bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors that Influence Satisfaction of People Living with HIV(PLHIV) with Differentiated ART Delivery Models in East Central Uganda: A Cross-Sectional Study
Authors: Baleeta Keith , Muhwezi Augustin , Tumwesigye Nathan , Kintu Betty Nsangi , Riese Sara , Byonanebye Dathan , Mbonye Martin , Mwehire Daniel , Iriso Robert , Ayebazibwe Bernard , Bailey Lauren , Lopez Deborah , McGough Laura , Etukoit Michael , Nantamu Dyogo , Wasswa Jacob , TIbengana Baker , Nakitende Louisa 
Published: June 2021

Abstract
Background
The World Health Organization and Uganda Ministry of Health recommend differentiated service delivery models (DSDM) as patient-focussed approaches for delivering antiretroviral therapy for people living with HIV/AIDS (PLHIV) who have undetectable viral loads. We sought to determine the factors significantly associated with patient satisfaction with ART services amongst PLHIV enrolled in DSDMs.
Methods
This was a cross-sectional study of a random sample of PLHIVs accessing ART within DSDMs at nine facilities in East Central Uganda. Eligible patients were adult PLHIVs active on ART and enrolled in a DSDM (Community Client Led ART Delivery (CCLAD), Community Drug Distribution Points (CDDP) and Fast-Track Drug Refill (FTDR) models) for at-least twelve months. Data was collected over two months (June-July 2019). A validated tool was used to assess PLHIV satisfaction with service delivery in DSD. Logistic regression was used to establish factors associated with patient satisfaction with DSD services.
Results
Overall out of the 842 participants enrolled onto the study, 530(63.5%) accessed HIV care through CDDPs, 166(20.1%) through CCLAD, and 146 (16.3%) through FTDR DSDMs. Generally, 541 (64.2%) were satisfied with DSDM services : 78.7% in CDDP, 42.8% in CCLAD and 36.3% in CCLAD. The factors associated with patient satisfaction were being on CDDP [aOR = 3.42, 95% CI = 2.15–5.44] and FTDR[aOR = 2.92, 95% CI = 1.34–6.31] DSDMs relative to CCLAD, greater than three years on DSDM [aOR = 2.32, 95% CI = 1.12–4.87], lower transport costs (< $ 1.35) per clinic visit [aOR = 2.39, 95% CI = 1.59–3.60] being employed either in agriculture[aOR = 4.41, 95% CI = 2.62–7.41] or any other employment sector [aOR = 4.22, 95% CI = 2.46–7.27]relative to being unemployed, participation of a friend/relative [aOR = 1.79, 95% CI = 1.22–2.61] and not drinking alcohol [aOR = 2.33, 95% CI = 1.24–4.29].
Conclusions
The study highlighted that 64.2% of the patients are satisfied with services in DSDM. Service delivery factors (DSDM model type, time spent in DSDM, and having friend or relative enrolled at the ART point providing social support), social factors (employment, and alcohol consumption), and transport costs were all associated with patient satisfaction with DSDM. Implementers of DSDMs need to further adapt services to address these factors to improve patient satisfaction in DSDMs.
Thyroid Function and Reduced Kidney Function with Aging in Chinese Older Adults: A Cross- sectional Study
Authors: Wei Lu , Bai Yun , Zhang Yu , Yong Zhenzhu , Zhang Qun , Zhao Weihong , Zhu Bei 
Published: June 2021

Abstract
Background: Thyroid function may be a factor influencing renal function in general population. Renal function and thyroid function vary with aging, thus the association of thyroid function and declining kidney function in older adults was different from this in the young and remains controversial. The aim of this study was to estimate association between thyroid function in reference interval and reduced kidney function with aging in Chinese older adults.Methods: A total of 15729 adults, 23.3% (N= 3624) of which were older population, were collected in the health check-up department of the First Affiliated Hospital of Nanjing Medical University between January 2018 to January 2020.Basic demographic information was collected by physician-administered questionnaire. The variation tendency of thyroid function with aging was investigated by mean of free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulatinghormone (TSH) in subgroups for every 10 years. Associations between kidney and thyroid function were estimated with β value by multiple linear regression and with odds ratio (OR) by multivariable logistic regression models adjusted for age, gender, body mass index and serum urine acid. Results: In the older population, an increased trend of TSH, a decreased trend of FT3 and little change of FT4 were identified with aging. Estimated glomerular filtration rate (eGFR) remarkably decreased with increasing TSH (β: -0.081) and declining FT3 (β: 0.083) concentrations. Compared with the population in the lowest FT3 quartile (3.10-4.45 pmol/L), the prevalence of eGFR< 75ml/min/1.73m2 significantly decreased by 22.0% with FT3 4.46-4.81 pmol/L, 27.6% with FT3 4.82-5.20 pmol/L and 34.9% with FT3 5.21-6.8 pmol/L in older individuals (P for trend <.001). The OR was 1.315 with high-normal TSH, comparing to low-normal TSH in older persons (P: 0.025). Similar results were found between prevalent eGFR< 60ml/min/1.73m2 and thyroid function. The prevalent reduced kidney function was not remarkably associated with FT4 in the reference range.Conclusions: This study demonstrated a significant association between thyroid function and kidney function, especially FT3 in older population. The clinician were advised to evaluate renal function with low-normal FT3 and high-normal TSH in case of potential decreased kidney function.
Urban-Rural Dimension of Fall and its Associated Risk Factors Amongst Community Dwelling Older Adult in Indonesia
Authors: Nugraha Susiana , Prasetyo Sabarinah , Susilowati Indri Hapsari , Rahardjo Tribudi W 
Published: June 2021

Abstract
Background: Falls are common problem among older people, WHO (2014) estimated 424,000 fatal cases of falls occur every year, making fall as the one of the causes of death in the older adult due to accidental injury. This study aimed to assess the risk of falling among community dwelling older adult in rural and urban area. Method: Using a proportional sample size we determine 2 areas that describe rural and urban area in West Java Prefecture. The incidence of fall in the last 12 month is selected as outcome variable. Sociodemographic background, chronic medical condition, fear of falling, visual and hearing impairment, Activity Daily Living (ADL) Barthel index, the physical performance (Short Performance Physical Battery (SPPB)), and living environment were assessed to identify the factor contribute to the incidence of falling. Result: a total of 611 older people participated this study consist of 381 (62%)older persons living in rural area and 230 (38%) person are living in urban area, 70 percent of them at the range of 60-69 years old, and 73% of them are female. The prevalence of fall in rural area (16.5%), is significantly higher than urban area (10.7%). The multiple logistic regression analysis showed, male gender (OR= 0.29;95%CI (0.095 - .882)), chronic illness (OR=3.25 95%CI (1.236 - 8.533) and visual impairment (OR=3.6; 95%CI (1.517 - 8.544)) are associated with risk of fall in among older adult living in urban area. On the other hand, Visual impairment (OR=1.81; 95%CI (1.027– 3.179)) and living environmental (OR=3.36; 95% CI (1.137-9.921)) are significantly associated with fall in among older adult living in rural area. Conclusion: We identify the different risk factors for falls in urban and rural area. The results can be concluded that a different approach is needed to reduce the risk of falling for the older adult in urban and rural areas based on risk factors.
Nanobody Armed T Cells Endow CAR-T Cells the Ability to Against Lymphoma Cells
Authors: Wang Hongxia , Wang Liyan , Li Yanning , Li Guangqi , Zhang Xiaochun , Jiang Dan , Zhang Yanting , Liu Liyuan , Chu Yuankui , Xu Guangxian 
Published: June 2021

Abstract
BackgroundTaking advantages of nanobody (Nb) in immunotherapy, here we investigate the cytotoxicity of Nb based Chimeric antigen receptor T cells (Nb CAR-T) against Lymphoma cells.MethodsCD19 Nb CAR-T, CD20 Nb CAR-T, and Bispecific Nb CAR-T cells were generated by panning anti-human CD19, CD20 specific nanobodies sequences from naive phage display library, then integrating Nb genes with lentiviral cassette that included other CARs elements, and finally transducing T cells that were expanded under optimization system with above prepared CARs lentiviruses. Prepared Nb CAR-T cells were co-cultured with tumor cell lines or primary tumor cells for 24 hours or 5 days to evaluate the biological function. ResultsObtained several Nb sequences specific to CD19 and CD20. Optimized culture conditions of T cells that expand 87.5 folds after 7 days of activation. Generated Nb CAR-T cells that could recognize Burkitt lymphoma cell lines (Raji and Daudi), induce activation, proliferation, and therefore kill target cells specifically. Furthermore, same results were also obtained from patient samples with cytotoxicity about 60%. Conclusions﻿Our study demonstrated that nanobody based single and bispecific CAR-T cells have certain killing ability against both tumor cell lines and patient-derived tumor cells in vitro.
Efficacy and Safety Among Second-Generation and Other Basal Insulins in Adult Patients with Type 1 Diabetes: A Systematic Review and Network Meta-Analysis
Authors: - Martin , Zhou Yi , Takagi Tatsuya , Tian Yu-Shi 
Published: June 2021

Abstract
Aims: To assess the comparative efficacy and safety of second-generation basal insulins (glargine U300 and degludec U100) vs. neutral protamine Hagedorn (NPH) and first-generation basal insulins (glargine U100 and detemir) in type 1 diabetes (T1D) adults. Methods: PubMed, the Cochrane Library, ClinicalTrials.gov, and Google Scholar (until January 2021) were systematically searched. Randomized controlled trials (RCTs) with ≥ 12 weeks of follow-up comparing efficacy (HbA1c) or safety (hypoglycemia and weight gain) between second-generation basal insulins vs. other basal insulins in T1D adults were included. Bayesian network meta-analyses were used to estimate risk ratio, hazard ratio, and mean difference. Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was used to appraise evidence certainty. Results: Eighteen RCTs (≥ 24 weeks of follow-up) involving 7,283 randomized participants were included for main analysis. Moderate to high certainty evidence suggested that second-generation basal insulins showed equivalent HbA1c reduction compared with NPH and first-generation basal insulins. Compared with second-generation basal insulins, low to high certainty evidence suggested that NPH was associated with a higher risk of patients experiencing severe hypoglycemia; NPH and first-generation basal insulins were associated with a higher rate of nocturnal confirmed hypoglycemic events. For the weight gain, glargine U300 was comparable to detemir (low certainty), but degludec U100 was greater than detemir (moderate certainty).Conclusions: In T1D adults, second-generation basal insulins maintained equivalent efficacy of glycemic control (moderate to high certainty), with differences in safety (low to high certainty) compared with NPH and first-generation basal insulins during ≥ 24 weeks of follow-up.
Upper Cervical Spine Fracture-Dislocation in Patients With Ankylosing Spondylitis: Application of Halo Vest Before and During Posterior Surgery
Authors: Yang Haisong , Sun Yuling , Wang Liang , Gao Chunyan , Yu Fengbin , Xu Tianming , Lu Xuhua 
Published: June 2021

Abstract
Background

It is a challenge to reduce and immobilize the broken “bamboo spine”, especially for the upper cervical spine, in patients with ankylosing spondylitis (AS) before and during posterior surgery.
Methods

We retrospectively analyzed the case histories, operations, neurologic outcomes, follow-up data, and imaging records of 17 patients with AS and upper cervical spine fracture-dislocation who underwent surgical treatment in three clinical spine center from 2010 to 2019. A halo vest was used to reduce and immobilize fractured spinal column ends. The neurological injury was evaluated using the American Spinal Injury Association (ASIA) impairment scale score and Japanese Orthopaedic Association (JOA) score before and after operation. Complications and time of bone fusion were recorded.
Results

Fourteen patients achieved closed anatomical reduction after halo vest application. No displacement in fracture ends and loss of reduction occurred after prone position. No patient presented with secondary neurological deterioration. All patients was performed posterior surgery. The surgery improved the ASIA grade in all patients (P < 0.001). The mean JOA score also increased significantly at last follow-up compared to preoperation (14.5 ± 2.3 vs. 9.2 ± 2.4, P < 0.01). No severe complication and death occurred. All patients reached solid bony fusion at 12-month follow-up.
Conclusions

Use of a halo vest before and during the operation is safe and effective in patients with AS who develop upper cervical spine fracture-dislocation. This technique makes positioning, awake nasoendotracheal intubation, nursing, and the operation more convenient. It can also provide satisfactory reduction and rigid immobilization and prevent secondary neurologic deterioration. .
Bacillus Licheniformis PF9 Improves Barrier Function and Alleviates Inflammatory Responses Against Enterotoxigenic Escherichia Coli F4 Infection in the Porcine Intestinal Epithelial Cells
Authors: Li Qiao , Chen Yanhong , Yu Changning , Azevedo Paula , Gong Joshua , Yang Chengbo 
Published: June 2021

Abstract
Background: Enterotoxigenic Escherichia coli (ETEC) F4 commonly colonizes the small intestine and releases enterotoxins that impair the intestinal barrier function and trigger inflammatory responses. Although Bacillus licheniformis (B. licheniformis) has been reported to enhance intestinal health, it remains to be seen whether there is a functional role of B. licheniformis in intestinal inflammatory response in intestinal porcine epithelial cell line (IPEC-J2) when stimulated with ETEC F4.Methods: In the present study, the effects of B. licheniformis PF9 on the release of pro-inflammation cytokines, cell integrity and nuclear factor-κB (NF-κB) activation were evaluated in ETEC F4-induced IPEC-J2 cells.Results: B. licheniformis PF9 treatment was capable of remarkably attenuating the expression levels of inflammation cytokines tumor necrosis factor-α (TNF-α), interleukin (IL)-8, and IL-6 during ETEC F4 infection. Furthermore, the gene expression of Toll-like receptor 4 (TLR4)-mediated upstream related genes of NF-κB signaling pathway has been significantly inhibited. These changes were accompanied by a significant decreased phosphorylation of p65 NF-κB during ETEC F4 infection with B. licheniformis PF9 treatment. The immunofluorescence and western blot analysis revealed that B. licheniformis PF9 increased the expression levels of zona occludens 1 (ZO-1) and occludin (OCLN) in ETEC F4-infected IPEC-J2 cells. Meanwhile, the B. licheniformis PF9 could alleviate the epithelial barrier function assessed by the trans-epithelial electrical resistance (TEER) and cell permeability assay. Interestingly, B. licheniformis PF9 protect IPEC-J2 cells against ETEC F4 infection by decreasing the gene expressions of virulence-related factors (including luxS, estA, estB, and elt) in ETEC F4.Conclusions: Collectively, our results suggest that B. licheniformis PF9 might reduce inflammation-related cytokines through blocking the NF-κB signaling pathways. Besides, B. licheniformis PF9 displayed a significant role in the enhancement of IPEC-J2 cell integrity.
‘They don’t want to give people bad news’: a qualitative exploration of the potential of prognostic indicators for initiating and supporting difficult conversations at the end-of-life
Authors: Griffiths Jane , Spencer K. , Stone P. , Kalpakidou A. K. , Keeley V. , Buckle P. , Finlay D-A , Todd C. 
Published: June 2021

Abstract
Background There is increasing evidence that patients with incurable cancer approaching the end-of-life, their carers and clinicians want to know how much time is left to live. Prognostic models can help with planning for the end of life and sorting out affairs, but we know very little about the acceptability of the models to patients, carers and clinicians.Method Semi-structured interviews were conducted with a purposive sample of 29 patients, 20 carers and 32 clinicians who took part in a large validation study of prognostic models, to find out how acceptable they are. Interview data were entered into NVivo 10 and analysed using the five stages of Framework Analysis: (i) familiarisation, (ii) developing a thematic framework, (iii) indexing, (iv) charting, and (v) mapping and interpretation.Findings The use of prognostic models was acceptable to patients and carers, and largely acceptable to clinicians. There was marked discrepancy however between the wishes of patients and carers for prognostic discussions, and the willingness of clinicians to initiate and conduct these conversations. Clinicians’ reluctance was founded on the dual principles of working in patients’ best interests and doing no harm, but was at odds with what patients and carers actually wanted. Conclusion Prognostic models such as PiPS may be a useful adjunct to clinical decision making, but also a helpful tool for initiating difficult conversations at the end of life. In order to conduct these conversations skilfully, communication skills training tailored to end of life prognostic conversations is needed.
Characterization of aerosol particles during a high pollution episode over Mexico City
Authors: Carabali Giovanni , Villanueva-Macías José , Ladino Luis , Álvarez-Ospina Harry , Raga Graciela , Andraca-Ayala Gema , Miranda Javier , Grutter Michel , Silva Monserrat , Riveros-Rosas David 
Published: June 2021

Abstract
More than 7 thousand wildfires were recorded over Mexico in 2019, affecting almost 640 thousand hectares. Most of these fires occurred during the warm-dry season generating dense smoke plumes, impacting urban areas in the central part of the Mexican plateau. From May 10 to 17, 2019, biomass burning (BB) plumes affected Mexico City (MC) and diffused across the basin, drastically reducing visibility. Due to the severity of this high atmospheric pollution (HAP) episode, the local government declared an environmental contingency, warning the population. Fine particle (PM2.5) concentrations were ~ 2 times higher than the nation's air quality standards. Likewise, aerosol optical measurements indicated that visibility was mainly affected by fine aerosol particles. Electron microscopy analysis of aerosol samples obtained during the HAP days shows a high incidence of strong absorbent soot and tarballs (TB). These types of particles were simultaneously observed in MC and at the high-altitude Altzomoni Atmospheric Observatory (~ 4010 m.a.g.l.). Elemental analysis of the particles shows that the composition is dominated by sulfur and potassium, evidencing a strong influence of the BB emissions, but also suggests the presence of urban pollution from MC at the remote Altzomoni site.
Unsteady Couette Flow Past Between Two HorizontalRiga Plates With Hall and Ion Slip Current
Authors: Nasrin Sonia , Mondal Rabindra Nath , Alam Md. Mahmud 
Published: June 2021

Abstract
In this article, we have investigated an unsteady Couette flow past between two horizontal Riga plates with the Hall and Ion-slip effects. Riga plate is the combination of electrodes and permanent magnets that creates a plane surface that produced the electromagnetic hydrodynamic fluid behavior and mostly uses in industrial processes with fluid flow affairs. It is used as an agent to reduce skin friction and also diminish the turbulent effects. The numerical solutions are acquired by using the explicit finite difference method and estimated results have been gained for various values of dimensionless pressure gradient parameter, the Hall and Ion-slip parameters, modified Hartmann number, Prandtl number, Eckert number. The expression of skin friction and Nusselt number has been computed and the outcomes of the relevant parameters on various distributions have been sketched and presented as well as graphically.
Clinical Outcomes in the Definitive Treatment of High-energy Tibial Diaphyseal Fractures using Hexapod External Fixator Versus Monolateral External Fixator
Authors: Liu Yanshi , Liu Kai , Cai Feiyu , Zhang Xingpeng , Li Hong , Zhang Tao , Ma Chuang , Yusufu Aihemaitijiang 
Published: June 2021

Abstract
Background: External fixation, which can preserve the biomechanical microenvironment of fracture healing, playing an important role in managing the high-energy fractures with poor surrounding soft tissues. The purpose of this study was to determine the differences of clinical outcomes, if any, between hexapod external fixator and monolateral external fixator in the definitive treatment of high-energy tibial diaphyseal fractures.Methods: A total of 53 patients with high-energy tibial diaphyseal fractures and definitively treated by the hexapod external fixator (HEF) or monolateral external fixator (MEF) were retrospectively collected and analyzed, from March 2015 to June 2019. There were 31 patients in the HEF treatment, and the other 22 patients were managed by the MEF. The demographic data, surgical duration, external fixation time, final radiological results, complications, and clinical outcomes were documented and analyzed. Difficulties that occur during the treatment were classified according to Paley. The clinical outcomes were evaluated by the Association for the Study and Application of the Method of Ilizarov criteria (ASAMI) at the last clinical visit.Results: The mean surgical duration in the HEF group (62.4±8.3 minutes) was shorter than that in the MEF group (91.4±6.9 minutes) (P<0.05). All patients acquired complete bone union finally. Patients in the HEF group (24.2±3.1 weeks) underwent a shorter average external fixation time than that in the MEF group (26.3±3.8 weeks) (P<0.05). Satisfactory alignment was achieved in all patients without the need for remanipulation. The residual sagittal plane deformities in the HEF group were all less than that in the MEF group (P<0.05). The complication rate was 35.5% in the HEF group, while 45.5% in the MEF group. There was no statistically significant difference between the two groups in ASAMI scores (P>0.05).Conclusion: There is no statistically significant difference in finally clinical outcomes between hexapod external fixator and monolateral external fixator in the definitive treatment of high-energy tibial diaphyseal fractures. The hexapod external fixation treatment is a superior effective method, including advantages of stable fixation, less surgical duration, postoperatively satisfactory fracture reduction, and fewer complications.