bluuebunny/crossref_metadata_2025_split huggingface dataset:
Immediate effects on cervical mobility and spiratory flow, after bilateral manipulation of first rib, in non-specific chronic neck pain: study protocol for a randomized controlled trial
Authors: Gonzalez-Gerez Juan Jose , Utrera Carlos Bernal , Anarte Ernesto , Rodriguez-Blanco Cleofas 
Published: May 2020

Abstract
Background: Numerous publications have showed the biomechanical influence of thoracic spine on cervical spine. Recently, some authors have pointed out the role of other physiological systems in this relationship, what have been calle interdependence regional model. It has been studies that interventions applied over thoracic spine have a neurophysiological influence on cervical spine and respiratory system. Our study evaluates the influence of bilateral manipulative technique of first rib on pain and pulmonary function in subjects with chronic non-specific neck pain. Methods: The immediate changes produced by bilateral direct manipulation (HVLA) of first rib in subjects with non-specific chronic neck pain will be studied. The sample will be randomly divided into two groups, experimental and placebo. As dependent variables of the study, we will measure the peak expiratory flow and cervical rom. Findings will be analyzed statistically considering a 5% significance level (p ≤ 0.05) Discussion: Our study aims to provide knowledge about the influence of bilateral manipulative technique of first rib in pain and pulmonary capacity in subjects with non-specific chronic neck pain. The efficacy of this technique may entail an easy access and low cost strategy in patients with pain and a reduction in pulmonary function. Trial registration Brazilian Clinical Trial Registry, RBR-4dsvfy. Registered on 17 March 2020. Retrospectively registered
Pattern of liver injury in adult patients with COVID-19: a retrospective analysis of 105 patients
Authors: Wang Qi , Zhao Hong , Liu Ligai , Wang Yanbin , Zhang Ting , Li Minghui , Xu Yanli , Gao Guiju , Xiong Haofeng , Fan Ying , Cao Ying , Ding Rui , Wang Jingjing , Cheng Cheng , Xie Wen 
Published: May 2020

Abstract
【Background】Recent studies reported that patients with coronavirus disease-2019 (COVID-19) might have liver injury. However, few data on the combined analysis and change patterns of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBil) have been shown.【Methods】 This is a single-center retrospective study. A total of 105 adult patients hospitalized for confirmed COVID-19 in Beijing Ditan Hospital between January 12, and March 17, 2020 were included, and divided into mild and severe groups. We compared liver functional test results between the two groups. Category of ALT change during the disease course was also examined.【Results】 56.2% of the patients had unnormal ALT, AST, or total TBil throughout the course of the disease, but in 91.4% cases the level of ALT, AST or TBil ≤ 3 fold of the upper normal range. The overall distribution of ALT, AST, and TBil were all significantly difference between mild and severe group (p<0.05).The percentage of the patients with both elevated ALT and AST was 12.7% in mild cases vs. 46.2% in severe cases (p = 0.001). 34.6% severe group patients started to have abnormal ALT after admission，and 73.4% of all patients had normal ALT before discharge.【Conclusion】Elevated liver function index is very common in patients with COVID-19 infection, and the level were less than 3 × ULN，but most are reversible. The abnormality of 2 or more indexes is low in the patients with COVID-19, but it is more likely to occur in the severe group.
Quantitative susceptibility mapping of brain iron deposition in patients with type 2 diabetes mellitus
Authors: Li Jing , Zhang Qihao , Zhang Nan , Guo Lingfei 
Published: May 2020

Abstract
Background Noninvasive quantitative susceptibility mapping (QSM) analysis was applied to assess brain iron deposition in the gray matter nucleus in type 2 diabetes mellitus (T2DM) patients and healthy elderly individuals.Methods Thirty-two T2DM patients and thirty-two age- and gender-matched healthy controls (HCs) were enrolled in this research. All participants underwent brain magnetic resonance examinations. Twenty-three DM patients and twenty-six healthy controls received cognitive function assessments. Imaging data were collected with three-dimensional fast low-angle shot sequences to obtain magnitude and phase images; with preprocessed QSM data, ITK-SNAP helped to measure the susceptibility values reflecting the content of iron in the regions of interest (ROIs).Results The study included thirty-two T2DM patients (20 males and 12 females; mean age of 61.09 ± 9.99 years) and 32 HCs (14 males and 18 females; mean age of 59.09 ± 9.77 years). These participants were age- and gender-matched, with no significant difference (P > 0.05). T2DM patients exhibited an obviously (P < 0.05) lower MoCA score (26.78 ± 2.35; normal standard, ≥ 27) and higher SCWT score (157 (128,188); HC, 123 (112,152)) than HCs. The mean susceptibility values in the left putamen and right putamen as well as dentate nucleus in the left thalamus appeared obviously higher in T2DM patients than in HCs (P < 0.05). In all participants, the susceptibility values in the left dentate nucleus were significantly higher than those in the right side (P < 0.05). The susceptibility values and cognitive assessment scores showed no obvious association (P > 0.05). However, an obvious correlation exists between the changes in the susceptibility values across hemispheres in the dentate nucleus and the putamen (left, r = 0.439, P = 0.000; right, r = 0.260, P = 0.038).Conclusion T2DM patients showed increased iron deposition in the putamen, dentate nucleus and left thalamus. Cerebral iron deposition exacerbates cognitive decline in T2DM patients. Changes in susceptibility values in these regions are likely to be quantitative imaging markers of central nervous system injury in T2DM patients, and QSM may benefit their detection and evaluation.
Infant and young child feeding practices and nutritional status in two Health Zones of South Kivu, Eastern Democratic Republic of Congo: a community-based study.
Authors: Kambale Richard Mbusa , Ngaboyeka Gaylord Amani , Kasengi Joe Bwija , Niyitegeka Sarah , Cinkenye Boss Rutakaza , Baruti Armand , Mutuga Kizito Chentwali , Linden Dimitri Van der 
Published: May 2020

Abstract
Background In DRC, childhood undernutrition remains a serious public health concern. Internationally recommended infant and young child feeding (IYCF) practices may improve child nutritional status. This study aimed to describe IYCF practices, factors associated with inappropriate complementary feeding, and infant’s nutritional status.Methods A community-based cross-sectional study including 1,009 mother-infant pair was conducted in August 2019 in 32 health areas (16 in rural health zone and 16 in urban one) of South Kivu, Democratic Republic of Congo (DRC), among mothers who had infants under 24 months of age. Infant’s nutritional status was assessed using WHO Anthro plus software. To describe IYCF practices, we used the indicators recommended by the WHO. To study the factors associated with inappropriate complementary feeding practices, we performed univariable and multiple logistic regression analyzes. The data was analyzed in SPSS version 25.Results The prevalence of early initiation of breastfeeding and exclusive breastfeeding up to 6 months of age was 73.7% and 42.2% respectively. Of the 746 infants aged 6–23.9 months, 246 (32.3%) received appropriate complementary feeding. Of the 997 infants who had valid anthropometric parameters, 416 (41.7%) were well-nourished, 374 (37.5%) were undernourished and 207 (20.8%) were overweight. Multivariable logistic regression analysis revealed that residence in rural area [Adjusted Odds Ratio (AOR): 2.38 (95% Confidence Interval (CI): 1.49, 3.78)], non-attendance at postnatal care (AOR 1.63; 95% CI 1.12, 2.96), low household socioeconomic (AOR 1.72; 95% CI 1.14, 2.59) and low maternal education (AOR 1.83; 95% CI 1.20, 2.77) were factors associated with inappropriate complementary feeding. Mothers with inappropriate complementary feeding practices were 6.88 times more likely to have undernourished infants than their counterparts (AOR 6.88; 95% CI 1.24, 18.37).Conclusion Findings from this study provide strong evidence, both of association between inappropriate complementary feeding and undernutrition, and of the double burden of malnutrition with the co-existence of under- and overnutrition in the infant population in South Kivu. Interventions should focus on both preventing undernutrition and overweight to promote child well-being.
A new and spontaneous animal model for ankylosing spondylitis is found in cynomolgus monkeys
Authors: JIA Huanhuan , CHEN Meili , LUO Xiaoling , HOU Gang , LUO Ting , LIAO Jin’e , LI Yongfeng , CHEN Wei , CHEN Jun , LI Qingnan , MIU Kai Kei , Huang Ren , LU Li 
Published: May 2020

Abstract
Background
Ankylosing spondylitis (AS) is a progressive, disabling joint disease that affects millions worldwide. There is a lack of useful disease model to conduct comprehensive mechanistic studies. Non-human primate model is a potential spontaneous model for ankylosing spondylitis (AS).
Methods
A group of cynomolgus monkeys with abnormal joints and abnormal movements were screened out from about 20,000 cynomolgus monkeys primarily. A 2-years follow-up study of this group of cynomolgus monkeys having joint lesions reported of spinal stiffness was performed by conducting hematological testing, radiographic examination, family aggregation analysis, pathological analysis and genetic testing.
Results
These diseased animals suffered from spontaneous AS with clinical features recapitulating human AS disease progression. The spontaneous incidence rate and the onset age of AS in monkeys similar to epidemiological features of AS patients. The disease progression in disease monkeys have shown bone erosion, osteophyte formation and “Bamboo-like” change. ESR, CRP IL-17, TNF-α and VEGF levels significantly increase in AS monkeys comparing with normal monkeys. Several features similar to AS patients, including cartilage destruction, cartilage ossification, chondroid metaplasia and bone formation were shown in AS monkeys pathological examination results. Both the serum bone resorption and bone formation biomarkers of AS monkeys were significantly reduce. In our current SNP sequencing results, loci that similar to AS-relative SNPs in human genome have not yet been found.
Conclusions
The study offers a promising non-human primate model for spontaneous ankylosing spondylitis which may serve as an excellent substitute for its pre-clinical research.
Factors that discriminate invasive adenocarcinoma from minimally invasive adenocarcinoma and adenocarcinoma in situ in patients with pure ground-glass pulmonary nodules
Authors: Yang Huan-Huan , Lv Yi-Lv , Fan Xing-Hai , Ai Zhi-Yong , Xu Xiu-Chun , Ye Bo , Hu Ding-zhong 
Published: May 2020

Abstract
Purpose
The aim of the present study was to investigate predictors of pathological invasiveness and prognosis of lung adenocarcinoma in patients with pure ground-glass nodules (pGGNs).
Methods
Clinical and computed tomography (CT) features of invasive adenocarcinomas (IACs) and pre-IACs were retrospectively compared in 641 consecutive patients with pGGNs and confirmed lung adenocarcinomas who had been followed up by CT postoperatively, and potential predictors of prognosis were investigated.
Results
Of 659 pGGNs in 641 patients, 258 (39.1%) were adenocarcinomas in situ, 265 (40.2%) were minimally invasive adenocarcinomas, and 136 (20.6%) were IACs. Respective optimal cutoffs for age, serum carcinoembryonic antigen, maximal diameter, mean diameter, and CT density for distinguishing preIACs from IACs were 53 years, 2.19 ng/mL, 10.78 mm, 10.09 mm, and − 582.28 Hounsfield units (HU). In univariable analysis sex, age, maximal diameter, mean diameter, CT density, and spiculation were significant predictors of lung IAC. In multivariable analysis age, maximal diameter, and CT density were significant predictors of lung IAC. During a median follow-up of 41 months no pGGN IACs recurred.
Conclusions
pGGNs may be lung IACs, especially in patients aged > 55 years with lesions that are > 1 cm in diameter and exhibit CT density > − 600 HU. pGGN IACs of < 3 cm in diameter have good post-resection prognoses. These data may assist the selection of surgical procedures in patients with pGGNs at high risk of malignancy.
­Knowledge and behaviour about preconception care among women desiring conception, from tribal and non-tribal areas; a qualitative study using focused group discussions
Authors: Doke Prakash Prabhakarrao , Gothankar Jayashree Sachin , Patil Archana Vasantrao , Pore Prasad Dnyandeo , Palkar Sonali Hemant , Deshpande Aniruddh Vinayakrao , Karnataki Madhusudan Vamanrao , Bhuyan Khanindra Kumar , Shrotri Aparna Nishikant , Chutke Amruta Paresh 
Published: May 2020

Abstract
Background India has the highest number of under-five deaths in any country in the world. World Health Organization and Government of India recommended roll out of preconception care (PCC) for reduction of maternal and child mortality. However, very few countries including India have implemented a comprehensive package of PCC services. PCC has been rolled out among all women, who desire to be pregnant in one year through the government health system in two blocks of Nashik district of Maharashtra State, India. In order to assess the impact of PCC in these two blocks, baseline and post intervention studies (both quantitative and qualitative) on women’s knowledge and behaviour on PCC, their health status and pregnancy outcomes are planned in these two intervention blocks as well as in two control blocks. To assess women’s knowledge and behaviour on PCC before implementation of the project, focus group discussions (FGDs) were carried out as part of this impact assessment project.Methods From each of the four blocks, two villages having sub centre were selected for conducting FGD. A house to house survey was conducted by Accredited Social Health Activist (ASHA) to enlist women who desire a baby in one year. From the list, eight to twelve women were invited to sub centre for FGDs, which were conducted in June 2018.Results A total of 76 women having mean age 23.97 years participated in the FGDs. Most of them (46.05%) had completed 10 years of education. About 50% of pregnancies are planned. The decision about first pregnancy is influenced by the mother-in-law. Women knew that they should not conceive before 20 years of age and their inadequate weight may have adverse impact on the health of new-born. Women had some knowledge about adverse effects of tobacco and alcohol use, very few consumed these. Most of them did not practice behaviours or accessed services related to PCC.
N-CAM expression: The study of muscle disease in a tertiary center of Thailand
Authors: Laoyoung Kanyarat , Waisayarat Jariya 
Published: May 2020

Abstract
Background

The neural cell adhesion molecule (N-CAM), also called CD56, is a cell-surface glycoprotein that mediates intercellular adhesive interactions in the nervous system. N-CAM is expressed in neuromuscular endplates, nerves, satellite cells, and embryonic muscle, but it is lost as development proceeds and is nearly absent from adult muscle. N-CAM re-expression was detected in a denervated, regenerating and degenerated muscle fibres. Muscle disease or myopathy is diagnosed based on the presence of denervated, regenerating and degenerated fibres on muscle biopsy combined with clinical information. Some regenerating fibres looked like normal fibre and were challenging to identify but showed positive N-CAM staining.
Objectives

To explore the expression of N-CAM in muscle disease.
Methods

N-CAM expression and interpretation were performed in a 3-year retrospective study of 75 muscle biopsies diagnosed with myopathies. The pathological findings and clinical information were also thoroughly reviewed.
Results

Of 75 myopathy patients, 41 (55%) cases were female, and 34 (45%) cases were male. The mean age was 35 years. The range of age was 3 months to 83 years. The expression of N-CAM and clinical information, including pathological findings, were analyzed using Fisher’s exact versus chi-square tests. N-CAM expression data was performed in 75 samples, 35 (46.67%) were positive for N-CAM, and 40 (53.33%) were negative for N-CAM. The diagnosis of the muscle disease was nonspecific myopathy with 35 (46%) cases, inflammatory myopathy with 17 (23%) cases, neurogenic myopathy with 9 (12%) cases, muscular dystrophy with 7 (9%) cases, non-diagnostic myopathy with 5 (7%) cases, and mitochondrial myopathy with 2 (3%) cases. The inflammatory myopathy showed positive N-CAM in 15 out of 17 cases with statistical significance (p-value < 0.001, ORs (95% CI) 14.250 (2.960-68.606)). N-CAM was also positive in muscular dystrophy, neurogenic myopathy, and nonspecific myopathy but was not statistically significant in p-value. No positive N-CAM was found in mitochondrial myopathy and non-diagnostic myopathy.
Conclusion

N-CAM expression accompanied by the pattern of staining could be considered to help narrow down the differential diagnosis of myopathies. We recommend further study in a larger group.
Local treatment combined with chemotherapy improves survival of patients with pulmonary metastases of colorectal cancer—a real-world retrospective study
Authors: Cai Zikai , Wang Qingbing , Yang Xiaofeng , Ye Xiaolong , Fang Jiafeng , Chen Tufeng , Lei Purun , Zheng Zongheng , Xiao Jian’an , Wei Bo , Wei Hongbo 
Published: May 2020

Abstract
Background The effect of local treatments for pulmonary metastases from colorectal cancer (CRC-PM) remains controversial. This study aims to figure out whether local treatments combined with chemotherapy could improve patients’ survival by comparing the outcomes of CRC-PM patients who submitted to local interventions combined with chemotherapy or just chemotherapy.Patients and Methods From January 2009 to July 2019, a total of 119 patients with CRC-PM from two surgical centers were reviewed. Patients were divided into two groups according to treatments for the lung metastases: Local intervention combined with chemotherapy (Group-LI) and Chemotherapy alone (Group-Chem). Overall survival (OS) and progression-free survival (PFS) were assessed with the Kaplan-Meier method. Clinical characteristics associated with prognosis were analyzed by using a Cox proportional hazards regression model. Propensity score matching analyses were used to overcome the possible biases in some baseline characteristics.Result Multivariable analysis revealed that the level of carcinoembryonic antigen (CEA) and treatment for CRC-PM are independent predictors of both OS and PFS. The median OS in Group-LI (n = 39) and Group-Chem (n = 80) were 34.5 months and 13.8 months, respectively(P < 0.001). The 3-year progression-free survival rate in Group-LI and Group-Chem were 75.2% and 45.1% (P < 0.001). After propensity score matching, patients in Group-LI had better OS (HR = 3.304, P = 0.022) and PFS (HR = 4.029, P < 0.001) than Group-Chem.Conclusion. CRC-PM patients with lower lever of CEA or local treatment of lung metastases are more likely to be those with favorable prognosis. Selected CRC-PM patients could benefit from local treatment of pulmonary metastases.
How should community health workers in fragile contexts be supported: Qualitative evidence from Sierra Leone, Liberia and Democratic Republic of Congo
Authors: Raven Joanna , Wurie Haja , Idriss Ayesha , Bah Abdulai Jawo , Baba Amuda , Nallo Gartee , Kollie Karsor K. , Dean Laura , Steege Rosie , Martineau Tim , Theobald Sally 
Published: May 2020

Abstract
Background Community Health Workers (CHWs) are critical players in fragile settings, where staff shortages are particularly acute, health indicators are poor and progress towards Universal Health Coverage is slow. Like other health workers, CHWs need support to contribute effectively to health programmes and promote health equity. Yet the evidence base of what kind of support works best is weak. We present evidence from three fragile settings - Sierra Leone, Liberia and Democratic Republic of Congo on managing CHWs, and synthesise recommendations for best approaches to support this critical cadre.Methods We used a qualitative study design to explore how CHWs are managed, the challenges they face and potential solutions. We conducted interviews with decision makers and managers (n = 37), life history interviews with CHWs (n = 15) and reviewed policy documents.Results Fragility disrupts education of community members so that they may not have the literacy levels required for the CHW role. This has implications for selection, role, training and performance of CHWs. Policy preferences about selection need discussion at the community level, so that they reflect community realities. CHWs scope of work is varied and may change over time, requiring ongoing training. The modular, local, and mix of practical and classroom training approach worked well, helping to address gender and literacy challenges and develop a supportive cohort of CHWs. A package of supervision, community support, regular provision of supplies, performance rewards and regular remuneration is vital to retention and performance of CHWs. But there are challenges with supervision, scarcity of supplies, inadequate community recognition and unfulfilled promises about allowances. Clear communication about incentives with facility staff and communities is required as is their timely delivery.Conclusions This is the first study that has explored the management of CHWs in fragile settings. CHWs interface role between communities and health systems is critical because of their embedded positionality and the trust they (often) have. Their challenges are aligned to those generally faced by CHWs but chronic fragility exacerbates them and requires innovative problem solving to ensure that countries and communities are not left behind in reforming the way that CHWs are supported.