bluuebunny/crossref_metadata_2025_split huggingface dataset:
Survival status and predictor of mortality among adult stroke patients in Saint Paul’s hospital millennium medical college, Addis Ababa, Ethiopia
Authors: Sahle Adeba Tadesse , Mekonen Hussen , Alemu Tsion , Alate Tamrat , Melis Tamirat 
Published: July 2022

Objective: In Africa, there is up to 316 per 100,000 annual incidence rate of stroke, a prevalence of up to 1460 per 100,000, and a 3-year mortality rate higher than 80%. The incidence of stroke mortality in Ethiopia is 19.2%. Stroke is a major cause of disability and death worldwide. Early mortality in-hospital and deprived functional outcomes are common in acute stroke. This study aims to assess survival status and predictors of mortality among adult stroke patients. Methods: Institution-based retrospective cohort was conducted on patients who were admitted to Saint Paul’s Hospital Millennium Medical College. A simple random sampling technique was used. Bivariate and multivariable cox regression analysis were used to identify predictors of stroke mortality. For multivariable cox regression analysis statistically, significance was declared at p-value <0.05 and 95% CI. Results: A total of 251 adult stroke patient charts were included in the study. The overall Kaplan–Meier estimate showed that the probability of in-hospital stroke patients’ survival on the 41st day was nearly 50%. In this study, 77 (30.7%) of the study participants died. Decreased Glasgow Coma Scale (GCS) with adjusted hazard ratio (AHR) 4.26 (95% CI: 2.25–8.07) and p-value ⩽ 0.01 and presence of pneumonia with AHR 3.05 (95% CI: 1.29–7.21) and p-value ⩽ 0.01 are the predictor of mortality. Conclusion: The probability of survival relatively falls as follow-up time increases. The overall incidence of mortality among adult stroke patients was high. The decreased GCS and the presence of pneumonia are predictors of mortality among adult stroke patients.
Osteoradionecrosis: Experience from the Oral and Maxillofacial Surgery Unit at Christchurch Hospital, New Zealand
Authors: Khor Celine , Graham Danyon O. , Coghlan Peter , Erasmus Jason 
Published: July 2022

Background and objectives: Osteoradionecrosis of the jaws (ORN) is a debilitating complication of radiotherapy among head and neck cancer patients. Dentists are critical to the management of patients at risk and may be the first clinicians to encounter new onset ORN. Oral and Maxillofacial Surgical teams are commonly involved in the surgical management of such patients. To the best of our knowledge there have been no studies examining the referral pathways of patients with ORN to Oral and Maxillofacial Surgical Services in New Zealand. Methods: A retrospective study was conducted and included all patients with ORN referred to the Oral and Maxillofacial Surgical Service at Christchurch Hospital, New Zealand in the 3-year period 1st January 2018 to 31st December 2020. Clinical records were accessed to collect data endpoints. To illustrate the potential severity of ORN we also present a case report of a patient with mandibular ORN and pathologic fracture that was managed. Results: Thirteen patients with ORN were referred to the Oral and Maxillofacial Surgical Service at Christchurch Hospital over the study period. The majority of patients were referred by internal Christchurch Hospital colleagues (Otorhinolaryngology and Hospital Dentists). A wide range of presenting signs/symptoms were found. All patients presented with exposed necrotic bone however no other symptoms were found to be of high sensitivity for ORN. Patients required a range of treatment modalities, from conservative management to resection and fibula free-flap reconstruction. Conclusions: Most patients at risk of ORN are being maintained on long-term Hospital based recall lists for clinical review. Given the wide range of presenting signs/symptoms of ORN, oral health practitioners must exercise a high degree of clinical suspicion when encountering these in irradiated patients.
Fn14 exacerbates acute lung injury by activating the NLRP3 inflammasome in mice
Authors: Guan Xin-Xin , Yang Hui-Hui , Zhong Wen-Jing , Duan Jia-Xi , Zhang Chen-Yu , Jiang Hui-Ling , Xiang Yang , Zhou Yong , Guan Cha-Xiang 
Published: July 2022

Abstract
Background
Uncontrolled inflammation is an important factor in the occurrence and development of acute lung injury (ALI). Fibroblast growth factor-inducible 14 (Fn14), a plasma membrane-anchored receptor, takes part in the pathological process of a variety of acute and chronic inflammatory diseases. However, the role of Fn14 in ALI has not yet been elucidated. This study aimed to investigate whether the activation of Fn14 exacerbated lipopolysaccharide (LPS)-induced ALI in mice.

Methods
In vivo, ALI was induced by intratracheal LPS-challenge combined with/without Fn14 receptor blocker aurintricarboxylic acid (ATA) treatment in C57BL/6J mice. Following LPS administration, the survival rate, lung tissue injury, inflammatory cell infiltration, inflammatory factor secretion, oxidative stress, and NLRP3 inflammasome activation were assessed. In vitro, primary murine macrophages were used to evaluate the underlying mechanism by which Fn14 activated the NLRP3 inflammasome. Lentivirus was used to silence Fn14 to observe its effect on the activation of NLRP3 inflammasome in macrophages.

Results
In this study, we found that Fn14 expression was significantly increased in the lungs of LPS-induced ALI mice. The inhibition of Fn14 with ATA downregulated the protein expression of Fn14 in the lungs and improved the survival rate of mice receiving a lethal dose of LPS. ATA also attenuated lung tissue damage by decreasing the infiltration of macrophages and neutrophils, reducing inflammation, and suppressing oxidative stress. Importantly, we found that ATA strongly inhibited the activation of NLRP3 inflammasome in the lungs of ALI mice. Furthermore, in vitro, TWEAK, a natural ligand of Fn14, amplified the activation of NLRP3 inflammasome in the primary murine macrophage. By contrast, inhibition of Fn14 with shRNA decreased the expression of Fn14, NLRP3, Caspase-1 p10, and Caspase-1 p20, and the production of IL-1β and IL-18. Furthermore, the activation of Fn14 promoted the production of reactive oxygen species and inhibited the activation of Nrf2-HO-1 in activated macrophages.

Conclusions
Our study first reports that the activation of Fn14 aggravates ALI by amplifying the activation of NLRP3 inflammasome. Therefore, blocking Fn14 may be a potential way to treat ALI.
Current physical therapy practice and implementation factors regarding the evidence-based ‘Rehabilitation of Mobility after Stroke (ReMoS)’ guideline in Germany: a cross-sectional online survey
Authors: Scheffler Bettina , Schimböck Florian , Schöler Almut , Rösner Katrin , Spallek Jacob , Kopkow Christian 
Published: July 2022

AbstractBackgroundEvaluation of the current physical therapy practice for German stroke rehabilitation with respect to the ‘Rehabilitation of Mobility after Stroke (ReMoS)’ guideline recommendations and the associated implementation factors.MethodsA descriptive cross-sectional study employing an online survey was performed among German physical therapists in 2019. The survey consisted of three sections with open and closed questions: 1) self-reported use of ReMoS recommendations, 2) barriers of guideline use and 3) socio-demographic characteristics. The benchmark level for guideline adherent physical therapy was set at > 80%.ResultsData from 170 questionnaires were eligible for analysis. Participants’ mean age was 41.6 years, 69.4% were female, while 60.1% had no academic degree. The ReMoS guideline was unknown to 52.9% of the responders. Out of all the 46 ReMoS guideline recommendations, only ‘intensive walking training without a treadmill’ was reported to be performed in a guideline adherent manner. Respondents usually denied any personal limitations, such as limited knowledge, or that the ReMoS guideline did not fit their routine practice.ConclusionsAmong German physical therapists, the ReMoS guideline is not well-known and many interventions are not performed as recommended, illustrating the discrepancies between the ReMoS guideline recommendations and current physical therapy practice. Interventions aimed at overcoming this gap should consider both knowledge of existing barriers and facilitators of guideline usage.Trial registrationThe study was retrospectively registered to the German Clinical Trials Register (DRKS00026681).
The impact of dietary diversity and seasonality in food availability on the quantile distribution of birth size among pregnant women in rural Malawi – a cross-sectional study
Authors: Hjertholm Katrine G. , Holmboe-Ottesen Gerd , Mdala Ibrahimu , Shi Zumin , Iversen Per O. 
Published: July 2022

AbstractBackgroundDietary diversity scores can be used as a proxy for dietary intakes and for assessment of nutrient adequacy. Studies from low-resource settings have found maternal dietary diversity scores to be associated with neonatal birth size. We here investigated the relationship between the dietary diversity score among pregnant mothers and birth size of their offspring across quantiles of the birth size variables; birth weight, length, abdominal circumference, and head circumference. We also investigated if seasonality affects birth size across different quantiles.MethodsDietary intake and anthropometric data were collected from 190 pregnant women and their neonates in rural Malawi through two agricultural seasons. Dietary data was collected using 24-hour recall interviews and was categorized into the 10-food group dietary diversity score proposed for women by the Food and Agriculture Organization. Neonatal anthropometrics were collected upon delivery at health facilities. Quantile regression analyses were used to investigate associations between dietary diversity scores and birth size, as well as between seasonality and birth size.ResultsWe found that neonatal abdominal circumference was 0.9 cm larger during the post-harvest season compared to the pre-harvest season among neonates in the 25th quantile. Birth weight was 281.4 g higher for those born during the post-harvest season in the 90th quantile. For a one-unit increase in maternal dietary diversity score, birth weight increased by 56.7 g among those in the 25th quantile and neonatal head circumference increased by 0.2 cm for those in the 70th quantile. However, these findings did not remain significant when considering the cluster effect of the neonatal anthropometric data.ConclusionsOur findings indicate that the relationship between seasonality and birth size differs across the distribution of birth size. Investigating the effect of seasonality across the distribution of birth size could be important to identify vulnerable subgroups and develop better, targeted interventions to improve maternal and child nutrition and health.
Treatment retention in opioid agonist therapy: comparison of methadone versus buprenorphine/naloxone by analysis of daily-witnessed dispensed medication in a Canadian Province
Authors: Sadek Joseph , Saunders Joseph 
Published: July 2022

Abstract
Background
The last decade has shown a remarkable increase in the rates of illicit opioid use in Canada and internationally, which is associated with large increases in opioid related morbidity and mortality. While the differences between methadone and buprenorphine/naloxone in terms of retention have been studied outside Canada, the unique location and design of this study, gives it a specific significance.

Objectives
This study aims to describe the relative treatment retention rates for first episode opioid replacement treatment between methadone and buprenorphine/naloxone for patients receiving daily witnessed dispensed medications in Nova Scotia.

Methods
A longitudinal retrospective descriptive study analyzing secondary data from the Nova Scotia Prescription Monitoring Program on patients 18 years of age and older who started first episode opioid agonist therapy with methadone or buprenorphine/naloxone for opioid use disorder in Nova Scotia between 2014 and 2018. Treatment episode was defined as date of initial opioid agonist prescription until there is a gap of greater than 6 days without receiving opioid agonist medication at a pharmacy.

Results
One thousand eight hundred sixty-seven of whom were analyzed as they had at least 1 day in treatment. There was significant treatment dropout within the first 2 weeks of treatment, which did not show a significant difference between OAT medication (23.4% of buprenorphine/naloxone; 22.2% methadone). Median duration of retention in treatment was 58 days for those treated with buprenorphine/naloxone and 101 days for patients treated with methadone.
Multivariate cox proportional hazards model showed that buprenorphine/naloxone use as compared to methadone lead to increased hazard of treatment dropout by 62% (HR = 1.62).
Hazard rate of treatment dropout for patients below 25 years of age was calculated. (HR 1.53).
Median duration of retention in treatment for this subgroup of patients younger than age 25 was 37.5 days for patients treated with buprenorphine/naloxone and 69 days for patients treated with methadone.

Conclusions
Our data suggests that methadone is a numerically superior medication for opioid use disorder when the metric of treatment retention is viewed in isolation, for our population in Nova Scotia. However, the results should be interpreted carefully considering the number of limitations of this study. There are social/accessibility, pharmacologic/safety, and patient preference factors which are also key in decision making when prescribing opioid agonist therapy. These must all be considered when deciding on which medication to initiate for a patient beginning a new treatment episode with OAT for opioid use disorder. This study should stimulate further research into this important area in addiction medicine.
Weight loss outcomes achieved by adults accessing an online programme offered as part of Public Health England’s ‘Better Health’ campaign
Authors: Toon Josef , Geneva Martina , Sharpe Paul , Lavin Jacquie , Bennett Sarah , Avery Amanda 
Published: July 2022

AbstractEffective use of health technology may offer a scalable solution to the obesity pandemic. Online digital programmes provide a convenient and flexible way for more people to access regular support. This service evaluation aims to determine whether adults accessing an online weight management programme via a national campaign are successful in losing weight.Data was analysed for adults registering with Slimming World’s online programme using a discounted membership offered as part of PHE’s ‘Better Health’ campaign between July and December 2020. Last-weight carried forward was used to calculate weight outcomes for participants who had the opportunity to complete 12-weeks and recorded ≥ one weight besides baseline. Engagement was determined using number of online weekly weights recorded with high engagers having weight data for ≥ 9 occasions. Socioeconomic status was assessed using postcode data. Resubscription and uploaded weight data were used to determine numbers who continued beyond the offer period.Twenty-seven thousand two hundred forty-eight adults (5.3% males) with mean age 41.0 ± 11.4 years met inclusion criteria. Mean baseline BMI was 33.4 ± 6.8 kg/m2(29.2% 30–34.9, 18.3% 35–39.9 and 15.1% > 40 kg/m2). Mean weight loss at 12 weeks was 2.7 (± 3) kg representing a mean loss of 3% (± 3.1) body weight with 42.3% achieving ≥ 3% and 22.1% weight loss ≥ 5%. Median number of weigh-ins was six. Men had greater weight losses compared to women (p < 0.001). High engagers, both men and women, achieved greater weight losses (p < 0.001). Absolute weight loss was associated with joining BMI (rs = -0.15,p < 0.001) but for % weight change only small differences were seen (max effect size = 0.03) with no differences in weight change for high engagers between different baseline BMI categories (p > 0.05). 30.9% were in the lowest two IMD quintiles and absolute and percentage weight change did not differ across deprivation quintiles (p > 0.05). 34.9% continued to access the online support after the offer period.This service evaluation shows that an online programme, offered as part of a national campaign, can offer effective support to a large number of people with different starting BMIs and from different socioeconomic backgrounds. An increased level of engagement leads to better weight losses.
Experience with open schools and preschools in periods of high community transmission of COVID-19 in Norway during the academic year of 2020/2021
Authors: Stebbings Sara , Rotevatn Torill Alise , Larsen Vilde Bergstad , Surén Pål , Elstrøm Petter , Greve-Isdahl Margrethe , Johansen Tone Bjordal , Astrup Elisabeth 
Published: July 2022

Abstract
Background
Schools and preschools have largely remained open in Norway throughout the pandemic, with flexible mitigation measures in place. This contrasts with many other high-income countries that closed schools for long periods of time. Here we describe cases and outbreaks of COVID-19 in schools and preschools during the academic year 2020/2021, to evaluate the strategy of keeping these open with infection prevention control measures in place.

Methods
In this descriptive study, the Norwegian Institute of Public Health initiated systematic surveillance for COVID-19 cases and outbreaks in schools and preschools in October 2020. Data was compiled from the national outbreak alert system VESUV, municipality websites, and media scanning combined with the national emergency preparedness register Beredt C-19. An outbreak was defined as ≥ 2 cases among pupils or staff within 14 days at the same educational setting. Settings were categorized as preschool (1–5-years), primary school (6–12-years), lower secondary school (13–15-years) and upper secondary school (16–18- years). We reported the incidence rate among preschool and school-aged pupils and gave a descriptive overview of outbreaks and included cases per educational setting.

Results
During the whole academic year, a total of 1203 outbreaks in preschools and school settings were identified, out of a total of 8311 preschools and schools nationwide. The incidence of COVID-19 in preschool- and school-aged children and the rates of outbreaks in these settings largely followed the community trend. Most of the outbreaks occurred in primary schools (40%) and preschools (25%). Outbreaks across all settings were mostly small (median 3 cases, range 2 to 72), however, 40 outbreaks (3% of total) included 20 or more cases. The larger outbreaks were predominantly seen in primary schools (43%).

Conclusions
We observed few large outbreaks in open schools and preschools in Norway during the academic year of 2020/2021, also when the Alpha variant was predominant. This illustrates that it is possible to keep schools and preschools open even during periods of high community transmission of COVID-19. Adherence to targeted IPC measures adaptable to the local situation has been essential to keep educational settings open, and thus reduce the total burden on children and adolescents.
Distribution and clinical significance of circulating CD8+CD28− regulatory T cells in the peripheral blood of patients with pulmonary tuberculosis
Authors: Yu Xin , Lin Yao , Chen Hui , Wu Min-Juan , Huang Li-Na , Song Yi-Yan , Gu Bin-Bin , Ye Zhi-Jian , Xu Ping , Zhang Jian-Ping , Xu Jun-Chi 
Published: July 2022

Abstract
Background
Regulatory T cells (Treg cells) in the peripheral blood of patients with pulmonary tuberculosis (PTB) may be closely related to the progression of PTB. In this study, the distribution characteristics and clinical importance of CD8+CD28− Treg cells in patients with tuberculosis were systematically analyzed, and the role and importance of CD8+CD28− Treg cells in influencing the immune response and progression of tuberculosis were discussed, which will provide immunological indices and reference values for the clinical diagnosis of tuberculosis.

Methods
Flow cytometry, sputum smears and computed tomography imaging were used to analyze the distribution characteristics of CD8+CD28− Treg cells in the peripheral blood of patients with PTB and the correlation between CD8+CD28−Treg cells and clinical and immune indices.

Results
The percentages of CD4+CD25high and CD8+CD28− Treg cells in the peripheral blood of patients with PTB were significantly higher than those in the healthy control (HC) group. Further analysis showed that the percentage of CD4+CD25highTreg cells in the Stage II group was significantly higher than that in the HC group. The percentages of CD4+CD25high and CD8+CD28− Treg cells increased significantly in patients in the Stage II group. The proportion of CD8+CD28− Treg cells was directly proportional to the degree of positivity in sputum smears, while CD4+CD25highTreg cells did not exhibit this trend.
The correlations between the percentage of CD4+CD25high and CD8+CD28− Treg cells and the percentage of lymphocyte subsets were examined. The percentage of CD8+CD28− Treg cells was negatively correlated with the percentage of CD4+T cells and positively correlated with the CD8+T cell percentage in the HC and PTB groups. The percentage of CD4 + CD25highTreg cells was positively correlated with the percentage of CD4+T cells only in the PTB group.

Conclusions
This study was the first to show that the proportion of CD8+CD28− Treg cells in the peripheral blood of patients with PTB was significantly increased, and the increase in CD8+CD28− Treg cells was related to the progression of PTB, which may affect the proportion of immune cell subsets by inhibiting the immune response, resulting in the progression of PTB.
Impact of preoperative biopsy on tumor spread through air spaces in stage I non-small cell lung cancer: a propensity score-matched study
Authors: Ding Yun , Li Jiuzhen , Li Xin , Xu Meilin , Geng Hua , Sun Daqiang 
Published: July 2022

Abstract
Background
Percutaneous needle biopsy (PNB) and bronchoscopic biopsy (BB) are widely used in the preoperative diagnosis of pulmonary nodules, but whether PNB or BB may cause tumor spread through air spaces (STAS) has not been reported.

Methods
433 postoperative patients with pathological stage I non-small cell lung cancer (NSCLC) from January 2015 to December 2018 at our hospital were enrolled and divided into PNB group (n = 40), BB group (n = 48) and non-biopsy group (n = 345). The PNB and BB groups were matched using propensity score matched (PSM) separately from the non-biopsy group, after which the effects of PNB and BB on STAS, recurrence-free survival (RFS) and overall survival (OS) were assessed.

Results
After PSM for 9 confounding factors (gender, age, smoking history, tumor site, scope of surgery, pathology type, stage, maximum tumor diameter and postoperative treatment), 38 cases in the PNB group were successfully matched with 38 cases in the non-biopsy group and 28 cases in the BB group were successfully matched with 28 cases in the non-biopsy group. After PSM, there was no significant difference in the incidence of STAS between the PNB and non-biopsy groups (42.1% vs. 34.2%, P > 0.05) and between the BB and non-biopsy groups (42.9% vs. 46.4%, P > 0.05). The results after PSM showed no significant effect of both PNB and BB on RFS and OS after radical surgery (P > 0.05).

Conclusion
Preoperative biopsy in patients with stage I NSCLC has not been shown to increase the occurrence of STAS, nor postoperative recurrence and death.