bluuebunny/crossref_metadata_2025_split huggingface dataset:
Associations of Homocysteine Metabolism With the Risk of Spinal Osteoarthritis Progression in Postmenopausal Women
Authors: Nakano Masaki , Nakamura Yukio , Urano Tomohiko , Miyazaki Akiko , Suzuki Takako , Watanabe Kazuki , Takahashi Jun , Shiraki Masataka 
Published: August 2021

Abstract

Context
Although homocysteine accumulation is a reported risk factor for several age-related disorders, little is known about its relationship with osteoarthritis (OA).

Objective
We investigated for associations of homocysteine and C677T polymorphism in methylenetetrahydrofolate reductase (MTHFR), which is involved in homocysteine clearance, with the development and progression of spinal OA through a combined cross-sectional and longitudinal cohort study.

Methods
A total of 1306 Japanese postmenopausal outpatients participating in the Nagano Cohort Study were followed for a mean 9.7-year period. Cross-sectional multiple logistic regression for spinal OA prevalence at registration by serum homocysteine level was performed with adjustment for confounders. In addition to Kaplan–Meier analysis, multivariate Cox regression was employed to examine the independent risk of MTHFR C677T variant for spinal OA progression.

Results
Multivariate regression analysis revealed a significant association between homocysteine and spinal OA prevalence (odds ratio 1.38; 95% CI 1.14-1.68). Kaplan–Meier curves showed a gene dosage effect of the T allele in MTHFR C677T polymorphism on the accelerated progression of spinal OA severity (P = 0.003). A statistically significant independent risk of the T allele for spinal OA advancement was validated by Cox regression analysis. Respective adjusted hazard ratios for the CT/TT and TT genotypes were 1.68 (95% CI, 1.16–2.42) and 1.67 (95% CI, 1.23–2.28).

Conclusion
Circulating homocysteine and C677T variant in MTHFR are associated with the prevalence rate and ensuing progression, respectively, of spinal OA. These factors may represent potential interventional targets to prevent OA development and improve clinical outcomes.
Atuação do enfermeiro na prevenção do câncer do colo de útero em Unidades de Saúde
Authors: Dias Ernandes Gonçalves , Carvalho Beatriz Celestino de , Alves Naiara Silva , Caldeira Maiza Barbosa , Teixeira Jeisabelly Adrianne Lima 
Published: August 2021

Objetivo: investigar a atuação do Enfermeiro na prevenção do câncer do colo de útero nas Unidades de Saúde da Atenção Básica de município de Espinosa, Minas Gerais. Metodologia: trata-se de um estudo descritivo, exploratório, de natureza qualitativa. Os dados foram coletados no período de setembro a outubro de 2019, com nove enfermeiros submetidos a uma entrevista semiestruturada. Resultados: as ações assistenciais de enfermagem direcionadas para prevenção do câncer de colo do útero são, essencialmente, a educação em saúde e a coleta de material citopatológico para realização do exame. As ações são programadas e organizadas dentro de um fluxo de trabalho previamente estabelecido na rotina das equipes. Conclusão: é importante resignificar as ações de prevenção, tanto para os profissionais como para as mulheres, para romper os estigmas de uma cultura curativista que dificulta a adesão das mulheres ao exame preventivo.
Assessment of the performance of the Brazilian Portuguese Nottingham Health Profile in adult growth hormone deficiency and pulmonary hypertension
Authors: Heaney Alice , de Oliveira Rafael W. R. , Bizzi Mariana , Correa Ricardo Amorim , Corso Pereira Monica , Simao Mol Suelem , Santana Soares Beatriz , McKenna Stephen P. , Ribeiro-Oliveira Jr Antonio ,   Study Investigators
Published: August 2021

Background: The Nottingham Health Profile (NHP) is a generic measure of perceived distress that has been used widely as an outcome measure in clinical practice and trials. The availability of two Brazilian datasets provided the opportunity to assess the psychometric performance of the NHP in different populations - adult growth hormone deficiency (GHD) and pulmonary hypertension (PH). The purpose of the study was to see how valuable the NHP could be in assessing outcomes in diseases where no disease-specific measures are available. Methods: Secondary analyses were performed with NHP data. Patients diagnosed with adult GHD or PH were administered the NHP during clinic visits on two occasions, two weeks apart. A disease-specific measure of quality of life (QoL) was also administered to the relevant sample of patients on each occasion. Results: The psychometric properties of the NHP were good for both disease groups. As expected, both samples reported high scores on energy level, the PH sample scored high on physical functioning and the GHD sample on emotional reactions. For both samples, most of the NHP sections were able to distinguish between groups of respondents with different ratings of perceived general health. While most sections of the NHP were relatively highly correlated with the QoL measures, pain and sleep did not seem to be important predictors of QoL in either of the samples. Conclusions: The use of the NHP in adult GHD and PH populations in Brazil is not recommended as there are high-quality disease-specific measures available for each disease. However, where no disease-specific measures are available, the NHP can provide good descriptive information of the impact of disease on different patient populations.
Case Report: Infected primary hydatid cyst of the thigh
Authors: Jrad Myriam , Zlitni Haifa , Zouari Hakim , Boumediene Miriam , Soussi Ines , Bouzrara Meriem 
Published: August 2021

Hydatic cyst may occur in many organs such as the liver, lung, brain or heart with radiologic features of liver and lung involvement being well known. The musculo-skeletal site is infrequent accounting for 0.7–3% cases of all cases resulting from direct implantation of oncospheres more often than hematic dissemination. We report the case of an 18-year-old female student who visited our hospital because of a swelling in the posteroexternal aspect of the left thigh that had grown during the previous six months and had become tender in the previous month with setup of fever three days before admission. Superficial ultrasound and magnetic resonance imaging demonstrated a cystic mass of the posterior compartment of the thigh developed within the short chief of the biceps femoris. Serology for hydatid cyst was positive. The diagnosis of an infected hydatid cyst was suspected preoperatively, and the patient was given antibiotics and anthelminthic treatment. The cyst was then completely excised and the histopathologic exam confirmed the hydatic origin. The patient was put on oral anti-helminthics and has been on regular follow up for last twelve months with no evidence of recurrence. Hydatidosis rarely occurs in the soft tissues and the diagnosis is challenging particularly when it is secondary infected. Hydatid serology provides certainty in the diagnosis of echinococcosis when it is positive. When it’s negative, imaging (Ultrasound, Computed tomography (CT) and Magnetic resonance imaging (MRI)) may be an approach for making the diagnosis revealing the most characteristic features of hydatid cyst.
Effectiveness of quality improvement strategies for type 1 diabetes in children and adolescents: a systematic review protocol
Authors: Ryan Paul M , Zahradnik Michael , Konnyu Kristin J , Rader Tamara , Halasy Michael , Shulman Rayzel , Ivers Noah , Hawkes Colin P , Grimshaw Jeremy M 
Published: August 2021

Introduction: Optimal glycaemic control is often a challenge in children and adolescents with type 1 diabetes (T1D). Implementation of patient, clinician or organisation-targeted quality improvement (QI) strategies has been proven to be beneficial in terms of improving glycaemic outcomes in adults living with diabetes. This review aims to assess the effectiveness of such QI interventions in improving glycaemic control, care delivery, and screening rates in children and adolescents with T1D. Methods and analysis: MEDLINE, EMBASE, CINAHL and Cochrane CENTRAL databases will be searched for relevant studies up to January 2021. Trial registries, ClinicalTrials.gov and ICTRP, will also be explored for any ongoing trials of relevance. We will include trials which examine QI strategies as defined by a modified version of the Cochrane Effective Practice and Organisation of Care 2015 Taxonomy in children (<18 years) with a diagnosis of T1D. The primary outcome to be assessed is glycated haemoglobin (HbA1c), although a range of secondary outcomes relating to clinical management, adverse events, healthcare engagement, screening rates and psychosocial parameters will also be assessed. Our primary intention is to generate a best-evidence narrative to summarise and synthesise the resulting studies. If a group of studies are deemed to be highly similar, then a meta-analysis using a random effects model will be considered. Cochrane Risk of Bias 1.0 tool will be applied for quality assessment. All screening, data extraction and quality assessment will be performed by two independent researchers. Dissemination: The results of this review will be disseminated through peer-reviewed publication in order to inform invested partners (e.g., Paediatric Endocrinologists) on the potential of QI strategies to improve glycaemic management and other related health outcomes in children with T1D, thereby guiding best practices in the outpatient management of the disorder. PROSPERO registration number: CRD42021233974 (28/02/2021).
Suramin attenuates intervertebral disc degeneration by inhibiting NF-κB signalling pathway
Authors: Liu Zi-Miao , Lu Cheng-Chang , Shen Po-Chih , Chou Shih-Hsiang , Shih Chia-Lung , Chen Jian-Chih , Tien Yin Chun 
Published: August 2021

AimsInterleukin (IL)-1β is one of the major pathogenic regulators during the pathological development of intervertebral disc degeneration (IDD). However, effective treatment options for IDD are limited. Suramin is used to treat African sleeping sickness. This study aimed to investigate the pharmacological effects of suramin on mitigating IDD and to characterize the underlying mechanism.MethodsPorcine nucleus pulposus (NP) cells were treated with vehicle, 10 ng/ml IL-1β, 10 μM suramin, or 10 μM suramin plus IL-1β. The expression levels of catabolic and anabolic proteins, proinflammatory cytokines, mitogen-activated protein kinase (MAPK), and nuclear factor (NF)-κB-related signalling molecules were assessed by Western blotting, quantitative real-time polymerase chain reaction (qRT-PCR), and immunofluorescence analysis. Flow cytometry was applied to detect apoptotic cells. The ex vivo effects of suramin were examined using IDD organ culture and differentiation was analyzed by Safranin O-Fast green and Alcian blue staining.ResultsSuramin inhibited IL-1β-induced apoptosis, downregulated matrix metalloproteinase (MMP)-3, MMP-13, a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS)-4, and ADAMTS-5, and upregulated collagen 2A (Col2a1) and aggrecan in IL-1β-treated NP cells. IL-1β-induced inflammation, assessed by IL-1β, IL-8, and tumour necrosis factor α (TNF-α) upregulation, was alleviated by suramin treatment. Suramin suppressed IL-1β-mediated proteoglycan depletion and the induction of MMP-3, ADAMTS-4, and pro-inflammatory gene expression in ex vivo experiments.ConclusionSuramin administration represents a novel and effectively therapeutic approach, which could potentially alleviate IDD by reducing extracellular matrix (ECM) deposition and inhibiting apoptosis and inflammatory responses in the NP cells. Cite this article: Bone Joint Res 2021;10(8):498–513.
Iatrogenic peripheral nerve injury: a guide to management for the orthopaedic limb surgeon
Authors: Bage Timothy , Power Dominic M. 
Published: August 2021

Nerves may be inadvertently injured during trauma surgery due to distorted anatomy, traction applied to a limb, soft tissue retraction, by power tools, instrumentation and from compartment syndrome. Elective orthopaedic surgery has additional risks of joint dislocation for arthroplasty surgery, limb lengthening, thermal injury from cement and direct injury from peripheral nerve blocks. The true incidence is unknown, and many cases are diagnosed as neurapraxia with the expectation of a full and timely recovery without the need for intervention. The incorrect assignation of a neurapraxia diagnosis may delay treatment for a higher grade of injury and in addition fails to recognize that a diagnosis of neurapraxia should be made with caution and a commitment to regular clinical review. Untreated, a neurapraxia can deteriorate and result in axonopathy. The failure to promptly diagnose such a nerve injury and instigate treatment may result in further deterioration and expose the clinician to medicolegal challenge. The focus of this review is to raise awareness of iatrogenic peripheral nerve injuries in orthopaedic limb surgery, the importance of regular clinical examination, the role of investigations, timing and nature of interventions and also to provide a guide to when onward referral to a specialist peripheral nerve injury unit is recommended. Cite this article: EFORT Open Rev 2021;6:607-617. DOI: 10.1302/2058-5241.6.200123
Hybrid integrated low-noise linear chirp frequency-modulated continuous-wave laser source based on self-injection to an external cavity
Authors: Tang Liwei , Jia Hongxiang , Shao Shuai , Yang Sigang , Chen Hongwei , Chen Minghua 
Published: August 2021

A hybrid integrated low-noise linear chirp frequency-modulated continuous-wave (FMCW) laser source with a wide frequency bandwidth is demonstrated. By employing two-dimensional thermal tuning, the laser source shows frequency modulation bandwidth of 10.3 GHz at 100 Hz chirped frequency and 5.6 GHz at 1 kHz chirped frequency. The intrinsic linewidth of 49.9 Hz with 42 GHz continuous frequency tuning bandwidth is measured under static operation. Furthermore, by pre-distortion linearization of the laser source, it can distinguish 3 m length difference at 45 km distance in the fiber length measurement experiment, demonstrating its application potential in ultra-long fiber sensing and FMCW light detection and ranging.
The 20-minute whole blood clotting test (20WBCT) for snakebite coagulopathy—A systematic review and meta-analysis of diagnostic test accuracy
Authors: Lamb Thomas , Abouyannis Michael , de Oliveira Sâmella Silva , Shenoy K. Rachana , Geevar Tulasi , Zachariah Anand , Sharma Sanjib Kumar , Bhatt Navin , Mukaka Mavuto , Harriss Eli , Lalloo David G. , Ashley Elizabeth A. , Monteiro Wuelton Marcelo , Smithuis Frank , Eddleston Michael 
Published: August 2021

Background
The 20-minute whole blood clotting test (20WBCT) has been used to detect coagulopathy following snakebite for almost 50 years. A systematic review and meta-analysis of the 20WBCT was conducted to evaluate the accuracy of the 20WBCT to detect coagulopathy, indicative of systemic envenoming.

Methods and findings
Databases were searched from inception up to 09/12/2020 to identify studies that compared the 20WBCT and INR/fibrinogen on five or more subjects. Data was extracted from full-text articles by two reviewers using a predetermined form. Authors of 29 studies that lacked sufficient details in the manuscript were contacted and included if data meeting the inclusion criteria were provided. Included studies were evaluated for bias using a tailored QUADAS-2 checklist. The study protocol was prospectively registered on PROSPERO database (CRD42020168953).
The searches identified 3,599 studies, 15 met the inclusion criteria and 12 were included in the meta-analysis. Data was reported from 6 countries and included a total of 2,270 patients. The aggregate weighted sensitivity of the 20WBCT at detecting INR >1.4 was 0.84 (CI 0.61 to 0.94), the specificity was 0.91 (0.76 to 0.97) and the SROC AUC was 0.94 (CI 0.91 to 0.96). The aggregate weighted sensitivity of the 20WBCT at detecting fibrinogen <100 mg/dL was 0.72 (CI 0.58 to 0.83), the specificity was 0.94 (CI 0.88 to 0.98) and the SROC AUC was 0.93 (0.91 to 0.95). Both analyses that used INR and fibrinogen as the reference test displayed considerable heterogeneity.

Conclusions
In the absence of laboratory clotting assays, the 20WBCT remains a highly specific and fairly sensitive bedside test at detecting coagulopathy following snakebite. However, clinicians should be aware of the importance of operator training, standardized equipment and the lower sensitivity of the 20WBCT at detecting mild coagulopathy and resolution of coagulopathy following antivenom.
Use of lay vaccinators in animal vaccination programmes: A scoping review
Authors: Duamor Christian Tetteh , Hampson Katie , Lankester Felix , Sambo Maganga , Kreppel Katharina , Wyke Sally , Cleaveland Sarah 
Published: August 2021

Background
The human resource gap in veterinary sectors, particularly in low-income countries, imposes limitations on the delivery of animal healthcare in hard-to-reach populations. Lay animal health workers have been deployed in these settings to fill the gap though there are mixed views about the benefits of doing this and whether they can deliver services safely. We mapped evidence on the nature and extent of roles assigned to lay animal vaccinators, and identified lessons useful for their future deployment.

Methodology/Principal findings
Following the PRISMA Extension for Scoping Reviews guidelines, we searched seven bibliographic databases for articles published between 1980 and 2021, with the search terms lay OR community-based OR volunteer AND "animal health worker" OR vaccinator*, and applied an a priori exclusion criteria to select studies. From 30 identified studies, lay vaccinators were used by non-government developmental (n = 12, 40%), research (n = 10, 33%) and government (n = 5, 17%) programmes to vaccinate domestic animals. The main reason for using lay vaccinators was to provide access to animal vaccination in the absence of professional veterinarians (n = 12, 40%). Reported positive outcomes of programmes included increased flock and herd sizes and farmer knowledge of best practice (n = 13, 43%); decreased disease transmission, outbreaks and mortality (n = 11, 37%); higher vaccination coverage (10, 33%); non-inferior seroconversion and birth rates among vaccinated herds (n = 3, 10%). The most frequently reported facilitating factor of lay vaccinator programmes was community participation (n = 14, 47%), whilst opposition from professional veterinarians (n = 8, 27%), stakeholders seeking financial gains to detriment of programmes goals (n = 8, 27%) and programming issues (n = 8, 27%) were the most frequently reported barriers. No study reported on cost-effectiveness and we found no record from a low and middle-income country of lay vaccinator programmes being integrated into national veterinary services.

Conclusion
Although the majority of included studies reported more benefits and positive perceptions of lay vaccinator programmes than problems and challenges, regularization will ensure the programmes can be designed and implemented to meet the needs of all stakeholders.
To achieve 95-95-95 targets we must reach men and youth: High level of knowledge of HIV status, ART coverage, and viral suppression in the Botswana Combination Prevention Project through universal test and treat approach
Authors: Lebelonyane Refeletswe , Bachanas Pamela , Block Lisa , Ussery Faith , Alwano Mary Grace , Marukutira Tafireyi , El Halabi Shenaaz , Roland Michelle , Abrams William , Ussery Gene , Miller James A. , Lockman Shahin , Gaolathe Tendani , Holme Molly Pretorius , Hader Shannon , Mills Lisa A. , Wirth Kathleen , Bock Naomi , Moore Janet 
Published: August 2021

Background
Increasing HIV treatment coverage is crucial to reducing population-level HIV incidence.

Methods
The Botswana Combination Prevention Project (BCPP) was a community randomized trial examining the impact of multiple prevention interventions on population-level HIV incidence and was conducted from October 2013 through June 2017. Home and mobile campaigns offered HIV testing to all individuals ≥ age 16. All identified HIV-positive persons who were not on antiretroviral therapy (ART) were referred to treatment and tracked to determine linkage to care, ART status, retention in treatment, and viral suppression

Results
Of an estimated total of 14,270 people living with HIV (PLHIV) residing in the 15 intervention communities, BCPP identified 13,328 HIV-positive persons (93%). At study start, 10,703 (80%) of estimated PLHIV knew their status; 2,625 (20%) learned their status during BCPP, a 25% increase with the greatest increases occurring among men (37%) and youth (77%). At study start, 9,258 (65%) of estimated PLHIV were on ART. An additional 3,001 persons started ART through the study. By study end, 12,259 had initiated and were retained on ART, increasing coverage to 93%. A greater increase in ART coverage was achieved among men (40%) compared to women (29%). Of the 11,954 persons who had viral load (VL) test results, 11,687 (98%) were virally suppressed (HIV-1 RNA ≤400 copies/mL). Overall, 82% had documented VL suppression by study end.

Conclusions
Knowledge of HIV-positive status and ART coverage increased towards 95–95 targets with universal testing, linkage interventions, and ART. The increases in HIV testing and ART use among men and youth were essential to reaching these targets.

Clinical trial number
NCT01965470.
High resolution flat-panel CT arthrography vs. MR arthrography of artificially created osteochondral defects in ex vivo upper ankle joints
Authors: Pöhler Gesa H. , Sonnow Lena , Ettinger Sarah , Rahn Alexandra , Klimes Filip , Becher Christoph , von Falck Christian , Wacker Frank K. , Plaass Christian 
Published: August 2021

Purpose
High resolution flat-panel computed tomography arthrography (FPCT-A) and magnetic resonance arthrography (MR-A) are well suited to evaluate osteochondral lesions. The current study compares the performance of FPCT-A versus MR-A in an experimental setting.

Methods
Fourteen cadaveric ankles were prepared with artificial osteochondral defects of various sizes in four separate talar locations. After intra-articular contrast injection, FPCT-A and 3-T MR-A were acquired. Each defect was then filled with synthetic pallets. The resulting cast was used as reference. Two independent radiologists measured the dimensions of all defects with FPCT-A and MR-A. Intra-class correlation coefficients (ICC) were calculated. Data were compared using t-tests and Bland-Altman plots.

Results
The correlation for FPCT-A and cast was higher compared to MR-A and cast (ICC 0.876 vs. 0.799 for surface [length x width]; ICC 0.887 vs. 0.866 for depth, p<0.001). Mean differences between FPCT-A and cast measurements were -1.1 mm for length (p<0.001), -0.7 mm for width (p<0.001) and -0.4 mm for depth (p = 0.023). By MR-A, there were no significant differences for length and width compared to cast (p>0.05). Depth measurements were significantly smaller by MR-A (mean difference -1.1 mm, p<0.001). There was no bias between the different modalities.

Conclusions
Ex vivo FPCT-A and MR-A both deliver high diagnostic accuracy for the evaluation of osteochondral defects. FPCT-A was slightly more accurate than MR-A, which was most significant when measuring lesion depth.