bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of blood glucose change and microvascular complications of type 2 diabetes mellitus patients in Felege Hiwot and Debre Markos referral hospital, North West Ethiopia
Authors: Shita Nigusie Gashaye , Isayu Ashagrie Sharew 
Published: May 2022

AbstractBackgroundMicrovascular complications lead to disability, dependency, and accelerated morbidity and mortality. This study aimed to identify predictors of blood glucose change and time to microvascular complications among patients with type 2 diabetes.MethodsA retrospective cohort study was conducted among type 2 diabetes mellitus patients enrolled between December 2014 and December 2015 at Felege Hiwot and Debre Markos Referral Hospital. A total of 318 T2DM patients were included in the study. Joint modelling of longitudinal and survival analysis was employed to identify predictors of Blood Glucose Change and Microvascular Complications in Type 2 Diabetes Mellitus Patients.ResultsThe prevalence of microvascular complications in Type 2 diabetes patients was 26.3%, 95%confidence interval(CI):(21.5, 31.1). Of which, half of the patients developed a microvascular complication after 30 months from the onset of the follow-up. The significant predictors of developing microvascular complication were positive proteinurea (adjusted hazard ratio (AHR) = 1.418, 95%CI: 1.080, 1.861), Serum creatinine (AHR = 3.704, 95%CI: 1.992, 6.887), Weight (AHR = 1.058, 95%CI: 1.023, 1.094), and log fasting blood glucose(log(FBS))(AHR = 1.013, 95%CI: 1.010, 1.015). The predictors of fasting blood glucose progression were higher baseline FBS(est(estimate) = 0.002,95%CI:0.0018, 0.0022), Systolic blood pressure (SBP) (est = 0.003, 95%CI: 0.002, 0.004), diastolic blood pressure (DBP) (est = 0.002, 95%CI: 0.0002, 0.004), and age (est = 0.003, 95%CI: 0.001, 0.004).ConclusionThe progression of the fasting blood glucose level for rural patients was faster than for urban patients. Patients having higher baseline FBS, previous hypertension history, higher SBP, higher DBP, older age, and fewer visits to the hospital have a relatively more progressive change in blood sugar levels. Patients having higher triglyceride levels, positive proteinuria, higher fasting blood sugar, higher weight, and a lesser number of hospital visits have a higher risk of developing a complication. In response to this finding, an aggressive intervention that targets to prevent microvascular complications is required.
Improving care for hypertension and diabetes in india by addition of clinical decision support system and task shifting in the national NCD program: I-TREC model of care
Authors: Jindal Devraj , Sharma Hanspria , Gupta Yashdeep , Ajay Vamadevan S. , Roy Ambuj , Sharma Rakshit , Ali Mumtaj , Jarhyan Prashant , Gupta Priti , Srinivasapura Venkateshmurthy Nikhil , Ali Mohammed K. , Narayan K M Venkat , Prabhakaran Dorairaj , Weber Mary Beth , Mohan Sailesh , Patel Shivani A. , Tandon Nikhil 
Published: May 2022

Abstract
Background
The growing burden of hypertension and diabetes is one of the major public health challenges being faced by the health system in India. Clinical Decision Support Systems (CDSS) that assist with tailoring evidence-based management approaches combined with task-shifting from more specialized to less specialized providers may together enhance the impact of a program. We sought to integrate a technology “CDSS” and a strategy “Task-shifting” within the Government of India’s (GoI) Non-Communicable Diseases (NCD) System under the Comprehensive Primary Health Care (CPHC) initiative to enhance the program’s impact to address the growing burden of hypertension and diabetes in India.

Methods
We developed a model of care “I-TREC” entirely calibrated for implementation within the current health system across all facility types (Primary Health Centre, Community Health Centre, and District Hospital) in a block in Shaheed Bhagat Singh (SBS) Nagar district of Punjab, India. We undertook an academic-community partnership to incorporate the combination of a CDSS with task-shifting into the GoI CPHC-NCD system, a platform that assists healthcare providers to record patient information for routine NCD care. Academic partners developed clinical algorithms, a revised clinic workflow, and provider training modules with iterative collaboration and consultation with government and technology partners to incorporate CDSS within the existing system.

Discussion
The CDSS-enabled GoI CPHC-NCD system provides evidence-based recommendations for hypertension and diabetes; threshold-based prompts to assure referral mechanism across health facilities; integrated patient database, and care coordination through workflow management and dashboard alerts. To enable efficient implementation, modifications were made in the patient workflow and the fulcrum of the use of technology shifted from physician to nurse.

Conclusion
Designed to be applicable nationwide, the I-TREC model of care is being piloted in a block in the state of Punjab, India. Learnings from I-TREC will provide a roadmap to other public health experts to integrate and adapt their interventions at the national level.

Trial registration
CTRI/2020/01/022723.
High level of heterozygous haplotype of hemoglobin in Abidjan population with mild malaria
Authors: Koui Tosséa A. Stéphane , Gnondjui Alloh Albert , Gbessi Adji Eric , Ako Ako Aristide Bérenger , Coulibaly Baba , Aka A. Delpêche , Gonedele Bi Sery E. , Toure Offiana André , Jambou Ronan 
Published: May 2022

Abstract
Background
Sickle cell disease (SCD) is a hemoglobin disorders that concern 300,000 newborns each year around the world. There are hemoglobin haplotypes that affect SCD clinic expression.

Methods
Our goal was to identify the hemoglobin’s haplotypes among individuals with mild malaria independently of SCD status in Côte d’Ivoire. To determine these haplotypes, specific restriction enzyme (RE) is used after PCR amplification with each primer. According to the digestion of PCR product by RE, five hemoglobin’s haplotypes are found in the world.

Results
In Côte d’Ivoire, no study has yet deeply described the distribution of haplotypes. Four different “classical” haplotypes of hemoglobin were detected: Benin (56.5%), Bantou (28.5%), Senegal (4%), Cameroun (1%); and 10% of atypical profiles. Heterozygous haplotype (69%) were more frequent than homozygous haplotype (31%).

Conclusions
In this preliminary study, we note a high prevalence of atypical and heterozygous haplotype. Benin haplotype that is associated with severity of SCD was most predominant in our studied population.
NOX4 blockade suppresses titanium nanoparticle-induced bone destruction via activation of the Nrf2 signaling pathway
Authors: Wang Wei , Liang Xiaolong , Liu Xin , Bai Jiaxiang , Zhang Wei , Li Wenming , Wang Tianhao , Li Meng , Wu Zerui , Chen Liang , Yang Huilin , Gu Ye , Tao Yunxia , Zhou Jun , Wang Huaiyu , Geng Dechun 
Published: May 2022

AbstractPeriprosthetic osteolysis (PPO) triggered by wear particles is the most severe complication of total joint replacement (TJR) surgeries, representing the major cause of implant failure, which is public health concern worldwide. Previous studies have confirmed the specialized role of osteoclast-induced progressive bone destruction in the progression of PPO. Additionally, the reactive oxygen species (ROS) induced by wear particles can promote excessive osteoclastogenesis and bone resorption. Nicotinamide adenine dinucleotide phosphate oxidase 4 (NOX4), a cellular enzyme, is considered to be responsible for the production of ROS and the formation of mature osteoclasts. However, NOX4 involvement in PPO has not yet been elucidated. Therefore, we investigated the mechanism by which NOX4 regulates osteoclast differentiation and the therapeutic effects on titanium nanoparticle-induced bone destruction. We found that NOX4 blockade suppressed osteoclastogenesis and enhanced the scavenging of intracellular ROS. Our rescue experiment revealed that nuclear factor-erythroid 2-related factor 2 (Nrf2) silencing reversed the effects of NOX4 blockade on ROS production and osteoclast differentiation. In addition, we found increased expression levels of NOX4 in PPO tissues, while NOX4 inhibition in vivo exerted protective effects on titanium nanoparticle-induced osteolysis through antiosteoclastic and antioxidant effects. Collectively, these findings suggested that NOX4 blockade suppresses titanium nanoparticle-induced bone destruction via activation of the Nrf2 signaling pathway and that NOX4 blockade may be an attractive therapeutic approach for preventing PPO.
Graphical Abstract
Serum proteome alterations during conventional and extracorporeal resuscitation in pigs
Authors: Bernhard Patrick , Bretthauer Berit Amelie , Brixius Sam Joé , Bügener Hannah , Groh Johannes Elias , Scherer Christian , Damjanovic Domagoj , Haberstroh Jörg , Trummer Georg , Benk Christoph , Beyersdorf Friedhelm , Schilling Oliver , Pooth Jan-Steffen 
Published: May 2022

Abstract
Background
Only a small number of patients survive an out-of-hospital cardiac arrest (CA) and can be discharged from hospital alive with a large percentage of these patients retaining neurological impairments. In recent years, extracorporeal cardiopulmonary resuscitation (ECPR) has emerged as a beneficial strategy to optimize cardiac arrest treatment. However, ECPR is still associated with various complications. To reduce these problems, a profound understanding of the underlying mechanisms is required. This study aims to investigate the effects of CA, conventional cardiopulmonary resuscitation (CPR) and ECPR using a whole-body reperfusion protocol (controlled and automated reperfusion of the whole body—CARL) on the serum proteome profiles in a pig model of refractory CA.

Methods
N = 7 pigs underwent 5 min of untreated CA followed by 30 min CPR and 120 min perfusion with CARL. Blood samples for proteomic analysis were drawn at baseline, after CPR and at the end of the CARL period. Following albumin-depletion, proteomic analysis was performed using liquid chromatography–tandem mass spectrometry.

Results
N = 21 serum samples were measured resulting in the identification and quantification of 308–360 proteins per sample and 388 unique proteins in total. The three serum proteome profiles at the investigated time points clustered individually and segregated almost completely when considering a 90% confidence interval. Differential expression analysis showed significant abundance changes in 27 proteins between baseline and after CPR and in 9 proteins after CARL compared to CPR. Significant findings were further validated through a co-abundance cluster analysis corroborating the observed abundance changes.

Conclusions
The presented data highlight the impact of systemic ischemia and reperfusion on the entire serum proteome during resuscitation with a special focus on changes regarding haemolysis, coagulation, inflammation, and cell-death processes. Generally, the observed changes contribute to post-ischemic complications. Better understanding of the underlying mechanisms during CA and resuscitation may help to limit these complications and improve therapeutic options.
Strategies for utilisation management of hospital services: a systematic review of interventions
Authors: Doshmangir Leila , Khabiri Roghayeh , Jabbari Hossein , Arab-Zozani Morteza , Kakemam Edris , Gordeev Vladimir Sergeevich 
Published: May 2022

Abstract
Background
To achieve efficiency and high quality in health systems, the appropriate use of hospital services is essential. We identified the initiatives intended to manage adult hospital services and reduce unnecessary hospital use among the general adult population.

Methods
We systematically reviewed studies published in English using five databases (PubMed, ProQuest, Scopus, Web of Science, and MEDLINE via Ovid). We only included studies that evaluated interventions aiming to reduce the use of hospital services or emergency department, frequency of hospital admissions, length of hospital stay, or the use of diagnostic tests in a general adult population. Studies reporting no relevant outcomes or focusing on a specific patient population or children were excluded.

Results
In total, 64 articles were included in the systematic review. Nine utilisation management methods were identified: care plan, case management, care coordination, utilisation review, clinical information system, physician profiling, consultation, education, and discharge planning. Primary case management was shown to effectively reduce emergency department use. Care coordination reduced 30-day post-discharge hospital readmission or emergency department visit rates. The pre-admission review program decreased elective admissions. The physician profiling, concurrent review, and discharge planning effectively reduced the length of hospital stay. Twenty three studies that evaluated costs, reported cost savings in the hospitals.

Conclusions
Utilisation management interventions can decrease hospital use by improving the use of community-based health services and improving the quality of care by providing appropriate care at the right time and at the right level of care.
Market survey on the traditional medicine of the Lijiang area in Yunnan Province, China
Authors: Zhang Mingshuo , Li Haitao , Wang Junqi , Tang Maohong , Zhang Xiaobo , Yang Shaohua , Liu Jianqin , Li Ying , Huang Xiulan , Li Zhiyong , Huang Luqi 
Published: May 2022

Abstract
Background
Traditional markets are important trading places for medicinal plants, and researchers performing market surveys often engage in ethnobotanical research to record the herbal plants used locally and any related traditional knowledge. However, information on market-traded medicinal plants from traditional markets in the Lijiang area of Yunnan is not well documented. This research is an ethnobotanical survey focusing on medicinal plants traded in the traditional markets of the Lijiang area and contributes to the understanding of medicinal plants and related information used by the Naxi people.

Methods
Ethnobotanical surveys were performed for two years (2019–2020). Three traditional markets in the Lijiang area were investigated. The methods we used included literature research, participatory surveys and group discussions. The collected voucher specimens were identified using the botanical taxonomy method and were deposited in the herbarium. The data were analysed through the informant consensus factor and use frequency (UF). These medicinal plants were compared with the Information System of Chinese Rare and Endangered Plants from the Chinese Academy of Sciences. Those results were in turn compared with the Dongba Sutras and Yulong Ben Cao.

Results
A total of 277 species from 97 families were recorded, with Asteraceae providing the maximum numbers of medicinal plants. Among them, 248 species (89%) were wild plants and 266 species (92.39%) were from the local area. Root (40.43%) was the most common medicinal part. A total of 267 species (96.04%) had a UF value above 0.5. Eighty-three investigated human ailments were grouped into 16 categories. Diseases of the digestive system (166 mentions) were most frequently mentioned in this study. There were 19 species of nationally protected plants in China, including 2 species of first-level nationally protected plants and 17 species of second-level nationally protected plants. A total of 31 species of these medicinal plants can be found in the Dongba Sutra or Yulong Ben Cao.

Conclusion
We surveyed the herbal medicine in the markets covering the Lijiang area, analysing and revealing the resource composition and current market situations. The medicinal plants used by the Naxi people are diverse and are used to treat a wide spectrum of body disorders. There are many wild medicinal plants, and to ensure sustainable development, their natural protection should be strengthened. Knowledge of the medicinal plants recorded in Naxi medical classics has ethnobotanical value and should be further developed.
Quantitative analysis with load–displacement ratio measured via digital arthrometer in the diagnostic evaluation of chronic ankle instability: a cross-sectional study
Authors: Chen Yungu , Cao Shengxuan , Wang Chen , Ma Xin , Wang Xu 
Published: May 2022

Abstract
Background
Arthrometry has been introduced to evaluate the laxity of ankle joint in recent years. However, its role in the diagnosis of chronic ankle instability is still debatable. Therefore, we assessed the diagnostic accuracy of a digital arthrometer in terms of sensitivity and specificity.

Methods
According to the inclusion and exclusion criteria proposed by the International Ankle Consortium, we recruited 160 uninjured ankles (control group) and 153 ankles with chronic ankle instability (CAI group). Ankle laxity was quantitively measured by a validated digital arthrometer. Data of loading force and joint displacement were recorded in a continuous manner. Differences between the control and CAI groups were compared using 2-tailed independent t test. A receiver operating characteristic curve analysis was used to calculate area under a curve, sensitivity and specificity.

Results
Load–displacement curves of the two groups were depicted. Differences of joint displacement between the control and CAI groups were compared at 30, 45, 60, 75, 90, 105 and 120 N, which were all of statistical significance (all p < 0.001) with the largest effect size at 90 N. Statistical significance was found in the differences between the two groups in load–displacement ratio at 10–120 N, 10–40 N, 40–80 N and 80–120 N (all p < 0.001), with the largest effect size at 10–40 N. Load–displacement ratio at the interval of 10–40 N had the highest area under a curve (0.9226), with sensitivity and specificity of 0.804 and 0.863, respectively, when the cutoff point was 0.1582 mm/N.

Conclusion
The digital arthrometer measurement could quantitively analyze the ankle laxity with high diagnostic accuracy. The load–displacement ratio would be a reliable and promising approach for chronic ankle instability diagnosis.
Level of evidence level II.
Impact of GERAADA score in patients with acute type A aortic dissection
Authors: Sugiyama Kayo , Watanuki Hirotaka , Tochii Masato , Futamura Yasuhiro , Kitagawa Yuka , Makino Satoshi , Ohashi Wataru , Matsuyama Katsuhiko 
Published: May 2022

Abstract
Background
Despite continuous developments and advances in the perioperative management of patients suffering from acute aortic dissection type A (AADA), the associated postoperative morbidity and mortality remain high and strongly depend on the preoperative clinical status. The associated postoperative mortality is still hard to predict prior to the surgical procedure. The so-called German Registry of Acute Aortic Dissection Type A (GERAADA) score uses very basic and easily retrievable parameters and was specifically designed for predicting the 30-day mortality rate in patients undergoing surgery for AADA. This study evaluated impact of the GERAADA score in the authors’ institutional results.

Methods
Among 101 acute type A aortic dissection patients treated at our hospital during August 2015–March 2021, the GERAADA was calculated individually and retrospectively. Predicted and actual mortalities were assessed, and independent predicted factors were searched. The primary endpoint was defined as comparison of GERAADA scores and early mortality, and the secondary endpoints were defined as comparison of GERAADA scores and other postoperative results, and comparison of preoperative factors and postoperative results regardless to GERAADA scores.

Results
While the overall 30-day mortality for the entire study cohort calculated by the GERAADA score was 14.3 (8.1–77.6)%, the actual mortality rate was 6%. However, the GERAADA score was significantly high in some postoperative complications and showed significant correlation with some peri- and post-operative factors. In addition, factors not belonging to GERAADA score such as time from onset to arrival at the hospital, time from onset to arrival at the operation room, spouse presence, and hemodialysis were significantly associated with 30-day mortality.

Conclusions
Although the actual mortality was lower than predicted, GERAADA score may impact on the postoperative course. In addition, it would be desirable to add parameters such as the time from onset to arrival, family background, and hemodialysis for further accuracy.
Pharmacological activities and molecular mechanisms of Pulsatilla saponins
Authors: Zhong Jinmiao , Tan Lihua , Chen Meiwan , He Chengwei 
Published: May 2022

AbstractSaponins are found in a variety of higher plants and display a wide range of pharmacological activities, including expectorant, anti-inflammatory, vasoprotective and antimicrobial properties.Pulsatilla chinensis(P. chinensis,Bai Tou Weng, 白頭翁) has been used medically in China for thousands of years for the treatment of diseases caused by bacteria, and it is rich in triterpenoid saponins. In recent decades, anemoside B4 (Pulchinenoside C) is well studied since it has been used as a quality control marker forP. chinensis. At the same time, more and more other active compounds were found in the genus ofPulsatilla. In this review, we summarize the pharmacological activities ofPulsatillasaponins (PS) and discuss the cellular or molecular mechanisms that mediate their multiple activities, such as inducing cancer cell apoptosis, inhibiting tumor angiogenesis, and protecting organs via anti-inflammatory and antioxidant measures. We aim to provide comprehensive analysis and summary of research progress and future prospects in this field to facilitate further study and drug discovery of PS.
Phenotype expansion of variants affecting p38 MAPK signaling in hypospadias patients
Authors: Lin Defu , Du Huakang , Zhao Sen , Liu Bowen , Song Hongcheng , Wang Guannan , Zhang Weiping , Liang Haiyan , Liu Pei , Liu Chao , Han Wenwen , Li Zhenwu , Yang Yang , Chen Shuofan , Zhao Lina , Li Xiaoxin , Wu Zhihong ,   DISCO (Deciphering Disorders Involving Scoliosis & COmorbidities) study group, Qiu Guixing , Wu Zhihong , Zhang Terry Jianguo , Wu Nan , Wang Shengru , Liu Jiaqi , Liu Sen , Zuo Yuzhi , Liu Gang , Yu Chenxi , Liu Lian , Shao Jiashen , Zhao Sen , Yan Zihui , Zhao Hengqiang , Niu Yuchen , Li Xiaoxin , Wang Huizi , Ma Congcong , Chen Zefu , Liu Bowen , Cheng Xi , Lin Jiachen , Du Huakang , Li Yaqi , Song Shuang , Tian Weijie , Xie Zhixin , Zhao Zhengye , Zhao Lina , Zhao Zhi , Zheng Zhifa , Huang Yingzhao , Sun Ning , Wu Nan 
Published: May 2022

Abstract
Background
Hypospadias is a congenital anomaly of the male urogenital system. Genetics factors play an important role in its pathogenesis. To search for potential causal genes/variants for hypospadias, we performed exome sequencing in a pedigree with three patients across two generations and a cohort of 49 sporadic patients with hypospadias.

Results
A novel BRAF variant (NM_004333.6: c.362C > A) was found to co-segregate with the hypospadias phenotype in the disease pedigree. In cells overexpressing the BRAF mutant, the phosphorylation level of p38 MAPK was significantly increased as compared with the cells overexpressing the wild-type BRAF or RASopathy-related BRAF mutant. This variant further led to a reduced transcription level of the SRY gene, which is essential for the normal development of the male reproductive system. In the cohort of sporadic patients, we identified two additional variants in p38 MAPK signaling-related genes (TRIM67 and DAB2IP) potentially associated with hypospadias.

Conclusion
Our study expands the phenotypic spectrum of variants affecting p38 MAPK signaling toward the involvement of hypospadias.