bluuebunny/crossref_metadata_2025_split huggingface dataset:
Temporal trends in pre-ART patient characteristics and outcomes before the Test and Treat era in Central Kenya
Authors: Wekesa Paul , McLigeyo Angela , Owuor Kevin , Mwangi Jonathan , Isavwa Linda , Katana Abraham 
Published: December 2020

Abstract
Background Retention of patients who did not to initiate antiretroviral therapy (ART) has been persistently low compared to those initiated ART. Understanding the temporal trends in clinical outcomes prior to ART initiation is important to inform interventions targeting patients who do not initiate ART immediately after diagnosis. Methods A retrospective cohort analysis of known HIV-infected patients who did not initiate ART from healthcare facilities in Central Kenya was done to investigate temporal trends in characteristics, retention, and mortality outcomes. The data were sourced from the Comprehensive Care Clinic Patient Application Database (CPAD) and IQ care electronic patient-level databases for those enrolled between 2004 and 2014. Results A total of 13,779 HIV-infected patients were assessed, of whom 30.7% were men.There were statisitically significant differences in temporal trends relating to marital status, WHO clinical stage, and tuberculosis (TB) status from 2004 to 2014. The proportion of widowed patients decreased from 9.1% to 6.0%. By WHO clinical stage at enrollment in program, those in WHO stage I increased over time from 8.7% to 43.1%, while those in WHO stage III and IV reduced from 28.5% to 10.8% and 4.0% to 1.1% respectively. Those on TB treatment during their last known visit reduced from 8.3% to 3.9% while those with no TB signs increased from 58.5% to 86.8%. Trends in 6 and 12 month retention in the program, loss to follow-up (LTFU) and mortality were statistically significant. At 6 months, program retention ranged between 36.0% in 2004 to a high of 54.1% in 2013. LTFU at six months remained around 50.0% for most of the cohorts, while mortality at 6 months was 7.5% in 2004 but reduced to 3.8% in 2014. At 12 months, LTFU was above 50.0% across all the cohorts while mortality rate reached 3.9% in 2014. Conclusion Trends in pre ART enrollment suggested higher enrollment among patients who were women and at earlier WHO clinical stages. Retention and mortality outcomes at 6 and 12 months generally improved over the 11 year follow-up period, though dipped as enrollment in asymptomatic disease stage increased.
Retrospective analysis of pediatric patients with multiple rare-earth magnets ingestion: a single-center experience from China.
Authors: Zheng Yucan , Zhang Zhihua , Yan Kunlong , Guo Hongmei , Li Mei , Lian Min , Liu Zhifeng 
Published: December 2020

Abstract
Background The aim of this study was to characterize patients who ingested multiple rare-earth magnets, reveal the harm of rare-earth magnet foreign bodies in the digestive tract, and develop a clinical management algorithm. Methods This was a retrospective review of patients with rare-earth magnet foreign bodies in the digestive tract admitted to a university-affiliated pediatric medical center in China, between January 2016 and December 2019; the subset of medical data evaluated included clinical symptoms, signs, treatments and outcomes. Results A total of 51 cases were included in this study, including 36（70.6%） males and 15（29.4%） females. The magnets were passed naturally in 24（47.1%） patients and removed by intervention in 27（52.9%） patients, including 5（9.8%） cases by endoscopy and 22（43.1%） cases by surgery. Twenty-two（43.1%）cases had gastrointestinal obstruction, perforation, and fistula. Compared with the non-surgical group, the time of the surgical group from ingestion to arriving at the hospital was longer（［80（5-336） vs 26（2-216）］hours, p<0.001）while there was no significant difference in the mean age or the number of magnets swallowed. Conclusions Magnets are attractive to children, but lead to catastrophic consequences including gastrointestinal obstruction, perforation, and surgical interventions when ingested multiple magnets. Endoscopic resection should be urgently performed in the presence of multiple magnets as early as possible within 24 hours, even in asymptomatic patients.
An Inexpensive Retrospective Standard Setting Method Based on Item Facilities
Authors: McLachlan John C , Robertson K. Alex , Weller Bridget , Sawdon Marina 
Published: December 2020

Abstract
BackgroundStandard setting is one of the most challenging aspects of assessment in high-stakes healthcare settings. The Angoff methodology is widely used, but poses a number of challenges, including conceptualisation of the just-passing candidate, and the time-cost of implementing the method. Cohen methodologies are inexpensive and rapid but rely on the performance of an individual candidate. A new method of standard setting, based on the entire cohort and every item, would be valuable.MethodsWe identified Borderline candidates by reviewing their performance across all assessments in an academic year. We plotted the item scores of the Borderline candidates in comparison with Facility for the whole cohort and fitted curves to the resulting distribution.ResultsIt is observed that for any given Item, an equation of the form y ≈ C.eFxwhere y is the Facility of Borderline candidates on that Item, x is the observed Item Facility of the whole cohort, and C and F are constants, predicts the probable Facility for Borderline candidates over the test, in other words, the cut score for Borderline candidates. We describe ways of estimating C and F in any given circumstance, and suggest typical values arising from this particular study: that C = 12.3 and F = 0.021.ConclusionsC and F are relatively stable, and that the equation y = 12.3.e0.021xcan rapidly be applied to the item Facility for every item. The average value represents the cut score for the assessment as a whole. This represents a novel retrospective method based on test takers.Compared to the Cohen method which draws on one score and one candidate, this method draws on all items and candidates in a test. We propose that it can be used to standard set a whole test, or a particular item where the predicted Angoff score is very different from the observed Facility.
Genetic and clinical phenotypic analysis of familial stapes sclerosis caused by a NOG mutation
Authors: Yu Rong , Jiang Hong-Qun , Liao Hui-Huang , Luo Wu-Gen 
Published: December 2020

Abstract
Background: The noggin protein encoded by the NOG gene can interfere with the binding of bone morphogenetic protein to its receptor, thus affecting bone and joint development. The symptoms include abnormal skeletal development and conductive deafness.Methods: In a retrospective study, clinical data of the proband and her family members, including 8 people and 50 healthy normal controls, were collected. Second-generation sequencing was performed on peripheral blood samples from them.Results: The sequencing analysis indicated that in the proband, the NOG gene had a c.532T>C, p.C178R (cytosine deletion, NM_005450.6:c.532T>C), leading to an amino acid change. The proband's father, grandmother, second sister, and third sister also had this mutation, whereas family members with normal phenotypes did not have the mutation.Conclusion: Analysis of this family showed that the novel presentation of the c.532T>C, p.C178R mutation in the NOG gene resulted in syndrome-type autosomal dominant inheritance reflected in a mild clinical phenotype, which is of great importance for further studies of the clinical phenotype and pathogenesis of stapes sclerosis.
Integrating expert opinions with clinical trial data to analyse low-powered subgroup analyses: a Bayesian analysis of the VeRDiCT trial
Authors: Thirard Russell , Ascione Raimondo , Blazeby Jane , Rogers Chris A 
Published: December 2020

Abstract
BackgroundTypically, subgroup analyses in clinical trials are conducted by comparing the intervention effect in each subgroup by means of an interaction test. However, trials are rarely, if ever, adequately powered for interaction tests, so clinically important interactions may go undetected. We discuss the application of Bayesian methods by using expert opinions alongside the trial data. We applied this methodology to the VeRDiCT trial investigating the effect of preoperative volume replacement therapy (VRT) versus no VRT (usual care) in diabetic patients undergoing cardiac surgery. Two subgroup effects were of clinical interest, a) preoperative renal failure and b) preoperative type of antidiabetic medication. MethodsClinical experts were identified within the VeRDiCT trial centre in the UK. A questionnaire was designed to elicit opinions on the impact of VRT on the primary outcome of time from surgery until medically fit for hospital discharge, in the different subgroups. Prior beliefs of the subgroup effect of VRT were elicited face-to-face using two unconditional and one conditional questions per subgroup analysis. The robustness of results to the ‘community of priors’ was assessed. The community of priors was built using the expert priors for the mean average treatment effect, the interaction effect or both in a Bayesian Cox proportional hazards model implemented in the STAN software in R. ResultsExpert opinions were obtained from 7 clinicians (6 cardiac surgeons and 1 cardiac anaesthetist). Participating experts believed VRT could reduce the length of recovery compared to usual care and the greatest benefit was expected in the subgroups with the more severe comorbidity. The Bayesian posterior estimates were more precise compared to the frequentist maximum likelihood estimate and were shifted toward the overall mean treatment effect. Conclusions In the VeRDiCT trial, the Bayesian analysis did not provide evidence of a difference in treatment effect across subgroups. However, this approach increased the precision of the estimated subgroup effects and produced more stable treatment effect point estimates than the frequentist approach. Trial methodologists are encouraged to prospectively consider Bayesian subgroup analyses when low-powered interaction tests are planned.Trial registration ISRCTN, ISRCTN02159606. Registered 29th October 2008.
Whole-Exome Sequencing in 168 Korean Patients with Inherited Retinal Degeneration
Authors: Ma Dae Joong , Lee Hyun-Seob , Kim Kwangsoo , Choi Seongmin , Jang Insoon , Cho Seo-Ho , Yoon Chang Ki , Lee Eun Kyoung , Yu Hyeong Gon 
Published: December 2020

Abstract
Background To date, no genetic analysis of inherited retinal disease (IRD) using whole-exome sequencing (WES) has been conducted in a large-scale Korean cohort. The aim of this study was to characterise the genetic profile of IRD patients in Korea using WES. Methods We performed comprehensive molecular testing in 168 unrelated Korean IRD patients using WES. The potential pathogenicity of candidate variants was assessed using the American College of Medical Genetics and Genomics and the Association for Molecular Pathology variant interpretation guidelines, in silico prediction tools, published literature, and compatibility with known phenotypes or inheritance patterns.Results Causative variants were detected in 86/168 (51.2%) IRD patients, including 58/107 (54.2%) with retinitis pigmentosa, 7/15 (46.7%) with cone and cone-rod dystrophy, 2/3 (66.6%) with Usher syndrome, 1/2 (50.0%) with congenital stationary night blindness, 2/2 (100.0%) with Leber congenital amaurosis, 1/1 (100.0%) with Bietti crystalline dystrophy, 1/1 (100.0%) with Joubert syndrome, 9/10 (90.0%) with Stargardt macular dystrophy, 1/10 (10.0%) with vitelliform macular dystrophy, 1/11 (9.1%) with other forms of macular dystrophy, and 3/4 (75.0%) with choroideraemia. USH2A, ABCA4, and EYS were the most common causative genes associated with IRD. For retinitis pigmentosa, variants of USH2A and EYS were the most common causative gene mutations.Conclusions This study demonstrated the distribution of causative genetic mutations in Korean IRD patients. The data will serve as a reference for future genetic screening and development of treatment modalities for Korean IRD patients.
The path linking disease severity and cognitive function with quality of life in Parkinson's disease:the mediating effect of activities of daily living and depression.
Authors: He Yao , Tian Yuling , Han Hongjuan , Cui Jing , Ge Xiaoyan , Qin Yao , Luo Yanhong , Bai Wenlin , Yu Hongmei 
Published: December 2020

Abstract
Background: Research on quality of life (QOL) with Parkinson’s disease (PD) has examined direct influencing factors, not mediators. The study aim was to explore whether PD severity and poor cognitive function may decrease physical and mental QOL by reducing activities of daily living (ADL) and increasing depression in sequence. Methods: We conducted a cross-sectional questionnaire study of 150 PD hospital patients in China. PD severity, cognitive function, ADL, depression, and QOL were evaluated. We used structural equation modeling to analyze the mediating effects of ADL and depression on the association between PD severity/cognition and physical (PCS) and mental (MCS) QOL. Results:There was a significant mediating effect of PD severity on PCS via ADL and depression (95%CI: −0.669, −0.026), and a significant direct effect (p<0.001). The mediating effect of PD severity on MCS via ADL and depression was significant (95%CI: −2.135, −0.726), but there was no direct effect (p = 0.548). There was a significant mediating effect of cognitive function on PCS via ADL and depression (95%CI: 0.025, 0.219) and a significant direct effect (p<0.001). The mediating effect of cognitive function on MCS via ADL and depression was significant (95%CI: 0.256, 0.645), but there was no direct effect (p = 0.313). The PCS models showed a partial mediation, and the MCS models showed a complete mediation, of ADL and depression.Conclusions:PD severity and cognitive function increase depression by reducing ADL, leading to lower QOL, and directly or indirectly affect PCS and MCS through different pathways.
Investigation of the role of AcTPR2 in kiwifruit and its response to Botrytis cinerea infection
Authors: Li Zhexin , Lan Jian-Bin , Liu Yi-Qing , Qi Li-Wang , Tang Jianmin 
Published: December 2020

Abstract
Background: Elucidation of the regulatory mechanism of kiwifruit response to gray mold disease caused by Botrytis cinerea can provide the basis for its molecular breeding to impart resistance against this disease. In this study, 'Hongyang' kiwifruit served as the experimental material; the TOPLESS/TOPLESS-RELATED (TPL/TPR) co-repressor gene AcTPR2 was cloned into a pTRV2 vector (AcTPR2-TRV) and the virus-induced gene silencing technique was used to establish the functions of the AcTPR2 gene in kiwifruit resistance to Botrytis cinerea.Results: Virus-induced silencing of AcTPR2 enhanced the susceptibility of kiwifruit to Botrytis cinerea. Defensive enzymes such as superoxide dismutase (SOD), peroxidase (POD), catalase (CAT), and phenylalanine ammonia-lyase (PAL) and endogenous phytohormones such as indole acetic acid (IAA), gibberellin (GA3), abscisic acid (ABA), and salicylic acid (SA) were detected. Kiwifruit activated these enzymes and endogenous phytohormones in response to pathogen-induced stress and injury. The expression levels of the IAA signaling genes—AcNIT, AcARF1, and AcARF2—were higher in the AcTPR2-TRV treatment group than in the control. The IAA levels were higher and the rot phenotype was more severe in AcTPR2-TRV kiwifruits than that in the control. These results suggested that AcTPR2 downregulation promotes expression of IAA and IAA signaling genes and accelerates postharvest kiwifruit senescence. Further, Botrytis cinerea dramatically upregulated AcTPR2, indicating that AcTPR2 augments kiwifruit defense against pathogens by downregulating the IAA and IAA signaling genes.Conclusions: The results of the present study could help clarify the regulatory mechanisms of disease resistance in kiwifruit and furnish genetic resources for molecular breeding of kiwifruit disease resistance.
First report of Thelazia callipaeda infection in Phortica okadai and wildlife in national nature reserves, China
Authors: Jin Yipeng , Liu Zichen , Wei Jiaqi , Wen Yifan , He Nianjun , Tang Liubin , Lin Degui , Lin Jiahao 
Published: December 2020

Abstract
Background: Thelazia callipaeda is a zoonotic parasitic nematode of the family Thelaziidae, with Phortica okadai as the intermediate host and the only confirmed vector in China. China has the largest number of cases of thelaziosis in humans of the world. It is generally believed that the infected domestic animals (dogs and cats) are the most important reservoir hosts of Thelazia callipaeda and directly threaten humans. At present, there is not much research and attention on the role of wildlife in the transmission cycle of thelaziosis in wildlife nature reserves.Methods: During 2016-2019, we selected four wildlife national nature reserve across the country as monitoring points for Phortica okadai and wildlife, and we chose to use fly-trap method for monitoring Phortica okadai density. Morphological analysis of the parasites collected from the conjunctival sac of the wildlife was taken as the first step, and a specific PCR was used for exact confirmation.Results: In 2019, the density of Phortica okadai in Foping National Nature Reserve of China, increased sharply and infected Phortica okadai were newly found in wildlife nature reserves. Wild giant panda, wild boar, leopard cat, and black bear were newly found to be infected by Thelazia callipaeda (one animal of each species). A total of four worms were collected and one worm was collected from each animals. The morphologic characteristics of the four worms led to their identification as Thelazia callipaeda, which was molecularly confirmed by a specific PCR amplification.Conclusions: This is the first report of Phortica okadai as well as a variety of wildlife including wild giant panda infected by Thelazia callipaeda in wildlife nature reserves in China. This indicates that there has been a transmission cycle of thelaziosis among wildlife in wildlife nature reserves. The increasing number of case reports in wildlife suggests the likely risk of infection of Thelazia callipaeda in villagers around wildlife nature reserves.
Mapping the Organizational Readiness to Change Assessment to the Consolidated Framework for Implementation Research
Authors: Kononowech Jennifer , Hagedorn Hildi , Hall Carmen , Helfrich Christian D. , Lambert-Kerzner Anne C. , Miller Susan C. , Sales Anne E. , Damschroder Laura 
Published: December 2020

Abstract
Background: Implementation researchers recognize the influential role of organizational factors and thus, seek to assess these factors using quantitative measurement instruments. However, researchers are hindered by instruments that measure similar constructs but rely on different nomenclature and/or definitions. The Consolidated Framework for Implementation Research (CFIR) provides a taxonomy of constructs derived from prior frameworks and empirical studies of implementation-related constructs. The CFIR includes constructs based on the original Promoting Action Research into Health Services (PARiHS) framework which highlights the key roles of strength of evidence for a specific evidence-based intervention (EBI); favorability of organizational context for change; and capacities to facilitate implementation of the EBI. Although the CFIR is among the most frequently used implementation frameworks, it does not include quantitative measures. The Organizational Resource and Context Assessment (ORCA) is a quantitative measurement instrument that was developed based on PARiHS, assessing its three domains. Factors within these three domains are conceptually similar to constructs in the CFIR but do not match directly. The aim of this work was to map ORCA survey items to CFIR constructs to enable direct comparisons and syntheses of findings across studies using the CFIR and/or ORCA. Methods: Two distinct, independent research teams, each used rigorous constant comparative techniques with deliberation and consensus to map individual items from the ORCA to the five domains and 39 constructs of CFIR. Results: ORCA items were mapped primarily to three of five CFIR domains: Inner Setting, Process and Intervention Characteristics. The two research teams agreed on 88% of mappings at the higher domain level; at the lower construct level, their mappings aligned for 62.2% of the ORCA items. Conclusions: Mapping results reveal that the ORCA focuses measurement prominently on Inner Setting, Process, and Intervention Characteristics. This mapping guide can help improve consistency in measurement and reporting, enabling more efficient comparison and synthesis of findings that use either the ORCA instrument or the CFIR framework. The guide helps advance implementation science utilizing mixed methods by providing CFIR users with quantitative measures for selected constructs and enables ORCA users to map their findings to CFIR constructs.
Myocardial lschemia Reperfusion Injury is Alleviated by Curcumin-Peptide Hydrogel via Upregulating Autophagy and Protecting Mitochondrial Function
Authors: Liao Chilin , Liu Yang , Huang Mengzhao , Liu Huayong , Ye Ziliang , Su Qiang 
Published: December 2020

Abstract
Background: Ischemia-reperfusion injury (IRI) is an important factor limiting the success of cardiac reperfusion therapy. Curcumin has a significant cardioprotective effect against IRI, inhibits ventricular remodeling induced by pressure load or MI, and improve cardiac function. However, the poor water solubility and low bioavailability of curcumin restrict its clinical application. Methods: In this study, we prepared and evaluated a curcumin-hydrogel ( cur-hydrogel ) to reduce cardiomyocyte apoptosis and reactive oxygen species formation induced by hypoxia-reoxygenation injury, promote autophagy, and reduce mitochondrial damage by maintaining the phosphorylation of Cx43. Results: Cur-hydrogel can restore cardiac function, inhibit myocardial collagen deposition and apoptosis, and activate JAK2/STAT3 pathway to alleviate myocardial ischemia-reperfusion injury in rats. Conclusions: This study elucidate the protective effects of cur-hydrogel on myocardial ischemia-reperfusion injury by regulating apoptosis, autophagy and mitochondrial injury in vitro and in vivo , which lays a new theoretical and experimental foundation for the prevention and reduction of IRI.
Relationship between the Severity of Endometriosis Symptoms (Dyspareunia, Dysmenorrhea and Chronic pelvic pain) with the Spread of the Disease on Ultrasound
Authors: Kor Elham , Mostafavi Seyed Reza Saadat , Mazhin Zahra Ahmadian , Dadkhah Adeleh , Kor Anis , Arvanagh Shirin Habibi , Noroozi Shima Ghafourian , Sadri Ghazal 
Published: December 2020

Abstract
Objectives: About 10-15% of women of childbearing age have endometriosis. The present study aimed to investigate the relationship between the severity of symptoms of endometriosis and the spread as well as the stage of the disease on ultrasonography. The present cross-sectional study evaluates the relationship between the severity of endometriosis symptoms and the spread of disease on ultrasonography in patients with endometriosis.Results: Considering different analyses, the cumulative size of posterior Deep Infiltrative Endometriosis (DIE) (less than 1 cm) is significantly correlated with minimal severity of dyspareunia and chronic pelvic pain. The incidence of dyspareunia was more prevalent in patients with complete stenosis of Douglas pouch than those with incomplete stenosis. Furthermore, the incidence of severe and very severe pain in patients with Douglas pouch stenosis is relatively higher than that in patients without stenosis. Only dyspareunia is related to the stage of endometriosis, and patients with dyspareunia are five times more at risk of a higher stage of the disease. The severity of dyspareunia is related to the stage of endometriosis and the severity of Douglas pouch stenosis. The results showed a correlation between chronic pelvic pain and r-ASRM score (revised American Society for Reproductive Medicine score).