bluuebunny/crossref_metadata_2025_split huggingface dataset:
Peer-Assisted Injection as a Harm Reduction Measure in a Supervised Consumption Service: A Qualitative Study of Client Experiences
Authors: Pijl Em M. , Oosterbroek Tracy , Motz Takara , Mason Erin , Hamilton Keltie , Bourque Stacey , Manning Jill 
Published: April 2020

Abstract
Background
Peer assistance is an emerging area of study in intravenous drug use. When Canada’s first supervised consumption site (SCS) opened in 2003 in Vancouver, BC, clients were prohibited from injecting their peers; only recently has this practice been introduced as a harm reduction measure at these sites. In Alberta, a government-sanctioned SCS recently received federal exemption to allow peer-assisted injection in their facility, under the Controlled Drugs and Substances Act. Literature pertaining to peer-assisted injection, while scant, addresses several topics: interpersonal relationships between the injector and recipient; the roles of ritual and pragmatism; and gender inequality.
Methods
In this qualitative, descriptive study, participants were interviewed about their experiences in a peer-assist program at an SCS regulated by Health Canada.
Results
Participants expressed being moved by compassion to help others inject. While their desire to assist was pragmatic, they felt a significant burden of responsibility for the outcomes. Other prominent factors were social connection, trust, safety, social capital, and reciprocity. Participants also made suggestions for improving the peer-assist program.
Conclusions
These findings reveal the humanity within a cohort of at-risk individuals, often dehumanized at the societal level. Relational equity and mutuality were evident, in contrast to other studies. Regular use of the SCS, and access to its resources, enabled participants to make healthier choices and practise lower-risk injections. At the federal level, there is considerable room to advocate for allowing clients to divide drugs safely within the SCS, and to increase capacity for safer alternatives such as inhalation.
Epidemiology, Prenatal Diagnosis, and Neonatal Outcomes of Congenital Heart Defects in Eastern China: A Hospital-Based Multicenter Study
Authors: zhang xiaohui , Sun Yu , Zhu Jiajun , Zhu Yuning 
Published: April 2020

Abstract
Background : Congenital heart disease (CHD) is one of the most common birth defect. Currently, the reported occurrence of CHD continues to increase at global or regional level. In 2013, Chinese government announced to end 1-child birth policy. We aimed to update the incidence, prenatal diagnosis, and neonatal outcomes of CHD since the ending of 1-child policy, in eastern China. Study design : Data were obtained from the Zhejiang provincial birth defects surveillance system. CHD identified during 2014-2018 were analyzed. Chi-square test, odds ratio (OR) and 95% confidence interval (CI) were used to explore incidence trends, prenatal diagnosis, birth outcomes and associated risk factors with CHD. Results : Overall, 8,546 of 534,002 births were identified with CHD. During the period, the overall incidence of CHD increased significantly, giving an average incidence as 16.0 per 1000 births (95% CI 15.69-16.32). However, the incidence of critical CHD (CCHD) remained stable over time (1.6 per 1000 births, 95% CI 1.47-1.69).Women aged less than 20 years (OR2.1, 95%CI 1.9-2.3) or ≥35 years (OR 1.2, 95% CI 1.2-1.3) were at higher risk of CHD than women aged 21-34 years. Births in urban areas (OR 1.2, 95% CI 1.2-1.3), male sex (OR 1.3, 95% CI 1.3-1.4), and multiple births (OR 4.0, 95% CI 3.7-4.4) had a higher risk of CHD than births in rural areas, female sex, and singletons, respectively. The three major subtypes of CHD were atrial septal defect (ASD, 68.0%), patent ductus arteriosus (PDA, 34.7%), and ventricular septal defect (VSD, 6.4%). A total of 22.2% of CHD was detected prenatally. Regarding to perinatal outcomes, there were 1457 (17.1%) stillbirths, 106 (1.2%) early neonatal deaths, and 6983 (81.7%) live births. Conclusion : The high incidence of CHD might be attributable to the large proportion of mild CHD. Pregnancies in urban areas, male births, and younger or older women were the risk factors for CHD. The prenatal detection rate for overall CHD was low, whereas the rate for CCHD was similar or even higher than other studies. The neonatal outcomes were comparable to previous literatures.
Effect of transient receptor potential vanilloid 4 activation on the delayed rectifier potassium current in the hippocampal pyramidal neurons and Kv subunit expression in the hippocampi of mice
Authors: Zhou Li , Xu Weixing , An Dong , Men Chen , Li Yingchun , Du Yimei , Chen Lei 
Published: April 2020

Abstract
Activation of transient receptor potential vanilloid 4 (TRPV4) can increase hippocampal neuronal excitability. Recent studies have reported that TRPV4 may be involved in the pathogenesis of epilepsy. Voltage-gated potassium channels (VGPCs) play an important role in regulating neuronal excitability and abnormal VGPCs expression or function is related to epilepsy. Activation of TRPV4 can modulate ion channels, but whether activation of it could modulate VGPCs in hippocampal neurons remains unknown. Here we examined the effect of TRPV4 activation on the delayed rectifier potassium current (IK) in the hippocampal pyramidal neurons and on the Kv subunits expression. We also explored the role of TRPV4 in changes in Kv subunits expression in mice following pilocarpine-induced status epilepticus (PISE). Application of TRPV4 agonists, GSK1016790A and 5,6-EET, markedly reduced IK in the hippocampal pyramidal neurons, shifted the voltage-dependent inactivation curve to the hyperpolarization direction, and had no effect on the voltage-dependent activation curve. GSK1016790A- and 5,6-EET-induced inhibition of IK was blocked by TRPV4 specific antagonists, HC-067047 and RN1734. GSK1016790A-induced inhibition of IK was markedly attenuated by calcium/calmodulin-dependent kinase II (CaMKII) antagonist, but was not affected by protein kinase C or protein kinase A antagonists. Application of GSK1016790A for up to 1 h did not change the hippocampal protein levels of Kv1.1, Kv1.2, or Kv2.1. Intracerebroventricular injection of GSK1016790A for 3 d reduced the hippocampal protein levels of Kv1.2 and Kv2.1, leaving that of Kv1.1 unchanged. Kv1.2 and Kv2.1 protein levels were reduced markedly in hippocampi on day 3 post PISE, which was significantly reversed by HC-067047. We conclude that activation of TRPV4 inhibits IK in the hippocampal pyramidal neurons, possibly by activating CaMKII. Persistent activation of TRPV4 decreased Kv1.2 and Kv2.1 expression, which may be associated with the decrease in Kv1.2 and Kv2.1 expression following PISE.
Analysis of Hand-Forearm Anthropometric Components in Assessing Handgrip and Pinch Strengths of School-Aged Children and Adolescents: A Partial Least Squares (PLS) Approach
Authors: Rostamzadeh Sajjad , Saremi Mahnaz , Vosoughi Shahram , Bradtmiller Bruce , Janani Leila , Farshad Ali Asghar , Taheri Fereshteh 
Published: April 2020

Abstract
Background The purpose of this study was to examine the influence of hand-forearm anthropometric dimensions on handgrip and pinch strengths among 7–18 years children and adolescents and to investigate the extent to which these variables can be used to predict hand strength.Methods Four types of hand strengths including handgrip, tip to tip, key, and three-jaw chuck pinches were measured in 2637 healthy children and adolescents (1391 boys and 1246 girls) aged 7–18 years using standard adjustable Jamar hydraulic hand dynamometer and pinch gauge. A set of 17 hand-forearm anthropometric dimensions were also measured with an accurate digital caliper and tape measure.Results No significant differences were found between the hand strengths of boys and girls up to the age of 10 years. Gender related differences in handgrip and pinches were observed from the age of 11 years onwards, with boys always being stronger. The dominant hand was stronger than the non-dominant hand (8% for handgrip and by about 10% for all three types of pinches). The strongest correlations were found between the hand length and hand strengths (r > 0.83 for handgrip and three all pinches; p < 0.001, 2-tailed). Based on the partial least squares (PLS) analysis, 8 out of 17 anthropometric indices including hand length, hand circumference, thumb length, index finger length, middle finger length, and forearm length had considerable loadings in the PLS analysis, which together accounted for 46% of the total variance.Conclusions These results may be used by health professionals in clinical settings as well as by designers to create ergonomic hand tools.
Immunosenescence of Lymphocytes T and Implications for Age-Related Disorders
Authors: Tylutka Anna , Morawin Barbara , Gramacki Artur , Zembron-Lacny Agnieszka 
Published: April 2020

Abstract
Background. The decrease in immunity with age is still a major health concern as elderly people are more susceptible to infections and increased incidence of autoimmunity. Consequently, there is an increasing interest in immunosenescence and changes in immunology cells like T cells. The aim of our study was to find a disproportion in subpopulation of T cells as well as CD4/CD8 ratio depending on the age, gender or comorbidities. Results. In the present study, a flow cytometry was used to indicate the differences between age, sex, disorders and fat content in the CD4+ and CD8+ T cells population divided into naïve and memory cells as well as CD4/CD8 ratio in people aged 71.9± 5.8 years (females n=83, males n=16) compared to young people aged 20.6 ± 1.1 years (females n=12, males n=19). The percentage of naïve CD4+ and CD8+ cells was found to be statistically significantly lower in the elderly compared to the young. In addition, gender was observed to play an important role in the outcomes in the analysed subpopulations and in female group, who live statistically longer than males, our older group of Polish women demonstrated a significantly higher percentage of naïve lymphocytes in both the CD4+ and CD8+ populations compared to men. The CD4/CD8 ratio increases with age, which can be considered one of the markers determining longevity. Elderly people with age-related diseases (hypertension) also show an increased level of CD4/CD8 ratio as well as CD4+. Conclusion. We demonstrated that changes in the T cells population, including naïve cell population as well as CD4/CD8 ratio, are important markers which can be predictive of healthy status. In order to accurately determine longevity, gender or age-associated diseases should be taken into account.
Primary signet ring cell carcinoma of colon and rectum often presents as long segment stenosis in young patients
Authors: Weng Meng Tzu , Chao Ko-Han , Tung Chien-Chih , Chang Hao-Chun , Shih I-Lun , Lin Been-Ren , Shieh Ming-Jium , Shun Chia-Tung , Wong Jau-Min , Wei Shu-Chen 
Published: April 2020

Abstract
Background: Primary signet ring cell carcinoma of the colon and rectum (PSRCCR) is rare, usually diagnosed at advanced stage with poor outcomes. We aimed to find possible diagnostic clues in order to help diagnosis. Methods: A retrospective study of PSRCCR patients from 1993 to 2018 was reviewed at a single tertiary center. Colorectal adenocarcinoma patients as control group with 1:4 ratio was also enrolled. Results: 18 patients with PSRCCR were identified. The prevalence rate was 0.16% (18 of 11,515). The mean age was 50.2 years-old in PSRCCR group and 63 years-old in non-SRCC colorectal cancer patients ( p < 0.001). Diagnosis tool depends on CFS were much less in PSRCCR group than control group (44.4 % vs 93 %, p < 0.001). SRCC patients had higher level of CEA (68.3 vs 17.7 ng/mL, p =0.004) and lower level of Albumin (3.4 vs 4.3 g/dL, p < 0.001). The majority of PSRCCR tumor configuration was ulcerative and infiltrative. More PSRCCR pathology presented as high-grade carcinoma (66.7 vs 1.4 %, p < 0.001) and lymphovascular invasion (77.8 vs 44.4 %, p = 0.011) than control group. More PSRCCR patients were diagnosed at advanced stage (88.8 vs 40.3 %, p = 0.001). Higher mortality was also noticed in PSRCCR group than control group (72.2 vs 20.8 %, p < 0.001). Conclusion: For young patients with long segment colonic stenosis and ulcerative/ infiltrative mucosa but endoscopic biopsy failed to identify malignant cells, earlier operation or non-colon site biopsy is suggested for diagnosing the PSRCCR.
Targeting tumor cell-derived CCL2 as a strategy to overcome bevacizumab resistance in ETV5+ colorectal cancer
Authors: Feng Haoran , Liu Kun , Liang Juyong , Wang Changgang , Qiu Weihua , Cheng Xi , Zhao Ren 
Published: April 2020

Abstract
Background
ETV5 mediated angiogenesis was dependent on PDGF-BB/PDGFR-β/Src/STAT3/VEGFA pathway in colorectal cancer (CRC) in our previous study. However, whether ETV5 affects effect of antiangiogenic therapy in CRC requires further investigation.
Methods
GSEA analysis and a series of experiments were performed to identify the critical candidate gene involved in bevacizumab resistance, and further explored whether the treatment targeting the candidate gene enhanced bevacizumab sensitivity in vitro and in vivo.
Results
ETV5 could directly bind to VEGFA promoter and promote translation of VEGFA. However, by in vitro and in vivo experiments, ETV5 actually accelerated anti-VEGF therapy (bevacizumab) resistance. GSEA analysis and further assays confirmed that ETV5 could promote angiogenesis by enhancing secretion of another tumor angiogenesis factor CCL2 in CRC cells, which resulted in bevacizumab resistance. ETV5 induced VEGFA and CCL2 were mutually independent to induce angiogenesis by activating PI3K/AKT and p38/MAPK signaling pathways in human umbilical vein endothelial cells. In CRC tissues, ETV5 protein level was positively associated with CD31, CCL2, VEGFA protein expression. CRC patients with high expression of ETV5/VEGFA or ETV5/CCL2 showed inferior prognosis than other patients. Combination of anti-CCL2 and anti-VEGFA (Bevacizumab) treatment could more effectively inhibited tumor angiogenesis and growth than single treatment did in CRCs with high expression of ETV5 (ETV5 + CRCs).
Conclusions
Our results not only revealed ETV5 as a novel biomarker for antiangiogenic therapy, but also indicated a potential combined therapy strategy by simultaneously targeting CCL2 and VEGFA in ETV5 + CRC.
Proposal for a new therapeutic high dosage of Pidotimod in children with Periodic fever, aphthous stomatitis, pharyngitis, adenitis (PFAPA) syndrome: an observational study.
Authors: Manti Sara , Filosco Federica , Parisi Giuseppe Fabio , Finocchiaro Giuseppe Germano , Papale Maria , Giugno Andrea , Barone Patrizia , Leonardi Salvatore 
Published: April 2020

Abstract
Background. Despite to PFAPA syndrome is considered a benign and self-limited condition in childhood its impact on patients and families can be remarkable in many cases. Currently, the therapeutic options for managing are non-specific and no consensus exists about the best treatment to use. Pidotimod has been suggested as a new potential treatment in PFAPA syndrome for its immunodulatory effects. We conducted a preliminary, prospective, controlled, open, cross-over trial to assess the efficacy and the safety of Pidotimod in the treatment of children with PFAPA syndrome.Methods. 22 children with PFAPA syndrome were randomly allocated to treatment with Pidotimod (with 2 vials of 400 mg daily) in combination with betamethasone 0.5-1 mg on need (group A) or betamethasone 0.5-1 mg on need (group B). Each treatment period was for 3 months (Phase 1), after that patients were switched to the other arm for other 3 months (Phase 2). Efficacy was expressed in terms of number of episodes of fever, tonsillitis, and aphthous stomatitis, as well as the additional use of betamethasone on need. Safety and tolerability of the Pidotimod were evaluated on the basis of the number and type of adverse events (AEs) recorded during the treatment.Results. Patients receiving Pidotimod and betametasone showed a significant decrease in frequency of fevers (p = 0.002); number of episodes of tonsillitis (p = 0.049); aphthous stomatitis (p = 0.036) as well as the betamethasone use on need (p = 0.007). Overall, 19/22 (86.4%) showed benefits from Pidotimod administration. The safety profile of Pidotimod was excellent as no serious adverse events have been reported in the treated groups.Conclusions. We firstly showed that high dosage of Pidotimod is an effective and safe to reduce the PFAPA attacks in children.
Survey of COVID-19 self-isolation patterns in UK dental professionals: initial findings (February – April 2020)
Authors: Haigh André , Vasant Ronuk , O'Hooley Dominic 
Published: April 2020

Abstract
Aim: Dentistry is routinely associated with aerosol generating procedures (AGP). AGP has been suggested as a possible route for the transmission of SARS-CoV-2 and may place the dental team at increased risk of infection. In the absence of widespread testing of the dental workforce to ascertain the incidence SARS-CoV-2, a web-based self-reporting survey captured self-isolation patterns in dental professionals.Method: A web-based closed questionnaire via the Survey Monkey platform captured reported COVID-19 self-isolation patterns in the dental team.Results: A total of 3,309 responses were collected. 2,888 (87.3%) responses contained valid data. 26.8% of respondents reported self-isolating. Of these 31.2% did so because they were suffering from COVID-like symptoms, 21.3% in order to protect a vulnerable member of their household, 25.7% because a member of their household was suffering from COVID-19 like symptoms, and 21.8% self-isolated in to protect themselves. The patterns of self-isolation of those who self-isolated due to COVID-like symptoms differed from the other three groups.Conclusion: Despite the inherent limitations of self-reporting surveys, a web-based self-reporting questionnaire rapidly captured self-isolating patterns in dental professionals. Those professionals who self-isolated due to COVID-like symptoms appeared to isolate earlier than those other groups. The initial findings from this survey would suggest that dental professionals have not experienced disproportionately higher levels of COVID-like symptoms.
Functional and diffusion MRI reveal the functional and structural basis of infants’ noxious-evoked brain activity
Authors: Baxter Luke , Moultrie Fiona , Fitzgibbon Sean , Aspbury Marianne , Mansfield Roshni , Bastiani Matteo , Rogers Richard , Jbabdi Saad , Duff Eugene , Slater Rebeccah 
Published: April 2020

Abstract
Understanding the neurophysiology underlying pain perception in infants is central to improving early life pain management. In this multimodal MRI study, we use resting-state functional and white matter diffusion MRI to investigate individual variability in infants’ noxious-evoked brain activity. In an 18-infant nociception-paradigm dataset, we show it is possible to predict infants’ cerebral haemodynamic responses to experimental noxious stimulation using their resting-state activity across nine networks from a separate stimulus-free scan. In an independent 215-infant Developing Human Connectome Project dataset, we use this resting-state-based prediction model to generate noxious responses. We identify a significant correlation between these predicted noxious responses and infants’ white matter mean diffusivity, and this relationship is subsequently confirmed within our nociception-paradigm dataset. These findings reveal that a newborn infant’s pain-related brain activity is tightly coupled to both their spontaneous resting-state activity and underlying white matter microstructure. This work provides proof-of-concept that knowledge of an infant’s functional and structural brain architecture could be used to predict pain responses, informing infant pain management strategies and facilitating evidence-based personalisation of care.
Maternal and fetal effects of covid-19 virus on a complicated triplet pregnancy. A case-report
Authors: Rabiei Maryam , Soori Tahereh , Abiri Amene , Shizarpour Arshia , Farsi Zohreh , Pirjani Reihaneh 
Published: April 2020

Abstract
Background: COVID-19 virus it is going to be pandemic all around the world. There is still limited scientific evidence on the manifestations and potential impact of this virus on pregnancy.Case presentation She was a 38 year-old triplet pregnant with a history of primary infertility and had become pregnant by induction ovulation and a history of hypothyroidism and also a history of gestational diabetes. She was hospitalized at 29 weeks and 2 days gestational age due to elevated liver enzymes and finally based on a probable diagnosis of gestational cholestasis, she was treated with ursodeoxycholic acid. On the first day after hospitalization, a sonography was performed in which biophysical scores and amniotic fluid were found normal in all three fetuses with normal Doppler findings in two fetuses and increased umbilical artery resistance (PI>95%) in one fetus. Four days after hospitalization, she developed fever, cough and myalgia and her covid-19 test was positive. After maternal infection with the virus, exacerbated placental insufficiency occurred in two of the fetuses so that absent umbilical artery end diastolic flow occurred rapidly in two fetuses and finally, six days later, she underwent cesarean section due to rapid exacerbated placental insufficiency and declined biophysical score in two of fetuses. Covid-19 test of nasopharyngeal swabs was negative for first and third babies and positive for second baby .The first and third babies died 3 and 13 days after birth respectively duo to collapsed white lung and sepsis. The second baby was discharged with a good general condition. The mother was discharged three days after cesarean section. She had no fever at discharge time and also she was in good general condition.Conclusions: It was a complicated triplet pregnancy, in which, after maternal infection with the Covid-19 virus, exacerbated placental insufficiency occurred in two of the fetuses, and another fetus had positive covid-19 virus test after birth. It sounds wise that in pregnancy infected by corona virus, in addition to managing the mother, special attention should also be given to the possibility of acute placental insufficiently and subsequent fetal hypoxia and also probability of vertical transmission.
Factors and impacts of informal settlements residents' sanitation practices on access and sustainability of sanitation services in the policy context of Free Basic Sanitation
Authors: Muanda Christophe , Goldin Jacqueline , Haldenwang Rainer 
Published: April 2020

Abstract
Through the Free Basic Sanitation (FBSan) service policy, many informal settlements in South Africa have been provided with basic sanitation facilities. However, access to these facilities remains challenging for many residents. These challenges have compelled residents to adopt a range of alternative sanitation practices. Through interviews, observation and focus group discussions in five informal settlements in the Western Cape, South Africa, 383 randomly selected respondents identified factors that shape their sanitation practices and how these practices impact on access to, and sustainability of sanitation services in the policy context of the FBSan. Residents' sanitation practices include the use of buckets, porta-potties, plastic bags, and existing facilities within and outside their settlements for either defecating or discharging the bucket contents and open defecation. These sanitation practices are informed by factors including safety concerns, poor conditions of the facilities, lack of privacy and choice. These findings suggest that the provision of facilities through the FBSan policy should consider the multiple and varied needs of residents, practices and conditions of their settlements prior to the selection and deployment of facilities to informal settlements in South Africa.
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