bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of the Sagittal Cobb* Angle to Guide the Rod Bending in the Treatment of Thoracolumbar Fractures：A Retrospective Clinical Study
Authors: Shi Zongpo , Wang Gang , Jin Zhen , Wu Tao , Wang Haoran , Sun Jinpeng , Nicolas Yap San Min , Rupesh KC , Yang Kaixiang , Liu Jun
Published: August 2020

Background: Pedicle screw fixation is a well-established technique for thoracolumbar fracture. A large number of studies have shown that the bending angle of the connecting rod has a significant correlation with the postoperative spinal stability. However, no studies have confirmed an objective indicator to guide the bending angle of the connecting rod during the operation. Our study aims to define a sagittal Cobb* angle to guide the bending angle of the connecting rod during surgery.Methods: The frontal and lateral X-ray films in 150 cases of normal thoracolumbar spine were included to measure the normal spinal sagittal Cobb* angle in each segment. The patients who underwent single segment thoracolumbar fractures and pedicle screw internal fixation surgery were included. The radiological parameters included lumbar lordosis (LL), thoracic kyphosis (TK), pelvic tilt (PT), pelvic incidence (PI) and sacral slope (SS) were measured. The incidence of adjacent segment degeneration（ASD）two years after surgery were measured.Results: The average values of normal sagittal Cobb* angle in each segment were -5.196±3.318 degrees (T12), 2.279±3.324 degrees (L1), 7.222±2.798 degrees (L2) and 12.417±11.962 degrees (L3) respectively. The LL in the three groups was 35.20±9.12 degrees，46.26±9.68 degrees and 54.24±15.3 degrees, respectively. Comparing with the normal group, there were significant differences in group A and group C respectively (P< 0.05). The results were similar in the parameters of TL, PT and SS. The incidences of SVA>50mm in group A, group B and group C were 23.33%,12.50% and 19.23%, respectively. The parameter of PI in three groups were 41.36±12.69, 44.53±15.27 and 43.38±9.85 degrees，respectively. The incidences of ASD in group A, group B and group C 2 years after surgery were 21.67%，13.75% and 17.95%, respectively.Conclusions: The study confirmed that the sagittal Cobb* angle can be used as a reference angle for bending rods. When the bending angle of the connecting rod is 4 to 8 degrees greater than the corresponding segment sagittal Cobb* angle, the patient's spinal sagittal stability is the best two years after the operation.
Radiographic and Clinical Evidence: Osteoarthritic Knee Can Change Surgical Result for Lumbar Degenerative Disease Patient Undergone Surgery for 3-year Follow-up: A Retrospective Comparative Clinical Study
Authors: Kim Yong-Chan , Kim Ki-Tack , Ha Kee-Yong , Ahn Joonghyun , Ko Seungnam , Luo Qiang , Kim Sung-Min , Kim Mingyu , Yoo Sunin
Published: August 2020

Background: There is a paucity of reports clarifying the implication of knee osteoarthritis (OA) on spinal sagittal alignment of patients undergone surgery for lumbar spine. This study aimed to analyze how osteoarthritic knee affects radiographic and clinical results of degenerative lumbar disease patients undergone lumbar fusion.Methods: We retrospectively reviewed the medical records and radiographs of 74 consecutive degenerative lumbar disease patients who underwent posterior instrumentation and fusion surgery between May 2016 and June 2017 and were followed up for minimum 3 years postoperatively. The patients were divided into 2 groups according to the severity of knee OA by Kellgren-Lawrence grading (KLG) scale (group I, KLG 1 or 2 [n=39]; group II, KLG 3 or 4 [n=35]). Patient demographic data, comorbidities, spinal sagittal parameters and clinical scores were extracted and compared at preoperative, postoperative 1 month and the ultimate follow-up between the groups. In radiographic assessment, sagittal alignment parameters and sagittal balance were used. In clinical assessment, the scores of Oswestry disability index (ODI) and Scoliosis Research Society questionnaire (SRS-22) were used. For the frequency analysis of categorical variables across the groups, chi-square test was used and student t tests was used to assess the differences of continuous variables.Results: In radiographic assessment, TLK(thoracolumbar kyphosis), LL(lumbar lordosis), PT(pelvic tilt), C7 SVA(sagittal vertical axis) in both groups improved significantly after surgery(p<0.05). However, LL, PT, C7SVA improved at postoperative 1 month in the group II were not maintained at the ultimate postoperative follow-up. In clinical assessment, preoperative Oswestry disability index (ODI, %) and all SRS-22 subscores of the group I and II were not different (p>0.05). There were significant differences between the groups at the ultimate follow-up in ODI (-25.6 vs -12.1, p<0.001), SRS total score (%) (28 vs 20, p=0.037), function subscore (1.4 vs 0.7, p=0.016), and satisfaction subscore (1.6 vs 0.6, p<0.001).Conclusion: Osteoarthritic knee with KLG 3 or 4 have a negative influence on maintaining postoperative spinal sagittal alignment, balance, and the clinical outcomes achieved immediately by posterior instrumentation and fusion for lumbar degenerative disease.Trial registration: This study was retrospectively registered with approval by the institutional review board(IRB) of our institution(approval number: 2018-11-007).
Correlation Study Between Preoperative Ultrasonic Features of Medullary Thyroid Carcinoma and Postoperative Recurrence
Authors: Zhu Qiaodan , Xu Dong
Published: August 2020

Background: To investigate factors that affects postoperative recurrence in medullary thyroid carcinoma (MTC) patients in terms of preoperative ultrasonic characteristics and so on. Method: A retrospective analysis of 74 MTC patients who underwent the first thyroid surgery from 2009 to 2018 at hospital and had complete follow-up information. According to the follow-up results, these patients were divided into recurrence group (17 cases) and non-recurrence group (57 cases). The preoperative ultrasound characteristics, preoperative and postoperative calcitonin level, and general information of the two groups were recorded separately. Univariate and multivariate analysis was performed. Results: Single factor KM analysis showed that: ①Preoperative ultrasonic characteristic of tumor size> 40.0 mm, capsular invasion, and abnormal cervical lymph node ,as well as preoperative calcitonin level > 565.8pg / ml, postoperative calcitonin (within one week) level > 45.0pg / ml are the factors that affect postoperative recurrence of MTC (P <0.05); ②There is no evidence shows that gender and age have statistical significance with postoperative recurrence of MTC patients (P> 0.05). Multi-factor COX regression analysis showed that abnormal cervical lymph node （HR=5.368,95%CI1.063-27.104，P=0.042）is an independent risk factor affecting postoperative recurrence of MTC patients. Conclusions: MTC patients with abnormal cervical lymph nodes prone to postoperative recurrence. In addition, MTC patients with tumor> 40.0mm, capsular invasion, preoperative calcitonin level > 565.8pg / ml, postoperative calcitonin level > 45.0pg / ml are more likely to have postoperative recurrence.
Longitudinal Analysis of Cell-free Mutated KRAS and CA 19-9 Predicts Survival Following Curative Resection of Pancreatic Cancer
Authors: Hussung Saskia , Akhoundova Dilara , Hipp Julian , Follo Marie , Klar Rhena , Philipp Ulrike , Scherer Florian , von Bubnoff Nikolas , Duyster Justus , Börries Melanie , Wittel Uwe , Fritsch Ralph
Published: August 2020

Background: Novel biomarkers and molecular monitoring tools hold potential to improve outcome for patients following resection of pancreatic ductal adenocarcinoma (PDAC). We hypothesized that the combined longitudinal analysis of mutated cell-free plasma KRAS (cfKRASmut) and CA19-9 during adjuvant treatment and follow-up might more accurately predict disease course than hitherto available parameters. Methods: Between 07/2015 and 10/2018, we collected 134 plasma samples from 25 patients (pts) after R0/R1-resection of PDAC during adjuvant chemotherapy and post-treatment surveillance at our institution. Highly sensitive discriminatory multi-target ddPCR assays were employed to screen plasma samples for cfKRASmut. cfKRASmut and CA19-9 dynamics were correlated with recurrence-free survival (RFS) and overall survival (OS). Patients were followed-up until 01/2020.Results: Out of 25 enrolled patients, 76% had undergone R0 resection and 48% of resected PDACs were pN0. 17/25 (68%) of patients underwent adjuvant chemotherapy. Median follow-up was 22.0 months, with 19 out of 25 (76%) pts relapsing during study period. Median RFS was 10.0 months, median OS was 22.0 months. Out of clinicopathologic variables, only postoperative CA19-9 levels and administration of adjuvant chemotherapy correlated with survival endpoints. cfKRASmut. was detected in 12/25 (48%) of patients, and detection of high levels inversely correlated with survival endpoint. Integration of cfKRASmut and CA 19-9 levels outperformed either individual marker. cfKRASmut outperformed CA19-9 as dynamic marker since increase during adjuvant chemotherapy and follow-up was highly predictive of early relapse and poor OS. Conclusions: Integrated analysis of cfKRASmut and CA19-9 levels is a promising approach for molecular monitoring of patients following resection of PDAC. Larger prospective studies are needed to further develop this approach and dissect each marker`s specific potential.
The value of a relatively safe method for predicting difficult laryngoscopy during the COVID-19 epidemic
Authors: Wu Hao , Hu Dandan , Chen Xu , Zhang Xuebing , Xia Min , Chai Xiaoqing , Wang Sheng , Zhang Wei
Published: August 2020

Background: The current global situation of COVID-19 epidemic is serious. Routine preoperative methods to assess airway such as the interincisor distance, Mallampati classification, and the upper lip bite test have a certain risk of upper respiratory tract exposure and virus spread. The condyle-tragus maximal distance can be used to assess the airway, and the assessment method does not require the patient to expose the upper respiratory tract, but its value in predicting difficult laryngoscopy compared to other indicators (Mallampati classification, interincisor distance, and upper lip bite test) remains unknown. The purpose of this study was to observe the value of condyle-tragus maximal distance to predict difficult laryngoscopy, and provide a new idea for preoperative airway assessment during epidemic. Methods: We enrolled adult patients who underwent general anesthesia and tracheal intubation. The interincisor distance, Mallampati test result, upper lip bite test result, and the condyle-tragus maximal distance of each patient were evaluated prior to the initiation of anesthesia. The primary outcome was difficult laryngoscopy defined as the Cormack-Lehane Level > grade 2. Results: A total of 304 patients were successfully included in the study ,39 patients were identified as difficult laryngoscopy. The correlation between the condyle-tragus maximal distance and Cormack-Lehane Level was the highest (Spearman correlation coefficient, -0.317; P＜0.001), and the area under the ROC curve was the highest (AUC：0.699,P＜0.01). The condyle-tragus maximal distance <1 finger width was the most consistent with difficult laryngoscopy (κ=0.485;99% CI,0.286-0.612) and its OR value was 10.09(95%CI: 4.19-24.28), sensitivity was 0.469(95%CI: 0.325-0.617), specificity was 0.929(95%CI: 0.877-0.964), positive predictive value was 0.676 (95%CI: 0.484-0.745), negative predictive value was 0.847(95%CI :0.825-0.865). Conclusion: Compared with the interincisor distance , Mallampati classification and the upper lip bite test, the condyle-tragus maximal distance has higher value in predicting difficult laryngoscopy, which can become a safer airway assessment method during the epidemic of COVID-19. Trial registration: The study was registered on October 21, 2019 in the Chinese Clinical Trial Registry (ChiCTR1900026775).
Multipolar mapping for catheter ablation of premature ventricular complexes originating from papillary muscles in the structurally normal heart: A case series
Authors: Cai Chi , Wang Jing , Niu Hongxia , Hua Wei , Chu Jianmin , Zhang Shu
Published: August 2020

Background: Previous studies on radiofrequency catheter ablation of premature ventricular complexes (PVCs) arising from the left ventricle (LV) papillary muscles (PM) show a modest procedural success rate with higher recurrence rate. Our study sought to explore the utility of using a multipolar mapping with a steerable linear duodecapolar catheter for ablating the PM PVCs.Methods：Detailed endocardial multipolar mapping was performed using a steerable linear duodecapolar catheter in 6 consecutive PM PVCs patients with structurally normal heart. The clinical features and procedural data as well as success rate were analysed.Results: LV endocardial electroanatomic mapping was performed in all patients via a retrograde aortic approach using a duodecapolar mapping catheter. All patients displayed a PVC burden with 16.2 ± 5.4%. Duodecapolar catheter mapping demonstrated highly efficiency with an average procedure time (95.8 ± 7.4 minutes) and fluoroscopy time (14.2 ± 1.5 minutes). The mean number of ablation applications points was 6.8 ± 1.9 with an average overall ablation duration of 6.1 ± 3.0 minutes. The values of earliest activation time during mapping using duodecapolar catheter were 37.8 ± 7.2 ms. All patients demonstrated acute successful ablation, and the PVC burden in all patients after an average follow-up of 8.5 ± 2.0 months was only 0.7%. There were no complications during the procedures and after follow-up.Conclusion: Mapping and ablation of PM PVCs using a duodecapolar catheter facilitated the identification of earliest activation potentials and pace mapping, and demonstrated a high success rate during follow-up.
Social work responses and household-level determinants of coronavirus preparedness in rural Ethiopia
Authors: Addis Yonnas , Abate Dubale , Ferreira João Batista
Published: August 2020

Background
The novel coronavirus (2019-nCOV) arisen in Ethiopia in early March at its capital city (Addis Ababa) and is now spreading to different administrative regions of the country. This study aimed to assess the attentiveness of the rural community to COVID 19, social work response, and major factors that affect rural community preparedness and response to COVID 19 in Ethiopia.
Methods
Descriptive statistics was used to analyze the data collected from a total of 190 sample respondents. Econometric model particularly a probit model was used to identify these major factors that affect rural households’ preparedness for the pandemic.
Results
Rural households recognize little about COVID 19 and in response, a few community groups, which consist of youth and university students, religious leaders, and elders were engaged to reduce the consequence of COVID 19. Results from the probit model employed indicate that literacy status (household head and family member), gender, age, and economical status of the households; extension information on COVID 19, cash income from non/off-farm activities, participation in community groups, and ownership of mobile phone with a household all influence households preparedness. The main barriers include a lack of information on COVID 19 and financial constraints.
Conclusions
Commitment to preparedness and response to COVID 19 by the rural community increases with enhancing proper information dissemination system and applicable support. Thus, much more attention needs to be given by a government and other stakeholders to reduce the venerability of the rural community in Ethiopia.
Multi-omics Analysis at Serum Proteomic and Metabolomic Levels Reveals Mechanisms of Moxibustion for a Mouse Model of Ankylosing Spondylitis
Authors: Xu Xiao , Liu Ting , Wang Rong-Yun , Shi Ya-Nan , Xu Jing-ming , Mao Wen , Wu Feng-qin , Wang Hong-yuan , Sun Zhi-Ling , Sun Qiu-hua
Published: August 2020

Background: Moxibustion is widely used in ameliorating symptoms of ankylosing spondylitis (AS). The aim of this study was to identify the potential molecular profiles of moxibustion on relieving AS mice through incorporating ultra-high-performance liquid chromatography quadrupole-time of flight mass spectrometry (UHPLC-Q-TOF/MS) based metabolomics approach and data independent acquisition-mass spectrometry (DIA-MS) based proteomic. Methods: In this research, mice with proteoglycan-induced spondylitis (PGISp) were intervened with moxibustion for four weeks at specific acupuncture points or at non-acupuncture points. Arthritis severity, histopathological examinations, cytokines and osteoblast (OB) related genes were assessed. Protein profiling and metabolite profiling of serum of mice were examined by UHPLC-Q-TOF/MS based metabolomics technology and DIA-MS based proteomic approach. A multi-omic analysis was implemented for integrating the results of the single proteomic and metabolomic. The levels of some novel proteins in significantly enriched integrated pathways were validated by the enzyme-linked immunosorbent assay (ELISA) method. Results: Our findings clearly indicate that acupuncture points’ moxibustion can significantly decrease the arthritis index (AI) score, improve the histopathological examination and reduce the serum levels of C-reactive protein (CRP), Interferon-γ (IFN-γ), Interleukin-17 (IL-17), Alkaline phosphatase (ALP) and Osteocalcin (OCN) for AS mice. A total of 21 differentially expressed metabolites and 21 differentially expressed proteins (DEPs) were identified as potential moxibustion-intervened biomarkers for AS mice. These molecules were mainly involved in six integrative canonical pathways: mineral absorption, lipid metabolism, purine metabolism, glycolysis/gluconeogenesis, glycine, serine and threonine metabolism and phenylalanine metabolism pathways. Furthermore, The ELISA analysis of four key proteins was consistent with the results of the proteomic analysis. Conclusions: Combing UHPLC-Q-TOF/MS based metabolomics approach and DIA-MS based proteomic, as a promising tool, can advance our understanding of potential mechanisms of action of moxibustion for AS from a holistic perspective.
Individualized transscleral cyclophotocoagulation as the initial surgical intervention for medically uncontrolled glaucoma after blunt trauma
Authors: Hou Xu , Wu Jing , Zhou Jian , Wang Yu-Sheng , Hu Dan
Published: August 2020

Background: To investigate the safety and feasibility of individualized transscleral cyclophotocoagulation (TSCPC) as the initial non-incisional surgical intervention for medically uncontrolled glaucoma after blunt trauma. Methods: The therapy records were reviewed of medically uncontrolled traumatic glaucoma after blunt trauma treated with TSCPC in a single hospital between January 2014 and December 2018. 31 patients (31 eyes) received individualized TSCPC after ultrasound biomicroscopy and gonioscopy examination to localize and quantify the injured quadrants of the anterior chamber angle. In addition to the number of IOP lowing drugs, visual acuity (VA), IOP, inflammation and hemorrhage in the anterior chamber were analyzed at 1 day, 3 weeks and 3 months after operation, respectively. Success was defined as the IOP was not more than 21 mmHg.Results: Compared with the data of pre-operation, constituent ratio of VA had no significant difference at 3 weeks (c2 = 0.56, P > 0.75). At 3 months the mean IOP was 22.2±5.0 mmHg, which was significantly lower than that of pre-operation (46.6±5.6 mmHg) (t=19.818, P<0.001). No IOP lowing drug was needed in 12 eyes, and more than 3 kinds of drugs were still needed in 5 eyes. The average number of medications decreased significantly (c2=93.496，P＜0.001). The complete success rate was 38.7% and the relative success rate (combined with no more than two kinds of drugs) was 83.9% at 3 months.Conclusions: Individualized TSCPC could be applied as an initial non-incisional surgical intervention to treat traumatic glaucoma refractory to the medicine therapy.
ZBTB7A, a potential biomarker for prognosis and immune infiltrates, inhibits progression of endometrial cancer based on bioinformatics analysis and experiments
Authors: Geng Rong , Zheng Yuhua , Zhou Donghua , Li Qingdong , Li Ruiman , Guo Xiaoling
Published: August 2020

The authors have withdrawn this preprint due to author disagreement.
Incidence of thromboembolism in patients with COVID-19: a systematic review and meta-analysis
Authors: Boonyawat Kochawan , Chantrathammachart Pichika , Numthavej Pawin , Nanthatanti Nithita , Phusanti Sithakom , Phuphuakrat Angsana , Niparuck Pimjai , Angchaisuksiri Pantep
Published: August 2020

Background
Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, the incidence of thromboembolism has been increasingly reported. The aim of this systematic review was to explore the incidence of venous and arterial thromboembolism among COVID-19 patients requiring hospitalization.
Methods
Medline, Embase, Scopus, and grey literature were searched until May 2020. Observational studies reported on the incidence of venous thromboembolism (VTE), including pulmonary embolism (PE) and deep vein thrombosis (DVT) or arterial thromboembolism (ATE) were included. The pool incidences and their 95% confidence intervals (CI) were calculated using the random-effects model.
Results
A total of 26 studies were included. In the intensive care unit (ICU) setting, the pooled incidence of VTE was 27% (95% CI, 20–35%). Subgroups based on compression ultrasound (CUS) screening revealed a higher incidence of DVT in the CUS screening group than in the no CUS screening group (27% [95% CI, 20–35%] vs. 3% [95% CI, 1–5%]). The pooled incidence of ATE in ICU was 3% (95% CI, 2–4%). In the non-ICU setting, the pooled incidence of VTE was 8% (95% CI, 4–12%,).
Conclusions
The incidence of VTE in COVID-19 patients was higher in the ICU setting than in the non-ICU setting, and also significantly higher in studies that incorporated the CUS screening protocol. The incidence of ATE in the ICU setting was low. VTE prophylactic measures should be given to all hospitalized patients diagnosed with COVID-19, especially in the ICU setting.
Father's Experiences During the Stay of the Premature Baby in the Neonatal Intensive Care Unit (NICU): A Systematic Review Protocol
Authors: Garnica-Torres ZulyKatherine , Dias Greicyani Brarymi , Pedroso Janari da Silva
Published: August 2020

Background: This systematic review aims to understand the father's experience in the neonatal Intensive Care Unit (NICU) while accompanying his premature baby. Prematurity rates are increasing; every year, millions of parents faced having their premature baby hospitalized in NICU without being prepared to face this situation. It is relevant to talk about how fathers feel with the experience of being parents of premature babies. The father-baby attachment is affected by prematurity, thus performing the kangaroo care method with the active participation of the father is vital to promote the attachment between the dyad. Method: The authors will include original father-centered research articles, with measurements made in the NICU. Databases included articles from 2010 to 2020, are APA PsycNet, BVS, Web of Science, PubMed, Scopus, and The Cochrane Library (Cochrane Central Register of Controlled Trials. CENTRAL). Two researchers will extract the data and evaluate the quality of each study through the Newcastle-Ottawa Scale (NOS) and the Critical Appraisal Skills Programme (CASP) and references will be managed in the Mendeley software. This review will not perform a meta-analysis, results will be presented in a qualitative narrative synthesis that includes all the data found.Discussion: This review will contribute to the construction of evidence about the father's experience in the neonatal intensive care unit, as well as how attachment develops between the baby and the father in this field and how the kangaroo care method promotes attachment in this dyad. Ethics and disseminationThis is a protocol for a systematic review, therefore, no approval from an ethics committee is required. We will submit the article to a peer-reviewed health journal, and the results will be published in congresses focused on neonatal, child, and psychological health.PROSPERO registration number: CRD42019142086
Analysis of the Gap in PCR Monitoring Availability for Patients with Chronic Myeloid Leukemia in 60 Low- and Middle-Income Countries
Authors: Rowley Seth , Garcia-Gonzalez Patricia , Radich Jerald P , Usherenko Irina , Babigumira Joseph B
Published: August 2020

Purpose: To estimate the resource gap in the polymerase chain reaction (PCR) monitoring for patients with chronic myeloid leukemia (CML) in low- and middle-income countries (LMICs). Methods: We developed a model of demand and supply of PCR monitoring of CML patients in 60 LMICs. PCR testing was assumed to use Cepheid’s GeneXpert® IV system. We included costs of GeneXpert® instruments, uninterrupted power supplies, warranties, calibration kits, test cartridges, and shipping. We calculated the country-specific monetary gap in PCR monitoring, stratified by country priority defined as the availability of tyrosine kinase inhibitors (TKIs) through The Max Foundation initiatives. Results: The five-year gap in PCR monitoring was $29.1 million across all countries, 22% ($6.4 million) in countries with all five TKIs available, 20% ($5.7 million) in countries with four TKIs available, 50% ($14.5 million) in countries with three TKIs available, 8% ($2.2 million) in countries with two TKIs available, and 1% ($0.3 million) in countries with one TKI available. The gap was highest in South Asia (52%; $15.1 million) and lowest in Latin America (6%; $1.9 million). Excluding labor costs, the bulk of the resource needs (86%; $25.2 million) were for procurement of BCR-ABL cartridges. Conclusion: Removing the five-year gap in PCR monitoring capacity for CML in LMICs will require the mobilization of significant resources and will likely lead to better treatment outcomes and reduced treatment costs through optimization of treatment, discontinuation of therapy in appropriate patients, and facilitation of clinical research. Development of streamlined monitoring guidelines for resource-limited countries should be considered.
Development of the Home based Virtual Rehabilitation System (HoVRS) to Remotely Deliver an Intense and Customized Upper Extremity Training
Authors: Qiu Qinyin , Cronce Amanda , Patel Jigna , Fluet Gerard G , Mont Ashley , Merians Alma S , Adamovich Sergei V
Published: August 2020

Background: After stroke, sustained hand rehabilitation training is required for continuous improvement and maintenance of distal function. Methods: In this paper, we present a system designed and implemented in our lab: the Home based Virtual Rehabilitation System (HoVRS). Fifteen subjects with chronic stroke were recruited to test the feasibility of the system as well as to refine the design and training protocol to prepare for a future efficacy study. HoVRS was placed in subjects’ homes, and subjects were asked to use the system at least 15 minutes every weekday for 3 months (12 weeks) with limited technical support and remote clinical monitoring. Results: All patients completed the study without any adverse events. Subjects on average spent 13.5 hours using the system. Clinical and kinematic data were collected pre and post study. The whole group improved on the Fugl-Meyer (FM) assessment and on six kinematic measurements. In addition, a combination of these kinematic measures was able to predict a substantial portion of subjects’ FM scores. Conclusion: The outcomes of this pilot study warrant further investigation of the system’s ability to promote recovery of hand function in subacute and chronic stroke.
Risk factors of acute cardiovascular events following acute exacerbation period for patients with COPD: a nested case-control study
Authors: Hu Weiping , Lhamo Tsokyi , Zhang Feng-ying , Hang Jing-qing , Zuo Yi-hui , Hua Jian-lan , Li Shan-qun , Zhang Jing
Published: August 2020

Background For patients with chronic obstructive pulmonary disease (COPD), the incidence of acute cardiovascular events (CVEs) increases during acute exacerbation (AE) period, causing increased inpatient mortality. Thus, we try to identify risk factors of acute CVEs in patients with AECOPD via a nested case-control study.Methods A total of 496 cases hospitalized for AECOPD were included into analysis, and followed-up for 6 months after discharge. Acute CVEs in the AE period were defined as the new or worsening acute coronary syndrome (ACS), arrhythmia, left ventricular disfunction (LVD). Risk factors were selected from several variables, including baseline characteristics and treatments in the stable period as well as symptoms, laboratory tests, complications and treatments in the AE period. Results Thirty cases (6.05%) had acute CVEs, including 2 with ACS, 13 with LVD, 19 with arrhythmia, and 4 deaths, with significantly increased mortality risk (P=0.001, OR=5.81). Moreover, patients who have had CVEs were inclined to have re-exacerbation within 3 months. Multivariate analysis showed that previous LVD history (P=0.004, OR=5.06), 20% increase in heart rate (HR) (P=0.003, OR= 10.19), electrolyte disturbance (P=0.01, OR= 4.24) and diuretics (P=0.002, OR = 6.37) were independent risk factors. In addition, usage of theophylline, fluoroquinolone and inhaled beta agonists in the AE period were not statistically associated with acute CVEs. Conclusions Our study preliminarily indicated that patients hospitalized for AECOPD with previous LVD history or increased HR need close observation and diuretics should be cautiously used with electrolyte monitoring. These findings needs to be confirmed in a large cohort.
Heat transfer and Entropy analysis of airflow around an airfoil subjected to an external magnetic field
Authors: Saffarzadeh Hamed , Djavareshkian M.H
Published: August 2020

In the present study, the thermal Lattice Boltzmann Technique is combined with the Ghost Fluid method to simulate the flow and heat transfer rate around a NACA 0015 airfoil in the presence of an external magnetic field source. It is tried to investigate the mutual effects of the Hartmann and Reynolds numbers as well as the magnetic field angle and the attack angle of the airfoil on the flow and heat transfer characteristics. Besides, the total entropy generation rate of the system was studied through its main components, i.e. entropy generation rate due to friction, heat transfer, and Magneto Hydrodynamics. Therefore, the tests were carried out for various Re and Ha numbers, plus different magnetic field angles and airfoil attack angles, and their influence on the active parameters which are Cd, Cl, and Nu, along with the entropy generation rate of the system,were recorded. The results revealed that with an increment of the Re number the Cd and Cl graphs drop, but the Nu value raises. Also, the total entropy generation rate of the system is at its maximum around\(\gamma =60\).
Haematological factors of SARS-CoV-2 infection aggravation: a COVID'HEMOS study
Authors: Billoir Paul , Alexandre Kevin , Duflot Thomas , Roger Maxime , Miranda Sebastien , Goria Odile , Joly Luc Marie , Demeyere Mathieu , Feugray Guillaume , Etienne Manuel , Duchez Veronique Le Cam
Published: August 2020

Since December 2019, a pandemic caused by a new coronavirus has spread to more than 170 countries around the world. Worsening infected patients requiring intensive care unit (ICU) admission, associated with 30% of mortality. A part of worsening is mediated by haemostasis deregulation. The primary aim of this study was to determine if haematological biomarkers, in addition to clinical risk factors on hospital admission, predict worsening (defined by ICU admission and/or death) in Covid-19 infected patients, and secondary, if they could predict the occurrence of thrombotic events. Thirty-five of the 99 patients got clinically worse and 8 developed pulmonary embolism (PE). Final model of the logistic regression analysis revealed that oxygenodependence (RR=7.27[1.50-19.31]), fibrinogen levels (RR=1.45[1.17-1.82]), thrombin peak (RR=1.28[1.03-1.59]), monocytes counts below 0.2 G/L (RR=2.88[1.67-3.19]) and prothrombin fragment 1+2 (F1+2) higher than 290 pM (RR=2.39[1.20-3.30]) were associated with clinical worsening. Fibrinogen level threshold of 5.5 g/L, thrombin peak measurement threshold of 99 pM and oxygenodepence allowed prediction of clinical outcome in near than 80% of our cohort. Moreover, using ROC curves, thrombin peak and F1+2 on admission with a threshold of 204 nM and 393 pM were sensitive and specific to predict PE (AUC: 85.7% Se: 70.8% Sp: 100% and AUC: 81.5% Se: 75.0% Sp: 86.8% respectively). In conclusion, we described a rapid decision tree to predict outcome of SARS-CoV-2 infected patients based on fibrinogen, TGA peak and oxygen dependence. Furthermore, thrombin peak and F1+2 seem to be specific haematological marker to predict PE, even in patients with thromboprophylaxis.
Effect of COVID-19 Non-Pharmaceutical Interventions and Threats to Human Rights
Authors: Hwang Ha , Hong Seung-Hun , Park Min-Hye
Published: August 2020

In response to the COVID-19 pandemic, many governments have implemented non-pharmaceutical interventions (NPIs) to curb rapid virus transmission. A growing concern is that such interventions, aimed at ensuring public safety, may severely restrain fundamental human rights. This paper examines which NPIs are more effective than others in containing COVID-19 with the consideration of their threat to human rights. After classifying NPIs into three categories according to their threat to human rights: the right to freedom of movement, the right to freedom of assembly, and the right to privacy, this paper conducts linear regression analyses on the effectiveness of NPIs in containing COVID-19 over 108 countries. This paper finds that school closure is effective in containing COVID-19 only when it is implemented along with complete contact tracing. We confirm the results of the regression analysis by examining the changes in the cumulated number of confirmed cases and the changes of NPIs in ten selected countries. Our findings imply that to contain COVID-19 effectively and minimize the risk of human rights abuse, governments should consider implementing prudently designed full contact tracing and school closure policies, among others. Other interventions limiting freedom of movement and assembly should be carefully adopted with minimal infringement of human rights.
Extubation success without using high-flow nasal cannula and non-invasive ventilation for patients with coronavirus disease 2019 (COVID-19): A retrospective observational study
Authors: Inoue Akira , Shirakawa Kazuhiro , Fujita Nonoka , Kanao Kunio , Saito Yutaka , Takuma Kiyotsugu
Published: August 2020

Background In March 2020, the World Health Organization declared coronavirus disease 2019 (COVID-19) to be a global pandemic. It was also reported that approximately 20%-23% of patients with COVID-19 admitted to the hospital required mechanical ventilation (MV). Reintubation rates ranged from 13–19%, leading to increased mortality. Moreover, exposure of health care workers is a serious problem and intubation is a high-risk procedure because of aerosol generation. To reduce reintubation, preventive high-flow nasal cannula (HFNC) and non-invasive ventilation (NIV) after extubation are recommended. However, using HFNC and NIV in patients with COVID-19 may lead to the spread of infection. Without using HFNC and NIV, conventional spontaneous breathing trial (SBT) may overestimate a patient’s respiratory status. A highly demanding SBT accurately assesses a patient’s reserve capacity and may reduce reintubation. We did not use preventive HFNC or NPPV and extubated with a highly demanding SBT protocol. This study aimed to evaluate whether our protocol can be performed safely.Methods This single-centre study was conducted at the Kawasaki Municipal Hospital from February 2020 to June 2020. Patients with COVID-19 requiring MV were screened for their eligibility for the weaning procedure every day. Patients were extubated after administering methylprednisolone if SBT was well tolerated. SBT was performed with 3 cmH2O pressure support, 3 cmH2O positive end-expiratory pressure, and ≤ 0.30 fraction of inspired oxygen. In extubated patients, the reintubation rate, duration of MV, length of intensive care unit (ICU) and hospital stay, and rate of ventilator-associated pneumonia (VAP) were analyzed.Results Ten patients received MV. Two of 10 patients had no improvement in their respiratory status and did not qualify for the extubation criteria and died. Eight patients were extubated. No reintubations were performed (0%). The median durations of MV, ICU stay, and hospital stay were 13 (interquartile range [IQR], 10–16) days, 17 (IQR, 13–27) days, and 22 (IQR, 16–26), and 3 patients (37.5%) was diagnosed VAP.Conclusions Extubation was performed with a highly demanding SBT protocol, and no patients were reintubated. All patients did not require HFNC and NIV. Further research is required in critically ill patients.
Dietary Seaweed-derived Polysaccharides Improve Growth Performance of Weaned Pigs Through Maintaining Intestinal Barrier Function and Modulating Gut Microbial Populations 
Authors: Zou Tiande , Yang Jin , Guo Xiaobo , He Qin , Wang Zirui , You Jinming
Published: August 2020

Background: Seaweed-derived polysaccharides (SDP) represent an attractive source of prebiotic nutraceuticals for the food and animal husbandry industry. However, the mechanism by which SDP from Enteromorpha mediates pig growth are not fully understood. This study aimed to investigate how SDP supplementation influences the growth performance and intestinal health in weaned pigs.Results: In Exp. 1, 240 weaned pigs were randomly assigned to four dietary treatments and fed with a basal diet or a basal diet containing 200, 400 or 800 mg/kg SDP, respectively, in a 21-d trial. Pigs on the 400 or 800 mg/kg SDP-supplemented group had greater ADG and lower F/G ratio than those on the control group (P＜0.05). In Exp. 2, 20 male weaned pigs were randomly assigned to two treatments and fed with a basal diet (CON group) or a basal diet supplemented with 400 mg/kg SDP (the optimum does from Exp. 1), in a 21-d trial. Pigs fed the SDP diet had greater ADG, the concentrations of serum IL-6 and TNF-α and the activities of glutathione peroxidase, superoxide dismutase and catalase (P＜0.05), and lower F/G, diarrhea rate, as well as serum D-lactate concentrations and diamine oxidase activity (P＜0.05). Moreover, dietary SDP supplementation enhanced secretory immunoglobulin A content, villus height and villous height: crypt depth ratio in small intestine, as well as the lactase and maltase activities in jejunum mucosa (P＜0.05). SDP supplementation elevated the mRNA levels of inflammatory response-related genes (IL-6, TNF-α, TLR4, TLR6 and MyD88), and the mRNA and protein levels of ZO-1, Claudin-1 and Occludin in jejunum mucosa (P＜0.05). Importantly, SDP not only increased the Lactobacillus population but also reduced the Escherichia coli population in cecum (P＜0.05). Furthermore, SDP increased acetic acid and butyric acid concentrations in cecum (P＜0.05). Conclusions: These results not only suggest a beneficial effect of SDP on growth performance and intestinal barrier functions, but also offer potential mechanisms behind SDP-facilitated intestinal health in weaned pigs.
Prediction of the mechanisms of action of Yinqiao powder in Influenza: A network pharmacology study
Authors: shen xiao , He Linglin , Fan Fuyuan
Published: August 2020

Objective To predict the potential target and pharmacological mechanism of Yinqiao Powder (YQP) in the treatment of influenza. MethodsThe symptom mapping (SymMap) platform was retrieved to obtain the targets of all herbs in YQP. Influenza-related targets were obtained using the Comparative Toxicogenomics Database (CTD) and DisgeNet database. The String database was used to construct the protein-protein interaction (PPI) network; the Metascape platform was used to enrich key targets by GeneOntology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways. Data were visualized and analyzed using software such as Bioinformatics, Edrawmax, and Cytoscape. Results A total of 263 potential targets of YQP for influenza treatment were screened. There are 256 nodes and 3697 edges in the PPI network. The key targets of the PPI network are AKT1, TP53, INS, IL6, MAPK3, VEGFA, etc. The results of Go enrichment showed that YQP can interfere with biological processes such as response to toxic substance, cytokine-mediated signaling pathway, response to lipopolysaccharide, response to extracellular stimulus, and positive regulation of cell death. The results of KEGG pathway enrichment showed that YQP could interfere with the infection process of the influenza virus by intervening PI3K/Akt, TNF, IL-17, MAPK, and other pathways. Conclusion This study reflects the multi-target and multi-pathway action characteristics of Yinqiaosan, and its mechanism of action in the treatment of influenza may be related to the regulation of PI3K-Akt, NF-kappa B, and MAPK signaling pathways. However, further experimental studies are needed to verify the specific mechanism of YQP.
Interviewing children: the impact of the COVID-19 quarantine on children’s changes in routine and psychological distress. 
Authors: Segre Giulia , Campi Rita , Scarpellini Francesca , Clavenna Antonio , Zanetti Michele , Cartabia Massimo , Bonati Maurizio
Published: August 2020

Background: The COVID-19 outbreak has resulted in governments implementing disease containment measures such as school closures, social distancing, and home quarantine.To date, only a few studies have drawn attention to the psychological impact of lockdown on Italian children’s mental health. The present study aimed to investigate the psychological distress (anxiety and mood symptoms) and changes in routine among Italian primary and middle school students during the COVID-19 quarantine.Methods: This qualitative interview study was performed between the 18th of May and 7th of June 2020: it involved a sample of 82 children and adolescents living in Milan (Italy), attending primary and middle school (aged 6 to 14 years), and their parents.Results: Almost 30% of the subjects reported having struggled to adjust to home learning. 36 responders completely changed their dietary habits during the lockdown: they were not eating the same amount of food and were consuming more junk food. Sleep habits were also affected by the lockdown measures: 28% of the sample had difficulties sleeping and wished to sleep in their parents’ bed. Concerning psychological distress, 64 (78%) children and adolescents had anxiety symptoms; 43.9% of the students reported significant mood symptoms.Conclusions: Children are not indifferent to the dramatic impact of the COVID-19 epidemic: our data confirm their difficulties in adapting to the quarantine measures. The effects of stress exposure may not manifest later on during the children’s development, and, for this reason, it would be interesting to follow up on these participants to improve our understanding of how long these outcomes may last.
A Stochastic Programming Model for Service Scheduling with Uncertain Demand: An Application in Open-Access Clinic Scheduling
Authors: Fu Yu , Banerjee Amarnath
Published: August 2020

This paper addresses a scheduling problem which handles urgent tasks along withexisting schedules. The uncertainty in this problem comes from random situations ofexisting schedules and arrival of upcoming urgent tasks. To deal with the uncertainty,this paper proposes a stochastic integer programming (SIP) based aggregated onlinescheduling method. The method is illustrated through a study case from the outpatientclinic block-wise scheduling system which is under a hybrid scheduling policycombining regular far-in-advance policy and the open-access policy. The COVID-19pandemic brings more challenges for the healthcare system including the fluctuationsof serving time, and increasing urgent requests which this paper is designed for. TheSIP model designed in the method can easily accommodate uncertainties of theproblems, such as: no-shows, cancellations and punctuality of previously scheduledpatients as well as random arrival and preference of new patients. To solve the SIPmodel, the deterministic equivalent problem formulations are solved using theproposed bound-based sampling method.
Under-nutrition and associated factors among human immunodeficiency virus-infected children in sub-Saharan Africa: A systematic review and meta-analysis.
Authors: Nigussie Jemberu , Girma: Bekahegn , Molla Alemayehu , Mareg Moges
Published: August 2020

Background: In developing world including sub-Saharan Africa, HIV/AIDS has worsened the impact of under-nutrition in children. HIV infected children are highly vulnerable to malnutrition. Even though under-nutrition screening and intervention are incorporated into the care plan of HIV infected children, it is continued as a major problem for HIV infected children in Africa. Hence, the main aim of this systematic review and meta-analysis was to estimate the pooled prevalence of under-nutrition and associated factors among children infected with HIV.Methods: Primary studies were retrieved from PubMed/ MEDLINE online, Science direct, and Hinari databases. We found a total of 1847 records from these databases. After removing papers my using different exclusion criteria, 26 studies that report the prevalence of under-nutrition were included. We used a standardized data extraction format prepared in Microsoft Excel. STATA- version 14 statistical software was used for analysis. Heterogeneity was evaluated through I2 test. A random-effects meta-analysis model was used to estimate the pooled prevalence of under-nutrition and its associated factors. The summary estimates were also presented using Forest plots and tables.Results: The pooled prevalence of stunting, underweight, and wasting in HIV infected children were 51.4% (95% CI: 46.3, 56.4), 39.0% (95% CI: 33.7, 44.3), and 24.5% (95% CI: 19.2, 29.8) respectively. Household insecurity was associated with stunting [OR= 5.50 (95% CI 3.36, 8.98]. Low family economic status [OR= 5.25 (95% CI: 2.52, 10.92)])], feeding frequency [OR= 0.32 (95% CI 0.172, 0.605)] and caretakers attending dietary counseling [OR= 0.367 (95% CI: 0.182, 0.739)] were significantly associated with under-weight among HIV infected children. Conclusions: The pooled prevalence of under-nutrition among HIV infected children was high. Routine nutritional assessment and nutritional support shall be strengthened, monitored, and evaluated in HIV infected children. Implementation of policies and strategy sated by a national and international stakeholder in ART care centers should get maximum emphasis to reduce undernutrition in HIV infected children.
Supervised molecular dynamics for exploring the druggability of the SARS-CoV-2 spike protein
Authors: Deganutti Giuseppe , Prischi Filippo , Reynolds Christopher A.
Published: August 2020

The recent outbreak of the respiratory syndrome-related coronavirus (SARS-CoV-2) is stimulating an unprecedented scientific campaign to alleviate the burden of the coronavirus disease (COVID-19). One line of research has focused on targeting SARS-CoV-2 proteins fundamental for its replication by repurposing drugs approved for other diseases. The first interaction between the virus and the host cell is mediated by the spike protein on the virus surface and the human angiotensin-converting enzyme (ACE2). Small molecules able to bind the receptor-binding domain (RBD) of the spike protein and disrupt the binding to ACE2 would offer an important tool for slowing, or even preventing, the infection. Here, we screened 2421 approved small molecules in silico and validated the docking outcomes through extensive molecular dynamics simulations. Out of six drugs characterized as putative RBD binders, the cephalosporin antibiotic cefsulodin was further assessed for its effect on the binding between the RBD and ACE2, suggesting the importance of considering the dynamic formation of the heterodimer when judging any potential candidate.