bluuebunny/crossref_metadata_2025_split huggingface dataset:
Maternal HIV infection and risk of adverse pregnancy outcomes in Hunan province, China
Authors: Li Huixia , Liu Jiahui , Tan Danfeng , Huang Guangwen , Zheng Jianfei , Xiao Juan , Wang Hua , Huang Qun , Feng Na , Zhang Guoqiang 
Published: February 2020

Abstract
This study described the prevalence of adverse pregnancy outcomes (APOs) in Chinese HIV-infected pregnant women, and examined the relationship between maternal HIV infection /HIV-related factors and APOs.
This prospective cohort study was carried out among 483 HIV-infected pregnant women and 966 HIV-uninfected pregnant women. The HIV-infected and HIV-uninfected women were enrolled from midwifery hospitals in Hunan province between October 2014 and September 2017. All data were extracted in a standard structured form, including maternal characteristics, HIV infection status, HIV-related factors and their pregnancy outcomes. APOs were assessed by maternal HIV infection status and HIV-related factors using logistic regression analysis.
The incidences of stillbirth (3.9% vs 1.1%), preterm birth (PTB) (8.9% vs 3.7%), low birth weight (LBW) (12.2% vs 3.1%) and small for gestational age (SGA) (21.3% vs 7.0%) were higher in HIV-infected women than HIV-uninfected women, with adjusted ORs of 2.77 (95%CI: 1.24–6.17), 2.37 (95%CI: 1.44–3.89), 4.20 (95%CI: 2.59–6.82) and 3.26 (95%CI: 3.26–4.64), respectively. No differences were found in neonatal asphyxia or birth defects between HIV-infected and HIV-uninfected groups, with adjusted ORs of 1.12 (95%CI: 0.37–3.43) and 1.10 (95%CI: 0.51–2.39), respectively. Among HIV-infected pregnant women, different antiretroviral (ARV) regimens were significantly associated with stillbirths, but not PTB, LBW or SGA. Compared with untreated HIV infection (10.1%), both mono/dual therapy and HAART were associated with a reduced risk of stillbirths (2.0% and 3.2%, respectively), with an AOR of 0.19 (95%CI: 0.04–0.92) and 0.31 (95%CI: 0.11–0.85), respectively. Initial time of ARV drugs use and HIV infection status of the sexual partner were not associated with maternal APOs.
The findings of this study indicated that maternal HIV infection was associated with significantly increased risks of stillbirth, PTB, LBW and SGA, but not neonatal asphyxia or birth defects. On the condition that most HIV-infected pregnant women started ARV therapy in or after the second trimester, both mono/dual therapy and HAART had a protective effect on stillbirth compared with untreated HIV infection. As some important confounders were not effectively controlled and the specific regimens of HAART were not analyzed, the above findings may have certain bias.
Expressionof langerhans cell and plasmacytoid dendritic cell markers, and toll-like receptor 7/9 signaling pathway proteins in verruca vulgaris lesions
Authors: Tang Yi , Zhu Xiaoxia , Han Rui , Zhou Qiang , Cheng Hao 
Published: February 2020

AbstractLangerhans cells (LCs) and plasmacytoid dendritic cells (pDCs) play an important role in the cutaneous immune response to viral infection. Verruca vulgaris (VV) is a chronic benign disease caused by human papillomavirus (HPV) infection.To investigate the possible roles of LCs, pDCs and toll-like receptor (TLR)7/9 signaling pathways in the pathogenesis of VV, we detected the expression of CD1a, CD2AP, CD123, TLR7/9, IFN regulatory factor 7 (IRF7), and interleukin-1 receptor-associated kinase 1 (IRAK1) in VV lesions.The expression of CD1a, CD2AP, CD123, TLR7/9, IRF7, and IRAK1 in 20 VV lesions was tested by immunohistochemistry. The density and number of stained cells were compared between VV lesions and the perilesional normal skin.The density and number of CD1a-, CD2AP-, CD123-, TLR9-, and IRAK1-positive cells in the papillary layer of VV lesions were significantly higher than those in the perilesional normal skin (P < .05). There were no significant differences in the density and positive rate of CD1a+ cells in the epidermis and of TLR7+and IRF7+cells in the dermis between VV lesions and the perilesional normal skin at the edge (P > .05).In VV, the number of LCs increases only in the dermis, indicating that LC's antigen-presenting function might not be inhibited. The increased number of pDCs in VV lesions suggests that HPV infection may recruit the pDCs to the virus-infected epithelium. We speculate that the TLR7/9 downstream signaling pathway is not fully activated in VV, leading to difficulty of HPV removal and the relapse of HPV-infected lesions.
Anxiety among caregivers of children with epilepsy from western China
Authors: Yang Chunsong , Kang BingYao , Mao Yifei , Xu Qunfen , Yu Dan , Zhang Lingli 
Published: February 2020

Abstract
The current study aimed to evaluate the status of anxiety among caregivers of children with epilepsy and examine the associated factors.
A cross-sectional study was conducted in western China, which consecutively recruited children with epilepsy in 2018. The self-rating anxiety scale (SAS) was used to assess the status of anxiety among caregivers of children with epilepsy. We collected information about aspects of sociodemographic data, disease status, attitude of caregivers towards the disease and family conditions as independent variables, using multiple linear regression to analyze factors related to the status of anxiety among caregivers.
A total of 334 participants were included in the study with a response rate of 95.4% (334/350). The mean age of children with epilepsy was 6.05 ± 4.11 years. 7.2% (24/334) of patients were newly diagnosed and 55.4% (185/334) of patients presented with generalized epilepsy. A total of 25.7% (86/334) of caregivers among children with epilepsy presented the symptom of anxiety, with the scores of SAS 44.31 ± 10.558. SAS scores were negatively correlated with the children's age (B = −0.141; standard error = 0.135; P = .008), attitude towards seizures (B = −0.153; standard error = 1.192; P = .004) and medical expenses payment (B = −0.169; standard error = 1.703; P = .002).
Symptoms of anxiety are common among caregivers of children with epilepsy in western China. Healthcare providers should pay more attention to caregivers with younger children, difficult financial situation, and greater fear of seizures. Exploring mental health interventions for caregivers is important.
Prenatal diagnosis of 6pter-p24 deletion syndrome in a fetus from a Han Chinese family
Authors: Shi Qing-yang , Liu Yan-hong , Zhang Yong-sheng , Yu Xiao-wei 
Published: February 2020

Abstract

Introduction:
Chromosome 6pter-p24 deletion syndrome (OMIM #612582) is a rare genetic disorder characterized by deletion of the distal part of 6p. Human 6p deletion syndromes result in a variety of congential malformations.

Patient concerns:
The fetus was the fourth child born to healthy non-consanguineous parents with no relevant family history.

Diagnosis:
The fetus was diagnosed with 6pter-p24 deletion syndrome through prenatal ultrasound, magnetic resonance imaging, and chromosomal microarray analysis. The fetus had brain, skeletal, and heart malformations. The fetus was cytogenetically normal. Chromosomal microarray analysis detected an interstitial 7.999Mb deletion within the 6p25.1p24.3 region of chromosome 6.

Interventions:
There was no treatment for the fetus.

Outcomes:
Pregnancy was terminated.

Conclusions:
To the author's knowledge, the present case is one of the first to report the prenatal diagnosis of 6pter-p24 deletion syndrome in a fetus. No published reports have described the diagnosis of 6pter-p24 deletion syndrome using multiple technologies during the antenatal period; therefore, our findings may provide a reference for other clinicians. The clinical features and pathophysiology of this prenatal diagnosis are discussed.
Accuracy of ADC derived from DWI for differentiating high-grade from low-grade gliomas
Authors: Wang Qiang-ping , Lei De-qiang , Yuan Ye , Xiong Nan-xiang 
Published: February 2020

Abstract

Objective:
Quantitative apparent diffusion coefficient (ADC) values of diffusion weighted imaging (DWI) could be applied to grade gliomas. This meta-analysis was conducted to assess the accuracy of ADC analysis in differentiating high-grade (HGGs) from low-grade gliomas (LGGs).

Methods:
PubMed, Cochrane library, Science Direct, and Embase were searched to identify suitable studies up to September 1, 2018. The quality of studies was evaluated by the quality assessment of diagnostic accuracy studies (QUADAS 2). We estimated the pooled sensitivity, specificity, positive and negative likelihood ratios (LR), diagnostic accuracy ratio (DOR) with 95% confidence intervals (CI), and determined the accuracy of the data by using the summary receiver operating characteristic (SROC) and calculating the area under the curve (AUC) to identity the accuracy of ADC analysis in grading gliomas.

Results:
Eighteen studies including 1172 patients were included and analyzed. The pooled sensitivity, specificity, PLR, NLR, DOR, and AUC with 95% CIs of DWI with b values of 1000 s/mm2 for separating HGGs from LGGs were 0.81 (95% CI 0.75–0.86), 0.87 (95% CI 0.81–0.91), 6.1 (95% CI 4.2–8.9), 0.22 (95% CI 0.17–0.29), 28 (95% CI 17–45), and 0.91 (95% CI 0.88–0.93), respectively. DWI with b values of 3000 s/mm2 showed slightly higher accuracy than that of 1000 (sensitivity 0.80, specificity 0.90 and AUC 0.92). Meta-regression analyses showed that field strengths and b values had significant impacts on diagnostic efficacy. Deeks testing confirmed no significant publication bias in all studies.

Conclusions:
This meta-analysis suggested that ADC analysis of DWI have high accuracy in differentiating HGGs from LGGs. Standardized methodology is warranted to guide the use of this technique for clinical decision-making.
A pilot study on efficacy and safety of a new salt substitute with very low sodium among hypertension patients on regular treatment
Authors: Mu Lihong , Li Chenglong , Liu Ting , Xie Wuxiang , Li Ge , Wang Meixian , Wang Ruoxi , Rao Huakun , He Qin , Wang Wen , Wu Yangfeng 
Published: February 2020

Abstract

Objectives:
To understand the possible effect of a novel salt substitute with very low sodium in reducing blood pressure, salt intake and use of anti–hypertensive medications among patients on regular medications, to inform the future randomized trials.

Design:
Single-arm pilot trial.

Setting:
A community health service center in Chongqing, China.

Participants:
A total of 43 patients with hypertension taking anti-hypertensive medications regularly.

Intervention:
Patients received the salt substitute with 18% sodium chloride for 8 weeks.

Main outcome measures:
Patients were followed up weekly for the use of antihypertensive medications and measurements of blood pressure. We collected 24-h urine before and after the trial to measure sodium and potassium intake.

Results:
Among 39 patients who completed the 8 weeks’ intervention, 30.8% patients stopped or reduced anti-hypertensive medications during the trial. For patients that stopped or reduced medication, the mean SBP and DBP before intervention were 122.1 ± 9.6 and 68.9 ± 9.4 mm Hg and both did not increase after intervention (SBP change: 2.8 mm Hg (−5.1, 10.8), P = .48; DBP change: 1.8 mm Hg (−2.2, 5.7), P = .38). For the rest patients, the mean SBP and DBP before intervention were 141.6 ± 16.9 and 74.6 ± 6.6 mm Hg but reduced significantly after the intervention (SBP change: −16.0 mm Hg (−21.3, −10.6), P < .001; DBP change: −5.5 mm Hg (−8.1, −2.9), P < .001). The 24-h urine sodium decreased (P < .001) and potassium increased (P < .001) among all patients. No severe adverse events were reported.

Conclusions:
The novel salt substitute showed potential in reducing blood pressure and use of antihypertensive medications. Further randomized double–blind controlled trial is warranted to validate these findings.
Clinical Trial Registration—URL:http://www.clinicaltrials.gov. Unique identifier: NCT03226327.
Blood pressure control in hypertensive patients and its relation with exercise and exercise-related behaviors
Authors: Zhang Chenyun , Zhang Yanping , Lin Hao , Liu Siyang , Xie Jing , Tang Yao , Huang Huiling , Zhang Wenchang 
Published: February 2020

Abstract
The effects of exercise interventions on blood pressure control in hypertensive patients have received extensive attention and recognition. However, the influence of exercise-related behaviors on the effects of blood pressure control and the management factors that affect exercise behaviors remain inconclusive. Therefore, this study aimed to explore the relationships between exercise and exercise-related behaviors and blood pressure control, expecting to provide a scientific basis for further improvement of exercise intervention programs for patients with hypertension.
Long-term residents in a community in Fuzhou, Fujian Province, China who were diagnosed with hypertension at a medical facility were recruited for this study. Hypertensive patients with uncontrolled blood pressure were placed in the case group, and those with controlled blood pressure were placed in the control group. The count data were analyzed with the χ2 test based on α = 0.05. A univariate logistic regression analysis was performed to screen significant variables; independent variables were selected based on professional knowledge and were tested for co-linearity. These variables were incorporated into a non-conditional multivariate logistic regression analysis to analyze relevant factors for blood pressure control, while calculating odds ratio (ORs), 95% confidence intervals (CIs), and P values. Differences with a P < .05 were considered statistically significant.
A total of 598 patients were included in the present study. Univariate and multivariate analyses showed that exercise (OR = 0.194; 95%CI: 0.133–0.283), frequency of self-monitoring of blood pressure (OR = 2.412; 95%CI: 1.137–5.117), and regular housework (OR = 0.397, 95%CI: 0.248–0.633) were statistically significant factors for blood pressure control. In addition, there was a relationship between exercise-related behaviors and blood pressure control: walking (OR = 0.189, 95% CI: 0.065–0.551), 60 to 120 min/day of exercise time (OR = 0.317, 95% CI: 0.118–0.856). Sex (OR = 2.248, 95% CI: 1.279–3.954), health belief (OR = 0.016, 95% CI: 0.004–0.059), and company of a family member during exercise (OR = 0.048, 95% CI: 0.025–0.094) were significant factors predictive of regular exercise in hypertensive patients.
Improving exercise-related behaviors and their management can help improve the effects of exercise interventions on blood pressure control in middle-aged and elderly hypertensive patients.
Prognostic risk factors of surgical site infection after primary joint arthroplasty
Authors: Yang Guang , Zhu Yanbin , Zhang Yingze 
Published: February 2020

Abstract
Surgical site infection (SSI) can be a devastating complication in joint arthroplasty. Objective of this study was to identify potential risk factors associated with SSI following primary joint arthroplasty.
This retrospective cohort study was performed from January 2016 to October 2017. A total of 986 patients were enrolled. We extracted the patients’ baseline information, treatment-related variables and indexes of laboratory examination during their hospitalization. Receiver operating characteristic (ROC) analysis was performed to find the optimum cut-off value for serum albumin. Univariate and multivariate logistic analysis models were performed respectively to determine independent predictors of SSI.
Nine hundred eighty-six patients with complete data were included in the final analysis. There were 314 male and 672 females in this study with a mean age of 64.6 years, and twenty patients developed SSI. The overall incidence of SSI was 2.03%, with 0.20% for deep infection and 1.83% for superficial SSI. Independent predictors of SSI identified by multivariate analysis were ALB < 36.7 g/L (odds ratio = 3.42; 95% CI = 1.24–9.48; P = .018), BMI ≥28 (odds ratio = 5.08; 95%CI = 1.52–17.01; P = .008) and ASA class 3 or higher (odds ratio = 3.36; 95% CI = 1.22–9.30; P = .019). Drain use was demonstrated as a protective factor of postoperative wound healing.
The incidence of SSI following primary joint arthroplasty was 2.03%. ASA ≥3, BMI ≥28 and ALB < 36.7 g/L were demonstrated as risk factors of postoperative wound infection. Supplementary nutrition support is necessary to reduce the risk of infection in patients who underwent artificial joint arthroplasty.
The adoption of electronic medical record by physicians
Authors: Dutta Bireswar , Hwang Hsin-Ginn 
Published: February 2020

Abstract

Background:
The electronic medical record (EMR) is considered to be a vital tool of information and communication technology (ICT) to improve the quality of medical care, but the limited adoption of EMR by physicians results in a considerable warning to its successful implementation. The purpose of the present review is to explore and identify the potential barriers perceived by physicians in the adoption of EMR.

Methods:
The systematic review was carried out based on literature published in 5 databases: PubMed, Web of Science, Scopus, The Cochrane Library, and ProQuest from 2014 to 2018, concerning barriers perceived by physicians to the adoption of EMR.

Results:
The present study incorporates 26 articles based on their appropriateness out of 1354 for the final analysis. Authors explore 25 barriers that appeared 112 times in the literature for the present review; the top 5 frequently mentioned barriers are privacy and security concerns, high start-up cost, workflow changes, system complexity, lack of reliability, and interoperability.

Conclusion:
The systematic review explores that physicians deal with different barriers as they intend to adopt EMR. The barriers explored in the present review are the potential to play as references for the implementer of the EMR system. Thus an attentive analysis of the definitive condition is needed before relevant intervention is determined as the implementation of EMR must be considered as a behavioral change in medical practice.
Association between neuropathic pain characteristics and DNA methylation of transient receptor potential ankyrin 1 in human peripheral blood
Authors: Takenaka Shiho , Sukenaga Norihiko , Ohmuraya Masaki , Matsuki Yuka , Maeda Lynn , Takao Yumiko , Hirose Munetaka 
Published: February 2020

Abstract
Elucidation of epigenetic mechanisms correlating with neuropathic pain in humans is crucial for the prevention and treatment of this treatment-resistant pain state. In the present study, associations between neuropathic pain characteristics and DNA methylation of the transient receptor potential ankyrin 1 (TRPA1) gene were evaluated in chronic pain patients and preoperative patients. Pain and psychological states were prospectively assessed in patients who suffered chronic pain or were scheduled for thoracic surgery. Neuropathic characteristics were assessed using the Douleur Neuropathique 4 (DN4) questionnaire. DNA methylation levels of the CpG islands in the TRPA1 gene were examined using whole blood. Forty-eight adult patients were enrolled in this study. Increases in DNA methylation rates at CpG -51 showed positive correlations with increases in the DN4 score both in preoperative and chronic pain patients. Combined methylation rates at CpG -51 in these patients also significantly increased together with increase in DN4 scores. Neuropathic pain characteristics are likely associated with methylation rates at the promoter region of the TRPA1 gene in human peripheral blood.
Clinical and Practice Variations in Pediatric Acute Recurrent or Chronic Pancreatitis
Authors: Dike Chinenye R. , Zimmerman Bridget , Zheng Yuhua , Wilschanski Michael , Werlin Steven L. , Troendle David , Shah Uzma , Schwarzenberg Sarah Jane , Pohl John , Perito Emily R. , Ooi Chee Y. , Nathan Jaimie D. , Morinville Veronique D. , McFerron Brian , Mascarenhas Maria , Maqbool Asim , Liu Quin , Lin Tom K. , Husain Sohail Z. , Heyman Melvin B. , Gonska Tanja , Giefer Matthew J. , Gariepy Cheryl E. , Fishman Douglas S. , Bellin Melena , Barth Bradley , Abu‐El‐Haija Maisam , Lowe Mark E. , Uc Aliye 
Published: February 2020

ABSTRACTObjective:The aim of the study was to determine whether clinical characteristics and management of pediatric acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP) differ across INSPPIRE (INternational Study Group of Pediatric Pancreatitis: In Search for a cuRE) sites.Study Design:Data were collected from INSPPIRE and analyzed per US regions and “non‐US” sites. Between‐group differences were compared by Pearson chi‐square test. Differences in disease burden were compared by Kruskal‐Wallis test.Results:Out of the 479 subjects, 121 (25%) were enrolled in West, 151 (32%) Midwest, 45 Northeast (9%), 78 (16%) South, and 84 (18%) at non‐US sites. Hispanic ethnicity was more common in South (P < 0.0001); white race in Northeast (P = 0.009). CP was less common and time from diagnosis of first acute pancreatitis to CP was longer in children at non‐US sites (P = 0.0002 and P = 0.011, respectively). Genetic mutations were most common among all groups; PRSS1 variants predominated in Midwest (P = 0.002). Gallstones were more frequent in South (P = 0.002). Endoscopic retrograde cholangiopancreatography (ERCP) and computed tomography (CT) imaging were more commonly utilized in United States compared with non‐United States (P < 0.0001), but there were no differences in the use of MRI/MRCP. Disease burden was highest in the West and Midwest, possibly as total pancreatectomy and islet autotransplantation (TPIAT) referral sites were located in these regions. All therapies were less commonly administered in non‐US sites (P < 0.0001).Conclusions:This is the first study to describe geographical variations in the INSPPIRE cohort, which possibly reflect variations in practice and referral patterns. The underlying reason behind the lower frequency of CP and fewer treatments in non‐United States sites need to be further explored.
The Roles of Endoscopic Ultrasound and Endoscopic Retrograde Cholangiopancreatography in the Evaluation and Treatment of Chronic Pancreatitis in Children
Authors: Liu Quin Y. , Gugig Roberto , Troendle David M. , Bitton Samuel , Patel Nishant , Vitale David S. , Abu‐El‐Haija Maisam , Husain Sohail Z. , Morinville Veronique D. 
Published: February 2020

ABSTRACTIntroduction:Pediatric chronic pancreatitis is increasingly diagnosed. Endoscopic methods [endoscopic ultrasound (EUS), endoscopic retrograde cholangiopancreatography (ERCP)] are useful tools to diagnose and manage chronic pancreatitis. Pediatric knowledge and use of these modalities is limited and warrants dissemination.Methods:Literature review of publications relating to use of ERCP and EUS for diagnosis and/or management of chronic pancreatitis with special attention to studies involving 0‐‐18 years old subjects was conducted with summaries generated. Recommendations were developed and voted upon by authors.Results:Both EUS and ERCP can be used even in small children to assist in diagnosis of chronic pancreatitis in cases where cross‐sectional imaging is not sufficient to diagnose or characterize the disease. Children under 15 kg for EUS and 10 kg for ERCP can be technically challenging. These procedures should be done optimally by appropriately trained endoscopists and adult gastroenterology providers with appropriate experience treating children. EUS and ERCP‐related risks both include perforation, bleeding and pancreatitis. EUS is the preferred diagnostic modality over ERCP because of lower complication rates overall. Both modalities can be used for management of chronic pancreatitis ‐related fluid collections. ERCP has successfully been used to manage pancreatic duct stones.Conclusion:EUS and ERCP can be safely used to diagnose chronic pancreatitis in pediatric patients and assist in management of chronic pancreatitis‐related complications. Procedure‐related risks are similar to those seen in adults, with EUS having a safer risk profile overall. The recent increase in pediatric‐trained specialists will improve access of these modalities for children.