bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neutrophil to Lymphocyte Ratio as a predictor for diagnosis of early Periprosthetic Joint Infection
Authors: Yu BaoZhan , Fu Jun , Chai Wei , Hao Libo , Chen Jiying 
Published: March 2020

Abstract
Background: Periprosthetic joint infection (PJI) is a catastrophic complication after total joint arthroplasty (TJA). The diagnosis of PJI is very difficult, especially in the early postoperative period. The value of the neutrophil to lymphocyte ratio (NLR) is useful for the diagnosis of infection. The purpose of this study was to determine the accuracy of the NLR in the diagnosis of early PJI after total knee or hip joint arthroplasty.Methods: We retrospectively reviewed consecutive primary total knee or hip arthroplasty and identified the patients who readmitted within the first 90 days postoperatively between January 2011 and October 2018. There were 20 cases diagnosed early PJI and 101 uninfected cases based on the modified Musculoskeletal Infection Society (MSIS) criteria. The serum parameters (C-reactive protein, erythrocyte sedimentation rate, white blood-cell count, NLR, interleukin-6 levels) were compared between the two groups. Receiver operating characteristic curves were generated to determine the optimal cutoff values for each parameter. Sensitivity, specificity, and positive and negative predictive values were calculated for each parameter. Results: The CRP, ESR, WBC, NLR and IL-6 values were all elevated in the infected group compared to the uninfected group. The mean CRP (infected=59.06, uninfected=10.09), ESR (infected=35, uninfected=17), WBC(infected=7.95x109,uninfected=6.16x109), NLR (infected=4.89, uninfected=2.18), IL-6 (infected=40.68, uninfected=7.46). All values were significant difference between the two groups. The best test for the diagnosis of early PJI was IL-6 (AUC=81.4%; optimal cutoff value 8.07pg/ml) followed by the NLR (AUC =80.2%; optimal cutoff value 2.13), CRP (AUC =79.3%; optimal cutoff value 9.27mg/l), ESR (AUC =74.4%; optimal cutoff value 22mm/h) and WBC (AUC = 63.2%; optimal cutoff value 8.91x109). Conclusions: This study is the first to show that NLR values are more accurate than CRP and may be considered as useful parameters for the diagnosis of early PJI because it is an easy, cheap and convenient parameters to be calculated in daily practice without extra costs.
Determinants of breastfeeding practices in Ecuador: implications for localized applications of breastfeeding promotion and policies
Authors: Freire Wilma B. , Waters William F. , Roman Diana , Belmont Philippe , Wilkinson-Salamea Emily , Diaz Adrian , Palacios Ivan , Bucheli Enrique 
Published: March 2020

Abstract
Background Best practices in breastfeeding are often not followed in spite of appropriate levels of knowledge and positive attitudes regarding the many benefits of human milk. For a variety of reasons, particular, women do not initiate breastfeeding, suspend breastfeeding early, or initiate complementary feeding earlier than recommended. This paper analyzes breastfeeding patterns in three settings in Ecuador: a suburban parish near Quito, the nation’s capital, urban and rural parts of a province in the Amazonian lowlands, and the province of Galapagos. Methods We analyse data produced by surveys conducted in the three locations, each of which included mothers of infants between 0 and 24 months of age. The surveys collected demographic information and data based on breastfeeding indicators established by WHO. Results Significant differences were found in breastfeeding practices, particularly between the suburban parish near Quito and Galapagos, on one hand, and urban and rural parts of the Amazonian province, on the other. Conclusions Differences among population segments reflect specific opportunities and barriers to practices related to promoting optimal infant health and nutrition. Consequently, regional or local conditions that often are not apparent in national-level data should orient policies and promotion activities in specific populations.
Comparison of the clinicopathological characteristics and their impact on outcomes of resected colorectal liver metastases across time
Authors: Chen Lionel , Syn Nicholas L. , Goh Brian K. P. , Cheow Peng Chung , Raj Prema , Koh Yexin , Chung Alexander , Lee Ser Yee , Ooi London Lucien , Chan Chung Yip , Teo Jin Yao 
Published: March 2020

Abstract
Background: Resection of colorectal liver metastases (CLM) has been established as the standard of care. This study aims to compare the change in clinicopathological characteristics of patients who underwent curative resection of CLM across two time periods – 2000 to 2010 (T1) and 2011 to 2016 (T2) and evaluate the prognostic impact of these characteristics on survival outcomes. Methods: Patients who undergo liver resection for CLM at Singapore General Hospital from January 2000 to December 2016 were identified from a prospectively maintained database. The primary end point was overall survival. ResultsThere were 183/318 (57.5%) patients and 135 /318 (42.5%) patients in T1 and T2 respectively. There was a lower proportion of patients who had nodal metastases from primary colorectal cancer and clinical risk score (CRS) less than 3 in T2 when compared to T1. There was no difference in survival between both time periods (HR 0.850 95% CI 0.601 – 1.201 p = 0.357). Independent predictors of survival for the cohort were CEA levels ≥200ng/ml, primary tumour grade and lymph nodal status. Independent predictors of poor survival in T1 were poorly differentiated colorectal cancer and nodal metastases while in T2, independent predictors of poor survival were multiple liver metastases and nodal metastases.Conclusion: Nodal metastases from primary colorectal cancer is an independent predictor of poor survival across time for resectable CLM. Although there is no difference in survival between the two time periods, patients with multiple liver metastases should be carefully considered prior to surgery as it is also an independent predictor of overall survival.
Placing assistive technology and telecare in everyday practices of people with dementia and their caregivers: Findings from an embedded ethnography of a national dementia trial
Authors: Lariviere Matthew , Poland Fiona , Woolham John , Newman Stanton , Fox Chris 
Published: March 2020

Abstract
Background: Policy makers and care providers see assistive technology and telecare as potential products to support people with dementia to live independently and safely in their homes and communities. Little research has examined how people with dementia and their caregivers actually use these technologies. The study aimed to examine how and why people with dementia and their caregivers used assistive technology and telecare in their own homes. Methods: This study used an ethnographic design embedded within the NIHR-funded Assistive Technology and Telecare to maintain Independent Living At home for people with dementia (ATTILA) randomized controlled trial. We collected 208 hours of observational data on situated practices of ten people with dementia and their ten caregivers. We used this data to construct extended cases to explain how technologies supported people with dementia in home and community settings. Results: We identified three themes: placing technology in care, which illustrates how people with dementia and caregivers ‘fit’ technology into their homes and routines; replacing care with technology, which shows how caregivers replaced normal care practices with ones mediated through technologies; and technology displacing care and everyday life, which highlights how technologies disrupted the everyday lives of people with dementia. Discussion: This study exemplifies unintended and unanticipated consequences for assistive technology and telecare uptake in ‘real world’ community-based dementia care. It underlines the need to identify and map the context of technological provision over time within the changing lives of people with dementia and their caregivers.
Protective effects of DPP-4 inhibitor on podocyte injury in glomerular diseases
Authors: Kubo Ayano , Hidaka Teruo , Nakayama Maiko , Sasaki Yu , Takagi Miyuki , Suzuki Hitoshi , Suzuki Yusuke 
Published: March 2020

Abstract
Background Dipeptidyl peptidase-4 (DPP-4) is a serine protease that inhibits the degradation of glucagon-like peptide 1. DPP-4 inhibitors are used worldwide to treat type 2 diabetes mellitus and were recently shown to have pleiotropic effects such as anti-oxidant, anti-inflammatory, and anti-fibrotic actions. DPP-4 inhibitors improve albuminuria and renal injury including glomerular damage independent of its hypoglycemic effect. Although DPP-4 is mainly expressed in the kidney, the physiological function of DPP-4 remains unclear. Methods The localization of renal DPP-4 activity was determined in human renal biopsy specimens with glycyl-1-prolyl-4-methoxy-2-naphthylamide and the effects of a DPP-4 inhibitor were examined in human cultured podocyte. Results DPP-4 activity under normal conditions was observed in some Bowman's capsular epithelial cells and proximal tubules, but not in the glomerulus. DPP-4 activity was observed in crescent formation in anti-neutrophil myeloperoxidase cytoplasmic antigen antibody nephritis, nodular lesions in diabetic nephropathy, and some podocytes in focal segmental glomerulosclerosis. Notably, the DPP-4 inhibitor saxagliptin suppressed DPP-4 activity in podocytes and the proximal tubules. To assess the effect of DPP-4 inhibitor on podocytes, human cultured podocytes were injured by Adriamycin, which increased DPP-4 activity; this activity was dose-dependently suppressed by saxagliptin. Treatment with saxagliptin maintained the structure of synaptopodin and RhoA and improved the detachment of podocytes. Conclusions DPP-4 activity induces degradation of synaptopodin, resulting in destruction of the podocyte cytoskeleton. Saxagliptin may have pleiotropic effects to prevent podocyte injury.
Reconciling relationships with physical activity: A qualitative study of women’s postnatal physical activity decision-making
Authors: Liva Sarah , Hall Wendy , Oliffe John 
Published: March 2020

Abstract
Background: Challenges with engaging in postnatal physical activity can negatively affect the health of new mothers and their families. This study investigated women’s physical activity decision-making processes and strategies to support their physical activity as part of a healthy postpartum transition. Methods: Thirty healthy women with infants aged 2.5-12 months completed 3-day activity diaries and an individual interview. Using Glaser and Charmaz’s grounded theory methodology, the core category, reconciling relationships with physical activity, was derived, which explained women’s processes of postnatal physical activity decision-making. Results: Through reconciling relationships with physical activity, women discerned the types of physical activity they were comfortable pursuing at various points in the postpartum transition. Based on the meaning physical activity held for participants and their views about risks, supports, and resources, women gauged their capacity and the workability of their physical activity desires. Most women were uncertain of their capacity (physical, emotional) to return to physical activity and viewed the achievement of several or all of their desired physical activities as unworkable. Only a third fully pursued the desirable physical activities they viewed as important for their well-being. Women adjusted the strategies they used to achieve physical activity when their expectations of capacity and workability did not align with their experiences. Some women lacked access to resources or supportive messaging about postpartum physical activity and downgraded their physical activity pursuit after negative physical or childcare experiences. Conclusions: Women can benefit from discussions about physiological birth recovery and navigating community and peer resources to support physical activity access and the safe return to physical activity following birth.
Efficacy evaluation of the photodynamic therapy for oral lichen planus: a systematic review and meta-analysis
Authors: He Yuqing , Deng Jiaxin , Zhao Yi , Tao Huiqian , Dan Hongxia , Xu Hao , Chen Qianming 
Published: March 2020

Abstract
Background Photodynamic therapy (PDT) is a new option for oral lichen planus (OLP) management, while there are different opinions on the efficacy of PDT for OLP. To comprehensively assess the efficacy of PDT in the treatment of OLP, and compare it with steroid therapy . Methods A systematic review and meta-analysis was conducted to assess the curative effect of PDT, five electronic databases were searched, including PubMed, Web of Science (SCI), the Cochrane Library, Embase, and EBSCO, up to December 1, 2019. Random or fixed effects models for pooled estimates calculation were used and the Meta package of R software was applied. Results Pooled estimates revealed that lesion size decreased by 1.53 cm 2 (95%: 0.71-2.35) after PDT, while partial response (PR) reached 0.77 (95% CI: 0.65–0.85). The visual analog scale score was decreased 3.82 (95%CI:2.80-4.85), and the Thongprasom sign score was decreased 1.33 (95%CI:0.56-2.10) after PDT. Subgroup analyses revealed that the 5-Aminolevulinic acid (5-ALA) was more effective than methylene blue (MB), with the PR was 0.87 (95%:0.80-0.91). Topical use of 5-ALA can yield better response than gargling methylene blue. In terms of VAS, the diode laser showed better clinic partial response in treatment of OLP. But on changes of lesion size, the efficacy of semiconductor laser is higher than diode laser. And the similar efficacy of PDT with topical corticosteroids was confirmed by pooled estimates of five RCT trials with 139 lesions. Conclusion This systematic review indicates that PDT is an effective treatment modality in the management of OLP. Besides, PDT is as effective as topical corticosteroid in treating OLP and could be used for cases resistant to steroids or when steroids are contraindicated.
Twin-block appliance promotes condylar remodeling in patients with Class II malocclusion: a systematic review
Authors: Xu Jingchen , Xu Lin , Yin Yuanyuan , Yin Ke , Chen Song 
Published: March 2020

Abstract
Background: To evaluate the changes of condylar in patients with Class II malocclusion treated with Twin-block appliance. Methods: Six electronic databases, including PubMed, Embase, Cochrane library, Chinese Biomedical Literature Database, China National Knowledge Infrastructure and VIP Database were searched until October 15, 2019 without language restrictions. Randomized controlled trials (RCTs) and clinical controlled trials (CCTs) reporting condylar changes produced by Twin-block appliance in Class II malocclusion patients were included. Literature filtering, data extraction, and methodological quality assessment were finished by two reviewers independently. Meta-analysis was performed with Review Manager (version5. 3; Nordic Cochrane Centre, Cochrane Collaboration, Copenhagen, Denmark). For continuous data, the mean difference and their 95% confidence intervals were used for statistical pooling. Results: Three studies with a total of 100 patients were included (1 RCT and 2 CCTs). The meta-analysis indicated a significant increase of condylar dimensions after Twin-block treatment in Class II malocclusion patients, including 0.91mm in height, 1.03mm in width, and 1.08mm in length. There were statistically significant increments in the superior and posterior joint spaces and no significant change in the anterior joint space. Conclusions: Twin-block appliance promotes the remodeling of condylar and stimulates forward and downward movement of condylar. Further high-quality studies with large samples and long-term evidence are still required to obtain more reliable conclusions. Keywords: Twin-block appliance; Class II malocclusion; Temporal Mandibular Joint; Systematic review; Meta-analysis
Examination of inter-rater and intra-rater reliability during retentive force measurement of different clasps using the developed small-sized retentive force measurement device
Authors: AKIYAMA Hitoshi , SAKAMOTO Maiko , AKAMA Ryoichi , TAKEI Jun 
Published: March 2020

Abstract
The purpose of the present study is to develop a small-sized retentive force measurement device that can easily measure the retentive force of a clasp used for a removable partial denture in daily clinical practice, and it is to examine the inter-rater and intra-rater reliability. A small-sized retentive force measurement device that can be easily measured in clinic has been developed. Using commercially available hard plaster cast, a skilled dental technician has made 10 types of cast clasps used in clinical practice using conventional techniques. There were 3 assessors who measured the retentive force of 10 types of cast clasps. In order to confirm the reliability, the intra-class correlation coefficients ICC (1,1) and ICC (1,3) of the 3 assessors were calculated, and the reliability within the assessor was examined. Further, the inter-class correlation coefficients ICC (3,1) and ICC (3,3) were calculated, and the reliability between the measurers was examined. The intra-class correlation coefficients of 3 assessors are as follows: assessor 1 has ICC (1,1) = 0.971, ICC (1,3) = 0.990, assessor 2 has ICC (1,1) = 0.967, ICC (1,3) = 0.989, assessor 3 has ICC (1,1) = 0.962, ICC (1,3) = 0.987. The inter-class correlation coefficients of 3 assessors are as follows: ICC (3,1) = 0.993, ICC (3,3) = 0.998. From the evaluation standard of the intraclass correlation coefficients of reliability value by ICC, it was evaluated as almost perfect and high reproducibility was confirmed. The developed small-sized retentive force measurement device has reproducibility within and between the assessors.
Tickborne disease awareness and protective practices among U.S. Forest Service employees from the Upper Midwest, USA
Authors: Schotthoefer Anna , Stinebaugh Kathryn , Martin Michael , Munoz-Zanzi Claudia 
Published: March 2020

Abstract
Background: People with occupations that require them to spend time working outdoors in suitable tick habitats are predicted to be at an increased risk for tick-borne diseases (TBDs). However, few studies have assessed the risks of outdoor employees.Methods: We conducted a cross-sectional survey to evaluate the exposure to ticks and tick-borne disease infections among U.S. Forest Service employees in a high TBD incidence region of northwestern Wisconsin, and to examine their knowledge, attitudes, and practices (KAPs) regarding TBDs to help guide future education and prevention programs. Chi-square contingency tables, calculations of odds ratios, and logistic regression models were used to identify associations among self-reported employee factors, and the proportion of correctly answered knowledge questions, their ranked concern for TBDs, practicing preventive behaviors, and willingness to pay for protective measures. Results: Ninety-five employees completed the survey. Nearly all respondents (97%) reported recent tick exposure and their knowledge of TBD was high (median score: 80% correct). Fifty-nine percent of respondents had high concern for TBDs, and there was high adherence to conducting body checks for ticks (83% reported always doing them), but only moderate use of tick repellents (24% reported always and 60% reported occasionally using). High concern (OR = 3.4 [1.33- 8.91]) and a history of TBD (OR = 4.66 [1.21 – 17.89]) were positively associated with high practice adherence. Respondents suggested they would be willing to pay for personal protective methods and get a hypothetical vaccine for Lyme disease, but not community-wide efforts to control ticks. Conclusions: Our study provides evidence that U.S. Forest Service employees in Wisconsin represent a high risk group for TBD, and despite relatively high TBD knowledge and engagement in tick protection activities, targeted prevention programs are still needed to reduce their risks for tick bites.
Biopsychosocial factors associated with opioid misuse in a 2017-2018 United States national survey: A comprehensive multivariate model
Authors: Ishino Francisco Alejandro Montiel , Gilreath Tamika , Salmeron Bonita , Williams Faustine 
Published: March 2020

Abstract
Background Few studies have comprehensively and contextually examined the relationship of variables associated with opioid misuse. Our purpose was to fill a critical gap in comprehensive risk models of opioid misuse in the United States by identifying the most salient predictors. Methods A multivariate logistic regression was used on the 2017 and 2018 National Survey on Drug Use and Health, which included all 50 states and the District of Columbia of the United States. The sample included all noninstitutionalized civilian adults aged 18 and older (N=85,580; weighted N=248,008,986). The outcome of opioid misuse was based on reported prescription pain reliever and/or heroin dependence or abuse. Biopsychosocial predictors of opioid misuse in addition to sociodemographic characteristics and other substance dependence or abuse were examined in our comprehensive model. Biopsychosocial characteristics included socioecological and health indicators. Criminality was the socioecological indicator. Health indicators included self-reported health, private health insurance, psychological distress, and suicidality. Sociodemographic variables included age, sex/gender, race/ethnicity, sexual identity, education, residence, income, and employment status. Substance dependence or abuse included both licit and illicit substances (i.e., nicotine, alcohol, marijuana, cocaine, inhalants, methamphetamine, tranquilizers, stimulants, sedatives). Results The comprehensive model found that criminality (adjusted odds ratio [AOR]=2.58, 95% confidence interval [CI]=1.98-3.37, p<0.001), self-reported health (i.e., excellent compared to fair/poor [AOR=3.71, 95%CI=2.19-6.29, p<0.001], good [AOR=3.43, 95%CI=2.20-5.34, p<0.001], and very good [AOR=2.75, 95%CI=1.90-3.98, p<0.001]), no private health insurance (AOR=2.12, 95%CI=1.55-2.89, p<0.001), serious psychological distress (AOR=2.12, 95%CI=1.55-2.89, p<0.001), suicidality (AOR=1.58, 95%CI=1.17-2.14, p=0.004), and other substance dependence or abuse were significant predictors of opioid misuse. Substances associated were nicotine (AOR=3.01, 95%CI=2.30-3.93, p<0.001), alcohol (AOR=1.40, 95%CI=1.02-1.92, p=0.038), marijuana (AOR=2.24, 95%CI=1.40-3.58, p=0.001), cocaine (AOR=3.92, 95%CI=2.14-7.17, p<0.001), methamphetamine (AOR=3.32, 95%CI=1.96-5.64, p<0.001), tranquilizers (AOR=16.72, 95%CI=9.75-28.65, p<0.001), and stimulants (AOR=2.45, 95%CI=1.03-5.87, p=0.044). Conclusions Biopsychosocial characteristics such as socioecological and health indicators, as well as other substance dependence or abuse were stronger predictors of opioid misuse than sociodemographic characteristics.