bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safely reducing haemodialysis frequency during the COVID-19 pandemic
Authors: Lodge Michelle da Silva , Abeygunaratne Thilini , Alderson Helen , Ali Ibrahim , Brown Nina , Chrysochou Constantina , Donne Rosie , Erekosima Ibi , Evans Philip , Flanagan Emma , Gray Simon , Green Darren , Hegarty Janet , Hyde Audrey , Kalra Philip A , Lamerton Elizabeth , Lewis David , Middleton Rachel , New David , Nipah Robert , O’Donoghue Donal , O’Riordan Edmond , Poulikakos Dimitrios , Rainone Francesco , Raman Maharajan , Ritchie James , Sinha Smeeta , Wood Grahame , Tollitt James 
Published: September 2020

Abstract
Background:Patients undergoing haemodialysis (HD) are at higher risk of developing worse outcomes if they contract COVID-19. In our renal service we reduced HD frequency from thrice to twice-weekly in selected patients with the primary aim of reducing COVID 19 exposure and transmission between HD patients.Methods:Dialysis unit nephrologists identified 166 suitable patients (38.4% of our HD population) to temporarily convert to twice-weekly haemodialysis immediately prior to the peak of the COVID-19 pandemic in our area. Changes in pre-dialysis weight, systolic blood pressure (SBP) and biochemistry were recorded weekly throughout the 4-week project. Hyperkalaemic patients (serum potassium > 6.0mmol/L) were treated with a potassium binder, sodium bicarbonate and received responsive dietary advice.Results:There were 12 deaths (5 due to COVID-19) in the HD population, 6 of which were in the twice weekly HD group; no deaths were associated with change of dialysis protocol. A further 19 patients were either hospitalised and/or developed COVID-19 and thus transferred back to thrice weekly dialysis as per protocol. Of 141 eligible patients 113 (80.1%) were still receiving twice-weekly HD by the end of the 4-week project. Indications for transfer back to thrice weekly were; fluid overload (19), persistent hyperkalaemia (4), patient request (4) and compliance (1). There were statistically significant increases in SBP and pre-dialysis potassium during the project. Conclusions:Short term conversion of a large but selected HD population to twice-weekly dialysis sessions was possible and safe. This approach could help mitigate COVID-19 transmission amongst dialysis patients in centres with similar organisational pressures.
Large autologous ilium with periosteum for tibiotalar joint reconstruction in Rüedi-Allgöwer III or AO/OTA type C3 pilon fractures. A pilot study
Authors: Li Dong , Li Jiao Jiao , Zhu Yuanyuan , Hou Fushan , Li Yuan , Zhao Bin , wang bin 
Published: September 2020

Abstract
Background: Management of Rüedi-Allgöwer III or AO/OTA type C3 pilon fracture presents numerous challenges to the orthopaedic surgeon. A joint preservation technique using a large autologous ilium with periosteum in combination with internal implant fixation was reported to improve the outcome of reconstruction. Methods: Twenty-five patients according to Tscherne/Oestern FxCO-I closed fracture and FxOI open fractures classification after Rüedi-Allgöwer III or AO/OTA type C3 pilon fracture received a large autologous ilium with periosteum for tibiotalar joint reconstruction and open reduction and internal fixation (ORIF), between March 2015 and September 2018. The visual analog scale (VAS), American Orthopaedic Foot & Ankle Society (AOFAS) score, and Burwell and Charnley criteria were used for outcome analysis. Results: Twenty patients with an average age of 45.2 years were followed for an average of 18.3 months. The VAS and AOFAS scores, and Burwell and Charnley ratings were recorded at the last follow-up after reconstructive surgery. Two patients developed redness and swelling at the wound site, but recovered after local care and dressing changes. No patient displayed deep surgical site infection, donor site complication, non-union or local complication during the final follow-up. The average bone union time was 18.3 months (range 3-36). Conclusions: Large autologous ilium with periosteum in combination with ORIF can be performed for tibiotalar joint reconstruction. This experimental procedure reduces the risk of post-operative complications following articular reconstruction for Rüedi-Allgöwer III or AO/OTA type C3 pilon fractures in short follow-up.Level of Evidence: Level III, retrospective cohort study
Molecular characteristics of rotavirus genotypes circulating in the south of Benin, 2016-2018
Authors: Agbla Jijoho Michel , Esona Mathew D , Agbankpé Alidéhou Jerrold , Capo-Chichi Annick , Gautam Rashi , Dougnon Tamègnon Victorien , Razack Osseni , Bowen Michael D , Bankolé Honoré Sourou 
Published: September 2020

Abstract
Objective: Rotavirus remains the main causative agent of gastroenteritis in young children in countries that have not yet introduced the vaccine. In Benin, rotavirus vaccine was introduced late December 2019 into the EPI. This study aims to provide pre-vaccination era rotavirus genotyping data in Benin. These data can supplement data from the surveillance system of Ministry of Health of Benin which is supported by the World Health Organization (WHO).Results: Of the 420 diarrheal stool samples, actively collected in southern Benin from July 2016 through November 2018 from children under five years old and suffering from gastroenteritis, 167 (39.8%) samples were rotavirus EIA positive. 186 (44.3%) samples contained amplifiable rotavirus RNA detected by qRT-PCR method and were genotyped using one-step RT-PCR multiplex genotyping method. G1P[8] represents the predominant genotype (32%) followed by the G2P[4] (26%), G3P[6] (16%), G12P[8] (13%) and mixed G and P types (1%). Four samples (2%) could not be assigned both G and P type speciﬁcity.
IFITM3 Regulates NCAPG Through Phosphorylation to Influence the Invasion and Metastasis of HCC
Authors: Liu Weiwei , Zhang Rongguiyi , Li Enliang , Wu Linquan , Wang Jiakun 
Published: September 2020

Abstract
Background: Several studies have demonstrated that the expression of IFITM3 and NCAPG is closely related to the prognosis of various tumors. However, the mechanism of action of these two is not yet clear. In this study, we have explored the mechanism of action of IFITM3 and NCAPG in the promotion of the invasion and metastasis of hepatocellular carcinoma (HCC). Methods: Specimens of liver cancer and adjacent tissues from 55 HCC patients at the Department of Hepatobiliary Surgery, Second Affiliated Hospital of Nanchang University were collected, and the expression of NCAPG and IFITM3 was determined by qRT-PCR and Western blot. Through the analysis of multiple databases, the relationship between IFITM3 and NCAPG was identified and verified by the CO-IP method. Using SiRNA and plasmids to downregulate and up-regulate IFITM3, we observed the expression of STAT3/CDK1, as well as NCAPG mRNA and protein. After downregulating and up-regulating the expression of IFITM3 and NCAPG, the ability of HCC cells to invade and metastasize was determined using a scratch test and Transwell. After using pathway inhibitors and activators, the expression of NCAPG was observed.Results: According to the database, both IFITM3 and NCAPG were highly expressed in Liver hepatocellular carcinoma. We also confirmed that IFITM3 and NCAPG were up-regulated in HCC tissues and cells. Furthermore, the bioinformatics analysis and CO-IP indicated that there was protein interaction between IFITM3 and NCAPG, and that IFITM3 could regulate NCAPG by phosphorylating it. We further confirmed our observations by retrospective experiments. Reuse of pathway inhibitors and activators indicated that IFITM3 could regulate NCAPG through STAT3/CDK1 to promote the invasion and metastasis of HCC. Finally, animal experiments confirmed that our results were also reproducible in vivo. Conclusion: IFITM3 can regulate NCAPG through STAT3/CDK1 to promote the invasion and metastasis of HCC.
Acute skeletal muscle wasting and dysfunction predict physical disability at hospital discharge in patients with critical illness
Authors: Mayer Kirby P. , Bastin Melissa L. Thompson , Montgomery-Yates Ashley A. , Pastva Amy M. , Dupont-Versteegden Esther E. , Parry Selina M. , Morris Peter E 
Published: September 2020

Abstract
Background: Patients surviving critical illness develop muscle weakness and impairments in physical function, however, the relationship between early skeletal muscle dysfunction and physical function at hospital discharge remains unclear. The primary purpose of this study was to determine if changes in muscle size, strength and power assessed in the intensive care unit (ICU) predict physical function at hospital discharge. Methods: Study design is a single-center, prospective, observational study in patients admitted to the medicine or cardiothoracic ICU with diagnosis of sepsis or acute respiratory failure. Rectus femoris (RF) and tibialis anterior (TA) muscle ultrasound images were obtained day one of ICU admission, repeated serially and assessed for muscle cross-sectional area (CSA), layer thickness (mT), and echointensity (EI). Muscle strength, as measured by Medical Research Council-sum score, and muscle power (lower-extremity leg-press) were assessed prior to ICU discharge. Physical function was assessed with performance on 5-times sit-to-stand (5STS) at hospital discharge.Results: Forty-one patients with median age of 61 years (IQR 55-68), 56% male, and sequential organ failure assessment score of 8.1 ± 4.8 were enrolled. RF muscle CSA decreased significantly a median percent change of 18.5% from day 1 to 7 (F = 26.6, p = 0.0253). RF EI increased at a mean percent change of 10.5 ± 21% in the first 7 days (F = 3.28, p = 0.081). At hospital discharge 25.7% of patients (9/35) met criteria for ICU-acquired weakness. Change in RF EI in first 7 days of ICU admission and muscle power measured prior to ICU were strong predictors of ICU-AW at hospital discharge (AUC = 0.912). Muscle power at ICU discharge, age and ICU length of stay were predictive of performance on 5STS at hospital discharge.Conclusion: ICU-assessed muscle dysfunction is a predictor of physical disability at hospital discharge in patients surviving critical illness.
Improving mobility and participation of older people with vertigo, dizziness and balance disorders in primary care using a care pathway: feasibility study and process evaluation
Authors: Seckler Eva , Regauer Verena , Krüger Melanie , Gabriel Anna , Hermsdörfer Joachim , Niemietz Carolin , Bauer Petra , Müller Martin 
Published: September 2020

Abstract
BackgroundCommunity-dwelling older people are frequently affected by vertigo, dizziness and balance disorders (VDB). We previously developed a Care Pathway (CPW) to improve their mobility and participation by offering standardised approaches for general practitioners (GPs) and physical therapists (PTs). We aimed to assess the feasibility of the intervention, its implementation strategy and the study procedures in preparation for the subsequent main trial.MethodsThis 12-week prospective cohort feasibility study was accompanied by a process evaluation designed according to the UK Medical Research Council’s guidance for developing and evaluating complex interventions. Patients with VDB (≥ 65 years), GPs and PTs in primary care were included. Intervention consisted of a diagnostic screening checklist for GPs and a guide for PTs. Implementation strategy contained specific educational trainings and a telephone helpline. Data for mixed-method process evaluation was collected via standardised questionnaires, field notes and qualitative interviews. Quantitative data were analysed using descriptive statistics, qualitative data via content analysis.ResultsA total of five GP practices (seven single GPs), 10 PT practices and 22 patients were included in the study. The recruitment of GPs and patients was challenging (response rate GP practices: 27,8%; PT practices: 38,5%). 91% of patients and all health professionals completed the study. The health professionals responded well to the educational trainings, the utilization of the telephone helpline was low (one call each from GPs and PTs). Routine in the intervention’s application and positive attitudes were emphasised as facilitators for the interventions’ implementation, whereas lack of time was mentioned as a barrier. Despite of difficulties in GPs’ adherence to intervention protocol, GPs, PTs and patients benefited from the intervention. The patients’ treatment adherence to physical therapy was good. There were minor issues in data collection, but no unintended consequences.ConclusionAlthough the process evaluation provides good support for the feasibility of study procedures, the intervention and its implementation strategy, we identified a need of improvement in recruitment, the GPs’ intervention part and data collection procedures. Findings will inform the main trial to prove the interventions effectiveness in a cluster RCT.Trial registrationDeutsches Register Klinischer Studien (German Clinical Trials Register) DRKS00022918, date of registration: 03.09.2020 (retrospectively registered); Projektdatenbank Versorgungsforschung Deutschland (German registry Health Services Research) VfD_MobilE-PHY_17_003910, date of registration: 30.11.2017
LDL-C/HDL-C is associated with ischaemic stroke in patients with non-valvular atrial fibrillation: a case-control study
Authors: Zhang Xiao-Xue , Wei Meng , Shang Lu-Xiang , Lu Yan-Mei , Zhang Ling , Li Yao-Dong , Zhang Jiang-Hua , Xing Qiang , Tu-Erhong Zu Kela , Tang Bao-Peng , Zhou Xian-Hui 
Published: September 2020

Abstract
Background: This study explored the relationships between the low-/high-density lipoprotein cholesterol ratio (LDL-C/HDL-C) and other clinical indicators and ischaemic stroke (IS) in patients with non-valvular atrial fibrillation (NVAF) in Xinjiang. The findings could provide a theoretical and therapeutic basis for NVAF patients.Methods: NVAF patients who were admitted to 10 medical centres across Xinjiang were divided into stroke (798 patients) and control (2671 patients) groups according to the occurrence of first acute IS occurred. Univariate and multivariate logistic regression analysis were used to examine the independent risk factors for IS in NVAF patients. Factor analysis and principal component regression analysis were used to analyse the main factors influencing IS. Receiver operating characteristic (ROC) curve analysis was used to evaluate the discriminatory ability of LDL-C/HDL-C for predicting the occurrence of IS.Results: The stroke group had an average age of 71.64 ± 9.96 years and included 305 females (38.22%). The control group had a mean age of 67.30 ± 12.01 years and included 825 females (30.89%). Multivariate logistic regression showed that the risk of IS in the highest LDL-C/HDL-C quartile ( ≥2.73) was 16.23-fold that of the lowest quartile ( < 1.22); IS risk was 2.27-fold higher in obese patients than in normal-weight subjects; IS risk was 3.15-fold higher in smoking patients than in non-smoking patients. The area under the ROC curve of LDL-C/HDL-C was 0.76, the optimal critical value was 2.33, the sensitivity was 63.53%, and the specificity was 76.34%. Principal component regression analysis showed that LDL-C/HDL-C, age, smoking, drinking, LDL-C and hypertension were risk factors for IS in NVAF patients.Conclusions: LDL-C/HDL-C >1.22, smoking, BMI ≥24 kg/m2 and CHA2DS2-VASc score were independent risk factors for IS in NVAF patients; LDL-C/HDL-C was the main risk factor.
Concentrations of Estradiol, Progesterone and Testosterone in Serum and Cerebrospinal Fluid of Patients with Aneurysmal Subarachnoid Hemorrhage Correlate Weakly with Transcranial Doppler Flow Velocities
Authors: Martin Jan , Plank Eva , Ulm Bernhard , Gempt Jens , Wostrack Maria , Jungwirth Bettina , Kagerbauer Simone Maria 
Published: September 2020

Abstract
Background:The implication of the steroids estradiol, progesterone and testosterone in cerebral vasospasm after aneurysmal subarachnoid hemorrhage (aSAH) has not been comprehensively assessed. In rodents, studies suggested beneficial effects of steroids on cerebral vasospasm after experimental SAH. Studies in humans are warranted, however, a general dilemma of human studies on neuroactive substances is that the brain is not directly accessible and that concentrations in the periphery may not adequately parallel concentrations in the central compartments. In the present study, concentrations of estradiol, progesterone and testosterone in serum and cerebrospinal fluid (CSF) of patients with aSAH were determined. Blood flow velocities in cerebral arteries were measured by transcranial Doppler sonography (TCD). The aim of this study was to evaluate the correlations between the cerebral blood flow velocities and levels of estradiol, progesterone and testosterone in CSF and serum.Results:Samples of serum and CSF of 42 patients with aSAH were collected concomitantly daily or every other day via the arterial line and the external ventricular drainage for two weeks after the hemorrhage. Blood flow velocities in the cerebral arteries were determined by TCD. Total estradiol, progesterone and testosterone concentrations were measured by electro-chemiluminescence immunoassay. The strength of correlation was assessed by Spearman’s rank correlation coefficient. The correlation analysis revealed very weak correlations between cerebral blood flow velocities and concentrations of estradiol, progesterone and testosterone levels in both compartments with correlation coefficients below 0.2.Conclusions:In humans with aSAH, merely very weak correlations between flow velocities of cerebral arteries and concentrations of estradiol, progesterone and testosterone in serum and CSF were demonstrated. The relevance of steroids on cerebral vasospasm in humans remains unclear although beneficial effects were described in rodent studies. Pathways leading to neurological deterioration linked and unlinked to cerebral vasospasm remain complex and possibly interrelated. Thus, the implication of steroids in cerebral vasospasm or other processes of neurological deterioration warrants further clarification.
Gender Discrimination as a Barrier to High-Quality Maternal and Newborn Health Care in Nigeria: Findings From a Cross-Sectional Quality of Care Assessment
Authors: Oduenyi Chioma , Banerjee Joya , Adetiloye Oniyire , Rawlins Barbara , Okoli Ugo , Orji Bright , Ugwa Emmanuel , Ishola Gbenga , Betron Myra 
Published: September 2020

Abstract
BackgroundPoor reproductive, maternal, newborn, child, and adolescent health outcomes in Nigeria can be attributed to several factors, not limited to low health service coverage, a lack of quality care, and gender inequity. Providers’ gender-discriminatory attitudes, and men’s limited positive involvement correlate with poor utilization and quality of services.MethodsWe conducted a cross-sectional, observational, baseline quality of care assessment from April-July 2016 to inform a maternal and newborn health project in health facilities in Ebonyi and Kogi States. We observed 435 antenatal care consultations and 47 births, and interviewed 138 providers about their knowledge, training, experiences, working conditions, gender-sensitive and respectful care, and workplace gender dynamics. The United States Agency for International Development’s Gender Analysis Framework was used to analyze findings.ResultsSixty percent of providers disagreed that a woman could choose a family planning method without a male partner’s involvement, and 23.2% of providers disagreed that unmarried clients should use family planning. Ninety-eight percent believed men should participate in health services, yet only 10% encouraged women to bring their partners. Harmful practices were observed in 59.6% of deliveries and disrespectful or abusive practices were observed in 34.0%. No providers offered clients information, services, or referrals for gender-based violence. Sixty-seven percent reported observing or hearing of an incident of violence against clients, and 7.9% of providers experienced violence in the workplace themselves. Over 78% of providers received no training on gender, gender-based violence, or human rights in the past three years.ConclusionAddressing gender inequalities that limit women’s access, choice, agency, and autonomy in health services as a quality of care issue is critical to reducing poor health outcomes in Nigeria. Inherent gender discrimination in health service delivery reinforces the critical need for gender analysis, gender responsive approaches, values clarification, and capacity building.
Technical Potential of Biogas Technology Adoption in Replacing Firewood, Kerosene and Chemical Fertilizer: The Case of Misrak and Mirab Estie Districts, in Northern Ethiopia
Authors: Fentie Haile , Sime Getachew 
Published: September 2020

Abstract
Background: The depletion of bioenergy sources has caused significant deforestation, low agricultural production and energy crisis. This study evaluates the technical potential of biogas technology adoption in replacing firewood, charcoal, kerosene and chemical fertilizer in Northern Ethiopia. Methods: Questionnaire household survey, key informant interview, focus group discussion and field obervation were used for data collection. Results: Biogas technology adoption reduced the use of firewood, charcoal, dung cake, and kerosene consumption by 58%, 36%, 71%, and 74%, respectively. It also reduced the use of chemical fertilizer by 94% and the combined use of chemical fertilizer and manure by 91%. Adoption turned the majority of households (65.4%) to use combination of bio-slurry and chemical fertilizer. It helped the majority (89.95%) of adopters to construct and connect toilets to biogas operational system. In doing so, adoption reduced defecation in the field and improved environmental sanitation and human health. It further enabled saving of about 38% of adopters’ time, which otherwise would be expended for firewood and dung collection. It similarly enhanced adopters’ income through decreasing expenses for chemical fertilizer, kerosene, and other fuel sources. Conclusions: Biogas technology has huge potential of replacing traditional fuel sources for domestic consumption, and of reducing the consumption of kerosene and chemical fertilizers as well as of increasing income and decreasing time for biofuel collection.