bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preliminary Establishment of a Spinal Stability Scoring System for Multiple Myeloma
Authors: Yao Xingchen , Shi Xiangjun , Xu Ziyu , Tan Jie , Wei Yanzhe , Qi Lei , Zhou Zihao , Li Lihong , Du Xinru 
Published: September 2020

Abstract
Background: Multiple myeloma (MM) is an incurable malignant plasma cell disorder that represents the most common primary malignant bone tumor. It commonly involves bone metastasis in multiple vertebral bodies, which SINS scoring system may not be fully applicable to MM patients. We designed a stability evaluation system to evaluate the spinal stability of patients with MM spinal involvement in order to guide clinical treatment. Methods: By using Delphi method, information was collected and extracted through a series of questionnaires and improved via feedback and we preliminary establishment of a spinal stability scoring system for multiple myeloma. Results: Fifteen clinicians completed a second round of questionnaires and compared their answers with those of the first round of questionnaires to identify significant comments or changes that required group discussions. As a result, no further feedback was used to improve the scoring system. After integrating the information from the expert consultation questionnaire, we established the initial scoring system for MM spine stability and used the scoring system to assess a series of representative clinical cases. The scoring system consisted of the following six components.The MM spinal stability scoring system was created by calculating the scores of the six separate components: Location, Pain, Number of segments, Physiological curvature, Comorbidities and Neurological function. The minimum value was ‘0’, and the maximum value was ‘24’. A score of ‘0-10’ indicated ‘spine stability’, a score of ‘11-17’ indicated ‘potential instability’, and a score of ‘18-24’ indicated ‘spine instability’. Patients with a score of ‘11-24’ need an intervention such as surgery. Conclusions: The initial establishment of the MM spine stability scoring system provides a vital theoretical basis for the evaluation of spine stability in individuals with MM. Trial registration: As this was a retrospective study, it did not require ethical approval; all patients had signed informed consent when they received treatment, and all treatment options were voluntary.
A Novel Primary Healthcare Physician Associate Internship: Results from a Service Evaluation
Authors: Cottrell Elizabeth , Silverwood Victoria , Minshull Lucy , Edwards John J , Strivens-Joyce Alex , Aiello Matt , Lawton Sarah , Turner Sharon 
Published: September 2020

Abstract
Background: Physician associates (PA) are dependent healthcare professionals with two-years post-graduate generalist medical education. PAs can work in primary care immediately after graduation. However, PAs are novel to, and still relatively uncommon within, UK primary care. Recognising the challenges presented by UK primary care, including the undifferentiated, complex sociomedical and non-protocolised presentations, a novel one-year internship scheme was established to support PAs to work in primary care and to support PA retention in primary care and within the geographical region. This evaluation sought to gain feedback to guide further roll-out and development of the internship and to establish its success in supporting PAs into primary care.Methods: The Staffordshire PA Internship (SPAI) scheme was introduced in Staffordshire in 2017. PAs worked concurrently in primary and secondary care posts for one year, with protected weekly primary care focussed education sessions. Posts were subsidised and PAs were centrally employed. Evaluation data pertaining to the first two cohorts were sought from the PA interns, supervising GPs and practice managers.Results: By evaluation end, eight of the ten PAs had completed the internship. Practices valued the subsidised, central employment model of the internship as it provided a risk-limited opportunity to explore the PA role, which iteratively developed to establish weekly timetables that best suited PAs and practices. While the one-year PA programme had seen PA interns develop significantly from the start, many practices and PAs felt that a two year programme may have been preferable. There were mixed views about whether a split post or sequential posts may be preferable, however, PAs did not have experience of the latter.Conclusions: This test-of-concept SPAI was successful in retaining PAs in primary care in the geographical area of the internship. However, it highlighted the need for PA interns to have intensive supervision, particularly in the early weeks, and a dedicated educational programme, which was only possible due to the internship arrangements. The optimal internship design remains unknown, however, sole primary care internship posts may accelerate upskilling of PA interns for the challenges of primary care and may better support their integration within practices.
Perceptions of Risk of Attending Hospital During the COVID-19 Pandemic: A UK Public Opinion Survey
Authors: Pritchard Rebecca , Brady Emer M , Chudasama Yogini V , Davies Melanie J , McCann Gerry P 
Published: September 2020

Abstract
Background: To inform clinical and research practice in secondary care in the COVID-19 pandemic we consulted patients and the public on their feelings of safety, factors affecting feelings of safety, intention to participate in research, attitudes to research and comfort with new ways of working in order to inform secondary care policy on restarting research and some clinical activity. Method: An online survey was used to collect public opinions on attending hospitals. The survey link was circulated via the National Institute for Health Research (NIHR) Public Involvement (PPI) Leads network and social media.Results: 402 people completed the survey. Participants age ranged from the 18-85+, with the majority (337 (84%)) aged between 35 to 74 years. There were a higher number of women (77%) compared to men (23%); and were mainly White European (91%) compared to Black, Asian and Minority Ethnic (BAME) (6%), or other (2%).Results for feelings of safety scales show bi-polarity with few respondents in the middle ground. Implementation of COVID-19 related safety measures such as social distancing, use of personal protective equipment (PPE) and cleaning were strongly supported by most respondents. There was ambivalence around less certain measures such as staff antigen and antibody testing. Respondents were most likely to participate in research related to their own condition, COVID-19 and vaccine, but less likely to participate as healthy volunteers, especially if suffering from a pre-existing comorbidity identified with increased risk or were female. There was general agreement that participants are comfortable with new ways of working, such as remote consultation, though women and BAME respondents were less comfortable.Conclusions: Findings raise concerns for health inequalities already impacting some groups in the pandemic. The role of clinical necessity and personal benefit support the reopening of services in line with clinical necessity. Moderate caution in respect of vaccine research relative to patient-participant research presents a challenge for pending recruitment demands, and would benefit from qualitative research to explore themes and concerns in more depth and support development and targeting of key messaging.
Expression of NAD(P)H:Quinone Oxidoreductase 1 and Its Significance in Human Abdominal Aortic Aneurysmal Tissues
Authors: Zhang Jin-jin , Zhao Jun-jian , Xiong Yan-jie , Chang Quan , Bi Xi-le , Li Qing-zhao , Sun Jian , Ma Dong 
Published: September 2020

Abstract
Background NAD(P)H:quinone oxidoreductase 1 (NQO1) protein protects cells against redox cycling of quinones and oxidative stress. Oxidative stress represents key mechanisms leading to abdominal aortic aneurysm (AAA) formation. However, a role of NQO1 in AAA formation has not been investigated previously.Methods The Tandem Mass Tag (TMT) labeling quantitative proteomics technique was utilized to detect 3 AAA tissues and 3 corresponding adjacent normal abdominal aorta tissue specimens. Immunohistochemistry was used to detect NQO1 expression in 8 AAA tissues, and the correlation with AAA size, MDA and SOD levels was analyzed. The senescence model of human vascular smooth muscle cell (VSMCs) induced by Angiotensin II (AngII) was established in vitro. The effect of AngII on the level of reactive oxygen species (ROS) and β-galactosidase activity of VSMCs were observed after NQO1 expression was inhibited by specific interfering RNA (si-NQO1) technique.Results NQO1 expression was the highest up-regulation (3.1fold) among 11 differentially expressed oxidative stress-related proteins (> 1.2 or<0.83 and P<0.05), and the expression of NQO1 was positively correlated with the AAA size (R2=0.517, P<0.05) and MDA level (R2=0.659, P<0.05). AngII treatment of human VSMCs increased ROS expression and β-galactosidase activity, while knocking down NQO1 expression promoted AngII-induced ROS production and cell aging. Conclusion Up-regulation of NQO1expression plays an antioxidant role in AAA, and it is expected to be a biomarker for early diagnosis and prognosis assessment of AAA.
Development of a High-dorsiflexion Assistive System for Subacute Stroke Patients: Intervention Experiment on Healthy Subjects With Dorsiflexion Movement Restriction
Authors: Hong Jing-Chen , Cheng Hao , Ohashi Hiroki , Iwata Hiroyasu 
Published: September 2020

Abstract
A number of robotic ankle-foot orthoses with practical application for stroke patients have been developed in recent years. However, targets are mainly patients in the chronic phase. In this paper, we present development of a high-dorsiflexion assistive system aiming to support passive dorsiflexion movement in the swing phase for subacute patients in the early phase of gait rehabilitation. By applying a McKibben-type artificial muscle, output of high dorsiflexion torque with a low-weighted prototype was realized. This is expected to minimize loading burden on subacute stroke patients. An experiment on six healthy participants was conducted, and different extents of compensatory movements were applied when their dorsiflexion movements were restricted. The results of processed surface electromyography data significantly decreased when dorsiflexion movement was assisted with our system. Meanwhile, the results of spatial parameters also showed significant improvement of compensatory movement inclination with sufficient assistance. These indicate the potential of realizing assistance of passive ankle movements for patients with very low dorsiflexion abilities, which shows the potential for our future planning of practical pilot studies.
Pre-menarche adolescent girls’ menstrual knowledge and preparedness to menarche in North Shewa zone of Amhara region, Ethiopia
Authors: Zeru Abayneh Birlie , Muluneh Mikyas Arega 
Published: September 2020

Abstract
Background: Many adolescent girls in Ethiopia attain menarche without adequate knowledge and preparation which could have a distressing negative impact on their psychosocial, physical, and emotional wellbeing. This study aimed to assess pre-menarche adolescent girls’ menstrual knowledge and preparedness to menstruation and associated factors in the North Shewa Zone of the Amhara region.Methods: A school-based cross-sectional study was conducted on participants selected through a multi-stage sampling technique. Data collected through a self-administered questionnaire were entered into Epi Data and exported to SPSS for analysis. Bi-variable and multivariable logistic regressions were computed to identify factors associated with the good menstrual knowledge and preparedness to menarche. An odds ratio with 95%CI was computed to measure the magnitude of the association. Variables with a p-value of <0.05 on multivariable analysis were considered statistically significant factors associated with the outcome variable.Results: From a total of 424 pre-menarche adolescent girls included in the study, 166(39.2%) had good menstrual knowledge and about a quarter 110(25.9%) had good preparedness towards menarche. An increase in the school grade level of adolescent girls, the educational status of the mother, and occupation of the father (government employment) were positively associated with good menstrual knowledge. Having good menstrual knowledge increased the preparedness of pre-menarche girls to menarche by over 13-fold than poorly knowledgeable girls.Conclusions: Menstrual knowledge and preparedness to menarche of pre-menarche adolescent girls were low in the North Shewa Zone of the Amhara region. The level of preparedness to menarche was also highly dependent on girls' menstrual knowledge. Thus, the school's health program and teachers should address the problem by delivering age-appropriate menstrual information to equip adolescent girls with accurate and adequate menstrual knowledge before the onset of menarche.
Eosinophils May Serve as CEA-Secreting Cells for ABPA Patients
Authors: yanfei Yang , qiqi Gao , yangyi Jin , mengdie Qi , guohua Lu , Hequan li 
Published: September 2020

Abstract
Background Allergic bronchopulmonary aspergillosis (ABPA) is a condition characterized by an exaggerated response of the immune system to the fungus Aspergillus. This study aimed to assess the relationship between carcinoembryonic antigen (CEA) and eosinophils in ABPA patients.Methods: We describes a case of a 50-year-old patient who was diagnosed with ABPA presenting with high level of CEA and eosinophils. Besides,we used immunohistochemistry and immunofluorescence to identify eosinophils and CEA in sections which were obtained by Endobronchial ultrasound-guided transbronchial lung biopsy aspiration (EBUS-TBLB). The sections were then visualized using confocal microscopy. We also retrospectively analyzed a cohort of 37 ABPA patients between January 2013 and December 2019 in our hospital.Results: We found the patient whose serum CEA levels were consistent with eosinophils during the follow-up(r=0.929,P=0.022). The positive expression of CEA and abnormal expression of eosinophils was higher in the ABPA tissue compared to the normal lung tissue. The co-localization was represented as pixels containing both red and green color in the image (with various shades of orange and yellow) which signified that eosinophils were immunohistochemically positive for CEA. Patients with higher levels of eosinophils had higher levels of CEA in the serum (P<0.001). The results of Pearson correlation analysis showed that the levels of eosinophils were positively correlated with serum CEA levels(r=0.459 and r=0.506，P=0.004 and P=0.001). Conclusion: Serum CEA level is elevated in ABPA patients. The elevated serum CEA level was shown to be normalized after treatment. Increased CEA levels in ABPA patients may be positively correlated with eosinophil levels, and eosinophils may be served as CEA-secreting cells in patients with ABPA.
Lending Rate, Exchange Rate and Household Consumption Relations in Sub-saharan Africa: Mean Group Approach
Authors: Onanuga Abayomi Toyin , Tella Sheriffdeen Adewale 
Published: September 2020

Abstract
Household consumption expenditure in Africa to the world aggregate is comparatively little, considering the population of the region. But empirical credence that elucidates estimated elasticities of the exchange rate, lending rate, and consumption relations remains dimply discerned in sub-Saharan Africa (SSA) amidst a high population growth rate. Therefore, this paper present new insights into the causative structure of the cost of consumer credit and exchange rate management as leverage for mass consumption in Africa. We rely on the mean group estimator to analyse the panel data with a sample of 37 African countries in 2008 through 2017. We found that lending and exchange rate induces positive changes in household consumption in SSA. Efficient management of the cost of consumer credit and stability of the exchange rate may significantly improve consumption in the region. Policy implications were discussed.JEl Classification: E21; E43; F31; C21; C23
Association Between Triglyceride Glucose Index and Risk of New-onset Diabetes Among Chinese Adults: Findings From the China Health and Retirement Longitudinal Study
Authors: Chen Chaolei , Liu Lin , Lo Kenneth , Huang Jiayi , Yu Yuling , Huang Yuqing , Feng Yingqing 
Published: September 2020

Abstract
Background: The triglyceride glucose (TyG) index has been proposed to be a simple surrogate of insulin resistance. We aimed to examine the relationship between TyG index and risk of incident diabetes in middle-age and elderly adults in China.Methods: Nationally representative data from the China Health and Retirement Longitudinal Study 2011-2015 were used. Sociodemographic, medical, anthropometric, and laboratory information were collected following a standard protocol. Cox proportional hazards models and restricted cubic spline regression were performed to estimate hazard ratio (HR) with 95% confidence interval (CI) of diabetes for TyG index. Subgroup analyses were also conducted to examine potential interactions. Results: Of 7428 participants without at baseline diabetes, 791 (10.6%) participants developed diabetes over 3.4 years of follow-up. The multivariate HR for every SD increase in TyG index was 1.22 (95% CI, 1.14-1.31). When dividing TyG index into quartiles, the multivariate HRs for new-onset diabetes were 1.22 (0.96-1.54) for Q2, 1.61 (1.28-2.01) for Q3, and 1.73 (1.38-2.16) for Q4 (P for trend < 0.001) compared with Q1. The restricted cubic spline regression confirmed a linear association. No interaction was found between subgroup variables and association of TyG index with risk of diabetes.Conclusions: TyG index was significantly and positively associated with risk of new-onset diabetes in middle-aged and elderly adults. TyG index may be a useful predictive marker for predicting new-onset diabetes.
Measuring Farm Technical Efficiency using Stochastic Frontier Production Function Model Approach
Authors: Ndubueze-Ogaraku Mercy Ebere , Graves Anil 
Published: September 2020

Abstract
Agricultural productivity in Africa is the lowest in the world
with many households not able to feed themselves. In Africa women
make up 70–80% of the labour forces in the agricultural sector and
play a core role in agriculture but underperform in terms of
productivity largely because they lack access to physical and human
resources. Well-being, a health resource is an important asset in
production because people can work when they are healthy. The study
is aimed to analyze farm technical efficiency of women farmers in
Niger Delta, Nigeria. 216 female farmers were randomly selected
from 18 communities of the three states in Niger Delta Nigeria.
Stochastic production frontier function model was the analytical
tools used. The result showed that farm size and labour positively
influenced technical efficiency and was significant at 1% with a
mean value of 68.8%. Farm efficiency level in Delta and Akwa Ibom
States are not significantly different. However, technical
efficiency level in both Delta and Akwa Ibom States are
significantly different from Rivers State. Inefficiency variables
of age and number of years spent schooling were significant at 5%
and 10% level respectively. The study recommends that women should
increase the use of farm plots and labour resource for higher
productivity.
Relationship Between Periosteal Reaction and Medial Compartment Knee Osteoarthritis in Observation of Chinese Patients: A Retrospective Single-Centre Comparative Study
Authors: Deng Xiangtian , Hu Hongzhi , Cheng Xiaodong , Zhu Jian , Ye Zhipeng , Wang Zhongzheng , Wang Yuchuan , Zhang Yingze 
Published: September 2020

Abstract
Background: The purpose of this study to evaluate the potential relationship between the periosteal reaction and medial compartment knee osteoarthritis (KOA), and to assess the related risk factors for the development of periosteal reaction associated with medial compartment KOA.Methods: From January 2019 to December 2019, a total of 476 consecutive patients with medial compartment KOA were included and assessed in this retrospective comparative study. They were divided into two groups: periosteal reaction group and non-periosteal reaction group. Radiological parameters was measured for malalignment of the lower extremities in coronal plane. Intra-observer and inter-observer reliabilities of all radiological measurements were analyzed by intraclass correlation coefficients (ICCs). Univariate analyses was conducted for comparison of differences with continuous variables between patients with periosteal reaction and without periosteal reaction. Multivariate binary logistical regression analysis were performed to determine the independent risk factors of radiographic parameters for periosteal reaction.Results: A total of 363 patients (726 knees) were selected for the study, including 91 males and 272 females, with an average age of 57.9±12.8 years (range, 18-82 years). The overall incidence of periosteal reaction associated with medial compartment KOA was 56.7%. Furthermore, the incidence of periosteal reaction significantly increased with age and K-L grade progressed (P＜0.05). Multivariate logistical regression analysis found that HKA and JICA were significantly correlated with the development of periosteal reaction adjacent to the lateral of proximal tibia diaphysis in medial compartment KOA (P＜0.05).Conclusions: Our observation of the reaction of periosteum may be an anatomical adaptation for medial compartment KOA. Patients with lower HKA and higher JICA are more likely to developing periosteal reaction, which occurred most commonly adjacent to the lateral of proximal tibia diaphysis.