bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diabetes Mellitus in adult Nigerians: patients’ characteristics, laboratory profile, practices and management outcome
Authors: Onyenekwe Belonwu M. , Young Ekenechukwu E. , Nwatu Chidinma B. , Okafor Christian I. , Ugwueze Chidiebere V. , Onuekwusi Kingsley O. 
Published: September 2019

Background: Type 2 diabetes constitutes more than 90% of cases seen in Nigeria. Previous reports had shown that patients were poorly controlled and failed to meet management target across a broad range of parameters. Objectives of this study evaluated the characteristics and practices of patients attending the outpatient diabetes clinic. The study also examined to what extent they achieved management goals and what practices by the patients impacted negatively on treatment outcome.Methods: This was a cross sectional descriptive study. All patients were eligible. Consecutive patients attending the Diabetes Clinic were evaluated. Their demographic, behavioural, social, clinical and laboratory data were obtained. Data analysis was done with SPSS V 21.Results: There were 193 subjects, 78 males and 115 females aged 35-82(59.8± 9.1) years. T2DM was diagnosed in 93.4%. Hypertension was coexistent in 74%. Present or past foot ulcer was recorded in 11.9%. Only 37% of the subjects had an exercise program, 35% did the daily foot exam, and 45% had ophthalmology consult. Skipping medication was widespread (64%), mainly due to self-titration of medications (44%) and cost (23%). Fear of hypoglycemia (83%) and hypotension (79%) was prevalent. Their body mass index was 18.2-41.2(27.6±4.8) kg/m2. Subjects were prescribed a total of 2-14 medications (5.5±1.6). Metformin was the most commonly used glucose lowering medication (88.6%), followed by sulfonylureas (64%) and insulin (27.5%). HbA1c ranged from 5.3-16; 9.0±2.4%(33-151; 75±2.7 mmol/mol).Conclusion: Glycaemic control was poor in the study population. Intermittent medication to avoid hypoglycemia played a major role. The patients lacked competence to manage their diabetes from day to day. Diabetes Self-Management Education and Support (DSMES) and early use of insulin are recommended.
Numerical Simulation of Macrosegregation Impurities in the Solidifying Continuous Casting Steel Billet
Authors: Hress Oleksandr Volodimirovich , Isayev O. B. , Chebotaryova O. O. , Wu Kaiming 
Published: September 2019

<p>In this study, new theoretical conceptions have been developed about an impurity segregation mechanism at the time of alloy solidification considering present microvolumes with different chemical compositions during alloy solidification. It has been concluded that this conception allows to establish and optimize technologic parameters that influence the production of the main types of macro-heterogeneity. The derived model conceptions have confirmed the final condition of real continuous casting billets by using the advanced analyzing methods. </p><p>Highlights </p><p>· The quasi-equilibrium theory used to study the hardening processes of alloys has been expanded and improved.<br />· The development of a numerical model for macrosegregation impurities in solidifying continuous casting billet is suggested.<br />· The adequacy of the developed model is checked under the industrial conditions using comparison theoretical<br />· calculations and practical data.<br />· The results and developments that are obtained are discussed.</p>
Providing Business Continuity Plan after Natural Disasters: a case stusy in the Staff Area of Water and Wastewater Company of Tehran
Authors: Shafaie Vahid , Darvish Farid , Nazariha Mehrdad , Givehchi Saeed 
Published: September 2019

Introduction: Each economic and non-economic institute is inevitably forced to pay special attention to the post-crisis phase to keep its organizational alive, carry out its missions, and reduce the damages and costs caused by various crises. In this research, we tried to extract the Business Continuity Plan (BCP) after the natural disaster of earthquake in the staff area of Water and Wastewater Company of Tehran within the localized framework of BS-25999 British Standards Institution (BSI).
Method: In this regard, a questionnaire was used for data collection. Analysis of the questionnaire results was performed by SPSS19 and Expertchoice11 applications.
Results: The manager of Water and Wastewater Company of Tehran was found to be the best authority for managing the emergency so that the company can continue its operation and return to normal situation. According to the findings, the hot site was selected as the best location for business continuity of Water and Wastewater Company of Tehran, which could be an alternative site to continue the activities and services after the disaster.
Conclusion: A localized post-earthquake Business Continuity Plan (BCP) was suggested in the staff area of Water and Wastewater Company of Tehran. In this site, necessary actions can be perfromed to continue the activities before, during, and after the disaster. Furthermore, organizational chart and task description can be redefined in it.
The Most Common Tools to Measure Trauma Severity: A review Study
Authors: Dehghani Tafti Abbasali , Nasiriani Khadijeh , Hajimaghsoudi Majid , Maki Mehri , Mirzaei Samaneh , Eftekhari Adel 
Published: September 2019

Introduction: Due to the increasing mortality rate from trauma, determining the severity of injury has a very important role in the prognosis of the injured person. On the other hand, the quality of medical care provided to the casualties is evaluated using the Trauma Scoring System. Various scales were used to determine the trauma severity of injured. In this study, the most commonly used tools are investigated.
Methods: This review was conducted by searching throughout the Persian data bases of Magiran, Barakat, SID and English databases of Scopus, Web of sciences, PubMed, and Google scholar. To conduct the search, the following keywords were used: "Severity of Trauma", "Trauma scoring", and "Trauma Scoring System" without considering any time intervals. Our early search resulted in 2125 articles. Finally, 17 articles were analyzed and different functions of traumatic assessment tools were compared and studied.
Results: Traumatic assessment methods vary based on the anatomical and physiological parameters and composition of these two methods. In this study, the Abbreviated Injury Scale (AIS), Injury Severity Score (ISS), and New Injury Severity Score (NISS) were considered as anatomical parameters; Revised Trauma Score (RTS) as physiological parameters; Trauma Score Injury Severity Score (TRISS) and A Severity Characterization of Trauma (ASCOST) were mentioned as a hybrid ranking system.
Conclusion: Application of accurate scientific evaluations in trauma severity assessment methods and application of each method in its appropriate position would result in appropriate improvements in the development of trauma care. In addition, these systems can play an important role in providing care to patients with traumatic injuries in the present and future.
Challenges of Health Technology Incubators in Iran: A Qualitative Study
Authors: Moghbeli Mohammad Ali , Kalantari Ali Reza , Hekmat Somayeh , Salemian pour Mahshid , Lorafshar Ehsan , Koushki Mohammad Saleh , Dehnavieh Reza 
Published: September 2019

Background: Health Technology Incubators (HTI) play an important role in paving the way depicted in Iran’s comprehensive health plan in order to achieve the aimed position in 2025. In light of the emerging nature of these centers in Iran, identification of HTI problems and challenges, as well as appropriate planning to resolve those problems can have a significant effect and improve Iran’s health system functionality.
Methods: This qualitative study was conducted in Iran in 2016. Data were collected through interviews with 24 experts (Interviewees included managers, deputies, and employees from the country's incubators) in the field. Purposeful sampling continued until data saturation level was achieved. All interviews were recorded and then analyzed, and main themes and subgroups were extracted from them based on a framework analysis. In all the mentioned steps the Atlas-Ti software has been employed.
Results: Challenges of Health Technology Incubators in Iran were categorized into eight concepts- Cultural, Rules and Principles, Funding, Concentrated Administrative System, Human Resources, Stewardship and Monitoring, Physical space and Equipment, and Communicational. Then 22 challenges were identified with in these concepts.
Conclusion: This study suggests that considering the challenges influencing technology incubators in the health sector, a sustainable program for these centers can be designed.
VIOLENCE, JUSTICE, AND ALIENATION IN EDWARD BOND'S PLAY SAVED
Authors: Alabody Asaad , Hanif Mohsen 
Published: September 2019

Purpose: The current study tries to explore the concept of violence; Justice and alienation in Edward Bond's play Saved. Saved is one of his plays to address the problem of social justice, violence and alienation in the modern world. It also seeks to show the causes which lead to violence and injustice in society. Then it goes to analyze the symbiotic relationship between the human imagination and reason in creating ideologies that affect the society and produce alienation, justice and violence.
Methodology: Violence, justice and alienation are prominent phenomena enormously discussed today. Many thinkers have tried to talk about these concepts, but this research has dealt with examining these concepts in the thought of Edward Bond. In this context, data have been collected by using library and documentary method. First, violence, justice and alienation are discussed. Bond a social theorist discusses that a healthy man is a man that connects with the world by love rather than violence, but the aliened man turns toward domination, submission, destruction or combination. Bond discusses that the root of alienation, justice and violence are found in capitalist society and are released through socially.
Results: Bond's life has witnessed the events of the Second World War and he has seen the destruction of the cities and the suffering of the people. He is highly aware of the miserable situation in which people lived. He could agitate the audience against the government by the violence shown in his plays. Bond deals with investigating the characteristics of a healthy society. Regarding the approach, he discussed that people having not the desired characteristics will be considered as aliened men. The man who does not have health symptoms would be alienated.
Implications: Since people engage in the inauthentic world, subjugated to oppression, live in the misery of universe, succumb to the disasters of everyday life and lack of rights, Playwrights can show and expose in their plays the suffering and suppression that individuals are subjected to. Writers and thinkers can guide people to authentic life and obvious truth of being through their lucid and objective language.
THE PALEOBOTANY AND PALEOECOLOGY OF THE EOCENE HERREN BEDS OF NORTH-CENTRAL OREGON, USA
Authors: JIJINA ANTHONY P. , CURRANO ELLEN D. , CONSTENIUS KURT 
Published: September 2019

ABSTRACTNew collections of plant macrofossils and radiometric dates from the Herren beds of north-central Oregon provide the opportunity to document floral communities and calculate foliar-derived climate estimates from the warm early Eocene and the cooler middle Eocene. Plant macrofossils were collected from one fluvial site at East Birch Creek approximately 2 m below a 51.9 ± 0.9 Ma tuff. Collections were also made at two co-occurring fluvial sites at Arbuckle Mountain, whose ages are constrained to ca. 44.5–43.8 Ma based on a dated tuff from Willow Creek (44.5 ± 0.8 Ma) and reported ages for the overlying Clarno Formation. Floral findings show an almost complete vegetation overturn, with only two genera (Glyptostrobus and Allantodiopsis) appearing in both floras. Both floras are species poor, but the older East Birch Creek flora has higher richness and evenness than the younger Arbuckle Mountain flora. The four named genera at East Birch Creek are taxa found throughout Eocene North America; named genera at Arbuckle Mountain also include taxa restricted to the Pacific Northwest. Leaf margin analysis and leaf area analysis of the East Birch Creek community suggest a warmer and possibly wetter (mean annual temperature 23.4 ± 4.3 °C; mean annual precipitation 206 +89, -63 cm) climate than the Arbuckle Mountain flora (16.4 ± 4.2 °C; 165 +50, -71.4 cm). This research provides a framework for future research on Eocene floristic, environmental, and climatic trends of the Pacific Northwest.
Nutritional status of tuberculosis patients, a comparative cross-sectional study.
Authors: Feleke Berhanu Elfu , Feleke Teferi Elfu , Biadglegne Fantahun 
Published: September 2019

Abstract
Background

Each year, more than 13.7 million people became an active case of tuberculosis and more than 1.5 million cases of TB patient will die. The association between TB and malnutrition is bi-directional, TB leads the patient to malnutrition, and malnutrition increases the risk of developing active TB by 6 to 10 times. Improving the nutrition of individual greatly reduces tuberculosis. The aims of this study were to assess the nutritional status and determinants of underweight among TB patients.Methods

A comparative cross-sectional study design was implemented. The sample size was calculated using 95% CI, 90% power, the prevalence of malnutrition in TB patients 50%,
TB patients to TB free resident ratio of 3, the design effect of 2 and a 5% non-response rate. Systematic random sampling was used to select TB patients and simple random sampling technique was used to select TB free residents. The data were collected from July 2015- May 2018. The data were collected by interviewing the patient, measuring anthropometric indicators and collecting the stool and blood samples. The data were entered into the computer using Epi-info software and analyzed using SPSS software. Descriptive statistics were used to find the proportion of malnutrition. Binary logistic regression was used to identify the determinants of malnutrition.Results

A total of 5045 study participants (1681 TB patients and 3364 TB free residents) were included giving for the response rate of 93.1%. The prevalence of underweight among TB patients was 57.17% (95% CI: 54.80%, -59.54%) and 88.52% of TB patients were anemic. The prevalence of malnutrition (underweight) among TB free residents was 23.37% (95% CI: 21.93-24.80). The nutritional status of TB patients was determined by site of infection AOR: 0.68 [0.49-0.94], sex of the patient AOR: 0.39 [0.25-0.56], residence AOR: 3.84 [2.74-5.54], intestinal parasite infection AOR: 7 [5.2-9.95], problematic alcohol use AOR: 1.52 [1.17-2.13].Conclusion

High proportions of TB patients were malnourished. TB patients were highly susceptible to malnutrition and even a very distal reason for malnutrition in the community became a proximal cause for TB patients.
The grapevine homeobox gene VvHB58 influences seed and fruit development through multiple hormonal signaling pathways
Authors: Li Yunduan , Zhang Songlin , Dong Ruzhuang , Wang Li , Yao Jin , Nocker Steve van , Wang Xiping 
Published: September 2019

Abstract
Background: Seedlessness is one of the most valuable traits in grapevine ( Vitis vinifera ), especially for the raisin and table grape industries. Previous transcriptome analyses of seed development in grape hybrids suggested that specific homeodomain transcription factors are involved in seed development in seedless cultivars. However, the molecular mechanism of homeobox gene regulating seed development in grape is rarely reported.
Results: Here, we report that the grapevine VvHB58 gene, encoding a homeodomain-leucine zipper (HD-Zip I) transcription factor, participates in regulating fruit size and seed number. The VvHB58 gene was differentially expressed during seed development between seedless and seeded cultivars . Subcellular localization assays revealed that the VvHB58 protein was located in the nucleus. Transgenic expression of VvHB58 in tomato led to loss of apical dominance, a reduction in fruit pericarp expansion, reduced fruit size and seed number , and larger endosperm cells. Analysis of the sequence and cytosine methylation within the VvHB58 promoter indicated that the differential expression during seed development between seedless and seeded grapes may be caused by different transcriptional regulatory mechanisms rather than promoter DNA methylation. Measurements of five classic endogenous hormones and expression analysis of hormone-related genes between VvHB58 transgenic and nontransgenic control plants showed that expression of VvHB58 resulted in significant changes in auxin, gibberellin and ethylene signaling pathways. Additio nally, several DNA methylation-related gene s were expressed differentially during seed development stages in seedless and seeded grapes , suggesting changes in methylation levels during seed development may be associated with seed abortion .
Conclusion: VvHB58 has a potential function in regulating fruit and seed development by impacting multiple hormonal pathways. These results expand understanding of homeodomain transcription factors and potential regulatory mechanism of seed development in grapevine, and provided insights into molecular breeding for grapes.
TRIal to slow the Progression Of Diabetes (TRIPOD): study protocol for a randomized controlled trial using wireless technology and incentives
Authors: Lim Robyn Su May , Gardner Daphne Su Lyn , Bee Yong Mong , Cheung Yin Bun , Bairavi Joann , Gandhi Mihir , Goh Su-Yen , Ho Emily Tse Lin , Lin Xinyi , Tan Ngiap Chuan , Tay Tunn Lin , Finkelstein Eric Andrew 
Published: September 2019

Abstract
Background: Outcomes for those with Type 2 Diabetes Mellitus (T2DM) in Singapore is poor. In this TRIal to slow the Progression Of Diabetes (TRIPOD), we will evaluate the effectiveness and cost-effectiveness of a comprehensive diabetes management package (DMP), with or without a financial incentives program, M-POWER Rewards, in efforts to improve HbA1c levels for individuals with T2DM.

Methods/Design: TRIPOD is a randomized, open-labelled, controlled, multi-center, superiority trial with three parallel arms, namely (1) usual care only, (2) usual care with DMP, and (3) usual care with DMP plus M-POWER Rewards. A total of 339 adults with sub-optimally controlled T2DM (self-reported HbA1c 7.5–11.0%) will be block randomized according to a 1:1:1 allocation ratio to the three arms. The primary outcome is mean change in HbA1c level at Month 12 from baseline. Secondary outcomes include mean change in HbA1c level at Months 6, 18, and 24; mean changes at Months 6, 12, 18, and 24 in weight, blood pressure, and self-reported physical activity, weight monitoring, blood glucose monitoring, medication adherence, diabetes self-management, sleep quality, work productivity and daily activity impairment, and health utility index; and proportion of participants initiating insulin treatment by Months 6, 12, 18, and 24. Incremental cost-effectiveness ratios will be computed based on costs per improvements in HbA1c at Month 12 and converted to cost per quality-adjusted life year gained.
Discussion: This study will present insights about the long-term cost-effectiveness and financial viability of the interventions and the potential for integrating within usual care.
Effects of Acupuncture on the Hypothalamus-Pituitary-Adrenal Axis in Chronic Insomnia Patients: A Study Protocol for a Randomized Controlled Trial
Authors: Liu Chengyong , Zheng Shiyu , Wu Wenzhong , Wang Xiaoqiu , Qin Shan , Zhao Yanan , Xi Hanqing , Wan Qingyun 
Published: September 2019

Abstract
Background : Acupuncture, as an important component of traditional Chinese medicine (TCM), has been widely applied in the treatment of chronic insomnia in China，while there is no clinical study related to its therapeutic mechanism. Methods/design : A single-center, single-blind, randomized, placebo-controlled trial will be conducted at Jiangsu Hospital of Traditional Chinese Medicine. A total of 60 patients will be registered.Eligible participantswill be randomly divided into acupuncture group and shamacupuncture group (n = 30 cases in each group). Patients in both groups will be treated once every other day, 3 times per week for 4 weeks.The primary outcome measures are Pittsburgh Sleep Quality Index (PSQI), concentrations of adrenocorticotropic hormone (ATCH), Corticotrophin-releasing hormone (CRH), and cortisol (CORT). Secondary outcome measures are Insomnia Severity Index (ISI) and Fatigue Severity Scale (FSS). Discussion : This study aims to evaluate the therapeutic effects of acupuncture on chronic insomnia by using PSQI, ISI, and FSS. The mechanism of acupuncture on CIPs will be preliminarily discussed by analyzing the changes in concentrations of CRH, ACTH, and CORT before and after treatment.
10% povidone-iodine versus 2% chlorhexidine gluconate for Periurethral cleansing before catheterization among hospitalized patients: A randomized controlled trial
Authors: vahabi elham , ghafari somayeh , haghighat somayeh 
Published: September 2019

Abstract
Background There are evidences that periurethral cleaning by antiseptics before catheterization decreases the risk of urinary tract infections. The purpose of this study was to Comparing 10% povidone-iodine and chlorhexidine gluconate (CHG) effectiveness in periurethral cleaning before catheterization on bacteriuria and pyuria in hospitalized patients. Methods A randomized controlled trial was used, and subjects were randomly allocated to either the 10% povidone -iodine group or the 2% chlorhexidine gluconate group. Urine specimens for culture and Analyse were collected 3 times for each subject within 5 days. Results Overall, 216 urine samples were collected in 72 subjects .There were no significant difference in results of bacteriuria of two groups immediately, 72 hrs. and 5 days after catheterization (p>0.05). There was no significant difference between two groups regarding positive pyuria immediately after sampling (p>0.05). Although its amount was significantly higher 72 hrs and 5days after catheterization in 10% povidone-iodine group than 2% chlorhexidine gluconate (p<0.05). In order to evaluate average of micro-organism in different time intervals between two groups Mann– Whitney test was used. This test showed that there was no significant difference of number of time intervals (p>0.05). Conclusions The results of this study showed that using 2% chlorhexidine gluconate reduced the amount of bacteriuria in catheterazied patients compared to 10% povidone-iodine. However this difference was not significant. Therefore doing more studies with more number of samples in this field is suggested. Trial registration: Retrospectively registered. IRCT20170712035044N2 Key words: 10% povidone-iodine- 2% chlorhexidine gluconate - Bacteriuria- Periurethral cleansing