bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and associated factors of visual impairment among adults at Debre Berhan Town, North Shewa, Ethiopia.
Authors: Assefa Natnael Lakachew , Admas Addisu , Adimasu Nebiyat 
Published: February 2020

Abstract
Background : Visual impairment refers to presenting distance visual acuity worse than 6/18 in the worst eye. It remains a global challenge that greatly affects the mobility, social participation and the quality of life of the people. This study was aimed to determine the prevalence and associated factors of visual impairment among adults aged 18 years. Methods: A community-based cross-sectional study was conducted at Debre Berhan town. Data were collected by interview with a pre-tested semi structured questionnaire and ocular examinations. The collected data were analyzed by SPSS version 20. Multivariate logistic regression was used to identify the determinant factors and p value less than 0.05 was considered as statistically significant. Results: A total of 416 participants were enrolled in the study with a 98.6% response rate. The prevalence of visual impairment among adults aged 18 years was 16.8% (95% CI: 13.5%-20.2%). Aged > 64 years (AOR=12.18, 95%CI: 4.47-33.20), illiterates AOR=3.02, 95% CI: 1.36-6.72), previous eye trauma (AOR=4.44, 95% CI: 1.64-12.04), family size > 5 (AOR: 4.44, 95% CI: 1.43-13.75) and family history of eye problem (AOR=7.02, 95% CI: 1.95-25.22) had statistically significant association with visual impairment. Conclusions: Prevalence of visual impairment among adults was found to be a significant public health problem. Older age, illiterates, previous eye trauma, large family size and family history eye problem were positively associated with visual impairment.
Cost of inappropriate antimicrobial use for upper respiratory infection in Japan
Authors: Tsuzuki Shinya , Kimura Yuki , Ishikane Masahiro , Kusama Yoshiki , Ohamagari Norio 
Published: February 2020

Abstract

Background : Antibiotics are often prescribed inappropriately to patients with upper respiratory infection (URI) in ambulatory care settings; however, the economic burden of such prescription has not been quantitatively assessed. Here, we aimed to evaluate the additional cost of antimicrobial prescription for URI at the population level in Japan.
Methods : We conducted a retrospective observational survey using longitudinal claims data between 2013 and 2016 obtained from JMDC Claims Database, which contains data from 5·1 million corporate employees and family members under the age of 65 years. Appropriateness of antibiotic prescription was assessed by a panel of six infectious disease physicians according to ICD-10 code in JMDC Claims Database. Total additional cost of antibiotic prescription for URI at the national level was estimated by weighting of age-structured population data.
Results : The annual additional cost of inappropriate antibiotic prescription for URI was estimated at 423·6 (95% CI: 416·8–430·5) million USD in 2013, 340·9 (95% CI: 335·7–346·2) million USD in 2014, 349·9 (95% CI: 344·5–355·3) million USD in 2015, and 297·1 (95% CI: 292·4–301·9) million USD in 2016. Three classes of broad-spectrum oral antibiotics (third-generation cephalosporins, macrolides, and fluoroquinolones) accounted for >90% of the total additional cost.
Conclusions : Although a decreasing trend was observed, annual additional costs of inappropriate antibiotic prescriptions for URI could be a substantial economic burden in Japan. Appropriately prescribing broad-spectrum oral antibiotics might be an important issue to reduce unnecessary medical costs in Japanese ambulatory care.
Modular stem in total hip arthroplasty for patients with trochanter valgus deformity: surgical technique and case series
Authors: Kong Xiangpeng , Chai Wei , Yang Minzhi , Ong Alvin , Chen Jiying , Wang Yan , Zhou Yonggang 
Published: February 2020

Abstract
Background: Trochanter valgus deformity (TVD) is a rare condition of total hip arthroplasty (THA). The femoral osteotomy might be required to correct the deformity to implant the femoral stem in severe TVD. In this study, we described one unpublished technique of reverse sleeve of S-ROM to get through the complex situation. This study aimed to summarize and evaluate its technical challenges, safety and effectiveness. Methods : From January 2006 to December 2014, the patients whose sleeves were implanted towards the great trochanter rather than sitting on the calcar, to solve the TVD in THA were enrolled. Their demographics, perioperative and postoperative information were recorded. To explore its indication, we measured and analyzed the ratio of greater trochanter/lesser trochanter (G/L ratio) and trochanter valgus angle (TVA). Results : Twelve patients (1 male and 11 female, average age 42.30±10.23) who had the complete clinical data were analyzed. The survivorship of femoral prosthesis were 100% with mean follow-up of 6 years. No other complications were found, except for two patients with intraoperative fracture of femur. The Harris hip score (HHS) increased from preoperative 34.31±14.43 to postoperative 84.12±11.33. All patients’ G/L ratio were larger than 1.50. Conclusions: The reverse sleeve of S-ROM was a reliable method for the patients with severe trochanter valgus deformity, which brought satisfying clinical outcomes in mid-term follow-up.
Is Procalcitonin (PCT) a reliable biomarker for preoperative diagnosing of low grade Periprosthetic Joint Infection? A Prospective Study
Authors: Busch André , Jäger Marcus , Engler Harald , Haversath Marcel , Bielefeld Charlotte , Landgraeber Stefan , Wegner Alexander 
Published: February 2020

Abstract
Background: Since a „gold-standard“ is missing, diagnosing periprosthetic joint infection (PJI) remains a challenge in orthopedic surgery. The purpose of this study was to evaluate the accuracy of serum and synovial fluid Procalcitonin (S-PCT and SF-PCT) as a diagnostic parameter and to compare it to the biomarkers recommended in the 2018 Definition of periprosthetic hip and knee infection. Methods: Between August 2018 and July 2019, a prospective cohort study was conducted in 70 patients with painful hip, shoulder and knee arthroplasty. Besides medical history, clinical and laboratory data was gathered. PJI was diagnosed based on the 2018 Definition of periprosthetic hip and knee infection. Preoperative blood and synovial joint fluid were taken for PCT measurement. S-PCT and SF-PCT levels were measured using standard quantitative PCT enzyme immunoassays. Results: Twenty three patients (33%) were classified as the PJI group and fourty seven patient (67%) as the aseptic group. The mean levels of S-PCT were significantly (p<0.001) higher in the PJI group than those in the aseptic group (PJI 0.05 ng/mL ± 0.21 (0.0-1.03) vs. aseptic 0.02 ng/mL ± 0.03 (0.0-0.18)). In synovial fluid, the mean PCT values in the aseptic group were significantly higher (p<0.001) than those of PJI group (PJI 2.7 ng/mL ± 1.4 (0.53-9.7) vs. aseptic 8.7 ng/mL ± 2.5 (0.25-87.9)). S- PCT, with a cut-off level of 0.5 ng/mL, had a sensitivity of 13.0% and a specificity of 91.0%. SF-PCT, with a cut-off level of 5.0 ng/mL, had a sensitivity of 13.0% and a specificity of 52.0%. Conclusion: S-PCT and SF-PCT appeared to be no reliable biomarkers in the differential diagnosis of PJI from aseptic loosening in total joint arthroplasty.
Predictive Value of Admission D-dimer for Contrast-induced Acute Kidney Injury and Poor Outcomes after Primary Percutaneous Coronary Intervention
Authors: Lin Kai-Yang , Chen Han-Chuan , Jiang Hui , Wang Sun-Ying , Chen Hong-mei , Wu Zhi-Yong , Jiang Feng , Guo Yan-Song , ZHU PENG-LI 
Published: February 2020

Abstract
Background DD was found to be associated with acute myocardial infarction (AMI) and renal insufficiency. However, it is uncertain whether DD is an independent risk factor of CI-AKI in patients undergoing pPCI. Methods We prospectively enrolled 550 consecutive patients with STEMI undergoing pPCI between January 2012 and December 2016. The predictive value of admission DD for CI-AKI was assessed by receiver operating characteristic(ROC) and multivariable logistic regression analysis. CI-AKI was defined as an absolute serum creatinine increase ≥0.3 mg/dl or a relative increase in serum creatinine ≥50% within 48 h of contrast medium exposure. Results Overall, the incidence of CI-AKI was 13.1%. The ROC analysis showed that the cutoff point of DD was 0.69 ug/ml for predicting CI-AKI with a sensitivity of 77.8% and a specificity of 57.3%. The predictive value of DD was similar to the Mehran score for CI-AKI (AUC DD =0.729 vs AUC Mehran =0.722; p =0.8298). Multivariate logistic regression analysis indicated that DD >0.69 ug/ml was an independent predictor of CI-AKI (odds ratio[OR]=3.37,95%CI:1.80-6.33, p <0.0001). Furthermore, DD >0.69 ug/ml was associated with an increased risk of long-term mortality during during a mean follow-up period of 16 months(hazard ratio=3.41, 95%CI:1.4-8.03, p =0.005). Conclusion admission DD >0.69 ug/ml is a significant and independent predictor of CI-AKI and long-term mortality in patients undergoing pPCI.
Heterogeneous components of lung adenocarcinomas confer distinct EGFR mutation and PD-L1 expression
Authors: Cai Yi-Ran , Wu Hongbo , Shi Xiaoqin , Dong Yujie , Chang Xiujun , Zhang Li , Zhou Lijuan , Su Dan , Yang Ming 
Published: February 2020

Abstract
Background Lung adenocarcinoma (LAC) is composed of lepidic, papillary, mucinous, micropapillary and solid components in its parenchyma. Complex responses to therapeutics result from intratumoral heterogeneity. However, it remains confused that what components in a mixed LAC tumor are responsible to the heterogeneous EGFR mutation and PD-L1 expression. Methods We investigated EGFR status via laser microdissection to capture spatially separated cancer cell subpopulations and digital droplet PCR to determine the abundance of EGFR sensitizing mutation and naïve T790M. Whilst, PD-L1 expression level via tumor proportion score (TPS) was evaluated by Ventana immunohistochemistry using SP263 antibody. PD-L1 expression levels were tiered in <1%, 1%-49% and >=50% groups. Results EGFR mutation harbored in 154 (59%) of 261 LAC patients and more frequently occurred in papillary, lepidic and micropapillary constituents. Higher levels of PD-L1 were found in LACs at stage III and IV (68.3%) versus those at stage I and II (31.7%) ( P =0.04). Solid predominant LACs (41.3%) expressed PD-L1 with TPS >=50%, versus mucinous and lepidic LACs ( P <0.01). LACs with solid constituents also had more positive proportion of PD-L1 protein. Cut-offs <1%, 1%–49% or >=50% were associated with patients’ progression-free survival and longer in the <1% group (22.9 month, 95% CI 17.6-28.2) (P<0.05). LACs consisting of two constituents with PD-L1 TPS <1% had a better prognosis than the groups with single component and more than two components ( P <0.05). Eighteen LACs (6.9%) had concomitantly deletion in exon 19 or L858R and naïve T790M mutation. The abundance of T790M varied diversely with sensitizing mutation. PD-L1 expression was not concordant in same components and usually negative in the EGFR -mutated constituents. Heterogeneous PD-L1 expression occurred in the vicinity of stromal tissues. Conclusion Intratumoral genetic heterogeneity of LACs was demonstrated associated with histological patterns. Heterogeneous PD-L1 expression in higher level usually occurred in solid component both in EGFR mutated and EGFR wild-typed LACs. EGFR mutated LACs heterogeneously had sensitizing and resistant mutation and was accompanied with PD-L1 expression, but discordant among histological constituents. Immune checkpoint inhibitor combined with third generation EGFR tyrosine kinase inhibitor should be more effective to these LACs.
Prognosis of patients with acute exacerbation of combined pulmonary fibrosis and emphysema: A retrospective single-center study
Authors: Ikuyama Yuichi , Ushiki Atsuhito , Kosaka Makoto , Akahane jumpei , Mukai Yuichi , Araki Taisuke , Kitaguchi Yoshiaki , Tateishi Kazunari , Urushihata Kazuhisa , Yasuo Masanori , Yamamoto Hiroshi , Hanaoka Masayuki 
Published: February 2020

Abstract
Background: Previous analyses of combined pulmonary fibrosis and emphysema (CPFE) cohorts have provided conflicting data on the survival of patients with CPFE. Therefore, the aim of this study was to investigate the clinical prognosis of acute exacerbation (AE) of CPFE.
Methods : We retrospectively reviewed the medical records of patients who had been treated at Shinshu University Hospital (Matsumoto, Japan) between 2003 and 2017. We identified 21 patients with AE of CPFE and 41 patients with AE of idiopathic pulmonary fibrosis (IPF) and estimated their prognoses using the Kaplan–Meier method.
Results : Treatment content and respiratory management were not significantly different between the two groups before and after exacerbation. At the time of AE, the median serum Krebs von den Lungen-6 level was significantly lower in the CPFE group (Krebs von den Lungen-6: 966 U/µL; white blood cell count: 8810 /µL) than that in the IPF group (Krebs von den Lungen-6: 2130 U/µL, p < 0.001; white blood cells: 10809/µL, p = 0.0096). The baseline Gender-Age-Physiology score was not significantly different between the two groups (CPFE, 4.5 points; IPF, 4.7 points; p = 0.58). Kaplan–Meier curves revealed that the survival time after AE for patients with CPFE was longer than that for patients with IPF ( p < 0.001, log-rank test).
Conclusions : Survival prognoses after AE were significantly better for patients with CPFE than that for patients with IPF. Our findings may improve the medical treatment and respiratory management of patients with AE-CPFE.
Effectiveness of orthodontic temporary anchorage devices in canine retraction and anchorage preservation during the two-step technique: A systematic review and meta-analysis
Authors: Tian Haonan , Xie Congman , Lin Min , Yang Hongmei , Ren Aishu 
Published: February 2020

Abstract
Background: Temporary anchorage devices have been used for decades in orthodontic practice for many applications. The aim of this systematic review was to assess the effectiveness of orthodontic temporary anchorage devices in canine retraction during the two-step technique. Methods: A search was systematically performed for articles published prior to June 30, 2019 in five electronic databases (PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, Scopus). The risk of bias was assessed using the Cochrane risk of bias tool for randomized controlled trials (RCTs) and the risk of bias in nonrandomized studies of interventions (ROBINS-I) tool for controlled clinical trials (CCTs) . The Grading of Recommendation, Assessment, Development and Evaluation (GRADE) approach was used for the quality assessment. Data concerning the mean difference in mesial molar movement and extent of canine retraction were extracted for statistical analysis. The mean difference s and 95% confidence intervals were analyzed for continuous data. A meta-analysis with a random-effects model for comparable outcomes was carried out. Results: Three RCTs and five CCTs were finally included. Meta-analysis showed a significant increase not only in anchorage preservation in the implant anchorage group in both the maxilla (1. 56 mm , 95% CI: 1.14 to 1.98, P <0.00001 ) and the mandible (1.62 mm , 95% CI: 1.24 to 2.01, P <0.00001 ) but also in canine retraction in the implant anchorage group in both the maxilla (0.43 mm , 95% CI: 0.16 to 0.69, P =0.001 ) and the mandible (0.26 mm , 95% CI: 0.02 to 0.49, P =0.03 ). Conclusions: There is very low-quality evidence showing that implant anchorage is more efficient than conventional anchorage during canine retraction. Additional high-quality studies are needed. Keywords: Orthodontic implants; Canine retraction; Systematic review; Meta-analysis
Association of macular thickness with parapapillary atrophy in myopic eyes
Authors: Piao Helong , Guo Yue , Ha Jun Young , Sung Mi Sun , Park Sang Woo 
Published: February 2020

Abstract
Background: To investigate whether macular structure could be affected by axial elongation and to determine the association between macular intraretinal thickness and the microstructure of β-zone parapapillary atrophy (PPA) in myopic eyes.Methods: The study recruited 113 healthy myopic subjects (113 eyes). Images of the macula, subfoveal choroid, and optic nerve head were acquired using spectral-domain optical coherence tomography (SD-OCT). An automatic segmentation algorithm was used to segment the macular images into 7 intraretinal layers. PPA widths with and without Bruch’s membrane (PPA+BM and PPA-BM, respectively) were evaluated. Linear regression analysis was performed to evaluate the association between macular intraretinal thickness and axial length and the microstructure of PPA.Results: An increase in axial length was associated with a decrease in whole macular thickness of the peripheral region and an increase in whole macular thickness of the central region. Thickness alterations of the macular intraretinal layers were most apparent in the peripheral region. A significant correlation was found between PPA-BM width and macular intraretinal layer thickness, whereas no significant correlation was found between PPA+BM width and macular intraretinal layer thickness. Moreover, both PPA+BM and PPA-BM widths significantly correlated with subfoveal choroidal thickness.Conclusions: Macular intraretinal layer thickness may be affected by PPA-BM width. These findings indicate that the microstructure of PPA should be considered when evaluating the macula in patient with myopia and glaucoma.
Modelling the impact of MAUP on environmental drivers for Schistosoma japonicum prevalence
Authors: Navas Andrea Araujo , Osei Frank , Magalhães Ricardo J. Soares , Leonardo Lydia R. , Stein Alfred 
Published: February 2020

Abstract
Background: The modifiable areal unit problem (MAUP) arises when the support size of a spatial variable affects the relationship between prevalence and environmental risk factors. Its effect on schistosomiasis modelling studies could lead to unreliable parameter estimates. The present research aims to quantify MAUP effects on environmental drivers of Schistosoma japonicum infection by (i) bringing all covariates to the same spatial support, (ii) estimating individual-level regression parameters at 30 m, 90 m, 250 m, 500 m, and 1 km spatial supports, and (iii) quantifying the differences between parameter estimates using five models.
Methods: We modelled the prevalence of Schistosoma japonicum using sub-provinces health outcome data and pixel-level environmental data. We estimated and compared regression coefficients from convolution models using Bayesian statistics.
Results: Increasing the spatial support to 500 m gradually increased the parameter estimates and their associated uncertainties. Abrupt changes in the parameter estimates occur at 1 km spatial support, resulting in loss of significance of almost all the covariates. No significant differences were found between the predicted values and their uncertainties from the five models. We provide suggestions to define an appropriate spatial data structure for modelling that gives more reliable parameter estimates and a clear relationship between risk factors and the disease.
Conclusions: Inclusion of quantified MAUP effects was important in this study on schistosomiasis. This will support helminth control programs by providing reliable parameter estimates at the same spatial support, and suggesting the use of an adequate spatial data structure, to generate reliable maps that could guide efficient mass drug administration campaigns.
Keywords: schistosomiasis modelling; modifiable areal unit problem; uncertainty; Bayesian statistics; convolution model.
Clinical efficacy of submucosal injection of triamcinolone acetonide in the treatment of type II/III interstitial cystitis/bladder pain syndrome
Authors: Jiang Tao , Zhou Xiaozhou , Chen Zhipeng , Xiong Tailing , Fu Jian , Liu Zhengchao , Yan Dishi , Zhou Zhansong , Shen Wenhao 
Published: February 2020

Abstract
Background: To evaluate the efficacy of submucosal injection of triamcinolone acetonide for the treatment of type II/III interstitial cystitis/bladder pain syndrome.Methods: A retrospective analysis of the clinical data of type II/III interstitial cystitis/bladder pain syndrome patients treated in our department from April 2016 to August 2018 was conducted, and changes in International Prostate Symptom Scores and the Pelvic Pain and Urgency/Frequency symptom scale after surgery were evaluated to explore factors that may affect patient outcomes.Results: A total of 27 female patients and 8 male patients were enrolled, with type II patients accounting for 62.9% of the sample, and the median follow-up duration was 31 months (range: 12-40 months). Twenty-two patients (74.3%) had significantly improved questionnaire scores at 4 weeks postoperatively. Treatment efficacy was sustained for at least 1 year in 15 patients, and persistent effectiveness was noted in 10 (28.6%) patients. Patients with an advanced age (p=0.015), high pain scores (p=0.040), and higher International Prostate Symptom Scores (p=0.037) and Pelvic Pain and Urgency/Frequency symptom scale scores (p=0.020) were more likely to benefit from submucosal injection of triamcinolone acetonide. Gender, disease duration, and the presence of Hunner’s lesions had no predictive value for treatment outcomes.Conclusion: Submucosal injection of triamcinolone acetonide can improve the clinical symptoms and quality of life in both men and women with type II/III interstitial cystitis/bladder pain syndrome. Patients with an advanced age and more severe interstitial cystitis/bladder pain syndrome related symptoms may benefit more from triamcinolone acetonide injection.
Targeted sequencing of the short arm of chromosome 6V of a wheat relative Haynaldia villosa for marker development and gene mining
Authors: Xiao Jin , Wan Wentao , Li Mengli , Yu Zhongyu , Zhang Xu , Liu Jia , Holušová Kateřina , Vrána Jan , Doležel Jaroslav , Wu Yufeng , Wang Haiyan , Wang Xiue 
Published: February 2020

Abstract
Background: Short arm of chromosome 6V (6VS) of Haynaldia villosa has been used in wheat breeding programs to introduce Pm21 resistance gene against powdery mildew and some other genes.
Results: In this work, 6VS was isolated from a wheat ( Triticum aestivum ) - 6VS telosome addition line by flow cytometric sorting and sequenced by illumina technology. The assembly length was 230.39 Mb with contig N50 of 9,788 bp. The sequence annotation identified 3,276 high confidence genes supported by RNA sequencing data, representing about 2.3% of the chromosome arm sequence; repetitive elements accounted for 74.91% of the arm sequence. Sequences homologous to 6VS genes were identified on short arms of chromosomes 6A of T. urartu , 6D of Aegilops tauschii , 6A and 6B of T. dicoccoides , 6A, 6B and 6D of T. aestivum and 6H of Hordeum vulgare , revealing synteny relationships among these chromosome arms. Based on differences in intron size between the homologous genes on 6VS and 6AS/6BS/6DS of T. aestivum , 222 primer pairs were designed. Out of them, 120 amplified 6VS-specific products and are suitable as intron-target (IT) markers to trace the 6VS chromatin introduced into wheat.
Conclusions: The results obtained and markers developed in this work will facilitate introduction of important genes to common wheat from its wild relative, while reducing the presence of unfavorable genes due to linkage drag.