bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neonatal mortality associated with perinatal asphyxia: a population-based study in a middle-income country
Authors: Kawakami Mandira D. , Sanudo Adriana , Teixeira Mônica L. P. , Andreoni Solange , de Castro Josiane Q. X. , Waldvogel Bernadette , Guinsburg Ruth , de Almeida Maria Fernanda 
Published: February 2021

Abstract
Background
It is challenging to decrease neonatal mortality in middle-income countries, where perinatal asphyxia is an important cause of death. This study aims to analyze the annual trend of neonatal mortality with perinatal asphyxia according to gestational age in São Paulo State, Brazil, during a 10-year period and to verify demographic, maternal and neonatal characteristics associated with these deaths.

Methods
Population-based study of neonatal deaths associated with perinatal asphyxia from 0 to 27 days in São Paulo State, Brazil, from 2004 to 2013. Perinatal asphyxia was considered as associated to death if intrauterine hypoxia, birth asphyxia or neonatal aspiration of meconium were noted in any line of the Death Certificate according to ICD-10. Poisson Regression was applied to analyze the annual trend of neonatal mortality rate according to gestational age. Kaplan-Meier curve was used to assess age at death during the 10-year study period. Hazard ratio of death during the neonatal period according to gestational age was analyzed by Cox regression adjusted by year of birth and selected epidemiological factors.

Results
Among 74,002 infant deaths in São Paulo State, 6648 (9%) neonatal deaths with perinatal asphyxia were studied. Neonatal mortality rate with perinatal asphyxia fell from 1.38‰ in 2004 to 0.95‰ in 2013 (p = 0.002). Reduction started in 2008 for neonates with 32–41 weeks, in 2009 for 28–31 weeks, and in 2011 for 22–27 weeks. Median time until 50% of deaths occurred was 25.3 h (95%CI: 24.0; 27.2). Variables independently associated with higher risk of death were < 7 prenatal visits, 1st minute Apgar score 0–3, and death at the same place of birth. Cesarean delivery compared to vaginal was protective against death with perinatal asphyxia for infants at 28–36 weeks.

Conclusions
There was an expressive reduction in neonatal mortality rates associated with perinatal asphyxia during this 10-year period in São Paulo State, Brazil. Variables associated with these deaths highlight the need of public health policies to improve quality of regionalized perinatal care.
The 5-year overall survival of cervical cancer in stage IIIC-r was little different to stage I and II: a retrospective analysis from a single center
Authors: Yang E , Huang Shuying , Ran Xuting , Huang Yue , Li Zhengyu 
Published: February 2021

Abstract
Background
The 2018 International Federation of Gynecology and Obstetrics (FIGO) staging guideline for cervical cancer includes stage IIIC recognized by preoperative radiology (IIIC-r) to state there are lymph nodes metastases (LNM) identified by imaging tools. We aim to explore the reasonability and limitations of stage IIIC-r and try to explore the potential reasons.

Methods
Electronic medical records were used to identify patients with cervical cancer. According to the new staging guidelines, patients were reclassified and assigned into five cohorts: stage I, stage II, stage IIIC-r, LNM confirmed by pathology (IIIC-p) and LNM detected by radiology and confirmed by pathology (IIIC r + p). Five-year overall survivals were estimated for each cohort. The diagnosis accuracy of computed tomography (CT), magnetic resonance imaging (MRI) and diameter of detected lymph nodes were also evaluated.

Results
A total of 619 patients were identified. The mean follow-up months were 65 months (95% CI 64.43–65.77) for all patients. By comparison, the 5-year overall survival rates were not statistically different (p = 0.21) among stage IIIC-r, stage I and stage II. While, the rates were both statistical different (p<0.001) among stage IIIC-p, IIIC r + p and stage I and stage II. The sensitivities of CT and MRI in detecting LNM preoperatively were 51.2 and 48.8%. The mean maximum diameter of pelvic lymph nodes detected by CT cohort was 1.2 cm in IIIC-r cohort, and was 1.3 cm in IIIC r + p cohort. While, the mean maximum diameter of pelvic lymph nodes detected by MRI was 1.2 cm in IIIC-r cohort, and was 1.48 cm in IIIC r + p cohort. When the diagnosis efficacy of the diameter of pelvic lymph nodes in detecting LNM were evaluated, the area under the receiver operating characteristic curve (ROC curve) was 0.58 (p = 0.05).

Conclusions
It seems that the FIGO 2018 staging guideline for cervical cancer is likely to has certain limitations for the classification of those with LNM. CT or MRI, however, has limitations on detecting LNM. It would be better to use more accurate imaging tools to identify LNM in the clinical practices.
Relationship between the higher inflammatory cytokines level in the aqueous humor of Fuchs uveitis syndrome and the presence of cataract
Authors: Wang Hui , Tao Yong 
Published: February 2021

AbstractBackgroundThis study aims to compare the levels of intraocular cytokines between Fuchs uveitis syndrome (FUS) eyes and the senile cataract eyes. The association between inflammatory cytokine levels and cataract severity in FUS is evaluated to find the possible mechanism of cataract in FUS eyes.MethodsA retrospective study of 28 eyes with FUS was performed. Auxiliary examinations were performed, including ophthalmic examinations, laser flare-cell photometry, and levels of inflammatory cytokines in the aqueous humor were measured. The control group included 25 eyes with senile cataract. Data on the aqueous humor inflammatory cytokines were compared between the two groups. The association between the aqueous humor cytokine levels and severity of posterior subcapsular cataract was assessed.ResultsThere were 28 eyes with FUS in 27 patients. Unilateral involvement was noted in 26 patients (96.30%). Stellate keratic precipitates (KPs) were noted in 16 eyes (57.14%). Heterochromia was observed in 21.43% of affected eyes. Posterior subcapsular cataract (PSC) was observed in 16 of the 28 eyes. Eyes with FUS had significantly higher aqueous humor (AH) cytokine levels (VEGF, bFGF, IL-6, IL-8 and IL-10) compared with the control eyes (P < 0.05). There was a statistically significant positive correlation between the severity of cataract and IL-6 and IL-8 levels in the AH (τ = 0.664 and 0.634, respectively;P = 0.001,P = 0.002, respectively).ConclusionsExpression of VEGF, bFGF, IL-6, IL-8 and IL-10 in the AH of FUS patients was significantly higher than in senile cataract eyes, and the aqueous humor levels of IL-6 and IL-8 were significantly positively associated with the severity of posterior subcapsular cataract. Our results imply that an inflammation mechanism may be involved in the early development of cataract in FUS.
Factors influencing adolescent girls and young women’s participation in a combination HIV prevention intervention in South Africa
Authors: McClinton Appollis Tracy , Duby Zoe , Jonas Kim , Dietrich Janan , Maruping Kealeboga , Abdullah Fareed , Slingers Nevilene , Mathews Catherine 
Published: February 2021

Abstract
Background
For interventions to reach those they are intended for, an understanding of the factors that influence their participation, as well as the facilitators and barriers of participation are needed. This study explores factors associated with participation in a combination HIV prevention intervention targeting adolescent girls and young women (AGYW) aged 15–24-years-old, as well as the perspectives of AGYW, intervention implementers, and facilitators who participated in this intervention.

Methods
This study used mixed-methods approach with quantitative household survey data from 4399 AGYW aged 15–24-years-old in six of the ten districts in which the intervention was implemented. In addition, qualitative methods included a total of 100 semi-structured in-depth interviews and 21 focus group discussions in five of the ten intervention districts with 185 AGYW who participated in one or more of the key components of the intervention, and 13 intervention implementers and 13 facilitators. Thematic analysis was used to explore the perspectives of participating and implementing the intervention.

Results
Findings reveal that almost half of AGYW (48.4%) living in the districts where the intervention took place, participated in at least one of the components of the intervention. For both 15–19-year-olds and 20–24-year-olds, factors associated with increased participation in the intervention included being HIV negative, in school, never been pregnant, and having had a boyfriend. Experiencing intimate partner violence (IPV) and/or sexual violence in the past 12 months was associated with increased levels of participation in the intervention for 20–24-year-olds only. In our analysis of the qualitative data, facilitators to participation included motivating participants to join the interventions through explaining the benefits of the programme. Barriers included misguided expectations about financial rewards or job opportunities; competing responsibilities, interests or activities; family responsibilities including childcare; inappropriate incentives; inability to disrupt the school curriculum and difficulties with conducting interventions after school hours due to safety concerns; miscommunication about meetings; as well as struggles to reach out-of-school AGYW.

Conclusion
Designers of combination HIV prevention interventions need to address the barriers to participation so that AGYW can attend without risking their safety and compromising their family, childcare and schooling responsibilities. Strategies to create demand need to include clear communication about the nature and potential benefits of such interventions, and the inclusion of valued incentives.
The attenuation of insulin-like growth factor signaling may be responsible for relative reduction in matrix synthesis in degenerated areas of osteoarthritic cartilage
Authors: Tanaka Nobuho , Tsuno Hirotaka , Ohashi Satoru , Iwasawa Mitsuyasu , Furukawa Hiroshi , Kato Tomohiro , Fukui Naoshi 
Published: February 2021

Abstract
Background
In osteoarthritis (OA), cartilage matrix is lost gradually despite enhanced matrix synthesis by chondrocytes. This paradox may be explained, at least partly, by reduced chondrocyte anabolism in degenerated area of OA cartilage. However, to date, it is not known why chondrocyte anabolism is suppressed in those areas.

Methods
Cartilage was obtained from control knees and end-stage OA knees in macroscopically preserved areas and degenerated areas, and gene expression was analyzed in respective regions of cartilage using laser capture microdissection and qPCR. For the cartilage protein analysis, cartilage was obtained from preserved areas and degenerated areas of OA knees in pairs, and proteins were extracted using urea buffer. Protein concentrations were determined by Luminex and compared between the areas. Cartilage explants prepared from preserved areas and degenerated areas of OA knees were cultured in the presence or absence of an AKT inhibitor, and the gene expression was evaluated by qPCR. Finally, the expression of SP1 was evaluated in OA and control cartilage, and the significance of Sp1 on the expression of IGF1R and IRS1 was investigated in experiments using primary cultured chondrocytes.

Results
Within OA cartilage, the expression of IGF-1, IGF-2, IGF1R and IRS1 was reduced in degenerated areas compared to preserved areas, while the expression of all six IGF-binding protein genes examined was enhanced in the former areas. Consistent results were obtained by a protein analysis. In explant culture, the inhibition of AKT signaling abrogated the abundant matrix gene expression in the preserved areas over the degenerated areas, indicating that suppressed matrix synthesis in degenerated areas may be ascribed, at least partly, to attenuated IGF signaling. Within OA cartilage, the expression of Sp1 was considerably reduced in severely degenerated areas compared to preserved areas, which correlated well with the expression of IGF1R and IRS1. In experiments using primary cultured chondrocytes, the expression of IGF1R and IRS1 was enhanced by the induction of Sp1 expression and reduced by the suppression of Sp1 expression.

Conclusions
The results of this study suggest that attenuated IGF signaling may be responsible, at least partly, for the reduced matrix synthesis in degenerated areas of OA cartilage.
Persisting inter‐limb differences in patients following total hip arthroplasty four to five years after surgery? A preliminary cross‐sectional study
Authors: John Stefanie , Weizel David , Heumann Anna S. , Fischer Anja , Orlowski Katja , Mrkor Kai-Uwe , Edelmann-Nusser Jürgen , Witte Kerstin 
Published: February 2021

Abstract
Background
Total hip arthroplasty (THA) is an effective procedure for patients with end-stage hip osteoarthritis. However, whether or not pre-operatively existing functional deficits are persisting several years post-surgery in the affected limb has not been thoroughly researched. Therefore, the primary aim of this preliminary study was to include patients four to five years after undergoing THA and to investigate potential differences between the operated and non-operated leg in hip strength, range of motion (ROM), balance, and gait. The secondary aim was to compare these values from the operated leg of the patients to those of the legs of healthy subjects.

Methods
Sixteen patients (age: 65.20 ± 5.32 years) following unilateral THA (post-operation time: 4.7 ± 0.7 years) and ten, healthy, age-matched control subjects (age: 60.85 ± 7.57 years) were examined for maximum isometric hip muscle strength, active ROM of the hip joint, balance and gait on both limbs. Paired t-tests were used to assess the inter-limb differences in the THA group. Analyses of covariance (ANCOVA) were performed to compare groups, using age as a covariate.

Results
The analysis of inter-limb differences in patients following THA revealed significant deficits on the operated side for hip abduction strength (p = 0.02), for hip flexion ROM (p < 0.01) and for balance in terms of the length of center of pressure (COP) (p = 0.04). Compared to values of the control subjects, the patients demonstrated significantly reduced hip strength in flexion, extension and abduction (p < 0.05) on the operated leg as well as reduced ROM measures in hip flexion, extension and abduction (p < 0.05).

Conclusions
The first results of this explorative study indicated that inter-limb differences as well as reduced hip strength and hip ROM compared with control subjects were still present four to five years after THA. These persisting asymmetries and deficits in patients following THA may be one explanation for the decrease in health-related quality of life (HRQoL) seen in patients over the years after surgery. Further studies are required to replicate these findings with a larger sample size.

Trial registration
DRKS, DRKS00016945. Registered 12 March 2019 – Retrospectively registered,
Mutation-based clustering and classification analysis reveals distinctive age groups and age-related biomarkers for glioma
Authors: Jean-Quartier Claire , Jeanquartier Fleur , Ridvan Aydin , Kargl Matthias , Mirza Tica , Stangl Tobias , Markaĉ Robi , Jurada Mauro , Holzinger Andreas 
Published: February 2021

Abstract
Background
Malignant brain tumor diseases exhibit differences within molecular features depending on the patient’s age.

Methods
In this work, we use gene mutation data from public resources to explore age specifics about glioma. We use both an explainable clustering as well as classification approach to find and interpret age-based differences in brain tumor diseases. We estimate age clusters and correlate age specific biomarkers.

Results
Age group classification shows known age specifics but also points out several genes which, so far, have not been associated with glioma classification.

Conclusions
We highlight mutated genes to be characteristic for certain age groups and suggest novel age-based biomarkers and targets.
Implications for the design of a Diagnostic Decision Support System (DDSS) to reduce time and cost to diagnosis in paediatric shoulder instability
Authors: Philp Fraser , Faux-Nightingale Alice , Woolley Sandra , de Quincey Ed , Pandyan Anand 
Published: February 2021

Abstract
Background
Currently the diagnosis of shoulder instability, particularly in children, is difficult and can take time. These diagnostic delays can lead to poorer outcome and long-term complications. A Diagnostic Decision Support System (DDSS) has the potential to reduce time to diagnosis and improve outcomes for patients. The aim of this study was to develop a concept map for a future DDSS in shoulder instability.

Methods
A modified nominal focus group technique, involving three clinical vignettes, was used to elicit physiotherapists decision-making processes.

Results
Twenty-five physiotherapists, (18F:7 M) from four separate clinical sites participated. The themes identified related to ‘Variability in diagnostic processes and lack of standardised practice’ and ‘Knowledge and attitudes towards novel technologies for facilitating assessment and clinical decision making’.

Conclusion
No common structured approach towards assessment and diagnosis was identified. Lack of knowledge, perceived usefulness, access and cost were identified as barriers to adoption of new technology. Based on the information elicited a conceptual design of a future DDSS has been proposed. Work to develop a systematic approach to assessment, classification and diagnosis is now proposed.
Trial Registraty This was not a clinical trial and so no clinical trial registry is needed.
Spatial clustering of fourteen tick species across districts of Zimbabwe
Authors: Shekede Munyaradzi Davis , Chikerema Silvester Maravanyika , Spargo Moregood , Gwitira Isaiah , Kusangaya Samuel , Mazhindu Aldridge Nyasha , Ndhlovu Daud Nyosi 
Published: February 2021

AbstractBackgroundTicks transmit several diseases that result in high morbidity and mortality in livestock. Tick-borne diseases are an economic burden that negatively affect livestock production, cost countries billions of dollars through vaccine procurement and other disease management efforts. Thus, understanding the spatial distribution of tick hotspots is critical for identifying potential areas of high tick-borne disease transmission and setting up priority areas for targeted tick disease management. In this study, optimised hotspot analysis was applied to detect hotspots and coldspots of 14 common tick species in Zimbabwe. Data on the spatial distribution of tick species were obtained from the Epidemiology Unit of the Division of Veterinary Field Services of Zimbabwe.ResultsA total of 55,133 ticks were collected withRhipicephalus decoloratusbeing the most common species (28.7%), followed byAmblyomma hebraeum(20.6%), andRhipicephalus sanguineussensulato(0.06%) being the least common species. Results also showed that tick hotspots are species-specific with particular tick species occupying defined localities in the country. For instance,Amblyomma variegatum,Rhipicephalus appendiculatus,Rhipicephalus decoloratus, Rhipicephalus compostus, Rhipicephalus microplus,Rhipicephalus pravus, andRhipicephalus simuswere concentrated in the north and north eastern districts of the country. In contrast,Amblyomma hebraeum,Hyalomma rufipes, Hyalomma trancatumandRhipicephalus evertsi evertsiwere prevalent in the southern districts of Zimbabwe.ConclusionThe occurrence of broadly similar hotspots of several tick species in different districts suggests presence of spatial overlaps in the niche of the tick species. As ticks are vectors of several tick-borne diseases, there is high likelihood of multiple disease transmission in the same geographic region. This study is the first in Zimbabwe to demonstrate unique spatial patterns in the distribution of several tick species across the country. The results of this study provide an important opportunity for the development of spatially-targeted tick-borne disease management strategies.
Yersinia pseudotuberculosis serotype O:1 infection in a captive Seba’s short tailed-fruit bat (Carollia perspicillata) colony in Switzerland
Authors: Hahn K. , Veiga I. B. , Schediwy M. , Wiederkehr D. , Meniri M. , Schneeberger M. , den Broek P. Rüegg-van , Gurtner C. , Fasel N. J. , Kittl S. , Fredriksson-Ahomaa M. , Schmitt S. , Stokar-Regenscheit N. 
Published: February 2021

AbstractBackgroundBetween February and April 2016, a slight increase in mortality was observed in a colony consisting of 400 captive Seba’s short-tailed bats (Carollia perspicillata). These animals cohabited with other nocturnal animal species in a dome of a private zoo in Switzerland.ResultsGross and histological analysis of two (14.3%) out of the 13 animals submitted for necropsy within this period revealed a necrosuppurative pneumonia, hepatitis, splenitis, enterocolitis, and endometritis, with abundant intralesional colonies of Gram-negative rods.Yersinia(Y.)pseudotuberculosisserotype O:1 and biotype 1 belonging to the sequence type ST90 was isolated from the affected organs in both animals. Following this diagnosis, ¼ of the colony (99 animals) was culled and submitted for gross and histopathological analysis, and a bacterial culture selective forYersiniaspp. of lung, liver, and spleen was performed. From these 99 animals, one gravid female was tested and found to be positive forY. pseudotuberculosisin the absence of clinical symptoms and histopathological lesions.PCR analysis of altogether three bacterial isolates for virulence factors revealed the presence of theailgene, and one isolate was also positive for thevirFandyadAplasmid genes.ConclusionsThese findings suggest thatCarollia perspicillataare susceptible to lethal yersiniosis but do not represent a regular reservoir forY. pseudotuberculosis. Culling of ¼ of the population was sufficient to limit the spread of this infection among the colony. Moreover, no infections were detected in cohabitant nocturnal animals and caretakers, indicating that the zoonotic risk in this case was low.