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Association of baseline diaphragm, rectus femoris and vastus intermedius muscle thickness with weaning from mechanical ventilation.

Respir Med 2021 Jun 12;185:106503. Epub 2021 Jun 12.

Division of Intensive Care Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey. Electronic address:

Background: To determine whether baseline diaphragm (T), rectus femoris (RF) and vastus intermedius (VI) muscle thickness (T and T) are associated with weaning success.

Material And Methods: Right T, T and T were measured by ultrasonography within 36 h of intubation and diaphragmatic excursion (DE) was evaluated at the first spontaneous breathing trial in adult critically-ill patients. Reintubation or death within 7 days after extubation was defined as weaning failure. Read More

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Intubation timing as determinant of outcome in patients with acute respiratory distress syndrome by SARS-CoV-2 infection.

J Crit Care 2021 Jun 17;65:164-169. Epub 2021 Jun 17.

Departamento de Medicina Intensiva, Pontificia Universidad Católica de Chile, Chile. Electronic address:

Purpose: To determine whether time-to-intubation was associated with higher ICU mortality in patients with COVID-19 on mechanical ventilation due to respiratory insufficiency.

Materials And Methods: We conducted an observational, prospective, single-center study of patients with confirmed SARS-CoV-2 infection hospitalized with moderate to severe ARDS, connected to mechanical ventilation in the ICU between March 17 and July 31, 2020. We examined their general and clinical characteristics. Read More

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Pairwise kinship testing with microhaplotypes: Can advancements be made in kinship inference with these markers?

Forensic Sci Int 2021 Jun 12;325:110875. Epub 2021 Jun 12.

Faculty of Forensic Medicine, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, PR China; Guangdong Province Translational Forensic Medicine Engineering Technology Research Center, Sun Yat-sen University, Guangzhou 510080, PR China. Electronic address:

Kinship testing based on genetic relatedness is one of the major tasks in forensic genetics. Although short tandem repeats (STRs) are the "gold standard" biomarkers for relationship testing, microhaplotypes (MHs) have also emerged as viable options for kinship elucidation. In this work, the kinship testing efficiency of 54 highly polymorphic MHs was studied in two extended families consisting of parent-offspring, full siblings, grandparent-grandchildren, uncle/aunt-nephew/nieces, and first cousins. Read More

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Analytic Morphomics Are Related to Outcomes After Lung Volume Reduction Surgery.

Semin Thorac Cardiovasc Surg 2021 Jun 21. Epub 2021 Jun 21.

Division of Acute Care Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA.

Lung volume reduction surgery continues to have a high morbidity despite National Emphysema Treatment Trial selection criteria. This study evaluated the association between analytic morphomics on chest computed tomography scans and outcomes after lung volume reduction surgery. In a retrospective review of 85 lung volume reduction surgery patients from 1998-2013, dorsal muscle group area, subcutaneous and visceral fat area, and bone mineral density were assessed using analytic morphomics. Read More

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Cerebral Perfusion and Metabolism with Mean Arterial Pressure 90 vs. 60 mmHg in a Porcine Post Cardiac Arrest Model with and without Targeted Temperature Management.

Resuscitation 2021 Jun 21. Epub 2021 Jun 21.

Department of Anaesthesiology, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

Aim: To determine whether targeting a mean arterial pressure of 90 mmHg (MAP90) would yield improved cerebral blood flow and less ischaemia compared to MAP 60 mmHg (MAP60) with and without targeted temperature management at 33 °C (TTM33) in a porcine post-cardiac arrest model.

Methods: After 10 minutes of cardiac arrest, 41 swine of either sex were resuscitated until return of spontaneous circulation (ROSC). They were randomised to TTM33 or no-TTM, and MAP60 or MAP90; yielding four groups. Read More

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The role of PD-1/PD-L1 checkpoint in arsenic lung tumorigenesis.

Toxicol Appl Pharmacol 2021 Jun 21:115633. Epub 2021 Jun 21.

Department Pharmacology & Nutritional Sciences, University of Kentucky College of Medicine, Lexington, KY 40536, USA. Electronic address:

Chronic exposure to environmental arsenic promotes lung cancer. Emerging evidence indicates that compromised host immunity, particularly T cell anti-tumor immunity, may play a critical role in cancer development. However, there is a knowledge gap in terms of the effects of arsenic exposure on T cell anti-tumor immunity and how that may contribute to arsenic lung carcinogenicity. Read More

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Sociodemographic characteristics, complications requiring hospital admission and causes of in-hospital death in patients with liver cirrhosis admitted at a district hospital in Ghana.

PLoS One 2021 24;16(6):e0253759. Epub 2021 Jun 24.

Department of Biostatistics, St. Dominic Hospital, Akwatia, Ghana.

Background: Chronic liver diseases including liver cirrhosis are a major cause of morbidity and mortality globally. Despite the high burden of liver cirrhosis in Ghana, data on this disease is lacking.

Objective: To determine the sociodemographic characteristics, reasons for admission, and in-hospital mortality of patients with cirrhosis of the liver seen at a district hospital in Ghana. Read More

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Real-world outcomes of first- and second-generation tyrosine kinase inhibitors first-line in patients with epidermal growth factor receptor mutation-positive non-small cell lung cancer: A retrospective observational cohort study.

PLoS One 2021 24;16(6):e0253335. Epub 2021 Jun 24.

Division of Chest Medicine, Department of Internal Medicine, Shin Kong Wu-Ho-Su Memorial Hospital, Taipei, Taiwan.

The sequencing of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) in patients with EGFR mutation-positive (EGFRm+) non-small cell lung cancer (NSCLC) remains a matter of controversy. This cohort study analyzed the overall survival (OS) and progression-free survival (PFS) of afatinib compared with erlotinib and gefitinib first-line. EGFRm+, advanced NSCLC patients treated with either afatinib, erlotinib or gefitinib were retrospectively analyzed. Read More

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Vancomycin resistant Enterococci and its associated factors among HIV infected patients on anti-retroviral therapy in Ethiopia.

PLoS One 2021 24;16(6):e0251727. Epub 2021 Jun 24.

Department of Medical Microbiology, Arba Minch University, Arba Minch, Ethiopia.

Background: The emergence of vancomycin resistant Enterococci (VRE) has alarmed the global community due to its tendency for colonization of the gastrointestinal tract. Human Immunodeficiency Virus (HIV) patients are colonized by vancomycin resistant Enterococci than other groups. The aim of this study was to determine the incidence of vancomycin resistant Enterococci and its associated factors among HIV infected patients on Anti-Retroviral Therapy (ART). Read More

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Renin Kinetics Are Superior to Lactate Kinetics for Predicting In-Hospital Mortality in Hypotensive Critically Ill Patients.

Crit Care Med 2021 Jun 24. Epub 2021 Jun 24.

University of Maryland School of Medicine, Baltimore, MD. Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD. Division of Nephrology and Hypertension, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH. Department of Anesthesiology and Critical Care Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC. Department of Pathology, University of Maryland School of Medicine, Baltimore, MD. Department of Medicine, University of Wisconsin-Madison, Madison, WI. Department of Obstetrics and Gynecology, University of Maryland School of Medicine, Baltimore, MD R. Adams Cowley Shock Trauma Center, Surgical Critical Care, Baltimore, MD.

Objectives: Whole blood lactate concentration is widely used in shock states to assess perfusion. We aimed to determine if the change in plasma renin concentration over time would be superior to the change in lactate concentration for predicting in-hospital mortality in hypotensive patients on vasopressors.

Design: Prospective, observational cohort study. Read More

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Association of Proximity to a Long-Term Acute Care Hospital With Hospital Tracheostomy Practices.

Crit Care Med 2021 Jun 24. Epub 2021 Jun 24.

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Denver Health Hospital Association, Denver, CO. Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO. Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicin,. National Jewish Health, Denver, CO. Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO. Veteran's Affairs Eastern Colorado Geriatric Research Education and Clinical Center, Denver, CO. Adult and Child Consortium for Outcomes Research and Delivery Science, University of Colorado, Aurora, CO.

Objectives: Availability of long-term acute care hospitals has been associated with hospital discharge practices. It is unclear if long-term acute care hospital availability can influence patient care decisions. We sought to determine the association of long-term acute care hospital availability at different hospitals with the likelihood of tracheostomy. Read More

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The role of leaf litter as a protective barrier for copper-containing pesticides in orchard soils.

Environ Sci Pollut Res Int 2021 Jun 24. Epub 2021 Jun 24.

Departamento de Ecosistemas y Medio Ambiente, Facultad de Agronomía e Ingeniería Forestal, Pontificia Universidad Católica de Chile, Vicuña Mackenna 4860, 7820436, Santiago, Chile.

This study assessed the capacity of leaf litters to adsorb copper ions applied as a copper-based pesticide. Leaf litters of two fruit tree species with different lignin/N ratios were examined to determine their protective role against the incorporation of Cu into soil. A leaf litter Cu-adsorption capacity assay and a degradation assay were performed using table grape (lignin/N = 2. Read More

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Association of interleukin-18 genotypes (-607C > A) and (-137 G > C) with the hepatitis B virus disease progression to hepatocellular carcinoma.

Mol Cell Biochem 2021 Jun 24. Epub 2021 Jun 24.

Department of Biochemistry, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.

Chronic infection with HBV has been reported to be associated with the development of HCC. The inflammation mounted by cytokine-mediated immune system plays an important role in the pathogenesis of HBV-associated HCC. IL-18 is a pro-inflammatory cytokine whose role in the development of HBV-associated chronic to malignant disease state has not been much studied. Read More

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Estimated Cost-effectiveness of Solar-Powered Oxygen Delivery for Pneumonia in Young Children in Low-Resource Settings.

JAMA Netw Open 2021 Jun 1;4(6):e2114686. Epub 2021 Jun 1.

University of Alberta, Edmonton, Canada.

Importance: Pneumonia is the leading cause of childhood mortality worldwide. Severe pneumonia associated with hypoxemia requires oxygen therapy; however, access remains unreliable in low- and middle-income countries. Solar-powered oxygen delivery (solar-powered O2) has been shown to be a safe and effective technology for delivering medical oxygen. Read More

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Genome-wide association study of body fat distribution traits in Hispanics/Latinos from the HCHS/SOL.

Hum Mol Genet 2021 Jun 24. Epub 2021 Jun 24.

Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, 91101, USA.

Central obesity is a leading health concern with a great burden carried by ethnic minority populations, especially Hispanics/Latinos. Genetic factors contribute to the obesity burden overall and to inter-population differences. We aimed to identify loci associated with central adiposity measured as waist-to-hip ratio (WHR), waist circumference (WC), and hip circumference (HIP) adjusted for body mass index (adjBMI), using the Hispanic Community Health Study/Study of Latinos (HCHS/SOL); determine if differences in associations differ by background group within HCHS/SOL; and determine whether previously reported associations generalize to HCHS/SOL. Read More

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Treatment with melatonin ameliorates febrile convulsion via modulating the MEG3/miR‑223/PTEN/AKT signaling pathway.

Int J Mol Med 2021 Aug 24;48(2). Epub 2021 Jun 24.

Neurology Department, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430016, P.R. China.

The PTEN/AKT signaling pathway is involved in the pathogenesis of febrile convulsion (FC), a convulsion caused by abnormal electrical activity in the brain. The objective of the present study was to evaluate the therapeutic effect of melatonin (MT) on FC and the according underlying molecular mechanisms. Reverse transcription‑quantitative PCR and western blot analysis were used to explore the effects of MT on the expression levels of MEG3, microRNA (miRNA/miR)‑223, phosphatase and tensin homolog (PTEN) and protein kinase B (AKT). Read More

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Microalbuminuria as a Predictor of Pre-eclampsia in Pregnant Women Presenting in the Antenatal Clinic at Dhulikhel Hospital.

Kathmandu Univ Med J (KUMJ) 2020 Oct.-Dec.;18(72):349-353

Department of Biochemistry, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences Dhulikhel, Kavre, Nepal.

Background Pre-eclampsia is described as a pregnancy-specific syndrome that can affect virtually every organ system. The appearance of proteinuria remains an important diagnostic criterion. Proteinuria is an objective marker and reflects system-wide endothelial leak, which characterizes the pre-eclampsia syndrome. Read More

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Visceral segment aortic thrombus is associated with proximal aortic degeneration after infrarenal abdominal aortic aneurysm repair.

Vascular 2021 Jun 24:17085381211021282. Epub 2021 Jun 24.

Department of Vascular Surgery, Miller Family Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA.

Objective: To identify predictors of aortic aneurysm formation at or above an infrarenal abdominal aortic aneurysm repair.

Methods: A total of 881 infrarenal abdominal aortic aneurysm repairs were identified at a single institution from 2004 to 2008; 187 of the repairs were identified that had pre-operative and post-operative computed tomography imaging at least one year or greater to evaluate for aortic degeneration following repair. Aortic diameters at the celiac, superior mesenteric, and renal arteries were measured on all available computed tomographic scans. Read More

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Association between Plasma Osmolality and Case Fatality within 1 Year after Severe Acute Ischemic Stroke.

Yonsei Med J 2021 Jul;62(7):600-607

Center of Cerebrovascular Disease, Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.

Purpose: Plasma osmolality, a marker of dehydration, is associated with cardiovascular mortality. We aimed to investigate whether elevated plasma osmolality is associated with case fatality within 1 year after severe acute ischemic stroke.

Materials And Methods: We included severe ischemic stroke patients (defined as National Institutes of Health Stroke Scale ≥15 score) within 24 hours from symptom onset admitted to the Department of Neurology, West China Hospital between January 2017 and June 2019. Read More

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Management of patients presenting with low back pain to a private hospital emergency department in Melbourne, Australia.

Emerg Med Australas 2021 Jun 23. Epub 2021 Jun 23.

Emergency Department, Cabrini Health, Melbourne, Victoria, Australia.

Objective: Recent studies suggest many patients with non-specific low back pain presenting to public hospital EDs receive low-value care. The primary aim was to describe management of patients presenting with low back pain to the ED of a private hospital in Melbourne, Australia, and received a final ED diagnosis of non-specific low back pain. We also determined predictors of hospital admission. Read More

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Prognostic Utility of Daily Changes in Glasgow Coma Scale and the Full Outline of Unresponsiveness Score Measurement in Patients with Metabolic Encephalopathy, Central Nervous System Infections and Stroke in Uganda.

Neurocrit Care 2021 Jun 23. Epub 2021 Jun 23.

Department of Neurology, Mayo Clinic, Phoenix, AZ, USA.

Background: Metabolic encephalopathy (ME), central nervous system (CNS) infections, and stroke are common causes of reduced level of consciousness in Uganda. However, the prognostic utility of changes in the daily measurements of the Full Outline of Unresponsiveness (FOUR) score and Glasgow Coma Scale (GCS) score in these specific disorders is not known.

Methods: We conducted secondary analyses of data from patients who presented with reduced level of consciousness due to CNS infections, stroke, or ME to a tertiary hospital in Uganda. Read More

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Bony callus stiffness indirectly evaluated by the axial load-share ratio in vivo as a guide to removing a monolateral external fixator safely.

Int Orthop 2021 Jun 23. Epub 2021 Jun 23.

Department of Trauma and Microreconstructive Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.

Purpose: As the monolateral external fixator is increasingly used in trauma-control and definitive management for high-energy long bone fractures, timing the fixator removal remains a challenge for surgeons. The purpose of this study was to determine the feasibility and effectiveness of the bony callus stiffness indirectly evaluated by the axial load-share ratio in vivo as a guide to removing a monolateral external fixator safely.

Methods: A total of 131 patients with tibial shaft fractures treated by the monolateral external fixator in our institution were collected from January 2013 to July 2019. Read More

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Effect of type 2 diabetes on Gd-EOB-DTPA uptake into liver parenchyma: replication study in human subjects.

Abdom Radiol (NY) 2021 Jun 23. Epub 2021 Jun 23.

Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.

Purpose: Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) is a contrast agent for magnetic resonance imaging (MRI), which specifically taken up by hepatocytes through organic anion-transporting polypeptides (OATPs). Previous research in mice has shown that type 2 diabetes is associated with reduced uptake of Gd-EOB-DTPA into the liver parenchyma, reflecting reduced expression of OATP. Since considerable differences in OATP expression exist between mice and humans, human studies are necessary to clarify the effect of diabetes to Gd-EOB-DTPA uptake. Read More

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Contributing role of TNF, IL-10, sTNFR1 and TNF gene polymorphisms in disease severity of leptospirosis.

Med Microbiol Immunol 2021 Jun 23. Epub 2021 Jun 23.

Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka.

The immune response is hypothesized as an important factor in the disease outcome of leptospirosis. Exaggerated immune response may promote tissue damage that lead to severe disease outcome. In this study TNF, IL-10, sTNFR1 levels were measured among sixty-two hospitalized leptospirosis confirmed patients in Sri Lanka. Read More

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How effective are digital interventions in increasing flu vaccination among pregnant women? A systematic review and meta-analysis.

J Public Health (Oxf) 2021 Jun 23. Epub 2021 Jun 23.

The Unit of Academic Primary Care, Warwick Medical School, The University of Warwick, Coventry CV4 7AL, UK.

Background: Flu can have serious consequences for pregnant woman and unborn babies. Vaccination provides safe and effective protection, yet uptake among pregnant women is below national targets. Digital interventions are effective at increasing adherence to health interventions. Read More

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Coronary Stent Healing in Cancer Patients-An Optical Coherence Tomography Perspective.

Front Cardiovasc Med 2021 7;8:665303. Epub 2021 Jun 7.

Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.

This study assessed stent healing patterns and cardiovascular outcomes by optical coherence tomography (OCT) in cancer patients after drug-eluting stent (DES) placement. Cancer treatment, owing to its cytotoxic and antiproliferative effects, could delay stent healing and increase stent thrombosis risk, especially when dual antiplatelet therapy (DAPT) is discontinued early for oncological treatment. OCT can assess stent endothelialization and other healing parameters, which may provide clinical guidance in these challenging scenarios. Read More

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SGLT-2i and Risk of Malignancy in Type 2 Diabetes: A Meta-Analysis of Randomized Controlled Trials.

Front Public Health 2021 7;9:668368. Epub 2021 Jun 7.

Department of Endocrinology, Ningbo Yinzhou No. 2 Hospital, Ningbo, China.

Currently, the association between sodium-glucose cotransporter 2 inhibitor (SGLT-2i) and malignancy risk has yet to be fully elucidated. This meta-analysis aimed to determine the relationship between SGLT-2i and malignancy risk in type 2 diabetes (T2D) patients. We searched PubMed, ScienceDirect, EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science to identify randomized controlled trials (RCTs) published up to August 2020 related to T2D patients treated with SGLT-2i vs. Read More

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Hospital outcome of concomitant tricuspid annuloplasty during totally endoscopic mitral valve surgery: a propensity matched study.

J Thorac Dis 2021 May;13(5):3042-3050

Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China.

Background: This study aimed to determine how concomitant tricuspid annuloplasty (TAP) affects the clinical outcomes of patients undergoing totally endoscopic mitral valve surgery.

Methods: This was a single-centre, retrospective study. Between January 2019 and June 2020, 143 patients who underwent totally endoscopic mitral valve surgery in our institution were enrolled. Read More

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Role of surgery in a case-control study of patients with clinical stage IIIA small cell lung cancer.

J Thorac Dis 2021 May;13(5):2738-2745

Department of Thoracic Surgery, Tongji University Affiliated Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.

Background: The role of surgery in the multidisciplinary treatment of clinical stage IIIA small cell lung cancer is yet to be verified. This study was performed to determine the benefit of surgery in patients with stage IIIA small cell lung cancer.

Methods: Patients diagnosed with stage IIIA small cell lung cancer at Shanghai Pulmonary Hospital from 2005 to 2015 were included and divided into two groups: the surgery with neoadjuvant and adjuvant chemotherapy group and the concurrent chemo-radiotherapy group. Read More

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Only one in four lactating mothers met the minimum dietary diversity score in the pastoral community, Afar region, Ethiopia: a community-based cross-sectional study.

J Nutr Sci 2021 1;10:e41. Epub 2021 Jun 1.

Department of Nursing, Samara University, Samara, Afar, Ethiopia.

Maternal dietary feeding practice is one of the proxy indicators of maternal nutrient adequacy and it improves outcomes for both mothers and their offspring. The minimum maternal dietary diversity score of lactating women is defined as when the mother ate at least four and above food groups from the nine food groups 24 h preceding the survey regardless of the portion size. Therefore, the present study aimed to determine the minimum dietary diversity score (MDDS) and its predictors among lactating mothers in the Pastoralist community, Ethiopia. Read More

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