bluuebunny/crossref_metadata_2025_split huggingface dataset:
Masquelet Technique: Effects of Topical Mechanical Stability on the Formation of Masquelet Membrane in a Rabbit Radial Defect Model
Authors: Jie Xie , Donghao Liu , Haoyi Wang , Haitao Long , Yong Zhu , Yihe Hu , Liang Cheng , Zeng Min 
Published: January 2020

Abstract
Purpose The Masquelet technique is a commonly treatment strategy for segmental bone defects. Still, the exact generating mechanism is unknown. This study intends to explore the effects of topical mechanical stability on the formation of Masquelet membrane. Methods Thirty-six New Zealand white rabbits were evenly randomized into three groups. Segmental left radius shaft defect (length, 9 mm) was created in all rabbits. Bone defects were filled with polymethylmethacrylate (PMMA) in Non-fixation group, and with PMMA fixed with plates in Fixation group, and subjected to no disposal in control group. The stability of PMMA and plates were monitored via X-ray. And the membranes were excised for further Histological, IHC (Ki67, COL I, and CD31), and Western-Blotting analysis (RUNX2, ALP, VEGFA, and TGF-β1), 4 and 6 weeks post-operatively Results X-ray revealed no sign of plates loosening, or shift of PMMA. Pathological examinations suggested that vascularized and osteogenic membranes were formed around PMMA. IHC and Western-Blotting analysis revealed that both Fixation and Non-fixation group exerted significant effects on the expression of Ki67, COL I, and CD31 positive cells, as well as the protein expression of osteogenic (RUNX2, ALP) and angiogenic (VEGFA, TGF-β1) factors. And compared with membrane in Non-fixation group, Fixing PMMA spacer with plates caused a significant increase in osteogenic and angiogenic expression, 4 and 6 weeks post-operatively. Conclusion The present study indicates that rigid fixation provided by internal plate in Masquelet technique positively alters the quality of membrane formed surrounding PMMA, in terms of significantly osteogenic and angiogenic potential.
In vitro study of foot bone kinematics via a custom-made cadaveric gait simulator
Authors: Zhu Genrui , Wang Zhifeng , Yuan Chengjie , Geng Xiang , Yu Jian , Zhang Chao , Huang Jiazhang , Wang Xu , Ma Xin 
Published: January 2020

Abstract
BackgroundQuantifying detailed kinematics of the intrinsic foot bone during gait is crucial for understanding biomechanical functions of the foot complex musculoskeletal structure and making appropriate surgery decisions.Research question The purpose of this experiment is to measure bones kinematic of the normal foot in a gait cycle via a custom-made cadaveric gait simulator.MethodsIn this experiment, we used a custom-made 6 degrees of freedom (DOF)of robotic gait simulator simulating normal human gait to measure the 3-dimensional (3D) kinematics of tibia, calcaneus, cuboid, navicular, medial cuneiform, first metatarsal, and fifth metatarsal through six cadaveric feet.ResultsThe results showed that the kinematic of the intrinsic foot bones in the stance phase of the gait was successfully quantified using a custom-made robotic gait simulator. During walking stance, the joints in the medial column of foot had less movement than those in the lateral column. And during the later portion of stance, no rotational cease was observed in the movement between navicular and cuboid, calcaneocuboid joint, or cuneonavicular joint.SignificanceThis study described foot bone motion using a biomechanically near-physiological gait simulator with 6 DOF of the tibia. The kinematic data helps to clarify previous descriptions of several joints kinematics that are difficult to study in vivo. The methodology also provides a platform for researchers to explore more invasive foot biomechanics under dynamic and near-physiologic conditions.
Translating evidence into practice: A longitudinal qualitative exploration of allied health decision making.
Authors: White Jennifer , Grant Kellie , Sarkies Mitchell , Haines Terrence 
Published: January 2020

Abstract
BackgroundHealth policy and management decisions rarely reflect research evidence. In response, it is important to determine how to improve evidence-informed decision-making. As part of a broader study exploring implementation science strategies we examined how allied health managers respond to two distinct recommendations and the evidence that supports them. MethodsAllied health managers across Australia and New Zealand who were responsible for weekend allied health resource allocation decisions towards the provision of inpatient service to acute general medical and surgical wards, and sub-acute rehabilitation wards were eligible for inclusion. Consenting participants were randomised to: (1) control group or; (2) Implementation Group 1: received an evidence-based policy recommendation document guiding weekend allied health resource allocation decisions, or (3) Implementation Group 2: received the same policy recommendation document guiding weekend allied health resource allocation decisions with support from a knowledge broker. Serial focus groups were conducted with a sample of over 80 allied health managers recruited to Implementation Group 2 only. Out of 6 waves of recruitment, up to four focus groups were conducted with each wave during the 12 months study period. In total 17 health services participated in serial focus groups according to their allocated wave, over a 12-month study period. Data were analysed using an inductive thematic approach with constant comparison. Thematic saturation was achieved.ResultsResults provide insights into resource allocation and decision-making, including the interplay between barriers and facilitators concerning implementation of recommendations outlined in evidence-based policy recommendation document. Five key themes emerged: (1) Local data trumps, or is more influential; (2) How good is the evidence and does it apply to us; (3) It is difficult to change things; (4) Historically that’s how we have done things; and (5) What if we get complaints?ConclusionsThis study explored implementation of strategies to bridge gaps in evidence-informed decision-making. Results provide insight into barriers, which prevent the implementation of evidence base practice from fully, and successfully occurring such as attitudes towards evidence, limited skills in critical appraisal, and lack of authority to promote change. In addition, strategies are needed to manage the risk of confirmation biases in decision-making processes.
Screening of organic micropollutants in raw and drinking water in the Yangtze River Delta, China
Authors: Ren Hanwei , Tröger Rikard , Ahrens Lutz , Wiberg Karin , Yin Daqiang 
Published: January 2020

Abstract
Background The vast occurrence of organic micropollutants in surface waters has raised concerns about drinking water safety and public health. The Tai Hu Basin region in China, a typical developing and populous area, is facing the challenge of water pollution. To ensure drinking water safety, the knowledge on how treatment techniques and raw water quality affect the quality of finished water must be improved. The aim of the current study was to evaluate drinking water quality in relation to source water origin and treatment strategies. Five drinking water treatment plants (DWTPs), using three different source waters in the Tai Hu River Basin, (i) Yangtze River, (ii) Wetland River Network, and (iii) Lake Tai Hu, were studied by analyzing 291 micropollutants in raw and finished water.Results Major differences in water characteristics were observed among the source waters. The dominating group of micropollutants in the River Network was pesticides, while Yangtze was mainly polluted by flame retardants. The total concentration of poly- and perfluoroalkyl substances (PFASs) in Tai Hu water was far higher than in others. In total, 51 compounds were detected in finished water, with an overall average total concentration of 730 ± 160 ng L -1 . The removal efficiency of the detected compounds in the DWTPs averaged 24 ± 149%, which highlights the major challenge for the DWTPs to remove emerging organic micropollutants through current treatment processes.Conclusions Our study showed that if the source water contains high levels of PFASs and organophosphorus flame retardants, even advanced treatment procedures are inefficient in removing the micropollutants, and the finished water may contain cumulative levels in the mg L -1 range. On the other hand, if pesticides and pharmaceuticals dominate, high overall treatment efficiencies may be obtained if using advanced treatment techniques. DWTPs are advised to use advanced treatment techniques or alternative water sources to guarantee the safety of drinking water. As surface water systems are highly impacted by upstream activities, efforts should also be made in the comprehensive water sector for improved surface water quality.
The high resistance of bacteria to clindamycin and cefepime: a call to revisit antibiotics reserved for use at tertiary hospitals in Tanzania
Authors: Mikomangwa Wigilya P. , Bwire George M. , Kilonzi Manase , Mlyuka Hamu , Mutagonda Ritah , Kibanga Wema , Marealle Alphonce Ignace , Minzi Omary , Mwambete Kennedy D. 
Published: January 2020

Abstract
Background Antibiotic resistance poses burden to the community and health care services. Efforts are being made at local, national and global level to combat the rise of antibiotic resistance including antibiotic stewardship. Surveillance to antibiotic resistance is of importance to aid in planning and implementing infection prevention and control measures. The study was conducted to assess the resistance pattern to cefepime, clindamycin and meropenem, which are reserved antibiotics for use at tertiary hospitals in Tanzania Methods A Hospital-based antibiotic resistance surveillance was conducted between July and November 2019 using 201 consecutively selected clinical isolates at Muhimbili National Hospital and Bugando Medical Center, Tanzania. All organisms isolated were identified based on colony morphology, Gram staining and relevant biochemical tests. Antibiotic susceptibility testing was performed on Muller-Hinton agar using Kirby-Bauer disc diffusion method. Antibiotic susceptibility on the selected antibiotic discs (cefepime, clindamycin and meropenem) was performed according to the protocol by National Committee for Clinical Laboratory Standards. Results A total of 201 clinical samples were tested in this study. Urine (39.8%, n=80) and blood (35.3%, n=71) accounted for most of the collected samples followed by pus (16.9%, n=34). The overall bacterial resistance to clindamycin, cefipime and meropenem was 70.1%, 72.4% and 8.5% respectively. Most (88.9%) of Enterococcus spp were resistant to clindamycin. About 68.4% Staphylococcus aureus isolates were resistant to clindamycin whereby 56.3%, 75.6%, 93.8% and 100% of the tested Escherichia coli , Klebsiella spp , Pseudomonas aeruginosa and Enterobacter cloacae respectively, were cefepime resistant. About 8.5% of isolated Klebsiella spp were resistant and 6.4% had intermediate susceptibility to meropenem. Also , Pseudomonas aeruginosa was resistant by 31.2% and 25% had intermediate susceptibility to meropenem. All Acinetobacter baumannii and Proteus spp (both 100.0%, n=4) were susceptible to meropenem. Conclusion The overall bacterial resistance to clindamycin and cefepime is high and low in meropenem. Henceforth, culture and susceptibility results should be used to guide the use of these antibiotics. Antibiotics with low resistance rate should be introduced to the reserve category and continuous antibiotic surveillance is warranted.
Fecundity disorders in older women: declines in follicular development and endometrial receptivity
Authors: Wang Li , Lv Shulan , Mao Wenjun , Bai E , Yang Xiaofeng 
Published: January 2020

Abstract
Background Fecundity declines in older women are associated with decreased ovarian function and oocyte quality, but little research is available on endometrial receptivity in older women. This study aimed to assess follicular development and endometrial receptivity, and to evaluate ultrasonic parameters in predicting endometrial receptivity during the implantation window in older women.Methods For this prospective case-control study, 224 older women and 215 women under the age of 35 were recruited. The follicular development and endometrial thickness were monitored by transvaginal ultrasound before ovulation. During the implantation window, defined as 6 to 7 days after ovulation, the pulsatility index (PI) and resistance index (RI) of the uterine arteries and subendometrial region were calculated based on colour Doppler, and the endometrial volume, vascularization index (VI), flow index (FI) and vascularization flow index (VFI) were also determined using the VOCAL imaging program with 3-D mode power Doppler. The ultrasonic parameters were used to assess endometrial receptivity in older women.Results The serum anti-Mullerian hormone (AMH) concentration and antral follicle count (AFC) were significantly lower in older women than in controls ( P <0.05). The average diameter of the dominant follicle was significantly smaller, and the subendometrial region RI was significantly higher in older women compared with controls ( P <0.05). The normal ovulation rate was significantly lower in older women than in controls ( P <0.01). The subendometrial region RI was significantly higher, and the endometrial VI, FI, and VFI were significantly lower in older women compared with controls ( P <0.05). The biochemical pregnancy rate, clinical pregnancy rate and ongoing pregnancy rate of older women were significantly lower than those of controls ( P <0.05). The best ultrasonic parameter for predicting endometrial receptivity during the implantation window in older women was VI, followed by FI.Conclusions Older women present decreased serum AMH concentrations and AFC, defined as indicators of ovarian reserve function. Older women are characterized by decreased follicular development and endometrial receptivity, which may lead to fecundity disorders.
Qualitative stocktaking on assessment of barriers and facilitators to contraceptive and post-abortion care services use following Zika epidemic in Tegucigalpa, Honduras.
Authors: Belizan Maria , Maradiaga Edna , Roberti Javier , Casco-Aguilar Maricela , Ortez Alison F. , Avila-Flores Juan C. , González Gloria , Bustillo Carolina , Calderón Alejandra , Bock Harry , Cafferata María L. , Tavares Adriano , Alger Jackeline , Ali Moazzam 
Published: January 2020

Abstract
Background. Zika virus (ZIKV) infection during pregnancy has severe consequences on the new-born. The World Health Organization declared the Zika outbreak to be a Public Health Emergency of International Concern (PHEIC) in 2016. Health facilities in the regions most affected by Zika lacked the capacity to respond to the increased demand for contraception. The objective was to explore and describe users’ experiences regarding access to and use of contraceptive and post-abortion care (PAC) services in the context of a Zika outbreak in Tegucigalpa, Honduras, and to follow these services over time. Methods. This study was part of a broader implementation research study. We used an inductive inquiry method consistent with grounded theory approach. Semi-structured interviews and focus groups were performed with women and their partners who used contraceptive services or received PAC services. Data was collected in two stages from December 2017 to July 2018. Themes explored included contraception, Zika and PAC services. Results. Participants had positive attitude towards the use of contraceptive methods and demanded more information on safety, efficacy and on side effects. Health care services were inconsistent in the provision of information on Zika and contraception services. ZIKV vector transmission was known but fewer participants were aware of risk of sexual transmission of Zika. Barriers to access healthcare services included contraceptive and PAC services included distance to healthcare facilities, disorganized admission process, long waiting times and out-of-pocket expenditure to purchase medicines. Furthermore, poor quality, mistreatment and abuse of women seeking PAC was prevalent. Some positive changes were noted over time, such as improvements in infrastructure including improved privacy and cleanliness, removal of fees, requisite to bring clean water to hospital. Conclusions. Our results highlighted the challenges and areas for improvement in policy and practice related to contraceptive services and PAC in the context of ZIKV infection. Public policies to prevent epidemics should focus more on providing proper sanitation; removing barriers to access and use of effective contraception as human rights priority. Zika epidemic has highlighted weaknesses in health systems that obstruct access to and use of sexual and reproductive health services.
Association between Doppler snuffbox resistive index and tissue perfusion in septic patients
Authors: Wang Cui , wang xiaoting , Zhang Hongmin , Huang Wei , Liu Dawei 
Published: January 2020

Abstract
Background: Doppler snuffbox resistive index (SBRI) can be a accurate parameter at the bedside to evaluate the status of peripheral vascular. We evaluated whether SBRI could relate to tissue hypoperfusion and could predict lactate clearance in septic patients.
Methods: We conducted a prospective observational study in a tertiary general and teaching hospital in China.From July 2019 to Decemeber 2019,all consecutive adult patients with septic shock who required ICU admission were included. At the same time,postoperative patients were studied as a control group.we recorded the hemodynamic parameters including SBRI and PI which were measured simultaneously after involved .
Results: We evaluated 44 patients with septic shock in study group and 20 stable postoperative patients in control group. Patients with septic shock had higher SOFA scores,PCT, CI and lactate than patients in control group.The SBRI was correlated with PI and lactate. The CI was not correlated with lactate in all patients.Based on Lactate clearance in first 6 hours, the septic shock patients were divided into the Lactate clearance ≥20% or the Lactate clearance <20% group.CI is no significal difference between two groups.SBRI of the Lactate clearance <20% group is higher than Lactate clearance≥20% group and control group.PI of the Lactate clearance <20% group is lower than Lactate clearance≥20% group and control group.The cutoff of the SBRI value was ≥1.09 for predicting 6h-lactate clearance after resuscitation, resulting in a sensitivity of 68.8% and a specificity of 85.7%. The cutoff of the PI value was ≤0.99 for predicting 6h-lactate clearance after resuscitation, resulting in a sensitivity of 64.3% and a specificity of 81.2%. The SBRI was significantly better than the PI for predicting 6h-lactate clearance after resuscitation.
Conclusions: SBRI is correlated with tissue perfusion parameters in critical ill patients. Abnormal SBRI was better than PI in suggesting disorder of lactate clearance of septic patients. SBRI is a better indicator of abnormal tissue perfusion than CI. Further investigations are required to determine whether the correction of abnormal SBRI and PI may improve success rate of resuscitation of septic shock.
Clinical value of full-length tryptophanyl-tRNA synthetase for sepsis detection in critically ill patients-A retrospective clinical assessment
Authors: Choi Ji Soo , Yoon Bo Ra , Sin Ju Hye , Lee Su Hwan , Leem Ah Young , Park Moo Suk , Kim Young Sam , Chung Kyung Soo 
Published: January 2020

Abstract
Background Sepsis is associated with high mortality, and the related innate immune system activation and diagnostic factors are not fully understood. This study aimed to statistically analyse the clinical value of full-length tryptophanyl-tRNA synthetase (WRS) induced through inflammatory stimuli in the detection of sepsis and mortality prediction in critically ill patients. Method In this retrospective analysis, we prospectively collected blood samples from patients in the medical intensive care unit (ICU) at Yonsei University College of Medicine, from March 2015 to June 2018. Sepsis detection and mortality prediction using WRS levels were compared to that with procalcitonin (PCT), C-reactive protein (CRP), and interleukin-6 (IL-6) levels, and with Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, using area under the receiver operating characteristic curve (AUROC) and Cox proportional-hazards and Kaplan-Meier survival analyses.Results We enrolled 241 study patients, of whom 190 (78.8%) had been diagnosed with sepsis on ICU admission. The AUROCs for sepsis discrimination with WRS, PCT, CRP, and IL-6 levels, and SOFA and APACHE II scores were 0.864, 0.727, 0.625, 0.651, 0.840, and 0.754, respectively. The prediction of 28-day mortality in patients with sepsis using WRS levels was possible and non-inferior to that with the SOFA score (WRS vs. SOFA, AUROC 0.687 vs. 0.711; AUROC difference, 0.024; P = 0.650). Conclusions WRS secreted early in sepsis may be useful not only for early detection of sepsis but also for mortality prediction in critically ill patients.
Mean arterial pressure within 24 hours of admission predicts short-term prognosis in patients with intermediate-risk and high-risk pulmonary embolism
Authors: Chen Jialong , Lin Jing , Wu Danshen , shi songjing 
Published: January 2020

Abstract
OBJECTIVEPulmonary embolism is a terrible cardiovascular condition with considerable morbidity and mortality.Previous studies have investigated that systolic blood pressure(Systolic BP)and diastolic blood pressure(Diastolic BP) were related to 30-day and in-hospital mortality.We aimed to determine if the average mean arterial pressure(aMAP) in the first 24 hours of hospital admission is useful to predict short-term outcomes of intermediate-risk and high-risk PE patients.MethodWe conducted a single center retrospective study.From May 2012 and April 2019, 122 intermediate-risk and high-risk PE patients were included.The primary outcome was in-hospital mortality.The secondary outcome was adverse events.ROC curves and cut-off values for aMAP predicting in-hospital-death were computed.According to cut-off values,we categorize five groups defined as followed:group 1:aMAP<70mmHg;group2:70mmHg≤aMAP<80mmHg;group3:80mmHg≤aMAP<90mmHg;group4:90mmHg≤aMAP<100mmHg;group5:aMAP≥100mmHg.Cox regression models were calculated to investigate associations between aMAP and in-hospital-death.ResultIn the study group of 122 patients,15 patients (12.30%) died in hospital due to PE.ROC analysis for MAP predicting in-hospital-death revealed an AUC of 0.729 with cut-off value of 79.4mmHg.Cox regression models showed a significant association between in-hospital death and aMAP group1(Ref),aMAP group2(OR1.680,95CI%0.020-140.335),aMAPgroup3(OR0.003,95CI%0.0001-0.343),aMAPgroup4(OR0.006,95CI%0.0001-1.671),aMAPgroup5(OR0.003,95%CI0.0001-9.744. It is aMAP 80-90mmHg that suffer from minimum adverse events ConclusionPrognostic role of MAP at the first 24 hours of hospital admission should be emphasized in patients with PE.80 to 90mmHg may be the optimal range of MAP for intermediate-risk and high-risk PE patients.