ICER per HH reaching UC were US$ 0.68 and US$ 2.24, respectively. Both incremental net benefit (for delivered LLIN and for HHs reaching UC) were positive (intervention deemed cost-effective). Overall, the newer delivery model was the more cost-effective intervention. However, the long-term sustainability of either delivery models is far from guaranteed in Mozambique’s current economic context.
Prevalence and associated factors of chronic kidney disease among adult hypertensive patients in Tigray teaching hospitals: A cross-sectional study
Authors: Bahrey Degena , Gebremedhn Gebreamlak , Mariye Teklewoini , Girmay Alem , Aberhe Woldu , Hika Assefa , Teklay Girmay , Tasew Hagos , Zeru Teklay , Gerensea Hadgu , Demoz Gebre Teklemariam 
Published: October 2019

Abstract
Objective: The aim of this study was to assess the prevalence of chronic kidney disease and to identify associated factors of chronic kidney disease among hypertensive patients. A cross-sectional study was conducted among selected five hundred seventy eight hypertensive patients. Data were collected using face to face interviewing questionnaires and from medical chart review. Binary logistic regression analyses were performed and analyzed using SPSS version 23.0.
Result: Of the total 578 hypertensive patients the prevalence of chronic kidney disease was found to be 128 ( 22.1%). Of these hypertensive patients, patients with uncontrolled blood pressure, overweight/obesity, dyslipidemia and diabetic mellitus, 43.3%, 33.7% , 27.3 % and 28.2 respectively. After adjustment, the independent variables the significant associated factors of chronic kidney disease among hypertensive patients were age [AOR (95% CI = 1.43 (1.07-1.81) ] , uncontrolled hypertension 4.434 [AOR ( 95%CI =9.45 (1.34, 14.73) ] , overweight/obese [AOR ( 95%CI =7.422 ( 2.72, 20.28) ] , dyslipidemia [AOR (95% CI) = 13.749 (5.69, 33.215)], diabetic mellitus [AOR (95% CI) = 2.137 (1.07, 4.26)]. In conclusion, the prevalence of chronic kidney disease was considerably high. The major associated factors of chronic kidney disease were age, uncontrolled hypertension, overweight/obese, diabetic mellitus and dyslipidemia.
Maternal H. pylori seropositivity is associated with gestational hypertension but irrelevant to fetal growth and development in early childhood
Authors: Lai Fu-Ping , Tu Yi-Fang , Sheu Bor-Shyang , Yang Yao-Jong 
Published: October 2019

Abstract
Background: Helicobacter pylori infection is known to alter growth-related hormones and cause growth faltering in young children. It is still unknown if maternal H. pylori infection has an impact on the levels of cord blood growth-related hormones and can predict intrauterine growth restriction and poor physical and neurodevelopmental outcomes in children. This study aimed to examine the associations between maternal H. pylori infection and pregnancy-related adverse events, fetal growth and early childhood development. Methods: The prospective cohort study recruited singleton pregnant women without major medical illnesses from January 2014 to January 2015. Seropositivity for H. pylori was defined by >12 U/ml of anti- H. pylori IgG in the maternal serum. Demographic data and pregnancy-related medical issues of the cohort were documented. Cord blood levels of insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein-3 (IGFBP-3), insulin, and ghrelin were determined using ELISA test. The growth of eligible neonates was monitored annually for up to 3 years, and cognitive development was assessed using the comprehensive developmental inventory for infants and toddlers (CDIIT) test 3 years after birth. Results: Of the 106 enrolled women, 25 (23.6%) were H. pylori -seropositive. Maternal H. pylori seropositivity was correlated with a higher risk of developing gestational hypertension (GH) (12% vs. 1.2%, p =0.04) and lower cord blood levels of IGF-1 (<35 ng/ml, 70.0% vs. 40.7%, p =0.02) and IGFBP-3 (<1120 ng/ml, 100.0% vs. 76.3%, p =0.02) compared with the seronegative women. No significant impact on birth weight, childhood growth and cognitive development was found to correlate with maternal H. pylori seropositivity during pregnancy. Conclusions: Maternal H. pylori infection during pregnancy was more likely to develop GH, but not correlated with fetal and childhood growth and development. In addition to close monitoring of hypertension, H. pylori eradication can be considered for such H. pylori -infected mothers.
Trends and Distribution in Mortality Rates of Coronary Heart Disease in Hexi Corridor of Gansu in China from 2006 to 2015
Authors: li xinghui , ren xiaolan , qiao yan , xie ping , wang nan , nie fangfei , lei linfeng , wang chenchen , wang lijun , han junxian 
Published: October 2019

Abstract
Background: The mortality rate of coronary heart disease (CHD) in China is different from region to region, and there are sex, age and urban-rural differences. This study described trend and distribution of CHD in Hexi corridor of Gansu province from 2006 to 2015.
Method: The death data of CHD were obtained using the Death Reporting System of Gansu CDC for 2006-2015. The trend of the death cases of CHD by year, month and its distribution by sex, age and region were studied, and the changing characteristics of epidemiology was analyzed.
Results: Overall, The mortality rate of CHD in Hexi corridor showed a decline trend from 2006 to 2015, a tendency that higher in winter and spring, and lowest in summer.
The relative mortality of males was higher than that of females ( P < 0.05), increased with age ( P < 0.05), and that of rural areas was higher than that of urban areas ( P < 0.05). The trend analysis of death rate for ten-year showed a marked decline in females, an increase in 18-39 years old, a small change in 40-59 years old, a decrease in over 60 years old, and a downward tendency of urban areas. Further analysis showed that the mortality rate of males were higher than that of females in 18-39 years old and 40-59 years old group and also in urban areas group ( P < 0.05), while no sex difference in over 60 years old group and rural areas group ( P > 0.05).
Conclusion: The mortality of CHD in Hexi corridor of Gansu province in China was lower than the national average from 2006 to 2015, but increased gradually in specified population such as in males, young and middle-age, rural areas groups. The prevention and control measures should be strengthened in these special populations.
A prospective cohort study of maternal body mass index and maternal and neonatal outcomes in Fiji
Authors: Black Kirsten , Mudaliar Jyotishna , Nusair Pushpa , Rouse Ian 
Published: October 2019

Abstract
Background:
Maternal obesity is highly prevalent in Fiji and the perinatal and long-term consequences are likely to be significant. We investigated the relationship between maternal body mass index and maternal and neonatal outcomes and birth weight centiles in Fijian women.
Aims: We sought to use the Intergrowth 21 st (IG21) standard to record the proportion of babies born over the 90 th centile and to examine the association of other maternal and neonatal outcomes with normal weight, overweight and obesity amongst women presenting for antenatal care at the Colonial War Memorial Hospital in Fiji.
Methods: From January 2014 – December 2015 we undertook a prospective cohort study that used a structured questionnaire to collect data on women presenting for antenatal care. Body weight was recorded at the booking visit and adjusted to estimated pre-pregnancy bodyweight based on gestation at booking. Midwives collected follow up data regarding the outcomes of these pregnancies and we used the IG21 standard to estimate birthweight centiles.
Results: Of the 1397 records, 79 women were underweight and were excluded for detailed analysis. For the remaining 1318 cases detailed pregnancy and follow-up data were available. Compared to normal weight women overweight women were older, parous and were more likely to have pregnancy-related hypertension and were more likely to have an induction of labour. A sixth (n=224;16.7%) of the babies were above the 90 th centile of birthweight according to IG21 standard and as maternal BMI class increased, the odds of the baby’s birthweight being > 90 th centile increased. Compared to normal weight women, women with class II or II obesity were three times more likely to have a baby over the 90 th centile (AOR 3.053; CI 1.907-4.889).
Conclusions: A significant proportion of babies born in Fiji are large for gestational age which predisposes them to long term adverse metabolic health outcomes. Addressing maternal obesity before pregnancy is going to be key if Fiji is to curb the growing trend in child and adult obesity and metabolic disease in later life.
Genome-wide Survey of bHLH Super Gene Family in Brassica napus and Their Roles in Roots
Authors: Ke Yunzhuo , Wu Yunwen , Zhou Hongjun , Chen Ping , Wang Mangmang , Liu Mingming , Li Pengfeng , Yang Jing , Li Jiana , Du Hai 
Published: October 2019

Abstract
Background: Basic helix-loop-helix (bHLH) gene family is one of the largest transcription factors in plants and are functionally characterized in diverse species. However, less is known about their functions in the economically important allopolyploid oil crop, Brassica napus .
Results : We identified 602 potential bHLHs in B. napus genome ( BnbHLHs ) and categorized them into 36 subfamilies, including seven newly separated subfamilies, based on phylogeny, protein structure and exon-intron organization analysis. The intron insertion patterns of this gene family were corrected and a total of eight types were identified in the bHLH regions of BnbHLHs . Chromosome distribution and synteny analyses revealed that hybridization between Brassica rapa and Brassica oleracea was the main expansion mechanism for BnbHLHs . Expression analyses showed that BnbHLHs were wide and formed six main patterns, suggesting they may participate in various aspects in B. napus during the development. The expression profiles under five hormone treatments (IAA, ABA, ACC, GA3, 6-BA) in roots further revealed the active response of BnbHLHs with a large proportion of which being induced. qRT-PCR analysis confirmed the expression profiles of five candidate BnbHLHs under five hormone inductions. Up to 246 BnbHLHs from nine subfamilies were predicted to have potential roles relating to root development by joint analysis of expression profile and homolog function. Further, the MYB/bHLH/WD40 (MBW) protein complex regulating root hair development were verified in B. napus by yeast two-hybrid experiment.
Conclusion: The 602 BnbHLHs identified from B. napus could be classed into 36 subfamilies, and those members from the same subfamily generally have similar sequence motifs. BnbHLHs may widely involve in root biological process in B. napus . Overall, this study provides important insights into the characterization and potential functions of B. napus bHLH super gene family and thus will be useful in future gene function research.