bluuebunny/crossref_metadata_2025_split huggingface dataset:
Data utilisation and factors influencing the performance of the health management information system in Tanzania
Authors: Mboera Leonard E. G. , Rumisha Susan F. , Mbata Doris , Mremi Irene R. , Lyimo Emanuel P. , Joachim Catherine 
Published: May 2021

Abstract
Background
Health Management Information System (HMIS) is a set of data regularly collected at health care facilities to meet the needs of statistics on health services. This study aimed to determine the utilisation of HMIS data and factors influencing the health system’s performance at the district and primary health care facility levels in Tanzania.

Methods
This cross-sectional study was carried out in 11 districts and involved 115 health care facilities in Tanzania. Data were collected using a semi-structured questionnaire administered to health workers at facility and district levels and documented using an observational checklist. Thematic content analysis approach was used to synthesise and triangulate the responses and observations to extract essential information.

Results
A total of 93 healthcare facility workers and 13 district officials were interviewed. About two-thirds (60%) of the facility respondents reported using the HMIS data, while only five out of 13 district respondents (38.5%) reported analysing HMIS data routinely. The HMIS data were mainly used for comparing performance in terms of services coverage (53%), monitoring of disease trends over time (50%), and providing evidence for community health education and promotion programmes (55%). The majority (41.4%) of the facility’s personnel had not received any training on data management related to HMIS during the past 12 months prior to the survey. Less than half (42%) of the health facilities had received supervisory visits from the district office 3 months before this assessment. Nine district respondents (69.2%) reported systematically receiving feedback on the quality of their reports monthly and quarterly from higher authorities. Patient load was described to affect staff performance on data collection and management frequently.

Conclusion
Inadequate analysis and poor data utilisation practices were common in most districts and health facilities in Tanzania. Inadequate human and financial resources, lack of incentives and supervision, and lack of standard operating procedures on data management were the significant challenges affecting the HMIS performance in Tanzania.
Vitamin D receptor (VDR) expression in different molecular subtypes of canine mammary carcinoma
Authors: Sánchez-Céspedes R. , Fernández-Martínez M. D. , Raya A. I. , Pineda C. , López I. , Millán Y. 
Published: May 2021

Abstract
Background
The molecular-based classification of canine mammary carcinomas (CMCs) has been the focus of much current research. Both in canines and humans, the triple-negative (TN) molecular subtype of mammary cancer is defined by a lack of expression of progesterone receptor (PR), oestrogen receptor (ER) and HER2. It has a poor prognosis; no effective targeted therapy is available. Vitamin D displays anticarcinogenic properties, and the expression of its receptor (VDR) has been found in different molecular subtypes, being about 30–40 % of TN breast cancer (TNBC) positive to it. We assessed the VDR expression in the different molecular subtypes of 58 CMCs from 45 female dogs using an immunohistochemical panel for the molecular classification of included: PR, ER, HER2, cytokeratin (CK) 5, CK14, and Ki67. In addition, we studied the relationship among the molecular subtypes of CMCs and clinicopathologic parameters.

Results
Investigation showed VDR positivity in 45.0 % of the triple-negative CMCs (TNCMCs), 27.3 % of luminal B and 19.0 % of luminal A. Luminal A was the most molecular subtype represented of the total tumours (36.2 %), followed of TNCMCs (34.5 %), luminal B (20.7 %) and HER2-overexpression (10.3 %). Both HER2-overexpression and TNCMC subtypes were positively related to lymphatic invasion (P = 0.028), simple histologic subtype (P = 0.007), a higher histological grade (P = 0.045) and a trend to higher proliferation index (P = 0.09).

Conclusions
The highest VDR expression was observed in TNCMC, being almost half of them (45 %) positive to this receptor. VDR expression was absent in HER2-overexpression tumours and low in luminal A and B molecular subtypes.
Clinical significance of circulating tumour cells and Ki-67 in renal cell carcinoma
Authors: Song Jinbo , Yu Zhe , Dong Bingqi , Zhu Mingkai , Guo Xiaofeng , Ma Yongkang , Zhao Shiming , Yang Tiejun 
Published: May 2021

Abstract
Background
Renal cell carcinoma (RCC) is a common malignant tumour of the genitourinary system. We aimed to analyse the potential value of metastasis-related biomarkers, circulating tumour cells (CTCs) and the proliferative marker Ki-67 in the diagnosis of RCC.

Methods
Data from 24 laparoscopic radical nephrectomies (RNs) and 17 laparoscopic partial nephrectomies (PNs) were collected in 2018. The numbers and positive rates of CTCs and circulating tumour microemboli (CTM) in the peripheral blood were obtained at three different time points: just before surgery, immediately after surgery and 1 week after surgery. Ki-67 protein expression was evaluated in the RCC tissue by immunohistochemistry.

Results
Except for the statistically significant association between the preoperative CTC counts and tumour size, no association between the number and positive rate of perioperative CTCs and clinicopathological features was found. The CTC counts gradually decreased during the perioperative period, and at 1 week after surgery, they were significantly lower than those before surgery. High Ki-67 expression was significantly positively correlated with preoperative CTC counts. In addition, Ki-67 expression was higher in the high CTC group (≥ 5 CTCs).

Conclusion
Our results suggest that surgical nephrectomy is associated with a decrease in CTC counts in RCC patients. CTCs can act as a potential biomarker for the diagnosis and prognosis of RCC. A careful and sufficient long-term follow-up is needed for patients with high preoperative CTC counts.
The global end-ranges of neck flexion and extension do not represent the maximum rotational ranges of the cervical intervertebral joints in healthy adults - an observational study
Authors: Andersen Victoria , Wang Xu , de Zee Mark , Østergaard Lasse Riis , Plocharski Maciej , Lindstroem René 
Published: May 2021

Abstract
Background
In clinical diagnosis, the maximum motion of a cervical joint is thought to be found at the joint’s end-range and it is this perception that forms the basis for the interpretation of flexion/extension imaging studies.
There have however, been representative cases of joints producing their maximum motion before end-range, but this phenomenon is yet to be quantified.

Purpose
To provide a quantitative assessment of the difference between maximum joint motion and joint end-range in healthy subjects. Secondarily to classify joints into type based on their motion and to assess the proportions of these joint types.

Study design
This is an observational study.

Subject sample
Thirty-three healthy subjects participated in the study.

Outcome measures
Maximum motion, end-range motion and surplus motion (the difference between maximum motion and end-range) in degrees were extracted from each cervical joint.

Methods
Thirty-three subjects performed one flexion and one extension motion excursion under video fluoroscopy. The motion excursions were divided into 10% epochs, from which maximum motion, end-range and surplus motion were extracted. Surplus motion was then assessed in quartiles and joints were classified into type according to end-range.

Results
For flexion 48.9% and for extension 47.2% of joints produced maximum motion before joint end-range (type S). For flexion 45.9% and for extension 46.8% of joints produced maximum motion at joint end-range (type C). For flexion 5.2% of joints and for extension 6.1% of joints concluded their motion anti-directionally (type A).
Significant differences were found for C2/C3 (P = 0.000), C3/C4 (P = 0.001) and C4/C5 (P = 0.005) in flexion and C1/C2 (P = 0.004), C3/C4 (P = 0.013) and C6/C7 (P = 0.013) in extension when comparing the joint end- range of type C and type S.
The average pro-directional (motion in the direction of neck motion) surplus motion was 2.41° ± 2.12° with a range of (0.07° -14.23°) for flexion and 2.02° ± 1.70° with a range of (0.04°-6.97°) for extension.

Conclusion
This is the first study to categorise joints by type of motion. It cannot be assumed that end-range is a demonstration of a joint’s maximum motion, as type S constituted approximately half of the joints analysed in this study.
Hip geometry in hip fracture patients in Greenland occurring over a 7.7-year period
Authors: Fleischer Inuuteq , Laursen Mogens , Andersen Stig 
Published: May 2021

Abstract
Background
Hip geometry influences hip fracture risk. Hip fractures are common, and they are associated with pain, disability, premature death and marked costs on society. Osteoporotic fractures are frequent in Arctic populations and increase with advancing age in this society with a steep rise in life expectancy. Greenland Inuit is a distinct ethnic group, and data on hip geometry is missing. We thus aimed to describe hip geometry in 7.7 years of consecutive hip fracture patients in Greenland.

Methods
We evaluated collodiaphysial angle, femoral neck length, the outer and inner diameter of the femur at 2 and 5 centimetres below the centre of the lesser trochanter and the cortical thickness from pelvic and hip radiographs in all patients operated in Greenland over 7.7 years. We included all 84 patients with one non-fractured hip visible for geometric analysis. Analyses were conducted in duplicate.

Results
We found a collodiaphysial angle of 134.8/132.6o in men/women (p = 0.06) and a femoral neck length of 38.0/33.9 mm in men/women (p = 0.001). Cortical thickness was affected by sex in the adjusted analysis (p < 0.001). Cortical thickness index at 5 cm below the centre of the lesser trochanter decreased with age (p = 0.026) and may be influenced by height (2 cm below the centre of the lesser trochanter, p = 0.053).

Conclusion
Our findings differed from European data and suggest a delicate balance in hip geometry in Arctic populations. Ethnic peculiarities influence the structure of the hip and may influence fracture risk. A focus on hip geometry and risk factors for osteoporotic fractures in Arctic populations is warranted.
The interrelationship between pregnancy, venous thromboembolism, and thyroid disease: a hypothesis-generating review
Authors: Andersen Stine Linding , Nielsen Kasper Krogh , Kristensen Søren Risom 
Published: May 2021

AbstractPregnancy induces physiological changes that affect the risk of thrombosis and thyroid disease. In this hypothesis-generating review, the physiological changes in the coagulation system and in thyroid function during a normal pregnancy are described, and the incidence of venous thromboembolism (VTE) and thyroid disease in and after a pregnancy are compared and discussed. Furthermore, evidence regarding the association between thyroid disease and VTE in non-pregnant individuals is scrutinized. In conclusion, a normal pregnancy entails hormonal changes, which influence the onset of VTE and thyroid disease. Current evidence suggests an association between thyroid disease and VTE in non-pregnant individuals. This review proposes the hypothesis that maternal thyroid disease associates with VTE in pregnant women and call for future research studies on this subject. If an association exists in pregnant women specifically, such findings may have clinical implications regarding strategies for thyroid function testing and potential thromboprophylaxis in selected individuals.
The role of epigenetic mechanisms in the regulation of gene expression in the cyclical endometrium
Authors: Retis-Resendiz Alejandra Monserrat , González-García Ixchel Nayeli , León-Juárez Moisés , Camacho-Arroyo Ignacio , Cerbón Marco , Vázquez-Martínez Edgar Ricardo 
Published: May 2021

AbstractBackgroundThe human endometrium is a highly dynamic tissue whose function is mainly regulated by the ovarian steroid hormones estradiol and progesterone. The serum levels of these and other hormones are associated with three specific phases that compose the endometrial cycle: menstrual, proliferative, and secretory. Throughout this cycle, the endometrium exhibits different transcriptional networks according to the genes expressed in each phase. Epigenetic mechanisms are crucial in the fine-tuning of gene expression to generate such transcriptional networks. The present review aims to provide an overview of current research focused on the epigenetic mechanisms that regulate gene expression in the cyclical endometrium and discuss the technical and clinical perspectives regarding this topic.Main bodyThe main epigenetic mechanisms reported are DNA methylation, histone post-translational modifications, and non-coding RNAs. These epigenetic mechanisms induce the expression of genes associated with transcriptional regulation, endometrial epithelial growth, angiogenesis, and stromal cell proliferation during the proliferative phase. During the secretory phase, epigenetic mechanisms promote the expression of genes associated with hormone response, insulin signaling, decidualization, and embryo implantation. Furthermore, the global content of specific epigenetic modifications and the gene expression of non-coding RNAs and epigenetic modifiers vary according to the menstrual cycle phase. In vitro and cell type-specific studies have demonstrated that epithelial and stromal cells undergo particular epigenetic changes that modulate their transcriptional networks to accomplish their function during decidualization and implantation.Conclusion and perspectivesEpigenetic mechanisms are emerging as key players in regulating transcriptional networks associated with key processes and functions of the cyclical endometrium. Further studies using next-generation sequencing and single-cell technology are warranted to explore the role of other epigenetic mechanisms in each cell type that composes the endometrium throughout the menstrual cycle. The application of this knowledge will definitively provide essential information to understand the pathological mechanisms of endometrial diseases, such as endometriosis and endometrial cancer, and to identify potential therapeutic targets and improve women’s health.
Brain connectivity and metacognition in persons with subjective cognitive decline (COSCODE): rationale and study design
Authors: Ribaldi Federica , Chicherio Christian , Altomare Daniele , Martins Marta , Tomczyk Szymon , Jelescu Ileana , Maturana Enrique , Scheffler Max , Haller Sven , Lövblad Karl-Olof , Pievani Michela , Garibotto Valentina , Kliegel Matthias , Frisoni Giovanni B. 
Published: May 2021

Abstract
Background
Subjective cognitive decline (SCD) is the subjective perception of a decline in memory and/or other cognitive functions in the absence of objective evidence. Some SCD individuals however may suffer from very early stages of neurodegenerative diseases (such as Alzheimer’s disease, AD), minor psychiatric conditions, neurological, and/or somatic comorbidities. Even if a theoretical framework has been established, the etiology of SCD remains far from elucidated. Clinical observations recently lead to the hypothesis that individuals with incipient AD may have overestimated metacognitive judgements of their own cognitive performance, while those with psychiatric disorders typically present underestimated metacognitive judgements. Moreover, brain connectivity changes are known correlates of AD and psychiatric conditions and might be used as biomarkers to discriminate SCD individuals of different etiologies. The aim of the COSCODE study is to identify metacognition, connectivity, behavioral, and biomarker profiles associated with different etiologies of SCD. Here we present its rationale and study design.

Methods
COSCODE is an observational, longitudinal (4 years), prospective clinical cohort study involving 120 SCD, and 80 control study participants (40 individuals with no cognitive impairment, and 40 living with mild cognitive impairment - MCI, or dementia due to AD), all of which will undergo diffusion magnetic resonance imaging (MRI) and functional magnetic resonance imaging (fMRI) as well as behavioral and biomarker assessments at baseline and after 1 and 2 years. Both hypothesis-driven and data-driven cluster analysis approaches will be used to identify SCD sub-types based on metacognition, connectivity, behavioral, and biomarker features.

Conclusion
COSCODE will allow defining and interpreting the constellation of signs and symptoms associated with different etiologies of SCD, paving the way to the development of cost-effective risk assessment and prevention protocols.
Hydrogel spacer shrinkage during external-beam radiation therapy following low-dose-rate brachytherapy for high-risk prostate cancer: a case series
Authors: Kubo Katsumaro , Kenjo Masahiro , Kawabata Hideo , Wadasaki Koichi , Kajiwara Mitsuru , Doi Yoshiko , Nakao Minoru , Miura Hideharu , Ozawa Shuichi , Nagata Yasushi 
Published: May 2021

AbstractBackgroundFew studies have assessed hydrogel spacer shrinkage during external-beam radiation therapy following brachytherapy for localized high-risk prostate cancer. This case presentation evaluated the changes in hydrogel spacer appearance by magnetic resonance imaging during external-beam radiation therapy after brachytherapy for prostate cancer and analyzed the effect of this shrinkage on the dose distribution in four cases.Case presentationIn all cases, we implanted125I sources using a modified peripheral loading pattern for seed placement. The prescribed dose for each implant was 110 Gy. After delivering the sources, a hydrogel spacer was injected. All cases underwent external-beam radiation therapy approximately 1–2 months after brachytherapy. The prescribed dose of external-beam radiation therapy was 45 Gy in 1.8-Gy fractions. Magnetic resonance imaging was performed for evaluation on the day following seed implantation (baseline), at external-beam radiation therapy planning, and during external-beam radiation therapy. The median hydrogel spacer volume was 16.2 (range 10.9–17.7) cc at baseline, 14.4 (range, 9.4–16.1) cc at external-beam radiation therapy planning, and 7.1 (range, 2.0–11.4) cc during external-beam radiation therapy. The hydrogel spacer volume during external-beam radiation therapy was significantly lower than that at external-beam radiation therapy planning. The rectum V60–80 (rectal volume receiving at least 60–80% of the prescribed dose of external-beam radiation therapy) during external-beam radiation therapy was significantly higher than that at external-beam radiation therapy planning.ConclusionsThe potential reduction in hydrogel spacer size during external-beam radiation therapy following brachytherapy can lead to unexpected irradiation to the rectum. This case presentation would be helpful for similar cases.
Cloning and expression of the EsxA gene and the growth-promoting effects of the encoded protein on rice seedlings
Authors: Yu Wen-qing , Wang Xin , Tang Yi-cong , Yan Feng-chao , Liu Wen-zhi , Zheng Gui-ping , Yin Dong-mei 
Published: May 2021

AbstractAn EsxA-encoding gene (esxA) was previously identified in the genome of the plant growth-promoting rhizobacterium Paenibacillus terrae strain NK3-4. The esxA was cloned and expressed in Pichia pastoris, after which the effects of the EsxA protein on rice seedling growth were analyzed to determine whether EsxA contributes to the plant growth-promoting activity of strain NK3-4. The esxA was successfully cloned from the NK3-4 genome and ligated to the eukaryotic expression vector pPICZαA. The resulting pPICZαA-esxA recombinant plasmid was transinfected into yeast cells, and esxA expression in the yeast cells was confirmed. The treatment of seed- buds with the EsxA protein increased the root length by 1.35-times, but decreased the bud length. Additionally, in rice seedlings treated with EsxA, the root and shoot lengths increased by 2.6- and 1.7-times, respectively. These findings imply that EsxA is important for the promotion of rice plant growth by P. terrae strain NK3-4. Furthermore, the construction of the esxA expression vector and the engineered strain may be useful for future investigations of the mechanism underlying the plant growth-promoting effects of EsxA, with implications for the application of EsxA for regulating plant growth.
Seed biostimulant Bacillus sp. MGW9 improves the salt tolerance of maize during seed germination
Authors: Li Heqin , Yue Haiwang , Li Li , Liu Yu , Zhang Haiyan , Wang Jianhua , Jiang Xuwen 
Published: May 2021

AbstractCrop performance is seriously affected by high salt concentrations in soils. To develop improved seed pre-sowing treatment technologies, it is crucial to improve the salt tolerance of seed germination. Here, we isolated and identified the strain Bacillus sp. MGW9 and developed the seed biostimulant MGW9. The effects of seed biopriming with the seed biostimulant MGW9 in maize (Zea mays L.) under saline conditions were studied. The results show that the strain Bacillus sp. MGW9 has characteristics such as salt tolerance, nitrogen fixation, phosphorus dissolution, and indole-3-acetic acid production. Seed biopriming with the seed biostimulant MGW9 enhanced the performance of maize during seed germination under salinity stress, improving the germination energy, germination percentage, shoot/seedling length, primary root length, shoot/seedling fresh weight, shoot/seedling dry weight, root fresh weight and root dry weight. Seed biostimulant MGW9 biopriming also alleviated the salinity damage to maize by improving the relative water content, chlorophyll content, proline content, soluble sugar content, root activity, and activities of superoxide dismutase, catalase, peroxidase and ascorbate peroxidase, while decreasing the malondialdehyde content. In particular, the field seedling emergence of maize seeds in saline-alkali soil can be improved by biopriming with the seed biostimulant MGW9. Therefore, maize seed biopriming with the seed biostimulant MGW9 could be an effective approach to overcoming the inhibitory effects of salinity stress and promoting seed germination and seedling growth.
Stability of an HTLV-HIV coinfection model with multiple delays and CTL-mediated immunity
Authors: AlShamrani N. H. 
Published: May 2021

AbstractIn the literature, several mathematical models have been formulated and developed to describe the within-host dynamics of either human immunodeficiency virus (HIV) or human T-lymphotropic virus type I (HTLV-I) monoinfections. In this paper, we formulate and analyze a novel within-host dynamics model of HTLV-HIV coinfection taking into consideration the response of cytotoxic T lymphocytes (CTLs). The uninfected$\mathrm{CD} 4^{+}\mathrm{T}$CD4+Tcells can be infected via HIV by two mechanisms, free-to-cell and infected-to-cell. On the other hand, the HTLV-I has two modes for transmission, (i) horizontal, via direct infected-to-cell touch, and (ii) vertical, by mitotic division of active HTLV-infected cells. It is well known that the intracellular time delays play an important role in within-host virus dynamics. In this work, we consider six types of distributed-time delays. We investigate the fundamental properties of solutions. Then, we calculate the steady states of the model in terms of threshold parameters. Moreover, we study the global stability of the steady states by using the Lyapunov method. We conduct numerical simulations to illustrate and support our theoretical results. In addition, we discuss the effect of multiple time delays on stability of the steady states of the system.