bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determinantes físicos del estado funcional en mujeres mayores de 60 años con artrosis de rodilla
Authors: Casilda-López Jesús , Ortiz-Rubio Araceli , Torres-Sánchez Irene , Cabrera-Martos Irene , Romero-Fernández Ramón , Valenza Marie Carmen 
Published: April 2020

Introducción: La afectación funcional es el aspecto que más discapacidad genera en los pacientes con artrosis de rodilla, por encima de la destrucción articular y de la afectación del movimiento. En este sentido, la funcionalidad y sus determinantes se han convertido en una prioridad para la decisión terapéutica más eficaz. Objetivo: El objetivo del presente estudio fue explorar el estado de salud y los determinsntes físicos según el nivel de independencia funcional en mujeres mayores de 60 años con diagnóstico de artrosis de rodilla. Materiales y métodos: Se desarrolló un estudio observacional de corte transversal en el que fueron incluidas un total de 126 mujeres mayores de 60 años con diagnóstico de artrosis de rodilla. Se evaluó el perfil clínico, funcional y variables físicas: fatiga, equilibrio y fuerza de miembros inferiores. Resultados: La muestra fue dividida en dos grupos según su estado funcional: grupo con afectación funcional (n=71) y grupo sin afectación funcional (n=49). El grupo con afectación funcional presentó valores significativamente peores en las características clínicas. En las variables físicas se encontraron diferencias significativas entre grupos en el equilibrio (p<0,001) y fuerza de miembros inferiores. Conclusiones: El estado funcional se encuentra influido por los determinantes físicos.
Stress analysis of implant-supported removable partial denture with anterior fixed prostheses and conventional implant supported overdentures in the edentulous mandible
Authors: Ozel Gulsum Sayin , Inan Ozgur , Ozyilmaz Ozgun Yusuf 
Published: April 2020

Abstract
Background: Recently, a new alternative treatment protocols without complex surgical or grafting procedures has become popular in clinical dentistry. A new treatment concept is implant-supported removable partial dentures retained with anterior fixed prosthesis in edentulous mandible. The purpose of this study was to compare this new design implant supported removable partial dentures, with a conventional locater and bar attached implant overdenture prostheses retained by two or four implants via photoelastic stress analysis. Methods: This study was designed to evaluate the force transmission of commercially available titanium implants inserted into edentulous mandibles composed of photoelastic resin within two to four implants using two different types of prosthesis: overdentures and implant-retained removable partial dentures. In all models, implants were placed parallel to each other and the midline. A 300 N load was applied to the first premolars. Loading and stress distributions were photographed after the completion of the prostheses. Results: In the models with two implant-retained removable partial dentures, the stress distribution was found to be lower than that with the four implant-retained removable partial dentures. The locator, a stud attachment, showed the most equitable stress distribution for overdenture models. Despite this, non-splinted implants caused high stresses around the distal implant on the loading side. Conclusions: When models were compared, the stress loads were transmitted to other implants by splinting. Implant-supported removable partial dentures with an anterior fixed prosthetic design may serve as an acceptable and affordable alternative treatment option. These dentures appear to be advantageous in terms of stress transmission considering effects such as ease of use, esthetic requirements, patient requests, and reduction in the area covered by the prosthesis.
Conditional cash transfers, uptake of maternal and child health services, and health outcomes in western rural ChinaConditional cash transfers, uptake of maternal and child health services, and health outcomes in western rural China
Authors: Zhou Huan , Wu Yuju , Liu Chengfang , Sun Chang , Shi Yaojiang , Zhang Linxiu , Medina Alexis , Rozelle Scott 
Published: April 2020

Abstract
Background: Empirical evidence suggests that the uptake of maternal and child health (MCH) services is still low in poor rural areas of China. There is concern that the low uptake of MCH services may detrimentally affect child health outcomes. Previous studies have not yet identified the exact nature of the impact that conditional cash transfers (CCT) have on the uptake of MCH services and ultimately, on child health outcomes. The objective of this study is to examine the relationship between CCT, uptake of MCH services, and health outcomes among children in poor rural areas of western China.Methods: We designated two different sets of comparison villages and households that were used as comparison against which outcomes of the treated households could be assessed. In 2014 we conducted a large-scale survey of 1,522 households at 75 villages (including 25 treatment and 50 comparison) from nine nationally-designated poverty counties in two provinces of China. In each village, 21 households were selected based on their eligibility status for the CCT program. Difference-in-difference analyses were used to assess the impact of CCT on outcomes in terms of both Intention-to-treat (ITT) and average-treatment-effects-on-the-treated (ATT).Results: Overall, the uptake of MCH services in the sample households were low, especially in terms of post-partum care visits, early breast feeding, exclusive breast feeding, and physical examination of the baby. The uptake of the seven types of MCH services in the CCT treatment villages were significantly higher than that in the comparison villages. Results from both the ITT and ATT analyses showed the CCT program had a positive, although small, impact on the uptake of MCH services and the knowledge of mothers about MCH health issues. Nonetheless, the CCT program had no noticeable effect on child health outcomes.Conclusions: The CCT program generated modest improvements in the uptake of MCH services and mothers’ knowledge of MCH services in poor rural areas of Western China. These improvements, however, did not translate into substantial improvements in child health outcomes for two possible reasons: poor CCT implementation and the low quality of rural health facilities.
Multi-HLA class II tetramer analyses of citrulline-reactive T cells and early treatment response in rheumatoid arthritis
Authors: Gerstner Christina , Turcinov Sara , Hensvold Aase H , Chemin Karine , Uchtenhagen Hannes , Ramwadhdoebe Tamara H , Dubnovitsky Anatoly , Kozhukh Genadiy , Rönnblom Lars , Kwok William W , Achour Adnane , Catrina Anca I , Baarsen Lisa G. M. van , Malmström Vivianne 
Published: April 2020

Abstract
Background: HLA class II tetramers can be used for ex vivo enumeration and phenotypic characterization of antigen-specific CD4+ T cells. They are increasingly applied in settings like allergy, vaccination and autoimmune diseases. Rheumatoid arthritis (RA) is a chronic autoimmune disorder for which many autoantigens have been described.Results: Using multi-parameter flow cytometry, we developed a multi-HLA class II tetramer approach to simultaneously study several antigen specificities in RA patient samples. We focused on previously described citrullinated HLA-DRB1*04:01-restricted T cell epitopes from α-enolase, fibrinogen-b, vimentin as well as cartilage intermediate layer protein (CILP). First, we examined inter-assay variability and the sensitivity of the assay in peripheral blood from healthy donors (n=7). Next, we confirmed the robustness and sensitivity in a cohort of RA patients with repeat blood draws (n=14). We then applied our method in two different settings. We assessed lymphoid tissue from seropositive arthralgia (n=5) and early RA patients (n=5) and could demonstrate autoreactive T cells in individuals at risk of developing RA. Lastly, we studied peripheral blood from early RA patients (n=10) and found that the group of patients achieving minimum disease activity (DAS28 <2.6) at 6 months follow-up displayed a decrease in the frequency of citrulline-specific T cells. Conclusions: Our study demonstrates the development of a sensitive tetramer panel allowing simultaneous characterization of antigen-specific T cells in ex vivo patient samples including RA ‘at risk’ subjects. This multi-tetramer approach can be useful for longitudinal immune-monitoring in any disease with known HLA-restriction element and several candidate antigens.
Effect Of Smoking On Treatment Outcome Among Tuberculosis Patients In Malaysia; A Multicentre Study
Authors: Khan Amer Hayat , Sulaiman Syed Azhar Syed , Hassali Mohamed Azmi , Khan Kashif Ullah , Ming Long Chiau , Mateen Umer , Malik Obaid Ullah 
Published: April 2020

Abstract

Background: Smoking plays a key role in the development of tuberculosis (TB) infection and is also a predictor of poor TB treatment prognosis and outcomes. Current study was conducted to determine the prevalence of smoking and to assess the effects of smoking on treatment outcomes among TB patients.Methods: A multi-center retrospective study design was used to collect data from TB patients in four different states of Malaysia, namely Penang, Sabah, Sarawak, and Selangor. The study included medical records of TB patients admitted to the selected hospitals in the period from January 2006 to March 2009. Medical records with incomplete data were not included. Patient demographics and clinical data were collected using a validated data collection form.Results:Of all patients with TB (9337), the prevalence of smokers was 4313 (46.2%). Among smoker’s, 3584 (83.1%) were associated with pulmonary TB, while 729 (16.9%) were associated with Extra-pulmonary TB. Male gender (OR= 1.43, 95% CI 1.30-1.58), Chinese ethnicity (OR= 1.23, 95% CI 1.02-1.49), Sarawak indigenous ethnicity (OR= 0.74, 95% CI 0.58-0.95), urban residents (OR= 1.46, 95% CI 1.33-1.61), employed individuals (OR= 1.21, 95% CI 1.09-1.34), alcoholics (OR= 4.91, 95% CI 4.04-5.96), drug abusers (OR= 7.43, 95% CI 5.70-9.60) and presence of co-morbid condition (OR= 1.27, 95% CI 1.16-1.40) showed significant association with smoking habits. This study found that 3236 (75.0 %) patients were successfully treated in the smoker group, while 4004 (79.7 %) patients were non-smokers. The proportion of death rate 283 (6.6%), defaulters 284 (6.6%) and treatment interruption 204 (4.7%) was high in the smoker's group.Conclusions:Smoking had a strong influence on TB and is a major barrier towards treatment success (OR= 0.76, 95% CI 0.69-0.84, p< 0.001). Therefore, the findings point out that smoking cessations are an effective way to decrease treatment failure and drug resistance.
Resilient Health Care: a systematic review of conceptualisations, study methods and factors that develop resilience.
Authors: Iflaifel Mais HM , Lim Rosemary , Ryan Kath M , Crowley Clare 
Published: April 2020

AbstractBackground Traditional approaches to safety management in health care have focused primarily on counting errors and understanding how things go wrong. Resilient Health Care (RHC) provides an alternative complementary perspective of learning from incidents and understanding how, most of the time, work is safe. The aim of this review was to identify how RHC is conceptualised, described and interpreted in the published literature, to describe the methods used to study RHC, and to identify factors that develop RHC. Methods Electronic searches of PubMed, Scopus and Cochrane databases were performed to identify relevant peer-reviewed studies, and a hand search undertaken for studies published in books that explained how RHC as a concept has been interpreted, what methods have been used to study it, and what factors have been important to its development. Studies were evaluated independently by two researchers. Data was synthesised using a thematic approach. Results Thirty-six studies were included; they shared similar descriptions of RHC which was the ability to adjust its functioning prior to, during, or following events and thereby sustain required operations under both expected and unexpected conditions. Qualitative methods were mainly used to study RHC. Two types of data sources have been used: direct (e.g. focus groups and surveys) and indirect (e.g. observations and simulations) data sources. Most of the tools for studying RHC were developed based on predefined resilient constructs and have been categorised into three categories: performance variability and Work As Done, cornerstone capabilities for resilience, and integration with other safety management paradigms. Tools for studying RHC currently exist but have yet to be fully implemented. Effective team relationships, trade-offs and health care ‘resilience’ training of health care professionals were factors used to develop RHC. Conclusions Although there was consistency in the conceptualisation of RHC, methods used to study and the factors used to develop it, several questions remain to be answered before a gold standard strategy for studying RHC can confidently be identified. These include operationalising RHC assessment methods in multi-level and diverse settings and developing, testing and evaluating interventions to address the wider safety implications of RHC amidst organisational and institutional change.
Missed Opportunities for Family Planning Counselling among HIV-Positive Women Receiving HIV Care in Uganda
Authors: Author) JULIET NABIRYE(Former Corresponding , Author) Joseph KB Matovu(New Corresponding , Bwanika John Baptist , Makumbi Fredrick , Wanyenze Rhoda K. 
Published: April 2020

Abstract
Introduction: HIV-positive women who are still in the reproductive years need adequate sexual and reproductive health information to make informed reproductive health choices. However, many HIV-positive women who interface with the health system continue to miss out on this information. We sought to: a) determine the proportion of HIV-positive women enrolled in HIV care who missed family planning (FP) counselling; and b) assess if any association existed between receipt of FP counselling and current use of modern contraception to inform programming. Methods: Data were drawn from a quantitative national cross-sectional survey of 5,198 HIV-positive women receiving HIV care at 245 HIV clinics in Uganda; conducted between August and November 2016. Family planning counselling was defined as provision of FP information (i.e. available FP methods and choices) to an HIV-positive woman by a health provider during ANC, at the time of delivery or at the PNC visit. Analyses on receipt of FP counselling were done on 2,760 HIV-positive women aged 15-49 years who were not currently pregnant and did not intend to have children in the future. We used a modified Poisson regression model to determine the Prevalence Ratio (PR) as a measure of association between receipt of any FP counselling and current use of modern contraception, controlling for potential confounders. Analyses were performed using STATA statistical software, version 14.1.Results: Overall, 2,104 (76.2%) HIV-positive women reported that they received FP counselling at any of the three critical time-points. Of the 24% (n=656) who did not, 37.9% missed FP counselling at ANC; 41% missed FP counselling during delivery; while 54% missed FP counselling at the post-natal care visit. HIV-positive women who received any FP counselling were significantly more likely to report current use of modern contraception than those who did not (adjusted PR [adj. PR] = 1.21; 95% Confidence Interval [CI]: 1.10, 1.33). Conclusion: Nearly one-quarter of HIV-positive women did not receive any form of FP counselling when they interfaced with the healthcare system. This presents a missed opportunity for prevention of unintended pregnancies, and suggests a need for the integration of FP counselling into HIV care at all critical time-points.
The development of early ascites is associated with shorter overall survival in patients with hepatocellular carcinoma treated with drug-eluting embolic chemoembolization
Authors: Pipa-Muniz María , Sanmartino Susana , Mesa Alicia , Alvarez-Navascués Carmen , González-Diéguez Maria Luisa , Cadahía Valle , Rodríguez José Eduardo , Vega Florentino , Rodríguez Manuel , Costilla-García Serafín Marcos , Calvo Maria Varela 
Published: April 2020

Abstract
Background: A single-centre cohort study was performed to identify the independent factors associated withthe overall survival (OS) of hepatocellular carcinoma (HCC) patients treated with transarterial chemoembolization with drug-eluting beads (DEB-TACE). Methods : A total of 216 HCC patients who underwent DEB-TACE from October 2008 to October 2015 at a tertiary hospital were consecutively recruited. The analysis of prognostic factors associated with overall survival after DEB-TACE, stressing the role of post-TACE events, was performed. Results: The objective response (OR) rate (Modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria) to the first DEB-TACE (DEB-TACE-1) was 70.3%; the median OS from DEB-TACE-1 was 27 months (95% confidence interval (CI), 24-30). In the multivariate analysis, tumor size, AFP < 100 ng/mL and serum alkaline phosphatase were independent factors for survival following DEB-TACE-1. The most important clinical event associated with poor survival was the development of early ascites after DEB-TACE-1 (median OS, 17 months), which was closely related to the history of ascites, albumin and hemoglobin but not to tumour load or to response to therapy. Conclusions : Early ascites post-DEB-TACE is associated with the survival of patients despite adequate liver function and the use of a supra-selective technical approach. History of ascites, albumin and hemoglobin are major determinants of the development of early ascites post-DEB-TACE.
The Effect of Different Estradiol Levels on Carotid Artery Distensibility During a Long Agonist IVF Protocol
Authors: Leppänen Jonna , Randell Kaisa , Schwab Ursula , Pihlajamäki Jussi , Keski-Nisula Leea , Laitinen Tomi , Heinonen Seppo 
Published: April 2020

Abstract
BACKGROUND:This study was made to figure out, does low and high estradiol levels during in vitro fertilization (IVF) cycles have a different effect on carotid artery distensibility (Cdis), carotid artery diameter (Cdia), blood pressure and metabolic factors? Can the stimulation protocol be considered safe to women’s vasculature? METHODS: We studied 28 women having a long agonist protocol IVF-treatment in Kuopio University Hospital during the years 2011-2016. Patients were examined at three time points: in the beginning of their own period (low estradiol), during the gonadotrophin releasing hormone (GnRH) analogue downregulation (low estradiol) and during the follicle stimulating hormone (FSH) stimulation (high estradiol). Women served as their own controls and their menstrual phase (2- to 5-day period after the beginning of menstruation with low estrogen) was used as the reference. Cdis and Cdia were assessed using ultrasound. Blood pressure, weight, estradiol levels and lipids were monitored. RESULTS : Cdis, Cdia, systolic and diastolic blood pressures peaked during the GnRH-analogue treatment with the lowest estradiol levels. Cdis, Cdia and systolic blood pressures declined by 11% (P=0.002) , 3,8% (P<0.001) and 2,5 % (P=0.026) during the FSH-stimulation when the estradiol levels were high. Cdis correlated significantly (P<0.05) with systolic blood pressure, diastolic blood pressure and triglycerides in high estrogenic environment and with diastolic blood pressure (P<0.05) when estrogen profiles were low. CONCLUSIONS: Carotid artery stiffens during the high estradiol levels compared to low levels and this was not explained by the higher diameter of the carotid artery, hyperlipidemia or blood pressure profiles. All the changes in Cdis and Cdia are variations of normal, and if there is no history of cardiovascular problems, it can be considered, that the stimulation protocol is not hazardous to vasculature.
Effect of the cagW-based gene vaccine on the immunologic properties of BALB/c mouse: an efficient candidate for Helicobacter pylori DNA vaccine
Authors: Chehelgerdi Mohammad , Doosti Abbas 
Published: April 2020

Abstract
Background Helicobacter pylori ( H. pylori ) infect more than half of the world population, and they cause different serious diseases such as gastric carcinomas. This study aims to design a vaccine on the basis of cagW against H. pylori infection. After pcDNA3.1 (+)- cagW -CS-NPs complex is produced, it will be administered into the muscles of healthy BALB/c mice in order to study the effect of this DNA vaccine on the interleukin status of mice, representing its effect on the immune system. After that, the results will be compared with the control groups comprising the administration of cagW -pCDNA3.1 (+) vaccine, the administration of chitosan and the administration of PBS in the muscles of mice. Methods The cagW gene of H. pylori was amplified by employing PCR, whose product was then cloned into the pcDNA3.1 (+) vector, and this cloning was confirmed by PCR and BamHI/EcoRV restriction enzyme digestion. CagW gene DNA vaccine was encapsulated in chitosan nanoparticles (pcDNA3.1 (+)- cagW -CS-NPs) using a complex co-acervation method. The stability and in vitro expression of chitosan nanoparticles were studied by DNase I digestion and transfection, and the immune responses elicited in specific pathogen-free (SPF) mice by the pcDNA3.1 (+)-cagW-CS-NPs were evaluated. Apart from that, the protective potential pcDNA3.1 (+)- cagW -CS-NPs was evaluated by challenging with H.pylori . Results The pcDNA3.1 (+)- cagW -CS-NPs comprises cagW gene of H. pylori that is encapsulated in chitosan nanoparticles, produced with good morphology, high stability, a mean diameter of 117.7 nm, and a zeta potential of + 5.64 mV. Moreover, it was confirmed that chitosan encapsulation protects the DNA plasmid from DNase I digestion, and the immunofluorescence assay showed that the cagW gene could express in HDF cells and maintain good bioactivity at the same time. In comparison to the mice immunized with the control plasmid, in vivo immunization revealed that mice immunized with pcDNA3.1 (+)- cagW -NPs showed better immune responses and prolonged release of the plasmid DNA. Conclusions This research proves chitosan-DNA nanoparticles as potent immunization candidates against H. pylori infection and paves the way for further developments in novel vaccines encapsulated in chitosan nanoparticles.