bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and Associated Risk Factors of Soil-Transmitted Helminth Infections among Schoolchildren around Lake Tana, Northwest Ethiopia
Authors: Getaneh Melsew , Hailegebriel Tamirat , Munshea Abaineh , Nibret Endalkachew 
Published: December 2022

Background. Soil-transmitted helminths (STHs) are among the most common neglected tropical diseases widely distributed in tropical countries with poor socioeconomic development. Ascaris lumbricoides, Trichuris trichiura, and hookworm are the three major STHs. This study aimed to determine the prevalence of STHs and associated risk factors among schoolchildren in selected primary schools around Lake Tana, Northwestern Ethiopia. Methods. A school-based cross-sectional study was conducted from February to May 2021 involving 337 study participants. A systematic random sampling method was utilized to select the study participants from the selected schools. Data related to sociodemographic characteristics of the study participants and risk factors for STH infections were collected using a pretested questionnaire. Stool samples were collected in sterile plastic containers from each participant and processed using Kato–Katz thick fecal smear and Ritchie’s concentration techniques. The data were analyzed using the Statistical Package for Social Sciences software tool version 23, and factors with a

p
<
0.05

were considered as statistically significant. Results. The overall prevalence of STH infection was 38.3% (95% CI: 33.1–43.7). Hookworm infection was the predominant STH infection, which was detected in 26.1% schoolchildren followed by A. lumbricoides (14.8%) and T. trichiura (1.5%). Most of the study subjects (34.1%) had single infections, whereas only 4.2% study subjects had multiple helminthic infections. Among the risk factors considered in the study, lack of shoe wearing habit (adjusted odds ratio [AOR]=29.5; 95% confidence interval [CI]=6.59–132.55;

p
<
0.001

), lack of knowledge on the prevention and control methods (

AOR
=
5.41

; 95% CI = 2.44–11.98;

p
<
0.001

), engagement in irrigation activities (

AOR
=
2.14

; 95% CI = 1.02–4.57,

p
=
0.049

), lack of toilet (

AOR
=
3.06

; 95% CI = 1.31–7.16;

p
=
0.01

), children grades of 5–8 (

AOR
=
2.62

; 95% CI = 1.26–5.43;

p
=
0.01

), playing on soils (

AOR
=
5.90

; 95% CI = 2.79–12.49;

p
<
0.001

), lack of fingernail trimming habit (

AOR
=
3.21

; 95% CI = 1.57–6.55;

p
=
0.001

), and male gender (

AOR
=
2.28

; 95% CI: 1.19–4.39;

p
=
0.013

) were significant explanatory factors for STH infection among schoolchildren in the study area. Conclusions. The present study showed that STHs were common among schoolchildren around Lake Tana. Therefore, education on personal and environmental hygiene should be taken into account to reduce the prevalence of STH infection in the study area.
The Effect of Diabetes Self Management Education (DSME) with Audiovisu-al Media on Self-Care and Decreasing Blood Sugar Levels in Diabetes Melli-tus Patients Type II
Authors: Nugrahenny Fabella Finandatyan , Darmawan Rendi Editya , Lestari Siti 
Published: December 2022

Background: Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia that occurs due to abnormal insulin secretion. Diabetes Self Management Education (DSME) is an important role in preventing or delaying complications in people with pre-diabetes and diabetes. Aim of study is to analize effect of Diabetes Self Management Education (DSME) with audiovisual media on self-care and decreasing blood sugar levels in diabetes mellitus patients type II
Methods: Using a quasy experiment research design with control group design. Samples is 34 respondents (17 respondents in the control group and 17 respondents in the experimental group) that chosen randomly with odd and even way according to data patients DM. Self care measured by Summary of Diabetes Self-Care Activity (SDSCA) questionnaire, and blood sugar level measure with a glucometer. Intervention group given DSME for 14 days, and control group get treatment according to community standards. Bivariate analysis used the non-parametric Wilcoxon test and to see the difference between pre-test and post-test on the self-care variable and to see the differences between groups using the Mann-Whitney test. Analysis of bivariate test on blood sugar levels drop variables using parametric test Paired T-Test and to see the difference between groups using Independent T-Test test.
Results: The results of the Wilcoxon test of self-care control group p=0.246 (p=<0.05), so there is no effect, the experimental group p = 0.005 (p=<0.05), so that concluded no effect. Mann-Whitney test results with personal care and experimental control group p=0.000 (p=<0.05), so that there is a significant difference. Results of Paired T-Test blood sugar control group p = 0.812 (p =<0.05), so there is no effect, the experimental group, p = 0.000 (p=<0.05), so that concluded no effect. The results of the Independent T-Test blood sugar levels in the control and experimental groups p=0.020 (p=<0.05), so there is a significant difference in effect.
Conclusion: There is the influence of Diabetes Self-Management Education (DSME) The Audiovisual Media on self-care and decrease blood sugar levels in people with Type II DiabetsMellitus.
Penerapan Proportional Odds Model pada Regresi Logistik Ordinal Determinan Tingkat Kebahagiaan di Provinsi Yogyakarta
Authors: Azizah Nur , Yanti Devi 
Published: December 2022

Pembangunan suatu wilayah dapat diukur dari sisi obyektif maupun subyektif. Kebahagiaan merupakan salah satu indikator kesejahteraan masyarakat dari sisi subyektif.. Berdasarkan data BPS pada tahun 2014, PDRB per kapita di Propinsi Yogyakarta merupakan terendah di Pulau Jawa, akan tetapi berdasarkan indeks kebahagiaan Propinsi Yogyakarta merupakan propinsi dengan indeks kebahagiaan tertinggi. Oleh karena itu, perlu dikaji lebih lanjut determinan apa yang mempengaruhi tingkat kebahagiaan di Propinsi Yogyakarta. Ukuran kebahagian seseorang biasanya diukur dengan tingkatan dari mulai tidak bahagia, bahagia, sangat bahagia. Dalam analisis statistik, ukuran bertingkat ini merupakan skala pengukuran ordinal. Model yang umum digunakan dalam regresi logistik ordinal adalah Proportional Odds Model. Dengan menggunakan data IFLS5 tahun 2014-2015 dilakukan pemodelan regresi logistik ordinal pada determinan tingkat kebahagiaan di Propinsi Yogyakarta. Hasil dari model yang diperoleh variabel yang signifikan mempengaruhi tingkat kebahagiaan di Propinsi Yogyakarta yaitu variabel usia, status perkawinan dan pendidikan. Berdasarkan nilai odds rasio dapat disimpulkan bahwa semakin tinggi usia individu di Propinsi Yogyakarta cenderung lebih tidak bahagia Sedangkan jika dilihat dari status perkawinan individu dengan status kawin cenderung lebih bahagia dibandingkan dengan individu yang tidak kawin. Begitu juga untuk variabel pendidikan, individu dengan kategori pendidikan tertinggi perguruan tinggi cenderung lebih bahagia dibandingkan dengan individu dengan kategori pendidikan tertinggi sekolah dasar.
On‐Treatment Platelet Reactivity and Ischemic Outcomes in Patients With Diabetes Mellitus: Two‐Year Results From ADAPT‐DES
Authors: Shahim Bahira , Redfors Björn , Stuckey Thomas D. , Liu Mengdan , Zhou Zhipeng , Witzenbichler Bernhard , Weisz Giora , Rinaldi Michael J. , Neumann Franz‐Josef , Metzger D. Christopher , Henry Timothy D. , Cox David A. , Duffy Peter L. , Brodie Bruce R. , Srdanovic Iva , Madhavan Mahesh V. , Mazzaferri Ernest L. , Mehran Roxana , Ben‐Yehuda Ori , Kirtane Ajay J. , Stone Gregg W. 
Published: December 2022

Background
Diabetes mellitus and high platelet reactivity (HPR) on clopidogrel are both associated with increased risk of ischemic events after percutaneous coronary intervention, but whether the HPR‐associated risk of adverse ischemic events differs by diabetes mellitus status is unknown.

Methods and Results

ADAPT‐DES (Assessment of Dual Antiplatelet Therapy With Drug‐Eluting Stents) was a prospective, multicenter registry of patients treated with coronary drug‐eluting stents. HPR was defined as P2Y12 reaction units >208 by the VerifyNow point‐of‐care assay. Cox multivariable analysis was used to assess whether HPR‐associated risk of major adverse cardiac events (MACE; cardiac death, myocardial infarction, or stent thrombosis) varied for patients with insulin‐treated diabetes mellitus (ITDM), non–ITDM, and no diabetes mellitus. Diabetes mellitus and HPR were included in an interaction analysis. Of 8582 patients enrolled, 2429 (28.3%) had diabetes mellitus, of whom 998 (41.1%) had ITDM. Mean P2Y12 reaction units were higher in patients with diabetes mellitus versus without diabetes mellitus, and HPR was more frequent in patients with diabetes mellitus. HPR was associated with consistently increased 2‐year rates of MACE in patients with and without diabetes mellitus (
P
interaction
=0.36). A significant interaction was present between HPR and non–insulin‐treated diabetes mellitus versus ITDM for 2‐year MACE (adjusted hazard ratio [HR] for non–ITDM, 2.28 [95% CI, 1.39–3.73] versus adjusted HR for ITDM, 1.02 [95% CI, 0.70–1.50];
P
interaction
=0.01).

Conclusions
HPR was more common in patients with diabetes mellitus and was associated with an increased risk of MACE in both patients with and without diabetes mellitus. In patients with diabetes mellitus, a more pronounced effect of HPR on MACE was present in lower‐risk non–ITDM patients than in higher‐risk patients with ITDM.

Registration

URL:
https://clinicaltrials.gov/ct2/show/NCT00638794
; Unique identifier: NCT00638794. ADAPT‐DES (Assessment of Dual Antiplatelet Therapy With Drug‐Eluting Stents).
Protective Role of Endothelial Fibulin‐4 in Valvulo‐Arterial Integrity
Authors: Nguyen Tram Anh Vu , Lino Caroline Antunes , Hang Huynh Thuy , Alves Juliano Vilela , Thang Bui Quoc , Shin Seung Jae , Sugiyama Kaori , Matsunaga Hiroko , Takeyama Haruko , Yamashiro Yoshito , Yanagisawa Hiromi 
Published: December 2022

Background

Homeostasis of the vessel wall is cooperatively maintained by endothelial cells (ECs), smooth muscle cells, and adventitial fibroblasts. The genetic deletion of fibulin‐4 (
Fbln4
) in smooth muscle cells (
SMKO
) leads to the formation of thoracic aortic aneurysms with the disruption of elastic fibers. Although
Fbln4
is expressed in the entire vessel wall, its function in ECs and relevance to the maintenance of valvulo‐arterial integrity are not fully understood.

Methods and Results

Gene silencing of
FBLN4
was conducted on human aortic ECs to evaluate morphological changes and gene expression profile.
Fbln4
double knockout (
DKO
) mice in ECs and smooth muscle cells were generated and subjected to histological analysis, echocardiography, Western blotting, RNA sequencing, and immunostaining. An evaluation of the thoracic aortic aneurysm phenotype and screening of altered signaling pathways were performed. Knockdown of
FBLN4
in human aortic ECs induced mesenchymal cell–like changes with the upregulation of mesenchymal genes, including
TAGLN
and
MYL9
.
DKO
mice showed the exacerbation of thoracic aortic aneurysms when compared with those of
SMKO
and upregulated Thbs1, a mechanical stress–responsive molecule, throughout the aorta.
DKO
mice also showed progressive aortic valve thickening with collagen deposition from postnatal day 14, as well as turbulent flow in the ascending aorta. Furthermore, RNA sequencing and immunostaining of the aortic valve revealed the upregulation of genes involved in endothelial‐to‐mesenchymal transition, inflammatory response, and tissue fibrosis in
DKO
valves and the presence of activated valve interstitial cells.

Conclusions
The current study uncovers the pivotal role of endothelial fibulin‐4 in the maintenance of valvulo‐arterial integrity, which influences thoracic aortic aneurysm progression.
Impact of Empagliflozin in Heart Failure With Reduced Ejection Fraction in Patients With Ischemic Versus Nonischemic Cause
Authors: Khan Muhammad Shahzeb , Butler Javed , Anker Stefan D. , Filippatos Gerasimos , Ferreira João Pedro , Pocock Stuart J. , Januzzi James L. , Piña Ileana L. , Böhm Michael , Ponikowski Piotr , Verma Subodh , Brueckmann Martina , Vedin Ola , Zeller Cordula , Zannad Faiez , Packer Milton 
Published: December 2022

Background
Outcomes and treatment effects of therapy may vary according to the cause of heart failure (HF).

Methods and Results

In this post hoc analysis of the EMPEROR‐Reduced (Empagliflozin Outcome Trial in Patients With Chronic Heart Failure With Reduced Ejection Fraction) trial, the effect of empagliflozin on cardiovascular and renal outcomes was assessed according to the cause of HF. The cause of HF was investigator reported and stratified as ischemic or nonischemic. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% CIs. Of the 3730 patients enrolled, 1929 (51.7%) had ischemic cause. In the placebo arm, patients with ischemic cause of HF did not have a significantly higher risk of cardiovascular mortality (HR, 1.21 [95% CI, 0.90–1.63]) and hospitalization for HF (HR, 0.90 [95% CI, 0.72–1.12]) compared with nonischemic cause. Empagliflozin compared with placebo significantly reduced the risk of cardiovascular death or hospitalization for HF in patients with ischemic and nonischemic cause (HR, 0.82 [95% CI, 0.68–0.99] for ischemic and HR, 0.67 [95% CI, 0.55–0.82] for nonischemic cause;
P
interaction=0.15). The benefit of empagliflozin on HF hospitalization, the renal composite end point, estimated glomerular filtration slope changes, and health status scores were also consistent in both groups without treatment by cause modification.

Conclusions
Empagliflozin offers cardiovascular and renal benefits in patients with heart failure with reduced ejection fraction regardless of the cause of HF.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03057977.
Coronary Slow Flow Is Not Diagnostic of Microvascular Dysfunction in Patients With Angina and Unobstructed Coronary Arteries
Authors: Dutta Utkarsh , Sinha Aish , Demir Ozan M. , Ellis Howard , Rahman Haseeb , Perera Divaka 
Published: December 2022

Background

Guidelines recommend that coronary slow flow phenomenon (CSFP), defined as corrected thrombolysis in myocardial infarction frame count (CTFC)

>

$$ > $$

27, can diagnose coronary microvascular dysfunction (CMD) in patients with angina and nonobstructed coronary arteries. CSFP has also historically been regarded as a sign of coronary endothelial dysfunction (CED). We sought to validate the utility of CTFC, as a binary classifier of CSFP and as a continuous variable, to diagnose CMD and CED.

Methods and Results

Patients with angina and nonobstructed coronary arteries had simultaneous coronary pressure and flow velocity measured using a dual sensor‐tipped guidewire during rest, adenosine‐mediated hyperemia, and intracoronary acetylcholine infusion. CMD was defined as the inability to augment coronary blood flow in response to adenosine (coronary flow reserve <2.5) and CED in response to acetylcholine (acetylcholine flow reserve ≤1.5); 152 patients underwent assessment using adenosine, of whom 82 underwent further acetylcholine testing. Forty‐six patients (30%) had CSFP, associated with lower flow velocity and higher microvascular resistance as compared with controls (16.5

±

$$ \pm $$

6.9 versus 20.2

±

$$ \pm $$

6.9 cm/s;
P
=0.001 and 6.26

±

$$ \pm $$

1.83 versus 5.36

±

$$ \pm $$

1.83 mm Hg/cm/s;
P
=0.009, respectively). However, as a diagnostic test, CSFP had poor sensitivity and specificity for both CMD (26.7% and 65.2%) and CED (21.1% and 56.0%). Furthermore, on receiver operating characteristics analyses, CTFC could not predict CMD or CED (area under the curve, 0.41 [95% CI, 0.32%–0.50%] and 0.36 [95% CI, 0.23%–0.49%], respectively).

Conclusions
In patients with angina and nonobstructed coronary arteries, CSFP and CTFC are not diagnostic of CMD or CED. Guidelines supporting the use of CTFC in the diagnosis of CMD should be revisited.
Predicting Arterial Thrombotic Events Following Peripheral Revascularization Using Objective Viscoelastic Data
Authors: Majumdar Monica , Hall Ryan P. , Feldman Zachary , Goudot Guillaume , Sumetsky Natalie , Jessula Samuel , Kirshkaln Amanda , Bellomo Tiffany , Chang David , Cardenas Jessica , Patell Rushad , Eagleton Matthew , Dua Anahita 
Published: December 2022

Background
Peripheral artery disease is endemic in our globally aging population, with >200 million affected worldwide. Graft/stent thrombosis after revascularization is common and frequently results in amputation, major adverse cardiovascular events, and cardiovascular mortality. Optimizing medications to decrease thrombosis is of paramount importance; however, limited guidance exists on how to use and monitor antithrombotic therapy in this heterogeneous population. Thromboelastography with platelet mapping (TEG‐PM) provides comprehensive coagulation metrics and may be integral to the next stage of patient‐centered thrombophrophylaxis. This prospective study aimed to determine if TEG‐PM could predict subacute graft/stent thrombosis following lower extremity revascularization, and if objective cut point values could be established to identify those high‐risk patients.

Methods and Results

We conducted a single‐center prospective observational study of patients undergoing lower extremity revascularization. Patients were followed up for the composite end point postoperative graft/stent thrombosis at 1 year. TEG‐PM analysis of the time point before thrombosis in the event group was compared with the last postoperative visit in the nonevent group. Cox proportional hazards analysis examined the association of TEG‐PM metrics to thrombosis. Cut point analysis explored the predictive capacity of TEG‐PM metrics for those at high risk. A total of 162 patients were analyzed, of whom 30 (18.5%) experienced graft/stent thrombosis. Patients with thrombosis had significantly greater platelet aggregation (79.7±15.7 versus 58.5±26.4) and lower platelet inhibition (20.7±15.6% versus 41.1±26.6%) (all
P
<0.01). Cox proportional hazards analysis revealed that for every 1% increase in platelet aggregation, the hazard of experiencing an event during the study period increased by 5% (hazard ratio, 1.05 [95% CI, 1.02–1.07];
P
<0.01). An optimal cut point of >70.8% platelet aggregation and/or <29.2% platelet inhibition identifies those at high risk of thrombosis with 87% sensitivity and 70% to 71% specificity.

Conclusions
Among patients undergoing lower extremity revascularization, increased platelet reactivity was predictive of subacute postoperative graft/stent thrombosis. On the basis of the cut points of >70.8% platelet aggregation and <29.2% platelet inhibition, consideration of an alternative or augmented antithrombotic regimen for high‐risk patients may decrease the risk of postoperative thrombotic events.
Drivers of an Ecologically Relevant Summer North American Dipole
Authors: Bai Husile , Strong Courtenay , Zuckerberg Benjamin 
Published: December 2022

Abstract
The teleconnection mechanisms associated with midlatitude climate dipoles are of high interest because of their potential broad impacts on ecological patterns and processes. A prominent example attracting increasing research interest is a summer (June–August) North American dipole (NAD), which drives continental-scale bird irruptions in the boreal forest (semiperiodic movements of large numbers of individual birds). Here, the NAD is objectively defined as a second principal component of 500-hPa geopotential height and is linked to two mechanisms: 1) Rossby waves associated with Madden–Julian oscillation (MJO) convection and 2) a pan-Pacific stationary Rossby wave triggered by East Asian monsoonal convection. The MJO mechanism relates to anomalously frequent occurrence of MJO phase 1 or 6, which are captured by the leading principal component of daily summer MJO phases (PCM1; accounting for 46% of the phase variance). In “nonuniform” MJO summers, defined as |PCM1| > 0.5, anomalously frequent phase 1 triggers positive NAD, and anomalously frequent phase 6 triggers negative NAD, yielding the correlation r(NAD, PCM1) = 0.55, p < 0.01. During “uniform” MJO summers, defined as |PCM1| ≤ 0.5, the effect of East Asian precipitation anomalies PEA becomes apparent, and r(NAD, PEA) = 0.49, p < 0.01. The impacts of PEA are largely masked during nonuniform MJO summers, meaning this subset of summers lacks a significant correlation between the NAD and PEA. Our interpretation is that uniformly distributed MJO allows monsoonal convection over the midlatitudes to modulate the NAD, whereas tropical convection anomalies associated with anomalously frequent MJO phases 1 and 6 overwhelm the extratropical teleconnection.
Comparing Outcomes of Sub-Total Cholecystectomy Versus Open Cholecystectomy as Bailout Procedures for the Difficult Gallbladder
Authors: Grossman Holly , Holder Katherine G. , Freedle Caroline , Dhanasekara Chathurika S. , Dissanaike Sharmila 
Published: December 2022

Background Although laparoscopic cholecystectomy is one of the most common operations performed, there is no consensus on the best surgical approach when inflammation obscures hepatocystic anatomy in severe cholecystitis. Traditionally, this situation triggered conversion to open cholecystectomy (COC); however, in recent decades, alternative approaches have been described. We compared outcomes of bailout procedures for severe cholecystitis, primarily focusing on COC versus laparoscopic subtotal cholecystectomy (LSTC). Study Design Retrospective review comparing outcomes of intended laparoscopic cholecystectomy cases that were converted to bailout procedures between 2015–2020 at a single institution. Bailout procedures were categorized into LSTC and COC groups. Demographics, clinical presentation, time to surgery, operative indications, operative duration, and post-operative outcomes were compared using independent sample t-tests with Welch-Satterthwaite correction or Wilcoxon rank-sum tests (continuous variables) or Fisher’s exact/χ2 tests. A P-value of less than .05 was considered significant. Results Final analysis included 158 subjects: 55 LSTC and 99 COC. Patient demographics and clinical presentations were similar between groups. LSTC had shorter operative time, fewer ICU admissions, and shorter length of stay than COC ( P < .05). There were 9 (9.2%) cases of ileus, 4 (4.0%) cases of post-operative bleeding, and 2 (2.0%) cases of bile duct injury in COC. There was 1 (1.8%) case of ileus, 1 (1.8%) case of post-operative bleeding, and no bile duct injury in LSTC. Conclusion LSTC was associated with fewer complications than COC, which had higher rates of biliary injury, bleeding, ileus, ICU admission, and longer hospital stay.