bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment Pattern and Overall Survival of Patients with Advanced Non-Squamous Non-Small Cell Lung Cancer: A Multicentric Real-World Study in China (CTONG1506)
Authors: Zhou Qing , Song Yong , Zhang Xin , Chen Gongyan , Zhang Yiping , Yu Ping , Chen Jianhua , Yu Zhuang , Hu Yi , Song Xia , Zhong Diansheng , Feng Guosheng , Yang Lulu , Zhan Lu jing , Ma Xiao , Lu Xingwei , Wu Yi-Long
Published: June 2020

Background:CTONG1506, an observational study assessed the real-world treatment patterns and overall survival (OS) of Chinese advanced non-squamous non-small cell lung cancer (NSCLC) patients in current treatment practices.Methods:Patients initiated with 1st line therapy were identified from 12 tertiary hospitals across China. Survival data were collected 1- and 2-years after study initiation. OS was estimated using the Kaplan-Meier method.Results:Among 540 patients with survival data, median OS was 21.4 months (95% CI: 18.1–25.5), and 2-year OS rate was 46.3% (95% CI: 42.0%-51.0%). Median OS for patients with epidermal growth factor receptor (EGFR+) mutation (n = 203), anaplastic lymphoma kinase (ALK+) rearrangement (n = 24), EGFR-/ALK- were 27.9 months (95% CI: 23.4-NA), 24.5 months (95% CI: 18.1-NA), and 15.7 (95% CI: 13.1–21.1) months, respectively. Median OS was not reached in EGFR exon 19 deletion patients compared to EGFR exon 21 L858R mutation patients (21.4 months, 95% CI: 16.7–35.6, P = 0.038). 93 EGFR + patients received tyrosine kinase inhibitor (TKI) alone, 21 received chemotherapy alone and 66 received TKI and chemotherapy [median OS 25.5 months, 18.1 months, and 35.6 months, respectively]. For EGFR + patients, TKI alone was the preferred therapy in 1st (58.2%) and 2nd (56.8%) line when compared to chemotherapy (35.1% and 31.1% respectively). In 3rd line, chemotherapy was preferred (46.0%) over TKI only (38.0%) in these patients.ConclusionsOS for patients with advanced non-squamous NSCLC patients aligned with previous trials. EGFR + patients who received both TKI and chemotherapy had longer median OS, which is consistent with results from other trials.
WITHDRAWN: Long-term Elevated Siglec-10 in Cerebral Spinal Fluid Heralds Better Prognosis for Patients with Aneurysmal Subarachnoid Hemorrhage
Authors: Gao Sen , Peng Zheng , Chen Xiang-Xin , Liu Xun-Zhi , Wang Han , Lu Yue , Zhuang Zong , Hang Chun-Hua , Li Wei
Published: June 2020

Background
The presence of aneurysmal subarachnoid hemorrhage (aSAH) is usually accompanied by excessive inflammatory response leading to the destruction of central nervous system, while the sialic acid-binding Ig-like lectin 10 (Siglec-10) is a factor recognized as having the ability to modify the inflammatory microenvironment, indicating a potential protective effect in aSAH.
Methods
We collected the cerebrospinal fluid (CSF) of control group and aSAH patients at different time points, measured the Siglec-10 concentration by the enzyme-linked immunosorbent assay (ELISA), and evaluated the changes of Glasgow Outcome Scale (GOS) and Glasgow Coma Scale (GCS) in the disease progression.
Results
Our data showed that the Siglec-10 level in CSF could respond to aSAH and quickly rose to a peak, then fell back to a stable range slightly higher than the normal range. Severely impaired patients were likely to maintain high levels of Siglec-10 for longer periods. Generally, having high-level and long-term Siglec-10 indicated a better prognosis.
Conclusions
These results suggested that Siglec-10 could possibly reduce the degree of inflammatory response related to the damage-associated molecular patterns (DAMPs) by regulating the balance between pro-inflammatory and anti-inflammatory, thereby improving the patient's prognosis. These findings might provide new treatment perspectives for aSAH and other inflammation-related diseases.
A simple kinetic modelling of coronavirus infection in a system
Authors: NaaderAlizadeh
Published: June 2020

In this paper, provide an analysis of data on the characteristics of patients with confirmed COVID-19 infection throughout Iran and other countries such as China, S. Korea,USA, Italy, Spain, Germany, France, UK, Austria, and Argentina, and presented a kinetic modelling for prediction of infection, death, recovery and patients populations.The predict results of infection, death and recovery rate constants helps to interpret of public sentiment on disseminating related health information, and comparison different governments behavior to overcoming the outbreak of the coronavirus (COVID-19). Calculation results are in agreement with the census data of the coronavirus infection in many regions of the world.
The influence of laparoscopy-assisted gastrectomy versus open gastrectomy to long-term survival for early gastric cancer: an updated meta-analysis based on randomized controlled trials
Authors: Zhai Zhao , Lou Shenghan , Zhu Ziyu , Cong Xiliang , Gao Jialiang , Han Bangling , Yin Xin , Zhang Yu , Xue Yingwei
Published: June 2020

BackgroundThere is a controversy for the therapeutic effect of laparoscopy-assisted gastrectomy (LADG) and open gastrectomy for a long time. The meta-analysis in this article evaluates and compares the effectiveness of these two treatments to patients' long-term survival.MethodWe searched MEDLINE (PubMed), EMBASE (Ovid) and the Cochrane Library and identified all qualified researches from January 2002 to January 2020. The statistic analysis is performed by Revman 5.3 and Version 3 Comprehensive Meta-analysis. Through the results, we compared the advantages and long-term survival of LADG and ODG.ResultAccording to the result of 8 randomized controlled trials which involves 2650 patients with early gastric cancer, compared with ODG, LAGD has longer surgery time (MD=78.11，95%CI=59.14-97.07，P＜0.00001), less blood loss (MD=-100.59，95%CI=-127.71--73.46，P＜0.00001), a shorter incision (MD=-12.25，95%CI=-13.18--11.31，P＜0.00001), shorter time to start the first time of flatus (MD=-0.66，95%CI=-1.01--0.32，P=0.0001), shorter hospital stay (MD=-0.94，95%CI=-1.66--0.22，P=0.01), and lower frequency of analgesic utilization (MD=-1.69，95%CI=-2.18--1.21，P＜0.00001). However, there is no statistical difference between ODG and LAGD on the number of harvested lymph nodes, time of the first meal, short-term surgical complications, cancer recurrence rate, and long-term survival rate.ConclusionAccording to the result of meta-analysis, compared with ODG, LADG has a significant advantage in blood loss in surgery, early rehabilitation, scar development, management of postoperative pain, etc. Meanwhile, LADG and ODG have the same performance on long-term survival. Therefore, we believe LADG is a safe and effective replacement of ODG for early gastric cancer.
Modeling and Simulation to Improve the Efficiency of Transportation Systems: A Tool for Decision Support
Authors: Suryani Erma , Hendrawan Rully Agus , Adipraja Philip Faster Eka , Indraswari Rarasmaya , Ahyudanari Ervina , Jauhari Achmad , Prambayanto Prasetyo
Published: June 2020

The authors have withdrawn this preprint due to author disagreement.
Development and Validation of a Nomogram to Predict Deteriorating Trajectory in Patients with COVID-19 Infection: A Population-Based Prospective Study
Authors: Chen Wei , Zhu Menglin , Li Jian , Pan Cuiping , Zhao Demian , Jin Yuting , Li Manxiu , Wu Shun , Feng Yaojun , Wang Tiejun
Published: June 2020

Background Most of the patients with COVID-19 infection are mild to moderate initially. However, there is no effective prediction for the patients to develop into severe or extremely severe. This study aims to develop an effective clinical prediction model.Methods A single-center, retrospective, observational study conducted. A nomogram was conducted based on the results of multivariate logistic regression analysis. Results A total of 483 patients diagnosed mild to moderate were included, among these patients 62 developed severe or extremely critical illness. Seven variables including hyperlipidemia, vomiting, diarrhea, lymphocyte, imaging and mentality were associated with deteriorating trajectory. The ROC curve showed that model was robust, for which the area under the curve of the training set and the validation set are 0.873 and 0.813.Conclusions For patients with mild to moderate COVID-19 infection, nomogram score can effectively predict the possibility of patients developing into severe or extremely critical.
Comparison of sagittal spinopelvic parameters in different types of double-level degenerative lumbar spondylolisthesis: a retrospective study
Authors: zhang guangzhi , Deng Yajun , He Xuegang , Ren Enhui , Wu Zuolong , Yang Fengguang , Yang Liang , Ma Zhanjun , Gao Yichen , Guo Xudong , Wang Yidian , Liu Mingqiang , Zhu Daxue , Kang Xuewen
Published: June 2020

Background

Degenerative lumber spondylolisthesis (DLS), a common orthopaedic disease causing low back pain, seriously affects daily life and work. Although sagittal spinopelvic parameters have been studied in single-level DLS patients, investigations into different types of double-level DLS are scarce. This study aims to analyse the demographic and radiological parameters of patients with different types of double-level DLS and compare their differences to provide a reference for guiding surgical treatment and restoring sagittal balance of DLS patients.
Methods

From January 2014 to January 2020, double-level DLS patients’ records were retrospectively reviewed and divided into three types: anterior, posterior, and combined; the anterior and combined types were studied. Two spin surgeons measured the sagittal spinopelvic parameters: C7 tilt, maximal thoracic kyphosis (TKmax), maximal lumbar lordosis (LLmax), pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS). Following descriptive analysis, demographic and radiographic data were compared between the anterior and combined types.
Results

Patients in the anterior type group (n = 40) were older (67.68 ± 6.66 vs. 61.72 ± 10.06 years, P = 0.031), and the proportion of females were significantly higher (90% vs. 50%, P = 0.001) than the combined group (n = 18). Both groups had different levels of chronic lower back pain, but the incidence of radiating leg pain and neurogenic claudication was significantly higher in the anterior type. Owestry disability index and visual analogue scale lower back scores were also higher in the anterior type. In the anterior type, C7 tilt (7.14 ± 2.15 vs. 5.41 ± 2.28, P = 0.007), LLmax (50.02 ± 14.76 vs. 36.96 ± 14.56, P = 0.003), PI (68.28 ± 9.16 vs. 55.53 ± 14.19, P < 0.001), PT (28.68 ± 7.31 vs. 19.38 ± 4.70, P < 0.001), and PT/PI (42.45 ± 11.22 vs. 36.04 ± 9.87, P = 0.041) were significantly higher. In the anterior type, PI correlated significantly positively with LLmax (r = 0.59) and SS (r = 0.71). LLmax and SS (r = 0.65) had a positive correlation. PT/PI and SS (r = -0.77) had a negative correlation. In the combined type, PI correlated positively with LLmax (r = 0.61) and SS (r = 0.88), and PT/PI correlated negatively with SS (r = -0.81).
Conclusions

In patients with double-level DLS, the sagittal spinopelvic parameters differ between the anterior and combined types. PI and LLmax were significantly higher in the anterior type, resulting in compensation by forward flexion and pelvic retroversion. Spinal surgeons should focus on correcting sagittal deformities, relieving postoperative clinical symptoms, and improving quality of life during fusion surgery, which is proven to guarantee long-term surgical results.
Association between smoking and cancers among women: results from the FRiCaM multisite cohort study
Authors: Mezzoiuso Angelo Giosuè , Odone Anna , Signorelli Carlo , Russo Antonio Giampiero
Published: June 2020

BackgroundSmoking is one of the leading causes of death worldwide, and it is strongly associated with several human cancers. However, the differential effects of cigarette smoke on the development and progression of different types of cancer remain unclear, and related data are limited.MethodsIn this longitudinal cohort study conducted among 75,324 women aged 41–76 years, we aimed to evaluate the effect of exposure to tobacco smoke on cancer development. The participants completed a questionnaire assessing sociodemographic characteristics, anthropometric measures, health status, and lifestyle habits, including smoking and dietary habits; Cox proportional hazards regression modelling was used to evaluate the association between smoking and 21 different types of cancer.ResultsAfter a 15-year follow-up, 9,487 cases of cancer were identified through record linkage with the Cancer Registry of Milan. Smoking was found to be positively associated with all neoplasms, with a hazard ratio 1.10 (95% CI, 1.04–1.16); cancer of the oral cavity 2.63 (1.72–4.01]), oesophagus 3.09 (1.37–6.96), stomach 1.52 (1.10–2.11), pancreas 1.69 (1.29–2.21), larynx 34.81 (8.07-150.14), lung 8.48 (7.09–10.14), cervix uteri 2.51 (1.38–4.57), and bladder and urinary tract 5.67 ( 3.96–8.14); lymphoma 1.37 (1.03–1.83); and colorectal cancer 1.30 (1.11–1.51).ConclusionsOur results thus demonstrate how smoke exposure increases the risk of several types of cancer. Considering the increasing prevalence of smoking among women, our results highlight the need to prioritize the development of anti-smoking campaigns targeted at women in order to contrast the evident gender inequality with respect to healthcare.
A Preliminary Study on the Utility of Root® with SedLine® for Sleep Evaluation in Critically Ill Patients: Comparison With Polysomnography and the Richards−Campbell Sleep Questionnaire
Authors: Nagatomo Kanae , Sanui Masamitsu , Masuyama Tomoyuki , Iizuka Yusuke , Makino Jun , Shiotsuka Junji
Published: June 2020

Background To date, there has not been a practical evaluation of patient sleep in critical care units, where sleep disturbance is commonly found. This study aimed to validateฎ a portable electroencephalography monitor, as a sleep monitoring device, against polysomnography (PSG) for objective sleep evaluation and the Richards − Campbell Sleep Questionnaire (RCSQ) for subjective sleep quality in critically ill patients.Methods In this observational study, the sleep pattern of 10 adult patients staying in an ICU for at least 72 hours was evaluated for 24 hours using PSG and the Patient State Index (PSI) from SedLine. Additionally, their nighttime sleep was subjectively scored using the RCSQ to compare with the objective parameters.Results Sleep architecture from PSG showed an increase in light sleep and a prominent decrease in restorative sleep, despite preserved quantity of nocturnal sleep. Based on PSG results, PSI was distributed in accordance with sleep depth. Subjective quality of nocturnal sleep from the RCSQ was correlated with the PSI (r = -0.816, 95% confidence interval [CI]: -0.955 to -0.383), as well as with the nighttime stage N2 ratio from PSG alone (r = 0.741, 95% CI: 0.209 to 0.935) or combined with restorative sleep (r = 0.801, 95% CI: 0.347 to 0.951). The cutoff value of PSI to distinguish between the stage N1 and N2 was 67.0 (specificity, 0.641; sensitivity, 0.845 with area under curve [AUC] of 0.818).Conclusion SedLine is considered a feasible and valid instrument for sleep quality assessment in ICU patients.Trial registration: This investigation was part of an interventional trial registered with the University Hospital Medical Information Network Individual Clinical Trials Registry (UMIN-CTR000026350, http://www.umin.ac.jp/icdr/index-j.html) on March 1, 2017.
Technical Efficiency and Productivity of Tobacco Control Policies in 16 Selected OECD Countries: A Comparative Study Using Data Envelopment Analysis, 2008-2014
Authors: Lari Majid Safaei , Raei Behzad , Tehrani Pedram Nourizadeh , Takian Amirhossein
Published: June 2020

Background: To date, there is no synthesized evidence about the technical efficiency (TE) of cross-country tobacco control policies. This study aims to measure the efficiency and productivity of tobacco control policies across 16 selected countries of Organization for Economic Co-operation and Development (OECD) from 2008 to 2014.Method: We used data envelopment analysis (DEA). MPOWER is an acronym for a WHO proposed package consisting of six tobacco reduction interventions that can be adapted to present a commitment of the parties to a treaty labeled FCTC (Framework Convention on Tobacco Control).Taxation on tobacco products and pictorial warning labels were chosen as the inputs. Percentage of daily smokers’ population above 15 years old and the number of cigarettes used per smoker per day were output variables. Additionally, the Malmquist total factor productivity (TFP) was used to analyze the panel data and measure productivity change and technical efficiency changes over time.Results: The highest TE score (1.05) was attributed to Norway and the lowest (0.9175) belonged to the United Kingdom (UK). Technological change with a total average of 1.069 would imply that the technology and creativity have increased, while countries have been able to promote their creativity over the time period. Norway with the TFP score of 1.15 was the most productive country, while the UK and Turkey with the TFP scores of 0.95 and .098 respectively, were the least productive countries in the implementation of the MPOWER policies.Conclusion: Most OECD countries have productively implemented MPOWER policies. Such productive performances are the results of the strong pivotal pictorial warnings. Consequently, the policy of plain packaging seems to hamper the MPOWER policies. Taxation on tobacco products were relatively weak and inefficient.
Regulation on BCAAs catabolism pathway plays the key role in cyclophosphamide-induced leucopenia BALB/c mice after the treatment of a typical Traditional Chinese Medicine of Lvjiao Buxue Granules
Authors: Tian Jun-sheng , Zhao Hui-liang , Wang Qi , Xiang Huan , Xu Xiang-ping , Huang Sheng , Yan Dong-lan , Qin Xue-mei
Published: June 2020

Background: Cyclophosphamide is a common tumor chemotherapy drug used to treat various cancers, but the resulting immunosuppression leads to leukopenia, which is a serious limiting factor in clinical application. Therefore, the introduction of immunomodulators as adjuvant therapy may help to reduce the hematological side effects of cyclophosphamide. Lvjiao Buxue Granules has been widely used in clinical treatment of gynecological diseases such as anemia and irregular menstruation, and recently, it has been found to increase the role of white blood cells, but its mechanism of action is still unclear. In this research, we applied the 1H-NMR metabolomics approach to characterize metabolites in cyclophosphamide-induced leucopenia mice spleen, so as to fully understand the metabolic processes of leucopenia and improve the leukocyte function of Lvjiao Buxue Granules.Methods: Cyclophosphamide was used to establish the leucopenia mice with cancer chemotherapy and the content of white blood cells, red blood cells, hemoglobin, platelets, and other routine blood indexes were measured. The changes of endogenous metabolites in spleen analyzed by 1H-NMR metabolomics technique were investigated the regulation effect of LBG in mice with leukopenia. Afterward, the chemical components-targets-differential metabolites network of Lvjiao Buxue Granules was constructed by the use of biological targets network, thus leucopenia-relevant metabolism pathways were dissected. Results: The blood routine parameters and organ indexes levels of leucopenia mice with cancer chemotherapy were improved by Lvjiao Buxue Granules. The metabolomic study revealed that 15 endogenous metabolites in mice spleen were considered as potential biomarkers of Lvjiao Buxue Granules for its protective effect. Integrated analysis of metabolomics and biological targets network indicated that Lvjiao Buxue Granules exerted the leukocyte elevation activity by inhibiting the branched-chain amino acids (BCAAs) degradation pathway and increasing the levels of valine, leucine and isoleucine. Conclusion: Lvjiao Buxue Granules exert obvious efficacy on the mice model of leucopenia, which could be improved by regulating the branched-chain amino acid degradation pathway and the levels of valine, leucine and isoleucine.
Cementless total hip arthroplasty for failed treatment of subtrochanteric fracture
Authors: Jin Sheng-Yu , Jin Jing-Yao , Kim Woo-Jong , Yoon Taek-Rim , Park Kyung-Soon
Published: June 2020

Background Failed treatment of subtrochanteric fractures commonly leads to pain, limping, and poor function. Cementless total hip arthroplasty (THA) could be an option as a salvage procedure in such cases. This study was to evaluate the clinical and radiological results and complications of this treatment in our hospital. Method Eighteen cementless THAs for failed treatment of subtrochanteric fractures were performed at our institution between January 2001 to December 2017. There were eleven males and seven females, and the average age was 74 years (range 57.0-89.0). Eight patients were previously operated with an intramedullary nail, six patients were treated with a dynamic hip screw, two patients were treated with an angled blade plate, one patient was treated with a proximal femur locking plate, and one patient was treated with a dynamic compression plate. Results The mean follow-up was 5.2 years (range 2.2-10.8). The mean duration of the operation was 98.0 minutes (standard deviation [SD],15.4; range 70-135). The mean total blood loss was 992.2 mL (SD,171.2; range 640-1260 mL), and the amount of transfusion was 2.2 units (SD, 0.8, range 1-4). The mean Harris hip score (HHS) was 38.2 (SD, 9.3; range, 24-56) preoperatively and 85.4 (SD, 4.9; range, 79-92) at the last follow-up. Compared to the patients treated with plate-screws, those treated with an intramedullary nail had significantly shorter surgical duration, fewer blood transfusions, and less intraoperative blood loss. Kaplan-Meier survivorship with an endpoint of revision was 94.4% (95% confidence interval 72.7-99.9) at five years. Conclusion Cementless THA is one of the acceptable procedures for failed treatment of the subtrochanteric fracture with fewer complications.
Determinants of Private Investment Contracts in the Basic Sanitation Sector: Evidence for Developing Countries
Authors: Borges Dianifer Leal , Fernandez Rodrigo Nobre , Shikida Cláudio Djissey , Costa Luciana de Andrade
Published: June 2020

Investment in infrastructure is a key factor for improving the quality of life of the population and, consequently, for the economic development of nations. In this context, the universalization of water and sanitation services is of great importance due mainly to their impact on public health. Based on the work of Yehoue et al. (2006) and Sharma (2012), this article studies the determinants of the number of private investment contracts for the basic sanitation sector. In the empirical analysis, with a panel of developing countries during the years 2003-2016, we use the following counting estimators to study the number of contracts in the sector: Negative, Poisson, Negative Binomial, and Zero Inflated negative binomial with corrected Vuong (ZINBCV). The results show that the channels of the macroeconomic environment, foreign investment and the political environment are the main determinants in the formulation of new contracts in the basic sanitation sector.
Effects of Preoperative Oral Carbohydrate on Cirrhotic Patients Under Endoscopic Therapy with Anesthesia: A Randomized Controlled Trial
Authors: Wang Yan , Tu Yichun , Liu Zhenglv , Li Hui , Chen Hongtan , Cheng Baoli , Fang Xiangming
Published: June 2020

Background: Preoperative fasting is a major cause of perioperative discomfort in patients. Addressing this problem by preoperative oral carbohydrate (POC) has been recommended as an important element of the enhanced recovery after surgery (ERAS) protocol, but its effect on cirrhotic patients who tend to show abnormalities in gastric emptying function has not yet been clarified. Our study aims to investigate the influence of POC on gastric empting and preoperative well-being in cirrhotic patients. Methods: A prospective, randomized and controlled study of cirrhotic patients with gastroesophageal varices scheduled for elective endoscopic therapy under intravenous anesthesia was conducted. 180 patients were enrolled in this study. Patients were divided into three groups: those not supplement with carbohydrate for 8h prior to endoscopic therapy (Control group), those given a carbohydrate beverage 2h (2h group) or 4h (4h group) prior to endoscopy. Gastric emptying was evaluated by gastric sonography score and collecting gastric content aspirated endoscopically before anesthesia. Stresses caused by examination associated fasting were evaluated by visual analogue scale (VAS) scores for six parameters (thirst, hunger, mouth dryness, nausea, vomit and weakness) preoperatively. Hemodynamic changes, peristole and postoperative complications were also recorded. Results: Before anesthesia, gastric sonography score was similar among three groups. In addition, no patient had residual gastric volume more than 1.5ml/kg in control and 4h group, but six patients (11%) reached a residual gastric volume of more than 1.5ml/kg in 2h group. Moreover, compared with control fasting, VAS scores for six parameters (thirst, hunger, mouth dryness, nausea, vomiting and fatigue) in 2h group and for three parameters (thirst, hunger and mouth dryness) in 4h group were both significantly lower. Gastric peristaltic score and operation score before operation, postoperative complication, lengths of hospital stay and in-hospital expense were not significantly different among three groups.Conclusions: For the first time, we demonstrate that avoiding preoperative fasting with oral carbohydrates given 4h prior to anesthesia can improve preoperative well-being feelings, without enhancing the risk of aspiration and regurgitation in cirrhotic patients. Our study adds knowledge for preoperative fasting guidelines in anesthesia for cirrhotic patients. Trial registration: This trial was registered at Clinicaltrials.gov under the number ChiCTR2000032394.
Caring For Children With Congenital Heart Diseases: Economic Burden Of Pre-Surgical Treatment On Nigerian Families
Authors: Duru Chika Onyinyechi , OKPOKOWURUK Frances SAM , ADESINA ADEDOTUN DANIEL DANIEL , WORGU GLORY OVUNDA , ADENIJI FOLUKE OLUKEMI , Aliyu Ibrahim
Published: June 2020

Background Congenital Heart Disease (CHD) places an enormous economic burden on families of affected children in Nigeria. This study sought to determine the healthcare costs of pre-surgical management of CHD and describe its effects on the family’s income.Methods Using a semi-structured interviewer-administered questionnaire, family income, type of CHD, co-morbidity, healthcare payment mechanism and healthcare cost were investigated among 121 families with CHD children. Indicators of Catastrophic Health Expenditure (CHE); healthcare spending in excess of 10% family income were calculated. Factors associated with increased healthcare spending in CHD management were explored using the Kruskal Wallis test of significance.Results Of the 121 parents interviewed, about 80% paid for healthcare using out-of-pocket payment mechanism. Mean annual total cost of healthcare was ₦87,951± ₦120,213 ($244.31± $333.92) with direct medical care accounting for 81.0% of this total annual cost. Mean annual consultation, medication, investigation and admission cost were ₦5,515 ($15.32), ₦57,882 ($160.78), ₦30,462 ($84.62) and ₦87,789 ($243.86) respectively. Mean estimated annual indirect cost was ₦19,233 ± ₦31,722 ($53.42 ± $88.12). Incidence of CHE was 35.5% while catastrophic overshoot and mean positive overshoot attributable to CHD healthcare cost were 6.5% and 32.9% of family income respectively. Healthcare cost was significantly higher in families of children with co-morbidities (p = 0.016) and those who suffered financial catastrophe (p = 0.001). Health insurance did not significantly reduce healthcare spending among the insured.Conclusion The economic burden of pre-surgical management of children with CHD is high in Nigeria. There is the need to scale up the inclusion of CHD under the National health insurance scheme.
Investigating occupational stress of disaster and emergency medical management center 115 and the role of demographic variables
Authors: lebni Javad Yoosefi , Gheshlaghi Parvin Abdi , Toghroli Razie , Garosi Vahid Hatami , Abbas Jaffar , Kalhori Reza Pourmirza , Salahshoor Mohammad Reza , Kianipour Neda , Tharwani Munira , ziapour arash
Published: June 2020

Background: The first and one of the most important chains of providing care to patients is pre-hospital emergency medical services. Personnel employed in this sector are at risk of occupational stress due to the nature of their job which can affect their health and quality of services provided to patients. Therefore, the present study was conducted to investigate the occupational stress of the personnel of disaster and emergency medical management center 115 and the role of demographic variables in 2019.Methods: This is a descriptive-analytical study. 200 medical emergency personnel of Kermanshah province were selected through stratified sampling and according to inclusion criteria. A two-part questionnaire including demographic information and HSE standard questionnaire were used for collecting data. Finally, descriptive and inferential statistics (t-test and one-way ANOVA) were used for data analysis. Significance level was considered P<0.05. Results: The mean score of total occupational stress was 3.41±0.26. The highest and the lowest stress levels related to the role dimensions was calculated (4.34±0.35) and changes (2.72±0.86). There was a significant relationship between stress level with age, marital status, educational level, type of base of work place and hours of work per month, while there was no relationship between type of employment and work experience with stress level. Conclusion: Emergency medical personnel experience a high level of occupational stress. Senior managers can use the results of similar studies to think measures to reduce the experience of employees' stress.
Degenerative knee osteoarthritis animal model and changes in intraosseous pressure during pathological processes
Authors: Wang Shuo , Du Yu-ren , Ma Jian-xiong , Xue Yuan , Liu Wei , Huang Hong-chao , Zhang Lei , Ma Xin-long
Published: June 2020

Background Degenerative knee osteoarthritis (KOA) is a common clinical disease which affecting patients' quality of life. However, there is currently no standard animal model for KOA research. The purpose of this study was to find a reasonable age range of animal model for the studying of KOA pathological process, and to investigate Intraosseous pressure (IOP) in the process during different degeneration stages of KOA. Methods Male Dunkin-Hartley guinea pigs were selected and divided into groups of 3, 6, 9, 12, 18 months old by age, 10 in each group. All knees underwent imaging examination including X-ray, Micro CT and MRI. Observed the imaging findings with the use of Kellgren-Lawrence (K-L) classification and knee osteoarthritis MRI scores. Measured the IOP of distal femur and proximal tibia in each group, and observed the differences of bilateral tibiofemoral articular cartilage in histological and immunohistochemistry, staining results were evaluated by using Mankin’s score. Using one-way ANOVA and T-test were used to compare the differences indicators between groups. Results With the increase of age, changes in X-ray, Micro-CT and MRI imaging findings and pathological staining results of articular cartilage in all stages were consistent with the changing of degenerative KOA process. The IOP of distal femur and proximal tibia increased gradually with age, and reached its peak in 12-month age group, and then gradually decreased, there was a statistically significant difference of IOP between each group (femur side: F=8.261, P=0.000; tibial side: F=8.469, P=0.000). The IOP of the distal femur was slightly higher than that of proximal tibia, but the difference was not statistically significant (P>0.05). Conclusions Dunkin-Hartley guinea pig can be used as an animal model to study different pathological stages of KOA. And there might be a correlation between the changes of IOP and the pathological progress of articular cartilage and subchondral bone in distal femur and proximal tibia.
Secular Change of Interdependencies in the Japanese Motor Vehicle Industry between Aichi and Other Regions: Analysis using Chubu-region Multi-regional Input-Output Table and Hypothetical Extraction Method
Authors: KIMURA Shinichiro
Published: June 2020

The authors have requested that this preprint be removed from Research Square.
Involvement of Final year Medical Students in Hospital work during COVID-19 pandemic: A students’ perspective
Authors: Rawat Priya , Joshi Chitra , Joshi Anil Kumar , Sayana Ashutosh , Bisht Yamini , Joshi Shreya
Published: June 2020

Background: The Coronavirus disease (COVID-19) has upended medical education. This pandemic has risen uncertainty over the start of the normal routine of studies in medical universities. Amidst the worldwide shortage of doctors, there is widespread dilemma and disagreement regarding the role of the medical students during this pandemic. Medical education is suspended and the students are barred from being direct medical providers unless there is a critical need for the additional healthcare workforce. Considering these facts we have done a survey amongst medical students of pre-final and final year to know and evaluate their opinion and outlook regarding their involvement in the hospital work at the time of the ongoing COVID 19 pandemic. Materials and Method: This is a cross-sectional study among the clinic going medical students of Government Doon Medical College Dehradun, India. It is used to know their opinion regarding their voluntary initiative to actively participate and usefulness in the hospital works while going through their classes and hospital postings. We have circulated a questionnaire among 385 medical students to know their mindset and formulate a plan to include them in the future clinical hospital works in case the pandemic situation worsens.Statistical analysis is performed using SPSS version 25. Chi-square test was used to evaluate the association between the two variables. A two-tailed p < 0.05 was considered statistically significant. Results: Out of 294 respondents 62.2% had a high motivation to work in the hospital. This was synergized by the worldwide appreciation of doctors according to 88.8% of students. A sense of duty towards the patients was clear by the responses which surpassed the fear of the disease and the belief of being a better doctor (94.2%). Conclusion: The majority of medical students were highly motivated to be a part of the hospital workforce and help to fight this apocalyptic pandemic.
NEB mutation is associated with high mutational burden and worse colorectal-cancer survival
Authors: Xu Mingyue , Yuan Lijun , Wang Yan , Chen Shuo , Zhang Lin , Zhang Xipeng
Published: June 2020

Background: Nebulin (NEB) as a protein-coding gene have been well demonstrated its vital roles in skeletal muscles but no study for association between NEB mutation and cancer.Methods: Here, we systematically analyzed mutation spectrum of colorectal cancer (CRC) samples and associations between NEB somatic mutation and CRC patients' tumor mutation burden (TMB) and prognosis by using TCGA-COAD project mutation dataset.Results: Mutational signatures detected from CRC samples indicated pivotal roles of defective DNA damage repair process and polymerase activity in CRC initiation. NEB somatic mutation was found in about 16% CRC patients. Besides, NEB mutation was identified as an independent factor for high CRC TMB and inferior prognosis. Significantly mutated gene (SMG) analysis identified several genes including RNF43, SETD1B, MBD6 and so on, whose mutation states were profoundly influenced by NEB mutation and might be tumor driver genes in CRC initiation and progression.Conclusions: In conclusion, NEB might be a novel CRC-related genes that could affect patients' prognosis by perturbing genome instability.
Sunlight and vitamin D in the prevention of coronavirus disease (COVID-19) infection and mortality in the United States
Authors: Li Yajia , Li Qiangxiang , Zhang Ning , Liu Zhenhua
Published: June 2020

The coronavirus disease (COVID-19) is an infectious disease caused by the most recently discovered coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study aims to investigate associations between sunlight and vitamin D, using latitude as an indicator, with COVID-19 cases and related deaths in the United States. General regression and Chi-square test were used to examine the associations between latitude and COVID-19 cases and deaths. The analyses indicated that latitudes were marginally associated with cases (p = 0.0792) and deaths (p = 0.0599), with an increase of 2491 cases and 189 deaths of the total numbers in the mainland of US for every unit of increase of the latitude. When the states were classified into high latitude (>N 370) and low latitude (<N 370) groups, both the cases (702 vs 255 cases/100k population) and deaths (43 vs 11 deaths/100k population) were significantly different (p < 0.001) between the two categories. The results suggested that sunlight and vitamin D, with latitude as an indicator, might be associated with decreased risks for both COVID-19 cases and deaths. These findings warranted urgent needs of large cohort, clinical and pre-clinical studies to assess the impact of VD on the prevention of COVID-19.
Understanding the COVID19 infection curves -- finding the right numbers
Authors: Anghel Dragos-Victor , Anghel Ioan Tudor Alexandru
Published: June 2020

We analyze the evolution of the COVID19 pandemics and show that the basic compartmental SIR model cannot explain the data, some characteristic time series being by more than an order of magnitude different from the fit function over significant parts of the documented time interval. To correct this large discrepancy, we amend the SIR model by assuming that there is a relatively large population that was infected but was not tested and confirmed. This assumption qualitatively changes the fitting possibilities of the model and, despite its simplicity, in most cases, all the time series can be quite well reproduced. Nevertheless, in some cases (i.e., countries or regions) the estimated susceptible population decreases too fast. In such a case, the observed dynamic is only due to the transitions between the two infected compartments--the confirmed infected and the unconfirmed infected--and the rate of closing the cases (by recovery or death) in the confirmed infected compartment. Our analysis proves that the number of infected people is significantly larger than the one recorded and we provide a method to estimate it. We also discuss some relevant extensions of this model, to improve the interpretation and the fitting of the data.
A web survey to assess the perceived mental healthcare among Medical Imaging Professionals during COVID-19 pandemic
Authors: Kotian Rahul P , Faujdar Disha , D'souza Brayal , Kotian Sneha P , Kunaparaju Sindhura , David Leena R
Published: June 2020

Importance: Medical Imaging Professionals (MIP’s) providing imaging services exposed to coronavirus disease 2019 (COVID-19) could be psychologically stressed.Objective: To assess the magnitude of the perceived mental health outcomes among MIP’s providing imaging services to patients exposed to COVID-19. We examined the psychological stress, depression and anxiety, experienced by MIP’s in the midst of the outbreak. Background: During the first week of March,2020 the surge of coronavirus disease (COVID-19) cases reached all over the globe with more than 150,000 cases. Healthcare national and international authorities have already initiated awareness and lockdown activities. Design, Settings, and Participants: This cross-sectional, web survey-based study collected demographic data and mental health measurements from 250 MIP’s from April 29, 2020, to May 15, 2020. MIP’s working during the pandemic in hospitals for patients with COVID-19 were eligible. An online sample of MIPs was successfully recruited via the authors' networks in India using data collection tool – write google forms. A DASS21 online questionnaire was completed by the participants and then their mental health was assessed.Results: Of 400 invited MIP’s, 314 (78.5%) participated in the study; and 187 (59.5%)were included as per inclusion criteria. Hundred and three (55.08%) participants screened positive for depression, 105 (56.14%) for anxiety, and 80 (42.78%) for stress. However, 25 (13.36%), 18 (9.62%) and 16 (8.55%) screened positive for extremely severe for depression, anxiety and stress respectively.Conclusion and Relevance: In this web survey of MIP’s during COVID-19 pandemic, participants reported experiencing high rates of psychological depression, anxiety and stress, especially frontline MIP’s directly engaged in the imaging procedures for patients with COVID-19.
Engineering mesenchymal stem cells with neutralizing and anti- inflammation dual-capability against SARS-CoV-2 infection
Authors: Zhang Xiaoqing , Han Ping , Wang Haiyong , Xu Yanqin , Li Fanlin , Li Min , Fan Lilv , Zhang Huihui , Dai Qiang , Lin Hao , Qi Xinyue , Liang Jie , Wang Xin , Yang Xuanming
Published: June 2020

The emergence of the novel human coronavirus SARS-CoV-2 has caused a worldwide epidemic of coronavirus disease 2019 (COVID-19), which markedly affected the global health and economy. Both uncontrolled viral replication and proinflammatory cytokine storm can cause severe tissue damage in COVID-19 patients. SARS-CoV-2 utilizes angiotensin-converting enzyme 2 (ACE2) as its entry receptor. In this study, we generated ACE2 extracellular domain-Fc and scFv-IL6R-Fc fusion protein to differentially neutralize virus and temper cytokine storm. The hACE21-740-Fc fusion protein showed potent inhibitory effect on pseudotyped SARS-CoV-2 entry and good safety profile in mice. The scFv-IL6R-Fc showed strong blockade effect on IL-6 signal activation. In addition, we established a mesenchymal stem cells (MSCs)-based hACE21-740-Fc and scFv-IL6R-Fc delivery strategy, which provided a potential rapid option for urgent clinic therapeutic need of COVID-19 patients.
Ferromagnetism of LaCoO$_3$ films
Authors: Sotnikov Andrii , Ahn Kyo-Hoon , Kuneš Jan
Published: June 2020

We study ferromagnetic ordering and microscopic inhomogeneity in
tensile strained LaCoO_33
using numerical simulations. We argue that both phenomena originate from
effective superexchange interactions between atoms in the high-spin (HS)
state mediated by the intermediate-spin excitations. We derive a model
of the HS excitation as a bare atomic state dressed by electron and
electron-hole fluctuations on the neighbor atoms. We construct a series
of approximations to account for electron correlation effects
responsible for HS fluctuations and magnetic exchange. The obtained
amplitudes and directional dependence of magnetic couplings between the
“dressed” HS states show a qualitative agreement with experimental
observations and provide a new physical picture of
LaCoO_33
films.
$\mathcal{N}=2$ minimal models: A holographic needle in a symmetric orbifold haystack
Authors: Belin Alexandre , Benjamin Nathan , Castro Alejandra , Harrison Sarah M. , Keller Christoph
Published: June 2020

We explore large-NN
symmetric orbifolds of the \mathcal N=2𝒩=2
minimal models, and find evidence that their moduli spaces each contain
a supergravity point. We identify single-trace exactly marginal
operators that deform them away from the symmetric orbifold locus. We
also show that their elliptic genera exhibit slow growth consistent with
supergravity spectra in AdS_33.
We thus propose an infinite family of new holographic CFTs.
Исследование влияния буферного слоя на поверхности подложки и среды процесса на особенности формирования нанокластеров в структуре Si1 – xGex
Authors: Строгова А. С. , Ковалевский А. А.
Published: June 2020

Представлены экспериментальные результаты влияния исходного буферного слоя на поверхности подложки и среды процесса на возможность и особенности формирования нанокластеров Si1 –xGex(Si, Ge и SiGe). Предложен механизм формирования кремниевых, германиевых и кремний-германиевых нанокластеров (НК) на буферных слоях аморфного кремния, нитрида кремния и оксидов кремния, диспрозия и иттрия. Показано влияние исходного буферного слоя на поверхности подложек в условиях технологического процесса осаждения пленок наноструктурированного кремния, легированного германием (НСК(Ge)), на конфигурацию, размеры и поверхностную концентрацию НК.
Проникновение противоопухолевых нуклеотид-актиномициновых нанокомплексов в тимоциты
Authors: Дойникова А. Н. , Кучин А. В. , Векшин Н. Л.
Published: June 2020

С помощью спектрофотометрии, спектрофлуориметрии, ИК-спектроскопии и квазитемнопольной и флуоресцентной микроскопии изучены условия проникновения гетероциклического противоопухолевого антибиотика актиномицина Д (АМД) и его флуоресцирующего производного 7-амино-актиномицина Д (7ААМД) в Т-лимфоциты (тимоциты) из тимуса молодых крыс. Выявлено, что сами по себе АМД и 7ААМД плохо проникают в тимоциты. Следовательно, при использовании в качестве лекарственных средств они не подавляют клеточный иммунитет, необходимый для защиты организма от онкологии. Проникновение АМД и 7ААМД в тимоциты усиливается при повышенной концентрации антибиотика и увеличении длительности инкубации клеток при 37°С. При добавлении НАД (никотинамидадениндинуклеотида), АМФ (аденозинмонофосфата), ГМФ (гуанозинмонофосфата) и других нуклеотидных аналогов, способных образовывать нанокомплексы с антибиотиком, вхождение АМД и 7ААМД в тимоциты заметно возрастает. Поэтому лечение онкологических заболеваний актиномициновыми антибиотиками нельзя проводить на фоне высоких концентраций указанных веществ. С другой стороны, полученные результаты по усиленному вхождению антибиотика в присутствии нуклеотидных аналогов означают, что в их присутствии терапевтическую концентрацию антибиотика можно снизить. Эти данные могут быть использованы при лечении лимфом, лейкозов и других онкологических заболеваний. В этом случае применение НАД и других нуклеотидных аналогов будет полезным. Процент погибших клеток, определяемый по окрашиванию трипановым синим, особенно сильно возрастает при применении НАД.
Синтез и свойства композитов на основе гидроксиапатита, магнитита и 2-ариламинопиримидина
Authors: Игнатович Ж. В. , Новик Х. А. , Абакшонок А. В. , Королева Е. В. , Шумская Е. Е. , Канюков Е. Ю.
Published: June 2020

Продемонстрирована методика одностадийного синтеза магнитного нанокомпозита на базе гидроксиапатита и оксида железа с использованием модифицированного метода стехиометрического титрования. Показана возможность модификации предложенной методики для одностадийного синтеза магнитного нанокомпозита с присоединенным биологически активным соединением (БАС) 2-ариламинопиримидинового ряда. Проведено изучение состава, морфологии, структурных особенностей и магнитных характеристик нанокомпозита, синтезированного с БАС и без него. Изучена кинетика высвобождения БАС в растворе, моделирующем среду желудка. Полученный композит перспективен для биомедицинских применений в качестве инструмента для адресной доставки лекарств.