bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors associated with in-hospital mortality in adult sepsis with Escherichia coli infection
Authors: Song Kun , Guo Cuirong , Zeng Zhao , Li Changluo , Ding Ning 
Published: February 2022

Abstract
Background
Escherichia coli (E. coli) is an important pathogen in sepsis. This study aimed to explore the factors which were associated with in-hospital mortality in adult sepsis with E. coli infection based on a public database.

Methods
All sepsis patients with E. coli infection in MIMIC-III were included in this study. Clinical characteristics between the survivor and non-survivor groups were analyzed. Factors associated with in-hospital mortality were identified by multivariate logistic regression.

Results
A total of 199 patients were eventually included and divided into two groups: a survivor group (n = 167) and a non-survivor group (n = 32). RDW and HCT were identified as the factors with clinical outcomes. The area under the ROC curve (AUC) were 0.633 and 0.579, respectively. When combined RDW and HCT for predicting in-hospital mortality, the AUC was 0.772, which was significantly superior to SOFA and APACHEII scores.

Conclusion
RDW and HCT were identified as factors associated with in-hospital mortality in adult sepsis patients with E. coli infection. Our findings will be of help in early and effective evaluation of clinical outcomes in those patients.
Development and validation of the Health Education Adherence Scale for Stroke Patients: a cross-sectional study
Authors: Ding Weiwei , Chen Junya , Liu Jing , Lin Beibei , Li Shihen , Li Fengzhen , Guo Junyi , Li Yun , Li Jufang 
Published: February 2022

Abstract
Background
Due to the lack of health education adherence assessment tools for stroke patients, the assessment of health education adherence in this population is insufficient, which hinders the prevention and rehabilitation of stroke. This study aims to develop and validate a Health Education Adherence Scale for Stroke Patients (HEAS-SP).

Methods
A cross-sectional design with a purposive sampling method was used for this study. Six hundred and fifty-four eligible participants completed the demographic questionnaire and the HEAS-SP. The data collection lasted for 7 months, from March 1stto September 30th in 2019. Item analysis and exploratory and confirmatory factor analysis were employed to develop and validate the HEAS-SP.

Results
The item analysis, exploratory and confirmatory factor analysis resulted in a 20-item HEAS-SP with 4 domains: medication adherence, diet adherence, rehabilitation exercise adherence, and healthy lifestyle adherence. The four-domain model demonstrated acceptable model fit indexes and the 20-item HEAS-SP demonstrated acceptable reliability and validity.

Conclusion
The 20-item HEAS-SP was shown to have acceptable reliability and validity for assessing health education adherence with respect to diet, medication, rehabilitation exercise and healthy lifestyle in stroke patients, making it a potential basis for developing targeted interventions for stroke patients.
Prognostic utility of systemic inflammatory markers and chronic hepatitis C virus infection status in hepatocellular carcinoma patients treated with local ablation
Authors: Ali Mohamed Abdulwahab Mohamed , Harmsen William Scott , Morsy Khairy Hammam , Galal Ghada Moustapha Kamal , Therneau Terry M. , Roberts Lewis Rowland 
Published: February 2022

Abstract
Background
Hepatocellular carcinoma (HCC) has high incidence and mortality worldwide. Local ablation using radiofrequency ablation (RFA) or microwave ablation (MWA) is potentially curative for early-stage HCC with outcomes comparable to surgical resection. We explored the influence of demographic, clinical, and laboratory factors on outcomes of HCC patients receiving ablation.

Methods
This retrospective cohort study included 221 HCC patients receiving local ablation at Mayo Clinic between January 2000 and October 2018, comprising 140 RFA and 81 MWA. Prognostic factors determining overall survival (OS) and disease-free survival (DFS) were identified using multivariate analysis.

Results
There was no clinically significant difference in OS or DFS between RFA and MWA. In multivariate analysis of OS, pre-ablation lymphocyte-monocyte ratio [Hazard ratio (HR) 0.7, 95% confidence interval (CI) 0.58–0.84, P = 0.0001], MELD score [HR 1.12, 95%CI 1.068–1.17, P <  0.0001], tumor number [HR 1.23, 95%CI 1.041–1.46, P = 0.015] and tumor size [HR 1.18, 95%CI 1.015–1.37, P = 0.031] were clinically-significant prognostic factors. Among HCC patients with chronic hepatitis C (HCV) infection, positive HCV PCR at HCC diagnosis was associated with 1.4-fold higher hazard of death, with 5-year survival of 32.8% vs 53.6% in HCV PCR-negative patients. Regarding DFS, pre-ablation lymphocyte-monocyte ratio [HR 0.77, 95%CI 0.66–0.9, P = 0.001], MELD score [HR 1.06, 95%CI 1.022–1.11, P = 0.002], Log2 AFP [HR 1.11, 95%CI 1.033–1.2, P = 0.005], tumor number [HR 1.29, 95%CI 1.078–1.53, P = 0.005] and tumor size [HR 1.25, 95%CI 1.043–1.51 P = 0.016] were independently prognostic.

Conclusions
Pre-ablation systemic inflammation represented by lymphocyte-monocyte ratio is significantly associated with OS and DFS in HCC patients treated with local ablation. HCV viremia is associated with poor OS. Tumor biology represented by tumor number and size are strongly prognostic for OS and DFS while AFP is significantly associated with DFS only.
Association of annexin A10 expression with poor prognosis of intrahepatic cholangiocarcinoma
Authors: Shao Yu-Yun , Kuo Hung-Yang , Jeng Yung-Ming , Wu Yao-Ming , Wang Hsiu-Po , Hsu Chiun , Hsu Chih-Hung , Hsu Hey-Chi , Cheng Ann-Lii , Lin Zhong-Zhe 
Published: February 2022

AbstractBackgroundAnnexin A10 expression influences the prognosis of several gastrointestinal cancers. We explored the association of annexin A10 expression with the overall survival (OS) of patients who underwent curative surgery for cholangiocarcinoma.MethodsPatients who underwent curative surgery for cholangiocarcinoma (except gallbladder cancer) and had pathological stage T1-3N0M0 disease were enrolled. Annexin A10 expression was examined by performing immunohistochemical staining. Patient demographics and survival outcome data were retrieved from medical records.ResultsIn total, 185 patients were enrolled. The primary tumor location was intrahepatic and extrahepatic (including the perihilar region) for 89% and 11% of patients, respectively. Positive annexin A10 staining was detected for 61 (33%) patients and associated with extrahepatic or perihilar cholangiocarcinoma (p = 0.001) and lower histological grade (p < 0.001). Patients with positive annexin A10 staining exhibited significantly poorer survival relative to patients with negative staining results (median OS, 2.5 vs. 4.9 years,p = 0.025). In the multivariate analysis adjusting for age, sex, tumor location, tumor grade, hepatitis infection, and disease stage, positive annexin A10 remained an independent predictor of poor OS (hazard ratio 1.572,p = 0.034). In the subgroup analysis, the association between annexin A10 and prognosis was restricted to intrahepatic cholangiocarcinoma. Among patients with intrahepatic cholangiocarcinoma, patients with positive annexin A10 staining exhibited significantly poorer survival compared with patients with negative annexin A10 staining (median OS, 2.3 vs. 4.9 years,p = 0.008).ConclusionPositive annexin A10 expression was associated with poor prognosis of intrahepatic cholangiocarcinoma.
Effects of Kinesio taping on skin deformation during knee flexion and extension: a preliminary study
Authors: He Fei , Wang Xiaoxuan , Yu Menglian , Chen Yiyi , Yu Bo , Lu Jianqiang 
Published: February 2022

Abstract
Background
Kinesio Taping (KT) is proved useful to many musculoskeletal disorders. But the mechanism remains unclear. The kinesio tape works by sticking to the skin surface. So exploring the interaction between the tape and the skin and analyzing its biomechanical influence may be an effective way to explore the mechanism of the tape.

Objectives
This study aimed to investigate the effect of Kinesio taping and taping methods on skin deformation during knee joint flexion and extension motion and further explore its possible functional mechanisms.

Methods
Ten healthy and pain-free subjects (4 males, 6 females) were recruited in this study. The skin observation area on the anterior side of the right thigh of the subjects was divided into 11 segments by 12 reflective marker points for distance measurement, from the distal knee to the proximal knee, the length of the interval was L1 to L11, and the total length was L0. Subjects were treated with no KT (NT), resting positive taping (RPT), resting negative taping (RNT), stretching positive taping (SPT), and stretching negative taping (SNT). A Qualisys infrared high-speed three-dimensional spatial coordinate capture system was used to observe changes in the length of the observed skin surface on the right anterior thigh during right knee flexion and extension in the sitting position.

Results
During right knee flexion and extension in the seated position in 10 subjects, all skin segment deformations produced significant differences between intervention groups (P < 0.05), except for L1 during flexion (P = 0.07). During right knee flexion and extension, total length, L0, and spacing lengths, L1, L6, and L11, were longer in the NT group than in all other groups. L0 and L1 were both longer in the stretched position than in the rest position; L11 also showed this trend.

Conclusions
The usage of the KT had an effect on the biomechanical changes of the skin, resulting in changes in skin deformation. I-tape, natural tension taping can shorten the skin distance between the two ends of the tape. Limb position during taping may influence the KT’s effects. However, the change in taping direction showed no significant effects on skin deformation during exercise. KT may apply a pre-stress in the biomechanics of the skin.
Elevated blood urea nitrogen-to-creatinine ratio increased the risk of Coronary Artery Disease in patients living with type 2 diabetes mellitus
Authors: Liu Feng , Ma Guanhui , Tong Chao , Zhang Shan , Yang Xinghua , Xu Cong , Yang Weihao , Xia Guobao , Li Mingliang 
Published: February 2022

Abstract
Background
High Blood Urea Nitrogen (BUN) and high Serum Creatinine (SCr) levels are risk factors for Coronary Artery Disease (CAD). However, the relationship between the Blood Urea Nitrogen to Creatinine (BUN/SCr) ratio (UCR) and the risk of CAD in patients living with new-onset diabetes is unclear. This study aimed to examine the relationship between blood UCR and the risk of CAD in patients living with new-onset type 2 diabetes mellitus (T2DM).

Methods
We analyzed the data from the cohort of 12,299 patients living with type 2 diabetes mellitus. Primary endpoints were the events of CAD. The ANOVA test (continuous indicators) and χ2 test (categorical indicators) were used to assess the differences of baseline characteristics across the groups of UCR. In order to understand the correlation between variables, we performed correlation analysis on variables that have significant differences between CAD group and non-CAD group. Multivariate-adjusted Cox proportional hazard regression models were applied to estimate the association of the blood UCR with the risk of CAD in patients living with T2DM. The Kaplan–Meier survival function plotting and the log-rank test were used to evaluate the event-free survival according to the groups of UCR. The restricted cubic spline model was used to show the adjusted association between blood UCR and risk of CAD in patients living with T2DM.

Results
During a median follow-up of 2.66 years, 1173 CAD were recorded with an event rate of 28.49 events per 1000 person-years. In multivariate-adjusted Cox regression models, elevated blood urea nitrogen to creatinine ratio (UCR) was associated with higher risk of CAD in patients living with T2DM [hazard ratio (HR), 1.782; 95% confidence interval (CI), 1.237–2.567]. The Kaplan–Meier survival curves indicated that the high group of UCR tended to have a lower event-free survival than the low group and medium group. There was a nonlinear trend toward increasing risk of CAD across the groups of UCR. And cubic spline function graph suggested that the influence of UCR level on HR for CAD increased significantly at UCR levels above 6.67.

Conclusions
An elevated UCR was significantly associated with an increased risk for CAD in patients living with T2DM.
Screening the components of Saussurea involucrata for novel targets for the treatment of NSCLC using network pharmacology
Authors: Zhang Dongdong , Zhang Tieying , Zhang Yao , Li Zhongqing , Li He , Zhang Yueyang , Liu Chenggong , Han Zichao , Li Jin , Zhu Jianbo 
Published: February 2022

AbstractBackgroundSaussurea involucrata (SAIN), also known as Snow lotus (SI), is mainly distributed in high-altitude areas such as Tibet and Xinjiang in China. To identify novel targets for the prevention or treatment of lung adenocarcinoma and lung squamous cell carcinoma (LUAD&LUSC), and to facilitate better alternative new drug discovery as well as clinical application services, the therapeutic effects of SAIN on LUAD&LUSC were evaluated by gene differential analysis of clinical samples, compound target molecular docking, and GROMACS molecular dynamics simulation.ResultsThrough data screening, alignment, analysis, and validation it was confirmed that three of the major active ingredients in SAIN, namely quercetin (Q), luteolin (L), and kaempferol (K), mainly act on six protein targets, which mainly regulate signaling pathways in cancer, transcriptional misregulation in cancer, EGFR tyrosine kinase inhibitor resistance, adherens junction, IL-17 signaling pathway, melanoma, and non-small cell lung cancer. In addition, microRNAs in cancer exert preventive or therapeutic effects on LUAD&LUSC. Molecular dynamics (MD) simulations of Q, L, or K in complex with EGFR, MET, MMP1, or MMP3 revealed the presence of Q in a very stable tertiary structure in the human body.ConclusionThere are three active compounds of Q, L, and K in SAIN, which play a role in the treatment and prevention of non-small cell lung cancer (NSCLC) by directly or indirectly regulating the expression of genes such as MMP1, MMP3, and EGFR.
Factors associated with burnout among Chinese nurses during COVID-19 epidemic: a cross-sectional study
Authors: Wan Zhiying , Lian Mengfei , Ma Hui , Cai Zhongxiang , Xianyu Yunyan 
Published: February 2022

Abstract
Background
The coronavirus disease 2019 (COVID-19) epidemic has broken out and even spread globally. The healthcare system worldwide faces enormous challenges, and nurses are at the highest risk as one of the leading forces. It's worth paying attention to nurses' anxiety and job burnout. This study aimed to investigate nurses' levels of burnout and anxiety during the epidemic of COVID-19 and to analyze influencing factors of burnout.

Methods
A cross-sectional survey was conducted from 19 to 25 February 2020. Questionnaires such as the basic information questionnaire, Maslach Burnout Inventory-General Survey (MBI-GS), and State-Trait Anxiety Inventory (STAI) were used among 1011 nurses in Wuhan tertiary hospitals via the online survey. The final number of valid questionnaires was 885. The effective response rate was 87.5%.

Results
The average score of MBI-GS was 11.50, 6.02, 24.47, respectively. The average score for state anxiety was 45.52 and trait anxiety, 43.78. Anxiety was positively associated with emotional exhaustion and cynicism, and negatively related to personal accomplishment. The protective factors of burnout were personnel agency, five years or less work experience, living in hospital dormitory, Wuhan medical team, working time exceeding 9 h, and the best knowledge of COVID-19. The absence of siblings, median job title, working in isolation wards, three or more night shifts per week, living in hotels, and being surrounded by confirmed or suspected medical staff were all negative factors.

Conclusions
Nurses had high anxiety levels during the COVID-19 period, but the level of burnout was mild to moderate. Managers should continue to pay attention to nurses' psychological state and related factors and intervene to stabilize the nursing team.
Implications of national tax policy on local pharmaceutical production in a southwestern state nigeria – qualitative research for the intersection of national pharmaceutical policy on health systems development
Authors: Obembe Taiwo A. , Adenipekun Adebisi B. , Morakinyo Oyewale M. , Odebunmi Kehinde O. 
Published: February 2022

Abstract
Background
Universal access to quality and affordable medicines is one of the targets of the Sustainable Development Goals (SDGs). Access to essential medicines is defined as the availability of medicine at an affordable price in public and private health institutions including retail pharmacies in the proximity of less than an hour from the home of the population. The dependence on importation to meet the drug needs of an expanding population has implications on the growth of the local pharmaceutical industry, availability, and affordability of essential medicines in the country. This study aims to understand the dynamics of tariffs and tax policy on local drug production in the pharmaceutical industry in Nigeria.

Methods
This was a qualitative study involving the use of Key Informant Interviews (KIIs). A total of 15 stakeholders were interviewed. Interviews conducted were analysed thematically. The data generated were analysed using Atlas.Ti version 8.2.

Results
Assessment of the pharmaceutical industry sub-sector underscores myriads of challenges facing the industry and explains why the pharmaceutical industries in Nigeria are performing sub-optimally. Key stakeholders in the sector expressed concern about the fact that substantial percentage of drugs consumed in Nigeria are imported. Local manufacturers are underperforming due to several factors. Some highlighted factors were unfriendly tax environment, high cost of production, infrastructural deficit, low patronage from the government, and lack of access to low-interest rate loans. However, tax incentives and tax cuts are proven strategies to encourage and facilitate the growth of entrepreneurs in the pharmaceutical industry.

Conclusions
Stakeholders’ perspective of implications of the tax environment on the pharmaceutical sector of Nigeria revealed the unfriendliness of the government policy to local manufacturers. Although the checklist for availability and prices of essential medicines in Osun state, Nigeria revealed that the pre-selected drugs were available in the facilities, the observed prices further affirmed the relative difficulty that is experienced by local manufacturers to compete with imported brands of the same drugs.
Factors associated with health insurance enrolment among Ghanaian children under the five years: analysis of secondary data from a national survey
Authors: Anaba Emmanuel Anongeba , Tandoh Akua , Sesay Foday Robert , Fokukora Theopista 
Published: February 2022

Abstract
Background
Health insurance enrolment provides financial access to health care and reduces the risk of catastrophic healthcare expenditure. Therefore, the objective of this study was to assess the prevalence and correlates of health insurance enrolment among Ghanaian children under five years.

Methods
We analysed secondary data from the 2017/18 Ghana Multiple Indicator Cluster Survey. The survey was a nationally representative weighted sample comprising 8,874 children under five years and employed Computer Assisted Personal Interviewing to collect data from the participants. In addition, Chi-square and Logistic Regression analyses were conducted to determine factors associated with health insurance enrolment.

Results
The results showed that a majority (58.4%) of the participants were insured. Health insurance enrollment was associated with child age, maternal educational status, wealth index, place of residence and geographical region (p < 0.05). Children born to mothers with higher educational status (AOR = 2.14; 95% CI: 1.39–3.30) and mothers in the richest wealth quintile (AOR = 2.82; 95% CI: 2.00–3.98) had a higher likelihood of being insured compared with their counterparts. Also, children residing in rural areas (AOR = 0.75; 95% CI: 0.61–0.91) were less likely to be insured than children in urban areas.

Conclusion
This study revealed that more than half of the participants were insured. Health insurance enrolment was influenced by the child's age, mother's educational status, wealth index, residence, ethnicity and geographical region. Therefore, interventions aimed at increasing health insurance coverage among children should focus on children from low socio-economic backgrounds. Stakeholders can leverage these findings to help improve health insurance coverage among Ghanaian children under five years.
Basics for the potential use of saliva to evaluate stress, inflammation, immune system, and redox homeostasis in pigs
Authors: Cerón J. J. , Contreras-Aguilar M. D. , Escribano D. , Martínez-Miró S. , López-Martínez M. J. , Ortín-Bustillo A. , Franco-Martínez L. , Rubio C. P. , Muñoz-Prieto A. , Tvarijonaviciute A. , López-Arjona M. , Martínez-Subiela S. , Tecles F. 
Published: February 2022

AbstractThe use of saliva as a biological sample has many advantages, being especially relevant in pigs where the blood collection is highly stressful and painful, both for the animal and the staff in charge of the sampling. Currently one of the main uses of saliva is for diagnosis and detection of infectious diseases, but the saliva can also be used to measure biomarkers that can provide information of stress, inflammation, immune response and redox homeostasis. This review will be focused on the analytes that can be used for such evaluations. Emphasis will be given in providing data of practical use about their physiological basis, how they can be measured, and their interpretation. In addition, some general rules regarding sampling and saliva storage are provided and the concept of sialochemistry will be addressed. There is still a need for more data and knowledge for most of these biomarkers to optimize their use, application, and interpretation. However, this review provides updated data to illustrate that besides the detection of pathogens in saliva, additional interesting applicative information regarding pigs´ welfare and health can be obtained from this fluid. Information that can potentially be applied to other animal species as well as to humans.