bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends and inequalities in children aged 6–59 months who received Vitamin A supplementation: evidence from the 2003, 2008 and 2014 Ghana Demographic and Health Survey
Authors: Okyere Joshua , Azure Simon Agongo , Budu Eugene , Mensah Felix , Ahinkorah Bright Opoku , Ameyaw Edward Kwabena , Seidu Abdul-Aziz 
Published: December 2022

Abstract
Background
Vitamin A deficiency is considered a public health issue, particularly among children under 5 years. Vitamin A supplementation is among the ten key essential nutrition actions put in place to tackle malnutrition in children and helps to reduce under-five mortality by almost a quarter in Vitamin A deficient areas. We, therefore, examined inequalities in Vitamin A uptake among children 6–59 months in Ghana.

Methods
We used data from the 2003, 2008, and 2014 Ghana Demographic and Health Surveys. The WHO’s HEAT version 3.1 software was used for all the analyses. We adopted six equity stratifiers (maternal age, economic status, level of education, place of residence, sex of the child, and region) to disaggregate Vitamin A supplementation among children 6–59 months. Four measures were used to compute inequality, namely, Difference (D), Population Attributable Risk (PAR), Population Attributable Fraction (PAF) and Ratio (R).

Results
Over the 11-year period, the proportion of children who received Vitamin A supplementation declined from 78.6% to 65.2%. There were inequalities by maternal age, particularly in 2003 (D = 13.1, CI: 2.3, 23.9; PAF = 0.5, CI: − 12.3, 13.2). The widest inequality in Vitamin A supplementation by economic status was noted in 2003 (D = 8.8, CI: 3.3–14.2; PAF = 8.3, CI: 5, 11.5). In terms of sex, the indices revealed mild inequality in Vitamin A supplementation throughout the period studied. For education, the highest inequality was observed in 2014 (D = 11.6, CI: 6.0, 17.1), while the highest inequality in terms of place of residence was observed in 2003 (D = 4.0, CI: − 0.1–8.4). In the case of region, substantial inequality was noted in 2014 (D = 34.7, CI: 22.6, 46.8; PAF = 21.1, CI: 15.3, 27).

Conclusions
We conclude that there is a need for the government of Ghana to deploy targeted interventions to enhance the uptake of Vitamin A supplementation among the most disadvantaged subpopulations. Interventions targeted at these disadvantaged populations should be pro-poor in nature. In addition, the inequalities in the dimension of place of residence were mixed, favoring both rural and urban children at different points. This calls for a comprehensive and all-inclusive approach that enhances Vitamin A supplementation uptake in an equitable manner in both areas of residence. Empowerment of women through formal education could be an important step toward improving Vitamin A supplementation among children in Ghana.
Associations between paraclinical parameters, symptoms and quality of life in patients with acromegaly: a cross sectional study
Authors: Gliga Maximilian Cosma , Reti Zsuzsanna , Gliga Camelia , Pascanu Ionela Maria 
Published: December 2022

Abstract
Introduction
Acromegaly is a rare chronic endocrine disorder that can lead to significant quality of life (QoL) impairment and persistent symptomatology in both biochemically uncontrolled as well as in cured or controlled patients. We aimed to conduct an observational cross-sectional study investigating the associations between biochemical disease control, associated comorbidities, and symptoms severity on QoL in a cohort of acromegalic patients.

Methods
Thirty-one patients with acromegaly were enrolled in our study. AcroQoL and PASQ (Pain assessed acromegaly symptoms questionnaire) questionnaires were applied to all patients. Information about disease status, associated comorbidities, and other relevant clinical and paraclinical data were gathered.

Results
Patients with uncontrolled acromegaly presented worse QoL and symptoms scores than controlled patients, but the difference was not statistically significant (AcroQoL 57.22 vs 64.04, p > 0.05; PASQ 12 vs 16.47, p > 0.05). Worse symptoms were significantly associated with impaired QoL (overall symptoms score on PASQ was negatively correlated with AcroQoL total score, r = − 0.61, p < 0.05). Cardiovascular complications were associated with lower QoL scores, but not with worse symptoms (AcroQoL total score in patients with- versus patients without cardiovascular complications: 54.89 vs 70.14, p < 0.05).

Conclusions
Achieving biochemical control of acromegaly might not be enough to reverse the QoL impairment and improve symptomatology in acromegalic patients. While symptoms severity and the presence of cardiovascular complications seem to play an important role in reducing patients QoL, the roles of disease control, diabetes, and pituitary insufficiency are less clear.
Volumetric parameters of the primary tumor and whole-body tumor burden derived from baseline 18F-FDG PET/CT can predict overall survival in non-small cell lung cancer patients: initial results from a single institution
Authors: Mahmoud Hemat A. , Oteify Walaa , Elkhayat Hussein , Zaher Ahmed M. , Mohran Taha Zaki , Mekkawy Nesreen 
Published: December 2022

Abstract
Background
Metabolic tumor volume (MTV) and total lesion glycolysis (TLG) are volumetric parameters derived from 18F-FDG PET/CT, suggested to have a prognostic value in cancer patients. Our study aimed to test whether these volumetric parameters of the primary tumor and whole-body tumor burden (WBTB) can predict overall survival (OS) in non-small cell lung cancer (NSCLC) patients.

Materials and methods
Thirty biopsy-proven NSCLC patients who had not begun anti-tumor therapy were included in this prospective study. A baseline 18F-FDG PET/CT study was acquired. Scans were interpreted visually and semi-quantitatively by drawing a 3D volume of interest (VOI) over the primary tumor and all positive lesions to calculate metabolic, volumetric parameters, and WBTB. The PET parameters were used to stratify patients into high- and low-risk categories. The overall survival was estimated from the date of scanning until the date of death or last follow-up.

Results
At a median follow-up of 22.73 months, the mean OS was shorter among patients with higher tu MTV and tu TLG and high WBTB. High WB TLG was independently associated with the risk of death (p < 0.025). Other parameters, e.g., SUVmax, SUVpeak, and SUVmean, were not predictive of outcomes in these patients. Conclusion: In patients with NSCLC, tu MTV, tu TLG, and WBTB determined on initial staging 18F-FDG PET/CT seems to be a strong, independent imaging biomarker to predict OS, superior to the clinical assessment of the primary tumor. The WB TLG was found to be the best predictor of OS.
Long-term effects of percutaneous coronary intervention versus coronary artery surgery in elderly with multi-vessel coronary artery disease
Authors: Kamal Amr , Kandil Abdel Megeid , Sadaka Mohamed , Ramadan Basem 
Published: December 2022

Abstract
Background
The most prevalent illness among the elderly is coronary artery disease (CAD), and most of this population present with multi-vessel CAD which constitutes a common management difficulty among elderly people. This study aimed to compare long-term consequences of percutaneous coronary intervention (PCI) versus coronary artery bypass graft (CABG) revascularization in elderly patients with multi-vessel coronary artery disease.

Results
This retrospective study evaluated 100 elderly patients with multi-vessel CAD divided into two groups, group 1 the PCI group and group 2 the CABG group. The main findings of the study showed that CABG group had a longer hospital stay than the PCI group (8.16 vs. 2.02 days; P < 0.001). A considerably higher mean residual SYNTAX score was observed in the PCI group than CABG group which was 1.15 and 0.2, respectively (p-value < 0.001). The in-hospital major adverse cardiac events rate (MACE) in both groups was not statistically significant. Regarding the in-hospital mortality rate, although it was higher in the CABG group (6%) versus 2% in the PCI group, yet it was not statistically significant. The long-term MACE in this study revealed that 12.2% of PCI patients had heart failure compared to 6.4% in the CABG group, which was statistically insignificant. In the long-term follow-up, the revascularization rate of CABG group was higher than the PCI group; however, it was statistically insignificant. CABG group had a higher rate of stroke than PCI group being 4.3% and 2%, respectively; yet this difference was not statistically considerable. The long-term mortality rate among the PCI and CABG group was 10.2% and 4.3%, respectively.

Conclusions
Elderly patients with multi-vessel CAD, PCI with stenting, and CABG were statistically equivalent in long-term death and MI rates, stroke, repeat revascularization. A non-statistically notable distinction between the two groups as regards MACE, composite of death or MI, and all-cause mortality was found. This may have implication on choice of management strategy among elderly patients with multi-vessel CAD.
Psychiatric symptoms in patients with non-valvular atrial fibrillation
Authors: Yossef Manar , Amer Reham , Elsokkary Hatem , Shama Gamal 
Published: December 2022

AbstractBackgroundAtrial fibrillation (AF) is one of the leading causes of hospitalization and even death worldwide. Complex bidirectional associations have been suggested between psychiatric disorders and AF disease. This study was conducted to investigate the prevalence of psychiatric symptoms in a cohort of Egyptian population presented with symptomatic non-valvular AF (NVAF) and to identify the high-risk subjects in need for professional psychiatric consultation. A total of 100 eligible symptomatic NVAF patients were recruited in this cross-sectional study. Each patient was subjected to: (1) cardiac evaluation included electrocardiogram, trans-esophageal echocardiography, and the European Heart Rhythm Association (EHRA). (2) Psychiatric evaluation consisted of clinical psychiatric interviewing, Hospital Anxiety and Depression Scales (HADS), Mini–Mental State Examination (MMSE), type-D personality screening, and the short form-36 (SF-36) health survey for the assessment of health-related quality of life (HRQoL).ResultsForty-four percent of our enrolled AF patients had anxiety symptoms, 32% had depressive symptoms, 24% had mild cognitive impairment, and 32% had type-D personality. Linear regression analysis demonstrated that the left atrial dimension (LAD) and the age were the main significant predictors of MMSE, while the main predictors of HADS were SF-36 (physical functioning and general health) and the age. Neither psychiatric symptoms, nor type-D personality was a significant predictor for the evaluated cardiac parameters.ConclusionsMild cognitive impairment as well as depressive and anxiety symptoms is not uncommon associates with NVAF patients. Assessment of cognitive function and HRQoL is strongly advised for AF patients presented with enlarged LAD particularly among old adults.
Vitamin D receptor polymorphisms and vitamin D insufficiency are not associated with sepsis in critically ill children: a case-control study
Authors: Shaheen Iman , Afifi Rasha , Abulata Nelly , Aboukhalil Reham , Meligy Basant , Algebaly HebatAllah F. , Abd El Dayem Omnia Y. 
Published: December 2022

Abstract
Background
Vitamin D is a fat-soluble vitamin that regulates calcium and phosphorous homeostasis to maintain a healthy mineralized skeleton. It can also influence immune responses and has immunomodulatory properties. Vitamin D receptor (VDR) is a nuclear receptor that mediates the activities of the hormonal form of vitamin D. VDR polymorphisms can alter immunity and susceptibility to infections by modulating VDR expression and vitamin D activity. This study aimed to investigate the levels of serum vitamin D as well as four VDR polymorphisms: FokI, BsmI, ApaI, and TaqI in fifty children admitted to intensive care unit (ICU) with a diagnosis of sepsis and one-hundred age- and sex-matched healthy children.

Methods
Vitamin D levels were measured in serum, in both patients and controls, using an enzyme-linked immunosorbent assay (ELISA) approach. VDR polymorphisms were also studied in both groups using specific restriction enzymes.

Results
Vitamin D levels were low in both patients and controls. Moreover, serum levels were unaffected by VDR polymorphisms, and their distribution was similar in both groups. Neither the need for mechanical ventilation or inotropic treatment nor the sepsis outcome was impacted by serum vitamin D levels or VDR polymorphisms.

Conclusion
In children admitted to pediatric ICU, neither vitamin D levels nor VDR polymorphisms were associated with sepsis. Further larger studies including different types of sepsis are recommended.
Ο σχολικός κήπος εργαλείο εξέλιξης του σχολείου
Authors: Aslanis Antonios , Gounari Georgia , Paschali Irini , Diakomanolis Ioannis 
Published: December 2022

Στη σύγχρονη εποχή, κοινωνικοί παράγοντες, όπως η αριθμητική συρρίκνωση των µελών της οικογένειας και η εξαφάνιση της γειτονικής «αλάνας», περιόρισαν τις εκτός σχολείου δυνατότητες κοινωνικοποίησης των παιδιών (Ματσαγγούρας, 1997). Την ίδια στιγμή η σύγχρονη αγορά εργασίας αναζητά άτομα που έχουν τη δυνατότητα να συνεργάζονται ομαλά µέσα σε δίκτυα επικοινωνίας και να εξελίσσονται συνεχώς. Τα δύο αυτά στοιχεία κατέστησαν επιτακτική την ανάγκη να καλύψει το σχολείο από την μια το έλλειμμα κοινωνικοποίησης και από την άλλη να μάθει στο μαθητή να μαθαίνει µόνος του, αυτόβουλα, κάνοντας χρήση των εσωτερικών του εμπειριών και δυνατοτήτων. Για τον σκοπό αυτό το 5ο Δημοτικό Σχολείο σε συνεργασία με την αστική εταιρεία «Ιπποκράτης» έχοντας ως επίκεντρο τον ελαιώνα και το υπό διαμόρφωση σχολικό κήπο σχεδίασε κι υλοποίησε τρία εκπαιδευτικά προγράμματα (σχολικές δράσεις): «Οι μαθητές σε μαγειρικές περιπέτειες», «Η αυλή των θαυμάτων» και το πρόγραμμα «Εστία».
The intensity of empathy in adolescents treated in a day unit – preliminary reports
Authors: Modrzejewska Renata , Wasik Anna , Cofór-Pinkowska Paulina , Pac Agnieszka , Siwek Marcin 
Published: December 2022

Cel pracyCelem badania pilotażowego było porównanie poziomu empatii wśród młodzieży leczonej w oddziale dziennym psychiatrycznym w grupach zróżnicowanych pod względem wieku, płci i rodzaju zaburzenia (zaburzeń zachowania i emocji oraz depresyjno-lękowych).MetodaBadanie przeprowadzono w grupie 117 adolescentów (69 dziewcząt oraz 48 chłopców) w wieku 13-20 lat leczonych w Oddziale Dziennym Klinicznym Kliniki Psychiatrii Dorosłych, Dzieci i Młodzieży SU w Krakowie w latach 2016-2021. Do badań wykorzystano Skalę Empatii Davisa oraz Skalę Empatii Cohena.WynikiDziewczęta osiągnęły istotnie wyższe wyniki w skalach Empatii Cohena i Davisa oraz w podskali Davisa: Osobistej Przykrości w porównaniu do chłopców. Zaobserwowano istotne statystycznie interakcje dla czynników płci i wieku oraz wieku i rodzaju zaburzenia. Starsi chłopcy w porównaniu do młodszych cechowali się znamiennie statystycznie wyższymi wynikami w skali empatii Davisa, natomiast u dziewcząt zaobserwowano odwrotną prawidłowość, która jednak nie osiągnęła istotności statystycznej. Starsi pacjenci z zaburzeniami zachowania osiągali istotnie niższe wyniki w skali Empatii Cohena w porównaniu do młodszych, w grupie pacjentów z zaburzeniami depresyjno-lękowymi zaobserwowano odwrotną prawidłowość, która jednak nie osiągnęła znamienności statystycznejWnioskiDziewczęta cechuje wyższy poziom empatii afektywnej i poznawczej niż chłopców. Nasilenie empatii zmienia się wraz z wiekiem w grupie chłopców (rośnie), dla dziewcząt otrzymane różnice nie są istotne statystycznie. Nasilenie empatii jest istotnie niższe w grupie starszych nastolatków z zaburzeniami zachowania i emocji w porównaniu do ich młodszych kolegów z tym samym rozpoznaniem. W grupie z zaburzeniami depresyjno-lękowymi odnotowano odwrotną, choć nieistotną prawidłowość. Otrzymane unikalne wyniki wskazują na różną trajektorię rozwoju empatii w grupie pacjentów z zaburzeniami zachowania oraz z zaburzeniami depresyjno-lękowymi.
Efficacy of the therapeutic use of video games on the depressive state of stroke patients: Protocol for systematic review and meta-analysis
Authors: Blázquez-González Patricia , Mirón-González Rubén , Lendínez-Mesa Alejandro , Moro-Tejedor María Nieves , Cobo-Sánchez José Luis , Mancebo-Salas Noelia , Camacho-Arroyo María Teresa , Rodríguez-Leal Leyre , Luengo-González Raquel 
Published: December 2022

Aim
To assess the effects of virtual reality (VR) on the depressive state of patients with stroke admitted to neuro-rehabilitation units. Design: Systematic review and meta-analysis protocol.

Methods
Randomized Controlled Trials (RCTs) focusing on the effects of virtual reality on depressive state as a primary outcome will be included. Grey literature and the following databases will be consulted: PubMed, Cinahl, PsycInfo, Scopus, Embase, Cochrane Library and Web of Science. The recently revised Cochrane risk of bias tool will be used to assess the quality of included studies. Data will be extracted and meta-analyses will be performed within the specific condition of the emotional state of stroke patients admitted to neurorehabilitation units. Meta-regression and subgroup analyses will be used to identify effective modes and patterns of therapy delivery. The approach of assessment, development and evaluation of recommendations will be applied to reach a convincing conclusion.

Discussion
An accurate, transparent and standardized review process is expected to provide recommendations on the use of VR technology in the healthcare of stroke patients.

Impact
Emotional difficulties are common after stroke and have an impact on rehabilitation outcome. VR seems to have an important role in the treatment and depression in neurological patients, as it is able to improve levels of well-being, coping strategies and social relationships. The systematic review may contribute to a more convincing and specific conclusion compared to existing studies of this type.

Trial registration
Systematic review registration: CRD42022303968.
Clinical and economic burden of surgical site infections in inpatient care in Germany: A retrospective, cross-sectional analysis from 79 hospitals
Authors: Eckmann Christian , Kramer Axel , Assadian Ojan , Flessa Steffen , Huebner Claudia , Michnacs Kristian , Muehlendyck Christian , Podolski Kim Mirjam , Wilke Michael , Heinlein Wolfgang , Leaper David John 
Published: December 2022

Background
Surgical site infections (SSI) present a substantial burden to patients and healthcare systems. This study aimed to elucidate the prevalence of SSIs in German hospitals and to quantify their clinical and economic burden based on German hospital reimbursement data (G-DRG).

Methods
This retrospective, cross-sectional study used a 2010–2016 G-DRG dataset to determine the prevalence of SSIs in hospital, using ICD-10-GM codes, after surgical procedures. The captured economic and clinical outcomes were used to quantify and compare resource use, reimbursement and clinical parameters for patients who had or did not have an SSI.

Findings
Of the 4,830,083 patients from 79 hospitals, 221,113 were eligible. The overall SSI prevalence for the study period was 4.9%. After propensity-score matching, procedure type, immunosuppression and BMI ≥30 were found to significantly affect the risk of SSI (p<0.001). Mortality and length of stay (LOS) were significantly higher in patients who had an SSI (mortality: 9.3% compared with 4.5% [p<0.001]; LOS (median [interquartile range, IQR]): 28 [27] days compared with 12 [8] days [p<0.001]). Case costs were significantly higher for the SSI group (median [IQR]) €19,008 [25,162] compared with € 9,040 [7,376] [p<0.001]). A median underfunding of SSI was identified at €1,534 per patient.

Interpretation
The dataset offers robust information about the “real-world” clinical and economic burden of SSI in hospitals in Germany. The significantly increased mortality of patients with SSI, and their underfunding, calls for a maximization of efforts to prevent SSI through the use of evidence-based SSI-reduction care bundles.
Temporal trends in heart failure over 11 years in the aging Korean population: A retrospective study using the national health insurance database
Authors: Cho Dong-Hyuk , Lee Chan Joo , Son Jung-Woo , Choi Jimi , Hwang Jinseub , Yoo Byung-Su 
Published: December 2022

Background
Understanding national trends of heart failure (HF) is crucial for establishing prevention and treatment strategies. We aimed to investigate the 11-year trends of HF in the South Korean population.

Methods
Using the Korean National Health Insurance Service database, we identified 3,446,256 patients with HF between 2004 and 2014.

Results
The prevalence of HF was 1.42% in 2004, steadily increasing to 1.98% in 2014. However, the age-adjusted prevalence of HF remained stable (1.43% in 2014). The incidence of HF was 6.1/1000 person-years in 2004 and remained at similar levels, reaching 5.4/1000 person-years in 2014. The age-adjusted incidence of HF slowly decreased to 3.94/1000 person-years in 2014. The event rate for hospitalized patients with HF remained stable increasing from 1.40 in 2004 to 1.87/1000 person-years in 2014, and the age-adjusted event rate of hospitalized HF decreased to 1.22 in 2014.

Conclusions
In South Korea, between 2004 and 2014, the prevalence of HF increased while the incidence of HF remained stable. Furthermore, the age-adjusted HF prevalence was stable, and the age-adjusted incidence decreased. This indicates that the aging population is the main cause of the increasing national burden associated with HF and that further attention is warranted in the management of HF in older adults.
EDUCAÇÃO, INSTRUÇÃO E ASSISTÊNCIA AOS ÓRFÃOS (RIBEIRA DO SERIDÓ, CAPITANIA DO RIO GRANDE DO NORTE, SÉC. XVIII)
Authors: Macêdo Muirakytan Kennedy de , Araújo Marta Maria de 
Published: December 2022

O trabalho discute a relação entre orfandade e educação nos sertões setecentistas da Ribeira do Seridó. A proposta do texto é de entender os mecanismos sociais compensatórios que amparavam a educação das crianças órfãs na periférica Capitania do Rio Grande do Norte. As práticas assistenciais e os agentes participantes delas são analisados através da noção de processualização, na direção civilizatória dessa educação e no sentido da governamentalidade da Coroa no que tange Ã gestão familiar e populacional. Utilizamos, também, a "categoria nativa" de criação entendida na acepção pedagógica e familiar de ensinar, instruir as crianças nos bons costumes e conforme seu cabedal. Foram investigadas fontes paroquiais (livros de batizados, casamentos e óbitos) e a documentação produzida pelas famílias coloniais daquela Ribeira (inventários e testamentos). Nos sertões coloniais da Ribeira do Seridó, detectamos a trama jurídica e a assistência educacional aos órfãos promovidas, principalmente, pelo agente público do juizado de órfãos e pelo amparo particular da família.
Projeto de extensão "atenção básica ao idoso e seu cuidador": um relato de experiência
Authors: Freitas Joana Elisabeth de Sousa Martins , Pimentel Caroline Coelho , Pereira Joevia Gomes , Nunes Jefferson Torres , Granjeiro Laerte Gonçalves , Granjeiro Lierio Gonçalves , Monteiro Marina Stela de Sousa , Nascimento Marla Mayara da Silva 
Published: December 2022

Este artigo tem o objetivo de relatar a experiência do projeto de extensão universitária: Atenção Básica ao Idoso e seu Cuidador, promovido por estudantes de medicina na Comunidade do Buenos Aires em Teresina-Pi. Descreve algumas ações desenvolvidas pela Medicina integrada Ã Estratégia da Saúde da Família do Centro de Saúde Deputada Francisca Trindade como suporte aos idosos e seus respectivos cuidadores através da interação de uma equipe de saúde interdisciplinar e estudantes de medicina.