bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characteristics and predictors of muscle strength deficit in mechanical ankle instability
Authors: Hou Zong-chen , Miao Xin , Ao Ying-fang , Hu Yue-lin , Jiao Chen , Guo Qin-wei , Xie Xing , Zhao Feng , Pi Yan-bin , Li Nan , Zhang Zhi-yu , Jiang Dong 
Published: September 2020

Abstract
Purpose: Muscle strength training is a common strategy for treating chronic ankle instability (CAI), but the effectiveness decreases for mechanical ankle instability (MAI) patients with initial severe ligament injuries. The purpose of this study was to investigate the characteristics and the potential predictors of muscle strength deficit in MAI patients, with a view to proposing a more targeted muscle strength training strategy.Methods: A total of 220 MAI patients with confirmed initial lateral ankle ligament rupture and a postinjury duration of more than 6 months were included. All patients underwent a Biodex isokinetic examination of the ankle joints of both the affected and unaffected sides. Then, the associations between the limb symmetry index (LSI) (mean peak torque of the injury side divided by that of the healthy side) and the patients’ sex, body mass index, postinjury duration, presence of intra-articular osteochondral lesions, presence of osteophytes and ligament injury pattern (i.e., isolated anterior talofibular ligament (ATFL) injury or combined with calcaneofibular ligament injury) were analysed.Results: There was significantly weaker muscle strength on the affected side than on the unaffected side in all directions (p<0.05). The LSI in plantar flexion was significantly lower than that in dorsiflexion at 60°/s (0.87 vs 0.98, p<0.001). A lower LSI in eversion was significantly correlated with female sex (0.82 vs 0.94, p=0.016) and isolated ATFL injury (0.86 vs 0.95, p=0.012). No other factors were found to be associated with muscle strength deficits.Conclusion: MAI patients showed significant muscle strength deficits on the affected side, especially in plantar flexion. There were greater strength deficits in eversion in females and individuals with an isolated ATFL injury. Thus, a muscle strength training programme for MAI patients was proposed that focused more on plantar flexion training and eversion training for females and those with an isolated ATFL injury.
Mechanical ventilation of patients in helicopter emergency medical service transport: An international survey.
Authors: Hilbert-Carius Peter , Struck Manuel , Hofer Veronika , Hinkelbein Jochen , Rognas Leif , Adler Jörn , Christian Michael D. , Wurmb Thomas , Bernhard Michael , Hossfeld Björn 
Published: September 2020

Abstract
Background: Mechanical ventilation in helicopter emergency medical service (HEMS) environments is a procedure which carries a significant risk of complications. Limited data on the quality and performance of mechanical ventilation in HEMS are available in the literature.Method: We conducted an international survey to evaluate mechanical ventilation infrastructure in HEMS and collect data of transported ventilated patients. From June 20-22, 2019, the participating HEMS bases were asked to provide data via a web-based platform. Vital parameters and ventilation settings of the patients at first patient contact and at handover were compared using non-parametric statistical tests. Results: Out of 215 invited HEMS bases, 53 responded. Respondents were from Germany, Denmark, United Kingdom, Luxembourg, Austria and Switzerland. Of the HEMS bases, all teams were physician staffed, mainly anesthesiologists (79%), the majority were board certified (92.5%) and trained in intensive care medicine (89%) and had a median (range) experience in HEMS of 9 (0-25) years. HEMS may provide a high level of expertise in mechanical ventilation whereas the majority of ventilators are able to provide pressure controlled ventilation and continuous positive airway pressure modes (77%). Data of 30 ventilated patients with a median (range) age of 54 (21-100) years and 53% male gender were analyzed. Of these, 24 were primary missions and 6 interfacility transports. At handover, oxygen saturation (p<0.01) and positive end-expiratory pressure (p=0.04) of the patients were significantly higher compared to first patient contact.Conclusion: In this survey, the management of ventilated HEMS-patients was not associated with ventilation related serious adverse events. Patient conditions, training of medical crew and different technical and environmental resources are likely to influence management. Further studies are necessary to assess safety and process quality of mechanical ventilation in HEMS.Trial Registration: The survey was prospectively registered at Research Registry (researchregistry2925).
Identifying conflict of interest disclosure in systematic reviews of surgical interventions and devices: a cross-sectional survey
Authors: Yu Jiajie , Su Guanyue , Hirst Allison , Yang Zengyue , Zhang You , Li Youping 
Published: September 2020

Abstract
Background: Conflict of interest (COI) is an important source of bias in research and disclosure is the most frequent strategy to manage COI. Considering the importance of systematic reviews (SRs) and the prevalence of COI is varying among different research fields, we conducted a survey to identify the range of conflict of interest in SRs assessing surgical intervention and devices, and explored the association between COI disclosure and conclusion.Methods: We retrieved SRs of surgical interventions and devices published in 2017 via PubMed. Information regarding general characteristics, funding source and COI disclosure were extracted. We conducted descriptive analyses of study characteristics of included systematic reviews. The difference between groups in the authors’ conclusions were compared using the Chi-square test. Results were expressed as odds ratio and its 95% confidence interval.Results: 155 SRs were finally identified in 2017, more than half of SRs (58.7%) reported their funding source and 94.2% reported authors’ COI disclosure. Among 146 SRs that stated COI disclosures, only 35 (22.6%) SRs declared at least one author had a COI. More than 40 terms were used to describe COI. Cochrane SRs were more likely to provide a detail description of COI comparing with those in non-CSR (48.0% versus 25.4%, P=0,023). No association between a positive conclusion and COI disclosure was found (P=0.484, OR=0.43, 95%CI: 0.08, 2.16). In the subgroup analyses, SRs stating no COI disclosure were more likely to report positive conclusion than those stating at least one type of COI, but the difference is not significantly different (P=0.406, OR=1.38, 95%CI: 0.64, 2.98)Conclusion: A high rate of COI disclosure without any detailed information. The identification and statement of COI, particularly nonfinancial interests, are still needed to be improved. Some efficient and effective methods/tools for identifying, quantifying, and minimizing potential COI in systematic reviews are necessary.
Analysis on risk factors for neck shortening after internal fixation for Pauwels II femoral neck fracture in young patients
Authors: Zhao Fulong , Guo Lijuan , wang xuefei , Zhang Yakui 
Published: September 2020

Abstract
Background: Femoral neck shortening can occur in young patients receiving closed reduction and internal fixation for Pauwels type II femoral neck fracture. The risk factors for neck shortening, which can affect hip function, are not clear. This study aimed to retrospectively identify risk factors for neck shortening after closed reduction and internal fixation with parallel partially threaded cannulated cancellous screws for Pauwels type II femoral neck fracture in young patients.Methods: Clinical data from 122 cases with Pauwels type II femoral neck fracture from February 2014 to February 2019 were reviewed and analyzed, and causes of neck shortening were statistically analyzed. These patients were followed (average follow-up: 12 months). And the chi-square test or t test was used to compare indicators. Multivariate analysis was conducted with non-conditional logistic regression analysis. Results: Statistically significant differences were found in age, sex, BMD, BMI, fracture type, posterior medial cortex comminution, and reduction quality between patients with femoral neck shortening and those without femoral neck shortening. Logistic regression analysis showed that fracture type, posterior medial cortex comminution, and reduction quality were the main risk factors for neck shortening. Conclusion：Fracture type, posterior medial cortex comminution, and reduction quality can be used as important reference indexes to predict the possibility of neck shortening after closed reduction and internal fixation with parallel, partially threaded, cannulated cancellous screws for Pauwels type II femoral neck fracture in young patients.BMD and BMI may be also risk factors.
Data quality of the routine health management information system at the primary healthcare facility and district levels in Tanzania
Authors: RUMISHA SUSAN F. , LYIMO EMANUEL P. , MREMI IRENE R. , TUNGU PATRICK K. , MWINGIRA VICTOR S. , MBATA DORIS , MALEKIA SIA E. , JOACHIM CATHERINE , Mboera Leonard 
Published: September 2020

Abstract
Background: Effective planning for disease prevention and control requires accurate, adequately-analysed, interpreted and communicated data. In recent years, efforts and investments have been put in strengthening health management information systems (HMIS) in Sub-Saharan Africa to improve data accessibility to decision-makers. This study assessed the quality of routine HMIS data at primary healthcare facility (HF) and district levels in Tanzania. Methods: The assessment involved Outpatient, Inpatient, Antenatal care, Family Planning, Post-natal care, Labour and Delivery, and Provider-initiated Testing and Counselling service areas in primary health care facilities. Records were tracked and compared at different phases of the data journey i.e. registers, tally-sheets, HF monthly reports submitted to the district level, and electronic database. We assessed the availability and utilization of each HMIS tool and quantified completeness and accuracy levels of the collected data in each phase of the reporting system. Results: A total of 115 HFs (including hospitals, health centres, and dispensaries) in 11 districts were assessed. Registers (availability rate=91.1%; interquartile range (IQR):66.7%-100%) and report forms (86.9%; IQR:62.2%-100%) were the most utilized HMIS tools. There was a limited use of tally-sheets (77.8%; IQR:35.6%-100%). Tools availability at the dispensary was 91.1%, health-centre 82.2% and hospital 77.8%, and was low in urban districts. The availability rate at the district level was 65% (IQR:48%-75%). Reports were highly over-represented in comparison to registers’ records, with large differences observed at the HF phase of the data journey and more profound in hospitals. Tool availability and data quality in the reproductive health service area outperformed the general services (outpatient and inpatient) areas. Indicators with large number of clients, multiple variables, disease categorization, or those linked with dispensing of medicine performed poorly. Conclusion: There are high variations in the tool utilisation and data accuracy at facility and district levels. A significant improvement on patient registration and use of tally-sheets was observed over the years. The routine HMIS is weak and data at district level inaccurately reflects what is available at the source (HFs). These results highlight the need to design tailored and inter-service strategies for improving data quality.
Airway Obstruction as the Primary Manifestation of Infantile Thyroid Hemangioma: A Case Report and Literature Review
Authors: Liang Yujian , Pu Ronghui , Huang Xueqiong , Li Suping , Chen Yingqian , Tang Wen 
Published: September 2020

Abstract
Background: Thyroid hemangioma mostly occurs in adults and is extremely rare in infants. So far, only four pediatric cases of thyroid hemangioma have been reported, one of which has only been clinically diagnosed. Most of the reported cases are of cavernous hemangiomas; capillary hemangioma cases are very rare. To date, there are no reports on capillary thyroid hemangioma in an infant. Therefore, here we present the case of an infant with a primary capillary hemangioma of the thyroid gland, and discuss its treatment and follow-up. Case Presentation: A 2-month-old infant with normal thyroid function presented with airway obstruction as the primary manifestation of thyroid hemangioma. The main symptoms were laryngeal wheezing and dyspnea. Ultrasonography revealed hypoechoic lesions at the lower pole of the bilateral thyroid. Computed tomography revealed enlargement of the thyroid gland, inhomogeneous parenchyma enhancement, and multiple thyroid nodules. However, these imaging modalities were unable to provide an exact diagnosis and the nature of the tumor remained unknown prior to an operation. Therefore, a postoperative histopathological examination was undertaken, which revealed capillary thyroid hemangioma. The symptoms significantly improved by a combined treatment involving surgery and oral propranolol (2 mg/kg per day). Conclusion: When a well-defined capsulate mass is detected on the medical image, the possibility of primary thyroid hemangioma must be considered.
Risk areas for tuberculosis among children and their inequalities in a city from Southeast Brazil.
Authors: Alves Yan Mathias , Berra Thais Zamboni , Alves Luana Seles , de Assis Ivaneliza Simionato , Arcoverde Marcos Augusto Moraes , Ramos Antônio Carlos Vieira , Arroyo Luiz Henrique , Campoy Laura Terenciani , Bruce Alexandre Tadashi Inomata , Santos Felipe Lima dos , Souza Ludmilla Leidianne Limírio , Crispim Juliane de Almeida , Arcêncio Ricardo Alexandre 
Published: September 2020

Abstract
BACKGROUND: The objective of the study was to identify areas of risk for the appearance of tuberculosis in children and their association with social inequalities in a municipality in southeastern Brazil. METHODS: Ecological study conducted in Ribeirão Preto, Brazil. To identify areas of spatial risk for tuberculosis in children, we used spatial scanning statistics. To analyze the association of cases of childhood tuberculosis with social vulnerability, we used the Social Vulnerability Index of São Paulo, and four explanatory statistical models were listed. RESULTS: There were 96 cases of childhood tuberculosis, of which 90 were geocoded through a process of converting addresses to geographic coordinates. A risk area was identified in the municipality, where children under 15 years old have 3.14 times greater risk of contracting tuberculosis than those living outside this area. The variables identified as risk factors were: number of private and collective households, proportion of children aged 0 to 5 years in the population, proportion of households without per capita income, and the proportion of private households with monthly nominal incomes of up to one quarter of wage minimums. The variables identified as protection factors were the proportion of women under the age of 30 years responsible for the household under and women responsible for the household with an average income over BRL 2,344. CONCLUSION: The study showed areas of risk for the occurrence of tuberculosis in children. The study is in line with the End TB Strategy and the 2030 Agenda, which aim to support strategic actions and, therefore, save the lives of children through the systematic, intensified, and comprehensive identification of children with tuberculosis respiratory symptoms in the community.
LncRNA LEF1-AS1 promotes metastasis of prostatic carcinoma via the Wnt/β-catenin pathway
Authors: Li Weiyuan , Yang Ganggang , Yang Dengke , Li Dong , Sun Qian 
Published: September 2020

Abstract
Background

Long noncoding RNAs (lncRNAs), which are important functional regulators in cancer, have emerged as critical molecular regulators in various biological processes. However, the mechanisms by which LEF1-AS1 modulates Androgen-Independent Prostate Cancer (AIPC) development remain largely unknown.

Methods

The LEF1-AS1 expression level was detected in tumour tissues and adjacent normal tissues of AIPC patients by using next-generation sequencing technology and qRT-PCR. Cell proliferation, migration and invasion were assessed by colony formation, EDU assays and transwell assays, respectively. Xenograft assay was conducted to determine the effect of LEF1-AS1 on cell proliferation in vivo.

Results

LEF1-AS1 promoted the proliferation, migration, invasion and angiogenic ability of AIPC cells in vitro and in vivo. In this mechanism, LEF1-AS1 recruited the transcription factor C-myb to the promoter region of FZD2, which activated FZD2 transcription. Moreover, LEF1-AS1 functioned as a competing endogenous RNA (ceRNA) acting as a sponge for miR-328, which activated CD44.

Conclusion

Collectively, these data indicate that LEF1-AS1 is a tumour promoter in the development of AIPC and that it may contribute to the improvement of AIPC diagnosis and therapy.
Contraceptive needs and fertility intentions of women with breast cancer in Cape Town, South Africa: a qualitative study
Authors: Harries Jane , Constant Deborah , Cairncross Lydia , Moodley Jennifer 
Published: September 2020

Abstract
Background:No known studies have been undertaken in South Africa exploring the contraceptive and fertility needs and preferences of women of reproductive age (18-49) diagnosed with breast cancer. This study set out to understand the contraceptive needs and fertility intentions of women with breast cancer in Cape Town, South Africa.Methods:Qualitative in-depth interviews were conducted with 24 women diagnosed with breast cancer and 4 health care providers at a tertiary hospital in Cape Town, South Africa. We explored contraceptive use prior to diagnosis; the impact of breast cancer on future fertility intentions and contraceptive use; understanding of suitable contraceptive methods during and after treatment and women’s fertility related counseling needs during their continuum of care. Data were analysed using a thematic analysis approach. Results: Since being diagnosed with breast cancer, of those women using a contraceptive method, the non-hormonal intrauterine device (IUD) was the most commonly used method. However, women reported receiving limited information from health care providers about contraceptive use and future fertility planning post treatment when fertility desires might change. Many women reported limited information received from healthcare providers about the impact of cancer treatment on their future fertility. Most women did not receive information around fertility preservation options, and few were familiar with the concept. Providers focus was more on preventing pregnancy during treatment and ensuring a patient was on a non-hormonal contraceptive method. Providers supported a more holistic, multidisciplinary approach to breast cancer patient’s contraceptive and future fertility needs. Conclusions:Limited contraceptive and future fertility counseling were reported by women despite many women being provided with the IUD. There is a need for improved information and counseling regarding the impact of treatment on contraceptive and fertility options. It is important that cancer care providers provide timely information regarding fertility options and communicate with patients about their fertility concerns prior to treatment and throughout the course of survivorship. The development of evidence-based information tools to enhance patient- provider communication and counseling could address knowledge gaps
Investigation of the differences between the medical personnel’s and general population’s view on the doctor-patient relationship in China by a cross-sectional survey
Authors: Sang Tianqing , Zhou Hongli , Li Muhan , Li Wenting , Shi Haibo , Chen Haibin , Zhou Hongguang 
Published: September 2020

Abstract
Background: Due to economic development and an increase in the aging population, the demand for medical resources is increasing. A good doctor-patient relationship (DPR) can optimize patients’ medical experience and improve treatment efficiency. The DPR, however, is currently in crisis in China. To explore ways to improve DPR, this study assessed the views on the status of the DPR, medical services, and the general situation of medical work among medical personnel (MP) and the general population (GP). Methods: This cross-sectional study, conducted between December 2019 and March 2020, targeted the MP and the GP in Nanjing City, Jiangsu Province, and Zhengzhou City, Henan Province. A total of 154 MP and 329 GP answered a self-administered questionnaire through Questionnaire Star and WeChat apps. Wilcoxon's Sign Rank Test, Chi-square test, and frequency distributions and percentages were used to process the data. Results: Only 11.04% of the MP and 14.89% of the GP believed that the current DPR was harmonious. Moreover, 54.55% of the MP and 71.12% of the GP believed that the medical industry was a service industry. While 14.29% of the MP and 64.44% of the GP thought medical stuff earned high salaries, 19.48% of the MP and 47.11% of the GP wanted their children to be in the medical industry. The recognition of the current status of the DPR did not affect the GP’s preference for their children's practice (p<0.05). Most MP hoped to improve salaries (40.26%), followed by safety (17.53%) and social status (12.99%); only 8.44% of the MP wanted to improve the DPR. Conclusion: The MP’s and GP’s views on the current status of DPR, the importance of medical service attitudes, and the general sense of the medical industry were similar. However, there was a significant difference in the perception of the nature of medical services and the income of the people employed in the medical industry between the two groups. Balancing the expectations of patients in the medical industry and increasing public awareness of the actual situation in the medical industry may be a feasible way to improve the DPR.
A 4-gene signature predicts prognosis of uterine serous carcinoma
Authors: Chen Hui , Li Lingjun , Qin Ping , Xiong Hanzhen , Chen Ruichao , Zhang Minfen , Jiang Qingping 
Published: September 2020

Abstract
Background: Uterine serous carcinoma (USC) is an aggressive type of endometrial cancer that accounts for up to 40% of endometrial cancer deaths, creating an urgent need for prognostic biomarkers. Methods: USC RNA-Seq data and corresponding patients’ clinical records were obtained from The Cancer Genome Atlas and Genotype-Tissue Expression datasets. Univariate cox, Lasso, and Multivariate cox regression analyses were conducted to forge a prognostic signature. Multivariable and univariable cox regression analysis and ROC curve evaluated the prediction efficiency both in the training and testing sets. Results: We uncovered 1385 genes dysregulated in 110 cases of USC tissue relative to 113 cases of normal uterine tissue. Functional enrichment analysis of these genes revealed the involvement of various cancer-related pathways in USC. A novel 4‐gene signature (KRT23, CXCL1, SOX9 and ABCA10) of USC prognosis was finally forged by serial regression analyses. Overall patient survival (OS) and recurrence-free survival (RFS) were significantly lower in the high-risk group relative to the low-risk group in both the training and testing sets. The area under the ROC curve of the 4-gene signature was highest among clinicopathological features in predicting OS and RFS. The 4-gene signature was found to be an independent prognostic indicator in USC and was a superior predictor of OS in early stage of USC. Conclusions: Our findings highlight the potential of the 4-gene signature as a guide for personalized USC treatment.