bluuebunny/crossref_metadata_2025_split huggingface dataset:
Normalization of Blood Clotting Characteristics Using Prothrombin Complex Concentrate, Fibrinogen and Fxiii In an Albumin Based Fluid: Experimental Studies In Thromboelastometry.
Authors: Koller Tobias , Kinast Nadia , Castellanos Andres Guilarte , Garcia Sergio Perez , Iglesias Pilar Paniagua , Vintro Xavi León , Arranz Jose Mateo , Seto Noelia Vilalta , García Maria Victoria Moral , Moreno-Castaño Ana Belén , Aznar-Salatti Jose , Albaladejo Gines Escolar , Ricart Maribel Diaz 
Published: November 2020

Abstract
Background: Colloid fluids supplemented with adequate combinations of coagulation factor concentrates with capability to restore coagulation could be a desirable future treatment component in massive transfusion.Methods: Starting from a coagulation factor and blood cell free albumin solution we added Prothrombin Complex Concentrate, Fibrinogen Concentrate and Factor XIII in different combinations and concentrations to analyze their properties to restore thromboelastometry parameters without the use of plasma. Further analysis under presence of platelets was performed for comparability to whole blood conditions.Results: Albumin solutions enriched with Fibrinogen Concentrate, Factor XIII and Prothrombin Complex Concentrate at optimized concentrations show restoring coagulation potential. Prothrombin Complex Concentrate showed sufficient thrombin formation for inducing fibrinogen polymerization. The combination of Prothrombin Complex Concentrate and Fibrinogen Concentrate led to the formation of a stable in vitro fibrin clot. Fibrinogen and Factor XIII showed excellent capacity to improve fibrin clot firmness expressed as Amplitude at 10 minutes and Maximal Clot Firmness. Fibrinogen alone, or in combination with Factor XIII, was able to restore normal Amplitude at 10 minutes and Maximal Clot Firmness values. In the presence of platelets, the thromboelastometry surrogate parameter for thrombin generation (Clotting Time) improves and normalizes when compared to whole blood.Conclusions: Combinations of coagulation factor concentrates suspended in albumin solutions have the capacity to restore thromboelastometry parameters in the absence of plasma. This kind of artificial colloid fluids with coagulation-restoring characteristics might offer new treatment alternatives for massive transfusion.Trial registration: Study registered at the institutional ethic committee “Institut de Recerca, Hospital Santa Creu i Sant Pau, with protocol number IIBSP-CFC-2013-165.
Can Intersectionality Help with Understanding and Tackling Health Inequalities? Perspectives of Professional Stakeholders
Authors: Holman Daniel , Salway Sarah , Bell Andrew , Beach Brian , Adebajo Adewale , Ali Nuzhat , Butt Jabeer 
Published: November 2020

Abstract
Background: The concept of ‘intersectionality’ is increasingly employed within public health arenas, particularly in North America, and is often heralded as offering great potential to advance health inequalities research and action. Given persistently poor progress towards tackling health inequalities, and recent calls to reframe this agenda in the UK and Europe, the possible contribution of intersectionality deserves attention. Yet, no existing research has examined professional stakeholder understandings and perspectives on applying intersectionality to this field. In this paper we seek to address that gap. Methods: drawing upon a consultation survey and workshop undertaken in the UK. The survey included both researchers (n=53) and practitioners (n=20) with varied roles and levels of engagement in research and evaluation. Topics included: familiarity with the term and concept ‘intersectionality’, relevance to health inequalities work, and issues shaping its uptake. Respondents were also asked to comment on two specific policy suggestions; targeting and tailoring interventions to intersectional sub-groups, and evaluating the intersectional effects of policies. 23 people attended the face-to-face workshop. The aims of the workshop were to: share examples of applying intersectionality within health inequalities research and practice; understand the views of research and practice colleagues on potential contributions and challenges; and identify potential ways to promote intersectional approachesResults: Findings indicated a generally positive response to the concept and a cautiously optimistic assessment that intersectional approaches could be valuable. However, opinions were mixed and various challenges were raised, especially around whether intersectionality research is necessarily critical and transformative and, accordingly, how it should be operationalised methodologically. Nonetheless, there was general agreement that intersectionality is concerned with diverse inequalities and the systems of power that shape them.Conclusions: In the UK health inequalities policy and practice context there are a number of potential ways forward for intersectionality in helping to understand and tackle such inequalities.
Effect of Space Allowance and Mixing on Growth Performance and Body Lesions of Grower-finisher Pigs in Pens With a Single Wet-dry Feeder
Authors: Montoro Jordi Camp , Boyle Laura Ann , Solà-Oriol David , Muns Ramon , Gasa Josep , Manzanilla Edgar García 
Published: November 2020

Abstract
Background: Low space allowance (SA) and mixing may result in reduced growth performance (GP) and animal welfare issues because of adverse social behaviours directed to pen mates. This could be exacerbated in pens with single space feeders owing to social facilitation of feeding behaviour. The present study aimed to investigate the effect of SA and mixing on GP and body lesions (BL) in pens with one single space wet-dry feeder. Results: Two experiments were conducted on grower-finisher pigs from 10 to 21 weeks of age. In Exp1, pigs (N=216) were assigned to three SA; 0.96 m2/pig (n=6 pens; 10 pigs/pen; SA96), 0.84 m2/pig (n=6; 12 pigs/pen; SA84) and 0.72 m2/pig (n=6; 14 pigs/pen; SA72), in a randomized design. In Exp2, pigs (N=230) were used in a 2×2 factorial randomized design considering SA and mixing as treatments. Pigs were assigned to two SA; 0.96 m2/pig (n=10 pens; 10 pigs/pen; SA96) and 0.78 m2/pig (n=10; 13 pigs/pen; SA78) and were either mixed or not at the entry to the finishing facility. GP was not affected by SA (P > 0.05) in either experiment. In Exp2, non-mixed pigs were 5.4 kg heavier (P < 0.001), gained 74 g more per day (P = 0.004), consumed 101.8 g more of feed per day (P = 0.007) and tended to have higher feed efficiency (P = 0.079) than mixed pigs from 11 to 21 weeks of age. Number of BL was affected by SA in both experiments. In Exp1, SA72 pigs had 74.4% and 97.4% more BL than SA96 and SA84 pigs at 20 weeks of age respectively (P = 0.003). In Exp2, SA78 pigs had 48.6, 43.6 and 101.3% more BL than SA96 pigs at 12, 16 and 21 weeks of age respectively (P < 0.05). Mixing did not affect the number of BL from 12 to 21 weeks of age in Exp2 (P > 0.05).Conclusion: Mixing had a considerable effect on growth performance thus, strategies to avoid or mitigate mixing should be considered. Although space allowance had no effect on growth performance, high number of body lesions in the lower space allowance indicates that space allowances equal or below 0.78 m2/pig are detrimental to the welfare of pigs despite following the EU legislation.
An Atypical Presentation of Multidermatomal Herpes Zoster: A Case Report
Authors: Alhayyas Mohammed , Chaudhry Mehmood , Berdouk Sabrina 
Published: November 2020

Abstract
Background: Herpes Zoster (HZ) also known as shingles is common dermatological pathology seen in in the emergency department. Multidermatomal involvement is an uncommon presentation and usually is linked to individuals with compromised immune systems. However it is rarely reported in the immunocompetent population. Case presentation: We report a 30-year-old Emirati male complaining of low-grade fever for 3 days, sore throat and discomfortable pruritic erythematous rash over his chest and back for 2 days. He was treated the day preceding his presentation in another facility for a presumed allergic reaction after taking ibuprofen. On physical examination, he was found to have exudative tonsillitis and Influenza and was treated for both and discharged. He returned again reporting increasing pain and was referred to be seen in the dermatology clinic where a biopsy was obtained and he was discharged with a steroid topical cream. 14 days later, he returned to the clinic reporting crusting of the rash, the biopsy results were positive for Herpes Zoster. The diagnosis of multidermatomal herpes Zoster was made and he was then treated with antivirals. Conclusions: Herpes Zoster can present with atypical manifestations. Multidermatomal HZ is a rare dermatological manifestation in the immunocompetent adult. It is characterised by a rash spread over two or more adjacent dermatomes. This case highlights the challenging diagnosis of this dermatological presentation.
Prevalence of Hepatitis B Virus Genotypes Among Patients with Liver Disease in Eritrea
Authors: Hamida Mohammed Elfatih A. , Raja Saud Mohammed , Petros Yodahi , Wahab Munir , Seyoum Yemane , Elkhidir Isam Mohammed , Tekle Freweini 
Published: November 2020

Abstract
BackgroundHepatitis B virus (HBV) is a blood-borne hepatotrophic virus and a major causative agent of liver disease. The virus is highly endemic in African countries, and five genotypes (A–E) have been identified. This study aimed to establish the most prevalent genotypes of HBV among liver disease patients from different geographical regions of Eritrea, an East African multi-ethnic country.MethodsThis study included 293 Eritrean liver disease patients who were hepatitis B surface antigen (HBsAg)-positive. Enzyme-linked immunosorbent assay (ELISA)-based serological screening and multiplex-nested PCR using type-specific primer-based genotyping were performed to determine the prevalence of genotypes in the Eritrean population.ResultsThe mean (± standard deviation) age was 41.66 ± 13.84 years; 213 (72.7%) patients were males and 80 (27.3%) were females. The median (interquartile range) of HBV DNA and alanine aminotransferase levels were 3.47 (1.66) log IU/ml and 28 (15.3) IU/L, respectively. All patients’ sera were HBsAg- and anti-HBc-total positive; 20 (6.8%) were HBeAg-positive/anti-HBe-negative, 242 (82.6%) were HBeAg-negative/anti-HBe-positive, and 31 (10.6%) had neither HBeAg nor anti-HBe according to the ELISA screening test. Of the 293 patients, only 122 (41.6%) were positive for HBV DNA, 57.38% had a single genotype, and 42.62% had a mixed HBV genotype infection. Irrespective of mode of occurrence, HBV genotype D (n = 26; 21.3%) was the predominant circulating genotype, followed by genotypes C (n = 21; 17.2%), E (n = 19; 15.6%), C/D (n = 16; 13.1%), and C/E (n = 13; 10.7%). Genotypes C/D/E (n = 9; 7.4%), A/D (n = 6; 4.9%), D/E (n = 5; 4.1%), A (n = 3; 2.5%), and B, A/E, B/E, and A/D/C (each with n = 1; 0.8%) were also present.ConclusionHBV in Eritrea is comprised of a mixture of genotypes A, B, C, D, and E separately or in combinations. Our findings demonstrated that in Eritrea, the most prevalent HBV genotype in Eritrea is genotype D among theliver disease patients with higher HBeAg positivity. This is the first study of HBV genotyping based on PCR methods in Eritrea.
A Novel Quality Control Methodology on Screening out for Human Osteosarcoma Cell Adaptor Based on the Cell-SELEX Technique
Authors: Wang Hua , Liang Ji , Ma Yan , Zhou Lei , Zhang Yufei , Li Mingcheng 
Published: November 2020

Abstract
Background: We have successfully developed a novel molecular probe for recognition of human osteosarcoma cell using the cell-SELEX method. The study aims to establish an accurate, time-saving quality-monitoring method in screening for tumour cell adaptors in order to shorten the screening process and ensure the accurate preparation of the adaptor. Methods: Two kinds of human osteosarcoma cells (U2-OS, HOS) were selected as the forward screening target cells and human fibrosarcoma cells (HT-1080) as the reverse screening cells to screen the adaptors from the candidate oligonucleotide library. In each round of preparation of the library, PCR was optimised by using quantitative template concentration instead of percentage volume. Each round of forward screening was conducted with reverse screening; Fluorescence spectroscopy and flow cytometry were used to monitor and compare the aptamer libraries. Results: During quantitative PCR for U2-OS and HOS template, the results showed that the bands obtained from 14 cycles were bright and no non-specific amplification within the optimal template concentrations between 19.0 and 21.0ng/µl. Each round of forward screening was accompanied by reverse screening to accelerate the elimination of non-specific single-strand DNA (ssDNA). In the meanwhile, the adaptor groups were effectively purified specifically bounding to target cells. Besides, we observed that the fluorescence spectroscopy is more accurate, time-saving, and convenient for quality control compared with flow cytometry. Conclusion: The method proposed in the study is appropriate for the rapid screening out for human osteosarcoma cell adaptor. The quantitative template concentration, forward screening with back screening, and fluorescence spectroscopy are important methods for accurate preparation and quality control of tumour cell aptamers. It can provide scientific reference data for the amplification of dsDNAs in other sub-libraries.
A Novel Anatomic Titanium Mesh Cage for Reducing the Subsidence Rate After Anterior Cervical Corpectomy: A Finite Element Study
Authors: Wang Yuhang , Zhang Haiping , Zhao Qinpeng , Zhang Yongyuan , Sun Honghui , Hao Dingjun , Wang Biao 
Published: November 2020

Abstract
Background: Fusion with a titanium mesh cage (TMC) has become popular as a conventional method after cervical anterior corpectomy, but postoperative TMC subsidence has often been reported in the literature. We designed a novel anatomic cervical TMC to reduce the postoperative subsidence rate. This finite element study aims to investigate the anti-subsidence performance of a novel anatomic TMC and provide a theoretical basis for clinical application. Methods: According to the test process specified in the ASTM F2267 standard, three-dimensional finite element analysis was used to compare the anti-subsidence characteristics of a traditional TMC (TTMC) and novel TMC (NTMC). Abaqus software was used for the mesh, and the modulus of elasticity, Poisson's ratio and other material coefficients of each part were input into the model. Solidworks software was used to establish the TTMC and NTMC models and construct the two three-dimensional finite element models of TMC subsidence testing mentioned above. Through analysis, the relationships between the stiffness of the intervertebral body fusion device (Kd) and the stiffness of the polyurethane foam blocks (Ks) of the TTMC and NTMC were derived, respectively. Results: After fitting the linear segment, the Kd values of the TTMC and NTMC were 37314 N/mm and 89124 N/mm, respectively. After calculation, the Ks values of the TTMC and NTMC were 653.83 N/mm and 995.95 N/mm, respectively. The Kp values of the TTMC and NTMC were calculated to be 665.5 N/mm and 1007.2 N/mm according to the formula. Conclusion: The reported novel anatomic titanium mesh cage (NTMC) significantly improved the anti-subsidence performance after ACCF, which was approximately 51.3% higher than that of the traditional titanium mesh cage.
Bosworth Fracture-dislocation of the Ankle: A Case Report and Literature Review
Authors: Wang Zhi-qiang , Feng Qiu-xiang , Dai Yu-xiang , Jiang Hong , Yu Peng-fei , Yao Yun-juan , Lu Zhen , Li Xiao-chun , Liu Jin-tao 
Published: November 2020

Abstract
Introduction: Bosworth fracture-dislocation is an unusual variant of ankle joint fracture and dislocation, which has a high clinically missed diagnosis rate due to poor visibility on X-ray. At the same time, successful closed manipulations in an ankle joint fracture and dislocation are difficult because of the fibula attachment at the posterolateral ridge of the tibia or at the fractured end of the posterior tibia.Patient concerns: A 56-year-old man visited the hospital for further evaluation of a swollen, deformed right ankle resulting from a tumble 4 hours ago. There were no obvious complications such as skin damage or blood vessel and nerve damage at the time of treatment.Diagnosis: The patient was diagnosed with Bosworth fracture-dislocation according to clinical history and X-ray examination and computed tomography (CT), which indicated posterolateral talus dislocation; the distal end of the proximal fibular fragment was inserted behind the tibia.Interventions and outcomes: The patient initially failed to receive twice manipulative reductions. After the first attempt, roentgenograms and CT scan still showed a dislocated ankle and the proximal end of the fibula fracture was still inserted at the fractured end of the posterior tibia although the sound of the joint mounted into the acetabulum was heard. Then the inferior tibiofibula joint was fully exposed and locked with an inferior tibiofibula screw. Review roentgenograms and CT suggested that the ankle was manipulated successfully, and the broken end achieved perfect alignment, leading to a satisfactory function restoration.Lessons: Early diagnosis and reduction of Bosworth fracture-dislocation is recommended, which can significantly decrease complications. The characteristic clinical manifestations of Bosworth fracture-dislocation are worthy of attention, including extreme external rotation of the ankle and difficulty in reduction. Simultaneously, the axilla sign on mortise roentgenograms, posterior dislocation of the talus on the lateral roentgenogram and fibular position relative to the talus on the external oblique roentgenogram are intrinsically valuable. During the surgery, the floating position can better expose the broken fracture end and allow standard lateral roentgenograms. For the reduction of Bosworth fracture-dislocation, it is important to avoid repeated attempts at closed reduction. Intraoperative reduction of the fibula is the key.
Clinical Outcomes Comparison of C2 Dome-like Expansive Laminoplasty Versus C2 Open-door Laminoplasty for Multilevel Cervical Ossification of the Posterior Longitudinal Ligament Involving C2
Authors: Zhou Xin , Xia Bo , Chen Fei , Yang Jun , Guo Xiang , Han Zhao , Lu Xuhua , Guo Qunfeng , ni bin 
Published: November 2020

Abstract
Background: Cervical laminoplasty is a well-established surgical treatment for patients with cervical myelopathy due to OPLL. However, for cases with OPLL involving C2 segment, some surgeon preferred C2EL technique, but destruction of muscles attaching at C2 spinous process and lamina is inevitable. While C2DEL technique was also available which cause less destruction to the structures associated with C2. Nevertheless, it is still not confirmed whether it can achieve similar outcomes as C2EL. This study aimed to compare the clinical and radiographic outcomes of C2 dome-like expansive laminoplasty technique(C2DEL) and C2 extended laminoplasty technique(C2EL) applied in the treatment of cervical ossification of posterior longitudinal ligament (OPLL)involving C2 segment.Methods: Data of 56 patients with OPLL involving C2 segment who underwent cervical laminoplasty were retrospectively reviewed. 26 patients received C2EL technique while C2DEL technique was applied in another 30 patients. Functional outcomes evaluated by visual analog scale score for neck pain (VASSNP), Neck Disability Index (NDI), Japanese Orthopedic Association (JOA) score and Health-Related Quality-of-Life Short Form-36 Physical Component Summary (SF-36 PCS) were recorded and compared pre- and postoperatively. The radiographic outcomes assessed by the Cobb angle and range of motion (ROM) of cervical spine at C2-C7, as well as decompression effect at C2 level evaluated by space available for spinal cord (SAC) were measured in two groups. The intraoperative parameters including total blood loss and operation time were documented and compared between 2 groups.Results: At the final follow-up, JOA scores, NDI, and SF-36 PCS were significantly improved in both groups(all P＜0.05), but no significant differences were identified between two groups. VASSNP was reduced significantly in both groups(P＜0.05), but the cases in C2EL group experienced more severe neck pain than that of C2EL group(P＜0.05). Cobb angle at C2 and C7 and the cervical ROM in both groups reduced greatly, the SAC at C2 improved postoperatively and no significant difference was identified intergroup. No serious complications related to the surgical approach and instrumentation were observed in either group.Conclusion: C2DEL was comparable to C2EL for treating OPLL involving C2 segment. C2DEL was an ideal alternative treatment strategy for OPLL involving the C2 segment.
Attempted Development of a Clinical Decision-making Model to Assist in Femoral Neck Stress Fracture Screening in Military Trainees
Authors: Zimmerman Justin S , Deyle Gail D. , Lester Mark E , Morris Jamie B , Allen Christopher S 
Published: November 2020

Abstract
Background: Femoral neck stress fractures (FNSF) are serious injuries prevalent throughout the military, particularly within the initial entry training (IET) population. Delay in diagnosis and management can lead to complications secondary to fracture progression and displacement. Effective screening and identification of FNSF can reduce patient risk, mitigate costs associated with treatment, and prevent the potential medical discharge of IET personnel. There is currently no validated testing to assist in decisions for ordering advanced imaging to rule out FNSF. Military healthcare providers, therefore, must rely on advanced imaging of patients with hip region complaints to rule out suspected FNSF resulting in potential MRI over utilization. The purpose of this project was to determine if a clinical decision model can be developed from clinical findings to assist clinicians in deciding when magnetic resonance imaging (MRI) is warranted for FNSF screening in IET personnel with hip or groin pain. Methods: This was a prospective observational cross-sectional cohort process improvement project. We screened all IET Soldiers presenting to a medical clinic with hip or groin pain and evaluated 18 clinical variables. The reference standard was a FNSF diagnosed using fast-sequence MRI. Statistical analyses included correlation, receiver operating characteristic (ROC) curve assessments, and regression.Results: Final statistical analysis included 184 IET Soldiers, of which 49 had a FNSF. Frequency analysis observed the highest occurrence of FNSF in non-Hispanic white females. Ten subjective and physical examination variables had a weak correlation to positive MRI findings for FNSF. Regression analysis revealed six variables with positive MRI outcome predictive abilities; however, small to medium effect sizes, low ability to account for MRI outcome variance, and poor estimated sensitivity on ROC curve analysis limit this regression model’s clinical usefulness utilizing the identified variables. Conclusions: The regression models evaluating the clinical variables within this project failed to demonstrate adequate predictability and clinical usefulness when screening for the high-risk injury FNSF in an IET population. Clinicians should maintain a low threshold for ordering an MRI to screen for FNSF in this population. Clinicians also cannot rely on subject-reported pain locations or objective testing as definitive assessment signs to distinguish between IET Soldiers with and without a FNSF.Trial Registration: This study was deemed as a process improvement project by the Brooke Army Medical Center Institutional Review Board on 7 August 2017. A trial registration was not needed.