bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patients’ and HIV Service Managers’ Perceptions of The Impact of Loss of PEPFAR Support on HIV Services in Transitioned Health Facilities in Uganda: A Qualitative Study
Authors: Zakumumpa Henry , Paina Ligia , Wilhelm Jess , Ssengooba Freddie , Ssegujja Eric , Mukuru Moses , Bennett Sara Charlotte 
Published: September 2020

Abstract
Background: Although donor transitions from HIV programs are more frequent, little research exists seeking to understand the perceptions of patients and providers on this process. Between 2015 and 2016, PEPFAR implemented the ´geographic prioritization´ (GP) policy in Uganda whereby it withdrew direct support for HIV services from 734 health facilities and 10 districts with low HIV burden and intensified support to select facilities in high-burden districts. Our analysis intends to explore patient and provider perspectives on the impact of loss of PEPFAR support on HIV services in transitioned health facilities in Uganda.Methods: In this paper we report qualitative findings from a larger mixed-methods evaluation. Six facilities were purposefully selected as case studies seeking to ensure diversity in facility ownership, size, and geographic location. Five out of the six selected facilities had experienced transition. A total of 62 in-depth interviews were conducted in June 2017 (round 1) and November 2017 (round 2) with facility in-charges (n=13), ART clinic in-charges (n=12), representatives of PEPFAR implementing organizations (n=14), district health managers (n=23) and 12 patient focus group discussions (n=72) to elicit perceived effects of transition on HIV service delivery. Data were analyzed using thematic analysis. Results: While core HIV services, such as testing and treatment, offered by case-study facilities prior to transition were sustained, patients and providers reported changes in the range of HIV services offered and a decline in the quality of HIV services offered post-transition. Specifically, in some facilities we found that specialized pediatric HIV services ceased, free HIV testing services stopped, nutrition support to HIV clients ended and the ‘mentor mother’ ART adherence support mechanism was discontinued. Patients at three ART-providing facilities reported that HIV service provision had become less patient-centred compared to the pre-transition period. Patients at some facilities perceived waiting times at clinics to have become longer, stock-outs of anti-retroviral medicines to have been more frequent and out-of-pocket expenditure to have increased post-transition. Conclusions: Overall, participants perceived transition to have had important impacts on HIV service delivery in transitioned health facilities. Replacing the HIV programming gap left by PEPFAR in transition districts with Uganda government services is critical to the attainment of 90-90-90 targets in Uganda.
Prognostic Factors for Improvement in Pain and Disability after Multidisciplinary Rehabilitation in Patients with Chronic Neck Pain
Authors: Weigl Martin , Letzel Josefine , Angst Felix 
Published: September 2020

Abstract
Background: Recent clinical studies support the effectiveness of chronic neck pain specific multidisciplinary biopsychosocial rehabilitation programmes, but prognostic factors for improvement in pain and disability are unknown. The aim of this study was to identify predictors of improvement in patients with chronic neck pain after participation in a three-week multidisciplinary biopsychosocial rehabilitation programme. Methods: In this observational prospective cohort study patients were assessed at the beginning and the end of a multidisciplinary biopsychosocial rehabilitation programme. Inclusion for participation in the rehabilitation programme depended upon an interdisciplinary pain assessment. Consecutive patients who fulfilled the inclusion criteria were invited to participate in the study. A total of 112 patients participated. The primary outcomes, pain and disability, were measured by the Northern American Spine Society questionnaire (NASS), quantified by effect sizes (ES), and modelled with various co-factors. Secondary outcomes were mental health measured by the Short-Form 36 and total cervical active range of motion measured by a reliable, validated cervical range of motion instrument.Results: Patients’ mean age was 59.7 years (standard deviation=10.8); 70.5% were female. Patients improved significantly (p<0.001) in pain+disability (ES=0.56), mental health (ES=0.45) and cervical range of motion (ES=0.39). Prognostic factors for improvement in pain+disability were worse baseline scores (partial, adjusted correlation r=0.41, p<0.001), higher age (r=0.22, p=0.024), higher improvement in cervical range of motion (r=0.21, p=0.033) and higher improvement in mental health scale (r=0.20; p=0.047). Conclusions: Better outcomes for patients with improvement in neck range of motion, improvement of mental health, and higher age support the use of multidisciplinary biopsychosocial rehabilitation that combines physical and psychological treatment components. Furthermore, the results suggest that older patients may improve more compared to younger patients.
Comparison of Percutaneous Mesh-Container-Plasty and Pedicle Screw Fixation Plus Vertebroplasty for Thoracolumbar Osteoporotic Vertebral Burst Fractures: A Retrospective Study
Authors: Tang Chengxuan , Tang Xiaojun , Li Yimin , Zhong Xiqiang , Zhang Weihao , He Shaoqi 
Published: September 2020

Abstract
Background: Percutaneous mesh-container-plasty (PMCP) and pedicle screw fixation plus vertebroplasty (PSFV) were developed with advantages of bone cement leakage, height restoration and kyphotic angle reduction in osteoporotic vertebral compression fractures (OVBF). The purpose of the current study was to compare the effects and safety between PMCP and PSFV for treatment of thoracolumbar OVBF. Methods: A retrospective study of 227 consecutive patients with thoracolumbar OVBF without neurologic deficit who underwent PMCP (n=109) or PSFV (n=118) was conducted. The epidemiological data, surgical outcomes, clinical and radiological features were compared between the 2 groups. Clinical evaluation of VAS and ODI, and radiological evaluation of height restoration, deformity correction, cement leakages and canal compromise were calculated on preoperative, postoperative and 2 years postoperative.Results: Cost(4.82±0.21 vs. 5.50±0.29, P<0.05), blood loss(7.36±3.67 vs. 22.52±4.79, P<0.05), operation time(34.35±8.72 vs. 92.70±17.24, P<0.05) and hospital day(4.42±1.62 vs. 5.46±2.31, P<0.05) were significantly lower in the PMCP group than in the PSFV group. VAS [2(1,3) vs. 3(2.75,4), P<0.05] and ODI (21.01±7.90 vs. 33.81±8.81, P<0.05) scores were significantly lower in the PMCP group than in the PSFV group postoperative. However, no statistical difference was found in VAS and ODI between group PMCP and PSFV 2 years postoperative. Anterior(85.63±8.22% vs. 74.86±12.60%; 83.49±8.95% vs. 68.77±11.32%; P<0.05) and middle vertebral body height ratio(84.68±7.69% vs. 71.05±12.68%; 82.47±8.34% vs. 74.96±12.90%; P<0.05) were significantly higher in the PSFV group than in the PMCP group postoperative. Cobb angle(7.95±4.42 vs. 11.99±5.69, 8.59±4.46 vs. 12.95±5.74; P<0.05) and canal compromise(19.85±6.18 vs. 10.18±6.99, 10.03±7.20 vs. 19.90±5.98; P<0.05) were significantly lower in group PSFV than in the PMCP group postoperative. No statistical difference was found in cement leakage between group PMCP and PSFV. Conclusion: Despite of relative worse radiological results, PMCP is a safe, minimally invasive, and cost-effective surgical method and can obtain better satisfactory clinical results compared to PSFV for OVBF.
Work-Related and Personal Factors in Shoulder Disorders Among Electronics Workers
Authors: Chu Po-Ching , Wang Tyng-Guey , Guo Yue Leon 
Published: September 2020

Abstract
Background The electronics industry is one of the largest global industries, and significant numbers of workers are engaged in this industry. Evidence suggests two associations: between ergonomic risks and shoulder disorders, and between psychological stress and psychological problems among workers in this industry. There have been very few investigations on ergonomic risks, psychological stress, and gender effect for shoulder disorders in this industry. This study aimed to explore personal and work-related factors associated with shoulder disorders, and to investigate the combined effect of similar ergonomic risk factors. Methods In this cross-sectional study, 931 workers aged 20 to 58 from an electronics factory were recruited. Nordic musculoskeletal questionnaire was used to assess shoulder symptoms. The socio-demographic factors and work-related factors, including psychological stress, were assessed. 100 random sample workers with shoulder symptoms underwent a standardized clinical test for the evaluation of subacromial impingement syndrome. The ergonomic risks were assessed by the risk filter of “Upper limb disorders in the workplace”, including repetition, posture, force, vibration, and duration of exposure. Results The prevalence of shoulder symptoms was 30.5%, and 19% of those with shoulder symptoms had subacromial impingement syndrome. In multivariable analyses, older age (adjusted odds ratio (aOR) = 1.37, 95% CI 1.01-1.86), repetition (aOR = 1.73, 95% CI 1.15-2.60) and posture (aOR = 1.85, 95% CI 1.10-3.11) were associated with shoulder symptoms. About the gender effect, older age (aOR = 1.46, 95% CI 1.01-2.11), repetition (aOR = 1.64, 95% CI 1.00-2.68), posture (aOR = 1.89, 95% CI 1.01-3.52), and force (aOR = 1.68, 95% CI 0.99-2.85) were associated with shoulder symptoms in men, while repetition (aOR = 2.73, 95% CI 1.52-4.93) and posture (aOR = 2.12, 95% CI 0.99-4.57) were associated with the symptoms in women. Conclusions This study implies that repetition and posture were important risk factors for shoulder disorders in the electronics industry. The risk showed gender differences, and force was more important for shoulder disorders in men. Such information is useful to help occupational health practitioners and policy makers conduct preventive programs on shoulder disorders in this working population. Future longitudinal studies on work-related shoulder disorders are warranted.
Adaptive Response of HK-2 Cells to High Levels of COM Crystals Highlights CaSR as an Enhancer of Crystal Adhesion
Authors: Chen Siyu , Bao Junsheng , Lu Jianzhong , Ning Zhongyun , Yue Zhongjin , Li Xiaoran 
Published: September 2020

Abstract
Background: Calcium oxalate monohydrate (COM) is an aetiologic factor for urolithiasis. However, how Human Kidney-2 (HK-2) cells respond to a high COM has not yet been completely elucidated.Materials and methods: A gel-based proteomics approach was applied to investigate COM-induced cellular proteomic changes. The COM-induced upregulation of calcium-sensing receptor (CaSR) in HK-2 cells was studied. Surface phospholipids (PS), which play a role in urolithiasis formation by mediating adhesion of HK-2 cells, were labelled in the inner or outer leaflet of the plasma membrane of HK-2 cells with fluorescent nitrobenzoxadiazole (NBD) to form NBD-PS to detect transmembrane movements of PS. After labelling, HK-2 cells were exposed to COM in the presence of the CaSR-specific agonist gadolinium chloride (GdCl3) or the CaSR-specific antagonist NPS2390. Inward and outward transmembrane movements of PS were tracked with a fluorescence quenching assay. Surface-expressed PS was detected by an annexin V binding assay. Changes in aminophospholipid translocase (APLT), oxidative stress (OS), levels of apoptosis-related proteins in HK-2 cells and crystal adhesion were also assessed.Results: COM increased CaSR and surface-expressed PS levels, decreased APLT activity, impaired inward transport of PS, and enhanced outward transport of PS. However, pretreatment with GdCl3 further effectively inhibited the inward movement of PS and APLT activity and increased surface-expressed PS levels compared with COM treatment alone. In contrast, NPS2390 promoted the inward movement of PS and APLT activity and decreased surface-expressed PS levels compared with COM treatment alone. COM increased OS, apoptosis of HK-2 cells and crystal adhesion onto cells, and this increase was further enhanced by GdCl3 pretreatment but attenuated by NPS2390 treatment.Conclusions: These results strongly suggest that COM-induced CaSR generation may affect crystal adhesion by regulating PS externalization, apoptosis and OS in HK-2 cells.
The Hydricity and Reactivity Relationship in [ FeFe ]-hydrogenases
Authors: Artz Jacob , Mulder David , Ratzloff Michael , Peters John , King Paul 
Published: September 2020

Abstract
Reactivity of transition metal catalysts is controlled by covalent and non-covalent interactions that tune thermodynamic properties including hydricity. Hydricity is critical to catalytic activity and for modulating the reduction or oxidation of chemical compounds. Likewise, enzymes can employ transition metal cofactors and use metal-hydride intermediates tuned by protein frameworks to selectively control reactivity. One example, the [FeFe]-hydrogenases, catalyze reversible H2 activation with H2 oxidation to H+ reduction ratios spanning ~107 in rate, offering a model to determine the extent that hydricity controls reactivity. To address this question, the hydricity of the catalytic H cluster of two [FeFe]-hydrogenases, CpI and CpII, were compared. We show that for CpI, the higher rates of H+ reduction correspond to a more hydridic H cluster, whereas CpII, which strongly favors H2 oxidation, has a less hydridic H cluster. The results demonstrate that enzymes manipulate metal cofactor hydricity to enable an extraordinary range of chemical reactivity.
A Method for Extracting Travel Patterns Using Data Polishing
Authors: Hosoe Mio , Kuwano Masashi , Moriyama Taku 
Published: September 2020

Abstract
With the development of ICT (Information and Communication Technology), interest in using the large amount of accumulated data for traffic policy planning has been increasing. In recent years, data polishing has been proposed as a new methodology for big data analysis. Data polishing is one of the graphical clustering methods. This method can be used to extract patterns that are similar or related to each other by clarifying the cluster structures in the data. The purpose of this study is to reveal travel patterns of railway passengers by applying data polishing to smart card data collected in Kagawa Prefecture, Japan. This study uses 9,008,709 data points collected during the 15 months from December 1st, 2013 to February 28th, 2015. This data set includes such information as trip histories and types of passengers. The study uses the data polishing method to cluster 4,667,520 combinations of information about individual rides: day of the week, time of day, passenger type, origin station, and destination station. As a result, 127 characteristic travel patterns were specified from those combinations.
(Not-so) Unexpected Tumor Response to Palliative Pelvic Radiotherapy in Mismatch Repair-Deficient Advanced Prostate Cancer
Authors: Aluisio Giovanni , Mazzeo Ercole , Lohr Frank , Fiocchi Federica , Bettelli Stefania , Baldessari Cinzia , Paterlini Maurizio , Bruni Alessio 
Published: September 2020

Abstract
Mismatch-repair-deficiency resulting in microsatellite instability (MSI) may confer increased radiosensitivity in locally advanced/metastatic tumors and thus radiotherapy (RT) potentially might have a changing role in treating this subset of patients, alone or in combination with checkpoint inhibitors. We report a 76year-old patient presenting with locally advanced undifferentiated prostate cancer (LAPC), infiltrating bladder and rectum. Molecular analysis revealed high-MSI with an altered expression of MSH2 and MSH6 at immunohistochemistry. Two months after 6 chemotherapy cycles with Docetaxel associated to an LHRH analogue, a CT scan showed stable disease. After palliative RT (30Gy/10 fractions) directed to the tumor mass with a 3D-conformal setup, a follow-up CT scan at 8 weeks revealed an impressive response, that remained stable at CT after 9 months, with sustained biochemical response. To our knowledge, this is the first case of such a sustained response to low dose RT alone in H-MSI LAPC.Routine evaluation of MSI in patients with locally problematic advanced tumors might change treatment strategy and treatment aim in this setting, from a purely palliative approach to a quasi-curative paradigm.
A Nomogram Based on CENPP Expression for Survival Prediction in Breast Cancer
Authors: Chen Heyan , Pu Shengyu , Yu Shibo , Liao Xiaoqin , He Jianjun , Zhang Huimin 
Published: September 2020

Abstract
Introduction: In recent years, it has been found that the expression of 17 centromere proteins (CENPs) is closely related to malignant tumors. This study intends to investigate the prognostic value of CENPs in breast cancer (BC). Methods: A total of 800 BC patients were included from the TCGA database. The Cox proportional regression models was used to develop a CENPs-related prognostic signature. Furthermore, the mRNA expression and overall survival (OS) of CENPP (centromere protein P) in BC patients with different clinicopathological featureswas analyzed via GEPIA, bcGenExMiner v4.4 and Kaplan-Meier plotter. Finally, the nomogram was established based on the independent predictors recognized by multivariate Cox regression analysis and further validated by receiver-operating characteristic (ROC) curves and calibration plots internally and externally. Results: The result shown that age, Her2 status, pathologic_T stage, pathologic_M stage and CENPP expression with independent prognostic values for BC. CENPP was overexpressed in BC tissues and CENPP high expression was associated with better OS. We then established a nomogram based on those independent predictors, and the calibration curve demonstrated good fitness of the nomogram for OS prediction. In the training set, the AUC of 3−year and 5−year survival were 0.757 and 0.797, respectively. In the validation set, the AUC of 3−year and 5−year survival were 0.727 and 0.71. Conclusion: Our study showed that CENPP is a novel prognostic factor for patients with BC, and the established nomogram can provide valuable information on prognostic prediction for patients with BC.
The Impact of Radiotherapy Parameters on Lymphopenia and Overall Survival in Patients With Esophageal Cancer
Authors: Liu Ming , Li Xiaoyang , Cheng Huaidong , Wang Yansu , Tian Ye 
Published: September 2020

Abstract
PurposeWe sought to perform survival analysis of patients with thoracic esophageal squamous cell carcinoma (ESCC) receiving definitive radiotherapy and identify prognostic factors among hematological and dosimetric factors.MethodsCases of thoracic ESCC treated with chemoradiation between 2014 and 2017 were identified. The impact of clinicopathological factors’ on overall survival (OS) was analyzed via Cox proportional hazards model. Absolute lymphocyte counts (ALC) and the neutrophil-to-lymphocyte ratio (NLR = ANC/ALC) were assessed before radiotherapy (RT), during RT, and after RT. Cox regression was used to correlate clinical factors with both hematologic toxicities and overall survival. Multiple logistic regression analyses were used to find associations between lymphopenia and dosimetric parameters. The receiver operating characteristics (ROC) curve was used to determine cut-off points.ResultsNinety-nine ESCC patients were enrolled with the median overall survival of 23 months. The median RT dose was 55.75Gy(46–66Gy), and the mean does (Dmean) of thoracic vertebrae dose (TVB) was 27.04±9.65Gy. Based on multivariate analysis, V20 of TVB, pretreatment NLR, and ALC nadir were associated with a worse OS significantly. Concurrent CRT, increasing mean TVB dose and V20 of TVB were associated with higher odds of lymphopenia risk (P＜0.05) through multiple logistic regression analysis.ConclusionsIn ESCC patients who received definitive RT, V20 of TVB, pretreatment NLR, and ALC nadir during RT were independent prognostic factors and chemotherapy regimen, mean TVB dose, and V20 of TVB were associated with lymphopenia.
Optimization of Solid-State Fermentation Conditions of Astragali Radix Residues and Changes of Its Nine Constituents Content Before and After Fermentation
Authors: Liu Cuiyan , Zhu Yun , Fan Guangtai , Gu Jingang , Han Chunyang 
Published: September 2020

Abstract
Background: For the last few years huge quantity of herb residues are discharged in China, and so far there is not a good solution. The current methods of disposal and utilization of herb residues (stacking, incineration, and landfill) were not only great harmful to the ecological environment, but also cause the waste of medicinal herb resources. The fermentation can further decompose and transform the active ingredients and nutrients in herb residue, so the fermentation technology has good application prospect in the treatment of herb residues. In this study, we investigated the applicability of fermentation processes with the Aspergillus niger (ACCC 30583) strain for the reuse of Astragali Radix residues (ARR) by comparing the content changes of its nine constituents before and after fermentation. The contents of total protein and crude fat in the ARR were determined via near-infrared scanning; the iron, copper, zinc, and manganese contents were assayed with atomic absorption spectroscopy, the calycosin-7-glucoside and astragaloside Ⅳ content were determined by HPLC, and the polysaccharide content was determined via phenol sulfuric acid spectrophotometry. Results: The optimum fermentation conditions for ARR with ACCC 30583 was culture medium content 60%, fermentation time 5 days, and fermentation temperature 28 ℃. Compared with the residues before fermentation, the contents of total protein, calycosin-7-glucoside, astragaloside Ⅳ, Astragali Radix polysaccharides (ARP), and manganese increased significantly, the iron content decreased significantly, and the crude fat, zinc, and copper contents exhibited no significant changes. Conclusions: The solid fermentation of ARR with the Aspergillus niger (ACCC 30583) strain effectively promoted the separation of astragaloside Ⅳ and ARP from ARR, which provided methodological basis for the effective reuse of herb residues.