bluuebunny/crossref_metadata_2025_split huggingface dataset:
Meta-analysis of serum and/or plasma D-dimer in the diagnosis of periprosthetic joint infection
Authors: Li Cheng , Margaryan Donara , Ojeda-Thies Cristina , Perka Carsten , Trampuz Andrej 
Published: January 2020

Abstract
Background The purpose of this meta-analysis was to evaluate the diagnostic value of D-dimer in detecting periprosthetic joint infection (PJI). Methods A systematic search and screen of relevant studies was performed in the PubMed, Web of Science and Embase databases using the following medical subject headings (MeSH) or keywords: “arthroplasty or joint prosthesis or joint replacement or periprosthetic joint or prosthetic joint”, “infection or infectious or infected”, and “D-dimer or serum D-dimer or plasma D-dimer or fibrin degradation products”. Then, the data were analysed and processed by Meta-Disc software. Results A total of 7 studies with 1285 patients were included in this meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odds ratio (DOR) were 0.75 (95% confidence interval [CI]: 0.70 to 0.79), 0.69 (95% CI: 0.66 to 0.72), 3.01 (95% CI: 1.84 to 4.93), 0.32 (95% CI: 0.19 to 0.53) and 10.20 (95% CI: 3.63 to 28.64), respectively. Subgroup analyses showed that use of serum D-dimer had better sensitivity and specificity than plasma D-dimer for the diagnosis of PJI (0.86, 0.84 vs. 0.67, 0.60, respectively). Conclusion Serum D-dimer had a better diagnostic value than plasma D-dimer for the diagnosis of PJI.
El Niño Southern Oscillation as an early warning tool for dengue outbreak in India
Authors: Pramanik Malay K. , Singh Poonam , Kumar Gaurav , Ojha Vijay Prakash , Dhiman Ramesh C. 
Published: January 2020

Abstract
Background Dengue is rapidly expanding climate-sensitive mosquito-borne disease worldwide. Outbreaks of dengue occur in various parts of India as well but there is no tool to provide early warning. The current study was, therefore, undertaken to find out the link between El Niño, precipitation, and dengue cases, which could help in early preparedness for control of dengue.Methods Data on Oceanic Niño Index was extracted from CPC-IRI (USA) while the data on monthly rainfall was procured from India Meteorological Department. Data on annual dengue cases was taken from the website of National Vector Borne Disease Control Programme (NVBDCP). Correlation analysis was used to analyse the relationship between seasonal +ONI, ‘rainfall index’ and ‘dengue case index’ based on past 20 years state-level data. The ‘dengue case index’ representing ‘relative deviation from mean’ was correlated to the 3 months average Oceanic Niño Index (ONI). The computed r values of ‘dengue case index’ and ‘+ONI’ were further interpreted using GIS software to generate spatial correlation map. The short-term (1 year) prediction of dengue probability map has been prepared based on phase-wise (El Niño, La Niña, and Neutral) 20 years averaged ONI.Results A high correlation between +ONI and dengue incidence was found, particularly in the states of Arunachal Pradesh, Chhattisgarh, Haryana, Uttarakhand, Andaman and Nicobar Islands, Delhi, Daman and Diu. On the other hand, the states like Assam, Himachal Pradesh, Meghalaya, Manipur, Mizoram, Jammu & Kashmir, Uttar Pradesh, Orissa, and Andhra Pradesh shown negative correlation between summer El Niño and dengue incidence.Conclusion The generated map signifies the spatial correlation between +ONI and ‘dengue case index’, indicating positive correlation in the central part, while negative correlation in some coastal, northern, and north-eastern part of India. For improvement of results, a study at micro-scale (district level) month-wise association with Indian Ocean Dipole and local weather variables is desirable for better exploration of dengue outbreaks in the states with ‘no association’. The findings offer reliable tool for national programme for early preparedness for undertaking intervention measures on the basis of the forecast of El Niño Southern Oscillation (ENSO).
An investigation of an anthrax outbreak in Makoni District Ward 22 and 23 in Zimbabwe
Authors: Makurumidze Richard , Tafara Gombe Notion , Tapuwa Magure , Tshimanga Mufuta 
Published: January 2020

Abstract
Background : The first official clinical case of human anthrax case was made at Makoni District Medical Office on the 19 th of December 2013. This followed cattle deaths which were confirmed in the laboratory to be due to anthrax. We report the clinical characteristics, distribution of anthrax cases (place and time), risk factors for contracting the disease, environmental assessment, district preparedness and response and outbreak prevention and control measures. Methods: We conducted an outbreak investigation with the design of a 1:1 unmatched case-control study. Data were collected using a structured questionnaire. Environmental assessment, district preparedness and response and outbreak prevention and control measures were assessed using checklists through observations and key informant interviews. Data were analyzed using Stata-16. Bivariate analysis was performed to identify risk factors for contracting anthrax. Results: Thirty-seven cases (37) and 37 controls were interviewed. All the cases had cutaneous anthrax with commonest site of eschar being the hand (43%). Most of the cases (89%) were managed according to national guidelines. Eating meat from a from a cattle slaughtered due unknown illness or died alone [OR = 7.00 , 95%CI(2.06-23.82], skinning [OR = 5.04, 95%CI(1.77-14.36)], cutting meat [OR = 5.32, 95%CI(1.91-14.77)], cooking meat [OR = 3.42, 95%CI(1.32-8.91.)], source of from other villagers [vs butchery, OR = 14.85, 95%CI(2.79-79.06)], cuts during cutting meat or skinning cattle [OR = 3.50, 95% CI(1.18-10.51)], belonging to a religion which permits eating meat from a from a cattle slaughtered due unknown illness or died alone [OR = 6.29, 95%CI(1.85-21.39)] were associated with contracting anthrax. Having heard of anthrax before was protective against contracting anthrax [OR = 0.35, 95%CI (0.13-0.93)]. The district was ill-equipped and delay to respond to the outbreak. Conclusion: The anthrax outbreak resulted from contact with and consumption of infected cattle meat. The district delayed and was not prepared to control the outbreak. However, the outbreak was controlled through cattle vaccination; health education and awareness campaigns. The district should strengthen its emergence preparedness and response capacity, revive zoonotic committees, conduct awareness campaign during the high-risk period and improve the surveillance of anthrax during high risk periods.
The effect of multimorbidity patterns, and the impact of comorbid anxiety and depression, on primary health service use: the Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) Study
Authors: Ng Shu Kay , Martin Sean A , Adams Robert J , O'Loughlin Peter , Wittert Gary A 
Published: January 2020

Abstract
Background: Multimorbidity has been identified as a serious challenge on global health system, closely associated with lower quality of life, poorer health outcomes, and higher utilisation of health services. However, there are major gaps in our knowledge around multimorbidity, especially its effect on primary care services and the burden of comorbid mental health conditions on multimorbidity patterns. This study sought to determine patterns of multimorbidity and quantify their impact on use of primary health services in the presence and absence of anxiety and depression among a cohort of urban community-dwelling men. Methods: This was a prospective cohort study with Australian population. The study population consisted of 2,039 men aged ≥40, who were enrolled either in the Florey Adelaide Male Ageing Study (FAMAS) Stage 2 between 2007-2010 or in the North-West Adelaide Health Study (NWAHS) Stage 3 between 2008-2010. Data have been collected on the prevalence of 8 chronic conditions and linked Medicare data about individual health service utilization information on annual GP visits. Multinomial logistic regression was adopted to quantify the impact of anxiety and depression on the frequencies of GP visits, with adjustment for participant’s demographic and lifestyle characteristics. Results: Obesity and cardiovascular disease (CVD) were associated with the highest number of comorbid conditions. Two non-random multimorbidity “clusters” emerged: (CVD, Obesity, Diabetes) and (CVD, Obesity, Osteoarthritis). Participants with conditions comorbid with CVD were more likely to have 10 or more annual GP visits, compared to multimorbidity involving other conditions. Comparing to participants without CVD, the presence of CVD increased the chance of having 10 or more annual GP visits (adjusted risk ratio: 3.7; 95% CI: 2.8-4.8). When CVD was comorbid with anxiety and depression having 10 or more annual GP visits was more common (adjusted risk ratio: 1.8; 95% CI: 1.2-2.5). Conclusions: In Australian, community-dwelling men, multimorbidity is associated with a high use of GP services; especially for multimorbidity that includes CVD with comorbid anxiety and depression. Multimorbidity patterns involving CVD should be considered in developing clinical trials to better inform medical decision making and care for patients with CVD and comorbid conditions.
Hypophosphataemia after ferric carboxymaltose is unrelated to symptoms, intestinal inflammation or vitamin D status
Authors: Fang Wendy , Kenny Rachel , Rizvi Qurat-ul-Ain , McMahon Lawrence P. , Garg Mayur 
Published: January 2020

Abstract
Background and aims Intravenous iron replacement is recommended for iron-deficient patients with inflammatory bowel disease (IBD), but may be associated with hypophosphataemia, predisposing to osteomalacia and fractures. This study aimed to evaluate the incidence and risk factors for hypophosphataemia following intravenous ferric carboxymaltose (FCM) in patients with IBD. Methods This prospective observational study of patients with and without IBD evaluated serum phosphate for 28 days following intravenous FCM, and assessed associations with symptoms, markers of inflammation and vitamin D status. Results 24 patients with IBD (11 with Crohn’s disease [CD], 13 with ulcerative colitis [UC], mean age 45 years [range 19-90], 7 female), and 20 patients without IBD (mean age 56 [22-88]y, 11 female), were included. Overall, serum phosphate declined by a mean of 36% at Day 7, with a mean fall of 42% (SD 19%) at some time point over 28 days (p<0.001). Twenty-four of 44 (55%) patients developed moderate to severe hypophosphataemia (serum phosphate <0.6 mmol/L). No differences between patients with and without IBD were seen, but patients with CD had greater decline in phosphate than those with UC. There was no association between hypophosphataemia and symptomatic adverse events, faecal calprotectin, C-reactive protein, albumin, platelet count, 25(OH) vitamin D, or 1,25(di-OH) vitamin D. Intact fibroblast growth factor levels increased by mean 84% (p=0.004), within 2 days of infusion. Serum phosphate <1.05mmol/L on Day 2 predicted susceptibility to moderate-severe hypophosphataemia (OR 7.0). Conclusions Hypophosphataemia following FCM is common, unrelated to symptomatic adverse events, baseline intestinal or systemic inflammation, or vitamin D status.
Association between NAFLD and risk of prevalent chronic kidney disease: Why there is a difference between East and West?
Authors: Zhang Min , Lin Su , Wang Mingfang , Huang Jiaofeng , Liu Shiying , Wu Sumei , Zhang Haoyang , Wu Zimu , Liu Wenyue , Zhang Dongchu , Hao Chuanming , Zhu Yueyong , Zheng Minghua , Wang Xiaozhong 
Published: January 2020

Abstract
Background: There is a discrepancy between west and east on the relationship between non-alcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD). This study aimed to find out the possible reason for this and to clarify the association between NAFLD and CKD by analyzing two population-based datasets from the US and China. Methods: Two health examination datasets from China and the US were used. CKD was defined as an estimated glomerular filtration rate (eGFR) < 60ml/min/1.73m 2 or and/or abnormal albuminuria and/or overt proteinuria. Binary logistic regression was used to examine the association between NAFLD and CKD. Results: A total of 60965 participants were analyzed, including 11844 from the US and 51229 from China. The prevalence of NAFLD was 27.12% in the Chinese population and 36.08% in the US population (p<0.001). The proportions of CKD and late stage CKD (stages 3-5) were higher in the US population than the Chinese one. NAFLD was independently associated with an increased risk of CKD in Chinese population, whereas in the US population, the NAFLD was not an independent risk factor of CKD. In subgroup analyses which excluded late stages CKD (stages 3-5), the risks of mild renal function decline became consistent: NAFLD was associated with early stages of CKD but not the late stages of CKD in both populations. Conclusion: NAFLD increased the risk of early stages of CKD in both Chinese and the US population. The conflicting results reported by previous studies might result from the different proportion of late stages of CKD.
Case report on a swift shift in uropathogen from Shigella Flexneri to Escherichia Coli: A thin line between bacterial persistence and reinfection
Authors: Tufon Kukwah Anthony , Yolande Fokam Djike Puepi , Kouanou Youmbi Sylvain , Meriki Henry Dilonga 
Published: January 2020

Abstract
Background Urinary tract infections (UTI) are mostly caused by bacteria. Urine cultures are usually a definitive measure to select the appropriate antibiotics for the elimination of a uropathogen and recovery from the infection. However, the preferred antibiotics as determined by urine culture and sensitivity may still not eliminate the infection and would require further examination to ascertain the cause of treatment failure which could be unresolved bacteriuria, bacterial persistence, immediate reinfection with a different uropathogen or misdiagnosis. Case presentation A 2-year-old female was admitted in the Regional hospital of Buea following persistent fever. An auto medication with amoxicillin was reported. Urinalysis was done on the first day and the sediment of the cloudy urine revealed many bacteria and few pus cells. Ceftriaxone was prescribed as empirical treatment and a request for urine and blood culture was made. Three days after admission, the temperature and CRP were 39.0°c and 96 mg/l respectively. The urine culture results (>10 5 CFU/ml of Shigella flexneri sensitive to ofloxacin) were presented to the doctor on the 4 th day of admission. Patient was put on ofloxacin. Three days after, the temperature (38.5°c) and CRP (24mg/l) were still elevated. The blood culture result came out negative. A second urine culture was requested which came back positive (>10 5 CFU/ml of Escherichia coli resistant to second generation fluoroquinolones and susceptible to meropenem and amikacin). Ofloxacin was discontinued and the patient put on meropenem and amikacin. The third urine culture recorded no significant growth after 48 hours of incubation. The patient was discharged looking healthy once more with a normal body temperature. Conclusion Antibiotics tailored towards the elimination of a particular bacterial species may as well provide a favorable environment for other bacterial species that are resistant to it in the course of treating a UTI episode. This can imply overall treatment failure and may first of all require a second urine culture for confirmation rather than considering the possibilities of a misdiagnosis.
Ascending noradrenergic excitation from the locus coeruleus to the anterior cingulate cortex
Authors: Koga Kohei , Yamada Akihiro , Song Qian , Li Xu-Hui , Chen Qi-Yu , Liu Ren-Hao , Ge Jun , Zhan Cheng , Furue Hidemasa , Zhuo Min , Chen Tao 
Published: January 2020

Abstract
Anterior cingulate cortex (ACC) plays important roles in sensory perception including pain and itch. Neurons in the ACC receive various neuromodulatory inputs from subcortical structures, including locus coeruleus noradrenaline (LC-NA) neurons. Few studies have been reported about synaptic and behavioral functions of LC-NA projections to the ACC. Using viral-genetic method (AAV-DIO-eYFP) on DBH-cre mice, we found that LC-NA formed synaptic connections to ACC pyramidal cells but not interneurons. This is further supported by the electron microscopic study showing NAergic fibers contact the presynaptic inputs and post-synaptic areas of the pyramidal cells. NA application produced both pre- and post-synaptic potentiation effects in ACC excitatory transmission in vivo and in vitro . Activation of LC-NA projection to the ACC by optogenetic method produced enhancement of excitatory transmission in vitro and induced scratching and behavioral sensitization for mechanical stimulation. Our results demonstrate that LC-NA projections enhance or facilitate brain responses to pain and itch by potentiating glutamatergic synaptic transmissions in the ACC.
Cone beam computed tomographic analysis of the spatial limitation during mandibular arch distalization
Authors: Chen Chia-Ling , Chen Chia-Hui , Pan Chin-Yun , Chang Hong-Po , Chen Ping-Ho , Tseng Yu-Chuan 
Published: January 2020

Abstract
Background: In the literature, attempts are seldom made to quantify spatial limitation during mandibular arch distalization. This study aimed to investigate the spatial limitations associated with cortical contact with the mandibular second molar during mandibular arch distalization. Methods: The study population included 67 individuals who had undergone cone beam computed tomography (CBCT) (34 male and 33 female; mean age: 23.9 ± 2.72 years). The total ridge width, alveolar housing width, and root width were measured to evaluate the buccolingual limit. The space distal to the molar root represented the mesiodistal limit. The influence of sex, right versus left side, root-contact condition, malocclusion category, and presence of wisdom teeth were evaluated. Results: The rate of cortical contact was 49.3% before any orthodontic movement. No significant differences were observed in the alveolar width according to sex (male vs female), side assessed (right vs left), wisdom teeth (present vs absent), or malocclusion category. The ridge width and the alveolar width were smaller in the contact group than in the non-contact group ( P < 0.01). The group with wisdom teeth showed a larger available distalization distance, but a significant difference was observed only near the alveolar crest. Conclusions: Both ridge width and available distalization distance were limiting factors for mandibular teeth distalization. For cases in which whole-arch distalization is planned, CBCT is recommended before treatment, especially for non-extraction treatment. This approach ensures safe and predictable tooth movement.
Aspirin for metal stent in malignant distal common bile duct obstruction (AIMS): Study protocol for a multicenter randomized controlled trial
Authors: Choi Jin Ho , Paik Woo Hyun , You Min Su , Lee Kyong Joo , Choi Young Hoon , Shin Bang-sup , Lee Sang Hyub , Ryu Ji Kon , Kim Yong-Tae 
Published: January 2020

Abstract
Background Endoscopic retrograde biliary drainage (ERBD) is the treatment of choice for patients with malignant distal common bile duct (CBD) obstruction. Self-expandable metal stents (SEMS), which are commonly used in unresectable cases, have many clinical advantages, including longer stent patency. Although the expected patency of SEMS is around eight months, it has recently been reported that the duration of SEMS patency in patients using aspirin is prolonged. Our study therefore aims to confirm the effect of aspirin on SEMS patency. Methods This is an investigator-initiated, prospective, multicenter, double-blind, randomized placebo-controlled trial that will be conducted from November 2017 in four tertiary centers in South Korea. We intend to include in our study 184 adult (≥ 20 years) patients with malignant distal CBD obstruction for whom ERBD with SEMS was successfully performed. The patients will be randomly allocated to two groups, which will comprise patients who have either taken 100 mg aspirin or a placebo for six months after index ERBD. The primary outcome will be the rate of stent dysfunction, and the secondary outcomes will be the duration of patency, the rate of reintervention, and the occurrence of adverse events. Discussion The aspirin for metal stents in malignant distal common bile duct obstruction (AIMS) study will determine the efficacy of aspirin in maintaining metal stent patency in patients with malignant distal CBD obstructive.
Advanced ultrasound Methods in assessment of carotid plaque instability: A prospective multimodal study
Authors: Zamani Mahtab , Skagen Karolina , Scott Helge , Russell David , Skjelland Mona 
Published: January 2020

Abstract
Background: A significant proportion of ischemic strokes are caused by emboli from atherosclerotic, unstable carotid artery plaques. The selection of patients for endarterectomy in current clinical practice is primarily based on the degree of carotid artery stenosis and clinical symptoms. However, the content of the plaque is known to be more important for stroke risk. Intraplaque neovascularization (IPN) has recently emerged as a possible surrogate marker for plaque instability. Neo-microvessels from the adventitial vasa vasorum grow into the full thickness of the vessel wall in an adaptive response to hypoxia, causing subsequent intraplaque haemorrhage and plaque rupture. Conventional ultrasound cannot detect IPN. Contrast-enhanced ultrasound and Superb Microvascular Imaging (SMI), have, however, shown promise in IPN assessment. Recent research using Shear Wave Elastography (SWE) has also reported reduced tissue stiffness in the artery wall (reduced mean Young’s modulus) in unstable compared to stable plaques. The purpose of this study is to identify unstable carotid artery plaques at risk of rupture and future ischemic stroke risk using multimodal assessments.

Methods: Forty five symptomatic and 45 asymptomatic patients >18 years, with >50% carotid stenosis referred to Oslo University Hospital ultrasound lab will be included in this on-going project. Patients will undergo contrast enhanced ultrasound, SMI, carotid-MRI and PET-(18F-FDG). Contrast enhanced ultrasound will be analyzed semi-quantitatively (5-levels visual classification) and quantitatively by plotting time-intensity curve analyses to obtain plaque peak contrast enhancement intensity. Plaques removed at carotid endarterectomy will be assessed histologically and the number of microvessels, areas of inflammation, granulation, calcification, lipid and fibrosis will be measured.

Discussion: This multimodality study will primarily provide information on the clinical value of advanced ultrasound methods (SMI, SWE) for the detection of unstable carotid artery plaque in comparison with other methods including contrast-enhanced ultrasound, carotid-MRI and PET-(18F-FDG) using histology as the gold standard. Secondly, findings from the methods mentioned above will be related to cerebrovascular symptoms, blood tests (leukocytes, CRP, ESR, lipoproteins and inflammatory markers) and cardiovascular risk factors at inclusion and at 1-year follow-up. The overall aim is to optimize detection of plaque instability which can lead to better preventive decisions and reduced stroke rate.