bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Utility of a Pre-Transplant Psychosocial Evaluation in Predicting Post-Liver Transplant Outcomes
Authors: Becker Jacqueline H. , Shemesh Eyal , Shenoy Akhil , Posillico Ailie , Knight Christopher S. , Kim Se-Kang , Florman Sander S. , Schiano Thomas , Annunziato Rachel A. 
Published: December 2020

Background: There is insufficient evidence about the ability of pretransplant psychosocial evaluations to predict posttransplant outcomes. While standardized assessments were developed to increase predictive validity, it is unclear whether the risk scores they yield predict outcomes. We investigated if the Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT), a scaling approach to those assessments, would have been a superior predictor than the standard psychosocial evaluation. Methods: In this retrospective study, medical records of 182 adult liver transplant recipients who were at least 1 year posttransplant and prescribed tacrolimus for immunosuppression were analyzed. Regression analyses predicted outcomes of interest, including immunosuppressant nonadherence and biopsy-proven rejection, obtained 1-year posttransplant to time of data collection. Nonadherence was determined using the medication level variability index (MLVI). Results: Approximately 49% of patients had MLVI > 2.5, suggestive of nonadherence, and 15% experienced rejection. SIPAT total score did not predict adherence either using the continuous (P = .70), or dichotimized score, above or below > 2.5 (P = .14), or rejection (P = 0.87). Using a SIPAT threshold (total score > 69) did not predict adherence (p = .16) nor was a superior predictor of the continuous adherence score (P = .45), MLVI > 2.5 (P = .42), or rejection (P = 0.49), than the standard evaluation. Conclusion: Our findings suggest that the SIPAT is unable to predict 2 of the most important outcomes in this population, immunosuppressant adherence and rejection. Research efforts should attempt to evaluate the best manner to use psychosocial evaluations.
Pattern, predictors and clustering of handwashing practices in India
Authors: Pradhan Manas Ranjan , Mondal Sourav 
Published: December 2020

Background: Research on handwashing continues to draw researchers’ interest owing to its public health importance and significance in the reduction of infectious diseases. The aims of this study are to: (1) understand the pattern and predictors of handwashing using soap/detergent and water; and (2) assess the spatial clustering of handwashing through soap/detergent and water at the district level in India. Methods: Data of households where the place for handwashing was observed by the research investigators (n = 582,064), gathered through the National Family Health Survey-4 (2015–2016), were used for this analysis. The availability of soap/detergent and water at the usual place of handwashing was assumed to be used for handwashing. Binary logistic regression was carried out to examine the adjusted effect of socioeconomic characteristics on the use of soap/detergent and water for handwashing. The univariate local indicator of spatial association (LISA) cluster map and Moran’s I statistics were applied for assessing spatial autocorrelations at the district level. Analyses were carried out with IBM-SPSS Software. Results: Two-fifths of Indian households do not use both soap/detergent and water for handwashing. Households using both the cleansing elements vary considerably by socioeconomic characteristics— worse for the socioeconomically disadvantaged groups. There is spatial clustering in the use of soap/detergent and water for handwashing: lower in a cluster of districts in eastern India. Conclusion: Results suggest the need to generate awareness, particularly among the socioeconomically weaker populations, about advantages of hand hygiene, which will reduce the prevalence of infectious diseases like COVID-19 and be helpful to achieve many Sustainable Development Goals.
A domestic robotic rehabilitation device for assessment of wrist function for outpatients
Authors: Panny Matthias , Mayr Andreas , Nagiller Marco , Kim Yeongmi 
Published: December 2020

Introduction Available robot-assisted stroke rehabilitation systems are often limited in their utilization in the home environment, due to several barriers such as high cost, absence of therapists, tedious training tasks, or encumbering interfaces. This paper presents a low-cost robotic rehabilitation and assessment device for restoring wrist function, offering wrist exercises incorporating pronation-supination and flexion-extension movements. Furthermore, the device is designed for the assessment of joint stiffness of the wrist, and range of motion in two degrees of freedom. Methods: Mechanical/electrical design of the device as well as the control system is described. A preliminary evaluation focused on the measurement of the torsional stiffness of the limb is presented. It is evaluated by reconstructing the known stiffness values of torsional springs by measuring the motor current required to displace them. Results The device demonstrates the ability to determine the stiffness of an object with low-cost hardware. Use case scenarios of the device for training and assessment of the wrist are presented, allowing for a range of motion of [Formula: see text] and [Formula: see text], for pronation-supination and flexion-extension respectively. Conclusion The device shows potential to help objectively quantify the stiffness of the wrist movement, which consecutively could be used to represent and quantify the degree of impairment of patients after stroke in a more objective manner. Further clinical study is necessary to examine this.
What Are the Risk Factors for Adjacent Vertebral Fracture After Vertebral Augmentation? A Meta-Analysis of Published Studies
Authors: Zhang Tianyu , Wang Yanhua , Zhang Peixun , Xue Feng , Zhang Dianying , Jiang Baoguo 
Published: December 2020

Study Design: Meta-analysis. Objectives: To provide up-to-date evidence-based outcomes for the incidence and risk factors of adjacent vertebral fracture (AVF) after the vertebral augmentation. Methods: The MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched for studies assessing the risk factors of adjacent vertebral fracture after vertebral augmentation until June 2020. The AVF incidence and factors potentially affecting AVF were extracted and pooled. Results: A total of 16 studies, encompassing 2549 patients were included in the meta-analysis. The pooled incidence of AVF was 14% after vertebral augmentation. Female, lower T-score, thoracolumbar junction fracture, intravertebral cleft, more injected cement volume, intradiscal cement leakage significantly increased the risk of AVF. Age, body mass index, steroid medication, Cobb angle change, postoperative Cobb angle showed no significant association with AVF. Conclusions: Identifying the risk factors of AVF can facilitate prevention strategy to avoid the AVF. Female, T-score, thoracolumbar junction fracture, intravertebral cleft, more cement volume, and intradiscal cement leakage increased the risk of AVF.
Hamstring autograft and anatomical footprint evaluation for anterior talofibular ligament reconstruction: Cadaveric study
Authors: Karahan Nazım , Kaya Murat , Yılmaz Barış , Kurdal Demet Pepele , Keskinoz Elif Nedret , Çiçek Esma Esin Derin 
Published: December 2020

Purpose: The aim of the study was to evaluate whether or not there was any incompatibility between two-strand hamstring tendons taken from the same knee and the ATFL and it was the determination of suitable footprint points in the fibula and talus for anatomical ATFL reconstruction. Methods: 16 fresh frozen cadaver specimens were dissected to gracilis and semitendinosus tendons and the anterior talofibular ligament. The origins, insertions, distances from osseous landmarks of fibular talus of ATFL were determined. The diameters of gracilis, semitendinosus and ATFL were calculated. There was a moderate correlation between body height and the distance between the distal of inferior lateral malleolus and the fibular adhesion site of ATFL (r: 36.5 p: 0.036). There was a weak correlation between body height and the distance between the apex of the lateral talar process and the talus adhesion site of ATFL in a single bundle (r: 28.4 p: 0.002). There was no correlation between the distance from proximal and distal adhesion side of ATFL and body height in the double bundle (p: 0.241). Results: There was no significant relationship between ATFL diameter and gracilis, semitendinosus and both hamstring in women. A significant relationship at 80.5% was determined between the ATFL and the gracilis diameter in man. A significant relationship at 92.6% was determined between the ATFL and the semitendinosus diameter in man. Conclusion: It was determined that there is not compatibility between the gracilis tendons, the semitendinosus tendon and ATFL in women. It should be supported by biomechanical and clinical studies whether this incompatibility has a clinical effect or not.
Regulation of the Fasciola hepatica newly excysted juvenile cathepsin L3 (FhCL3) by its propeptide: a proposed ‘clamp-like’ mechanism of binding and inhibition
Authors: Pritsch Izanara C. , Tikhonova Irina G. , Jewhurst Heather L. , Drysdale Orla , Cwiklinski Krystyna , Molento Marcelo B. , Dalton John P. , Verissimo Carolina De M. 
Published: December 2020

AbstractBackgroundThe zoonotic worm parasiteFasciola hepaticasecretes an abundance of cathepsin L peptidases that are associated with virulence, invasiveness, feeding and migration. The peptidases are produced as inactive zymogens that activate at low pH by autocatalytic removal of their N-terminal pro-domain or propeptide. Propeptides bind to their cognate enzyme with high specificity. Little is known, however, about the mechanism by which the propeptide of FhCL3, a cathepsin L peptidase secreted by the infective newly excysted juveniles (NEJs), regulates the inhibition and activation of the mature enzyme before it is secreted into host tissues.ResultsImmunolocalisation/immunoblotting studies show that the FhCL3 zymogen is produced and secreted by gastrodermal cells of the NEJs gut. A recombinant propeptide of FhCL3 (ppFhCL3) was shown to be a highly potent and selective inhibitor of native and recombinantF. hepaticaFhCL3 peptidase, and other members of the cathepsin L family; inhibition constant (Ki) values obtained for FhCL1, FhCL2 and FhCL3 were 0.04 nM, 0.004 nM and < 0.002 nM, respectively. These values are at least 1000-fold lower than thoseKiobtained for human cathepsin L (HsCL) and human cathepsin K (HsCK) demonstrating the selectivity of the ppFhCL3 for parasite cathepsins L. By exploiting 3-D structural data we identified key molecular interactions in the specific binding between the ppFhCL3 and FhCL3 mature domain. Using recombinant variants of ppFhCL3 we demonstrated the critical importance of a pair of propeptide residues (Tyr46Lys47) for the interaction with the propeptide binding loop (PBL) of the mature enzyme and other residues (Leu66and Glu68) that allow the propeptide to block the active site.ConclusionsThe FhCL3 peptidase involved in host invasion byF. hepaticais produced as a zymogen in the NEJs gut. Regulation of its activation involves specific binding sites within the propeptide that are interdependent and act as a “clamp-like” mechanism of inhibition. These interactions are disrupted by the low pH of the NEJs gut to initiate autocatalytic activation. Our enzyme kinetics data demonstrates high potency and selectivity of the ppFhCL3 for its cognate FhCL3 enzyme, information that could be utilised to design inhibitors of parasite cathepsin L peptidases.
ABCDE cognitive aid tool in patient assessment – development and validation in a multicenter pilot simulation study
Authors: Peran David , Kodet Jiri , Pekara Jaroslav , Mala Lucie , Truhlar Anatolij , Cmorej Patrik Christian , Lauridsen Kasper Glerup , Sari Ferenc , Sykora Roman 
Published: December 2020

Abstract
Background
The so called ABCDE approach (Airway-Breathing-Circulation-Disability-Exposure) is a golden standard of patient assessment. The efficacy of using cognitive aids (CA) in resuscitation and peri-arrest situations remains an important knowledge gap. This work aims to develop an ABCDE CA tool (CAT) and study its potential benefits in patient condition assessment.

Methods
The development of the ABCDE CAT was done by 3 rounds of modified Delphi method performed by the members of the Advanced Life Support Science and Education Committee of the European Resuscitation Council.
A pilot multicentre study on 48 paramedic students performing patient assessment in pre-post cohorts (without and with the ABCDA CAT) was made in order to validate and evaluate the impact of the tool in simulated clinical scenarios.
The cumulative number and proper order of steps in clinical assessment in simulated scenarios were recorded and the time of the assessment was measured.

Results
The Delphi method resulted in the ABCDE CAT. The use of ABCDE CAT was associated with more performed assessment steps (804: 868; OR = 1.17, 95% CI: 1.02 to 1.35, p = 0.023) which were significantly more frequently performed in proper order (220: 338; OR = 1.68, 95% CI: 1.40 to 2.02, p < 0.0001). The use of ABCDE CAT did not prolong the time of patient assessment.

Conclusion
The cognitive aid for ABCDE assessment was developed. The use of this cognitive aid for ABCDE helps paramedics to perform more procedures, more frequently in the right order and did not prolong the patient assessment in advanced life support and peri-arrest care.
Efficacy of 104-week Telbivudine-based optimization strategy in patients with HBeAg-negative chronic hepatitis B virus infections
Authors: Gan Weiqiang , Li Jianguo , Zhang Chunlan , Chen Xuefu , Lin Chaoshuang , Gao Zhiliang 
Published: December 2020

Abstract
Background
Evaluate the safety and efficacy of 104-week regimen of Telbivudine(LdT)-based optimization strategy for Chinese patients who have chronic hepatits B(CHB) with HBeAg-negative.

Methods
This multi-center, open-label, prospective study enrolled 108 HBeAg-negative CHB patients who received LdT (600 mg/day) for 24 weeks, Adefovir (ADV) was added if HBV DNA remained detectable at week 24, otherwise LdT was maintained to use until 104 weeks. HBV DNA, alanine amino transferase (ALT), hepatitis B surface antigen(HBsAg), creatinine kinase(CK), and estimated glomerular filtration rate (eGFR) were measured, safety was assessed.

Results
Eighty-eight patients (81%) had HBV-DNA undetectable at 24 weeks and maintained to receive LdT monotherapy until 104 weeks, whereas the other 20 patients had HBV-DNA detectable and ADV was used in combination. For all patients, 72% of patients reached ALT normalization at 24 weeks, which increased to 80% at 52 weeks and 104 weeks, respectively.. 81% of total patients had undetectable HBV-DNA at 24 weeks, 92% at 52 weeks, and 94% at 104 weeks. The HBsAg titre declined steadily from baseline to 104 weeks (3.62 vs. 2.98 log10 IU/mL, p < 0.05), and the eGFR increased steadily from baseline to 104 weeks (92.9 vs. 104.4 mL/min/1.73 m2, p < 0.05). Although 79 patients (73%) had at least one time of elevated CK, most of these patients had CK elevated in Grade 1/2.

Conclusions
LdT was well tolerated and effective, and 94% of patients achieved virological suppression after 104 weeks.

Trial registration
This study was registered in clinicaltrials.gov on January 31, 2012 and the ID No. was NCT01521975.
Socioeconomic inequality in intermittent preventive treatment using Sulphadoxine pyrimethamine among pregnant women in Nigeria
Authors: Muhammad Fatima Mahmud , Majdzadeh Reza , Nedjat Saharnaz , Sajadi Haniye Sadat , Parsaeian Mahboubeh 
Published: December 2020

Abstract
Background
Intermittent preventive treatment using Sulphadoxine pyrimethamine (IPTp-SP) for malaria prevention is recommended for all pregnant women in malaria endemic areas. However, there is limited evidence on the level of socioeconomic inequality in IPTp-SP use among pregnant women in Nigeria. Thus, this study aimed to determine the level of socioeconomic inequality in IPTp-SP use among pregnant women in Nigeria and to decompose it into its contributing factors.

Methods
A secondary data analysis of Nigerian demographic and health survey of 2018 was conducted. A sample of 21,621 pregnant women aged between 15 and 49 years and had live birth in the previous 2 years before the survey were included in this analysis. The study participants were recruited based on a stratified two-stage cluster sampling method. Socioeconomic inequality was decomposed into its contributing factors by concentration index.

Result
Totally 63.6% of pregnant women took at least one dose of IPTp-SP prophylaxis. Among IPTp-SP users, 35.1% took one dose, 38.6% took two doses and 26.2% took three doses and more. Based on both concentration index of 0.180 (p-value = < 0.001, 95% CI: 0.176 to 0.183) and Erreyger’s normalization concentration index 0.280 (p-value = < 0.001, 95% CI: 0.251 to 0.309), the IPTp-SP utilization was pro-rich. The largest contributors to the inequality in IPTp-SP uptake were wealth index (47.81%) and educational status (28.66%).

Conclusion
Our findings showed that IPTp-SP use was pro-rich in Nigeria. Wealth index and educational status were the factors that significantly contributed to the inequality. The disparities could be reduced through free IPTp service expansion by targeting pregnant women from low socioeconomic status.
Clinical features of Japanese patients with exacerbations of chronic obstructive pulmonary disease
Authors: Tashiro Hiroki , Kurihara Yuki , Takahashi Koichiro , Sadamatsu Hironori , Haraguchi Tetsuro , Tajiri Ryo , Takamori Ayako , Kimura Shinya , Sueoka-Aragane Naoko 
Published: December 2020

Abstract
Background
Exacerbations are critical events in chronic pulmonary obstructive disease (COPD). The frequency of COPD exacerbations is associated with the prognosis, including mortality, but no useful biomarker has been established.

Methods
The present retrospective study investigated 481 COPD patients. Clinical features in the stable period were compared between patients who experienced severe exacerbation (n = 88, 18.3%) and those who never experienced severe exacerbation (n = 393, 81.7%). In the patients who experienced exacerbations, clinical features were also compared between frequent exacerbators (exacerbation rate ≥ 2 times/year, n = 27, 30.7%) and infrequent exacerbators (1 time/year, n = 61, 69.3%).

Results
Compared to COPD patients who never experienced exacerbations, body mass index (BMI), serum albumin, and pulmonary functions were significantly lower, and the cardiovascular disease comorbidity rate, COPD assessment test score, modified Medical Research Council dyspnea scale, and use of long-term oxygen therapy, long-acting β2 adrenergic agonist therapy, inhaled corticosteroid therapy, and macrolide therapy were significantly higher in COPD patients with exacerbations (all p < 0.01). In patients who experienced exacerbations, frequent exacerbators had significantly lower % forced expiratory volume in 1.0 s and a higher risk of critical exacerbations, percentage of blood eosinophils, history of mechanical ventilation use, and use of long-term oxygen therapy and of macrolide therapy than infrequent exacerbators (all p < 0.01). On multivariate analysis, the percentage of blood eosinophils was the parameter most correlated with exacerbation frequency (β value [95% confidence interval] 1.45 [1.12–1.88], p < 0.01).

Conclusion
Blood eosinophil in the stable period is the factor most correlated with the frequency of severe exacerbations.
Trial registration: The patients in this study was registered retrospectively
Using ultrasound features and radiomics analysis to predict lymph node metastasis in patients with thyroid cancer
Authors: Li Fu , Pan Denghua , He Yun , Wu Yuquan , Peng Jinbo , Li Jiehua , Wang Ye , Yang Hong , Chen Junqiang 
Published: December 2020

Abstract
Background
Lymph node metastasis (LNM) is an important factor for thyroid cancer patients’ treatment and prognosis. The aim of this study was to explore the clinical value of ultrasound features and radiomics analysis in predicting LNM in thyroid cancer patients before surgery.

Methods
The characteristics of ultrasound images of 150 thyroid nodules were retrospectively analysed. All nodules were confirmed as thyroid cancer. Among the assessed patients, only one hundred and twenty-six patients underwent lymph node dissection. All patients underwent an ultrasound examination before surgery. In the radiomic analysis, the area of interest was identified from selected ultrasound images by using ITK-SNAP software. The radiomic features were extracted by using Ultrosomics software. Then, the data were classified into a training set and a validation set. Hypothetical tests and bagging were used to build the model. The diagnostic performance of different ultrasound features was assessed, a radiomic analysis was conducted, and a receiver operating characteristic (ROC) curve analysis was performed to explore the diagnostic accuracy.

Results
Regarding the prediction of LNM, the ROC curves showed that the area under the curve (AUC) values of an irregular shape and microcalcification were 0.591 (P = 0.059) and 0.629 (P = 0.007), respectively. In the radiomics analysis, in the training set, the AUC value of LNM was 0.759, with a sensitivity of 0.90 and a specificity of 0.860. In the verification set, the AUC was 0.803, with a sensitivity of 0.727 and a specificity of 0.800.

Conclusions
Microcalcification and an irregular shape are predictors of LNM in thyroid carcinoma patients. In addition, radiomics analysis has promising value in screening meaningful ultrasound features in thyroid cancer patients with LNM. Therefore, the prediction of LNM based on ultrasound features and radiomic features is useful for making appropriate decisions regarding surgery and interventions before thyroid carcinoma surgery.
Enhanced recovery after surgery nursing program, a protective factor for stoma-related complications in patients with low rectal cancer
Authors: Shao Weiling , Wang Honggang , Chen Qun , Zhao Wen , Gu Yulian , Feng Guoqin 
Published: December 2020

Abstract
Background
This study aimed to investigate the association between enhanced recovery after surgery (ERAS) nursing program and stoma-related complications (SRCs) and prognosis in patients with low rectal cancer (LRC) undergoing abdominoperineal resection with sigmoidostomy.

Methods
LRC patients who underwent elective abdominoperineal resection with sigmoidostomy between May 2016 and May 2019 were retrospectively enrolled. The occurrence of early major or minor SRCs (within postoperative 30 days) was set as the primary end-point. Clinicopathological variables and laboratory tests were compared between patients with or without SRCs. The univariate and multivariate logistic regression analyses were performed to investigate risk factors for SRCs. Hospitalization satisfaction-related and prognosis-related variables were compared between LRC patients with or without ERAS nursing program.

Results
A total of 288 patients were enrolled and the incidence of SRCs was 26.7% (77/288). ERAS nursing program was the only independent risk factor for SRCs in LRC patients (OR 2.04, 95%CI 1.31–3.12, P = 0.016) by the multivariate logistic regression analysis. Moreover, ERAS nursing program was associated with higher hospitalization satisfaction rate, faster bowel function recovery, better psychological status, and higher quality of life.

Conclusions
ERAS nursing program was a protective factor for SRCs and associated with improved prognosis in LRC patients undergoing elective abdominoperineal resection with sigmoidostomy.