bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of Clavicle Chest Cage Angle Difference in Predicting Postoperative Shoulder Balance in Lenke 5C Adolescent Idiopathic Scoliosis Patients after Selective Posterior Fusion
Authors: Liu Zhen , Hu Zong‐shan , Qiu Yong , Zhang Zhen , Zhao Zhi‐hui , Han Xiao , Zhu Ze‐zhang 
Published: March 2017

ObjectiveTo evaluate the role of preoperative clavicle chest cage angle difference (CCAD) on postoperative radiographic shoulder imbalance, patient's satisfaction and surgeon's fulfillment in Lenke 5 adolescent idiopathic scoliosis (AIS). CCAD, as a novel radiographic parameter, has proven to be a reliable predictor for postoperative shoulder imbalance in Lenke 1 AIS patients. However, the value of CCAD in predicting shoulder balance has never been evaluated in Lenke 5 AIS patients.MethodsA total of 42 Lenke 5C AIS patients aged from 10 to 18 years old with a minimum 2‐year follow‐up were enrolled for evaluation. All patients underwent selective posterior spinal instrumentation and fusion using the all segmental pedicle screw technique by the same surgical team. The fusion levels were determined according to the Lenke criteria. Shoulder height difference (SHD) and CCAD were measured on anteroposterior (AP) standing radiographs. The patients’ satisfaction and the surgeons’ fulfillment were evaluated using a questionnaire. A receiver operative characteristic curve analysis was performed to explore the threshold values of preoperative CCAD in the prediction of the final follow‐up radiographic shoulder imbalance, patients’ satisfaction and surgeons’ fulfillment.ResultsThe average preoperative Cobb angle of the main curve was 46.8° ± 4.8°, and the average immediate postoperative Cobb angle was 13.3° ± 2.6°, representing an average surgical correction rate of 75.6% ± 8.5%. The average follow‐up time was 29.2 months. At the last follow‐up, the value of preoperative CCAD was significantly higher in patients with unbalanced shoulders (SHD ≥ 10 mm). At the final follow‐up, 66.7% (28/42) of the patients were satisfied with their appearance, while 33.3% (14/42) of the patients were not satisfied with their appearance. At the final follow‐up, 61.9% (26/42) of the surgeons were fulfilled with their operation, while 38.1% (16/42) of the surgeons were not. For patients’ satisfaction and surgeons’ fulfillment, the preoperative CCAD was significantly greater in patients with unsatisfied outcomes.DiscussionClavicle chest cage angle difference could be a reliable predictor for evaluating postoperative shoulder imbalance in AIS patients undergoing selective posterior fusion for Lenke 5C curves. A greater preoperative CCAD was significantly correlated with a postoperative radiographic imbalance of shoulders and dissatisfaction, which will guide spine surgeons in their preoperative planning and in the surgical management of AIS to reduce postoperative shoulder imbalance.
Comparison of Arthrodesis and Non‐fusion to Treat Lisfranc Injuries
Authors: Qiao Yu‐sen , Li Jun‐kun , Shen Hao , Bao Hai‐yan , Jiang Ming , Liu Yan , Kapadia Wasim , Zhang Hong‐tao , Yang Hui‐lin 
Published: March 2017

Objective“Lisfranc joint injury” is comprised of a tarsometatarsal joint‐complex injury. The Lisfranc complex injury is always a challenge for orthopedists, and the optimum treatment is still up for debate. Anatomic reduction and stable internal fixation prove to have no satisfactory outcomes. This research aims to compare the clinical curative effects, complications and radiographic features of arthrodesis and non‐fusion of the Lisfranc joint in the follow‐up of the patients who suffered Lisfranc injuries.MethodsA comparative retrospective study of 25 patients with acute or subacute Lisfranc complex injuries was conducted between September 2013 and March 2015 in the First Affiliated Hospital of Soochow University. All patients were classified by Myerson classification. Eight patients were treated with arthrodesis, while 17 patients received non‐fusion operations. The clinical curative effects, complications and image differences were compared between the two groups. American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score, Short Form‐36 (SF‐36) and Visual Analogue Scale (VAS) score were evaluated for each patient during the follow‐up. All statistics were analyzed using the SPSS software system.ResultsAll fractures healed for both the arthrodesis group and the non‐fusion group. Patients in the arthrodesis group had a higher AOFAS score compared with patients in the non‐fusion group (94.00 vs. 88.58, P = 0.034). Complications occurred in eight patients (8/17, 47%) in the non‐arthrodesis group, including the second and third phalanx abduction (1), talipes cavus (2), eversion deformity of front foot (3), eversion deformity of calcaneus (1), as well as postoperative infection (1). Only two patients (2/8, 25%) in the arthrodesis group suffered complications. One was a limitation of motion of the front foot and pain during walking; the other was an eversion deformity of front foot.ConclusionPrimary arthrodesis has advantages compared to primary open reduction and internal fixation (ORIF): reduced foot deformity rates, sustained biomechanical morphology of the feet, reduced complications, higher level of function recovery, shorter time of surgical procedures, fewer complications, higher AOFAS score and fewer frequency of complications. According to our research, primary arthrodesis may be a better choice for treating Lisfranc injury.
Profiles of Alzheimer's caregivers in Spain: social, educational and laboral characteristics
Authors: Ruiz‐Adame Reina Manuel , González‐Camacho María Carmen , Romero‐García José Enrique , Sánchez‐Reyes Fernández Luís María 
Published: March 2017

BackgroundA person suffering from dementia needs increasing help from another person, who, in most cases, is a female family member. Times are changing and this traditional role can no longer be maintained.AimThe aim of this research was mainly centred on ascertaining the profile of caregivers and to find out how determinants such as age, sex and educational level and living conditions led people to assume that role.MethodsA survey was designed and applied to 925 caregivers (778 of which were analysed) with the collaboration of the Alzheimer's Associations of Andalucía (Spain). Associations gave their ethical approbation for this research prior to the beginning and they informed their members. The participation was entirely voluntary, and caregivers were given the option to withdraw consent.ResultsWomen are the main caregivers in any kind of profile. Males become carers if they are old and the partner of a patient. Males use more external services. Cohabiting and working outside the home increase the use of external support services, and having a higher level of education increases the use of nursing homes. Younger caregivers perceive more intense socio‐economic consequences than the general profile.ConclusionsBeing a caregiver implies limitations to entering the job market and for job promotion. There is a generational gap in the caregiver profile, and more and new support services will be needed. Policymakers should take those into account.
Bayesian Analysis of the Proportional Hazards Model with Time‐Varying Coefficients
Authors: Kim Gwangsu , Kim Yongdai , Choi Taeryon 
Published: March 2017

AbstractWe study a Bayesian analysis of the proportional hazards model with time‐varying coefficients. We consider two priors for time‐varying coefficients – one based on B‐spline basis functions and the other based on Gamma processes – and we use a beta process prior for the baseline hazard functions. We show that the two priors provide optimal posterior convergence rates (up to the
term) and that the Bayes factor is consistent for testing the assumption of the proportional hazards when the two priors are used for an alternative hypothesis. In addition, adaptive priors are considered for theoretical investigation, in which the smoothness of the true function is assumed to be unknown, and prior distributions are assigned based on B‐splines.
Accounting for Diversity in Suicide Research: Sampling and Sample Reporting Practices in the United States
Authors: Cha Christine B. , Tezanos Katherine M. , Peros Olivia M. , Ng Mei Yi , Ribeiro Jessica D. , Nock Matthew K. , Franklin Joseph C. 
Published: March 2017

Research on suicidal thoughts and behaviors (STB) has identified many risk factors, but whether these findings generalize to diverse populations remains unclear. We review longitudinal studies on STB risk factors over the past 50 years in the United States and evaluate the methodological practices of sampling and reporting sample characteristics. We found that articles frequently reported participant age and sex, less frequently reported participant race and ethnicity, and rarely reported participant veteran status or lesbian, gay, bisexual, and transgender status. Sample reporting practices modestly and inconsistently improved over time. Finally, articles predominantly featured White, non‐Hispanic, young adult samples.
Health care‐seeking behaviours and health expenditures in adults aged 45 years and older in China, 2011–2013
Authors: Li Jiasen , Feng Xing Lin 
Published: March 2017

AbstractObjectivesTo provide an assessment of China's progress to universal health coverage (UHC) from the perspective of people‐centred care.MethodsWe obtained data on 28 103 participants from the China Health and Retirement Longitudinal Study (CHALRS) during 2011–2013. We used logistic regressions and generalised linear models to analyse care‐seeking behaviours and medical expenditures.ResultsWe found that 95.5% of the subjects were covered by social health insurance in 2013, and nearly 60% subjects in need of medical care were self‐medicated. Health insurance was a strong predictor for the access to outpatient care. Use of pure and mixed self‐medication increased by 15% and 32% respectively, while use of pure outpatient care fell by 10% between 2011 and 2013, after adjusting for predisposing, service needs and enabling factors. Such trends were particularly evident for the Urban Resident Basic Medical Insurance and the New Cooperative Medical Scheme, which covered more than 80%. The monthly out‐of‐pocket medical expenditures and the probability of encountering catastrophic health expenditures for outpatient care were four times larger than that for self‐medication. Between 2011 and 2013, outpatient care medical costs rose by nearly 50%, whereas there was no such obvious trend for self‐medication. People with insurance schemes offering lower cost sharing incurred consistently higher out‐of‐pocket outpatient payments.ConclusionsThe monitoring of global progress to UHC should incorporate self‐medication. In China, it seems that the current reform and the huge government investment have not resulted in access to affordable quality care. To achieve UHC, not only universal insurance, but system‐level efforts are needed.
LjMOT1, a high‐affinity molybdate transporter from Lotus japonicus, is essential for molybdate uptake, but not for the delivery to nodules
Authors: Duan Guilan , Hakoyama Tsuneo , Kamiya Takehiro , Miwa Hiroki , Lombardo Fabien , Sato Shusei , Tabata Satoshi , Chen Zheng , Watanabe Toshihiro , Shinano Takuro , Fujiwara Toru 
Published: March 2017

SummaryMolybdenum (Mo) is an essential nutrient for plants, and is required for nitrogenase activity of legumes. However, the pathways of Mo uptake from soils and then delivery to the nodules have not been characterized in legumes. In this study, we characterized a high‐affinity Mo transporter (LjMOT1) from Lotus japonicus. Mo concentrations in an ethyl methanesulfonate–mutagenized line (ljmot1) decreased by 70–95% compared with wild‐type (WT). By comparing the DNA sequences of four AtMOT1 homologs between mutant and WT lines, one point mutation was found in LjMOT1, which altered Trp292 to a stop codon; no mutation was found in the other homologous genes. The phenotype of Mo concentrations in F2 progeny from ljmot1 and WT crosses were associated with genotypes of LjMOT1. Introduction of endogenous LjMOT1 to ljmot1 restored Mo accumulation to approximately 60–70% of the WT. Yeast expressing LjMOT1 exhibited high Mo uptake activity, and the Km was 182 nm. LjMOT1 was expressed mainly in roots, and its expression was not affected by Mo supply or rhizobium inoculation. Although Mo accumulation in the nodules of ljmot1 was significantly lower than that of WT, it was still high enough for normal nodulation and nitrogenase activity, even for cotyledons‐removed ljmot1 plants grown under low Mo conditions, in this case the plant growth was significantly inhibited by Mo deficiency. Our results suggest that LjMOT1 is an essential Mo transporter in L. japonicus for Mo uptake from the soil and growth, but is not for Mo delivery to the nodules.
Improving the Specificity of Plasmodium falciparum Malaria Diagnosis in High-Transmission Settings with a Two-Step Rapid Diagnostic Test and Microscopy Algorithm
Authors: Murungi Moses , Fulton Travis , Reyes Raquel , Matte Michael , Ntaro Moses , Mulogo Edgar , Nyehangane Dan , Juliano Jonathan J. , Siedner Mark J. , Boum Yap , Boyce Ross M. 
Published: March 2017

ABSTRACT

Poor specificity may negatively impact rapid diagnostic test (RDT)-based diagnostic strategies for malaria. We performed real-time PCR on a subset of subjects who had undergone diagnostic testing with a multiple-antigen (histidine-rich protein 2 and
pan
-lactate dehydrogenase pLDH [HRP2/pLDH]) RDT and microscopy. We determined the sensitivity and specificity of the RDT in comparison to results of PCR for the detection of
Plasmodium falciparum
malaria. We developed and evaluated a two-step algorithm utilizing the multiple-antigen RDT to screen patients, followed by confirmatory microscopy for those individuals with HRP2-positive (HRP2
+
)/pLDH-negative (pLDH
−
) results. In total, dried blood spots (DBS) were collected from 276 individuals. There were 124 (44.9%) individuals with an HRP2
+
/pLDH
+
result, 94 (34.1%) with an HRP2
+
/pLDH
−
result, and 58 (21%) with a negative RDT result. The sensitivity and specificity of the RDT compared to results with real-time PCR were 99.4% (95% confidence interval [CI], 95.9 to 100.0%) and 46.7% (95% CI, 37.7 to 55.9%), respectively. Of the 94 HRP2
+
/pLDH
−
results, only 32 (34.0%) and 35 (37.2%) were positive by microscopy and PCR, respectively. The sensitivity and specificity of the two-step algorithm compared to results with real-time PCR were 95.5% (95% CI, 90.5 to 98.0%) and 91.0% (95% CI, 84.1 to 95.2), respectively. HRP2 antigen bands demonstrated poor specificity for the diagnosis of malaria compared to that of real-time PCR in a high-transmission setting. The most likely explanation for this finding is the persistence of HRP2 antigenemia following treatment of an acute infection. The two-step diagnostic algorithm utilizing microscopy as a confirmatory test for indeterminate HRP2
+
/pLDH
−
results showed significantly improved specificity with little loss of sensitivity in a high-transmission setting.
Strategies for Optimizing the Diagnostic Predictive Value of Clostridium difficile Molecular Diagnostics
Authors: Kociolek Larry K. 
Published: March 2017

ABSTRACT

Because nucleic acid amplification tests (NAATs) do not distinguish
Clostridium difficile
infection (CDI) and asymptomatic
C. difficile
carriage, the diagnostic predictive value of NAATs is limited when used in patients with a low probability of CDI. In this issue of the
Journal of Clinical Microbiology
, Truong et al. (J. Clin. Microbiol., 55:1276–1284, 2017,
https://doi.org/10.1128/JCM.02319-16
) report significant reductions in hospital-onset CDI and oral vancomycin utilization at their institution following implementation of a novel intervention that leveraged their clinical bioinformatics resources to prevent
C. difficile
testing of stools from patients without clinically significant diarrhea and in patients with recent laxative use.
Rapid Detection of Cell-Free Mycobacterium tuberculosis DNA in Tuberculous Pleural Effusion
Authors: Che Nanying , Yang Xinting , Liu Zichen , Li Kun , Chen Xiaoyou 
Published: March 2017

ABSTRACT

Tuberculous pleurisy is one of the most common types of extrapulmonary tuberculosis, but its diagnosis remains difficult. In this study, we report for the first time on the detection of cell-free
Mycobacterium tuberculosis
DNA in pleural effusion and an evaluation of a newly developed molecular assay for the detection of cell-free
Mycobacterium tuberculosis
DNA. A total of 78 patients with pleural effusion, 60 patients with tuberculous pleurisy, and 18 patients with alternative diseases were included in this study. Mycobacterial culture, the Xpert MTB/RIF assay, the adenosine deaminase assay, the T-SPOT.TB assay, and the cell-free
Mycobacterium tuberculosis
DNA assay were performed on all the pleural effusion samples. The cell-free
Mycobacterium tuberculosis
DNA assay and adenosine deaminase assay showed significantly higher sensitivities of 75.0% and 68.3%, respectively, than mycobacterial culture and the Xpert MTB/RIF assay, which had sensitivities of 26.7% and 20.0%, respectively (
P
< 0.01). All four of these tests showed good specificities: 88.9% for the adenosine deaminase assay and 100% for the remaining three assays. The T-SPOT.TB assay with pleural effusion showed the highest sensitivity of 95.0% but the lowest specificity of 38.9%. The cell-free
Mycobacterium tuberculosis
DNA assay detected as few as 1.25 copies of IS
6110
per ml of pleural effusion and showed good accordance of the results between repeated tests (
r
= 0.978,
P
= 2.84 × 10
−10
). These data suggest that the cell-free
Mycobacterium tuberculosis
DNA assay is a rapid and accurate molecular test which provides direct evidence of
Mycobacterium tuberculosis
etiology.
Oral Prion Disease Pathogenesis Is Impeded in the Specific Absence of CXCR5-Expressing Dendritic Cells
Authors: Bradford Barry M. , Reizis Boris , Mabbott Neil A. 
Published: March 2017

ABSTRACTAfter oral exposure, the early replication of certain prion strains upon stromal cell-derived follicular dendritic cells (FDC) in the Peyer's patches in the small intestine is essential for the efficient spread of disease to the brain. However, little is known of how prions are initially conveyed from the gut lumen to establish infection on FDC. Our previous data suggest that mononuclear phagocytes such as CD11c+conventional dendritic cells play an important role in the initial propagation of prions from the gut lumen into Peyer's patches. However, whether these cells conveyed orally acquired prions toward FDC within Peyer's patches was not known. The chemokine CXCL13 is expressed by FDC and follicular stromal cells and modulates the homing of CXCR5-expressing cells toward the FDC-containing B cell follicles. Here, novel compound transgenic mice were created in which a CXCR5 deficiency was specifically restricted to CD11c+cells. These mice were used to determine whether CXCR5-expressing conventional dendritic cells propagate prions toward FDC after oral exposure. Our data show that in the specific absence of CXCR5-expressing conventional dendritic cells the early accumulation of prions upon FDC in Peyer's patches and the spleen was impaired, and disease susceptibility significantly reduced. These data suggest that CXCR5-expressing conventional dendritic cells play an important role in the efficient propagation of orally administered prions toward FDC within Peyer's patches in order to establish host infection.IMPORTANCEMany natural prion diseases are acquired by oral consumption of contaminated food or pasture. Once the prions reach the brain they cause extensive neurodegeneration, which ultimately leads to death. In order for the prions to efficiently spread from the gut to the brain, they first replicate upon follicular dendritic cells within intestinal Peyer's patches. How the prions are first delivered to follicular dendritic cells to establish infection was unknown. Understanding this process is important since treatments which prevent prions from infecting follicular dendritic cells can block their spread to the brain. We created mice in which mobile conventional dendritic cells were unable to migrate toward follicular dendritic cells. In these mice the early accumulation of prions on follicular dendritic cells was impaired and oral prion disease susceptibility was reduced. This suggests that prions exploit conventional dendritic cells to facilitate their initial delivery toward follicular dendritic cells to establish host infection.
Tight Junction Protein Occludin Is a Porcine Epidemic Diarrhea Virus Entry Factor
Authors: Luo Xiaolei , Guo Longjun , Zhang Jian , Xu Yunfei , Gu Weihong , Feng Li , Wang Yue 
Published: March 2017

ABSTRACTPorcine epidemic diarrhea virus (PEDV), the causative agent of porcine epidemic diarrhea, has caused huge economic losses in pig-producing countries. Although PEDV was long believed to replicate in the intestinal epithelium by using aminopeptidase N as a receptor, the mechanisms of PEDV infection are not fully characterized. In this study, we found that PEDV infection of epithelial cells results in disruption of the tight junctional distribution of occludin to its intracellular location. Overexpression of occludin in target cells makes them more susceptible to PEDV infection, whereas ablation of occludin expression by use of small interfering RNA (siRNA) in target cells significantly reduces their susceptibility to virus infection. However, the results observed with occludin siRNA indicate that occludin is not required for virus attachment. We conclude that occludin plays an essential role in PEDV infection at the postbinding stages. Furthermore, we observed that macropinocytosis inhibitors blocked occludin internalization and virus entry, indicating that virus entry and occludin internalization are closely coupled. However, the macropinocytosis inhibitors could not impede virus replication once the virus had entered host cells. This suggests that occludin internalization by macropinocytosis or a macropinocytosis-like process is involved in the virus entry events. Immunofluorescence confocal microscopy showed that PEDV was trapped at cellular junctional regions upon macropinocytosis inhibitor treatment, indicating that occludin may serve as a scaffold in the vicinity of virus entry. Collectively, these data show that occludin plays an essential role in PEDV infection during late entry events. Our observation may provide novel insights into PEDV infection and related pathogenesis.IMPORTANCETight junctions are highly specialized membrane domains whose main function is to attach adjacent cells to each other, thereby forming intercellular seals. Here we investigate, for the first time, the role of the tight junction protein occludin in PEDV infection. We observed that PEDV infection induced the internalization of occludin. By using genetic modification methods, we demonstrate that occludin plays an essential role in PEDV infection. Moreover, PEDV entry and occludin internalization seem to be closely coupled. Our findings reveal a new mechanism of PEDV infection.