bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spatiotemporal analysis of insecticide-treated net use for children under 5 in relation to socioeconomic gradients in Central and East Africa
Authors: Kim Hana , Miller F. DeWolfe , Hernandez Andres , Tanser Frank , Mogeni Polycarp , Cuadros Diego F. 
Published: April 2020

Abstract
Background
Insecticide-treated net (ITN) use is the core intervention among the strategies against malaria in sub-Saharan Africa (SSA) and the percentage of ITN ownership has increased from 47% in 2010 to 72% in 2017 across countries in SSA. Regardless of this massive expansion of ITN distribution, considerable gap between ownership and use of ITNs has been reported. Using data from more than 100,000 households in Central and East Africa (CEA) countries, the main aim of this study was to identify barriers associated with low ITN use and conduct geospatial analyses to estimate numbers and locations of vulnerable children living in areas with high malaria and low ITN use.

Methods
Main sources of data for this study were the Demographic and Health Surveys and Malaria Indicator Surveys conducted in 11 countries in CEA. Logistic regression models for each country were built to assess the association between ITN ownership or ITN use and several socioeconomic and demographic variables. A density map of children under 5 living in areas at high-risk of malaria and low ITN use was generated to estimate the number of children who are living in these high malaria burden areas.

Results
Results obtained suggest that factors such as the number of members in the household, total number of children in the household, education and place of residence can be key factors linked to the use of ITN for protecting children against malaria in CEA. Results from the spatiotemporal analyses found that although total rates of ownership and use of ITNs across CEA have increased up to 70% and 48%, respectively, a large proportion of children under 5 (19,780,678; 23% of total number of children) still lives in high-risk malaria areas with low use of ITNs.

Conclusion
The results indicate that despite substantial progress in the distribution of ITNs in CEA, with about 70% of the households having an ITN, several socioeconomic factors have compromised the effectiveness of this control intervention against malaria, and only about 48% of the households protect their children under 5 with ITNs. Increasing the effective ITN use by targeting these factors and the areas where vulnerable children reside can be a core strategy meant to reducing malaria transmission.
Segmentation of finger tendon and synovial sheath in ultrasound image using deep convolutional neural network
Authors: Kuok Chan-Pang , Yang Tai-Hua , Tsai Bo-Siang , Jou I-Ming , Horng Ming-Huwi , Su Fong-Chin , Sun Yung-Nien 
Published: April 2020

Abstract
Background
Trigger finger is a common hand disease, which is caused by a mismatch in diameter between the tendon and the pulley. Ultrasound images are typically used to diagnose this disease, which are also used to guide surgical treatment. However, background noise and unclear tissue boundaries in the images increase the difficulty of the process. To overcome these problems, a computer-aided tool for the identification of finger tissue is needed.

Results
Two datasets were used for evaluation: one comprised different cases of individual images and another consisting of eight groups of continuous images. Regarding result similarity and contour smoothness, our proposed deeply supervised dilated fully convolutional DenseNet (D2FC-DN) is better than ATASM (the state-of-art segmentation method) and representative CNN methods. As a practical application, our proposed method can be used to build a tendon and synovial sheath model that can be used in a training system for ultrasound-guided trigger finger surgery.

Conclusion
We proposed a D2FC-DN for finger tendon and synovial sheath segmentation in ultrasound images. The segmentation results were remarkably accurate for two datasets. It can be applied to assist the diagnosis of trigger finger by highlighting the tissues and generate models for surgical training systems in the future.

Methods
We propose a novel finger tendon segmentation method for use with ultrasound images that can also be used for synovial sheath segmentation that yields a more complete description for analysis. In this study, a hybrid of effective convolutional neural network techniques are applied, resulting in a deeply supervised dilated fully convolutional DenseNet (D2FC-DN), which displayed excellent segmentation performance on the tendon and synovial sheath.
The prognostic impact of neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) in patients with distal bile duct cancer
Authors: Miyahara Yoji , Takashi Shida , Shimizu Yoshiaki , Ohtsuka Masayuki 
Published: April 2020

Abstract
Background
A growing body of evidence suggests that inflammatory response markers such as the neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) are associated with outcomes of various malignancies. However, no study has reported the prognostic value of NLR and LMR in patients with distal bile duct cancer (DBDC) to date. We investigated the prognostic significance of these inflammatory markers in patients with DBDC who underwent radical resection.

Methods
The study included 40 patients diagnosed with DBDC who underwent pancreaticoduodenectomy at Narita Red Cross Hospital between January 2000 and December 2017. The cutoff values for these markers were determined by receiver operating characteristic curve analysis. Survival curves are estimated for each group in the study considered separately using the Kaplan-Meier method. The association between overall survival (OS) and the NLR, LMR, and other prognostic factors was investigated using log-rank test and multivariate Cox proportional hazards regression analysis.

Results
Corresponding to the point with the maximum combined sensitivity and specificity on the ROC curve, the best cutoff value for NLR and LMR was determined to be 3.14 and 4.55, respectively. Most clinicopathological factors were not associated with the NLR and LMR based on these cutoff values. However, serum albumin levels were associated with both the NLR and LMR (P = 0.011 and P = 0.023, respectively), and serum carbohydrate antigen 19-9 (CA 19-9) levels were also associated with the LMR (P = 0.030). Univariate analysis showed that a high NLR (P < 0.001), low LMR (P = 0.002), hypoalbuminemia (P = 0.004), high serum CA 19-9 levels (P = 0.008), and lymph node metastasis (P = 0.033) were significantly associated with poor survival rates. Multivariate analysis showed that a high NLR (hazard ratio 5.799, 95% confidence interval 1.188–28.32, P = 0.030) and a low LMR (hazard ratio 4.837, 95% confidence interval 1.826–2.331, P = 0.025) were independent prognostic factors for OS.

Conclusion
Both NLR and LMR may serve as significant independent preoperative prognostic indicators of disease in patients with DBDC who undergo radical resection.
Plasma neurofilament light chain and glial fibrillary acidic protein predict stroke in CADASIL
Authors: Chen Chih-Hao , Cheng Yu-Wen , Chen Ya-Fang , Tang Sung-Chun , Jeng Jiann-Shing 
Published: April 2020

Abstract
Background
Stroke remains the most cumbersome disease burden in patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). This study aimed to investigate whether plasma biomarkers can reflect disease severity and predict stroke recurrence in CADASIL patients.

Methods
Sixty-three CADASIL patients (mean age 58.9 ± 9.3 years old, male 63%) from a multicenter registry and 17 controls were recruited. Plasma biomarkers, namely neurofilament light chain (NfL), glial fibrillary acidic protein (GFAP), tau, and ubiquitin carboxy-terminal hydrolase L1 (UCHL1), were measured using an ultra-sensitive single molecule array at baseline. Neuroimaging markers assessed included the Fazekas scale of white matter hyperintensity, numbers of lacunes, and cerebral microbleeds (CMBs). Cox proportional hazards regression models were applied to calculate the hazard ratio (HR) of plasma biomarkers at baseline for predicting incident stroke during follow-up.

Results
Plasma NfL, GFAP, and UCHL1 levels were significantly elevated in the CADASIL patients than in the controls. Among the CADASIL patients, both plasma NfL and GFAP levels positively correlated with the numbers of CMBs (r = 0.32 and r = 0.37, respectively; both p < 0.05). Higher plasma levels of NfL and GFAP were associated with any stroke (odds ratio 2.02, 95% confidence interval [CI] 1.06–3.87) and ICH (odds ratio 2.06, 95% CI 1.26–3.35) at baseline, respectively. Within a mean follow-up period of 3.1 ± 2.1 years, 10 patients (16%) had incident stroke and 6 of them were ICH. Higher baseline NfL (HR 1.93, 95% CI 1.19–3.13) predicted any incident stroke, whereas higher GFAP (HR 2.80, 95% CI 1.21–6.53) predicted incident ICH.

Conclusions
In CADASIL patients, plasma NfL can be a promising biomarker for monitoring incident stroke, whereas GFAP may have a role in cerebral hemorrhage.
Robotic therapy for the hemiplegic shoulder pain: a pilot study
Authors: Serrezuela Ruthber Rodríguez , Quezada Mauricio Torres , Zayas Marcia Hernández , Pedrón Arquímedes Montoya , Hermosilla Daily Milanés , Zamora Roberto Sagaró 
Published: April 2020

Abstract
Backgrounds
Exoskeletons development arises with a leading role in neurorehabilitation technologies; however, very few prototypes for upper limbs have been tested, contrasted and duly certified in terms of their effectiveness in clinical environments in order to incorporate into the health system. The purpose of this pilot study was to determine if robotic therapy of Hemiplegic Shoulder Pain (HSP) could lead to functional improvement in terms of diminishing of pain, spasticity, subluxation, the increasing of tone and muscle strength, and the satisfaction degree.

Methods
An experimental study was conducted in 16 patients with painful shoulder post- ischemic stroke in two experimental groups: conventional and robotic therapy. At different stages of its evolution, the robotic therapy effectiveness applied with anti-gravitational movements was evaluated. Clinical trial was developed at the Physical Medicine and Rehabilitation Department of the Surgical Clinical Hospital “Dr. Juan Bruno Zayas Alfonso” in Santiago de Cuba, from September 2016 - March 2018. Among other variables: the presence of humeral scapular subluxation (HSS), pain, spasticity, mobility, tone and muscle strength, and the satisfaction degree were recorded. Results with 95% reliability were compared between admission and third months of treatment. The Mann-Whitney U-Test, Chi-Square and Fisher’s Exact Tests were used as comparison criteria.

Results
Robotic therapy positively influenced in the decrease and annulment of pain and the spasticity degree, reaching a range increase of joint movement and the improvement of muscle tone.
Immunization with a fusion protein vaccine candidate generated from truncated peptides of human enterovirus 71 protects mice from lethal enterovirus 71 infections
Authors: Liu Jiangning , Zhao Binbin , Xue Ling , Wu Jing , Xu Yanfeng , Liu Yongdong , Qin Chuan 
Published: April 2020

Abstract
Background
Prophylactic vaccines are critical in preventing hand, foot, and mouth disease (HFMD) primarily caused by human enterovirus 71 (EV71) infection. Children aged less than 5 years are especially susceptible to EV71 infections. In addition to the development of vaccines containing the inactivated virus, those containing virus-like particles (VLPs) with repeated antigens also constitute an effective preventive strategy for EV71 infections, with safety and productivity advantages. We previously developed a fusion protein composed with truncated peptides of the EV71 capsid protein, which assembled into spherical particles. This study aimed to assess the immunoprotective effects of this fusion protein as a vaccine candidate in a mouse model of EV71 infection.

Methods
To evaluate the protective effect of fusion protein vaccine candidate, neonatal mice born by immunized female mice, as well as normal neonatal mice immunized twice were infected with EV71 virus. Whereafter, the survival rates, clinical scores and viral loads were measured.

Results
The high dosage and booster immunization helped induce specific serum antibodies with high neutralization titers, which were transferred to neonatal mice, thereby facilitating effective resistance towards EV71 infection. An active immune response was also observed in neonatal mice which generated following immunization.

Conclusions
The present results suggest that this fusion protein is a suitable vaccine candidate in treating EV71 infections.
Identification of protein inhibitor of activated STAT 4, a novel host interacting partner that involved in bovine viral diarrhea virus growth
Authors: Gong Xiaowei , Chen Qiwei , Zheng Fuying 
Published: April 2020

Abstract
Background
Bovine viral diarrhea virus (BVDV) belongs to the Flaviviridae family and the pestivius virus group. BVDV is responsible for significant economic loss in cattle industry worldwide because of reducing reproductive performance, increasing incidence of other diseases and mortality among young stock. The core (C) protein of the Flaviviridae family member is involved in host antiviral immune response through activation of related signaling pathways that affect the viral replication. However, the influence of C protein-interaction partners in BVDV infections is poorly defined.

Methods
To explore C-protein-interacting partners, yeast two-hybrid was used to screen the interaction protein of C protein using bovine peripheral blood mononuclear cell (PBMC) cDNA library. The co-immunoprecipitation and confocal assays were manipulated to determine the interaction between potential partners and C protein. Knockdown and overexpression of the partner were used to examine whether the C-protein-interacting partner plays a role in BVDV proliferation and virulence. Meanwhile, qRT-PCR and western blot assays were used to investigate the effect of C protein and C-protein-interacting partner on the immune response of host cells.

Results
We identified protein inhibitor of activated STAT 4 (PIAS4) as a novel interacting partner of the BVDV C protein. Co-immunoprecipitation and confocal assays demonstrated a strong interaction between C protein and PIAS4. Silencing of PIAS4 with small interfering RNA suppressed C protein expression and BVDV growth, while overexpression of PISA4 increased C protein expression and BVDV growth. The overexpression of PIAS4 increased the cell apoptosis. Meanwhile, the expressions of STAT4, SOCS3, IFITM, IFN-α were negatively regulated by the expression of PIAS4. The expression of C protein suppressed the antiviral proteins expression, and the inhibition effect was enhanced by interaction of PIAS4 and C protein. These results highlighted the beneficial properties of cellular PIAS4 for BVDV protein expression and growth.

Conclusions
This study provides reliable clues for understanding the roles of PIAS4 in the regulation of BVDV growth.
Rural development and shifts in household dietary practices from 1999 to 2010 in the Tapajós River region, Brazilian Amazon: empirical evidence from dietary surveys
Authors: Oestreicher Jordan Sky , do Amaral Deusilene Pereira , Passos Carlos José Sousa , Fillion Myriam , Mergler Donna , Davidson Robert , Lucotte Marc , Romaña Christina A. , Mertens Frédéric 
Published: April 2020

English abstract
Background
Research on changing dietary practices is rare in lower and middle income countries, and understanding the impact of global economic processes on population health and nutrition is important, especially of rural communities. We analyzed the diet of 22 families in Brasília Legal, a riverside community in the Tapajós River region of the Brazilian Amazon, using nonparametric tests to compare dietary surveys taken in 1999 and 2010.

Results
Data from the two surveys show that food obtained through commercial supply chains became more frequent in household diets, corresponding to significant increases in daily consumption of food items rich in energy, protein, and sugar. At the same time, there was a decline in traditional Amazonian food intake.

Conclusions
Comparing these results with household socio-economic characteristics and drawing on open-ended interviews, we consider the multiple influences that economic development processes may have had on local diets. The introduction of new income sources and employment opportunities, infrastructural and transportation expansion, as well as environmental change appear to have influenced the observed dietary shifts. Such shifts are likely to have important implications for the nutritional status of communities in the Amazon, highlighting concerning trade-offs between current development trajectories and human health. Public policies and health education programs must urgently consider the interactions between sustainable development priorities in order to address emerging health risks in this rapidly changing region.
The north-south policy divide in transnational healthcare: a comparative review of policy research on medical tourism in source and destination countries
Authors: Virani Altaf , Wellstead Adam M. , Howlett Michael 
Published: April 2020

AbstractMedical tourism occupies different spaces within national policy frameworks depending on which side of the transnational paradigm countries belong to, and how they seek to leverage it towards their developmental goals. This article draws attention to this policy divide in transnational healthcare through a comparative bibliometric review of policy research on medical tourism in select source (Canada, United States and United Kingdom) and destination countries (Mexico, India, Thailand, Malaysia and Singapore), using a systematic search of the Web of Science (WoS) database and review of grey literature. We assess cross-national differences in policy and policy research on medical tourism against contextual policy landscapes and challenges, and examine the convergence between research and policy. Our findings indicate major disparities in development agendas and national policy concerns, both between and among source and destination countries. Further, we find that research on medical tourism does not always address prevailing policy challenges, just as the policy discourse oftentimes neglects relevant policy research on the subject. Based on our review, we highlight the limited application of theoretical policy paradigms in current medical tourism research and make the case for a comparative policy research agenda for the field.
Mitral valve replacement in mitral stenosis; the problem of small left ventricle
Authors: Alkady Hesham , Saber Ahmed , Abouramadan Sobhy , Elnaggar Ahmed , Nasr Sherif , Mahmoud Eman 
Published: April 2020

Abstract
Background
Mitral valve stenosis in adults especially due to rheumatic heart disease may be associated with a smaller than normal left ventricular cavity. Mitral valve replacement in such cases may lead to hemodynamic instability either during weaning from cardiopulmonary bypass or in the early postoperative period manifested by the need for inotropic support and even mortality due to low cardiac output syndrome.

Patients and methods
184 patients with predominately severe stenotic mitral valves who underwent elective isolated mitral valve replacement in the period between January 2012 and January 2018 at our hospital were included in this study. Patients were divided into 2 matched groups; (small LV group) consisting of 86 cases and (normal or dilated LV group) consisting of 98 cases.

Results
There were no statistically significant differences in operative details among both groups apart from the need for inotropic support and intra-aortic balloon pump due to low cardiac output which were statistically significantly higher in (small LV group) than (normal or dilated LV group) with a p-values of 0.01 and 0.03 respectively. Within the ICU stay only the incidence of occurrence of heart failure was significantly higher in (small LV group) with a p-value of 0.008. No statistically significant difference could be elicited in the in-hospital mortality between both groups (p-value = 0.1).

Conclusion
Patients with mitral valve stenosis and small left ventricular cavity are in a higher need for inotropic and even mechanical support after mitral valve replacement as well as at a higher risk for the development of heart failure before hospital discharge than patients with mitral stenosis and normal-sized left ventricular cavity.
A 12-month follow-up of a transdiagnostic indicated prevention of internalizing symptoms in school-aged children: the results from the EMOTION study
Authors: Loevaas M. E. S. , Lydersen S. , Sund A. M. , Neumer S-P. , Martinsen K. D. , Holen S. , Patras J. , Adolfsen F. , Rasmussen L-M. P. , Reinfjell T. 
Published: April 2020

Abstract
Background
Anxious and depressive symptoms in youth are highly prevalent, are often comorbid and have a high rate of relapse. Preventive interventions are promising, but follow-up results are lacking. The transdiagnostic EMOTION program is an indicated preventive cognitive behavioral therapy (CBT) intervention targeting children aged 8–12 years.

Methods
The present study investigates the 12 months follow-up effects of the EMOTION intervention in a cluster randomized controlled trial (RCT) with 795 children that included both child self-reports and parental reports.

Results
Mixed model analyses showed a larger decrease of symptoms in the intervention group than in the control group for child self-reported anxious symptoms (The Multidimensional Anxiety Scale for Children (MASC) difference 4.56, CI 1.83 to 7.29, p = .001). Parental reports for both anxious (MASC difference 2.50, CI .26 to 4.74, p = .029) and depressive (The Mood and Feelings Questionnaire-short form (SMFQ) difference 1.55, CI .83 to 2.26, p ≤ .001) symptoms in children also showed a reduction. No statistically significant difference was found for child self-reported depressive symptoms (SMFQ difference .69, CI − .22 to 1.60, p = .139).

Conclusion
The transdiagnostic EMOTION program has shown the potential for long-term reductions in symptoms of both anxiety and depression in school-aged children. However, results regarding depressive symptoms must be considered preliminary as only parental report indicated effect.
Trial registration The regional ethics committee (REC) of Norway approved the study. Registration number: 2013/1909; Project title: Coping Kids: a randomized controlled study of a new indicated preventive intervention for children with symptoms of anxiety and depression. ClinicalTrials.gov Identifier; NCT02340637.