bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oral feeding skills in premature infants: A concept analysis
Authors: Astuti Dyah Dwi , Rustina Yeni , Wanda Dessie 
Published: August 2022

Background: The delay in developing oral feeding skills becomes a problem experienced by premature infants. One of the reasons for the delay may be related to inconsistent definitions of oral feeding skills, which can cause discrepancies in the provision of nursing care.
Objective: This study aimed to clarify the concept of oral feeding skills in premature infants.
Methods: The Walker and Avant concept analysis method was used. A literature search was also conducted from five databases: CINAHL, PubMed, ProQuest, EMBASE, and Google Scholar, to find articles between January 2020 and December 2022.
Results: The literature search obtained 20 articles on oral feeding skills from various disciplines. Five attributes were developed from the concept analysis, including (1) coordination ability to suck, swallow, and breathe, (2) the ability to regulate oral-motor functions, (3) the ability to regulate sensory functions, (4) the ability to maintain the stability of physiology function, and (5) the ability to regulate feeding behavior. Antecedents to oral feeding skills include immaturity of the nervous system, gestational age, feeding intolerance, increased length of stay and cost of care, increased rehospitalization, stress on parents, and increased morbidity and mortality. Consequences include optimization of growth and development, reduction of length of stay and cost of hospitalization, increased bonding attachment, increased self-efficacy of parents in caring for premature infants, and improvement of the quality of life of premature infants.
Conclusion: The concept analysis provides five comprehensive attributes and their antecedents and consequences. However, this concept can be used to provide nursing care to premature infants, assess the criteria for discharge, and optimize nutrition for the growth and development of premature infants.
Assessment of CO2 biofixation and bioenergy potential of microalga Gonium pectorale through its biomass pyrolysis, and elucidation of pyrolysis reaction via kinetics modeling and artificial neural network
Authors: Altriki Ahmed , Ali Imtiaz , Razzak Shaikh Abdur , Ahmad Irshad , Farooq Wasif 
Published: August 2022

This study investigates CO2 biofixation and pyrolytic kinetics of microalga G. pectorale using model-fitting and model-free methods. Microalga was grown in two different media. The highest rate of CO2 fixation (0.130 g/L/day) was observed at a CO2 concentration of 2%. The pyrokinetics of the biomass was performed by a thermogravimetric analyzer (TGA). Thermogravimetric (TG) and derivative thermogravimetric (DTG) curves at 5, 10 and 20°C/min indicated the presence of multiple peaks in the active pyrolysis zones. The activation energy was calculated by different model-free methods such as Friedman, Flynn-Wall-Ozawa (FWO), Kissinger-Akahira-Sunose (KAS), and Popescu. The obtained activation energy which are 61.7–287 kJ/mol using Friedman, 40.6–262 kJ/mol using FWO, 35–262 kJ/mol using KAS, and 66.4–255 kJ/mol using Popescu showed good agreement with the experimental values with higher than 0.96 determination coefficient (R2). Moreover, it was found that the most probable reaction mechanism for G. pectorale pyrolysis was a third-order function. Furthermore, the multilayer perceptron-based artificial neural network (MLP-ANN) regression model of the 4-10-1 architecture demonstrated excellent agreement with the experimental values of the thermal decomposition of the G. pectoral. Therefore, the study suggests that the MLP-ANN regression model could be utilized to predict thermogravimetric parameters.
Sequelae of Hospitalization for Diabetic Foot Ulcers at LASUTH Ikeja Lagos: A Prospective Observational Study
Authors: Adeleye Olufunmilayo Olubusola , Williams Adetutu Oluwatosin , Dada Akin Olusola , Ugwu Ejiofor T. , Ogbera Anthonia Okeoghene , Sodipo Olujimi Olanrewaju 
Published: August 2022

AbstractDiabetic foot ulcers (DFUs) remain important sequelae of diabetes (DM) which cause debilitating effects on the sufferer. The evolution of some aspects of epidemiology and the current clinical impact of DFUs was examined.MethodsA single-center prospective observational study. Study subjects were consecutively recruited.ResultsTotal medical admissions during the study period were 2288, 350 were DM related, out of these 112 were admitted for DFU. 32% of total DM admissions were for DFU. The mean age of the study subjects is 58 ± 11.0 range is from 35 years to 87 years. Males were slightly predominant (51.8%). Most of them were actively employed (92%), and the majority were in the 55 to 64 years age category. Most of them had not been diabetic for longer than 8 years (61%). The mean duration of DM is 8.32±7.27 years. The mean duration of ulcer at presentation was 72.0±138.13 days. The majority of the patients (80.3%) presented with severe (grades 3 to 5) ulcers, Wagner grade four was the most predominant. Regarding clinical outcome, 24 (24.7%) had an amputation, 3 of which were minor. The factor that was associated with amputation was concomitant heart failure – OR 6.00 CI 0.589-61.07, 0.498-4.856. Death occurred in 16 (18.4%). The factors associated with mortality were severe anemia OR 2.00 CI 0.65 – 6.113, severe renal impairment requiring dialysis OR 3.93 CI 0.232-66.5, concomitant stroke OR 8.42 CI 0.71-99.6, and peripheral arterial disease- OR 18.33 CI 2.27 -147 p-value- 0.006.ConclusionThe hallmark of DFU in this report is late presentation, it accounted for a significant proportion of the total medical admissions, although the case fatality of DFU reduced from previous reports from the center, mortality, and amputation rates are still unacceptably high. Concomittant heart failure was a factor of amputation. Mortality was associated with severe anemia, renal impairment and peripheral arterial disease.
Serum lipidomics profiles reveal potential lipid markers for prediabetes and type 2 diabetes in patients from multiple communities
Authors: Xuan Qiuhui , Hu Chunxiu , Zhang Yinan , Wang Qingqing , Zhao Xinjie , Liu Xinyu , Wang Congrong , Jia Weiping , Xu Guowang 
Published: August 2022

ObjectiveDyslipidemia is a hallmark of diabetes mellitus (DM). However, specific lipid molecules closely associated with the initiation and progression of diabetes remain unclear. We used a pseudotargeted lipidomics approach to evaluate the complex lipid changes that occurred long before the diagnosis of type 2 diabetes mellitus (T2DM) and to identify novel lipid markers for screening prediabetes mellitus (PreDM) and T2DM in patients from multiple communities.MethodsFour hundred and eighty-one subjects consisting of T2DM, three subtypes of PreDM, and normal controls (NC) were enrolled as discovery cohort. Serum lipidomic profiles of 481 subjects were analyzed using an ultrahigh performance liquid chromatography-triple quadrupole mass spectrometry (UHPLC-QqQ-MS)-based pseudotargeted lipidomics method. The differential lipid molecules were further validated in an independent case-control study consisting of 150 PreDM, 234 T2DM and 94 NC.ResultsMultivariate discriminative analyses show that lipidomics data have considerable potential for identifying lipidome differences among T2DM, subtypes of PreDM and NC. Statistical associations of lipid (sub)species display significant variations in 11 lipid (sub)species levels for T2DM and distinctive differences in 8 lipid (sub)species levels between prediabetic and normoglycemic individuals, with further differences in 8 lipid (sub)species levels among subtypes of PreDM. Adjusted for sex, age and BMI, only two lipid (sub)species of fatty acid (FA) and phosphatidylcholine (PC) were associated at p&lt; 0.05 for PreDM (all) and subtypes of PreDM. The defined lipid markers not only significantly improve the diagnostic accuracy of PreDM and T2DM but also effectively evaluating the risk of developing into each subtype of PreDM and T2DM when addition of age, sex, BMI, and FPG, respectively.ConclusionsOur findings improve insights into the lipid metabolic complexity and interindividual variations among subtypes of PreDM and T2DM, beyond the well-known differences in dyslipidemia in clinic.
Cortisol values during the standard-dose cosyntropin stimulation test: Personal experience with Elecsys cortisol II assay
Authors: Husni Hasan , Abusamaan Mohammed S. , Dinparastisaleh Roshan , Sokoll Lori , Salvatori Roberto , Hamrahian Amir H. 
Published: August 2022

PurposeThere has been debate regarding the appropriate cortisol cutoff during the cosyntropin stimulation test (CST) when newer cortisol assays are used. We aimed to evaluate the proper cortisol values during the standard dose CST in patients with normal hypothalamic-pituitary-adrenal (HPA) axis when the Elecsys® Cortisol II assay from Roche Diagnostics is used.MethodsWe retrospectively reviewed the medical records of patients evaluated for possible adrenal insufficiency using the standard-dose (250 mcg) CST from January 2018 to December 2020 and eventually judged to have a normal HPA axis. All the CSTs were done in the outpatient setting. Evaluation by an endocrinologist, restrictive exclusion criteria including prior glucocorticoid and opioid use, and lack of glucocorticoid treatment for at least 6 months after the CST was used to define normal HPA axis. The results are reported in the median (range).ResultsWe identified 63 patients who met the inclusion criteria and were considered to have a normal HPA axis. The median age was 54.7 (27.6-89.1) years; 32 (51%) were female, and 27 (43%) were white. The duration of follow-up after the CST without any glucocorticoid replacement was 13.9 (6.3-43.9) months. Cortisol levels were 21.7 (15.7-29.1) µg/dl and 24.4 (17.9-35.8) µg/dl at 30- and 60-minutes after cosyntropin administration, respectively. The lowest cortisol levels at 30 and 60 minutes for patients with either normal TSH or gonadal axis (n=47) or in whom both axes were normal (n=18) were similar to the ones of the entire cohort.ConclusionOur study supports using a lower than previously recommended cortisol cutoff value at 30 minutes after Cosyntropin using the Roche Elecsys® Cortisol II assay. The lowest cortisol levels in our cohort were 15.7 and 17.9 µg/dL at 30 and 60 minutes after the CST, respectively. Therefore, it is essential to consider the time of cortisol draw after cosyntropin administration.
Immunological signature of patients with thymic epithelial tumors and Good syndrome
Authors: Malfitano Anna Maria , D’Esposito Vittoria , De Placido Pietro , Tortora Marianna , Ottaviano Margaret , Pietroluongo Erica , Morra Rocco , Mucci Brigitta , Napolitano Fabiana , Montella Liliana , Giuliano Mario , De Placido Sabino , Terracciano Daniela , Palmieri Giovannella , Formisano Pietro 
Published: August 2022

BackgroundThymic epithelial tumors (TETs) are frequently accompanied by Good Syndrome (GS), a rare immunodeficiency, characterized by hypogammaglobulinemia and peripheral B cell lymphopenia. TETs can be also associated to other immunological disorders, both immunodeficiency and autoimmunity.MethodsIn this study, we enrolled TET patients with GS to address differences between patients with or without associated autoimmune diseases (AD). We analyzed the immunophenotype from peripheral blood of these patients focusing on selected immune cell subsets (CD4+T cells, CD8+T cells, T regulatory cells, NK cells, B-cells, monocytes, eosinophils, basophils, neutrophils) and serum levels of cytokines, chemokines and growth factors.ResultsWe observed higher number of leucocytes, in particular lymphocytes, B lymphopenia and lower number of T regulatory cells in TET patients with associated AD compared to TET patients without AD. In the group of TET patients with AD, we also observed increased serum levels of IL-15, VEGF, IP-10, GM-CSF, IL-6, and MIP-1α. Thus, we identified considerable differences in the lymphocyte profiles of TET patients with and without ADs, in particular a reduction in the numbers of B lymphocytes and T-regulatory cells in the former, as well as differences in the serum levels of various immune modulators.ConclusionsAlthough the pathogenic mechanisms are still unclear, our results add new knowledge to better understand the disease, suggesting the need of surveilling the immunophenotype of TET patients to ameliorate their clinical management.
Diagnostic and therapeutic dilemma in Stevens–Johnson syndrome-like acute graft-versus-host disease after liver transplantation: A case report
Authors: Hung Yi-Teng , Chang Yau-Ren , Wang Hsuan-Ning , Lee Wei-Chen , Lee Chen-Fang , Chen Chun-Bing 
Published: August 2022

BackgroundAcute graft-versus-host disease (aGVHD) is a severe and fatal complication after orthotopic liver transplantation (OLT). Clinical manifestations of severe aGVHD can resemble drug-induced Stevens–Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN), and there are also various medications, such as antibiotics and immunosuppressants, used after transplantation, causing a diagnostic dilemma. Furthermore, there have been no standardized diagnostic and therapeutic strategies for OLT-aGVHD due to its rarity.Case summaryA 52-year-old man presented with generalized maculopapular eruptions, fever, and pancytopenia 1 month after OLT and 4 days after taking sulfamethoxazole/trimethoprim. After assessment of the scoring criteria for drug causality of drug allergy, histopathological findings of skin biopsy, lymphocyte activation test of the potential offending drug, and microchimerism study, the diagnosis was in favor of aGVHD mimicking SJS/TEN. Considering severe sepsis, the anti-tumor necrosis factor alpha (TNF-α) agent, etanercept, was used to replace tacrolimus and corticosteroid. Skin lesions resolved gradually after anti-TNF-α biologics rescue; tacrolimus and corticosteroid therapy were re-administrated after controlling sepsis. Pancytopenia recovered and the patient was discharged in a stable condition.ConclusionWe demonstrated a diagnostic strategy for OLT-aGVHD. Targeting therapy with anti-TNF-α blockade and a temporary withdrawal of traditional immunosuppressants may be among effective and safe therapeutic options of OLT-aGVHD for those with severe sepsis.
Comparison of non-criteria antiphospholipid syndrome with definite antiphospholipid syndrome: A systematic review
Authors: Pires da Rosa Gilberto , Ferreira Ester , Sousa-Pinto Bernardo , Rodríguez-Pintó Ignasi , Brito Iva , Mota Alberto , Cervera Ricard , Espinosa Gerard 
Published: August 2022

ObjectivesPatients with laboratory or clinical manifestations suggestive of antiphospholipid syndrome (APS) but not fulfilling the classification criteria constitute a clinical challenge. This study aims to compare non-criteria APS (NC-APS) with definite APS in terms of clinical manifestations, therapies, and outcomes.MethodsA systematic review of observational studies comparing definite and NC-APS was performed searching four electronic databases. Data on clinical manifestations, therapies and clinical outcomes was extracted.ResultsSixteen studies, assessing a total of 3,798 participants, were included. Seven out of 10 studies found no significant difference in the prevalence of arterial or venous thrombosis between definite and NC-APS, with two studies on seronegative APS also finding no difference in thrombosis recurrence. Seven out of 12 studies found no significant difference in the prevalence of obstetric manifestations between groups, with the remaining exhibiting conflicting results. In 9 studies comparing treatment frequency in obstetric patients, all but one described similar treatment frequency, with the percentage of NC-APS treated during pregnancy ranging from 26% to 100%. In 10 studies comparing pregnancy outcomes of NC-APS versus definite APS, 7 found similar successful pregnancies/live births. Additionally, 5 studies described improvement of live births in both groups with treatment, with three signalling aspirin monotherapy as efficacious as combination therapy in NC-APS.ConclusionThis review hints at an absence of marked differences in most evaluated parameters between definite and NC-APS, emphasizing the value of a more active follow-up of these patients. The low-quality available evidence highlights the need for well-defined NC-APS populations in future studies.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero, identifier CRD42020210674.
The production of dissolved organic carbon by macroalgae and its consumption by marine bacteria: Implications for coastal ecosystems
Authors: Hall Jack R. , Albert Gerli , Twigg Isla M. , Baltar Federico , Hepburn Christopher D. , Martin Georg 
Published: August 2022

Through the fixation of large quantities of dissolved inorganic carbon (DIC), macroalgae facilitate the energetic foundation of highly productive coastal ecosystems. While the processes controlling photosynthesis and carbon fixation by macroalgae are well known, the fate of organic matter fixed by macroalgae is less well understood. This study quantified release rates of DOC by three ecologically significant Baltic macroalgae species: the perennial habitat forming Fucus vesiculosus and Furcellaria lumbricalis, and the seasonal fast-growing Ulva intestinalis, under both light and dark conditions. The released products were assessed using bacterial incubations whereby radiolabeled leucine was used to evaluate the uptake and lability of these products by marine heterotrophic bacteria. DOC was found to be released by both F. vesiculosus and U. intestinalis at rates of 0.27 mg C·h−1 under light and 0.13 mg C·h−1 per unit of dry mass under dark treatments, respectively, whereas F. lumbricalis DOC release was observed to be negligible under both light and dark. Our findings further validate previous hypotheses that factors such as photosynthetic activity are a primary driver behind DOC release and that DOC release is not an entirely passive process. Additionally, we reaffirm the need to relate a given species life characteristics and habitat in order to understand why DOC products are released. The consumption of macroalgae-derived DOC by heterotrophic bacteria reveals that released DOC is variable in its lability. After a period of 12 h and under maximum photosynthetic conditions, the release of DOC by F. vesiculosus and U. intestinalis achieved a peak rate of 219 µg C·L−1·day−1 and 214 µg C·L−1·day−1 for each gram of dry weight material, respectively, directly into the microbial loop via heterotrophic bacterial consumption. In contrast, F. lumbricalis’ low rate of DOC release and the subsequent low bacterial consumption indicate that habitats dominated by this species have a reduced importance in the transfer energy via the microbial loop. These findings have implications for how we view carbon transfer within coastal food webs and highlight how changes in species composition and coverage may dramatically affect coastal ecosystem productivity through the microbial loop.
Development and validation of outcome prediction models for acute kidney injury patients undergoing continuous renal replacement therapy
Authors: Li Bo , Huo Yan , Zhang Kun , Chang Limin , Zhang Haohua , Wang Xinrui , Li Leying , Hu Zhenjie 
Published: August 2022

ObjectThis study aimed to develop and validate a set of practical predictive tools that reliably estimate the 28-day prognosis of acute kidney injury patients undergoing continuous renal replacement therapy.MethodsThe clinical data of acute kidney injury patients undergoing continuous renal replacement therapy were extracted from the Medical Information Mart for Intensive Care IV database with structured query language and used as the development cohort. An all-subset regression was used for the model screening. Predictive models were constructed via a logistic regression, and external validation of the models was performed using independent external data.ResultsClinical prediction models were developed with clinical data from 1,148 patients and validated with data from 121 patients. The predictive model based on seven predictors (age, vasopressor use, red cell volume distribution width, lactate, white blood cell count, platelet count, and phosphate) exhibited good predictive performance, as indicated by a C-index of 0.812 in the development cohort, 0.811 in the internal validation cohort and 0.768 in the external validation cohort.ConclusionsThe model reliably predicted the 28-day prognosis of acute kidney injury patients undergoing continuous renal replacement therapy. The predictive items are readily available, and the web-based prognostic calculator (https://libo220284.shinyapps.io/DynNomapp/) can be used as an adjunctive tool to support the management of patients.
Systematic and meta-based evaluation on job satisfaction of village doctors: An urgent need for solution issue
Authors: Chen Yuquan , You Yanwei , Wang Yue , Wang Yudong , Dai Tao 
Published: August 2022

BackgroundVillage doctors are the health “gatekeepers” of rural residents in most developing countries. They undertake a series of strenuous but pivotal missions, including prevention, diagnosis, and treatment of complicated diseases, sanitation services and management, and preventive healthcare and education tasks. Hence, it is of great importance to evaluate the village doctors’ job satisfaction status, which is one of the most important indicators that can reflect the current working state, to provide guidelines for the healthcare policies.MethodsLiterature search was conducted in 7 authoritative databases, including PubMed, EMBASE, Web of Science, and China National Knowledge Infrastructure (CNKI). Experts in the field of social medicine were consulted to achieve supplement and obtain relevant literature. China was selected as a representative of the village doctor system for the in-depth analysis. Building on the previous literature, we modified and proposed a novel strategy that can transform and integrate the outcome indicators to conduct a meta-based and quantitative assessment on job satisfaction.ResultsA total of 37 publications and 23,595 village doctors were included in this research. The meta-analysis showed that the overall job satisfaction score of village doctors was 3.1858 (total score: 5.00), 95% CI: 2.9675–3.404, which represented the level of “neither satisfied nor dissatisfied.” However, in the subsequent adjustment of publication bias, this score reduced to 2.7579, 95% CI: 2.5254–2.9904, which indicated a direct “dissatisfied” level. To discover the underlying causes, a holistic analysis of each dimension and influencing factors of job satisfaction was conducted, and the results demonstrated that “Financial Rewards” (2.49) was the most important factor causing dissatisfaction among village doctors, followed by “Job Security (2.52)” and “Work Stress (3.05).” Several important themes were also identified and assessed to explore the factors related to this topic.ConclusionThis study indicated that there is an urgent need to improve the working status of health workers in rural and remote areas, especially in the middle- and low-income countries. Health policy makers should not only improve the current remuneration and subsidies of village doctors but also guide the professional development and give them more job security to enhance the work stability of this group. More specifically, in the context of the COVID-19 pandemic, further surveys on job satisfaction of village doctors should be carried out to take targeted measures.Systematic review registration[https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42021289139].