bluuebunny/crossref_metadata_2025_split huggingface dataset:
High-resolution MRI of flexor tendon pulleys using a 16-channel hand coil: disease detection and differentiation of psoriatic and rheumatoid arthritis
Authors: Abrar Daniel B. , Schleich Christoph , Nebelung Sven , Frenken Miriam , Radke Karl Ludger , Vordenbäumen Stefan , Brinks Ralph , Schneider Matthias , Ostendorf Benedikt , McGonagle Dennis , Sewerin Philipp 
Published: February 2020

Abstract
Background: To evaluate the value of 3 Tesla (T) magnetic resonance imaging (MRI) changes of flexor tendon pulleys for the differentiation of psoriatic (PsA) and rheumatoid arthritis (RA), using a novel 16-channel high resolution hand coil. Methods: Seventeen patients with active PsA, 20 patients with active RA and 16 healthy controls (HC) underwent high-resolution 3T MRI using the dedicated 16-channel hand coil. Images were analyzed by three independent readers for the degree of inflammatory changes, thickness of flexor tendon pulleys and comparison to the outcome measures for RA clinical trials (OMERACT) PsA MRI score (PsAMRIS) and to its sub-scores. For correlation analyses Spearman rho correlation was calculated. Results: Flexor tendon pulleys were thicker in PsA than in RA patients (mean difference 0.16 mm, p<0.001) and HC (mean difference 0.2 mm, p<0.001) and showed a higher degree of associated inflammatory changes (mean difference from RA: 4.7, p= 0.048; mean difference from HC: 14.65, p<0.001). Additionally, there was a strong correlation of accessory pulley inflammation and PsAMRIS and its acute-inflammatory sub-scores, flexor tenosynovitis, synovitis and periarticular inflammation (for second digit: synovitis ρ= 0.72, flexor tenosynovitis ρ= 0.7, overall PsAMRIS ρ= 0.72, p< 0.01). Similar robust correlations were evident in digits 3-5. Weaker correlations were evident in RA (synovitis ρ= 0.49, flexor tenosynovitis ρ= 0.49, periarticular inflammation ρ= 0.4). Conclusion: The assessment of MRI changes of flexor tendon pulleys is potentially beneficial for disease detection in PsA, as well as for its distinction from RA and HC. Trial registration: 2014123117, December 2014.
Understanding implementation barriers in the national scale-up of Differentiated ART delivery in Uganda
Authors: ZAKUMUMPA HENRY , Rujumba Joseph , Kwiringira Japheth , Katureebe Cordelia , Spicer Neil 
Published: February 2020

Abstract
Background: Although Differentiated Service Delivery (DSD) for anti-retroviral therapy (ART) has been rolled-out nationally in several countries since World Health Organization (WHO)’s landmark 2016 guidelines, there is little research evaluating post-implementation outcomes. The objective of this study was to explore patients’ and HIV service managers’ perspectives on barriers to implementation of Differentiated ART service delivery in Uganda.Methods: We employed a qualitative descriptive design involving 124 participants. Between April and June 2019 we conducted 76 qualitative interviews with national-level HIV program managers (n=18), District Health Team leaders (n=24), representatives of PEPFAR implementing organizations (11), ART clinic in-charges (23) in six purposively selected Uganda districts with a high HIV burden (Kampala, Luwero, Wakiso, Mbale, Budadiri, Bulambuli). Six focus group discussions (48 participants) were held with patients enrolled in DSD models in case-study districts. Data were analyzed by thematic approach as guided by a multi-level analytical framework: Individual-level factors; Health-system factors; Community factors; and Context.Results: Our data shows that multiple barriers have been encountered in DSD implementation. Individual-level: Individualized stigma and a fear of detachment from health facilities by stable patients enrolled in community-based models were reported as bottlenecks. Socio-economic status was reported to have an influence on patient selection of DSD models. Health-system: Insufficient training of health workers in DSD delivery and supply chain barriers to multi-month ART dispensing were identified as constraints. Patients perceived current selection of DSD models to be provider-intensive and not sufficiently patient-centred. Community: Community-level stigma and insufficient funding to providers to fully operationalize community drug pick-up points were identified as limitations. Context: Frequent changes in physical addresses among urban clients were reported to impede the running of patient groups of rotating ART refill pick-ups. Conclusion: This is one of the first multi-stakeholder evaluations of national DSD implementation in Uganda since initial roll-out in 2017. Multi-level interventions are needed to accelerate further DSD implementation in Uganda from demand-side (addressing HIV-related stigma, community engagement) and supply-side dimensions (strengthening ART supply chain capacities, increasing funding for community models and further DSD program design to improve patient-centeredness).
PTH Derivative Promotes Chronic Wound Healing via Synergistic Multicellular Stimulating and Exosomal Activities
Authors: Shen Yi-Fan , Huang Jing-Huan , Wang Kai-Yang , Zheng Jin , Cai Lin , Gao Hong , Li Xiao-Lin , Li Jing-Feng 
Published: February 2020

Abstract
Background: Chronic diabetic wounds are a disturbing and rapidly growing clinical problem. Parathyroid hormone related peptide (PTHrP-2) was assumed as multifunctional factor in angiogenesis, fibrogenesis and re-epithelization. This study aims to test PTHrP-2 efficiency and mechanism in chronic wound healing. Methods: Through repair phenomenon in vivo some problems were detected, and further research on their mechanisms was made. In vivo therapeutic effects of PTHrP-2 was determined by HE, Masson, microfil and immunohistochemical staining. In vitro direct effects of PTHrP-2 was determined by proliferation, migration, Vascular Endothelial Grown Factor and collagen I secretion of cells and Akt/ Erk1/2 pathway change. In vitro indirect effects of PTHrP-2 was study via exosomes. Exosomes from PTHrP-2 untreated and treated HUVECs and HFF-1 cells were insolated and identified. Exosomes were co-cultured with original cells, HUVECs or HFF-1 cells, and epithelial cells. Proliferation and migration and pathway change were observed. PTHrP-2-HUVEC-Exos was added into in vivo wound to testify its hub role in PTHrP-2 indirect effects in wound healing. Results: In vivo, PTHrP-2 exerted multifunctional pro-angiogenesis, pro-firbogenesis and re-epithelization effects. In vitro, PTHrP-2 promoted proliferation and migration of endothelial and fibroblast cells, but had no effect on epithelial cells. Therefore, we tested PTHrP-2 indirect effects via exosomes. PTHrP-2 intensified intercellular communication between endothelial cells and fibroblasts and initiated endothelial-epithelial intercellular communication. PTHrP-2-HUVEC-Exos played hub role in PTHrP-2 indirect effects in wound healing. Conclusion: The findings of this study indicate that PTHrP-2, a multifunctional factor, can promote chronic wound healing via synergistic multicellular stimulating and exosomal activities.
Age- and gender-specific trends in respiratory outpatient visits and diagnoses at a tertiary pediatric hospital in China: a 10-year retrospective study
Authors: Shi Peng , Zhang Xiaobo , Liu Lijuan , Tang Liangfeng , Li Jing , Wang Libo , Li Albert M. , Cao Yang , Xu Hong , Huang Guoying 
Published: February 2020

Abstract
Background: Respiratory infections are one of three leading causes of childhood mortality, and worldwide increase and recent plateau in childhood asthma has been reported. However, data on trends of respiratory diseases over long period of time is limited. This study aimed to determine the trends of respiratory disease outpatient visits (ROVs) and diagnoses (RODs) in one of the largest children’s teaching hospitals in China between 2009 and 2018.

Methods: A retrospective study based on routine administrative data was designed and implemented according to the RECORD statement. Demographic details and diagnoses of the outpatients <18 years visiting the respiratory department of the hospital were extracted from the Hospital Information System. Age- and gender-specific trends were illustrated by calculating average annual growth rate (AAGR) for ROVs and comparing change of proportion for different RODs over time.

Results: There were 698054 ROVs from 285574 children (40.4% female). AAGR of ROVs was 15.2%. Children aged 4 to < 7 years had a faster increase than other age groups. Bronchitis (27.6%), pneumonia (18.5%), pneumonia affecting other systems (18.4%), asthma and status asthmaticus (10.7%), and vasomotor and allergic rhinitis (9.2%) accounted for 84.4% of all RODs. The proportion of bronchitis decreased across years, with the concomitant increasing trend in the proportion of pneumonia. Age-specific trend in diagnoses showed greater proportion of asthma in all visits for the children aged 7 to < 18 years than younger children. Gender-specific trend in diagnoses showed the proportion of asthma was greater for males but the AAGR was greater for females.

Conclusion: The persistent upward trend in ROVs was observed among children at different ages and a gender difference was also seen. In contrast to what has been reported, burden of asthma and allergies diseases continues to increase locally.
Information-Motivation-Behavioral Skills Model of Consistent Condom Use among Transgender Women in Shenyang, China
Authors: Wang Huwen , Chang Ruijie , Shen Qiuming , Tsamlag Lhakpa , Zhang Shuxian , Shi Yue , Ma Tiecheng , Wang Zixin , She Rui , Lau Joseph TF , Wang Ying , Cai Yong 
Published: February 2020

Abstract
Background: The Information-Motivation-Behavioral Skills (IMB) model has received consistent empirical support in the context of HIV prevention among various key populations, but not yet among transgender women (TGW). None effective interventions has been carried out among TGW so far to control their high prevalence of unprotected anal intercourse. The intent of the current study is to examine the application of the IMB model to clarifying the association between condom use correlates and condom use frequency among TGW in China.
Methods: Using snowball sampling, we recruited 198 self-identified TGW in Shenyang, China from April 2017 to July 2017. Participants were required to complete a questionnaire assessing their background characteristics and IMB model constructs. Structural equation modeling (SEM) was conducted to demonstrate the utility of the IMB model.
Results: The consistent condom use (CCU) rate was 47.0%. Results of SEM indicated that HIV-preventive motivation (comprising condom use attitude and subjective norms; β = 0.823, P < 0.001) and behavioral skills (including condom use skills and self-efficacy; β = 0.979, P = 0.004) were related to more frequent condom use, whereas HIV knowledge was unrelated to condom use (β = 0.052, P = 0.540).
Conclusions: The low CCU rate suggested that TGW in China were at high risk of HIV infection and transmission and a key intervention population. HIV-preventive interventions for this population should focus on enhancing motivation and strengthening behavioral skills to increase condom use frequency and reduce HIV infection.
Ankle Joint Pressure Change in Varus Malalignment of the Tibia
Authors: Zhu Yuan , Li Xingchen , Xu Xiangyang 
Published: February 2020

Abstract
Background: Varus malalignment of the tibia could alter ankle biomechanics, and might lead to degenerative changes of the ankle joint. However, previous studies failed to report the detailed changes of ankle biomechanics in varus malalignment of the tibia. The aim of this biomechanical study was to evaluate how the ankle joint pressure would change in response to the incremental increases in varus malalignment of the tibia. Methods 8 fresh-frozen human cadaver legs were tested in this study. Varus malalignment of the tibia and a total of 600N compressive force was simulated using a custom made fixture. Intra-articular sensors (TeckScan) were inserted in the ankle joint to collect the ankle joint pressure data. The testing sequence was 0°, 2°,4°,6°,8°,10°,12°,14°,16°,18°,20° of tibial varus. Results As the tibial varus progressed, the center of force (COF) shifted laterally both for the medial and lateral aspect of the ankle joint. For the medial aspect of the ankle joint, the lateral shift reached its maximum at 8º [2.76 (1.62) mm, p=0.002] of tibial varus, while for the lateral aspect of the ankle joint, the lateral shift reached its maximum at 12º [2.11 (1.19) mm, p=0.002] of tibial varus. Thereafter, the COF shifted medially as the tibial varus progressed. For the lateral aspect of the ankle joint, The Pmean increased from 2103.8 (625.1) kPa at 0º to 2295.3 (589.7) kPa at 8º of tibial varus (p=0.047) , significant difference was found between the Pmean at 0º and 8º (p=0.047) of tibial varus. Then as the tibial varus progressed, the Pmean decreased to 1748.9 (467.2) kPa at 20º of tibial varus (p=0.002) . The lateral joint pressure ratio also increased from 0.481 (0.125) at 0º to 0.548 (0.108) at 10º of tibial varus (p=0.002) , then decreased to 0.517 (0.101) at 20º of tibial varus (p=0.002) . Conclusions For mild tibial varus deformities, there was a lateral shift of COF and lateral stress concentration within the ankle joint. However, as the tibial varus progressed, the COF shifted medially and the lateral stress concentration decreased.
Explanatory histological findings for urinary protein and serum creatinine levels at renal biopsy in lupus nephritis: A cross-sectional study
Authors: Katsuyama Eri , Miyawaki Yoshia , Sada Ken-ei , Asano Yosuke , Hayashi Keigo , Yamamura Yuriko , Hiramatsu-Asano Sumie , Morishita Michiko , Ohashi Keiji , Watanabe Haruki , Katsuyama Takayuki , Narazaki Mariko , Matsumoto Yoshinori , Wada Jun 
Published: February 2020

Abstract
Background To evaluate histological active and chronic lesions associated with proteinuria and serum creatinine (SCr) level as common clinical endpoints in many clinical trials for lupus nephritis (LN). Methods One hundred and nineteen patients from 1990 to 2015 with LN class III, IV, and V, as defined by the International Society of Nephrology/Renal Pathology Society classification, were enrolled. Multiple regression analysis was performed to explore semiquantitative histological variables related to urinary protein and SCr levels. Results The mean age of enrolled patients was 45 years and 79% were female. The mean SCr level was 0.87 mg/dl and mean urinary protein was 3.00 g/gCr at the time of the renal biopsy. Class IV (71%) was the most common type, followed by class III (17%) and class V (13%). Multicollinearity was confirmed between monocellular infiltration (variance inflation factor [VIF] = 10.22) and interstitial fibrosis (VIF = 10.29) and between karyorrhexis (VIF = 4.14) and fibrinoid necrosis (VIF = 4.29). After excluding fibrinoid necrosis and monocellular infiltration because of multicollinearity, only urinary protein level was correlated with wire loop (β−coefficient [β]: 1.09 and confidence interval [CI]: 0.35 to 1.83), and SCr level was correlated with glomerular sclerosis (β: 1.08 and CI: 0.43 to 1.74) by multiple regression analysis. Conclusion As urinary protein and SCr levels could not reflect active lesions quantitatively, they might be difficult to be evaluated for response to induction remission treatments in patients with LN.
Comparative study between Fenton and Intergrowth 21 charts in a sample of Lebanese premature babies
Authors: Samarani Marie , Restom Gianna , Mardini Joelle , Fares Georges Abi , Hallit Souheil , Khalife Marie-Claude Fadous 
Published: February 2020

Abstract
Background Different charts are used to assess premature growth. The Fenton chart, based on prenatal growth, has been used in the neonates’ intensive care unit (NICU) of the Notre Dame des Secours University Hospital to assess premature newborns’ development. Intergrowth21 is a new multidisciplinary, multiethnic growth chart better adapted to premature growth. Our objective was to compare both charts Fenton and Intergrowth21 in order to implement Intergrowth in our unit. Methods We analyzed 318 files of premature babies born who were admitted to the NICU from 2010 till 2017. Anthropometric data (weight, height and head circumference) converted to percentiles was filled on both charts from birth till 1 month of age. Results The results of the linear regression, taking the weight at birth as the dependent variable, showed that the Fenton scale (R2=0.391) would predict the weight at birth better than the Intergrowth 21 scale (R2=0.257). The same applies for height and cranial perimeter at birth when taken as dependent variables. When considering the weight and height at 2 weeks, the results showed that the Intergrowth 21 scale would predict those variables better than the Fenton scale, with higher R2 values higher in favor of the Intergrowth 21 scale for both weight (0.384 vs 0.311) and height (0.650 vs 0.585). At 4 weeks, the results showed that the Fenton scale would predict weight (R2=0.655 vs 0.631) and height (R2=0.710 vs 0.643) better than the Intergrowth 21 scale. The results obtained were adjusted over the newborns’ sociodemographic and clinical factors.
Exploring contraception myths and misconceptions among young men and women in Kwale County, Kenya
Authors: Mwaisaka Jefferson , Gonsalves Lianne , Thiongo Mary , Waithaka Michael , Sidha Hellen , Agwanda Alfred , Mukiira Carol , Gichangi Peter 
Published: February 2020

Abstract
Background: Myths and misconceptions around modern contraceptives have been associated with low contraceptive uptake. Nearly all the research on the link between contraceptives’ misconceptions and low contraceptive prevalence comes mostly from women with little focus on men. This qualitative study therefore sought to explore and understand both young men’s and young women’s knowledge of modern contraception and to identify key concerns regarding modern pregnancy prevention methods.Methods: We used focus group discussions (FGD) with vignette and writing activities to explore key myths and misconceptions around the use of contraceptives. Six FGDs (three for young men and three for young women) were conducted with a total of 28 young women and 30 young men from Kwale County, Kenya. We included 10 discussants aged 18-24 per FGD, one FGD had 8 participants.Results: Both men and women participants reported basic awareness of contraceptives. A mixture of biological and social misconceptions around contraception were discussed, they included jeopardizing future fertility, prolonged menstrual bleeding, problems conceiving, birth defects, promiscuity, against religion and perceived to be un-African including denying couples their sexual freedom. Compared to female respondents in the study, young men appeared to be strong believers of the perceived socio-cultural effects of contraceptives. Results are presented under three key themes namely (i) Awareness of contraception (ii) Myths and misconceptions around contraception and (iii) Males’ contraceptive narratives. Conclusions : This study revealed a low level of contraceptive knowledge among young men and women in Kwale County, Kenya. Most respondents reported contraceptive fears and misconceptions resulting from critical gaps in Sexual and Reproductive Health knowledge. Improved sexual and reproductive health (SRH) literacy to address contraceptives’ fears through appropriate and gender specific interventions to reach out to young men and women with factual SRH information may contribute to increased uptake of SRH services including modern contraceptive methods.
The incremental prognostic value of sIL-2R and HGF in acute ischemic stroke
Authors: Zhao Haiping , Li Fangfang , Huang Yuyou , Zhang Sijia , Li Lingzhi , Yang Zhenhong , Wang Rongliang , Tao Zhen , Han Ziping , Fan Junfen , Zheng Yangmin , Ma Qingfeng , Luo Yumin 
Published: February 2020

Abstract
Background: Inflammation affect long-term neurological outcome after acute ischemic stroke (AIS). Comprehensive and insightful understanding of correlation of inflammatory mediators and stroke outcome may offer new biomarkers or therapeutic approaches for AIS.
Methods: We collected plasma from 204 AIS patients and 76 healthy controls, and ten cytokines (HGF, IL-1β, IL-2, sIL-2R, IL-5, IL-10, IL-16, MIP-3α, CD40L and MMP1) screened out by Immune Monitoring 65-Plex Human ProcartaPlex Panel were measured. Functional outcome 3 months after stroke was assessed using the modified Rankin Scale. To assess the prognostic ability of inflammatory mediators, we applied multivariate logistic regression and construction of multimarker score.
Results: HGF, IL-10, IL-1β, MIP-3α, IL-2, sIL-2R, and IL-5 were significantly upregulated in AIS patients compared to controls. After multivariable adjustment, sIL-2R (OR, 1.138; 95% CI, 1.028-1.259; P=0.012) and HGF (OR, 1.121; 95% CI, 1.030-1.218; P=0.008) remained individually associated with unfavorable outcomes at 3 months after AIS (p < 0.05). Furthermore, adding sIL-2R and HGF to the conventional model significantly improved risk reclassification for unfavorable outcomes (continuous net reclassification improvement 32.18%, p < 0.001; integrated discrimination improvement 10.21%, p < 0.001).
Conclusions: Higher plasma sIL-2R was a new independent predictor of unfavorable outcomes in AIS, and incorporation of sIL-2R and HGF into the conventional model significantly improved risk stratification for unfavorable outcomes.
Subclavian steal syndrome without Stenosis: A Case Report and Review of the Literature
Authors: Lou Zhe , Jin Youhe , Yang Jun , Ma Chunyan , Li Qiaobei , Wang Xu 
Published: February 2020

Abstract
Background："Stealing" of the subclavian artery is a phenomenon where proximal subclavian artery stenosis or occlusion causes retrograde blood flow in the ipsilateral vertebral artery. This, combined with ischemic symptoms of vertebrobasilar arteries or ipsilateral upper limb artery, is called subclavian steal syndrome. Sometimes, subclavian steal syndrome can occur in patients without subclavian artery stenosis, such as in patients with high-flow arteriovenous dialysis fistulas or subclavian artery aneurysms. Interestingly, compared with classic atherosclerotic subclavian steal syndrome, the former patient is more prone to symptoms like paroxysmal vertigo, drop attacks, diplopia, and arm claudication. Case Presentation ： In our case, we present a 35-year-old male who suffered from paroxysmal vertigo. Clinical physical examination did not reveal any substantial evidence of proximal subclavian artery stenosis. Transcranial Doppler and ultrasonography revealed an abnormal blood flow pattern in the right vertebral artery, consistent with partial subclavian steal syndrome. Ultrasonography and computed tomography angiography showed no stenosis in the right subclavian artery and three aneurysms in the proximal segment. The hypoplastic vertebral artery originated from the third aneurysm. Conclusions ： There are few reports of subclavian steal syndrome caused by subclavian aneurysms in the literature; our case is the first to report partial subclavian steal syndrome caused by multiple aneurysms. Following a literature review, combined with our analysis of this case, we suggest that subclavian artery aneurysm which induced subclavian steal syndrome is an often unnoticed cause of vertigo.