bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimizing telemedical care in neurological outpatients by characterizing the patients’ needs in the physician–patient relationship—content analysis of guideline-based interviews
Authors: Hamann Till , Lemke Stella , Kropp Peter , Rimmele Florian , Jürgens Tim P. , Frielitz Fabian 
Published: July 2021

AbstractBackgroundThe use of new concepts in patient care, such as video-consultations, reminder systems, and online evaluation portals, is becoming increasingly important in the physician–patient relationship and outpatient care. This study examines the acceptance of these approaches in a neurological setting and determines the patients’ preferences.MethodsWe analyzed 16 guideline-based qualitative interviews with neurological patients using qualitative content analysis (inductive category formation).ResultsThe patients commented on the benefits and challenges of integrating new concepts of medical care. They identified advantages of telemedical care, including time savings (7 of 16; 43,8%) for both the patient and the physician, the prospect of more intensive (4 of 16; 25%) care, and the possibility for a quick response in case of urgent needs (3 of 16; 18.8%). Several challenges were reported, such as the limitations for patients with psychiatric (2 of 16; 12.5%) or complex diseases (4 of 16; 25%) and limited options for diagnostic procedures (such as physical examination (4 of 16; 25%)).For individual neurological patients' needs, telemedical and telecommunication structures could be discussed, which support the patients' specific requirements, such as answering questions while having a recall (2 of 16; 12.5%) and avoiding the journey (8 of 16; 50%). Also, patients are rejecting evaluation portals and are skeptical of telecare in the treatment of neurological diseases.DiscussionThe perception of telemedical care and the successful integration of new medical care concepts depend on fulfilling the individual patient’s needs. Regardless of the preferred nature of physician–patient interactions, there are specific instruments that can intensify the relationship. These individual needs of the patients must be inquired about and accommodated for.ConclusionsFor the first time, we could characterize the properties of optimal telemedical care for neurological patients. Interviews like the ones we conducted should be repeated during and after the pandemic, referring to our results and compare.
AMIC for traumatic focal osteochondral defect of the talar shoulder: a 5 years follow-up prospective cohort study
Authors: Götze Christian , Nieder Christian , Felder Hanna , Peterlein Christian Dominik , Migliorini Filippo 
Published: July 2021

AbstractBackgroundAutologous Matrix-Induced Chondrogenesis (AMIC) is addressed to osteochondral defects of the talus. However, evidence concerning the midterm efficacy and safety of AMIC are limited. This study assessed reliability and feasibility of AMIC at 60 months follow-up. We hypothesize that AMIC leads to good clinical outcome at midterm follow-up.MethodsSurgeries were approached with an arthrotomy via malleolar osteotomy. A resorbable porcine I/III collagen membrane (Chondro-Gide®, Geistlich Pharma AG, Wolhusen, Switzerland) was used. Patients were followed at 24 and 60 months. The primary outcome of interest was to analyse the Foot Function Index (FFI), and the subscale hindfoot of the American Orthopaedic Foot and Ankle Score (AOFAS). Complications such as failure, revision surgeries, graft delamination, and hypertrophy were also recorded. The secondary outcome of interest was to investigate the association between the clinical outcome and patient characteristics at admission.ResultsData from 19 patients were included. The mean age at admission was 47.3 ± 13.2 years, and the mean BMI 24.1 ± 4.9 kg/m2. 53% (10 of 19 patients) were female. At a mean of 66.2 ± 11.6 months, the FFI decreased at 24-months follow-up of 22.5% (P = 0.003) and of further 1.3% (P = 0.8) at 60-months follow-up. AOFAS increased at 24-months follow-up of 17.2% (P = 0.003) and of further 3.4 (P = 0.2) at 60-months follow-up. There were two symptomatic recurrences within the follow-up in two patients. There was evidence of a strong positive association between FFI and AOFAS at baseline and the same scores last follow-up (P = 0.001 andP = 0.0002, respectively).ConclusionAMIC enhanced with cancellous bone graft demonstrated efficacy and feasibility for osteochondral defects of the talus at five years follow-up. The greatest improvement was evidenced within the first two years. These results suggest that clinical outcome is influenced by the preoperative status of the ankle. High quality studies involving a larger sample size are required to detect seldom complications and identify prognostic factors leading to better clinical outcome.Level of evidenceII, prospective cohort study.
Management of chronic lung diseases in Sudan and Tanzania: how ready are the country health systems?
Authors: Egere Uzochukwu , Shayo Elizabeth , Ntinginya Nyanda , Osman Rashid , Noory Bandar , Mpagama Stella , Hussein ElHafiz , Tolhurst Rachel , Obasi Angela , Mortimer Kevin , Sony Asma El , Taegtmeyer Miriam ,   The IMPALA Consortium, Addo-Yobo Emmanuel , Allwood Brian , Banda Hastings , Bates Imelda , Binegdie Amsalu , Falade Adegoke , Khan Jahangir , Lesosky Maia , Mbatchou Bertrand , Meme Hellen , Mutayoba Beatrice , Niessen Louis , Rylance Jamie , Worodria William , Zar Heather , Zulu Eliya , Zurba Lindsay , Squire S Bertel 
Published: July 2021

Abstract
Background
Chronic lung diseases (CLDs), responsible for 4 million deaths globally every year, are increasingly important in low- and middle-income countries where most of the global mortality due to CLDs currently occurs. As existing health systems in resource-poor contexts, especially sub-Saharan Africa (SSA), are not generally oriented to provide quality care for chronic diseases, a first step in re-imagining them is to critically consider readiness for service delivery across all aspects of the existing system.

Methods
We conducted a mixed-methods assessment of CLD service readiness in 18 purposively selected health facilities in two differing SSA health system contexts, Tanzania and Sudan. We used the World Health Organization’s (WHO) Service Availability and Readiness Assessment checklist, qualitative interviews of key health system stakeholders, health facility registers review and assessed clinicians’ capacity to manage CLD using patient vignettes. CLD service readiness was scored as a composite of availability of service-specific tracer items from the WHO service availability checklist in three domains: staff training and guidelines, diagnostics and equipment, and basic medicines. Qualitative data were analysed using the same domains.

Results
One health facility in Tanzania and five in Sudan, attained a CLD readiness score of ≥ 50 % for CLD care. Scores ranged from 14.9 % in a dispensary to 53.3 % in a health center in Tanzania, and from 36.4 to 86.4 % in Sudan. The least available tracer items across both countries were trained human resources and guidelines, and peak flow meters. Only two facilities had COPD guidelines. Patient vignette analysis revealed significant gaps in clinicians’ capacity to manage CLD. Key informants identified low prioritization as key barrier to CLD care.

Conclusions
Gaps in service availability and readiness for CLD care in Tanzania and Sudan threaten attainment of universal health coverage in these settings. Detailed assessments by health systems researchers in discussion with stakeholders at all levels of the health system can identify critical blockages to reimagining CLD service provision with people-centered, integrated approaches at its heart.
Developing and implementing a model of equitable distribution of mentorship in districts with spatial inequities and maldistribution of human resources for maternal and newborn care in Rwanda
Authors: Ngabonzima Anaclet , Kenyon Cynthia , Kpienbaareh Daniel , Luginaah Isaac , Mukunde Gisele , Hategeka Celestin , Cechetto David F. 
Published: July 2021

Abstract
Background
The shortage of health care providers (HCPs) and inequity in their distribution along with the lack of sufficient and equal professional development opportunities in low-income countries contribute to the high mortality and morbidity of women and newborns. Strengthening skills and building the capacity of all HCPs involved in Maternal and Newborn Health (MNH) is essential to ensuring that mothers and newborns receive the required care in the period around birth. The Training, Support, and Access Model (TSAM) project identified onsite mentorship at primary care Health Centers (HCs) as an approach that could help reduce mortality and morbidity through capacity building of HCPs in Rwanda. This paper presents the results and lessons learnt through the design and implementation of a mentorship model and highlights some implications for future research.

Methods
The design phase started with an assessment of the status of training in HCs to inform the selection of Hospital-Based Mentors (HBMs). These HBMs took different courses to become mentors. A clear process was established for engaging all stakeholders and to ensure ownership of the model. Then the HBMs conducted monthly visits to all 68 TSAM assigned HCs for 18 months and were extended later in 43 HCs of South. Upon completion of 6 visits, mentees were requested to assist their peers who are not participating in the mentoring programme through a process of peer mentoring to ensure sustainability after the project ends.

Results
The onsite mentorship in HCs by the HBMs led to equal training of HCPs across all HCs regardless of the location of the HC. Research on this mentorship showed that the training improved the knowledge and self-efficacy of HCPs in managing postpartum haemorrhage (PPH) and newborn resuscitation. The lessons learned include that well trained midwives can conduct successful mentorships at lower levels in the healthcare system. The key challenge was the inconsistency of mentees due to a shortage of HCPs at the HC level.

Conclusions
The initiation of onsite mentorship in HCs by HBMs with the support of the district health leaders resulted in consistent and equal mentoring at all HCs including those located in remote areas.
HOXB7 acts as an oncogenic biomarker in head and neck squamous cell carcinoma
Authors: Wu Xiang , Li Jin , Yan Tingyuan , Ke Xueping , Li Xin , Zhu Yumin , Yang Jianrong , Li Zhongwu 
Published: July 2021

Abstract
Background
The homeobox gene Homeobox B7 (HOXB7) is overexpressed across a range of cancers and promotes tumorigenesis through varying effects on proliferation, survival, migration and invasion. However, its expression pattern and oncogenic role of HOXB7 in head and neck squamous cell carcinoma (HNSCC) remain largely unexplored. Here, we aimed to explore the expression pattern of HOXB7, its clinical significance as well as functional roles in HNSCC.

Methods
HOXB7 mRNA expression in HNSCC was determined by data mining and analyses from TCGA (The Cancer Genome Atlas) and GEO (Gene Expression Omnibus) datasets. The protein abundance of HOXB7 was measured by immunohistochemistry in 119 primary HNSCC samples and associations between its expression and clinicopathological parameters and patient survival were evaluated. The pro-tumorigenic roles of HOXB7 in HNSCC were further delineated in vitro by loss-of-function assay. And a xenograft tumor model was established in nude mice to assess the role of HOXB7 in tumor growth. Connectivity Map (CMap) analysis was performed to identify bioactive small molecules which might be potential inhibitors for HOXB7.

Results
Bioinformatics analyses showed that HOXB7 mRNA was significantly overexpressed in 8 independent HNSCC datasets from TCGA and GEO databases. HOXB7 protein was markedly upregulated in HNSCC samples as compared to normal counterparts and its overexpression significantly associated with high pathological grade, advanced clinical stage, cervical node metastasis (P = 0.0195, 0.0152, 0.0300) and reduced overall and disease-free survival (P = 0.0014, 0.0007). Univariate and multivariate Cox regression analyses further revealed HOXB7 as an independent prognostic factor for patients’ overall survival. Moreover, HOXB7 knockdown significantly inhibited cell proliferation, migration and invasion and induced cell apoptosis in HNSCC cells, and resulted in compromised tumour growth in vivo. Furthermore, CMap (Connectivity map) analysis has identified three potential bioactive small molecule inhibitors (NU-1025, thiamine, vinburnine) for HOXB7 targeted therapy in HNSCC.

Conclusions
Our findings revealed that overexpression of HOXB7 was associates with tumour aggressiveness and unfavourable prognosis by serving a novel prognostic biomarker in HNSCC. Moreover, HOXB7 might be involved in the development and progression of HNSCC as an oncogene, and thereby might be a potential therapeutic target for HNSCC.
Modified pedicle screw-rod versus anterior subcutaneous internal pelvic fixation for unstable anterior pelvic ring fracture: a retrospective study and finite element analysis
Authors: Pan Zhi-Hong , Chen Fan-Cheng , Huang Jun-Ming , Sun Cheng-Yi , Ding Sheng-Long 
Published: July 2021

Abstract
Objectives
This study compared the stability and clinical outcomes of modified pedicle screw-rod fixation (MPSRF) and anterior subcutaneous internal pelvic fixation (INFIX) for the treatment of anterior pelvic ring fractures using the Tornetta and Matta grading system and finite element analyses (FEA).

Methods
In a retrospective review of a consecutive patient series, 63 patients with Orthopaedic Trauma Association (OTA)/Arbeitsgemeinschaft für Osteosynthesefragen (AO) type B or C pelvic ring fractures were treated by MPRSF (n = 30) or INFIX (n = 33). The main outcome measures were the Majeed score, incidence of complications, and adverse outcomes, and fixation stability as evaluated by finite element analysis.

Results
Sixty-three patients were included in the study, with an average age of 34.4 and 36.2 in modified group and conventional group, respectively. Two groups did not differ in terms of the injury severity score, OTA classification, cause of injury, and time to pelvic surgery. However, the MPSRF group had a rate of higher satisfactory results according to the Tornetta and Matta grading system than the conventional group (73.33% vs 63.63%) as well as a higher Majeed score (81.5 ± 10.4 vs 76.3 ± 11.2), and these differences were statistically significant at 6 months post-surgery. FEA showed that MPSRF was stiffer and more stable than INFIX and had a lower risk of implant failure.

Conclusions
Both MPSRF and INFIX provide acceptable biomechanical stability for the treatment of unstable anterior pelvic ring fractures. However, MPSRF provides better fixation stability and a lower risk of implant failure, and can thus lead to better clinical outcomes. Therefore, MPSRF should be more widely applied to anterior pelvic ring fractures
Value of preoperative computed tomography for meso-Rex bypass in children with extrahepatic portal vein obstruction
Authors: Wu Huiying , Zhou Ning , Lu Lianwei , Chen Xiwen , Liu Tao , Zhang Binbin , Liu Hongsheng , Wen Zhe 
Published: July 2021

Abstract
Background
Extrahepatic portal vein obstruction (EHPVO) is the most important cause of hematemesis in children. Intrahepatic left portal vein and superior mesenteric vein anastomosis, also known as meso-Rex bypass (MRB), is becoming the gold standard treatment for EHPVO. We analyzed the value of preoperative computed tomography (CT) in determining whether MRB is feasible in children with EHPVO.

Results
We retrieved data on 76 children with EHPVO (50 male, 26 female; median age, 5.9 years) who underwent MRB (n = 68) or the Warren procedure (n = 8) from 2013 to 2019 and retrospectively analyzed their clinical and CT characteristics. The Rex recess was categorized into four subtypes (types 1–4) depending on its diameter in CT images. Of all 76 children, 7.9% had a history of umbilical catheterization and 1.3% had leukemia. Sixteen patients (20 lesions) had associated malformations. A total of 72.4% of Rex recesses could be measured by CT, and their mean diameter was 3.5 ± 1.8 mm (range 0.6–10.5 mm). A type 1, 2, 3, and 4 Rex recess was present in 9.2%, 53.9%, 11.8%, and 25.0% of patients, respectively. MRB could be performed in patients with types 1, 2, and 3, but those with type 4 required further evaluation. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of CT were 100%, 83.8%, 42.1%, 100%, and 85.5%, respectively.

Conclusions
Among the four types of Rex recesses on CT angiography, types 1–3 allow for the performance of MRB.
Fish otoliths from the early Miocene of Chile: a window into the evolution of marine bony fishes in the Southeast Pacific
Authors: Schwarzhans Werner W. , Nielsen Sven N. 
Published: July 2021

AbstractFew fossil fish otolith associations have been described from the Pacific side of the Americas and, except for a single species (Steindachneria svennielseni), none have been described from Pacific South America south of the Central American tropical region. Here, we describe a rich otolith assemblage obtained from fifteen early Miocene outcrop locations along the Chilean coast from about 33°S to about 45°S. More than 2,000 specimens were studied resulting in the recognition of 67 species, with 27 being new to science. This assemblage represents an important new data point distant from any previously known otolith-based fish fauna, with the nearest coeval associations being from the Caribbean Province in Venezuela, which lies about 5000 km to the north, and New Zealand, which is about 9000 km to the west. The fauna represents a mixture of offshore and shallow water fishes and is rich in myctophids, paralichthyids (Citharichthys), ophidiids (Lepophidium), steindachneriids, and macrourids. Typical tropical American fishes are nearly completely absent, with the exception of Steindachneria and certain anguilliforms. The mesopelagic faunal component, chiefly Myctophidae, shows a striking resemblance to the well-known coeval fish fauna from New Zealand, and both are interpreted as representing an early South Pacific mesopelagic bioprovince. The strong correlation with the mesopelagic otolith-based fish fauna from New Zealand constricts the time interval of the sampled sediments to the middle Burdigalian (approximately 17.5 to 18.5 Ma). All otoliths obtained from the early Miocene of Chile relate to extant fish groups of the area and few exotic components not currently present in the East Pacific. The sole exception is a morpho-type described as Navidadichthys which has an unresolved relationship, possibly with the Prototroctidae, a family that is today endemic to the freshwater and nearshore marine environments of Australia and New Zealand. The new taxa are in the sequence of taxonomic description: Pterothrissus transpacificus n. sp., Pythonichthys panulus n. sp., Chiloconger chilensis n. sp., Gnathophis quinzoi n.sp., Rhynchoconger chiloensis n. sp., Navidadichthys mirus n. gen. et n. sp., Maurolicus brevirostris n. sp., Polyipnus bandeli n. sp., Lampanyctus ipunensis n. sp., Physiculus pichi n. sp., Coelorinchus fidelis n. sp., Coelorinchus rapelanus n. sp., Nezumia epuge n. sp., Paracarapus chilensis n. gen. et n. sp., Lepophidium chonorum n. sp., Lepophidium mapucheorum n. sp., Sirembola supersa n. sp., Spectrunculus sparsus n. sp., Pseudonus humilis n. sp., Capromimus undulatus n. sp., Agonopsis cume n. sp., Cottunculus primaevus n. sp., Kuhlia orientalis n. sp., Citharichthys parvisulcus n. sp., Citharichthys vergens n. sp., Achirus australis n. sp., Achirus chungkuz n. sp.ZooBank LSID: urn:lsid:zoobank.org:pub:38A10A21-ECAA-4BBE-BF9B-3D9204B69CA4 https://zoobank.org/B0213E37-6E6F-445B-9B2B-B03494659964.
Feasibility study of the Home-based Exercises for Responsible Sex (HERS) intervention to promote correct and consistent condom use among young women
Authors: Knights Nicola , Stone Nicole , Nadarzynski Tom , Brown Katherine , Newby Katie , Graham Cynthia A. 
Published: July 2021

Abstract
Background
Male condoms are effective in preventing common sexually transmitted infections (STIs) and unintended pregnancy, if used correctly and consistently. However, condom use errors and problems are common and young people report negative experiences, such as reduced pleasure. The Kinsey Institute Home-Based Exercises for Responsible Sex (KIHERS) is a novel condom promotion intervention for young women, which aims to reduce condom errors and problems, increase self-efficacy and improve attitudes towards condoms, using a pleasure-focussed approach. The study objective was to test the operability, viability and acceptability of an adapted version of the KIHERS intervention with young women aged 16–25 years in the United Kingdom (UK) (Home-Based Exercises for Responsible Sex-UK (HERS-UK).

Methods
A repeated-measures single-arm design was used, with a baseline (T1) and two follow-up assessments (T2 and T3), conducted 4 weeks and 8 weeks post intervention over a 3-month period. Participants were provided a condom kit containing different condoms and lubricants and were asked to experiment with condoms alone using a dildo and/or with a sexual partner. Ten process evaluation interviews were conducted post intervention.

Results
Fifty-five young women received the intervention; 36 (65%) completed T2 and 33 (60%) completed T3. Condom use errors and problems decreased, self-efficacy increased and attitudes towards condoms improved significantly. The proportion of participants who reported using a condom for intercourse in the past 4 weeks increased from T1 (20; 47%) to T2 (27; 87%) and T3 (23; 77%) and using lubricant with a condom for intercourse increased from T1 (6; 30%) to T2 (13; 48%)) and T3 (16; 70%). However, motivation to use condoms did not change. Cronbach’s alpha scores indicated good internal consistency of measures used. Qualitative data provided strong evidence for the acceptability of the intervention.

Conclusions
HERS-UK was implemented as intended and the recruitment strategy was successful within a college/university setting. This feasibility study provided an early indication of the potential effectiveness and acceptability of the intervention, and the benefits of using a pleasure-focussed approach with young women. Measures used captured change in outcome variables and were deemed fit for purpose. Future research should explore cost-effectiveness of this intervention, in a large-scale controlled trial using a diverse sample and targeting young women most at risk of STIs.