bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do Changes in Pulse Pressure Variation and Inferior Vena Cava Distensibility During Passive Leg Raising and Tidal Volume Challenge Detect Preload Responsiveness in Case of Low Tidal Volume Ventilation?
Authors: Taccheri Temistocle , Gavelli Francesco , Teboul Jean-Louis , Shi Rui , Monnet Xavier 
Published: December 2020

Abstract
BackgroundIn patients ventilated with tidal volume (Vt) <8 mL/kg, pulse pressure variation (PPV) and, likely, the distensibility of the inferior vena cava diameter (IVCV) are unable to detect preload responsiveness. In this condition, passive leg raising (PLR) could be used but it requires a measurement of cardiac output. The tidal volume (Vt) challenge (PPV changes induced by a 1-min increase in Vt from 6 to 8 mL/kg) is another alternative, but it requires an arterial line. We tested whether, in case of Vt=6mL/kg, the effects of PLR could be assessed through changes in PPV or in IVCV rather than changes in cardiac output, and whether the effects of the Vt challenge could be assessed by changes in IVCV rather than changes in PPV.MethodsIn 30 critically ill patients without spontaneous breathing and cardiac arrhythmias, ventilated with Vt=6 mL/kg, we measured cardiac index (CI) (PiCCO2), IVCV and PPV before/during a PLR test and before/during a Vt challenge. A PLR-induced increase in CI ≥10% defined preload responsiveness.ResultsAt baseline, IVCV was not different between preload responders (n=15) and non-responders. Compared to non-responders, PPV and IVCV decreased more during PLR (by -38±16% and -26±28%, respectively) and increased more during the Vt challenge (by 64±42% and 91±72%, respectively) in responders. ∆PPVPLR, expressed either as absolute or percent relative changes, detected preload responsiveness (area under the receiver operating curve, AUROC: 0.98±0.02 for both). ∆IVCVPLR detected preload responsiveness only when expressed in absolute changes (AUROC: 0.76±0.10), not in relative changes. ∆PPVVt, expressed as absolute or percent relative changes, detected preload responsiveness (AUROC: 0.98±0.02 and 0.94±0.04, respectively). This was also the case for ∆IVCVVt but, the diagnostic threshold (1 point or 4%) was below the least significant change of IVCV (9[3-18]%).ConclusionsDuring mechanical ventilation with Vt=6 mL/kg, the effects of PLR can be assessed by changes in PPV. If IVCV is used, it should be expressed in percent and not in absolute changes. The effects of the Vt challenge can be assessed on PPV, but not on IVCV, since the diagnostic threshold is too small with regards to the reproducibility of this variable.Trial registrationIDRCB: 2016-A00893-48
A qualitative study of factors that protect against pregnancy among sexually-active teens in the South African Birth to Twenty Plus cohort
Authors: Bosire Edna N , Chiseri Katharine , Comeau Dawn L , Richter Linda , Stein Aryeh D , Norris Shane A 
Published: December 2020

Abstract
Background: Risky sexual behaviors contribute to increased risk of adolescent pregnancy and HIV infections. This qualitative study sought to understand factors that might buffer this risk amongst sexually-active adolescents in Soweto, South Africa.Methods: We used purposive sampling to recruit women at age 24 years from Soweto, South Africa, who self-reported having sexual debut by age 15 years. Twenty women were recruited into 2 equal groups: (i) those who did not become pregnant before 18 years (n=10) and (ii) those who became pregnant before 18 years (n=10). In-depth qualitative interviews were conducted with the two groups of women to understand their family backgrounds, the conversations about sex to which they are exposed, sexual behaviors and steps they took, or didn’t take, during adolescence to prevent early pregnancies. Interviews were transcribed verbatim and thematically analyzed with the aid of MAXQDA software.Results: Both groups of adolescents reported predisposing risks to early pregnancy including influence from peers and older friends to engage in early sex; unstable family relationships and limited conversations about sex. Key factors that differentiated the two groups were family structure and support, as well as, the adolescent’s ability to navigate choices and make decisions on consistent condom use, access to information and desire to complete schooling. Other supportive systems identified by those who did not become pregnant included life-orientation courses provided at school, access to health services, and positive peer influences. Conclusion: The family is a key institution in supporting adolescents’ decisions regarding their behaviors and choices, as are peers and exposures to formal or informal information they receive about sex. Policy makers should work closely with other social support systems such as schools, healthcare providers and peers to ensure that adolescents have access to relevant information, including sex education, and contraceptives.
Community Voice in Cross-Sector Alignment: Concepts and Strategies from a Scoping Review of the Health Collaboration Literature
Authors: Petiwala Aliza , Lanford Daniel , Landers Glenn , Minyard Karen 
Published: December 2020

Abstract
BackgroundHealth care access is an important driver of population health, and factors beyond health care also drive health outcomes. Recognizing the importance of the social determinants of health (SDOH), different actors in the health care, public health, and social service sectors are increasingly collaborating to improve health outcomes in communities. To support such collaboration, the Robert Wood Johnson Foundation recently developed the cross-sector alignment theory of change. According to the cross-sector alignment theory of change, community voice is critical for helping collaboratives address community health needs. Yet research on health collaboratives offers little guidance on how community voice should be understood, or which community voice strategies are most effective.MethodsThis study addresses a gap in the literature with a systematic scoping review of research on health-oriented collaboration and community voice. By scanning key academic journals, searching three academic databases, and obtaining documents from across our professional networks, we identified 36 documents that address community voice in health collaboratives. The review reveals several concepts of community voice and a range of community voice strategies.ResultsWe find that community voice strategies fall into two broad approaches: active and passive. These vary in the level of engagement required from the community and in the level of power shared between communities and collaborators, and this in turn has implications for community health outcomes. We also find that while most strategies are discussed in the context of short-term collaboration, many also lend themselves to adoption in the context of sustainable collaboration and, ultimately, cross-sector alignment.ConclusionThis review provides a characterization and conceptualization of community voice in health-oriented collaborations that provides a new theoretical basis for future research. Passive and active community voice strategies can be studied in more detail for their expected impact on health outcomes and disparities. The increased attention to active community voice can help practitioners achieve improved health outcomes and researchers understand the pathways to health improvement through collaboration.
Discrimination Due to Sexual Orientation and Associated Factors Among Men Who have Sex with Men in 12 Brazilian Cities: A Respondent-Driven Sampling Survey
Authors: Magno Laio , Dourado Inês , Leal Andrea Fachel , Knauth Daniela , Guimarães Mark Drew Crosland , Bermúdez Ximena Pamela Díaz , Rocha Gustavo Machado , Veras Maria Amélia , Kendall Carl , de Brito Ana Maria , Kerr Lígia 
Published: December 2020

Abstract
BackgroundDiscrimination due to sexual orientation (DDSO) has an important association with health outcomes among men who have sex with men (MSM). This study aimed to analyse factors associated with DDSO among MSM in 12 Brazilian cities.MethodsA cross-sectional study with 4,176 MSM participants recruited in 2016 through respondent-driven sampling in 12 Brazilian cities. In this analysis, ordinal logistic regression was used to assess associations with previously identified levels of DDSO, which were based on latent class analysis (LCA) on 13 variables from the discrimination section of the questionnaire. Weighted odds ratios and their respective 95% confidence interval were estimated using Gile estimator. ResultsMost participants were young, single, had a religious affiliation, a post-primary education, were black or mixed race and had a high and average socio-economic status. More than half reported DDSO in the previous 12 months (65%). DDSO was then classified into four latent classes (very high, high, average or low). We observed an independent association among the four latent classes of DDSO and the following variables: age< 25 years old, white skin color, experience of sexual or physical violence, revealing to a father his sexual orientation as MSM, experienced suicidal ideation in the previous two weeks and had taken illicit drugs in the last six months. ConclusionWe observed that sociodemographic characteristics, previous violence experiences, family knowledge about sexual orientation and mental health issues were associated with DDSO. Monitoring DDSO throws into sharp relief our broad social, political, and moral failings. These results should be used for the purposes of surveillance and protection for the human rights.
Association of the CFTR Gene With Asthma and Airway Mucus Hypersecretion
Authors: Lessmann Astrid Crespo , Bernal Sara , Río Elisabeth del , Rojas Ester , Martínez-Rivera Carlos , Malanda Nuria Marina , Pallarés-Sanmartín Abel , Pascual Silvia , García Juan Luis , Padilla Alicia , Curto Elena , Cisneros Carolina , Serrano Jose , Baiget Montserrat , Plaza Vicente 
Published: December 2020

Abstract
IntroductionAirway mucus hypersecretion is an undercharacterized phenotype of asthma. Objectives(1) To determine the presence of genetic variants of the CFTR gene in patients with asthma with and without airway mucus hypersecretion. (2) To identify the characteristics of the asthma phenotype with airway mucus hypersecretion.MethodComparative cross-sectional multicentre study including 39 hypersecretors and 61 non-hypersecretors asthma patients. Asthmatic hypersecretion was defined as the presence of cough productive of sputum on most days for at least three months in two successive years. Spirometry, fractional exhaled nitric oxide, induced sputum cell count, blood test and questionnaires were performed. Blood DNA samples were sequenced using a MiSeq sequencer and the Illumina platform was used for the CFTR gene analysis.ResultsGenetic differences were observed in the c.1680-870T>A genetic variant of the CFTR gene, significantly more evident in hypersecretors than in non-hypersecretors: 78.94% vs. 59.32% in the majority allele and 21.05% vs. 40.67% in the minority allele (p=0.036). Asthma hypersecretors were older (57.4 years vs. 49.4 years; p=0.004) and had greater asthma severity (58.9% vs. 23.7%; p=0.005), greater airway obstruction (FEV1/FVC% 64.3 vs. 69.5; p=0.041), poorer asthma control (60% vs. 29%; p=0.021), and lower IgE levels (126.4 IU/mL vs. 407.6 IU/mL; p=0.003).ConclusionPatients with asthma and with mucus hypersecretion may have a different disease mechanism produced by an intronic genetic variant in the CFTR gene (NM_000492.3:c.1680-870T>A). They present a more severe disease, poorer asthma control and a non-allergic inflammatory phenotype.
Convergence of Scaffold Guided Bone Regeneration and RIA Bone Grafting for the Treatment of a Critical-Sized Bone Defect of the Femoral Shaft
Authors: Kobbe Philipp , Laubach Markus , Hutmacher Dietmar W , Alabdulrahman Hatem , Sellei Richard M , Hildebrand Frank 
Published: December 2020

Abstract
BackgroundCritical-sized bone defects, mainly from trauma, infection or tumor resection are a challenging condition, often resulting in prolonged, complicated course of treatment. Autografts are considered as the gold standard to replace lost bone. However, limited amount of bone graft volume and donor site morbidity have established the need for the development of alternative methods such as scaffold-based Tissue Engineering (TE). The emerging market of additive manufacturing (3D-printing) has markedly influenced the manufacturing of scaffolds out of a variety of biodegradable materials. Particularly medical-grade polycaprolactone and tricalcium phosphate (mPCL-TCP) scaffolds show appropriate biocompatibility and osteoconduction with good biomechanical strength in large preclinical animal models. This case report aims to show first evidence of the feasibility, safety, and efficacy of mPCL-TCP scaffolds applied in a patient with a long bone segmental defect.Case presentationThe presented case comprises a 29-year-old patient who has suffered a left-sided II° open femoral shaft fracture. After initial external fixation and subsequent conversion to reamed antegrade femoral nailing the patient presented with an infection in the area of the formerly open fracture. Multiple revision surgeries followed to eradicate microbial colonization and attempt to achieve bone healing. However, 18 months after the index event, still insufficient diaphyseal bone formation was observed with circumferential bony defect measuring 6 cm at the medial and 11 cm at the lateral aspect of the femur. Therefore, the patient received a patient-specific mPCL-TCP scaffold, fitting the exact anatomical defect and the inserted nail, combined with autologous bone graft (ABG) harvested with the Reamer Irrigator Aspirator system (RIA – Synthes®) as well as bone morphogenetic protein-2. Radiographic follow-up 12 months after implantation of the TE scaffold shows advanced bony fusion and bone formation inside and outside the fully interconnected scaffold architecture.ConclusionThis case report shows a promising translation of scaffold-based TE from bench to bedside. Preliminary evidence indicates that the use of medical-grade scaffolds is safe and has the potential to improve bone healing. Further, its synergistic effects when combined with ABG show the potential of mPCL-TCP scaffolds to support new bone formation in segmental long bone defects.
Analysis of Structure Indicators Influencing 3-h and 6-h Compliance with the Surviving Sepsis Campaign Guidelines in China: A Systematic Review
Authors: Wang Lu , Ma Xudong , He Huaiwu , Su Longxiang , Guo Yanhong , Shan Guangliang , Zhou Xiang , Liu Dawei , Long Yun 
Published: December 2020

Abstract
Background: Compliance with the surviving sepsis campaign (SSC) guidelines (Cssc) is a key factor affecting the effects of sepsis treatment. We designed this study to investigate the relationships of the structure indicators of ICU on 3-h and 6-h Cssc in China. A total of 1854 hospitals were enrolled in a survey, led by the China National Critical Care Quality Control Center (China-NCCQC) from January 1, 2018, through December 31, 2018.Methods: We investigated the 1854 hospitals’ 3-h and 6-h Cssc, including compliance with each specific measure of the 3-h and 6-h SSC bundles. We also investigated the actual level of the structure indicators of ICU, released by China-NCCQC in 2015.The outcomes were in adherence with the SSC guidelines (2016). Monitoring indicators included 3-h and 6-h Cssc.Results: In the subgroup, the rate of broad-spectrum antibiotic therapy was the highest, and the rate of CVP and ScvO2 measurement was the lowest. Structure indicators related to 3-h and 6-h Cssc include the predicted mortality rate and the standardized mortality ratio (SMR). The relationships between 3-h and 6-h Cssc and the proportion of ICU in total inpatient bed occupancy, the proportion of acute physiology and chronic health evaluation (APACHE) II score ≥15 in all ICU patients were uncertain. There was no relationship of 3-h and 6-h Cssc with the proportion of ICU patients among total inpatients.Conclusions: Structure indicators influencing 3-h and 6-h Cssc in China are the predicted mortality rate and the standardized mortality rate.
Implementation of the Connect for Health Pediatric Weight Management Program: Study Protocol and Baseline Characteristics
Authors: Simione Meg , Farrar-Muir Haley , Mini Fernanda Neri , Perkins Meghan E , Luo Man , Frost Holly , Orav E. John , Metlay Joshua , Zai Adrian H , Kistin Caroline J , Sease Kerry , Hambidge Simon J , Taveras Elsie M 
Published: December 2020

Abstract
Background: Promising approaches for reduction of childhood obesity include interventions such as Connect for Health, a scalable, primary care-based intervention to improve family-centered outcomes for children ages 2-12 years. Substantial gaps remain in the adoption of proven-effective interventions particularly in settings that care for low-income children. Methods: We used the Consolidated Framework for Implementation Research to examine contextual determinants of implementation of Connect for Health in four organizations that deliver primary care to low-income children in Boston, MA, Denver, CO, and Greenville, SC. The Connect for Health program includes (1) electronic health record (EHR)-based clinical decision support tools to guide clinicians; (2) family educational materials; and (3) text messages for parents to support behavior change. We used the RE-AIM framework to guide our mixed-methods evaluation. Using a quasi-experimental design, we will examine the effectiveness of stakeholder-informed strategies in supporting program adoption and child outcomes. At baseline, we abstracted EHR data from the organizations to describe characteristics of children ages 2-12 years with a BMI ≥ 85th percentile.Results: During the 15-month period prior to implementation, 26,161 children with a BMI ≥ 85th percentile ages 2-12 years were seen for a primary care visit. Across the organizations, 79% of children with a BMI ≥ 85th percentile had public insurance, 49% were Hispanic, and 18% were Black. Approximately 37% of children had a BMI ≥ 95th percentile and 15% had a BMI in the severe obesity category. Childhood obesity ICD-10 diagnostic codes were used more for children with obesity (44%) and severe obesity (60%) than children with overweight (17%); nutrition (7%) and physical activity (6%) counseling codes were seldom used. Referrals for weight management programs were less than 17% and less than 16% for nutrition services. Laboratory evaluations were ordered more often for children with obesity (39%) and severe obesity (64%) than children with overweight (29%)Discussion: A majority of children with overweight and obesity lacked recommended diagnosis codes, referrals, and laboratory evaluations for assessment and management of obesity and related co-morbidities. These findings suggest the need to augment current approaches to increase uptake of proven-effective weight management programs. Trial Registration: Clinicaltrials.gov, NCT04042493, Registered on August 2, 2019; https://clinicaltrials.gov/ct2/show/NCT04042493
GJA1 rs2071165 A&gt;G Variant Increased Gastric Cancer Risk in Females of Northwest China: A Case-control Study
Authors: yuan lijuan , Wei Gang , Yang Ping , Lu Jianguo , Peng Shujia , Yang Zhengyu , Yang Lin , He Xianli , Bao Guoqiang 
Published: December 2020

Abstract
Background: Gastric cancer (GC) is one of the most common malignancies and its incidence rates vary widely between men and women. Previous studies have suggested that Cx43 and SCAMP1 are key functional proteins in tumors. Herein, the association between GJA1 and SCAMP1 polymorphisms and GC susceptibility and prognosis was evaluated.Methods: A total of three SNPs among 681 GC patients and 756 controls were tested using the Agena Mass ARRAY RS1000 system including GJA1 rs2071165, SCAMP1 rs4530741, and rs6874309. The strength of the association with cancer risk was assessed by the odds ratios and 95% confidence intervals generated from the logistic regression model. Kaplan-Meier Curve, long-rank tests, and a multivariate Cox proportional hazard model were used for prognosis analysis. The expression of GJA1 was assessed by immunohistochemistry.Results: The GJA1 rs2071165 AA/AG genotype significantly increased the risk of GC in the female Chinese population (odds ratio [OR] =1.55, 95% confidence interval, 95%CI] = 1.03–2.32, p = 0.034). Furthermore, the risk effect of rs2071165 was more evident in the subgroups of female patients with GC, stratified by age, clinical stage, tumor size, and recurrence/metastasis. However, no obvious differences in Cx43 expression in GC tissues were observed between males and females. Furthermore, no significant association between rs4530741 and rs6874309 polymorphisms in SCAMP1 and GC risk or prognosis was observed. Conclusion: In conclusion, this study suggests that GJA1 rs2071165 polymorphisms are associated with increased GC risk in females for the first time, which showed a potential new clinical marker for assessing GC risk in females.
Downregulation of GIRK2 Mediated by PPARγ Inhibition in DRG Contributes to the Neuropathic Pain Induced by Spare Nerve Injury
Authors: Mai Jing-Wen , Ji Yan-Qin , Luo Dexing 
Published: December 2020

Abstract
Neuropathic pain, as the most common chronic and intractable neurological disorder, seriously endangers the health and even life of patients. Due to the unclear mechanism, there is no effective treatment for neuropathic pain at present. Here, we used spared nerve injury (SNI) rat model to investigate the underlying mechanism involved in neuropathic pain. We found that SNI significantly decreased the expression of G protein-coupled inwardly rectifying potassium channel subunit 2 (GIRK2) and peroxisome proliferation-activated receptor gamma (PPARγ) in dorsal root ganglion (DRG). Activation of GIRK2 by intrathecal injection of activators-ML-297 or overexpression of GIRK2 by intrathecal injection of adenovirus associated virus (AAVs)-AAV-GIRK2-EGFP remarkably attenuated the mechanical allodynia induced by SNI in rats. Similarly, activation or overexpression of PPARγ also relieved the SNI-induced mechanical allodynia. We further found that the expression of PPARγ was co-localized with GIRK2-positive neurons, and overexpression of PPARγ rescued the down-regulation of GIRK2 induced by SNI. The results of chromatin immunoprecipitation (ChIP) assays further showed that PPARγ was bound to the potential binding site in the promoter region of GIRK2, and overexpression of PPARγ recovered the binding in GIRK2 promoter region in DRG, which was decreased by SNI. Altogether, our results suggested that the reduction of PPARγ induced downregulation of GIRK2 in DRG, whichwas involved in SNI-induced mechanical allodynia.