bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical Technique and Outcome of Joint Sparing Limb Salvage Surgery by Three-Dimensional-Printed Prothesis for Children with Osteosarcoma in Distal Femur
Authors: Cai Tao , Zhang Chunlin , Zhang Lei , Zhu Kunpeng , Hu Jianping , Zhang Taichen 
Published: August 2020

Abstract
Purpose The purpose of this study was to introduce the surgical technique and functional outcome of joint-sparing limb salvage surgery with metaphyseal osteotomy by dependent design of three-dimensional printed prothesis for children with osteosarcoma in distal femur.Methods Between 2012 to 2019, we performed twelve joint sparing limb salvage surgeries (JSLSS) with metaphyseal osteotomy for the children of osteosarcoma in the distal femur with our dependent design of 3D-printed guided plate and prothesis. The clinical assessment including resection margin, limb-length discrepancy, orthopaedic complications and functional outcome would be analyzed.Results The mean operation time for JSLSS was 107.6 minutes and the average blood loss was 194.5ml with the dependent design of 3D-printed prosthesis. With the assistance of guide plate, the mean margin of the osteosarcoma from the epiphyseal plate was 1.6 cm and the mean limb-length discrepancy was 2.2 cm with maximum follow-up period of seven years (mean 45.3 months, range 12-84 months). All the patients could bend their knee through >90° flexion, achieved similar results for ROMs in 6DOF during gait compared with normal data of Chinese knees, and the mean MSTS score was 94.7 for the patients with JSLSS. One patient had a superficial infection and there was one patient of local recurrence happened during the follow-up with the necrosis rate less than 90% by preoperative chemotherapy. None aseptic loosening happened in distal femur for the patients in this group with dependent design of 3D-printed prosthesis.Conclusion Joint-sparing limb salvage surgery by metaphyseal osteotomy with the dependent design of 3D-printed prosthesis and guide plate would be a good choice for the children with osteosarcoma in distal femur.
The volume of general surgery emergency cases in a government hospital during the COVID -19 pandemic and two other periods: A comparative study
Authors: shakra Ibrahim abu , Bez Maxim , Ganam Samer , Francis Rula , Muati Amir , Bickel Amitai , Merei Fahed , Talmi Ziv , Kamal Khatib , Kakiashvili Eli 
Published: August 2020

Abstract
Objective

We compared characteristics of patients admitted to a northern Israeli hospital with common surgical complaints during three periods: the lockdown due to the COVID-19 outbreak, the Second Lebanon War in 2006, and a regular period.
Background

During March and April 2020, reductions in non-COVID-19 hospital admissions were observed around the world. Elective surgeries, visits with general practitioners, and diagnoses of medical emergencies were consequently delayed.
Methods

Demographic, medical, laboratory, imaging, intraoperative, and pathological data were collected from electronic medical files of patients who received emergency treatment at the surgery department of a single hospital in northern Israel. We compared characteristics of patients who were admitted with various conditions during three periods.
Results

Patients’ mean age and most of the clinical parameters assessed were similar between the periods. However, pain was reportedly higher during the COVID-19 than the control period (8.7 vs. 6.4 on a 10-point visual analog scale, P < 0.0001). During the COVID-19 outbreak, the Second Lebanon War, and the regular period, the mean numbers of patients admitted daily were 1.4, 4.4, and 3.0, respectively. The respective mean times from the onset of symptoms until admission were 3, 1, and 1.5 days, P < 0.001. The respective proportions of surgical interventions for appendiceal disease were 95%, 96%, and 69%; P = 0.03.
Conclusion

Compared to a routine period, patients during the COVID-19 outbreak waited longer before turning to hospitalization, and reported more pain at arrival. Patients during both emergency periods were more often treated surgically than non-operatively.
Regional trends and associated factors of childhood visual impairment: a case study in Shandong province, China
Authors: HAN Lizhen , Jia Jinzhu , Wang Lu 
Published: August 2020

Abstract
Background
Visual impairment is a common child health problem. We hopes to analyze the regional trend, related factors and spatial distribution of children's visual impairment in Shandong province, to explore the spatial changes brought by time and their influencing factors, so as to provide scientific basis for prevention of childhood visual impairment.
Methods
This study covers 5 complete cross-sectional surveys (Physical examination data in Shandong province) from 2013 to 2017, involving about 29.24 million students. The 11th International Classification of Diseases was selected as the diagnostic standard. Spatial autocorrelation and hotspot analysis methods in ArcGIS software were used to analyze spatial features. The associated factors were analyzed by multinomial logistic regression.
Results
The visual impairment prevalence showed a trend of decreasing first and then increasing from 2013–2017, with slight changes. In terms of regional spatial differences, Weihai and Yantai have the highest VI rates in all years, and there was a large-scale spatial aggregation phenomenon. The southern low-value clusters, however, showed a weakening year by year. Further exploration revealed that the per capita disposable income of rural households, the growth rate of gross domestic product, total retail sales of consumer goods and number of full-time teachers were verified as risk factors for regional visual impairment levels.
Conclusions
The slight rebound of the prevalence of visual impairment and the high rate in the eastern and northern regions of Shandong province need more attention. It is suggested that relevant departments should focus on the influence of regional economic and educational factors when formulating relevant strategies.
Using Doppler sonography resistive index for the diagnosis of perinatal asphyxia: a multi-centered study
Authors: Pishdad Parisa , Yarmahmoodi Fatemeh , Eghbali Tannaz , Arasteh Peyman , Razavi Seyyed Mostajab 
Published: August 2020

Abstract
Background and objectiveInhere we evaluated the efficacy of Doppler sonography (DS) of the anterior cerebral artery (ACA), middle cerebral artery (MCA) and the basilar arteries (BA) based on resistive index (RI) for the diagnosis of asphyxia.MethodsIn this multi-centered cross-sectional study, neonates with clinical diagnosis of asphyxia, were considered for study. During the first 24 hours, neonates underwent DS. MRI was done for each neonate during the first month, after discharge or during hospital admission, after obtaining clinical stability. Staging based on DS was compared with staging based on MRI.ResultsOverall, 34 patients entered the study. DS of the ACA, MCA, BA all had significant correlation with MRI findings (regarding severity of asphyxia) (r>0.8 and p<0.001).In the receiver-operating-characteristic analysis, ideal cut-off point for diagnoses of asphyxia based on ACA and BA was RI≤0.62 [area under the curve (AUC) =0.957 and 95% CI: 0.819-0.997; sensitivity=95.65; specificity=100; positive predictive value (PPV) =100; negative predictive value (NPV) =90.9 and negative likelihood ratio (NLR) =0.043]. Regarding MCA, similarly, a RI≤0.62 was ideal for differentiating between normal and asphyxiated neonates (AUC=0.990 and 95% CI: 0.873-1; sensitivity=91.30; specificity=100; PPV=91.2; NPV=100 and NLR=0.087).ConclusionFor evaluating neonates clinically suspected of asphyxia, DS can be used as a first line diagnostic modality and RI of ≤0.62 is an appropriate cut-off for the diagnosis of perinatal asphyxia.
Level Scaling and Pulse Regulating Methods to Mitigate Cycle-to-cycle Variation in Memristor Based Learning System
Authors: Liao Zhiheng , Fu Jingyan , Wang Jinhui 
Published: August 2020

Abstract
As a novel non-volatile device, the memristive crossbar array has already delivered many of its promises including low computation complexity, high energy efficiency, and high density for the neuromorphic computing. However, the intrinsic variability of switching behavior has been a major obstacle to their implementation. Here we report a model that experimentally demonstrates the natural stochasticity of cycle-to-cycle variations and quantifies it. In addition, we propose level scaling and pulse regulating methods to mitigate the adverse impact of cycle-to-cycle variations. The relationship of the level of conductance and cycle-to-cycle variation is studied, and experiment results show an optimal number of the levels to mitigate cycle-to-cycle variations in the system. Additionally, the system compresses the number of pulses when the conductance is updated by the pulse stimulus to reduce cycle-to-cycle variations, resulting in the great energy and latency reduction. This work paves the way for the adoption of memristors for more efficient applications for the era of the edge computing and Internet of Things (IoT).
It’s a Woman’s Thing: Gender Roles Sustaining the Practice of Female Genital Mutilation Among the Kassena-Nankana of Northern Ghana
Authors: AKWEONGO PATRICIA , Jackson Elizabeth F. , Appiah-Yeboah Shirley Afua , Sakeah Evelyn , Phillips James F. 
Published: August 2020

Abstract
BackgroundThe practice of female genital mutilation (FGM) in traditional African societies is grounded in traditions of patriarchy that subjugate women. It is widely assumed that approaches to eradicating the practice must therefore focus on women’s empowerment and changing gender roles. MethodsThis paper presents findings from a qualitative study of the FGM beliefs and opinions of men and women in Kassena-Nankana District of northern Ghana. Data are analyzed from twenty-two focus group panels of young women, young men, reproductive age women, and male social leaders. ResultsThe social systemic influences on FGM decision-making are complex. Men represent exogenous sources of social influence on FGM decisions through their gender roles in the patriarchal system. As such, their FGM decision influence is more prominent for uncircumcised brides at the time of marriage than for FGM decisions concerning unmarried adolescents. Women in extended family compounds are relatively prominent as immediate sources of influence on FGM decision-making for both brides and adolescents. Circumcised women are the main source of social support for the practice, which they exercise through peer pressure in concert with co-wives. Junior wives entering a polygynous marriage or a large extended family are particularly vulnerable to this pressure. Men are less influential and more open to suggestions of eliminating the practice of FGM than women. ConclusionFindings attest to the need for social research on ways to involve men in the promotion of FGM abandonment, building on their apparent openness to social change. Investigation is also needed on ways to marshal women’s social networks for offsetting their extended family familial roles in sustaining FGM practices.
Institutional Delivery Service Utilization and Associated Factors in Rural Communities of Central Gondar zone, Northwest Ethiopia
Authors: Weldeab Adane Nigusie , Azale Telake , Yitayal Mezgebu , Derseh Lemma 
Published: August 2020

Abstract
Introduction: Institutional delivery has been considered as one of the important strategies to improve maternal and child health, and significantly reduces birth related complications however it is still low in developing countries though there are some improvements. Hence, the aim of this study was to assess the prevalence of institutional delivery service utilization and associated factors among women who gave birth in Central Gondar zone, North West Ethiopia. Methods: A community-based cross-sectional study was conducted from September to December 2019. A multistage systematic sampling technique was used to select a total of 1,394 study participants. Data were collected from women who gave birth during the past one year by using structured and pretested questionnaire. Binary logistic regression was performed to identify factors at 95% confidence level. Results: The prevalence of institutional delivery service utilization was 58.17 % (95%CI: 55.57%, 60.77%). Multivariable logistic regression showed that women age ( ≥35years) (AOR= 1.43; 95% CI 1.04,1.96), having a family size of less than five (AOR= 4.61; 95% CI 3.34,6.34), husbands educational status of primary school (AOR= 1.64; 95% CI 1.19,2.24), middle level household wealth index (AOR= 1.78; 95% CI 1.25,2.54), rich level household wealth index (AOR= 2.01; 95% CI 1.42,2.86), having family discussion (AOR= 4.05; 95% CI 2.74,5.97), antenatal care visit during their recent pregnancy (AOR= 1.86;95% CI 1.16,2.97),distance from the nearby clinic(≤30min) (AOR= 2.92; 95% CI 1.53,5.58), decision power about place of delivery (AOR= 2.50; 95% CI 1.56,4.01) and bad behavior of health workers (AOR= 0.27; 95% CI 0.19,0.39) were significantly associated with utilization of institutional delivery service. Conclusion: Institutional delivery service utilization was low in the study area. Women age (≥35years), having a family size of less than five, educational status of husband (primary), household wealth index (middle and rich), family discussion, antenatal care visit, distance from the nearby clinic (≤30min), decision power about place of delivery and bad behavior of health workers were predictors of institutional delivery. This study implies that strengthening family discussion and up taking antenatal Care services in regular ways are few of the suggested recommendations.
Symmetry function as a new tool for evaluating the symmetry of gait in transfemoral amputees
Authors: Winiarski Slawomir , Rutkowska-Kucharska Alicja , Kowal Mateusz 
Published: August 2020

Abstract
Background: Numerous studies have demonstrated significant asymmetries in unilateral amputee gait. The underlying dissimilarities between prosthetic and intact limbs have not yet been widely examined. To gain more insight into the functionality of asymmetries, we propose a new tool, the symmetry function (SF), to evaluate the symmetry of walking in terms of kinematic and dynamic variables of patients after unilateral transfemoral amputation and to identify areas with the largest side deviations in the movement cycle. Methods: An instrumented motion analysis system was used to register the gait of fourteen patients after unilateral trans-femoral amputation (TFA). Measurements involved evaluating the time series of gait variables characterizing a range of motion and the time series of the ground reaction force components. Comparison of the involved limb with the uninvolved limb in TFA patients was carried out on the basis of the SF values.Results: The symmetry function proved to be an excellent tool to localize the regions of asymmetry and their positive or negative directions in the full gait cycle. The difference between sides revealed by the symmetry function was the highest for the pelvis and the hip. In the sagittal plane, the pelvis was asymmetrically tilted, reaching the highest SF value of more than 25% at 60% cycle time. In the transverse plane, the pelvis was even more asymmetrically positioned throughout the entire gait cycle (50% difference on average). The hip in the frontal plane reached a 60% difference in SF throughout the single support phase for the prosthetic and then for the intact limb. Conclusions: The symmetry function allows for the detection of gait asymmetries and shifts in the center of gravity and may assess the precise in time adaptation of prostheses and rehabilitation monitoring, especially in unilateral impairments.Trial registration: The trial registration number (TRN): 379991 issued by the Australian New Zealand Clinical Trials Registry (ANZCTR) on 07.05.2020 (retrospectively registered).
The Use Of Dried Tube Specimens Of Plasmodium Falciparum In An External Quality Assessment Program To Evaluate Health Worker Performance For Malaria Rapid Diagnostic Testing In Healthcare Centers In Togo
Authors: Dorkenoo Monique Ameyo , Kouassi Kafui Codjo , Koura Adjane K. , Adams Martin L , Gbada Komivi , Katawa Gnatoulma , Yakpa Kossi , Charlebois Remi , Milgotina Ekaterina , Merkel Michele O , Aidoo Michael 
Published: August 2020

Abstract
Background: The use of rapid diagnostic tests (RDTs) to diagnose malaria is common in Sub-Saharan African laboratories, remote primary health facilities and in the community. Currently, there is a lack of reliable methods to ascertain health worker competency to accurately use RDTs in the testing and diagnosis of malaria. Dried tube specimens (DTS) have been shown to be a consistent and useful method for quality control of malaria RDTs, however, its application in National Quality Management programs has been limited. Methods: A P. falciparum strain was grown in culture and harvested to create DTS of varying parasite density (0, 100, 200, 500 and 1,000 parasites/µL). Using the dried tube specimens as quality control material, a proficiency testing (PT) program was carried out in 80 health centers in Togo. Health worker competency for performing malaria RDTs (mRDTs) was assessed using five blinded DTS samples, and the DTS were tested in the same manner as a patient sample would be tested by multiple testers per health center. Results: All the DTS with 100 parasites/µl and 50% of DTS with 200 parasites/µl were classified as non-reactive during the pre-PT quality control step. Therefore, data from these parasite densities were not analyzed as part of the PT dataset. PT scores across all 80 facilities and 235 testers was 100% for 0 parasites/µl, 63% for 500 parasites/µl and 93% for 1,000 parasites/µl. Overall, 59% of the 80 healthcare centers that participated in the PT program received a score of 80% or higher on a set of 0, 500 and 1,000 parasites/ µl DTS samples. Sixty percent of health workers at these centers scored higher than 80%. Conclusions: The use of DTS for a malaria PT program was the first of its kind ever conducted in Togo. The ease of use of the DTS illustrates that they can serve as well-characterized, stable samples to assess staff competency. The implementation of quality management systems, refresher training and expanded PT at remote testing facilities are essential elements to improve the quality of malaria diagnosis.
Relationships between serum total bilirubin levels and hypercholesterolemia in Chinese men and women.
Authors: Zhang Xuemei , Huang Chao , Fan Yaguang , Xu Ke , Li Xue , Liu Ming , Ren Xiaojun , Zhu Mei , He Qing , Zhang Qing , Song Kun , Jia Qiyu , Zhang Chunmei , Wang Xiaoran , Meng Zhaowei 
Published: August 2020

Abstract
Objective

Bilirubin, an antioxidant, is reported to relate with metabolic syndrome and cardiovascular diseases. The current study is to assess the relationship between total bilirubin (TB) and hypercholesterolemia in the Chinese population.
Methods

This cross-sectional study involved 48971 males and 31327 females who were in good health. Physical examinations and laboratory tests including TB and total cholesterol (TC) were performed. Subjects were divided into the following groups according to age: subjects younger than 30 years, subjects aged between 30 to 60 years and subjects older than 60 years. Binary logistic regression models examining factors independently related to TB was performed for males and females in different age groups.
Results

TB was negatively related to most parameters in males and females, such as body mass index (BMI), blood urea nitrogen (BUN), TC, triglycerides (TG), low-density lipoprotein (LDL) and glucose (G). The incidence of high TC was higher in females than in males and decreased with the increasing of TB in both genders. People older than 30 years demonstrated a similar trend. When there were no other covariates, TB appeared to be an important risk factor for high TC for men and women. However, this relationship disappeared when other covariates were added in the binary logistic regression models. Similar results also existed in men younger than 60 years and women younger than 30 years.
Conclusions

Our findings implied that serum TB concentration was not an independent risk predictor for hypercholesterolemia. TB was thought to be a covariate factor in the development of dyslipidemia.
Expression of VEGFA-mRNA in classical and MSX2-mRNA in non-classical monocytes in patients with spondyloarthritis is associated with peripheral arthritis.
Authors: Stec Małgorzata , Seweryn Michał , Korkosz Mariusz , Guła Zofia , Szatanek Rafał , Węglarczyk Kazimierz , Rutkowska-Zapała Magdalena , Lenart Marzena , Czepiel Marcin , Czyż Jarosław , Baran Jarosław , Gruca Anna , Wojnar-Lasoń Kamila , Wołkow Paweł , Siedlar Maciej 
Published: August 2020

Abstract
Background

Spondyloarthritis (SpA) is characterized by chronic inflammation and structural damage involving spine and peripheral joints. Monocytes, as part of innate immune system, following migration into affected tissue, may play a role in the pathogenesis of SpA. Here, potential associations between osteogenesis-linked gene expression profile in particular monocyte subpopulations and clinical signs of SpA were investigated.
Methods

The 20 patients with axial and 16 with peripheral SpA were enrolled in the study. Monocyte subpopulations (classical - CD14 + + CD16-, intermediate - CD14 + + CD16 + and non-classical - CD14 + CD16++) were isolated from blood using flow cytometry and gene expression analysis was performed using real-time PCR method and TaqMan™ Array, Human Osteogenesis, Fast 96-well plates. Next, the characteristic clinical features of axial or peripheral SpA were analyzed in the context of the expression of selected genes in the three subpopulations of monocytes.
Results

We demonstrated that expression of VEGFA in classical and MSX2 in non-classical monocytes were associated with the number of swollen and painful peripheral joints of SpA patients.
Conclusions

Monocytes may contribute to the development of peripheral arthritis in SpA patients. This might be possible through subpopulation specific effects, linking number of inflamed joints with expression of VEGFA in classical monocytes and MSX2 in non-classical monocytes.