bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sacrospinous ligament fixation: medium and long-term anatomical results, functional and quality of life results
Authors: Favre-Inhofer Angeline , Carbonnel Marie , Murtada Rouba , Revaux Aurélie , Asmar Jennifer , Ayoubi Jean-Marc 
Published: February 2021

Abstract
Background
To evaluate the medium and long-term anatomical results of sacrospinous ligament fixation (SLF) and its impact on quality of life (QoL).

Methods
We conducted a retrospective and observational single centre study. Fifty-nine patients were interviewed using the Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire and underwent physical examination using POP-Q several years after SLF. Primary outcome was the comparison of anatomic results of SLF at medium-term (group 1: 1–5 years after surgery) and long-term (group 2: more than 5 years after surgery). The secondary outcome was QoL evaluation.

Results
The overall recurrence and complication rates were respectively 22% and 10%, with no significant differences between groups 1 and 2. The recurrence rate was similar in both groups [twelve (35%) in group 1 and nine (20%) in group 2, p = 0.09]. Two patients (12%) in the recurrence and none in the no recurrence group had clinical symptoms (p = 0.08). Two patients (12%) in the recurrence and one patient (2%) in the no-recurrence group had a significant impact on their quality of life (p = 0.12).

Conclusion
This study showed sustainable anatomic and functional results of SLF in medium and long-term analysis with overall low morbidity.
Dual versus monotherapy with bronchodilators in GOLD group B COPD patients according to baseline FEV1 level: a patient-level pooled analysis of phase-3 randomized clinical trials
Authors: Kang Jieun , Lee Jae Seung , Lee Sei Won , Lee Jung Bok , Oh Yeon-Mok 
Published: February 2021

Abstract
Background
Which patients should receive dual therapy as initial treatment for chronic obstructive pulmonary disease (COPD) is only loosely defined. We evaluated if a lower forced expiratory volume in 1 s (FEV1) identifies a population more likely to benefit from dual therapy than monotherapy among group B COPD patients in whom Global initiative for Chronic Obstructive Pulmonary Disease (GOLD) recommends monotherapy as initial treatment.

Methods
This was a patient-level pooled analysis of phase-3 randomized controlled trials involving dual bronchodilators. Study patients were classified into two groups based on the FEV1 of 50% of the predicted value (GOLD I/II versus GOLD III/IV). We evaluated the efficacy of dual versus monotherapy (long-acting beta-2 agonist [LABA] or long-acting muscarinic antagonist [LAMA]) between these two groups in the following outcomes: changes in trough FEV1, the St. George’s Respiratory Questionnaire (SGRQ) score, the proportion of SGRQ responders, time to first exacerbation, and risk of adverse events.

Results
A total of 14,449 group B patients from 12 studies were divided into GOLD III/IV (n = 8043) or GOLD I/II group (n = 6406). In the GOLD III/IV group, dual therapy was significantly more effective in improving FEV1, reducing SGRQ scores, and achieving a higher proportion of SGRQ responders compared with either LABA or LAMA. Dual therapy also showed a significantly longer time to first exacerbation compared with LABA in the GOLD III/IV group. In contrast, in the GOLD I/II group, the benefits of dual therapy over monotherapy were less consistent. Although dual therapy resulted in significantly higher FEV1 than either LABA or LAMA, it did not show significant differences in the SGRQ score and proportion of SGRQ responders as compared with LABA. The time to first exacerbation was also not significantly different between dual therapy and either LABA or LAMA in the GOLD I/II group.

Conclusions
Dual therapy demonstrated benefits over monotherapy more consistently in patients with lower FEV1 than those with higher FEV1.
Role of Canagliflozin on function of CD34+ve endothelial progenitor cells (EPC) in patients with type 2 diabetes
Authors: Nandula Seshagiri Rao , Kundu Nabanita , Awal Hassan B. , Brichacek Beda , Fakhri Mona , Aimalla Nikhila , Elzarki Adrian , Amdur Richard L. , Sen Sabyasachi 
Published: February 2021

Abstract
Background
Endothelial progenitor cells (EPCs) has been shown to be dysfunctional in both type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) leading to poor regeneration of endothelium and renal perfusion. EPCs have been shown to be a robust cardiovascular disease (CVD) risk indicator. Effect of sodium glucose channel inhibitors (SGLT2i) such as Canagliflozin (CG) on a cellular biomarker such as CD34+ve progenitor cells, which may help predict CVD risk, in patients with T2DM with established CKD has not been explored.

Methods
This is a pilot study where 29 subjects taking metformin and/or Insulin were enrolled in a 16 week, double blind, randomized placebo matched trial, with a low dose 100 mg CG as the intervention group compared to matched placebo. Type 2 diabetes subjects (30–70 years old), with hemoglobin A1c (HbA1c) of 7–10%, were enrolled. CD34+ve cell number, migratory function, gene expression along with vascular parameters such as arterial stiffness, serum biochemistry pertaining to cardio-metabolic health, resting energy expenditure and body composition were measured. Data were collected at week 0, 8 and 16. A mixed model regression analysis was done and p value less than 0.05 was considered statistically significant.

Results
A significant expression of CXCR4 receptor with a concomittant increase in migratory function of CD34+ve cells was observed in CG treated group as compared to placebo group. Gene expression analysis of CD34+ve cells showed an increase in expression of antioxidants (superoxide dismutase 2 or SOD2, Catalase and Glutathione Peroxidase or GPX) and notable endothelial markers (PECAM1, VEGF-A, and NOS3). A significant reduction in glucose and HbA1c levels were observed along with improved systolic and diastolic blood pressure in the CG group. A significant increase in adiponectin (p = 0.006) was also noted in treatment group. Urinary exosomal protein leak in urine, examining podocyte health (podocalyxin, Wilm’s tumor and nephrin) showed reduction with CG

Conclusion
Low dose Canagliflozin has a beneficial effect on CD34+ cell function, serum biochemistry and urinary podocyte specific exosomes in type 2 diabetes.
How to improve access to health care for Roma living in social exclusion: a concept mapping study
Authors: Svobodova Ivana , Filakovska Bobakova Daniela , Bosakova Lucia , Dankulincova Veselska Zuzana 
Published: February 2021

Abstract
Background
Half of the people living in social exclusion in the Czech Republic are of Roma origin. The worse health of Roma could be partly explained by numerous barriers to accessing health care. Therefore, our study aimed to explore the perceptions of various stakeholders and experts who may have an impact on the inclusion of Roma and/or their access to health care on how to improve health care access for Roma living in social exclusion in the Czech Republic.

Methods
We conducted a concept mapping study and obtained data from 32 participants from health and social services, policymakers and others who were involved in different study phases (brainstorming, sorting, rating, interpretation).

Results
Out of 64 proposed measures sorted into six distinct clusters, 20 were rated as the most urgent and the most feasible and should be implemented with a priority to improve access to health care for Roma living in social exclusion. The proposed measures covered various topics, such as education and awareness of the target group as well as education and supervision of helping professionals, strengthening capacities and streamlining the health care system, health promotion and associated services and increasing the local and financial accessibility of health care. Overall, measures concerning the education and supervision of helping professionals were rated as both the most urgent and the most feasible. Individual priority measures targeted, for example, the health needs assessment of Roma living in social exclusion to set up interventions or to include topics such as participation, empowerment, cultural competence and communication training in the curricula of health care and helping professionals in postgraduate and continuing studies.

Conclusions
Stakeholders proposed a set of relevant and acceptable measures that may help improve access to health care for Roma living in social exclusion. The way they rated the proposed measures reflects both the current unfavourable mainstream and public discourse concerning Roma living in social exclusion and the most acute policy issues identified by several European and national bodies.
Nanopore sequencing from liquid biopsy: analysis of copy number variations from cell-free DNA of lung cancer patients
Authors: Martignano Filippo , Munagala Uday , Crucitta Stefania , Mingrino Alessandra , Semeraro Roberto , Del Re Marzia , Petrini Iacopo , Magi Alberto , Conticello Silvestro G. 
Published: February 2021

AbstractIn the “precision oncology” era the characterization of tumor genetic features is a pivotal step in cancer patients’ management. Liquid biopsy approaches, such as analysis of cell-free DNA from plasma, represent a powerful and noninvasive strategy to obtain information about the genomic status of the tumor. Sequencing-based analyses of cell-free DNA, currently performed with second generation sequencers, are extremely powerful but poorly scalable and not always accessible also due to instrumentation costs. Third generation sequencing platforms, such as Nanopore sequencers, aim at overcoming these obstacles but, unfortunately, are not designed for cell-free DNA analysis.Here we present a customized workflow to exploit low-coverage Nanopore sequencing for the detection of copy number variations from plasma of cancer patients. Whole genome molecular karyotypes of 6 lung cancer patients and 4 healthy subjects were successfully produced with as few as 2 million reads, and common lung-related copy number alterations were readily detected.This is the first successful use of Nanopore sequencing for copy number profiling from plasma DNA. In this context, Nanopore represents a reliable alternative to Illumina sequencing, with the advantages of minute instrumentation costs and extremely short analysis time.The availability of protocols for Nanopore-based cell-free DNA analysis will make this analysis finally accessible, exploiting the full potential of liquid biopsy both for research and clinical purposes.
A cross-sectional study on pelvic floor symptoms in women living with Female Genital Mutilation/Cutting
Authors: Binkova Alzbeta , Uebelhart Marion , Dällenbach Patrick , Boulvain Michel , Gayet-Ageron Angèle , Abdulcadir Jasmine 
Published: February 2021

Abstract
Background
Female Genital Mutilation/Cutting (FGM/C) concerns over 200 million women and girls worldwide and is associated with obstetric trauma and long-term urogynaecological and psychosexual complications that are often under-investigated and undertreated. The aim of this study was to assess the pelvic floor distress and the impact of pelvic floor and psychosexual symptoms among migrant women with different types of FGM/C.

Methods
This cross-sectional study was conducted between April 2016 and January 2019 at the Division of Gynaecology of the Geneva University Hospitals. The participants were interviewed on socio-demographic and background information, underwent a systematic gynaecological examination to assess the presence and type of FGM/C and eventual Pelvic Organ Prolapse (POP), and completed six validated questionnaires on pelvic floor and psychosexual symptoms (PFDI-20 and PFIQ7 on pelvic floor distress and impact, FISI and WCS on faecal incontinence and constipation, PISQ-IR and FGSIS on sexual function and genital self-image). The participants’ scores were compared with scores of uncut women available from the literature. The association between selected variables and higher scores for distress and impact of pelvic floor symptoms was assessed using univariate and multivariable linear regression models.

Results
124 women with a mean age of 31.5 (± 7.5), mostly with a normal BMI, and with no significant POP were included. PFDI-20 and PFIQ-7 mean (± SD) scores were of 49.5 (± 52.0) and 40.7 (± 53.6) respectively. In comparison with the available literature, the participants’ scores were lower than those of uncut women with pelvic floor dysfunction but higher than those of uncut women without such disorders. Past violent events other than FGM/C and forced or arranged marriage, age at FGM/C of more than 10, a period of staying in Switzerland of less than 6 months, and nulliparity were significantly associated with higher scores for distress and impact of pelvic floor symptoms, independently of known risk factors such as age, weight, ongoing pregnancy and history of episiotomy.

Conclusions
Women with various types of FGM/C, without POP, can suffer from pelvic floor symptoms responsible for distress and impact on their daily life.
Trial registration. The study protocol was approved by the Swiss Ethics Committee on research involving humans (protocol n°15-224).
Reduced immune-regulatory molecule expression on human colonic memory CD4 T cells in older adults
Authors: Dillon Stephanie M. , Thompson Tezha A. , Christians Allison J. , McCarter Martin D. , Wilson Cara C. 
Published: February 2021

Abstract
Background
The etiology of the low-level chronic inflammatory state associated with aging is likely multifactorial, but a number of animal and human studies have implicated a functional decline of the gastrointestinal immune system as a potential driver. Gut tissue-resident memory T cells play critical roles in mediating protective immunity and in maintaining gut homeostasis, yet few studies have investigated the effect of aging on human gut T cell immunity. To determine if aging impacted CD4 T cell immunity in the human large intestine, we utilized multi-color flow cytometry to measure colonic lamina propria (LP) CD4 T cell frequencies and immune-modulatory marker expression in younger (mean ± SEM: 38 ± 1.5 yrs) and older (77 ± 1.6 yrs) adults. To determine cellular specificity, we evaluated colon LP CD8 T cell frequency and phenotype in the same donors. To probe tissue specificity, we evaluated the same panel of markers in peripheral blood (PB) CD4 T cells in a separate cohort of similarly aged persons.

Results
Frequencies of colonic CD4 T cells as a fraction of total LP mononuclear cells were higher in older persons whereas absolute numbers of colonic LP CD4 T cells per gram of tissue were similar in both age groups. LP CD4 T cells from older versus younger persons exhibited reduced CTLA-4, PD-1 and Ki67 expression. Levels of Bcl-2, CD57, CD25 and percentages of activated CD38+HLA-DR+ CD4 T cells were similar in both age groups. In memory PB CD4 T cells, older age was only associated with increased CD57 expression. Significant age effects for LP CD8 T cells were only observed for CTLA-4 expression, with lower levels of expression observed on cells from older adults.

Conclusions
Greater age was associated with reduced expression of the co-inhibitory receptors CTLA-4 and PD-1 on LP CD4 T cells. Colonic LP CD8 T cells from older persons also displayed reduced CTLA-4 expression. These age-associated profiles were not observed in older PB memory CD4 T cells. The decline in co-inhibitory receptor expression on colonic LP T cells may contribute to local and systemic inflammation via a reduced ability to limit ongoing T cell responses to enteric microbial challenge.
The effect of lifestyle and risk factor modification on occlusive peripheral arterial disease outcomes: standard healthcare vs structured programme—for a randomised controlled trial protocol
Authors: Elfghi M. , Jordan F. , Dunne D. , Gibson I. , Jones J. , Flaherty G. , Sultan S. , Tawfick W. 
Published: February 2021

Abstract
Background
Peripheral arterial disease (PAD) affects more than 200 million of the global population. PAD represents a marker for premature cardiovascular events. Patients with PAD, even in the absence of a history of myocardial infarction or ischemic stroke, have approximately the same relative risk of death from cardiovascular causes as patients with a history of coronary or cerebrovascular disease. Despite the high prevalence of PAD and the strong association with cardiovascular morbidity and mortality, patients with PAD are less likely to receive appropriate treatment for their atherosclerotic risk factors than those who are being treated for coronary artery disease.
Atherosclerotic risk factor identification and modification play an important role in reducing the number of adverse outcomes among patients with atherosclerosis. Risk reduction therapy decreases the risk of cardiovascular mortality and morbidity in patients with PAD. In this study, we aim to evaluate the effectiveness of a lifestyle and risk factor modification intervention programme in achieving treatment goals for PAD risk factors.

Methods
This is a randomised, parallel group, active-control trial to compare the effectiveness of the risk factor modification intervention programme to standard healthcare in a tertiary vascular care centre, in the reduction of modified risk factors in PAD patients. The primary outcome of this study is to evaluate the effectiveness of a lifestyle and risk factor modification intervention programme in achieving treatment goals for PAD risk factors at 3 and 12 months. The secondary outcomes are to compare the impact of the programme on clinical outcomes in PAD patients at 12 months. Secondary outcomes include amputation-free survival, clinical improvement, haemodynamic improvement, need for revascularisation procedures, outcomes of revascularisation procedures, changes in quality of life and the incidence of adverse events.

Discussion
This study will provide clear evidence on the effectiveness of a lifestyle and risk factor modification intervention programme in achieving treatment goals for PAD risk factors, through a high-quality, well-powered clinical trial.

Trial registration
This trial was registered (11/07/2017) on the European Clinical Trials Database (EudraCT number 2017-002964-41) and ClinicalTrials.gov (NCT03935776) which was registered on 02 May 2019.
Industrial efficiency analysis based on the spatial panel model
Authors: Yin Xiaobo , Guo Liyan 
Published: February 2021

AbstractHigh-tech industrial agglomeration is conducive to boosting technological progress, promoting industrial structure upgrading and realizing economic transformation, and certainly affects the overall industrial environmental efficiency. However, few recent studies have focused on its impact on industrial environmental efficiency from a green perspective. In the context of promoting the development of green economy, it is of great significance to clarify the links between high-tech industrial agglomeration and industrial environmental efficiency. In this research, we first analyzed the theoretical mechanism of the impact of high-tech industrial agglomeration and its spatial spillover effects on industrial environmental efficiency and then made an empirical analysis based on the panel data of 29 provinces and cities in China from 2003 to 2016. During the research, Super-DEA method, ESDA method and spatial Dubin model are used. The result shows that: (1) There is a significant spatial positive correlation between China's industrial environmental efficiency and high-tech industrial agglomeration; (2) high-tech industrial agglomeration has improved the local industrial productivity and industrial technology level through scale effects and technical effects, which has accordingly significantly enhanced the corresponding environmental efficiency; (3) through the association of regional industries, the cross-regional cooperation of enterprises and the formation of innovation networks, high-tech industrial agglomeration promotes the spillover of knowledge and technology among regions, improves the level of industrial technology in neighboring regions, and enhances the industrial environmental efficiency in neighboring regions. All these three is helpful to re-evaluate the development mode of high-tech industry agglomeration and to formulate relevant government policies.
Further addition to the braconid fauna of Iran (Hymenoptera: Braconidae)
Authors: Gadallah Neveen S. , Ghahari Hassan , Quicke Donald L. J. 
Published: February 2021

Abstract
Background
The cosmopolitan family Braconidae is one of the largest in the order Hymenoptera. Many of its members are important as biological control agents against more than 120 pest species belonging it four insect orders (Coleoptera, Diptera, Hemiptera, Lepidoptera) that cause economic damage to various agricultural, horticultural, and forestry plants and trees. Due to the lack of regional studies, as well as taxonomic complexities compared with well-studied other western Palaearctic countries, the faunistic knowledge of this family is still largely incomplete.

Results
Based on specimens collected from different localities in Iran, as well as material deposited in different Iranian collections, twenty-five braconid species are recorded for the first time from Iran. Collectively, these belong to ten subfamilies (Alysiinae, Brachistinae, Braconinae, Cheloninae, Euphorinae, Exothecinae, Hormiinae, Ichneutinae, Microgastrinae, and Rogadinae). Two genera, Pentatermus Hedqvist (Rogadinae) and Stenobracon Szépligeti (Braconinae), are reported in the present study for the first time. Specimens are identified with the help of specialists, as well as using the available keys for each subfamily. A faunistic list comprising the valid species names and the extralimital distribution are given.

Conclusions
In the present study, a list of 25 species and two genera, Pentatermus Hedqvist (Rogadinae) and Stenobracon Szépligeti (Braconinae), are newly recorded from Iran, thus raising the total number of this important group as biocontrol agents to reach 1038 species.