bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neer Type-II Distal Clavicle Fractures
Authors: Fox Henry M. , Ramsey Duncan C. , Thompson Austin R. , Hoekstra Chris J. , Mirarchi Adam J. , Nazir Omar F. 
Published: December 2019

Background:
Neer type-II distal clavicle fractures are unstable and are generally appropriately managed with operative fixation. Fixation options include locking plates, hook plates, and suture button devices. No consensus on optimal technique exists.

Methods:
A decision tree model was created describing fixation of Neer type-II fractures using hook plates, locking plates, or suture buttons. Outcomes included uneventful healing, symptomatic implant removal, deep infection requiring debridement, and nonunion requiring revision. Weighted averages derived from a systematic review were used for probabilities. Cost-effectiveness was evaluated by calculating incremental cost-effectiveness ratios (ICERs). The ICER is defined as the ratio of the difference in cost and difference in effectiveness of each strategy, and is measured in cost per quality-adjusted life year (QALY). The model was evaluated using thresholds of $50,000/QALY and $100,000/QALY. Sensitivity analysis was performed on all outcome probabilities for each fixation strategy to assess cost-effectiveness across a range of values.

Results:
Forty-three papers met final inclusion criteria. Using suture buttons as the reference case in the health-care cost model, suture button repair was dominant (both less expensive and clinically superior). Hook plates cost substantially more ($5,360.52) compared with suture buttons and locking plates ($3,713.50 and $4,007.44, respectively). Suture buttons and locking plates yielded similar clinical outcomes (0.92 and 0.91 QALY, respectively). Suture button dominance persisted in the societal perspective model. Sensitivity analysis on outcome probabilities showed that locking plates became the most cost-effective strategy if the revision rate after their use was lowered to 2.2%, from the overall average in the sources of >19%. No other changes in outcome probabilities for any of the 3 techniques allowed suture buttons to be surpassed as the most cost-effective.

Conclusions:
The cost-effectiveness of suture buttons is driven by low revision rates and high uneventful healing rates. Similar QALY values for locking plate and suture button fixation were observed, which is consistent with existing literature that has failed to identify either as the clinically superior technique. Cost-effectiveness should fit prominently into the decision-making rubric for these injuries.

Level of Evidence:
Economic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Autologous Iliac Bone Graft Compared with Biphasic Hydroxyapatite and Calcium Sulfate Cement for the Treatment of Bone Defects in Tibial Plateau Fractures
Authors: Hofmann Alexander , Gorbulev Stanislav , Guehring Thorsten , Schulz Arndt Peter , Schupfner Rupert , Raschke Michael , Huber-Wagner Stefan , Rommens Pol Maria ,   on behalf of the CERTiFy Study Group
Published: December 2019

Background:
Bone-graft substitutes are commonly used for the augmentation of traumatic bone defects in tibial plateau fractures. However, their clinical performance compared with that of autologous bone-grafting, the gold standard in bone defect reconstruction, still remains under debate. This study investigates the differences in quality of life, pain, and radiographic outcomes in the treatment of tibial plateau fracture-associated bone defects with either autologous bone grafts or a bioresorbable hydroxyapatite and calcium sulfate cement (CERAMENT BONE VOID FILLER [CBVF]; BONESUPPORT).

Methods:
In this study, 135 patients with acute depression and split-depression fractures of the proximal part of the tibia (OTA/AO types 41-B2 and 41-B3) were enrolled in a prospective, controlled, randomized, multicenter trial including 20 hospitals in Germany. Patients were randomized to receive either autologous iliac bone graft or CBVF for reconstruction of the bone defect. The primary outcome measures were the Short Form (SF)-12 version 2 Physical Component Summary (PCS) score at week 26 (the study was designed to show noninferiority of the CBVF with regard to the PCS with a prespecified margin of −5 points) and the pain level at 26 weeks postoperatively measured by a visual analog scale (VAS). The secondary outcomes were the SF-12 version 2 Mental Component Summary (MCS) and SF-12 PCS scores at weeks 1, 6, and 12 and bone-healing on radiographs.

Results:
Age, sex, fixation methods, and fracture pattern were comparable in both groups. There were no significant differences (p > 0.05) in the SF-12 PCS or VAS scores at postoperative week 26. There was a significant reduction of blood loss (p = 0.007) and pain levels (p = 0.008) at postoperative day 1 in the CBVF group. The rates of fracture-healing, defect remodeling, and articular subsidence were not significantly different (p > 0.05) in both groups.

Conclusions:
Bioresorbable CBVF was noninferior to autologous bone graft with regard to both patient-reported and radiographic outcomes in tibial plateau fractures of OTA/AO types 41-B2 and 41-B3.

Level of Evidence:
Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Structure and ultrastructure of neurospheres spontaneously generated in culture from sheep ovarian cortical cells.
Authors: Salvador Concepción Rojo , Sánchez-Maldonado Belén , Galicia María de Lourdes , González-Gil Alfredo , González Rosa Ana Picazo 
Published: December 2019

Abstract
Background: Neurospheres derived from adult stem cells of non-neural tissues represent a promising source of neural stem cells (NSCs) and neural progenitor cells (NPCs) for autologous cell therapy in neurological diseases. Analyzing the fine structure of neurospheres can provide pivotal information regarding the phenotype of spheroid-integrating cells, being useful for cell characterization during differentiation, and oncogenic transformation. Neurospheres can be generated by culturing ovarian cortical cells under particular conditions. In order to assess the reliability of use of these spheroids in regenerative medicine, developmental biology, and to state whether they share morphological features with central nervous system (CNS) derived neurospheres, they were analyzed by light and transmission electron microscopy. Sheep ovarian cortical cells were cultured in serum-free medium for 21 days to generate neurospheres. On days 10, 15 and 21 of culture, expression of pluripotency (Nanog, Oct4, Sox2), and NSC/NPC (nestin, Pax6, P75NTR) transcripts by qRT-PCR, immunolocalization of NSC/NPC antigens (nestin, Pax6, P75NTR), structure, and ultrastructure, were analyzed in spheroids. Results: Spheroids expressed transcripts and antigens of pluripotency, and NSC/NPC. Structural analyses revealed that cells were arranged in a peripheral sheet cover comprised by a few layers of spindle-shaped cells exhibiting frequent mitoses, and large round cells; and an inner core, with intermediate-sized cells showing frequent events of apoptosis and necrosis. Ultrastructural analyses showed that in the inner core, most cells were electron dense (dark), showing frequent apoptotic and degenerative events; the outer epithelium-like sheet, was formed by low electron dense cells (light flat cells; LFCs) showing signs of intense metabolic activity, abundant cytoplasmic organelles, phagosomes, lysosome-like structures, apical microvilli, and filament bundles of cytoskeleton elements, indicating that LFCs play a role in extracellular exchanges. Apical-basal polarization of LFCs evidenced by frequent intercellular contacts, like adherens junctions and cytoplasmic interdigitations, was lost in some cells whose contacts with neighboring cells were loose intedigitations and expanded cytoplasmic processes. This might anticipate disengaging/aggregating of light protruding cells (LPCs) from/to the neurosphere, as consistently observed in cultures by inverted microscopy. Conclusions: Neurospheres spontaneously generated from ovarian cortical cells in culture, share most structural and ultrastructural characteristics of neurospheres derived from the CNS.
Effect of parental depression on asthmatic children’s problem behavior and academic performance: using actor and partner interdependence model of parental variables
Authors: Kim Jeong Min , Lee Hanna , Han jeongwon 
Published: December 2019

Abstract
Background The health issues of children with asthma is emerging to be a social problem because in many cases it is a disease that requires repetitive and long-term treatment, and the financial burden of parents raising children with asthma is relatively greater than parents raising normal children. It is necessary for health care providers to approach the mental health of parents in addition to managing the health of asthmatic children so that asthmatic children recover, smoothly adjust to school life like other normal children. This study attempts to determine the factors on the problem behavior and academic performance of the children with asthma.Methods The data of 236 pairs of children and parents from the 10th Panel Study on Korean Children were used and analysis was performed using SPSS 20.0 and AMOS 20.0.Results Parental depression had actor and partner effects on marital conflict, and marital conflict perceived by the father had actor and partner effects on parent-child interactions, while marital conflict perceived by the mother had actor effect on parent-child interactions. Parent-child interaction perceived by the father was found to affect the problem behavior of children, and parent-child interaction perceived by the mother was seen to affect the problem behavior of children. The problem behavior of children affects academic performance.Discussion This study is significant since it prepares basic data for improving the academic performance of children with asthma. We suggest research that longitudinally confirms the influence using variables presented in this study is necessary.
Evaluation of Infection, Prevention and Control Program in Goromonzi District, Zimbabwe, 2018: A process outcome evaluation
Authors: Emmanuel Govha , Tirivanhu Zizhou Simukai , Gerald Shambira , Notion Gombe Tafara , Juru Tsitsi , Chiwanda Simbarashe , Mufuta Tshimanga 
Published: December 2019

Abstract
Background A healthcare-associated infection (HAI) is defined as an infection originating in the environment of a health facility that was not present or incubating at the time of patient admission. HAIs can be prevented through infection, prevention and control (IPC) measures. No hazard identification and risk assessment IPC rounds and monthly meetings were conducted in Goromonzi district since 1st of January to 30th of June 2018. No trainings nor orientation for the new employees was conducted. We therefore evaluated Goromonzi District IPC program. Methods A process-outcome evaluation using the logic model was conducted in Goromonzi district’s 15 health facilities. Checklists, interviewer administered questionnaires and key informant guides were used to collect data on availability of inputs, knowledge of health workers, processes performed, outputs and outcomes achieved. Data were entered into Epi Info 7TM, which was used to generate frequencies and proportions. Qualitative data from checklists and key informants interviews was sorted manually into themes and analysed. Results All 15 health facilities had adequate stocks of HIV test kits and PEP kits. Adequate bins and detergents were found in only 3/15 (20%) of health facilities. All facilities failed to hold a single IPC meeting and none had specific budget for IPC in 2018. No IPC mentorship activities were carried out in the district. Only 7/13 (54%) health workers who had needle pricks received PEP with 2/7 (29%) of them finishing the course. No health facility had a functional HAI surveillance system. The overall knowledge rating was fair. Conclusion The IPC program inputs in Goromonzi district were inadequate hence its failure to achieve the intended outputs and outcomes. Inadequate knowledge, unavailability of health worker training plans, specific budgets and absence of IPC committees reflected non prioritisation of the program.
Psychiatrists’ Attitude to the Psychiatrist’s Style of Dressing and Addressing: A Cross -Sectional Study
Authors: Semnani Yousef , Ardalan Arash , Shahpouri Hamid Reza , bastami fatemeh 
Published: December 2019

Abstract
Background The relationship between physician and patient is important topic in medical practice. How a physician dresses and addresses the patients are key factors that contribute to developing a rapport. This study aimed to investigate the psychiatrist's perspectives in order to facilitate an effective communication with patients.Methods This descriptive-analytic study was done on psychiatrists and psychiatric residents through a non-selective and non-randomized sampling method. Data were collected based on a questionnaire. Variables were such as age, sex, duration of practice as a psychiatrist, priority for male psychiatrist dress preference, priority for female psychiatrist dress preferences, priority for choosing a doctor from a gender perspective, priority for being addressed by patients, using the word of the gentleman or lady to address the patients, and the type of verbs and pronouns used by the psychiatrist and the patient during the interview in terms of the total number of verbs and pronouns. Subsequently, eight photographs of male and female physician’s coverage according to the in Iranian culture were shown to the participants and they were asked to choose one.Results A total of 77 psychiatrists participated in this study, of which 45 (58.4%) were male and 32 (41.6%) were female. In case of male psychiatrist’s coverage, 56 (72.7%) participants preferred suits; whereas in case of female psychiatrist’s coverages, 25 (32.5%) participants chose colored mantos and scarves, 22 (28.6%) selected black manteos and head dresses. Sixty three (81.8%) patients believed that the gender of the physician was not important in determining the treating physician. According to the type of addressing the psychiatrist by patients, 71 (92.2%) participants preferred to call the doctor's name followed by surname and 60 (77.9%) psychiatrists wanted patients to use the word "Mr. or Ms.” prior their names. Sixty three (81.8%) psychiatrists stated that it was better to use plural pronouns and verbs in interviewing patients, and 67 (87%) preferred their patients to use plural verbs to address them.Conclusions Psychiatrists’ appearance and the accuracy of the patient-referring type, based on what the physicians believe, along with the characteristics of the patients’ perspectives, help improving physician-patient relationship.
MicroRNA-4651 targets bromodomain-containing protein 4 to inhibit non-small cell lung cancer cell growth
Authors: Zheng Jiangnan , Dong Lingyun , Zhang Yan , Cai Shang , Hu Xiaoyun , Chen Min-bin , Zhu Ye-han 
Published: December 2019

Abstract
Background: Bromodomain-containing protein 4 (BRD4) overexpression in non-small cell lung cancer (NSCLC) is important for cancer cell progression. The aim of the present study is to silence BRD4 through expression of its targeted microRNAs in NSCLC cells. Methods: Expression of BRD4 and its targeting miRNA, microRNA-4651 (miR-4651), was tested by qPCR and Western blotting assays. Genetic strategies were utilized to exogenously alter miR-4651 expression. NSCLC cell growth, proliferation and migration were tested. Results: miR-4651 selectively targets and negatively regulates BRD4 in A549 and primary human NSCLC cells. The Ago-2 immunoprecipitation experiments further confirmed that miR-4651 directly binds to BRD4 mRNA. Significantly, in A549 cells and primary NSCLC cells ectopic overexpression of miR-4651 downregulated BRD4’s 3-UTR activity and its expression, both were however elevated with miR-4651 inhibition. Functional studies demonstrated that NSCLC cell growth, proliferation and migration were significantly inhibited with miR-4651 overexpression, but enhanced with miR-4651 inhibition. BRD4 re-expression, by an 3’-UTR mutant BRD4, reversed miR-4651 overexpression-induced inhibitions on A549 cells. Additionally, miR-4651 overexpression or inhibition failed to affect the functions of BRD4-KO A549 cells. In vivo, miR-4651-overexpressed A549 xenografts grew significantly slower than control A549 xenografts in severe combined immunodeficient mice. At last we show that miR-4651 is downregulated in human NSCLC tissues, correlating with BRD4 elevation. Conclusions: miR-4651 targets BRD4 to inhibit NSCLC cell growth in vitro and in vivo.
Impact of Intestinal Parasites on Microbiota and Metagenomic Influences on Gene Encoding Cobalamin Pathway
Authors: Mejia Rojelio , Damania Ashish , Jeun Rebecca , Bryan Patricia , Vargas Paola , Juarez Marisa , Cajal Pamela , Nasser Julio , Krolewiecki Alejandro , Lefoulon Emilie , Long Courtney , Drake Evan , Ciminio Ruben , Slatko Barton 
Published: December 2019

Abstract
Background: Approximately 30% of children worldwide are infected with gastrointestinal parasites. Depending on the species, parasites can disrupt intestinal bacterial flora affecting nutritional status. We implemented a multi-parallel quantitative real-time PCR and whole-genome sequencing analysis for bacterial microbiota and Ascaris lumbricoides, Ancylostoma duodenale, Necator americanus, Strongyloides stercoralis, Trichuris trichiura, Cryptosporidium species, Entamoeba histolytica, and Giardia lamblia. Stool samples were collected from 37 asymptomatic children from rural Argentina. We focused this study on Giardia screening. Separate analyses were done for uninfected, Giardia only, Giardia/helminth coinfections, and helminth only groups.Results: For Giardia only infected children, DNA sequencing data showed a decrease in microbiota biodiversity compared to those uninfected that correlated with increasing Giardia burden. Clustering was statistically significant using Shannon alpha diversity. A non-significant increase in diversity was observed for helminth only infections with a compensatory decrease in Giardia/helminth coinfections. In Giardia only infections, microbiome taxonomy shifted from Firmicutes towards increasing proportions of Prevotella, with the degree of shift related to the intensity of infection compared to uninfected. An abundance of Prevotella bacteria was decreased in the helminths only group but increased for Giardia/helminth coinfections. Metagenomic analysis of the bacterial microbiota showed that the proportion of non-vitamin B12 producing bacteria (Prevotella) was higher in the Giardia group. Total cobalamin synthesis was decreased in the Giardia-infected only group compared to the control and helminth-infected group. Conclusion: Our data provide evidence for an effect of parasitic infections allowing permissive growth of anaerobic bacteria such as Prevotella, suggesting an altered capacity of vitamin B12 biosynthesis and potential impact on growth and development in children.
Methods for the Determination of the Purity of Exosomes
Authors: Kluszczyńska Katarzyna , Czernek Liliana , Cypryk Wojciech , Pęczek Łukasz , Düchler Markus 
Published: December 2019

Background:Exosomes open exciting new opportunities for advanced drug transport and targeted release. Furthermore, exosomes may be used for vaccination, immunosuppression or wound healing. To fully utilize their potential as drug carriers or immune-modulatory agents, the optimal purity of exosome preparations is of crucial importance.Methods:Articles describing the isolation and purification of exosomes were retrieved from the PubMed database.Results:Exosomes are often separated from biological fluids containing high concentrations of proteins, lipids and other molecules that keep vesicle purification challenging. A great number of purification protocols have been published, however, their outcome is difficult to compare because the assessment of purity has not been standardized. In this review, we first give an overview of the generation and composition of exosomes, as well as their multifaceted biological functions that stimulated various medical applications. Finally, we describe various methods that have been used to purify small vesicles and to assess the purity of exosome preparations and critically compare the quality of these evaluation protocols.Conclusion:Combinations of various techniques have to be applied to reach the required purity and quality control of exosome preparations.
Association between Single-nucleotide Polymorphisms of RXRG and Genetic Susceptibility to Type 2 Diabetes in South China
Authors: Yu Haibing , Wang Shu , Hu Wei , Xu Lin , Ding Yuanlin , Kong Danli , Pan Haiyan 
Published: December 2019

Objective:
To investigate the relationship between genetic polymorphisms of
RXRG rs1467664, rs3753898 and the genetic susceptibility of type 2 diabetes in the
Chinese Han population from South China.

Methods:
In our case-control study, single-nucleotide polymorphisms (SNPs) rs1467664
and rs3753898 were genotyped by SNPscanTM kit in 1092 patients with T2D as cases and
1092 normal persons as controls. The distributions of genotype and allele frequencies in
two groups were analyzed by the SPSS 20.0 software.

Results:
The distribution of genotypes and alleles of RXRG rs3753898 was statistically
significant between the two groups, but there was no significant difference in the
distribution of genotypes and alleles of the rs1467664. Before and after the adjustment of
age, sex and BMI, rs3753898 in the two groups had statistical significance under the
additive, dominant and recessive models (P<0.05), but no statistical differences were
found under the overdominance and co-dominant genetic models (P>0.05). There was no
significant difference in the genetic models of rs1467664 between the two groups
(P>0.05). The haplotype, which consists of rs1467664 allele T and rs3753898 allele A was
a high-risk factor for T2D, OR=1.27, 95% CI (1.09-1.47), Padj=0.002.

Conclusion:
Our results showed that the single nucleotide polymorphism of RXRG
rs3753898 may be related to genetic susceptibility of type 2 diabetes. The haplotype
consisting of the allele T of rs1467664 and the allele A of rs3753898 is a risk factor for type
2 diabetes, suggesting that the genetic variation of RXRG gene may be the genetic cause
of diabetes mellitus in the Chinese Han population.