bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adipose morphology and metabolic disease
Authors: Tandon Panna , Wafer Rebecca , Minchin James E. N. 
Published: March 2018

ABSTRACT
Adipose morphology is defined as the number and size distribution of adipocytes (fat cells) within adipose tissue. Adipose tissue with fewer but larger adipocytes is said to have a ‘hypertrophic’ morphology, whereas adipose with many adipocytes of a smaller size is said to have a ‘hyperplastic’ morphology. Hypertrophic adipose morphology is positively associated with insulin resistance, diabetes and cardiovascular disease. By contrast, hyperplastic morphology is associated with improved metabolic parameters. These phenotypic associations suggest that adipose morphology influences risk of cardiometabolic disease. Intriguingly, monozygotic twin studies have determined that adipose morphology is in part determined genetically. Therefore, identifying the genetic regulation of adipose morphology may help us to predict, prevent and ameliorate insulin resistance and associated metabolic diseases. Here, we review the current literature regarding adipose morphology in relation to: (1) metabolic and medical implications; (2) the methods used to assess adipose morphology; and (3) transcriptional differences between morphologies. We further highlight three mechanisms that have been hypothesized to promote adipocyte hypertrophy and thus to regulate adipose morphology.
Continuous training and certification in neonatal resuscitation in remote areas using a multi-platform information and communication technology intervention, compared to standard training: A randomized cluster trial study protocol
Authors: Delgado Carlos Alberto , Gómez Pomar Enrique M. , Velásquez Pablo , Sánchez Víctor , Shimabuku Roberto , Huicho Luis ,   RCPNEOPERU Study Group
Published: March 2018

Background: About 10% of all newborns may have difficulty breathing and require support by trained personnel. In Peru, 90% of deliveries occur in health facilities. However, there is not a national neonatal resuscitation and certification program for the public health sector. In addition, the Andes and the Amazon regions concentrate large rural remote areas, which further limit the implementation of training programs and the accomplishment of continuous certification. Neonatal resuscitation training through the use of information, communication and technology (ICT) tools running on computers, tablets or mobile phones, may overcome such limitations. This strategy allows online and offline access to educational resources, paving the way to more frequent and efficient training and certification processes. Objective: To evaluate the effects of a neonatal resuscitation training and certification program that uses a multi-platform ICT (MP-ICT) strategy on neonatal health care in remote areas. Methods: We propose to conduct the study through a cluster-randomized trial, where the study and analysis unit is the health care facility. Eligible facilities will include primary and secondary health care level facilities that are located in provinces with neonatal mortality rates higher than 15 per 1,000 live births. We will compare the proportion of newborns with a heart rate ≥100 beats per minute at two minutes after birth in health care facilities that receive MP-ICT training and certification implementation, with those that receive standard training and certification. Discussion: We expect that the intervention will be shown as more effective than the current standard of care. We are prepared to include it within a national neonatal resuscitation training and certification program to be implemented at national scale together with policymakers and other key stakeholders. Trial registration: ClinicalTrials.gov Nº NCT03210194 Status of the study: This study is enrolling participants by invitation only. Study protocol version 1.1 – March 31st, 2017
A survey of quality of life indicators in the Romanian Roma population following the ‘Decade of Roma Inclusion’
Authors: Powell Doherty Rebecca , Müller-Demary Daniel , Hosszu Alexandra , Duminica Ana , Bertke Andrea , Lewis Bryan , Eubank Stephen 
Published: March 2018

Background: This study explores how the Roma in Romania, the EU’s most concentrated population, are faring in terms of a number of quality of life indicators, including poverty levels, healthcare, education, water, sanitation, and hygiene.Methods: 135 surveys were conducted across five geographically diverse Romanian communities. Household participants were selected through a comprehensive random walk method. Analyses were conducted on all data using Pandas for Python.Results: These data indicate that the Roma in Romania face significant disparities in education, with Roma students less likely to progress beyond 8thgrade. In addition, the Roma population remains significantly disadvantaged with regard to safe and secure housing, poverty, and healthcare status, particularly in connection to diarrheal disease. In contrast, however, both Roma and non-Roma in rural areas face difficulties regarding full-time employment, sanitation, and water, sanitation, and hygiene infrastructure.Conclusions: These data demonstrate the challenges that remain to the Roma population in Romania, and also point to the myriad of ways in which all rural Romanians, regardless of ethnicity, are encountering hardship. This study highlights the areas in which improvements can be made to ensure the Roma, and indeed all Romanian citizens, have access to and confidence in sanitation services, clean water, and adequate healthcare treatment.
Understanding barriers to the introduction of precision medicines in non-small cell lung cancer: A qualitative interview protocol
Authors: Wright Stuart , Daker-White Gavin , Newman William , Payne Katherine 
Published: March 2018

Background: While precision medicines targeting genetic mutations and alterations in non-small cell lung cancer (NSCLC) have been available since 2010, their adoption into clinical practice has been slow. Evidence suggests that a number of barriers, such as insufficient clinician knowledge, a need for training of test providers, or a lack of specific clinical guidelines, may slow the implementation of precision in general. However, little attention has been given to the barriers to providing precision medicines in NSCLC. The purpose of this protocol is to outline the design for a qualitative interview study to identify the barriers and facilitators to the provision of precision medicines for NSCLC. Methods: This study will use semi-structured interviews with clinicians (n=10), test providers (n=10), and service commissioners (n=10) to identify the perceived barriers and facilitators to providing historical, current, and future precision medicines in NSCLC. Participants will be identified through mailing list advertisements and snowball sampling. Recruitment will continue until data saturation, indicated by no new themes arising from the data. Interviews will be conducted by telephone to facilitate geographical diversity. The qualitative data will be analysed using a framework analysis with themes anticipated to relate to; relevant barriers to providing precision medicines, the impact of different barriers on medicine provision, changes in the ability to provide precision medicines over time, and strategies to facilitate the provision of precision medicines. Ethics: This study has been approved by the University of Manchester Proportionate Review Research Ethics Committee (Reference number: 2017-1885-3619). Written consent will be obtained from all participants. Conclusion: This study is the first to explore the barriers and facilitators to providing precision medicines for NSCLC in the English NHS. The findings will inform strategies to improve the implementation of future precision medicines. These findings will be disseminated in peer-reviewed publications and national and international conferences.
Predictors of compartment syndrome of the foot after fracture of the calcaneus
Authors: Park Y. H. , Lee J. W. , Hong J. Y. , Choi G. W. , Kim H. J. 
Published: March 2018

AimsIdentifying predictors of compartment syndrome in the foot after a fracture of the calcaneus may lead to earlier diagnosis and treatment. The aim of our study was to identify any such predictors.Patients and MethodsWe retrospectively reviewed 303 patients (313 fractures) with a fracture of the calcaneus who presented to us between October 2008 and September 2016. The presence of compartment syndrome and potential predictors were identified by reviewing their medical records. Potential predictors included age, gender, concomitant foot injury, mechanism of injury, fracture classification, time from injury to admission, underlying illness, use of anticoagulant/antiplatelet agents, smoking status and occupation. Associations with predictors were analyzed using logistic regression analysis.ResultsOf the 313 fractures of the calcaneus, 12 (3.8%) developed a compartment syndrome. A Sanders type IV fracture was the only strongly associated factor (odds ratio 21.67, p = 0.007). Other variables did not reach statistical significance.ConclusionA Sanders type IV fracture is the best predictor of compartment syndrome after a fracture of the calcaneus. Cite this article: Bone Joint J 2018;100-B:303–8.
Biological augmentation of graft healing in anterior cruciate ligament reconstruction
Authors: Hexter A. T. , Thangarajah T. , Blunn G. , Haddad F. S. 
Published: March 2018

Aims The success of anterior cruciate ligament reconstruction (ACLR) depends on osseointegration at the graft-tunnel interface and intra-articular ligamentization. Our aim was to conduct a systematic review of clinical and preclinical studies that evaluated biological augmentation of graft healing in ACLR. Materials and Methods In all, 1879 studies were identified across three databases. Following assessment against strict criteria, 112 studies were included (20 clinical studies; 92 animal studies). Results Seven categories of biological interventions were identified: growth factors, biomaterials, stem cells, gene therapy, autologous tissue, biophysical/environmental, and pharmaceuticals. The methodological quality of animal studies was moderate in 97%, but only 10% used clinically relevant outcome measures. The most interventions in clinical trials target the graft-tunnel interface and are applied intraoperatively. Platelet-rich plasma is the most studied intervention, but the clinical outcomes are mixed, and the methodological quality of studies was suboptimal. Other biological therapies investigated in clinical trials include: remnant-augmented ACLR; bone substitutes; calcium phosphate-hybridized grafts; extracorporeal shockwave therapy; and adult autologus non-cultivated stem cells. Conclusion There is extensive preclinical research supporting the use of biological therapies to augment ACLR. Further clinical studies that meet the minimum standards of reporting are required to determine whether emerging biological strategies will provide tangible benefits in patients undergoing ACLR. Cite this article: Bone Joint J 2018;100-B:271–84.
Factors associated with health-related quality of life, hip function, and health utility after operative management of femoral neck fractures
Authors: Sprague S. , Bhandari M. , Heetveld M. J. , Liew S. , Scott T. , Bzovsky S. , Heels-Ansdell D. , Zhou Q. , Swiontkowski M. , Schemitsch E. H. 
Published: March 2018

Aims The primary aim of this prognostic study was to identify baseline factors associated with physical health-related quality of life (HRQL) in patients after a femoral neck fracture. The secondary aims were to identify baseline factors associated with mental HRQL, hip function, and health utility. Patients and Methods Patients who were enrolled in the Fixation using Alternative Implants for the Treatment of Hip Fractures (FAITH) trial completed the 12-item Short Form Health Survey (SF-12), Western Ontario and McMaster Universities Arthritis Index, and EuroQol 5-Dimension at regular intervals for 24 months. We conducted multilevel mixed models to identify factors potentially associated with HRQL. Results The following were associated with lower physical HRQL: older age (-1.42 for every ten-year increase, 95% confidence interval (CI) -2.17 to -0.67, p < 0.001); female gender (-1.52, 95% CI -3.00 to -0.05, p = 0.04); higher body mass index (-0.69 for every five-point increase, 95% CI -1.36 to -0.02, p = 0.04); American Society of Anesthesiologists class III ( versus class I) (-3.19, 95% CI -5.73 to -0.66, p = 0.01); and sustaining a displaced fracture (-2.18, 95% CI -3.88 to -0.49, p = 0.01). Additional factors were associated with mental HRQL, hip function, and health utility. Conclusion We identified several baseline factors associated with lower HRQL, hip function, and utility after a femoral neck fracture. These findings may be used by clinicians to inform treatment and outcomes. Cite this article: Bone Joint J 2018;100-B:361–9.
A randomized controlled trial comparing the Thompson hemiarthroplasty with the Exeter polished tapered stem and Unitrax modular head in the treatment of displaced intracapsular fractures of the hip
Authors: Sims A. L. , Parsons N. , Achten J. , Griffin X. L. , Costa M. L. , Reed M. R. , CORNET Trainee Collaborative  
Published: March 2018

Aims This study aimed to compare the change in health-related quality of life of patients receiving a traditional cemented monoblock Thompson hemiarthroplasty compared with a modern cemented modular polished-taper stemmed hemiarthroplasty for displaced intracapsular hip fractures. Patients and Methods This was a pragmatic, multicentre, multisurgeon, two-arm, parallel group, randomized standard-of-care controlled trial. It was embedded within the WHiTE Comprehensive Cohort Study. The sample size was 964 patients. The setting was five National Health Service Trauma Hospitals in England. A total of 964 patients over 60 years of age who required hemiarthroplasty of the hip between February 2015 and March 2016 were included. A standardized measure of health outcome, the EuroQol (EQ-5D-5L) questionnaire, was carried out on admission and at four months following the operation. Results Of the 964 patients enrolled, 482 died or were lost to follow-up (50%). No significant differences were noted in EQ-5D between groups, with a mean difference at four months of 0.037 in favour of the Exeter/Unitrax implant (95% confidence interval (CI) 0.014 to 0.087, p = 0.156), rising to 0.045 (95% CI 0.007 to 0.098, p = 0.09) when patients who died were excluded. The minimum clinically important difference for EQ-5D-5L used in this study is 0.08, therefore any benefit between implants is unlikely to be noticeable to the patient. There was no difference in mortality or mobility score. Conclusion Allowing for the high rate of loss to follow-up, the use of the traditional Thompson hemiarthroplasty in the treatment of the displaced intracapsular hip fracture shows no difference in health outcome when compared with a modern cemented hemiarthroplasty. Cite this article: Bone Joint J 2018;100-B:352–60.
DAMPAK PERATURAN PEMERINTAH NOMOR 48 TAHUN 2014 TERHADAP MASYARAKAT DAN PENGHULU (Studi di KUA Gondokusuman dan Tegalrejo Yogyakarta)
Authors: Arsyad Faiz Adzkia 
Published: March 2018

Based on Government Regulation Number 48 of 2014 about Marriage Registration Fee which contains about the cost of marrieage recording and referring for free or free of charge when done in KUA. If marriage applied outside KUA and outside working hours, it is charged Rp 600.000. The regulation subtitutes Government Regulation Number 47 of 2004 about Non-Tax State Revenue Rate that applied to the Ministry of Religious Affairs. The weakness of Government Regulation No. 47 of 2004 is the number of gratification practices among some headman. This resulted in the issuance of Government Regulation Number 48 of 2014 concerning about the Cost of marriage listing on the basis of the benefit to eliminate the practice of gratuities. Primary sources in this study are the views of the Head Office of Religious Affairs (KUA) Tegalrejo and Gondokusuman Subdistricts and View of bride and groom candidates in Tegalrejo and Gondokusuman Subdistricts. The secondary data are documents relating to the Office of Religious Affairs (KUA) Tegalrejo and Gondokusuman Sub-districts. The approach used is the normative approach. Data were analyzed qualitatively by using deductive and inductive methods. This paper describes the impact of the implementation of Government Regulation Number 48 of 2014 about the Cost of Marriage Listing in KUA Tegalrejo and Gondokusuman.[Berdasarkan Peraturan Pemerintah Nomor 48 tahun 2014 tentang Biaya Pencatatan Nikah yang berisi tentang biaya pencatatan nikah dan rujuk gratis atau tidak dipungut biaya sama sekali apabila dilakukan di dalam KUA. Jika melaksanakan nikah di luar KUA dan di luar jam kerja, maka dipungut biaya sebesar Rp 600.000. Peraturan tersebut menggantikan Peraturan Pemerintah Nomor 47 tahun 2004 tentang Tarif Penerimaan Negara Bukan Pajak yang Berlaku pada Departemen Agama. Kelemahan PP Nomor 47 tahun 2004 adalah banyaknya praktek gratifikasi di kalangan oknum penghulu. Hal ini menyebabkan lahirnya Peraturan Pemerintah Nomor 48 tahun 2014 tentang Biaya Pencatatan Nikah atas dasar kemaslahatan untuk menghilangkan praktek gratifikasi. Sumber primer dalam penelitian ini adalah Pandangan Kepala Kantor Urusan Agama (KUA) Kecamatan Tegalrejo dan Gondokusuman serta Pandangan Calon Manten di Kecamatan Tegalrejo dan Gondokusuman. Data sekundernya adalah dokumen yang berhubungan dengan Kantor Urusan Agama (KUA) Kecamatan Tegalrejo dan Gondokusuman. Pendekatan yang digunakan adalah pendekatan normatif. Data dianalisis secara kualitatif dengan menggunakan metode deduktif dan induktif. Tulisan ini menjelaskan tentang dampak implementasi Peraturan Pemerintah Nomor 48 tahun 2014 tentang Biaya Pencatatan Nikah di KUA Tegalrejo dan Gondokusuman.]
Inhibition of a Descending Prefrontal Circuit Prevents Ketamine-Induced Stress Resilience in Females
Authors: Dolzani S. D. , Baratta M. V. , Moss J. M. , Leslie N. L. , Tilden S. G. , Sørensen A. T. , Watkins L. R. , Lin Y. , Maier S. F. 
Published: March 2018

AbstractStress is a potent etiological factor in the onset of major depressive disorder and posttraumatic stress disorder (PTSD). Therefore, significant efforts have been made to identify factors that produce resilience to the outcomes of a later stressor, in hopes of preventing untoward clinical outcomes. The NMDA receptor antagonist ketamine has recently emerged as a prophylactic capable of preventing neurochemical and behavioral outcomes of a future stressor. Despite promising results of preclinical studies performed in male rats, the effects of proactive ketamine in female rats remains unknown. This is alarming given that stress-related disorders affect females at nearly twice the rate of males. Here we explore the prophylactic effects of ketamine on stress-induced anxiety-like behavior and the neural circuit-level processes that mediate these effects in female rats. Ketamine given one week prior to an uncontrollable stressor (inescapable tailshock; IS) reduced typical stress-induced activation of the serotonergic (5-HT) dorsal raphe nucleus (DRN) and eliminated DRN-dependent juvenile social exploration (JSE) deficits 24 h after the stressor. Proactive ketamine altered prelimbic cortex (PL) neural ensembles so that a later experience with IS now activated these cells, which it ordinarily would not. Ketamine acutely activated a PL to DRN (PL-DRN) circuit and inhibition of this circuit with Designer Receptors Exclusively Activated by Designer Drugs (DREADDs) at the time of IS one week later prevented stress prophylaxis, suggesting that persistent changes in PL-DRN circuit activity are responsible, at least in part, for mediating long-term effects associated with ketamine.
Patients with Multimorbidity and Their Treatment Burden in Different Daily Life Domains: A Qualitative Study in Primary Care in the Netherlands and Belgium
Authors: Van Merode Tiny , Van De Ven Karin , Van Den Akker Marjan 
Published: March 2018

Background Physicians and other healthcare professionals involved in the care of patients with multimorbidity should consider the problems these patients experience in managing their own conditions. However, treatment burden from the patient's perspective has been poorly explored, even though this might hamper treatment adherence. Objective The present study examined the experiences of patients with multimorbidity in primary care in the Netherlands and Belgium using semi-structured interviews, with special attention to the daily life domains of treatment burden. Design Individual interviews gathering qualitative data to explore the treatment burden experienced by patients with multimorbidity in primary care. Twenty-two patients agreed to participate: seven men and fifteen women. The recorded interviews were transcribed verbatim and evaluated using thematic content analysis. Results The patients reported numerous aspects of treatment burden they experienced in various domains of their daily lives. These topics were categorized into four daily life domains of burden: organization of care, medication, patient's role, and impact on daily life (including the involvement of caregivers). Conclusions The findings indicate that primary care patients with multimorbidity report treatment burden in several domains of their daily lives, not restricted to medical issues, such as side effects of medication. Some issues, such as those related to organization of care, seem easily modifiable. Further research is required focusing on special factors of treatment burden as experienced by patients with multimorbidity, and the implications for treatment adherence, especially in European settings, as little information is currently available.
Semen quality in patients with pituitary disease and adult-onset hypogonadotropic hypogonadism
Authors: Andreassen Mikkel , Juul Anders , Feldt-Rasmussen Ulla , Jørgensen Niels 
Published: March 2018

Objective
Gonadotropins (luteinizing hormone (LH) and follicle-stimulating hormone (FSH)) are released from the pituitary gland and stimulate Leydig cells to produce testosterone and initiates spermatogenesis. Little is known about how and when the deterioration of semen quality occurs in patients with adult-onset gonadotropin insufficiency.

Design and methods
A retrospective study comprising 20 testosterone-deficient men (median age, 29 years) with acquired pituitary disease who delivered semen for cryopreservation before initiation of testosterone therapy. Semen variables and hormone concentrations were compared to those of young healthy men (n = 340).

Results
Thirteen of 20 patients (65%) and 82% of controls had total sperm counts above 39 million and progressive motile spermatozoa above 32% (P = 0.05). For the individual semen variables, there were no significant differences in semen volume (median (intraquartile range) 3.0 (1.3–6.8) vs 3.2 (2.3–4.3) mL, P = 0.47), sperm concentration 41 (11–71) vs 43 (22–73) mill/mL (P = 0.56) or total sperm counts (P = 0.66). One patient had azoospermia. Patients vs controls had lower serum testosterone 5.4 (2.2–7.6) vs 19.7 (15.5–24.5) nmol/L (P = 0.001), calculated free testosterone (cfT) 145 (56–183) vs 464 (359–574) pmol/L (P < 0.001), LH 1.5 (1.1–2.1) vs 3.1 (2.3–4.0) U/L (P = 0.002) and inhibin b (P < 0.001). Levels of FSH were similar (P = 0.63). Testosterone/LH ratio and cfT/LH ratio were reduced in patients (both P < 0.001).

Conclusions
Despite Leydig cell insufficiency in patients with acquired pituitary insufficiency, the majority presented with normal semen quality based on the determination of the number of progressively motile spermatozoa. In addition, the data suggest reduced LH bioactivity in patients with pituitary insufficiency.