bluuebunny/crossref_metadata_2025_split huggingface dataset:
Novel drug delivery systems targeting oxidative stress in chronic obstructive pulmonary disease: a review
Authors: Xu You , Liu Hongmei , Song Lei 
Published: October 2020

AbstractOxidative stress is significantly involved in the pathogenesis and progression of chronic obstructive pulmonary disease (COPD). Combining antioxidant drugs or nutrients results in a noteworthy therapeutic value in animal models of COPD. However, the benefits have not been reproduced in clinical applications, this may be attributed to the limited absorption, concentration, and half-life of exogenous antioxidants. Therefore, novel drug delivery systems to combat oxidative stress in COPD are needed. This review presents a brief insight into the current knowledge on the role of oxidative stress and highlights the recent trends in novel drug delivery carriers that could aid in combating oxidative stress in COPD. The introduction of nanotechnology has enabled researchers to overcome several problems and improve the pharmacokinetics and bioavailability of drugs. Large porous microparticles, and porous nanoparticle-encapsulated microparticles are the most promising carriers for achieving effective pulmonary deposition of inhaled medication and obtaining controlled drug release. However, translating drug delivery systems for administration in pulmonary clinical settings is still in its initial phases.
Toward a human-centered use of technology: a stakeholder analysis of harm reduction and CBO staff
Authors: Aronson Ian David , Bennett Alex S. , Freeman Robert 
Published: October 2020

Abstract
Background
Technology can enable syringe service programs (SSPs) and other community-based organizations (CBOs) operating under a harm reduction framework to work with an increased number of clients and can also enable organizations to offer services more effectively (e.g., offering HIV testing in ways participants may be more likely to accept). In the current time of COVID-19 social distancing, technology can also help organizations more safely provide services to people with compromised immune systems and to clients who might otherwise not be reached. However, technology projects implemented in harm reduction settings are frequently conceptualized and developed by researchers or technology specialists rather than by SSP staff or clients.

Methods
To more effectively meet the needs of SSPs and other CBOs across the USA, our team conducted qualitative interviews with 16 individuals who have extensive backgrounds working in the field of harm reduction. Interviews were digitally recorded and professionally transcribed, and the transcripts were checked for accuracy by the interviewers. The resulting transcripts were coded and analyzed to determine emerging themes.

Results
Interviewees mentioned the ability of technology to deliver consistent quality messaging to multiple clients at the same time and the potential to customize or tailor technology-based messaging to specific client populations as positive benefits. Clear barriers to technology use also emerged, in particular regarding privacy, data security, and the need to maintain client trust when discussing sensitive issues (e.g., illicit drug use).

Conclusions
Technology offers the potential to deliver consistently high-quality health communication and maintain contact with clients who may have no other access to care. If designed and managed effectively, technology can also address issues related to providing services during times when physical contact is limited due to COVID-19 social distancing measures.
Women and barriers to harm reduction services: a literature review and initial findings from a qualitative study in Barcelona, Spain
Authors: Shirley-Beavan Sam , Roig Aura , Burke-Shyne Naomi , Daniels Colleen , Csak Robert 
Published: October 2020

Abstract
Background
There are an estimated 3.2 million women who inject drugs worldwide, constituting 20% of all people who inject drugs. The limited data that are available suggest that women who inject drugs are at greater risk of HIV and viral hepatitis acquisition than men who inject drugs. This increased vulnerability is a product of a range of environmental, social and individual factors affecting women, which also affect their ability to engage in health promoting services such as harm reduction.

Methods
The researchers undertook a narrative literature review examining access to harm reduction services for women who use drugs in Europe and conducted semi-structured focus groups with women who use drugs and harm reduction and prison health workers in Barcelona, Spain.

Results
Women who use drugs face multiple barriers to accessing harm reduction services. These include stigma, both in society in general and from health and harm reduction workers in prisons and in the community; gender-based violence and a lack of services that are equipped to address the interaction between drug use and experiences of violence; criminalisation in the form of legal barriers to access, arrest and harassment from law enforcement, and incarceration; and a lack of services focused on the specific needs of women, notably sexual and reproductive health services and childcare. In Barcelona, participants reported experiencing all these barriers, and that their engagement with the Metzineres harm reduction centre had to some extent mitigated them. However, women continued to experience structural barriers to harm reduction service access.

Conclusions
Women and gender non-conforming people who use drugs face unique barriers to accessing harm reduction services. While services such as Metzineres can be life changing and life affirming for its members, it is incumbent on states to act to address the structural barriers to health faced by women who use drugs.
Hepatitis C in Israeli prisons: status report
Authors: Michaeli Niv , Litvin Anat , Davidovitch Nadav 
Published: October 2020

AbstractThe article discusses and analyzes the changes that have taken place since 2016 in Israeli policy with regard to the treatment, diagnosis and detection of hepatitis C (HCV) in prison settings. The article finds indications of promising changes to official procedure, such as the statement by authorities that they plan to begin screening new inmates for HCV, and the increase in the number of inmates provided antiviral drugs. These measures, however, only came about after a prolonged campaign and legal battle by human rights organizations, patient advocacy groups and the medical community. Despite these encouraging changes, it appears that a significant portion of inmates in need of treatment are still not getting it due both to bureaucratic delays and to inmates’ reluctance. In addition, in the absence of a suitable screening program, the extant figures of morbidity—high in themselves—may reflect underdiagnosis. The flaws in the policymaking process and in its implementation may be attributed, at least in part, to the fact that the prison healthcare system is under the aegis of the Israel Prison Service and not that of a medical body. This reality places the medical staff in prisons in a state of dual loyalty, and also means the prison healthcare system is excluded from national health plans and major sources of budgeting, leaving it without sufficient means to provide the necessary level of care. These problems plague the prison healthcare system in general and are not limited to its handling of HCV. These challenges are not unique to Israel, and many other Western countries must also face the obstacles that are the result of prison healthcare services being subject to the authority of the correctional establishment. As this test case demonstrates, extended active involvement by civil organizations and the medical community are essential to promoting and ensuring inmates’ right to health.
The validity of the diabetes self-management questionnaire (DSMQ) in Hungarian patients with type 2 diabetes
Authors: Vincze Agnes , Losonczi Antonia , Stauder Adrienne 
Published: October 2020

Abstract
Background
A wide range of measuring instruments are available for diabetes self-management. According to several studies, a relatively new instrument, the diabetes self-management questionnaire (DSMQ), shows a consistent relationship with outcomes of diabetes treatment as well, such as glycated hemoglobin (HbA1c). Furthermore, the questionnaire is short, but covers the main aspects of diabetes management. Given the increasing prevalence of diabetes in Hungary, our goal was to adapt this user-friendly questionnaire and analyze its validity.

Methods
After the standard translation process, we analyzed a sample of 221 people. The construct validity of the questionnaire was tested with HbA1c and body mass index. Morisky Medication Adherence Scale-8 values were tested via Pearson correlations. Known-groups validity of the DSMQ in relation to groups based on glycemic control levels was investigated using one-way ANOVA.

Results
The “sum scale” of the questionnaire and the HbA1c values show an inverse relationship (r = − 0.253, p < 0.01). Body mass index was related to the “sum scale” (r = − 0.214, p < 0.01) and to the “physical activity” (r = − 0.219, p < 0.01), while questionnaire results reflecting medication adherence correlated with the “glucose management” (r = − 0.291, p < 0.01), “health-care use” subscale (r = 0.236, p < 0.01) and the “sum scale” (r = 0.281, p < 0.01). A significant difference (F = 6.225, p = 0.002) was found between the DSMQ mean scores of the three groups, defined by good, medium, and poor glycemic control levels.

Conclusions
The Hungarian version of the DSMQ was considered a valid tool for the measurement of diabetes self-management. With its help, problematic areas of self-management could be uncovered, and interventions can be improved.
Accuracy of the tuberculosis point-of-care Alere determine lipoarabinomannan antigen diagnostic test using α-mannosidase treated and untreated urine in a cohort of people living with HIV in Guatemala
Authors: García Juan Ignacio , Meléndez Johanna , Álvarez Rosa , Mejía-Chew Carlos , Kelley Holden V. , Sidiki Sabeen , Castillo Alejandra , Mazariegos Claudia , López-Téllez Cesar , Forno Diana , Ayala Nancy , Balada-Llasat Joan-Miquel , Mejía-Villatoro Carlos Rodolfo , Wang Shu-Hua , Torrelles Jordi B. , Ikeda Janet 
Published: October 2020

Abstract
Background
Improved point-of-care diagnostic tests for tuberculosis (TB) in severe immune suppressed people living with HIV (PLWH) are needed to decrease morbidity and mortality outcomes. The aim of the study is to evaluate the performance of the lipoarabinomannan antigen test (LAM-test) with and without α-mannosidase pre-treated urine in a cohort of PLWH in primary care clinics in Guatemala. We further determined TB incidence, and mortality rates and its risk factors in PLWH with TB symptoms.

Methods
Prospective longitudinal study of PLWH with TB symptoms. Urine samples were collected at 2 HIV sites to test the sensitivity of the LAM-test in urine with and without α-mannosidase pre-treatment. A composite reference standard of either a positive Mycobacterium tuberculosis complex culture and/or GeneXpert® MTB/RIF (Xpert, Cepheid, Sunnyvale, CA, USA) results was used in the LAM-test diagnostic accuracy studies. Cox proportional hazards regression was used to study mortality predictors.

Results
The overall sensitivity of the LAM-test was of 56.1% with 95% CI of (43.3–68.3). There were no differences in the LAM-test sensitivity neither by hospital nor by CD4 T cell values. LAM-test sensitivity in PLWH with < 200 CD4 T cells/µl was of 62.2% (95% CI 46.5–76.2). There were no significant differences in sensitivity when comparing LAM-test results obtained from untreated vs. α-mannosidase treated urine [55.2% (95% CI 42.6–67.4) vs. 56.9% (95% CI 44–69.2), respectively]. TB incidence in our cohort was of 21.4/100 person years (PYs) (95% CI 16.6–27.6), and mortality rate was of 11.1/100 PYs (95% CI 8.2–15.0). Importantly, PLWH with a positive LAM-test result had an adjusted hazard ratio (aHR) of death of 1.98 (1.0–3.8) with a significant p value of 0.044 when compared to PLWH with a negative LAM-test result.

Conclusions
In this study, α-mannosidase treatment of urine did not significantly increase the LAM-test performance, however; this needs to be further evaluated in a large-scale study due to our study limitations. Importantly, high rates of TB incidence and mortality were found, and a positive LAM-test result predicted mortality in PLWH with TB clinical symptoms.
A comparison of the effects and usability of two exoskeletal robots with and without robotic actuation for upper extremity rehabilitation among patients with stroke: a single-blinded randomised controlled pilot study
Authors: Park Jin Ho , Park Gyulee , Kim Ha Yeon , Lee Ji-Yeong , Ham Yeajin , Hwang Donghwan , Kwon Suncheol , Shin Joon-Ho 
Published: October 2020

Abstract
Background
Robotic rehabilitation of stroke survivors with upper extremity dysfunction may yield different outcomes depending on the robot type. Considering that excessive dependence on assistive force by robotic actuators may interfere with the patient’s active learning and participation, we hypothesised that the use of an active-assistive robot with robotic actuators does not lead to a more meaningful difference with respect to upper extremity rehabilitation than the use of a passive robot without robotic actuators. Accordingly, we aimed to evaluate the differences in the clinical and kinematic outcomes between active-assistive and passive robotic rehabilitation among stroke survivors.

Methods
In this single-blinded randomised controlled pilot trial, we assigned 20 stroke survivors with upper extremity dysfunction (Medical Research Council scale score, 3 or 4) to the active-assistive robotic intervention (ACT) and passive robotic intervention (PSV) groups in a 1:1 ratio and administered 20 sessions of 30-min robotic intervention (5 days/week, 4 weeks). The primary (Wolf Motor Function Test [WMFT]-score and -time: measures activity), and secondary (Fugl-Meyer Assessment [FMA] and Stroke Impact Scale [SIS] scores: measure impairment and participation, respectively; kinematic outcomes) outcome measures were determined at baseline, after 2 and 4 weeks of the intervention, and 4 weeks after the end of the intervention. Furthermore, we evaluated the usability of the robots through interviews with patients, therapists, and physiatrists.

Results
In both the groups, the WMFT-score and -time improved over the course of the intervention. Time had a significant effect on the WMFT-score and -time, FMA-UE, FMA-prox, and SIS-strength; group × time interaction had a significant effect on SIS-function and SIS-social participation (all, p < 0.05). The PSV group showed better improvement in participation and smoothness than the ACT group. In contrast, the ACT group exhibited better improvement in mean speed.

Conclusions
There were no differences between the two groups regarding the impairment and activity domains. However, the PSV robots were more beneficial than ACT robots regarding participation and smoothness. Considering the high cost and complexity of ACT robots, PSV robots might be more suitable for rehabilitation in stroke survivors capable of voluntary movement.
Trial registration The trial was registered retrospectively on 14 March 2018 at ClinicalTrials.gov (NCT03465267).
The global diet and activity research (GDAR) network: a global public health partnership to address upstream NCD risk factors in urban low and middle-income contexts
Authors: Oni Tolu , Assah Felix , Erzse Agnes , Foley Louise , Govia Ishtar , Hofman Karen J. , Lambert Estelle Victoria , Micklesfield Lisa K. , Shung-King Maylene , Smith Joanne , Turner-Moss Eleanor , Unwin Nigel , Wadende Pamela , Woodcock James , Mbanya Jean Claude , Norris Shane A. , Obonyo Charles O. , Tulloch-Reid Marshall , Wareham Nicholas J. ,   on behalf of the GDAR network, Bennett Nadia , Brugulat Anna , Guthrie-Dixon Nathalie , Hambleton Ian , Lebar Kelsey , Mabena Gugulethu , Mapa Clarisse , Mogo Ebele , Mba Camille , Motlhalhedi Molebogeng , Musuva Rosemary , Odunitan-Wayas Feyisayo A. , Okop Kufre J. , Tatah Lambed , Wasnyo Yves , Weimann Amy , Were Vincent 
Published: October 2020

Abstract
Background
Non-communicable diseases (NCDs) are the leading cause of death globally. While upstream approaches to tackle NCD risk factors of poor quality diets and physical inactivity have been trialled in high income countries (HICs), there is little evidence from low and middle-income countries (LMICs) that bear a disproportionate NCD burden. Sub-Saharan Africa and the Caribbean are therefore the focus regions for a novel global health partnership to address upstream determinants of NCDs.

Partnership
The Global Diet and Activity research Network (GDAR Network) was formed in July 2017 with funding from the UK National Institute for Health Research (NIHR) Global Health Research Units and Groups Programme. We describe the GDAR Network as a case example and a potential model for research generation and capacity strengthening for others committed to addressing the upstream determinants of NCDs in LMICs. We highlight the dual equity targets of research generation and capacity strengthening in the description of the four work packages. The work packages focus on learning from the past through identifying evidence and policy gaps and priorities, understanding the present through adolescent lived experiences of healthy eating and physical activity, and co-designing future interventions with non-academic stakeholders.

Conclusion
We present five lessons learned to date from the GDAR Network activities that can benefit other global health research partnerships. We close with a summary of the GDAR Network contribution to cultivating sustainable capacity strengthening and cutting-edge policy-relevant research as a beacon to exemplify the need for such collaborative groups.
Biomechanical evaluation of type p condylar head osteosynthesis using conventional small-fragment screws reinforced by a patient specific two-component plate
Authors: Pavlychuk Tetiana , Chernogorskyi Denis , Chepurnyi Yurii , Neff Andreas , Kopchak Andrii 
Published: October 2020

Abstract
Background
The aim of this study was to evaluate via finite element analysis (FEA) the biomechanical behavior of conventional small-fragment screws reinforced by a patient-specific plate in type p condylar head.

Methods
A finite element model of the mandible was created using Mimics 12.1 software. A type p condylar head fracture was simulated in the right condyle, and the left condyle was used as a control. Two patterns of fixation were investigated: conventional two-screw fixation and the same fixation system reinforced with a small, patient-specific plate. Surface models were imported into the software Ansys 5.7for further volume mesh generation.

Results
The highest stress gradients were observed in the cortical layer of the lateral fragment, located near the screw. The conventional fixation method resulted in equivalent stresses 2 to 10 times greater than the reinforced method. Rigidity of fixation in the reinforced method increased up to 1.25–3 times compared to the conventional two-screw technique.

Conclusion
This study’s findings suggest significant benefits in unfavorable biomechanical conditions from reinforcement of the standard two-screw fixation of condylar head fractures with a small, patient-specific plate acting as a washer.
Design of a robot-assisted system for transforaminal percutaneous endoscopic lumbar surgeries: study protocol
Authors: Fan Ning , Yuan Shuo , Du Peng , Zhu Wenyi , Li Liang , Hai Yong , Ding Hui , Wang Guangzhi , Zang Lei 
Published: October 2020

Abstract
Background
Transforaminal percutaneous endoscopic lumbar surgeries (PELS) for lumbar disc herniation and spinal stenosis are growing in popularity. However, there are some problems in the establishment of the working channel and foraminoplasty such as nerve and blood vessel injuries, more radiation exposure, and steeper learning curve. Rapid technological advancements have allowed robotic technology to assist surgeons in improving the accuracy and safety of surgeries. Therefore, the purpose of this study is to develop a robot-assisted system for transforaminal PELS, which can provide navigation and foraminoplasty.

Methods
The robot-assisted system consists of three systems: preoperative planning system, navigation system, and foraminoplasty system. In the preoperative planning system, 3D visualization of the surgical segment and surrounding tissues are realized using the multimodal image fusion technique of computed tomography and magnetic resonance imaging, and the working channel planning is carried out to reduce the risk for injury to vital blood vessels and nerves. In the navigation system, the robot can obtain visual perception ability from a visual receptor and automatically adjust the robotic platform and robot arm to the appropriate positions according to the patient’s position and preoperative plan. In addition, the robot can automatically register the surgical levels through intraoperative fluoroscopy. After that, the robot will provide navigation using the 6 degree-of-freedom (DOF) robot arm according to the preoperative planning system and guide the surgeon to complete the establishment of the working channel. In the foraminoplasty system, according to the foraminoplasty planning in the preoperative planning system, the robot performs foraminoplasty automatically using the high speed burr at the end of the robot arm. The system can provide real-time feedback on the working status of the bur through multi-mode sensors such as multidimensional force, position, and acceleration. Finally, a prototype of the system is constructed and performance tests are conducted.

Discussion
Our study will develop a robot-assisted system to perform transforaminal PELS, and this robot-assisted system can also be used for other percutaneous endoscopic spinal surgeries such as interlaminar PELS and percutaneous endoscopic cervical and thoracic surgeries through further research. The development of this robot-assisted system can be of great significance. First, the robot can improve the accuracy and efficiency of endoscopic spinal surgeries. In addition, it can avoid multiple intraoperative fluoroscopies, minimize exposure to both patients and the surgical staff, shorten the operative time, and improve the learning curve of beginners, which is beneficial to the popularization of percutaneous endoscopic spinal surgeries.