bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is post-operative non-weight-bearing necessary? Study protocol for a pragmatic randomised multicentre trial of operatively treated ankle fracture (DoWeCAST?).
Authors: Khojaly Ramy E , Niocaill Ruairí Mac , Shahab Muhammad , Vukanic Danilo , Nagle Matthew , Kearns Stephen , Taylor Colm , Rowan Fiachra E. , Cleary May 
Published: March 2020

Abstract
Background Post-operative management regimes vary following open reduction and internal fixation (ORIF) of unstable ankle fractures. There is an evolving understanding that extended periods of immobilisation and limitation of weight-bearing may lead to poorer clinical outcomes. Traditional non-weight bearing cast immobilisation may prevent loss of fixation, and this practice continues in many centres. The purpose of this trial is to investigate the safety and efficacy of immediate weight-bearing (IWB) and range of motion (ROM) exercise regimes following ORIF of unstable ankle fractures with a particular focus on functional outcomes and complication rate. Methods A pragmatic randomised controlled multi-centre trial, comparing IWB in a walking boot and ROM within 24 hours versus non-weight bearing (NWB) and immobilisation in a cast for six weeks, following ORIF of all types of unstable adult ankle fractures (lateral malleolar, bimalleolar, trimalleolar with or without syndesmotic injury) is proposed. All patients presenting to three trauma units will be included. Exclusion criteria will be skeletal immaturity and tibial plafond fractures. The three institutional review boards have granted ethical approval. The primary outcome measure will be the functional Olerud-Molander Ankle Score (OMAS). Secondary outcomes include; Wound infection (deep and superficial), displacement of osteosynthesis, total arc of ankle motion (plantar flexion and dorsal-flection), RAND 36-Item Short Form Survey (SF-36) scoring, time to return to work and postoperative hospital length of stay. The trial will be reported in accordance with the CONSORT statement for reporting a pragmatic trial and this protocol follow the SPIRIT guidance. Discussion Traditional management of operatively treated ankle fractures includes an extended period of non-weight bearing. There is emerging evidence that earlier weight-bearing may have equivocal outcomes and favourable patient satisfaction but with higher wound-related complications. These studies often preclude more complicated fracture patterns or patient-related factors. To our knowledge, immediate weight-bearing (IWB) following ORIF of all types of unstable ankle fractures has not been investigated in a controlled prospective manner. This pragmatic randomised-controlled multi-centre trial will investigate immediate weight-bearing following ORIF of all ankle fractures pattern in the usual condition of care. It is hoped that these results will contribute towards the modern management of ankle fractures.
Effectivity of a joint didactic intervention by School for Patients on inappropriate control prothrombin time anticoagulated patients. Protocol for developing a randomized and controlled clinical trial.
Authors: Ginel-Mendoza Leovigildo , Hidalgo-Natera Alfonso Hidalgo , Reina-Gonzalez Rocio , Poyato-Ramos Rafael , Lupianez-Perez Inmaculada , Morales-Naranjo Juana , Baca-Osorio Antonio , Gutierrez-Jansen Miguel , Fernandez-Lara María Paz , Lozano-Noriega Diego , Salgado-Carvallo Ulises , Bandera-García Cristina , Navarro-Moya Francisco Javier 
Published: March 2020

Abstract
Background Oral anticoagulant drugs represent an essential tool in thrombo-embolic events prevention. Most used are vitamin K antagonists, whose plasma level is monitored by measuring prothrombin time using the International Normalized Ratio. If it takes values out of the recommended range, the patient will have a higher risk of suffering from thromboembolic or hemorrhagic complications. Previous research has shown that about 33% of total patients keep values on inappropriate level. The purpose of the study is to improve International Normalized Ratio control figures by a joint didactic intervention based on the Junta de Andalucía School for Patients method that will be implemented by anticoagulated patients themselves. Methods A randomized clinical trial was carried out at primary care centers from one healthcare area in Málaga (Andalusia, Spain). Study population: patients included in an oral anticoagulant therapy program consisting in using vitamin K antagonists. First step detection of patients on oral anticoagulation program with International Normalized Ratio control on therapeutic level during 65% or less over total time. Second step: patients with inappropriate International Normalized Ratio control were included in two groups: Group 1 or Joint Intervention Group: patients were instructed a joint didactic intervention “from peer to peer”, by a previously trained and expert anticoagulated patient. Group 2 or Control Group: Control group performed usual clinical practice: people were schedule by nurses about one time per month, except cases in which controls were inappropriate; in those circumstances patients were schedule before that period expired. In order to built the study group and the control group, 312 individuals were required (156 in each group) to detect differences in INR figures equal or higher than 15% between both groups. Study variables time on therapeutic levels before and after intervention, sociodemographic variables, vital signs, existence of cardiovascular risk factors or accompanying diseases in the clinical records, laboratory test including complete blood count, bleeding time, and prothrombin time or partial thromboplastin time and blood chemistry, other prescribed drugs, and social support. Almost-experimental analytic study with before-after statistical analysis of the intervention were made. Lineal regression models were applied on main variables results (International Normalized Ratio value, time on therapeutic level) inputting sociodemographic variables, accompanying diseases and social support.
Long-term functional outcomes of diffuse pigmented villonodular synovitis of the knee after synovectomy with or without adjuvant radiotherapy
Authors: Chien Ju Chun , Wei Yi Ping , Chen Chun Yu , Hsiang Wei Hsin , Wang Yuan You , Liu Wen Shan , Chang Wei Ning , Yang Shan Wei 
Published: March 2020

Abstract
Background Diffuse pigmented villonodular synovitis (PVNS) of the knee is a rare benign disease that has a destructive clinical course. Reported treatment options include arthroscopic or open synovectomy with or without adjuvant radiotherapy of various doses. This study compared the long-term functional outcomes and disease control among treatment modalities and discussed 22 years of experience with radiotherapy (RT) as an adjuvant treatment for PVNS of knee.Methods A single-center database was searched for patients who received synovectomy of knee with the pathologic diagnosis of PVNS. General data, treatment modalities, and recurrent status were retrospectively collected from medical records. Functional outcomes were evaluated by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) through phone interviews by an independent orthopedist.Results From January 1995 to December 2017, 24 patients with diffuse PVNS of knee were identified, including 19 receiving open synovectomy (OP) and 5 undergoing arthroscopic surgery (AS). Adjuvant RT was performed on 14 patients with a median dose of 34.25 Gy (range 20-40 Gy). After median follow up of 6 years, clinically or radiographically confirmed recurrences were recorded in 10 cases. The local recurrence rate was significantly lower in the OP+RT group than the OP group (8.3% vs. 57.1%, p =0.038). Among those with preserved knee joints, there was no significant difference in the WOMAC score and stiffness score between patients in the OP+RT and OP groups.Conclusions In conclusion, for patients with diffuse PVNS of knee, the addition of moderate-dose adjuvant RT to open synovectomy provided excellent local control while maintaining good joint function with limited treatment-related morbidity. Our study emphasized the importance of moderate dose of RT in diffuse PVNS of knee joint.
Screening and identification of MSX1 for predicting progestin resistance in endometrial cancer
Authors: Yang Linlin , Cui Yunxia , Huang Ting , Sun Xiao , Wang Yudong 
Published: March 2020

Abstract
Background: Progestin resistance is a critical obstacle for endometrial conservative therapy. Therefore, the studies to acquire a more comprehensive understanding of the mechanisms and specific biomarkers to predict progestin resistance are very important. However, the pivotal roles of essential molecules of progestin resistance are still unexplored. Methods: We downloaded GSE121367 with gene expression profiles of medroxyprogesterone acetate (MPA) resistant and sensitive cell lines from the GEO database. The “limma” R language package was applied to identify differentially expressed genes (DEGs). Gene ontology and pathway enrichment analysis was performed through the database of DAVID. Meanwhile, we conducted GSEA analysis to identify pathway enrichments. Protein–protein interaction construction of top genes was conducted to screen hub genes by STRING and visualized in Cytoscape. A high connectivity degree of hub genes were picked out to perform the differential expression, methylation validation and overall survival analysis in the Gene Expression Profiling Interactive Analysis database, Human Protein Atlas database and Kaplan–Meier plotter online tool, respectively. In addition, microRNAs and upstream transcription factors of hub genes were predicted by miRTarBase and Network Analyst database. Results: A total number of 3282 differentially expressed genes were identified. Functional enrichment analysis demonstrated that these genes were mostly enriched in negative regulation of DNA binding, chronic inflammatory response and cell adhesion molecules pathway. We screened out ten hub genes including CDH1, JAG1, PTGES, EPCAM, CNTNAP2, TBX1, MSX1, KRT19, OAS1 and DAB2 among different groups. The genomic alteration rates of hub genes were low based on the current uterine corpus endometrial carcinoma sample sets. Their relevant microRNA and transcription factor were detected and has-miR-335-5p, has-miR-124-3p, MAZ and TFDP1 were the most prominent. The methylation status of CDH1, JAG1, EPCAM and MSX1 were decreased, corresponding to their high protein expression in endometrial cancers, which also indicated better overall survival. The homeobox protein of MSX1 showed significantly tissue specificity. Conclusions: Our study identified ten hub genes associated with progestin resistance of endometrial cancer and screened out the gene of MSX1 which promised to be the specific indicator. This would shed new light on the underlying biological marker to overcome the progestin resistance of endometrial cancer. Keywords : Bioinformatic analysis, Progestin resistance, Endometrial carcinoma, MSX1
Comprehensive analysis of pseudogene LDHAP5 expression level and its potential pathogenesis in ovarian serous cystadenocarcinoma
Authors: Lin Shitong , Meng Yifan , Cao Canhui , Wu Ping , Gao Peipei , Zhi Wenhua , Peng Ting , Wu Peng 
Published: March 2020

Abstract
Background We aim to find out differentially expressed pseudogenes and explore their potential functions in four types of common gynecologic malignancies (cervical squamous cell carcinoma, ovarian serous cystadenocarcinoma, uterine corpus endometrial carcinoma and uterine carcinosarcoma) using bioinformatic technology. Materials & methods: We identify up-regulated or down-regulated pseudogenes and build the pseudogenes-miRNA-mRNA regulatory network through public datasets to explore their potential functions in carcinogenesis and cancer prognosis. Results LDHAP5 was selected as the most potential candidate pseudogene among 63 up-regulated pseudogenes for it was significantly associated with poor overall survival in ovarian serous cystadenocarcinoma. KEGG pathway analysis revealed that LDHAP5 was most enrichment in microRNAs in cancer, pathway in cancer and PI3K-AKT signaling pathway. Further analysis revealed that EGFR was the potential target mRNA of LDHAP5 which may play a great role in ovarian serous cystadenocarcinoma. Conclusion LDHAP5 was first discovered to be associated with the occurrence and prognosis of ovarian serous cystadenocarcinoma, and it may be used as a novel specifically therapeutic target against ovarian serous cystadenocarcinoma.
Longitudinal relationships between maternal depressive/anxious symptoms and children’s tics
Authors: Yagi Tomoko , Ando Shuntaro , Usami Satoshi , Yamasaki Syudo , Morita Masaya , Kiyono Tomoki , Hayashi Noriyuki , Endo Kaori , Iijima Yudai , Morimoto Yuko , Kanata Sho , Fujikawa Shinya , Koike Shinsuke , Kano Yukiko , Hiraiwa-Hasegawa Mariko , Nishida Atsushi , Kasai Kiyoto 
Published: March 2020

Abstract
Background Previous studies have revealed an association between maternal depressive/anxious symptoms and children’s tics. However, the longitudinal relationship between these symptoms remains unclear. We examined the longitudinal relationships between maternal depressive/anxious symptoms and children’s tics across early adolescence in a population-based sample. Methods Participants were 3,171 children and their mothers from the Tokyo Teen Cohort study (TTC), a population-representative longitudinal study launched in Tokyo in 2012. Maternal depressive/anxious symptoms and children’s tics were examined using self-report questionnaires at the ages of 10 (time 1, T1) and 12 (time 2, T2). A cross-lagged model was used to explore the relationships between maternal depressive/anxious symptoms and children’s tics. Results As maternal depressive/anxious symptoms at T1 were greater, their children at T2 were more likely to have tics (β = .06, p = .001). Furthermore, the presence of tics at T1 was positively related to maternal depressive/anxious symptoms at T2 (β = .06, p = .001). Conclusions These findings suggest a longitudinal bidirectional relationship between maternal depressive/anxious symptoms and children’s tics during early adolescence which may exacerbate each other over time and possibly create a vicious circle. When an early adolescent has tics, it might be important to identify and care for maternal depressive/anxious symptoms.
The Implementation &amp; Sustainment Facilitation Strategy improved implementation effectiveness and intervention effectiveness: Results from a cluster-randomized type 2 hybrid trial
Authors: Garner Bryan , Gotham Heather , Chaple Michael , Martino Steve , Ford James , Roosa Mathew , Speck Kathryn , Vandersloot Denna , Bradshaw Michael , Ball Elizabeth , Toro Alyssa , Griggs Christopher , Tueller Stephen 
Published: March 2020

Abstract
Background Substance use disorders (SUD) among people with HIV are both prevalent and problematic. In 2014, the Substance Abuse Treatment to HIV care (SAT2HIV) Project was funded to test the team-focused Implementation & Sustainment Facilitation (ISF) strategy as an adjunct to the staff-focused Addiction Technology Transfer Center (ATTC) strategy for integrating a motivational interviewing-based brief intervention (MIBI) for SUD within HIV community-based organizations (CBOs). This article presents the main findings from the project.Methods Using a cluster-randomized, type 2 hybrid trial design, 39 HIV-CBOs were randomized to either: 1) ATTC (n = 19); or 2) ATTC+ISF (n = 20). HIV-CBOs identified two staff to be prepared to implement the MIBI (N = 78 MIBI staff). Subsequently, during the implementation phase, HIV-CBOs in each condition randomized client participants (N = 824 client participants) to one of two intervention conditions: 1) usual care (UC; n = 415); or 2) UC+MIBI (n = 409). Both staff-level outcomes and client-level outcomes were examined.Results The ISF strategy had a significant impact on implementation effectiveness (i.e., the consistency and quality of implementation; β = 0.65, p = 01), but not on time-to-proficiency (β = - 0.02) or level-of-sustainment (β = 0.09). Additionally, the ISF strategy was found to have a significant impact on intervention effectiveness (i.e., the effectiveness of the MIBI), at least in terms of significantly decreasing the odds (odds ratio = 0.11, p = .02) of clients using their primary substance daily during follow-up.Conclusions The ATTC strategy was sufficient for the preparation of HIV-CBO staff to implement a MIBI for SUDs, yet the ISF strategy was found to be an effective adjunct to the ATTC strategy in terms of implementation effectiveness and intervention effectiveness. Based on these findings, it is recommended future efforts to integrate the project’s MIBI for SUD within HIV-CBOs use the ATTC+ISF strategy. However, given the ISF strategy did not have a significant impact on level-of-sustainment, which was similarly low in both implementation conditions, implementation research testing the extent to which the ATTC+ISF strategy can be significantly enhanced via effective sustainment strategies is warranted.Trial registration: ClinicalTrials.gov: NCT02495402. Registered 7/6/2015. ClinicalTrials.gov: NCT03120598. Registered 4/18/2017, retrospectively registered.
Complement activating ABO IgM/IgG act synergistically to cause erythrophagocytosis: implications among minor ABO incompatible platelet transfusions
Authors: Pandey Priyanka , Anani Waseem Q. , Pugh Tina , Gottschall Jerome L. , Denomme Gregory A 
Published: March 2020

Abstract
Background Typically minor ABO incompatible platelet products are transfused without any incident, yet serious hemolytic transfusion reactions occur. To mitigate these events, ABO ‘low titer’ products are used for minor ABO incompatible transfusions. We sought to understand the role of IgG and complement activation by anti-A on extravascular hemolysis. Samples evaluated: i) Group O plasma from a blood donor whose apheresis platelet product resulted in an extravascular transfusion reaction, ii) Group O plasma from 12 healthy donors with matching titers that activated complement (N = 6) or not (N = 6), and iii) Group O sera from 10 patients with anti-A hemolysin activity. Monocytes from healthy donors were co-incubated with anti-A-sensitized fluorescently-labeled Group A1+ RBCs with and without fresh Group A serum, as a source of complement C3, and phagocytosis was analyzed by flow cytometry. The plasma and sera had variable direct agglutinating (IgM) and indirect (IgG) titers. Results None of 12 selected samples showed monocyte-dependent erythrophagocytosis with or without complement activation. The donor sample causing a hemolytic transfusion reaction and 2 of the 10 patient sera with hemolysin activity showed significant erythrophagocytosis (>10%) only when complement C3 was activated. The single donor plasma and two sera demonstrating significant erythrophagocytosis had high IgM (≥128) and IgG titers (>1024). The donor plasma anti-A was IgG1, while the patient sera were an IgG3 and an IgG1 plus IgG2. Conclusion High anti-A IgM/IgG titers act synergistically to cause significant monocyte erythrophagocytosis by activating complement C3, thus engaging both Fcγ- and CR1-receptors.
High susceptibility to collagen-induced arthritis in mice with progesterone receptors selectively inhibited in osteoprogenitor cells
Authors: Liu Lixian , Jia Junjing , Jiang Min , Liu Xueping , Dai Chenlin , Wise Barton , Lane Nancy , Yao Wei 
Published: March 2020

Abstract
Background. Progesterone receptor (PR) affects immunomodulation, and lack of PR in osteoprogenitor cells primarily affects pathways associated with immunomodulation, especially in the males. In this study, we selectively deleted PR from osteoprogenitor cells using Prx1-Cre to evaluate the tissue-specific effects of PR on inflammatory arthritis (IA). Methods. Collagen-induced arthritis (CIA) was used as an IA animal model, which we induced in PR D Prx1 mice and their wild type (WT) littermates were immunized with collagen II (CII) emulsified incomplete Freund's adjuvant ( CFA ) in both sexes. Joint erosion, inflammation, and cartilage damages were assessed using a semiquantitative histologic scoring system. Bone volume and erosions in knee and ankle joints were quantitated using microCT. We found that knee and paw joint erosions developed in 37.5% and 41.7% of the WT and PR D Prx1 female mice, respectively, and in 45.4 and 100%, respectively, of the male mice. Also, both knee and ankle joint inflammation scores, joint damage scores, and subchondral bone erosions were significantly more severe in male PRcKO mice than in male WT mice. Although of lower severity than in male mice, female PR D Prx1 mice also developed higher inflammation scores and bone erosions than the KO-normal or WT-CIA females. Immunohistochemistry staining of the NLRP3 inflammasome revealed the male PR D Prx1 mice had significantly higher expression of NLRP3 inflammasome in the knee joints. Conclusion. Our observations indicate that the presence of PR in osteoprogenitor cells counteracts the development of collagen-induced arthritis and might help to explain the sex differences observed in human inflammatory arthritis.
Sistema de evaluación cualitativa a través de dispositivos móviles
Authors: Parra Castrillón José Eucario 
Published: March 2020

El Sistema PruebaL es un producto del proyecto Evaluación Cualitativa a Través de Dispositivos Móviles, cuyo objetivo es analizar e implementar un sistema para gestionar procesos de evaluación. La temática se enmarca dentro de los conceptos de mobile learnig y su desarrollo consistió en el análisis de requerimientos funcionales y no funcionales, la definición del sistema, el diseño para las relaciones modulares de profesor, estudiante, administrador y pruebas y la implementación utilizando tecnología de teléfonos celulares. Se alcanzaron dos logros fundamentales: un modelo de evaluación cualitativa automatizada con el sistema PruebaL y la notificación efectiva a los teléfonos celulares matriculados en las bases de datos de estudiantes, para la presentación de las evaluaciones y el acceso Web a estas.
Systems thinking approach for analysing non-revenue water management reform in Malaysia
Authors: Lai Chee Hui , Tan David T. , Roy Ranjan , Chan Ngai Weng , Zakaria Nor Azazi 
Published: March 2020

Abstract
High volumes of non-revenue water (NRW) threaten water security in many developing countries. The traditional technocentric water management regime largely neglects social and systemic complexities that need to be addressed for successful reform. This paper explores the challenges of water sector reform and NRW reduction in Malaysia to identify possible drivers that can accelerate the NRW management reform. The analysis uses a system thinking approach, with key systemic relationships represented with causal loop diagrams (CLDs). Findings reveal that the NRW management reform is influenced by technical, environmental, economic, social, institutional, and corporate governance factors. Using the CLDs, leverage points that can accelerate NRW management reform are identified. Policies and strategies that can accelerate the NRW management reform in Malaysia are recommended: (1) water supply security and sustainable development must be emphasised as the main concern for water sector reform; (2) understanding of the socio-economic benefits of water tariff adjustment by stakeholders is necessary to build political alliances for water tariff increments; and (3) the newly privatised water services providers in Malaysia require an integrated NRW reduction plan to optimise the time taken for NRW reduction and at the same time, transforming their current human resources that were inherited from the previous public water utilities.