bluuebunny/crossref_metadata_2025_split huggingface dataset:
Non-communicable disease burden among inpatients at a rural district hospital in Malawi
Authors: Olds Peter , Kachimanga Chiyembekezo , Talama George , Mailosi Bright , Ndarama Enoch , Totten Jodie , Musinguzi Nicholas , Hangiwa Dickson , Bukhman Gene , Wroe Emily B. 
Published: February 2023

Abstract
Background
The burden of non-communicable diseases (NCDs) is high in Malawi. However, resources and training for NCD care remain scarce, especially in rural hospitals. Current care for NCDs in the developing world focuses on the WHO’s traditional 4 × 4 set. However, we do not know the full burden of NCDs outside of that scope, like neurological disease, psychiatric illness, sickle cell disease, and trauma. The goal of this study was to understand the burden of NCDs among inpatients in a rural district hospital in Malawi. We broadened our definition of NCDs beyond the traditional 4 × 4 set of NCDs, and included neurological disease, psychiatric illness, sickle cell disease, and trauma.

Methods
We conducted a retrospective chart review of all inpatients who were admitted to the Neno District Hospital between January 2017 and October 2018. We broke patients down by age, date of admission, type, and number of NCD diagnoses, and HIV status, and constructed multivariate regression models for length of stay and in-hospital mortality.

Results
Of 2239 total visits, 27.5% were patients with NCDs. Patients with NCDs were older (37.6 vs 19.7 years, p < 0.001) and made up 40.2% of total hospital time. We also found two distinct populations of NCD patients. The first were patients 40 years and older with primary diagnoses of hypertension, heart failure, cancer, and stroke. The second were patients under 40 years old with primary diagnoses of mental health conditions, burns, epilepsy, and asthma. We also found significant trauma burden, accounting for 40% of all NCD visits. In multivariate analysis, carrying a medical NCD diagnosis was associated with longer length of stay (coefficient 5.2, p < 0.001) and a higher risk of in-hospital mortality (OR 1.9, p = 0.03). Burn patients also had significantly longer length of stay (coefficient 11.6, p < 0.001).

Conclusions
There is a significant burden of NCDs in a rural hospital in Malawi, including those outside of the traditional 4 × 4 set. We also found high rates of NCDs in the younger population (under 40 years of age). Hospitals must be equipped with adequate resources and training to meet this burden of disease.
Combined ambient ionization mass spectrometric and chemometric approach for the differentiation of hemp and marijuana varieties of Cannabis sativa
Authors: Chambers Megan I. , Beyramysoltan Samira , Garosi Benedetta , Musah Rabi A. 
Published: February 2023

Abstract
Background
Hemp and marijuana are the two major varieties of Cannabis sativa. While both contain Δ9-tetrahydrocannabinol (THC), the primary psychoactive component of C. sativa, they differ in the amount of THC that they contain. Presently, U.S. federal laws stipulate that C. sativa containing greater than 0.3% THC is classified as marijuana, while plant material that contains less than or equal to 0.3% THC is hemp. Current methods to determine THC content are chromatography-based, which requires extensive sample preparation to render the materials into extracts suitable for sample injection, for complete separation and differentiation of THC from all other analytes present. This can create problems for forensic laboratories due to the increased workload associated with the need to analyze and quantify THC in all C. sativa materials.

Method
The work presented herein combines direct analysis in real time—high-resolution mass spectrometry (DART-HRMS) and advanced chemometrics to differentiate hemp and marijuana plant materials. Samples were obtained from several sources (e.g., commercial vendors, DEA-registered suppliers, and the recreational Cannabis market). DART-HRMS enabled the interrogation of plant materials with no sample pretreatment. Advanced multivariate data analysis approaches, including random forest and principal component analysis (PCA), were used to optimally differentiate these two varieties with a high level of accuracy.

Results
When PCA was applied to the hemp and marijuana data, distinct clustering that enabled their differentiation was observed. Furthermore, within the marijuana class, subclusters between recreational and DEA-supplied marijuana samples were observed. A separate investigation using the silhouette width index to determine the optimal number of clusters for the marijuana and hemp data revealed this number to be two. Internal validation of the model using random forest demonstrated an accuracy of 98%, while external validation samples were classified with 100% accuracy.

Discussion
The results show that the developed approach would significantly aid in the analysis and differentiation of C. sativa plant materials prior to launching painstaking confirmatory testing using chromatography. However, to maintain and/or enhance the accuracy of the prediction model and keep it from becoming outdated, it will be necessary to continue to expand it to include mass spectral data representative of emerging hemp and marijuana strains/cultivars.
Interventional therapy of acute coronary syndromes in very old patient population and results of 2 years follow-up
Authors: Boyraz Bedrettin , Peker Tezcan , Akgümüş Alkame , Balun Ahmet 
Published: February 2023

Abstract
Background
Research on cardiovascular treatment options and prognosis in very old age groups of patients is warranted. In our study, we evaluated and followed up on clinical conditions on admission and comorbidities of patients older than 80 years who were admitted to our hospital with acute myocardial infarction and shared our findings.

Results
A total of 144 patients were included in the study, with a mean age of 84.56 ± 5.01 years. No complications resulting in death or requiring surgery were observed in the patients. All-cause mortality was found to be related to heart failure, chronic pulmonary disease shock, and C-reactive protein levels. Cardiovascular mortality was correlated to heart failure, shock on admission, and C-reactive protein levels. No significant difference in mortality was observed between Non-ST elevated myocardial infarction and ST-elevation myocardial infarction.

Conclusions
Percutaneous coronary intervention is a safe treatment option with low complication and mortality rates in very old patients with acute coronary syndromes.
Generation of a mountain-valley wind in an atmospheric boundary wind tunnel: a gust-wind generator study
Authors: Zou Simin , He Xuhui 
Published: February 2023

AbstractAppropriate modeling of an experimental technology is necessary in order to estimate the aerodynamic characteristic of railway trains and infrastructure (e.g., bridges). Simulation of the earth’s wind characteristics of nature is a well-established practice by using an atmospheric boundary wind tunnel. However, in the mountainous area, the wind characteristics are strikingly different from those of the plain area, the amplitude variation of wind is related to complex terrain. Compared with atmospheric boundary layer winds, which are customarily treated as stationary, winds associated with gust winds originating from mountain areas exhibit rapid changes during a short period. A lack of available field test data and testing techniques has hindered such knowledge of the effect of mountain wind on railway-related applications. To simulate the characteristics of gust winds and prepare for follow-up studies of the impact on the railway-related structures, a gust wind generator was developed in an atmospheric boundary wind tunnel — the CSU wind tunnel. Further, the performance of the gust-wind generator was studied and analyzed under the condition of the combined operation between a gust-wind generator and a wind tunnel.
Diagnostic accuracy for a plasma SARS-CoV-2 Nucleocapsid Protein method
Authors: Kristiansen Søren , Schmidt Laura Emilie , Hillig Ann-Britt Nygaard , Nielsen Thyge Lynghøj , Pedersen Thomas Ingemann , Kirkby Nikolai Søren , Schiøler Thomas , Hillig Thore 
Published: February 2023

Background: The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) releases nucleocapsid proteins (NP) into the blood circulation in infected patients. We investigated whether plasma NP analysis could be used for diagnosing an infection and used for nosocomial screening. Methods: We collected blood samples from patients admitted to the hospital during a period with reverse transcription polymerase chain reaction (RT-PCR) based-screening of patients for SARS-CoV-2. Retrospectively the SARS-CoV-2 NP plasma concentrations were measured with an enzyme-linked immunosorbent assay (ELISA) method and used for an initial time course study to find the optimal time-point for sampling blood. Next, we estimated the diagnostic accuracy i.e. the clinical sensitivity and specificity at different plasma NP cut-off concentrations. Results: The time course study revealed profiles with rapid or more slow declines in NP titers after the RT-PCR result. Nevertheless, in the time interval 0 – 7 days after the RT-PCR result, the NP concentration was always above the level of detection at 1.66 pg/ml suggesting that the diagnosis could be established in the time interval of 0 - 7 days. The median time gap between the plasma NP and RT-PCR results was 0.0 days (n = 1957, interval: -26 to + 21 days). Reducing the time gap to seven days, the clinical sensitivity was 90.0% (n= 60, 95% CI, 82.4% to 97.6%) at a specificity of 95.9% (n=1876, 95% CI, 95.0% to 96.8%). Curve analysis by receiver operation characteristics identified a cut-off concentration of 1.87 pg/mL NP as optimal resulting in a positive predictive value of 41.2%, a negative predictive value of 99.7% and a prevalence of 3.1%. Conclusions: In conclusion, the NP method is acceptable for making the laboratory diagnosis of SARS-CoV-2, and an intended use of plasma NP as a prospective nosocomial screening method is considered feasible.
Uptake of same-day initiation of HIV treatment among adult men and women in Malawi, South Africa, and Zambia: the SPRINT retrospective cohort study
Authors: Huber Amy , Hirasen Kamban , Brennan Alana T. , Phiri Bevis , Tcherini Timothy , Mulenga Lloyd , Haimbe Prudence , Shakwelele Hilda , Nyirenda Rose , Wilson Matola Bilaal , Gunda Andrews , Rosen Sydney 
Published: February 2023

Background: Since 2017 global guidelines have recommended “same-day initiation” (SDI) of antiretroviral treatment (ART) for patients considered ready for treatment on the day of HIV diagnosis. Many countries have incorporated a SDI option into national guidelines, but SDI uptake is not well documented. We estimated average time to ART initiation at 12 public healthcare facilities in Malawi, five in South Africa, and 12 in Zambia. Methods: We sequentially enrolled patients eligible to start ART between January 2018 and June 2019 and reviewed their medical records from the point of HIV diagnosis or first HIV-related interaction with the clinic to the earlier date of treatment initiation or 6 months. We estimated the proportion of patients initiating ART on the same day or within 7, 14, 30, or 180 days of baseline. Results: We enrolled 826 patients in Malawi, 534 in South Africa, and 1,984 in Zambia. Overall, 88% of patients in Malawi, 57% in South Africa, and 91% in Zambia were offered and accepted SDI. In Malawi, most who did not receive SDI had not initiated ART ≤6 months. In South Africa, an additional 13% initiated ≤1 week, but 21% had no record of initiation ≤6 months. Among those who did initiate within 6 months in Zambia, most started ≤1 week. There were no major differences by sex. WHO Stage III/IV and tuberculosis symptoms were associated with delays in ART initiation. Conclusions: As of 2020, SDI of ART was widespread, if not nearly universal, in Malawi and Zambia but considerably less common in South Africa. Limitations of the study include pre-COVID-19 data that do not reflect pandemic adaptations and potentially missing data for Zambia. South Africa may be able to increase overall ART coverage by reducing numbers of patients who do not initiate ≤6 months. Registration: Clinicaltrials.gov (NCT04468399; NCT04170374; NCT04470011).
Gliflozins and their beneficial hypoglycaemic effect profile and prevention of cardiovascular complications in patients treated for type II diabetes mellitus
Authors: Sobańska Natalia , Teichman Rafał , Banasiak Aleksandra Paulina , Kasprowicz Jakub , Pierzchała Jakub Rafał , Hyjek Michał , Abram Kamila , Banaś Patryk , Bednarz Katarzyna , Adamus Justyna 
Published: February 2023

Introduction: Diabetes mellitus type 2 (DM2) is a population disease, it is predicted that by 2030 the DM2 will affect 7% of the population. Patients due to progress of the disease in case of micro and macro angiovascular changes develop organ complications mainly in terms of cardiovascular disease (CV). Sodium-glucose cotransporter 2 (SGLT2) inhibitors are relatively new group of drugs that apart from the hypoglycemic effect, also have other beneficial effects. Due to the scale and importance of the problem of diabetes complications researchers from around the world are working on its solution.

Aim of the study: The aim of this study was to present the effects of SGLT2 inhibitors on cardiovascular complications in DM2 patients.

Methods and materials
We reviewed the literature contained in the PubMed database, using keywords: „Diabetes type 2”; „SGLT2 inhibitors”; „Cardiovascular disease”; „Heart failure”

Results: In addition to their hypoglycaemic effects, SGLT2 inhibitors have also been shown to have beneficial effects on the CV system. Studies have shown that in DM2 patients treated with gliflozins, the risk of hospitalisation for heart failure decreased by 35% and the risk of death from cardiovascular causes by 38%. Retrospective studies have been carried out in which the efficacy of all drugs in the group in question, and not just individual substances, has been proven. In clinical experiments, phlazines were confirmed to reduce the risk of CV complications, including heart failure, myocardial infarction, angina, stroke or atrial fibrillation.

Conclusions: SGLT2 drugs reduce the risk of cardiovascular complications and reduce hospitalisations for heart failure in patients with DM2. Future studies should seek to determine at what stage treatment should be implemented to maximise the resulting benefits to the patient.
The Potential of Halal Anti-Foam Production from Vegetable Oil Derivatives: a Review
Authors: Srijanto Bambang , Gunawan Setiyo , Supriono Bambang , Zuhdan Muhammad J. 
Published: February 2023

The foam that occurs in the process can cause problems with the effectiveness of the process or the quality of the final product. The economic consequences of uncontrolled foaming can be very significant and cause serious losses and require expensive operating changes. Foaming problems can be just as expensive as treating other types of problems, such as corrosion, fouling, or emulsion. Indonesia is known as the largest producer of palm oil, so it has the potential as a producer of downstream palm oil derivative products, especially halal anti-foam with renewable raw materials. In the food industry, only calcium alginate, monoglycerides (MGS), and diglycerides (DGS) are permitted. The use of renewable raw materials in industrial processes is one of the steps to realizing the Sustainable Development Goals, especially the second goal, which is zero hunger in 2030. The details of the mechanism of action and the use of anti-foam in the food, medicine, cosmetics, textile, oil refining, petrochemical, paint, and pulp paper industries were discussed. Furthermore, the potential use of palm oil as raw material for halal anti-foaming is very prospective, considering that there are not many palm oil-based anti-foam products applied in various food industries.
Parents' perception of toddlers' nutritional state
Authors: Marinho Catarina , Koch Cândida , Santos Margarida Reis 
Published: February 2023

Background:Parents' perception of children's body image may assume an important role in children's development.Aims:to assess parental perception on toddlers' nutritional status.Methods:Study conducted with toddlers' parents who attended nurseries in the district of Viseu, Portugal. Data collection instruments: a survey which included questions for social and demographic characterisation and the ‘Toddler Silhouette Scale’.Findings:Most parents have considered that the children's silhouette, ideal (98.4%) and real (95.8%), corresponded to the one regarding normal weight. 21.1% of the children seen by the parents as having a normal weight, had in fact excess weight, 9% suffered from obesity and 0.5% were underweight.Conclusions:The results suggest the existence of an inaccurate parental perception about their children's weight, reinforcing the importance of nurses who inform parents about their children's nutritional status and guide them to adopt healthy lifestyles.
The lived experiences of discomfort in women with Crohn's disease: a hermeneutic phenomenological study
Authors: Nistor Oana-Irina , Wilson Rosemary , Tripp Dean , Camargo-Plazas Pilar 
Published: February 2023

Background: Discomfort in women with Crohn's disease is highly prevalent, even during remission. However, these women's lived experiences of discomfort are largely unknown. Aims: To explore the lived experiences of discomfort in women with Crohn's disease. Methods: Six women with Crohn's disease were recruited using purposive and snowball sampling. Semi-structured, audio-recorded interviews were conducted using Zoom and transcribed verbatim for analysis. van Manen's work guided the data analysis. Findings: Four phenomenological themes were identified: discomfort as an embodied experience, discomfort as a conscious experience, discomfort and social life, and discomfort as a way forward. Conclusion: Healthcare professionals and researchers can facilitate the recognition, impact and mitigating strategies of discomfort by acknowledging it as an essential phenomenon for women with Crohn's disease. Further research is recommended to understand better the experience of discomfort and its implications for women's quality of life and their social and therapeutic relationships.
Methotrexate-Induced Apoptotic Colopathy in Crohn's Disease
Authors: Chittajallu Vibhu , Liu Wendy , Nguyen Vu 
Published: February 2023

ABSTRACT
Apoptotic colopathy is a pattern of injury not frequently associated with Crohn's disease (CD) despite its association with medications used in CD management. We describe a patient with CD on methotrexate who underwent a diagnostic colonoscopy for abdominal pain and diarrhea, with biopsies demonstrating apoptotic colopathy. After methotrexate discontinuation, repeat colonoscopy demonstrated resolution of apoptotic colopathy in addition to diarrhea improvement.
Koniec z Françafrique? Polityka Emmanuela Macrona wobec państw afrykańskich
Authors: Ciesielska-Klikowska Joanna , Mądry Bartosz 
Published: February 2023

Francja przez stulecia była obecna na kontynencie afrykańskim, gdzie za sprawą polityki kolonialnej budowała swoje imperium. W czasie rządów kolonialnych Afryka postrzegana była przez Francję bardziej jako przedmiot niż podmiot polityki zagranicznej. Ogromną zmianę przyniosły wydarzenia połowy XX w., który okazał się czasem powstania współczesnych, niepodległych państw afrykańskich. Zachodzące wówczas procesy polityczne na świecie wymusiły na, najpierw IV, a następnie V Republice zmianę percepcji dawnych posiadłości, tworząc układ z założenia partnerski, choć niedoskonały. Dzisiaj, za sprawą największych wpływów spośród państw Unii Europejskiej w Afryce, Francję uznać można za nieformalnego przedstawiciela UE na tym kontynencie i łącznika we wzajemnych stosunkach. Stąd pozycja Paryża ma dla pozostałych państw Europy istotne znaczenie. Dekolonizacja otworzyła jednak drzwi dla nowych, pozaunijnych graczy w tym regionie, w tym Rosji.
Celem artykułu jest próba dokonania bilansu dotychczasowego okresu prezydentury Emmanuela Macrona w kontekście jego polityki wobec Afryki. W pracy skupiono się na analizie dokonań francuskiego przywódcy w odniesieniu do kreowania politycznych, społecznych i militarnych stosunków w regionie Afryki Subsaharyjskiej (operacja „Serval” i „Barkhane”). Ze względu na aktualne wydarzenia w Ukrainie zaprezentowano ponadto problem rywalizacji o wpływy w Afryce między Francją i Rosją.
Cerebral blood flow pulsatility and cerebral artery stiffness acutely decrease during hemodialysis
Authors: Paré Mathilde , Obeid Hasan , Labrecque Lawrence , Drapeau Audrey , Brassard Patrice , Agharazii Mohsen 
Published: February 2023

AbstractEnd‐stage kidney disease (ESKD) is associated with increased arterial stiffness and cognitive impairment. Cognitive decline is accelerated in ESKD patients on hemodialysis and may result from repeatedly inappropriate cerebral blood flow (CBF). The aim of this study was to examine the acute effect of hemodialysis on pulsatile components of CBF and their relation to acute changes in arterial stiffness. In eight participants (age: 63 ± 18 years, men: 5), CBF was estimated using middle cerebral artery blood velocity (MCAv) assessed with transcranial Doppler ultrasound before, during, and after a single hemodialysis session. Brachial and central blood pressure, along with estimated aortic stiffness (eAoPWV) were measured using an oscillometric device. Arterial stiffness from heart to MCA was measured as the pulse arrival time (PAT) between electrocardiogram (ECG) and transcranial Doppler ultrasound waveforms (cerebral PAT). During hemodialysis, there was a significant reduction in mean MCAv (−3.2 cm/s, p < 0.001), and systolic MCAv (−13.0 cm/s, p < 0.001). While baseline eAoPWV (9.25 ± 0.80 m/s) did not significantly change during hemodialysis, cerebral PAT increased significantly (+0.027 , p < 0.001) and was associated with reduced pulsatile components of MCAv. This study shows that hemodialysis acutely reduces stiffness of arteries perfusing the brain along with pulsatile components of blood velocity.
The influence of exercise volume and posture on exercise‐induced plasma volume expansion
Authors: Nelson W. Bradley , Walker James M. , Hansen Crystelle , Foote Kristopher M. , Bexfield Nathan A. , Mack Gary W. 
Published: February 2023

AbstractAcute high‐intensity interval exercise is known to expand plasma volume 24 h after exercise. Upright exercise posture plays a role in expanding plasma volume by influencing lymphatic outflow and redistributing albumin while supine exercise does not. We examined if further upright and weight‐bearing exercises could further promote plasma volume expansion. We also tested the volume of intervals needed to induce plasma volume expansion. To test the first hypothesis, 10 subjects performed intermittent high‐intensity exercise (4 min at 85% V̇O2max, 5 min at 40% V̇O2max repeated 8 times) on separate days on the treadmill and cycle ergometer. For the second study, 10 subjects performed four, six, and eight intervals of the same interval protocol on separate days. Changes in plasma volume were calculated from changes in hematocrit and hemoglobin. Transthoracic impedance (Z0) and plasma albumin were assessed while seated before and postexercise. Plasma volume increased 7.3% ± 4.4% and 6.3% ± 3.5% following treadmill and cycle ergometer exercise, respectively. For four, six, and eight intervals, plasma volume increased by 6.6% ± 4.0%, 4.7% ± 2.6%, and 4.2% ± 5.6%, respectively. The increases in plasma volume were similar for both exercise modes and all three exercise volumes. There were no differences in Z0 or plasma albumin content between trials. In conclusion, rapid plasma volume expansion following eight bouts of high‐intensity intervals appears to be independent of upright exercise posture (treadmill versus cycle ergometer). Meanwhile, plasma volume expansion was similar after four, six, and eight intervals of cycle ergometry.