bluuebunny/crossref_metadata_2025_split huggingface dataset:
Molecular surveillance of antimalarial drug resistance in the Democratic Republic of Congo: high variability of chloroquinoresistance and lack of amodiaquinoresistance
Authors: Yobi Doudou Malekita , Kayiba Nadine Kalenda , Mvumbi Dieudonné Makaba , Boreux Raphael , Kabututu Pius Zakayi , Situakibanza Hippolyte Nani-Tuma , Likwela Joris Losimba , De Mol Patrick , Okitolonda Emile Wemakoy , Speybroeck Niko , Mvumbi Georges Lelo , Hayette Marie-Pierre 
Published: February 2020

Abstract
Background The loss of chloroquine (CQ) effectiveness has led to its withdrawal from national policies as a first-line treatment for uncomplicated malaria in several endemic countries, such as the Democratic Republic of Congo (DRC). The K76T mutation on the pfcrt gene has been identified as a marker of CQ resistance and the SVMNT haplotype in codons 72–76 on the same gene has been associated with resistance to amodiaquine (AQ). In the DRC, the prevalence of K76T has decreased from 100% in 2000 to 63.9% in 2014. The purpose of this study was to determine the prevalence of K76T mutations in circulating strains of P. falciparum , sixteen years after CQ withdrawal in the DRC and to investigate the presence of the SVMNT haplotype. Methods In 2017, ten geographical sites across the DRC were selected. Dried blood samples were collected from patients attending health centres. Malaria was first detected by a rapid diagnostic test (RDT) available on site (SD Bioline Malaria Ag P.f or CareStart Malaria Pf ) or thick blood smear and then confirmed by a P. falciparum species-specific real-time PCR assay. A pfcrt gene segment containing a fragment that encodes amino acids at positions 72-76 was amplified by conventional PCR before sequencing. Results A total of 1070 patients were enrolled. Of the 806 PCR-confirmed P. falciparum positive samples, 764 were successfully sequenced. The K76T mutation was detected in 218 samples (28.5%; 95% CI: 25.4%–31.9%), mainly (96%) with the CVIET haplotype. Prevalence of CQ resistance marker was unequally distributed across the country, ranging from 1.5% in Fungurume to 89.5% in Katana. The SVMNT haplotype, related to AQ resistance, was not detected. Conclusion Overall, the frequency of the P. falciparum CQ resistance marker has decreased significantly and no resistance marker to AQ was detected in the DRC in 2017. However, the between regions variability of CQ resistance remains high in the country. Further studies are needed for continuous monitoring of the CQ resistance level for its prospective re-use in malaria management. The absence of the AQ resistance marker is in line with the use of this drug in the current DRC malaria treatment policy.
Exploring barriers and facilitators to integrated hypertension-HIV management in Ugandan HIV clinics using the Consolidated Framework for Implementation Research (CFIR)
Authors: Muddu Martin , Tusubira Andrew K. , Nakirya Brenda , Nalwoga Rita , Semitala Fred C. , Akiteng Ann R. , Schwartz Jeremy I , Ssinabulya Isaac 
Published: February 2020

Abstract
Background: Persons Living with HIV (PLHIV) receiving antiretroviral therapy have increased risk of cardiovascular disease (CVD). Integration of services for hypertension (HTN), the primary CVD risk factor, into HIV clinics is recommended in Uganda. Our prior work demonstrated multiple gaps in implementation of integrated HTN care along the HIV treatment cascade. In this study, we sought to explore barriers to and facilitators of integrating HTN screening and treatment into HIV clinics in Eastern Uganda. Methods: We conducted a qualitative study at three HIV clinics with low, intermediate, and high HTN care cascade performance, which we classified based on our prior work. Guided by the Consolidated Framework for Implementation Research (CFIR), we conducted semi-structured interviews and focus group discussions with health services managers, health care providers and hypertensive PLHIV (n=83). Interviews were transcribed verbatim. Three qualitative researchers used the deductive (CFIR-driven) method to develop relevant codes and themes. Ratings were performed to determine valence and strengths of each CFIR construct regarding influencing HTN/HIV integration. Results: Barriers to HTN/HIV integration arose from six CFIR constructs: organizational incentives & rewards, available resources, access to knowledge & information, knowledge & beliefs about the intervention, self-efficacy and planning. The barriers include: lack of functional BP machines, inadequate supply of anti-hypertensive medicines, additional workload to providers for HTN services, PLHIV’s inadequate knowledge about HTN care, sub-optimal knowledge, skills and self-efficacy of healthcare providers to screen and treat HTN and inadequate planning for integrated HTN/HIV services. Relative advantage of offering HTN and HIV services in a one-stop centre, simplicity (non-complex nature) of HTN/HIV integrated care, adaptability and compatibility of HTN care with existing HIV services are the facilitators for HTN/HIV integration. The remaining CFIR constructs were non-significant regarding influencing HTN/HIV integration. Conclusion: Using the CFIR, we have shown that while there are modifiable barriers to HTN/HIV integration, HTN/HIV integration is of interest to patients, healthcare providers and managers. Improving access to HTN care among PLHIV will require overcoming barriers and capitalizing on facilitators using a health system strengthening approach. These findings are a springboard for designing contextually appropriate interventions for HTN/HIV integration in low- and middle-income countries.
Highly-selective μ-opioid receptor antagonism does not block L-DOPA-induced dyskinesia in a rodent model
Authors: Bartlett Mitchell J. , So Lisa Y. , Szabò Lajos , Skinner David P. , Parent Kate L. , Heien Michael L. , Vanderah Todd W. , Polt Robin , Sherman Scott J. , Falk Torsten 
Published: February 2020

Abstract
Objectives Dopamine-replacement utilizing L-DOPA is still the mainstay treatment for Parkinson’s disease (PD), but often leads to development of L-DOPA-induced dyskinesia (LID), which can be as debilitating as the motor deficits. There is currently no satisfactory pharmacological adjunct therapy. The endogenous opioid peptides enkephalin and dynorphin are important co-transmitters in the direct and indirect striatofugal pathways and have been implicated in genesis and expression of LID. Opioid receptor antagonists and agonists with different selectivity profiles have been investigated for anti-dyskinetic potential in preclinical models. In this study we investigated effects of the highly-selective μ-opioid receptor antagonist CTAP (>1,200-fold selectivity for μ- over δ-opioid receptors) and a novel glycopeptide congener (gCTAP5) that was glycosylated to increase stability, in the standard rat LID model. Results Intraperitoneal administration (i.p.) of either 0.5 mg/kg or 1 mg/kg CTAP and gCTAP5 completely blocked morphine’s antinociceptive effect (10 mg/kg; i.p.) in the warm water tail-flick test, showing in vivo activity in rats after systemic injection. Neither treatment with CTAP (10 mg/kg; i.p.), nor gCTAP5 (5 mg/kg; i.p.) had any effect on L-DOPA-induced limb, axial, orolingual, or locomotor abnormal involuntary movements. The data indicate that highly-selective μ-opioid receptor antagonism alone might not be sufficient to be anti-dyskinetic.
How to recover from a bad start: size at metamorphosis affects growth and survival in a tropical amphibian
Authors: Szekely Diana , Cogalniceanu Dan , Szekely Paul , Armijos-Ojeda Diego , Espinosa-Mogrovejo Valentina , Denoel Mathieu 
Published: February 2020

Abstract
Background:
In species with complex life cycles, size at metamorphosis is a key life-history trait which reflects the complex interactions between costs and benefits of life in the aquatic and terrestrial environments. Whereas the effects of a deteriorating larval habitat (e.g. pond desiccation) on triggering an early metamorphosis have been extensively investigated in amphibians, the consequences of the resulting reduced size at metamorphosis on fitness in the post-metamorphic terrestrial stage remain poorly understood. We tested the hypothesis that a smaller size at metamorphosis negatively affects performance and survival in the ensuing terrestrial stage. Using as model a tropical amphibian (Ceratophrys stolzmanni) showing a large phenotypic plasticity in metamorphosing traits, we evaluated the effects of size at metamorphosis on fitness-related trophic and locomotor performance traits, as well as on growth and survival rates.
Results:
Our results support the hypothesis that a larger size at metamorphosis is correlated with better survival and performance. The survival rate of large metamorphosing individuals was 95%, compared to 60% for those completing metamorphosis at a small size. Locomotor performance and gape size were positively correlated with body size, larger animals being more mobile and capable to ingest larger prey. However, smaller individuals achieved higher growth rates, thus reducing the size gap.
Conclusions:
Overall, size at metamorphosis affected profoundly the chances of survival in the short term, but smaller surviving individuals partly compensated their initial disadvantages by increasing growth rates.
Intention to stop khat chewing and associated factors among khat chewers in Gondar city, northwest Ethiopia: using Trans Theoretical Model
Authors: Adugna Asmamaw , Azale Telake , Handebo Simegnew 
Published: March 2020

Abstract
Background Khat chewing practice is rapidly increasing worldwide and currently an estimated over 10 million people chew khat. Trans Theoretical Model (TTM) is a promising model to assess the of stages of behavior change is a combination of intention. Given a sufficient control over the behavior, people carry out their intentions when the enabling environments arises. Assessing intention to quit chewing khat, motivational factors that influence behavior, is important to design effective interventions. Methods Community-based cross-sectional study was conducted from March to April 2019 in Gondar city, northwest Ethiopia. Six hundred five khat chewers were selected from six kebeles using cluster sampling method. Structured interviewer-administered questionnaire was used to collect data. Bivariate and multi-variable logistic regression model were fitted. Adjusted Odds ratio (AOR) with 95% confidence interval and p-values <0.05 in the multi-variable model were used to declare significant association. Results Out of the total participants, 69.3% (95% CI: 65.8-72.9) had intention to stop khat chewing within six months from the day of interview or before. Majority of the study participants 55.4% were on contemplation stage. Higher self-reevaluation [AOR=2.8, (95%CI: 1.6-5.0)], environmental reevaluation [AOR=1.9, (95%CI: 1.1-3.3)] and social liberation [AOR=1.8, (95% CI: 1.0-3.1)] process of changes were associated with intention to quit khat chewing. In addition, using additional substances and start chewing at earlier age were associated with lower intention to quit chewing. Conclusion Majority of the khat chewers had the intention to stop khat chewing. Increased self-reevaluation, environmental reevaluation and social liberation process of changes enhance the intention of quitting khat chewing. Thus, stage-based interventions should be done to motivate Khat chewers to stop khat chewing.
The effects of computer-assisted cognitive-behavior therapy as an adjunct to enhance postoperative recovery during perioperative period: study protocol for a randomized controlled trial
Authors: Yang Yang , Li Yuling , Liu Zhifen , Zhang Haibin , Li Xinrong , Xu Yong , Wang Binquan 
Published: February 2020

Abstract
Background: Some serious surgeries may pose likelihood of developing complications such as anxiety, depression, insomnia, chronic pain, which may aggravate discomfort, impair quality of life and even increase mortality after surgery. Non-pharmacological mind–body interventions for psychosomatic symptom is are an area of growing interest. CBT is the most recommended treatment for anxiety, depression, insomnia and pain. However, access to trained therapists is limited. A growing amount of research is producing effective evidence of CCBT. But , CCBT used for surgery patients have been not reported at present, and the effectiveness and feasibility have been not research ed and validated too. The primary aim of this trial is to explore targeted psychotherapy technique based on CCBT for surgical patients and assess the effectiveness and feasibility of the newly developed software of CCBT-Prs to improve anxiety, depression, insomnia and postoperative pain as an adjunct to UC by subjective and objective indexes. Methods and analysis : It is a prospective, multi-centers, randomized controlled superiority trial which comprises two parallel groups (CCBT-Prs +UC and UC alone) . Participants who has been scheduled for surgery will be randomized to either of the two groups : (1) receiv ing CCBT- Prs software intervention based on UC as trial group (2) receiving UC intervention only as control group. All participants will undergo assessments using STAI-S, PHQ-9, AIS and VAS-Pain-10 at various time points in the perioperative period. Blood samples will be collected at baseline and pre - anesthesia to assess for Stress hormone markers(Cor and ACTH). Functional near infrared spectroscopy( fNIRS) will be applied to evaluate brain function before and after intervention. Discussion: Some difficulty is inevitable and encountered in all clinical trials. The ultimate aim is that mental health services benefit more non-psychiatric inpatients. CCBT can have more wider dissemination and implementation in mental health. Ethics and dissemination : This study has been approved by Ethics Committee of First Hospital of Shanxi Medical University in China. Research findings will be disseminated in the form of at least one peer reviewed article and presentations at conferences. Trial registration: Chinese Clinical Trial Registry (ChiCTR)( www.chictr.org.cn ) ChiCTR1900025994 . Registered on 17 September 2019. http://www.chictr.org.cn/ChiCTR1900025994.
Adjuvant Esophagectomy versus Definitive Chemoradiotherapy for Patients with Clinical Stage N0 and Pathological Stage T1b Esophageal Squamous Cell Carcinoma After Endoscopic Submucosal Dissection: Study Protocol for A Multicenter Randomized Controlled Trial (Ad-ESD Trial)
Authors: Yang Yang , Su Yuchen , Zhang Xiaobin , Liu Jun , Zhang Hong , Li Bin , Hua Rong , Tan Lijie , Chen Hezhong , Li Zhigang 
Published: February 2020

Abstract
Background: Esophagectomy is still the prior additional treatment for pathological T1b (pT1b) esophageal squamous cell carcinoma (ESCC) after endoscopic resection (ER). ER followed with definitive chemoradiotherapy (dCRT) has showed increased quality of life as well as comparable oncological outcomes to esophagectomy. However, there is no well-designed, phase III trial to compare the two treatment for patients with pT1b ESCC.Methods: One hundred seventy-six patients with clinical stage N0 (cN0) and pT1b ESCC will be recruited at three centers and randomized to the esophagectomy group or the dCRT group. The clinical lymph node status will be measured by image examination including computer tomography and positron emission tomography-computed tomography. The pathological tumor status will be diagnosed after endoscopic submucosal dissection (ESD). All patients will be followed up for 60 months after randomization. The primary endpoint is the 5-year overall survival. The secondary endpoints are quality of life, related adverse events, 3-year overall survival and relapse-free survival rates.Discussion: To the best of our knowledge, this is the first phase III randomized controlled trial to compare the esophagectomy and dCRT for patients with cN0-pT1b ESCC after ESD. Based on the results of this study, we will show whether dCRT will benefit patients more than esophagectomy. which will contribute more high-quality evidence to the primary salvage treatment for these patients.Trial registration : ClinicalTrials.gov, NCT04135664. Registered on 10 August 2019.
Formaldehyde formation in the glycine cleavage system and its use for an aldolase-based biosynthesis of 1,3-prodanediol
Authors: Xu Yingying , Meng Hao , Ren Jie , Zeng An-Ping 
Published: February 2020

Abstract
Glycine cleavage system (GCS) occupies a key position in one-carbon (C1) metabolic pathway and receives great attention for the use of C1 carbons like formate and CO 2 via synthetic biology. In this work, we demonstrate that formaldehyde exists as a substantial byproduct of the GCS reaction cycle. Three causes are identified for its formation. First, the principal one is the decomposition of N 5 ,N 10 -methylene-tetrahydrofolate (5,10-CH 2 -THF) to form formaldehyde and THF. Increasing the rate of glycine cleavage promotes the formation of 5,10-CH 2 -THF, thereby increasing the formaldehyde release rate. Next, formaldehyde can be produced in the GCS even in the absence of THF. The reason is that T-protein of the GCS can degrade methylamine-loaded H-protein (H int ) to formaldehyde and ammonia, accompanied with the formation of dihydrolipoyl H-protein (H red ), but the reaction rate is less than 0.16% of that in the presence of THF. Increasing T-protein concentration can speed up the release rate of formaldehyde by H int . Finally, a certain amount of formaldehyde can be formed in the GCS due to oxidative degradation of THF. Based on a formaldehyde-dependent aldolase, we elaborated a glycine-based one carbon metabolic pathway for the biosynthesis of 1,3-propanediol (1,3-PDO) in vitro . This work provides quantitative data and mechanistic understanding of formaldehyde formation in the GCS and a new biosynthetic pathway of 1,3-PDO.
Case report: A Re-operation Case of Asymptomatic Left Giant Pheochromocytoma and Literature Review
Authors: Dai Wei , Liu Xiaoguang , Dai Jialiang , Chen Minqiang , Mo Jian , Chen Ming , Tan Xiaoyu , Chen Xiaofeng , Lin Qiongyan , Wang Jie , Fang Shuo , Chen Nianping 
Published: February 2020

Abstract
Introduction: Pheochromocytoma (PCC) is a rare tumor which derives from adrenal medulla, when maximum diameter of pheochromocytoma is greater than 10CM, it is divided into Giant pheochromocytoma(GPCC), which is extremely rare and usually asymptomatic.Clinically, a huge and asymptomatic adrenal pheochromocytoma was usually misdiagnosed as other types of tumors, which result in notable increase of complication rates and death rates.Case presentation:In this case report, we described a clinically asymptomatic GPCC patient. Diagnosis:According to computed tomography (CT) scan, nuclear magnetic resonance(MR) scan, the patient is initially diagnosed as liposarcoma.After laparotomy, biochemical detection of catecholamine (CA) intermediate metabolites methoxyepinephrine (MN) and methoxy norepinephrine (NMN) and the pathological examination , diagnosis of GPCC was obtained. Intervention：The laparotomy was suspended and a diagnosis of pheochromocytoma was confirmed, because of unstable blood pressure and hypertension during separating and moving the mass during surgery. After consultation of multi-disciplinary team, adequate preoperative preparation was conducted according to the procedure of PCC surgical preparation. By the end of the regular phenoxybenzamine and intravenous fluids treatment for three weeks, the blood pressure of the patient was kept at an acceptable average. Therefore, the patient underwent the operationagain for radical resection. Outcome: After the operation, CA was basically normal in rechecking process, and the tumor was successfully removed. Pathological diagnosis of the mass after operation: Immunohistochemical resulted conformed to (epigastrium) pheochromocytoma. Immunohistochemistry: CgA(+), Inhibin-α(-), ki-67(<1%+), Syn(+). Pheochromocytoma had the definite pathological diagnosis. Conclusion: GPCC has the high diagnostic identification difficulty, it should be combined with imaging examination and biochemical measurement to identify. Before operation, the detailed imageological examination provides important reference for excision and surgical planning. Individualized and multi-disciplinary cooperation of management strategy in perioperative period should be recommended. Patients should conduct long-term follow-up.
Prediction of different airway gradings in T1-2 laryngeal cancer with anterior vocal commissure involvement
Authors: Luo Chunlin , Lei Wenbin 
Published: February 2020

Abstract
Background To investigate the clinical efficacy of the modified Mallampati test (MMT) combined with indirect laryngoscopy in measuring glottic exposure levels of early glottic laryngeal carcinoma (T1-2) with anterior vocal commissure involvement. Methods One hundred eighty-two patients with early glottic laryngeal cancer were divided into two groups: one group comprised patients treated with transoral carbon dioxide laser microsurgery (TLM, 65 patients), and the other group comprised patients treated with open partial laryngectomy (OPL, 117 patients). The MMT and indirect laryngoscopy were used to re-evaluate the level of glottic exposure and to classify the patients based on these levels. The local control and disease-free survival rates of those patients were measured based on their MMT and indirect laryngoscopy classifications. Results The 5-year local control rate was significantly different between the two groups according to the MMT (log-rank test: χ2=4.020, P=0.045, 90.9% in the OPL group vs. 71.4% in the TLM group). For patients diagnosed with grade IV tumors using indirect laryngoscopy, the 5-year local control rate was significantly different between the two groups (log-rank test: χ2=4.076, P=0.044, 91.7% in the OPL group vs. 54.7% in the TLM group). Among patients diagnosed with grade III or IV tumors using indirect laryngoscopy and with class III or IV tumors using MMT, the 5-year local control rate was significantly different between the two groups (log-rank test: χ 2 = 8.037, P = 0.005, 97.14% in the OPL group vs. 75.47% in the TLM groups). Conclusions The combination of the MMT and indirect laryngoscopy to evaluate difficult airways is relatively simple and is very useful for surgeons to better prepare for surgery.
An improved morphological staging method of midpalatal suture and its relationship with cervical vertebrate maturation (CVM) method
Authors: Gao Lu , Gu Yan 
Published: February 2020

Abstract
Background (1) Establish an improved morphological staging method of midpalatal suture. (2) Investigate the correlation between morphological stages of midpalatal suture (MPS stage) and cervical vertebrate maturation (CVM) stages. (3) Compare effects of traditional tooth-borne rapid maxillary expansion (RME) at different MPS stages. Methods 1076 CBCT images (675 females, 401 males, 6.0 to 21.0 years old) are included. MPS stages are classified based on observation of horizontal view. Correlation between MPS stage and CVM stage are investigated by Spearman correlation coefficient and diagnostic test analysis. Effects of traditional tooth-borne RME at different MPS stages were analyzed based on pre- and post-expansion dental casts. Results Five stages of midpalatal suture are established. Spearman coefficient between MPS stage and CVM stage is 0.803. Diagnostic pairs with the largest area under ROC curve (AUC) value are: CS 6 - MPS 5,CS 5 - MPS 4s2,CS 1 - MPS 1, CS 4 - MPS 4s1, CS 2 - MPS 1, CS 3 - MPS 3. 309/340 (90.9%) of individuals at CS 1-3 are at MPS 1-3, 31/340 (9.1%) are at MPS 4s1. 107/324 (31.2%) of individuals at CS 4 are at MPS 3, 151/324 (46.6%) are at MPS 4s1. Conclusion (1) An improved morphological staging method of midpalatal suture is established. (2) MPS stages have close relationship with CVM stages. (3) Pre-treatment CBCT is recommended for individuals at CS 4 to estimate the possibility of skeletal expansion with traditional tooth-borne RME.