bluuebunny/crossref_metadata_2025_split huggingface dataset:
A simple angle-measuring instrument for measuring cemented stem anteversion during total hip arthroplasty
Authors: Mitsutake Ryo , Tanino Hiromasa , Nishida Yasuhiro , Higa Masaru , Ito Hiroshi 
Published: October 2019

Abstract
Background During total hip arthroplasty (THA), the accurate placement of the femoral components is an important determinant of the success of the procedure. This study assessed the accuracy of cemented stem placement using a new angle-measuring instrument. The primary objective was to investigate the accuracy of the intraoperative measurements of cemented stem anteversion obtained using the angle-measuring instrument. Our secondary objective was to evaluate the accuracy of stem positioning performed using the angle-measuring instrument. Methods We compared the intraoperative stem anteversion measurements obtained using the angle-measuring instrument with postoperative stem anteversion measurements obtained using computed tomography in 149 hips (measurement accuracy). We also compared the target angle and postoperative stem anteversion in 105 hips (implantation accuracy). Results The mean amount of intraoperative stem anteversion was 37.9°±10.1°, and the mean amount of postoperative stem anteversion was 37.0°±10.4°. The mean measurement accuracy was 0.9°±6.1°, and the absolute measurement accuracy was 4.9°±3.7°. The correlation coefficient for the relationship between the intraoperative and postoperative stem anteversion measurements was 0.824 (p=0.000). The mean amount of target angle was 37.4°±7.6°, and the mean amount of postoperative stem anteversion was 35.9°±9.1°. The mean implantation accuracy was 1.4°±5.6°, and the mean absolute implantation accuracy was 4.3°±3.6°. The correlation coefficient for the relationship between the intraoperative and postoperative stem anteversion measurements was 0.824 (p=0.000). Conclusions The angle-measuring instrument is expected to allow cemented stems to be placed accurately, simply, and less invasively during THA and at significant cost savings.
Predictors of intra-hospital mortality in patients with diabetic foot ulcers in Nigeria: data from the MEDFUN Study.
Authors: ADELEYE OLUFUNMILAYO OLUBUSOLA , Ugwu Ejiofor T , Gezawa Ibrahim D , Okpe Innocent , Ezeani Ignatius , Enamino Marcelina 
Published: October 2019

Abstract
Background/Objective : Diabetic foot ulcers (DFU) are associated with high morbidity and mortality globally. Mortality in patients hospitalized for DFU in Nigeria is unacceptably high. We sought to document contributory factors which predict mortality in patients hospitalized for DFU. Methods : Multi-centre Evaluation of Diabetic Foot Ulcer in Nigeria ( MEDFUN ), one-year observational study conducted in six tertiary healthcare institutions across the 6 geopolitical zones of Nigeria. Consecutive type 1 or 2 diabetic patients hospitalized for DFU who consented. Co-morbid complications were documented. Results : Mean age 55.9 12.5 years.96.1% had type 2 diabetes (DM), mean duration of DM was 8.5 ± 5.7 years. Duration of ulcer was 39 days with a range of 28 to 54 days. 79.2% presented with at least grade 3 DFU. About one-fifth of the patients died (20.5%). Highest mortality among subjects with Wagner grade 5. Middle-aged subjects ( 45-64 years) had significantly higher mortality- odds ratio (OR) 5.107, Confidence interval (CI) of 1.429-18.252, and P-value 0.022. Variables significantly associated with mortality with the respective p- values are DM duration more than 120 months (0.008), ulcer duration > one month (0.013), ulcer severity of Wagner grade 3 and above (0.001), peripheral arterial disease (0.002), foot gangrene (< 0.001). Laboratory variables associated with mortality ; proteinuria (<0.001), positive blood cultures (<0.001), severe vascular stenosis (0.001), moderate vascular stenosis(< 0.001), Low HDL (< 0.001). Co-morbid complications significantly associated with mortality; shock at presentation (<0.001), anemia (0.034), cardiac failure (0.020), renal impairment (<0.001). Sepsis was the strongest predictor of mortality (adjusted OR 5.128; 95% CI 2.614 – 10.060) followed by renal impairment (adjusted OR 2.831; 95% C.I. for OR 1.346 – 5.953). Conclusions : Mortality among Nigerian diabetic patients admitted for DFU is high, univariate predictors of mortality: older age, higher Wagner grade (≥ 3) ulcer, longer duration of DM, longer duration of ulcer, peripheral arterial disease, foot gangrene, renal impairment, low HDL- cholesterol, anemia, shock, and cardiac failure. Renal impairment and positive blood culture were independent determinants of mortality.
Studying Microwave-Assisted Hydrolytic Degradation of Colchicine using RP-Chromatographic Methods: In Silico ADME/Tox Profile and Molecular Docking
Authors: abdelwahab nada , mokhtar hossam , aboulmaged asmaa 
Published: October 2019

Abstract
Colchicine, is a natural amide containing anti-gout treatment with versatile applications. Microwave assisted hydrolytic degradation is a newly alternative method thought to be more promising than traditional procedures of heating. It is an ecofriendly method that has more reproducible results due to the control of parameters. From this point, carrying on hydrolytic degradation of colchicine was tested for the first time under acidic conditions with the aided of microwave. The drug was hydrolyzed with the formation of deacylated analogue. Isolation of the resulted degradate was carried out using flash chromatography, the isolated one was elucidated based on 1 H NMR data. Moreover, the results of human pharmacokinetic predictions conducted from in silico data showed that colchicine had higher blood brain barrier (BBB), plasma protein binding, and oral absorption than its deacylated derivative. The study was also extended to forecast the binding of colchicine and its degradate to the target protein. Furthermore, two stability indicating chromatographic methods were developed for quantification of the drug and its degradation product with high sensitivity. The first method was RP-TLC densitometric method that based on using a solvent mixture of water: methanol: diethylamine (70: 30: 15, by volume). The second one was RP-HPLC at which a mixture of water (containing 0.02% diethyl amine): methanol: acetonitrile (50: 20: 30, by volume) was the used mobile phase. Validation parameters were calculated according to ICH recommendations and all were within the acceptable limits. These methods were used for determination of colchicine in its available tablets. They are the first developed stability indicating methods for analysis of colchicine and its degradation product.
Maternal age and educational level modify the association between chronic hepatitis B infection and preterm labor
Authors: Peng Songxu , Chen Hongyan , Li Xiu , Du Yukai , Gan Yong 
Published: October 2019

Abstract
Background To investigated whether maternal age and educational level could modify the association of chronic hepatitis B virus (HBV) infection with preterm labor.Methods A retrospective cohort study was performed on the pregnant women delivered from June 2012 to August 2017 at Wuhan Medical Care Center for Women and Children, Wuhan, China. Multivariate logistic regression analysis was used to measure the association between maternal HBV infection and preterm labor.Results 2050 HBsAg-positive pregnant women and 2050 HBsAg negative women were included into this study. In the stratified analyses, positive HBsAg status was associated with the increased risk of preterm labor in women aged <30 years, having low educational level, with an odds ratio of 1.65(95% CI 1.07-2.54) and 2.59(95% CI 1.41-4.76), respectively. After adjusting other covariables, we observed maternal HBV infection (OR 1.60, 95% CI 1.03-2.49) was still associated with risk of preterm labor in mothers with age <30. Similarly, the significant association of HBV infection (OR 2.49, 95% CI 1.34-4.63) with preterm labor remained in low educated women.Conclusions Our results indicated that HBV infection was associated with high risk of preterm labor, but maternal age and educational level could modify this association. Further studies are warranted to clarify the possible mechanisms behind such modifiable action.
Influence of ABCB1 C3435T gene polymorphisms on tumor response to neoadjuvant chemotherapy in locally advanced breast cancer patients from Northeastern Brazil.
Authors: Bezerra Diego de Aragão , Linhares Jose Juvenal , Noronha Emmanuelle Coelho , Tavares Kaio César Simiano , Antunes André Saraiva Leão Marcelo , Coelho Regina Freitas , Marques Marcos Vinicius Souza 
Published: October 2019

Abstract
Background: Breast cancer (BC) is the most common tumor and the leading cause of cancer-related death among the female population worldwide. To evaluate the association between the ABCB1 C3435T single gene nucleotide polymorphisms (SNPs) with the response to neoadjuvant chemotherapy in women with breast cancer. Methods: This study included 32 female patients who received neoadjuvant chemotherapy. The polymorphisms were genotyped through real-time allele-specific polymerase chain reaction (PCR). The statistical analysis was performed using the Fisher's exact test or Pearson's chi-square test in the Statistical Package for Social Sciences (SPSS) version 20.0 software. Results: The genotypes found for the C3435T polymorphism were in Hardy-Weinberg equilibrium and their genotypic distributions were CC= 10 (31.1%), CT= 14 (43.8%), and TT= 08 (25.0%) with χ2: 0.86 and p-value > 0.05. Allele frequencies were C = 0.54 and T = 0.46. There were no significant statistical differences between genotypes considering the response to neoadjuvant chemotherapy and immunohistochemistry; the presence of the T allele was associated with worsen axillary status response to neoadjuvant chemotherapy. Conclusion: No definite association between the presence of C3435T polymorphism and the response to neoadjuvant chemotherapy was observed. Further studies in Brazil involving larger samples will contribute to validating the results of this study. Keywords: Breast cancer; Neoadjuvant Chemotherapy; Polymorphisms; Gene ABCB1
Potential health risk assessment of toxic metals contamination in clay eaten as pica (geophagia) among pregnant women of Ho in the Volta Region of Ghana.
Authors: Kortei Nii Korley , Akonor Papa Toah , Manaphraim Nana Yaw Barima , Ayim-Akonor Matilda , Boadi Nathaniel Owusu , Essuman Edward Ken 
Published: October 2019

Abstract
Introduction: Geophagia although pleasurable and somewhat a necessity among pregnant women, also comes along with its own attendant problems such as exposure to potentially hazardous substances like bacteria, fungi, helminthes and ova, radioactive materials, and toxic elemental minerals in the soil depending on the geographical location. Methodology: This study evaluated the potential health risk involved during the exposure of pregnant women to toxic elemental minerals via the consumption of clay as pica (geophagia). Elemental mineral analysis was carried out using Buck Scientific 210VGP Flame Atomic Absorption Spectrophotometer (Buck Scientific, Inc. East Norwalk, USA). Risk assessment methods were also used to ascertain the various risks factors and the overall risk level. Results: Concentrations of the macro elements investigated were 1.38 ± 1.5, 2.40± 1.5, 7.74± 1.5, 4.01± 1.0, 13.24± 2.2 and 13.76± 2.1 mg/Kg for Fe, Cu, Zn, K, Mg and Na respectively. While that for the micro elements were 1.63± 0.03 µg/Kg, 4.72±0.8, 0.53±0.02 and 1.85±0.3 mg/kg respectively for Arsenic, Manganese, Lead and Nickel. Estimated Daily Intake (EDI), Hazard Quotient (HQ), Target Hazard Quotient (THQ) and Total Target Hazard Quotient (TTHQ) values ranged 0.611- 5.44 (mg/kg Bw/day), 6.26x10 -4 – 106.5, 0.067-10.34 and 15 respectively. Conclusion: There is the likelihood of posing adverse health problems when clay samples obtained from Anfoega which is sited in the Volta region of Ghana is consumed due to the fact that the calculated HQ’s of these elemental minerals were >1 which points to high content of Manganese (Mn) and Nickel (Ni). It is also likely to cause adverse health problems in an individual’s life time since THQ for Arsenic, Lead and Nickel were above 1. Ultimately, the cumulative effect of these toxicants were exceedingly great (≤ 15) which implied a high level of unsafety associated with this clay. Per the results from this study, it is not safe for pregnant women to consume clay as pica since these toxic elements may cause detrimental effects on the foetus of the unborn child.
Development of a decision support intervention for family members of adults who lack capacity to consent to trials
Authors: Shepherd Victoria , Wood Fiona , Griffith Richard , Sheehan Mark , Hood Kerenza 
Published: October 2019

Abstract
Background Informed consent is required for participation in clinical trials, however trials involving adults who lack capacity to consent require different enrolment processes. A family member usually acts as a proxy to make a decision based on the patient’s ‘presumed will’, but they can experience an emotional and decisional burden as a result. Decisions made on behalf of others are conceptually different from those we make for ourselves. Despite innovations to improve informed consent processes for research, including the development of decision aids, there are no interventions for proxies who arguably are faced with more complex decisions. This article outlines the development of a novel decision aid aimed at supporting families making decisions about research participation on behalf of an adult who lacks capacity to consent. Methods Decision support interventions should be developed using rigorous and evidence-based methods. This intervention was developed using the MRC guidance for the development of complex interventions, and a conceptual framework for the development and evaluation of decision aids for people considering taking part in a clinical trial. The intervention was informed by a systematic review and analysis of existing information provision. Previous qualitative research with families who had acted as proxies enabled the development of a theoretical framework to underpin the intervention. The intervention was iteratively developed in conjunction with lay advisors and relevant stakeholders. Results Previous research, theoretical frameworks, and decision aid development frameworks were used to identify and develop the intervention components. The decision aid includes information about the proxy’s role and uses a values clarification exercise and decision support methods to enable a more informed and better-quality decision. Stakeholders, including those representing implementers and receivers of the intervention, contributed to the design and comprehensibility of the decision aid and helped to ensure that it would be acceptable for use. Conclusions Frameworks for the development of decision aids for people considering participating in a clinical trial can be used to develop interventions for family members acting as proxy decision-makers. The decision support tool is acceptable to users but requires feasibility testing and outcome measure development prior to any evaluation of its effectiveness.
The Utility of Work-Based assessments in higher general surgical training – a systematic review
Authors: Aryal Kamal Raj 
Published: October 2019

Abstract
Background In the UK, work-based assessments (WBAs) including procedure based assessments (PBAs), case based discussion (CBDs), Clinical evaluation exercise (CEXes) and direct observation of procedural skills (DOPS) are used in Higher General Surgical Training Programme (HGSTP). This review aims to investigate trainer and trainee’s perception of the usefulness of WBAs based on the published literature in HGSTP.Methods Using mesh headings WBA or PBA or DOPS or Mini CEX with their full forms literature search was carried out in December 2018. Seventeen surgical studies were retrieved describing their usefulness. The usefulness was analysed according to van der Vluten’s utility formula, the product of educational impact, validity, reliability, acceptability, cost-effectiveness and feasibility.Results Among 6 studies on PBA, the validity, reliability, acceptability appeared good. The educational impact was positive to the Kirkpatrick level 1 and 2. One study on Mini CEX showed Kirkpatrick level 1 positive satisfaction in trainees and trainers. CBD had positive Kirkpatrick levels 1 and 2 impact and was valid and reliable by trainees in 2 studies. Two studies on DOPS showed good construct validity with positive Kirkpatrick level 1 impact. Based on 6 studies, the use of multiple methods as used in the intercollegiate surgical curriculum project (ISCP) portfolio was more negative in Kirkpatrick level 1 and 2. The recognised problems are lack of time, lack of faculty development and concerns about their validity and reliability.Conclusion Although the individual WBAs appeared useful in study settings, their perceived usefulness declined when used as multiple methods in practice.
Recombinant Human Thrombomodulin for Pneumonia-Induced Severe Acute Respiratory Distress Syndrome Complicated by Disseminated Intravascular Coagulation in Children: A feasibility study
Authors: Hirata Naoyuki , Ngo Dong Tien , Phan Phuc Huu , Ainai Akira , Phung Thuy Thi Bich , Tuan Ta Anh , Dien Tran Minh , Takasaki Jin , Kawachi Shoji , Nakajima Noriko , Hai Le Thanh 
Published: October 2019

Abstract
Background Recombinant human soluble thrombomodulin (rTM) has been used to treat disseminated intravascular coagulation (DIC). Recent studies have shown the efficacy of rTM through its anti-inflammatory effects for treatment of adults with acute respiratory distress syndrome (ARDS). However, the safety and efficacy of rTM in children with severe ARDS complicated by DIC have not been reported. In this study, we investigated the feasibility of using rTM for the treatment of pneumonia-induced severe ARDS complicated by DIC in children. Methods Six children (age: median 10 month-old) with pneumonia-induced severe ARDS complicated by DIC were enrolled in this feasibility study. rTM (380 U/kg) was administered for a maximum of 6 days, in addition to conventional therapies including cardiopulmonary support, antibiotics and/or antivirus drugs administration, steroid administration and intravenous immunoglobulin after diagnosis of severe ARDS complicated by DIC. After administration of rTM, we measured changes in the plasma TM concentration and evaluated the clinical course, status of DIC and ARDS, and other laboratory findings, including levels of cytokines, chemokines, and biomarkers. Results In all six children, the plasma concentration of TM increased and DIC scores decreased after administration of rTM. Four of the six children recovered from the severe ARDS complicated by DIC after treatment in the pediatric intensive care unit, and were discharged from the hospital with no complications. In surviving children, levels of soluble receptors for advanced glycation end products, interleukin-6, interleukin-8 and monocyte chemotactic protein-1 decreased after administration of rTM. Conclusions The rTM administration is feasible as a therapeutic strategy for children over 2 months with pneumonia-induced severe ARDS complicated by DIC.
Preparation for future care moderates the relationship between loneliness and depression among Chinese rural older adults: A cross-sectional study
Authors: Li Yuqin , Jia Jihui , Zhao Xia , Zhang Dan 
Published: October 2019

Abstract
Background: Loneliness and depression are common mental health concerns among older adults in rural China. Loneliness has been identified as a risk factor for depressive symptoms, while preparation for future care can be a protective factor. Little is known about the complex relationships among these factors in rural older adults. This study aimed to explore whether preparation for future care moderated the association between loneliness and depressive symptoms. Methods: A total of 481 rural older adults aged 60 years and above were recruited in Shandong, China. Loneliness, preparation for future care, and depressive symptoms were measured. Statistical analyses included d escriptive analysis, univariate analyses, and moderating effects analyses. Results: Our findings showed that preparation for future care and its related dimensions of gathering information, making decisions, and concrete planning can moderate the relationship between loneliness and depression. When the level of preparation for future care and its dimensions were higher, the effect of loneliness on depressive symptoms was weaker. Conclusions: As the first study on how preparation for future care moderates the relationship between loneliness and depression in rural older adults, the findings are significant. Preparation for future care should be taken into consideration when interventions are being developed to reduce depressive symptoms in older adults.
Effects of the ANXA6 polymorphisms on glioma risk and patients prognosis
Authors: Wang Tuo , Sun Yao , Xiong Zichao , Wu Jiamin , Ding Xiaoying , Guo Xiaoye , Shao Yuan 
Published: October 2019

Abstract
BACKGROUND Glioma is the most frequent malignant primary brain tumor, and the outcomes for patients with glioma remain poor. The purpose of this study is to explore the association between ANXA6 polymorphisms and glioma risk as well as the prognosis of glioma patients in the Chinese Han population.METHODS We selected nine single-nucleotide polymorphisms (SNPs) in ANXA6 which were genotyped by Agena MassARRAY from 593 glioma patients and 589 healthy controls. The odds ratio (OR) and 95% confidence interval (CI) were calculated by logistic regression analysis to evaluate the association SNPs with glioma risk. The association between polymorphisms and survival of glioma patient were evaluated using the log-rank test, Kaplan-Meier and Cox regression analysis. RESULTS: Overall analysis found that rs3762993 was significantly associated with an increased glioma risk. Stratification analysis found that rs11960458 was strongly associated with an increased risk of glioma in age >41; rs3762993 was also found to be associated an increased with glioma risk in age >41, ≤41, male and low-grade glioma; but rs4958892 was associated with a decreased risk of glioma in age>41 and male. Interestingly, rs11960458 and rs888988 were correlated with poor prognosis of glioma patient. Furthermore, age, extent of resection and chemotherapy were found to be key prognostic factors in survival of glioma patients.CONCLUSIONS In conclusion, our results indicated that ANXA6 polymorphisms were associated with glioma susceptibility and prognosis. Further studies are required to confirm the results and elucidate the mechanisms of the ANXA6 polymorphisms affect the glioma risk and prognosis.