bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors associated with relapses in relapsing-remitting multiple sclerosis
Authors: Xie Yao , Tian Ziyu , Han Fang , Liang Shibing , Gao Ying , Wu Dahua 
Published: June 2020

Abstract

Background:
The relapse is character of relapsing-remitting multiple sclerosis. The therapeutic goal is to reduce the risk of relapse. Factors associated with relapses can help to manage and prevent relapses. In addition, patients and doctors all pay attention to it. However, there are differences between studies. Our aim is to summarize factors associated with relapses in relapsing-remitting multiple sclerosis (RRMS).

Methods:
PubMed, EMBASE, Web of science, Cochrane library, CNKI, Wanfang, SinoMed, and VIP were searched to identify risk factors about relapses in RRMS, which should be in cohort or case-control studies. This article was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The quality of studies was evaluated by the Newcastle-Ottawa Scale (NOS). Meta-analysis, subgroup and sensitivity analyses, and publication bias were all performed with Stata. This research has been registered on the international prospective register of systematic reviews (PROSPERO, CRD42019120502).

Results:
43 articles were included. Infection, postpartum period, risk gene, stress, and vitamin D were risk factors for relapses in RRMS. Pregnancy period was the protective factor. Among those, infection increased the risk of relapses in infection period (relative risk [RR], 2.07 [confidence interval (CI), 1.64 to 2.60]). Women in the postpartum period increased the risk of relapses compared with women before pregnancy (RR, 1.43 [CI, 1.19 to 1.72]), or women in pregnancy period (RR, 2.07 [CI, 1.49 to 2.88]). Women in the pregnancy period decreased the risk of relapses (RR, 0.56 [CI, 0.37 to 0.84]) compared with women before pregnancy. However, fewer studies, heterogeneity, and sample size were the limitations.

Conclusion:
It is reliable to adopt results about infection, pregnancy period, and postpartum period.
The effects of gastrodin injection on hypertension
Authors: Qian Lichao , Yan Shihai , Li Yizhuo , Wu Lihua , Zheng Yawei , Wang Yixuan , Fang Zhuyuan 
Published: June 2020

Abstract

Background:
Hypertension is a common chronic disease and poses a huge burden to health care systems. Recent studies have shown that gastrodin injection (GI) has a potential supplementary therapeutic effect on hypertension.

Objectives:
To systematically assess the efficacy and safety of GI in treatment of hypertension.

Methods:
Systematic search was conducted on 7 databases (PubMed, Cochrane Library, Embase, Wanfang database, China biomedical literature service system, VIP Chinese Sci-tech journal database and China national knowledge internet). The retrieval time was from the establishment of database to February 15, 2020. Two researchers independently selected literature, extracted data and evaluated the risk of bias in the study. The methodological quality was evaluated with Cochrane handbook. The meta-analysis was performed with Stata 14.0 software.

Results:
Thirteen studies were included in this study involving 1525 patients. Compared with using conventional therapy alone, GI combined with conventional therapy can decrease systolic blood pressure (weighted mean difference [WMD] −6.67, 95% confidence interval [CI]: −10.30, −3.04. number of estimates [k] = 9, I
2 = 89.3%), diastolic blood pressure (WMD −4.52, 95% CI: −7.79, −1.26. k = 9, I
2 = 92.3%), and improve the clinical efficacy (relative risk [RR] 1.18, 95% CI: 1.10, 1.26. k = 6, I
2 = 12.6%).

Conclusions:
The current evidence showed that GI combined with conventional therapy can improve systolic blood pressure, diastolic blood pressure and clinical efficacy. GI can become a supplementary treatment for hypertension.
The evaluation of a nurse-led hypertension management model in an urban community healthcare
Authors: Miao Jian-Hong , Wang Hai-Shan , Liu Na 
Published: June 2020

Abstract

Background:
Hypertension is a silent disease of the masses with an increasing prevalence and poor control rates. This study aims to establish and test the efficacy of a nurse-led hypertension management model in the community.

Methods:
A single-blind, randomized controlled trial was performed. 156 hypertensive patients with uncontrolled blood pressure were equally and randomly allocated into 2 groups. Patients in the study group received a 12-week period of hypertension management. Blood pressure, self-care behaviors, self-efficacy, and satisfaction were assessed at the start of recruitment, 12 and 16 weeks thereafter.

Results:
After the intervention, blood pressure of patients in the study group had greater improvement in self-care behaviors and a higher level of satisfaction with the hypertensive care compared to the control group (both P < .05).

Conclusions:
The nurse-led hypertension management model is feasible and effective for patients with uncontrolled blood pressure in the community.
Intestinal lymphangiectasia in a 3-month-old girl
Authors: Fattorusso Antonella , Pieri Elena Sofia , Dell’Isola Giovanni Battista , Prontera Paolo , Mencaroni Elisabetta , Stangoni Gabriela , Esposito Susanna 
Published: June 2020

Abstract

Rational:
Intestinal lymphangiectasia (IL) is a rare disease characterized by dilatation and rupture of intestinal lymphatic channels leading to protein-losing enteropathy. IL is classified as primary and secondary types.

Patient concerns:
A 3-month-old girl born at term from vaginal delivery with an APGAR score of 10/10 and birth weight of 4.310 g (>97° percentile) was admitted to our hospital because of increasing abdominal tenderness and diarrhea. At first examination, she presented an abdominal circumference of 60 cm, edema of the lower extremities and vulva, and facial dysmorphisms (hypertelorism, flat nasal bridge, flat mid-face).

Diagnosis:
Once admitted, ultrasonography showed a large amount of ascites, while blood laboratory investigations revealed severe hypoproteinemia, hypoalbuminemia and hypogammaglobulinemia. Lymphoscintigraphy with 99m-Tc-nanocolloid demonstrated abnormal leakage of the tracer in the abdomen as evidence of IL. To detect a possible secondary, exams were performed and demonstrated positive antibody titres for CMV-IgM and IgG in blood and CMV-DNA positivity in blood, urine, saliva, maternal milk, and gastric and duodenal biopsies. Genetic investigations identified the genomic variant c.472C>T of the CCBE1 gene, coding for a protein variant (p.Arg158Cys), in homozygosity.

Interventions:
Total parenteral nutrition was started and continued for a total of 18 days, then gradually bridged by enteral nutrition with a special formula. In addition, antiviral therapy for CMV infection was added first with intravenous ganciclovir for 14 days, resulting in the disappearance of blood viral load after 7 days of therapy and then with valganciclovir per os for another 30 days.

Outcomes:
The clinical course of the child gradually improved. A few days after starting treatments, lower extremities and vulvar edema disappeared, and abdominal circumference gradually decreased to a stable value of 38 cm, without any ultrasonographic signs of ascites left. Moreover, serum albumin and IgG rose to normal values after 3 months (4.3 g/dL and 501 mg/dL, respectively).

Lessons:
This case suggests that in presence of IL both primary and secondary causes should be evaluated. On the other hand, genetic diagnosis is crucial not only for diagnosis but also for prognosis in HS. Life expectancy and quality could deeply vary among different gene mutations and protein variants of the same gene. Further studies and case reports are needed to better understand the clinical meaning of these genetic results and the role of CMV as trigger of IL.
Determinants of surgeon choice in cases of suspected implant rupture following mastectomy or aesthetic breast surgery
Authors: Zingaretti Nicola , Rampino Cordaro Emanuele , Parodi Pier Camillo , Marega Giulia , Modolo Francesca , Moreschi Carlo , Da Broi Ugo 
Published: June 2020

Abstract
Implant ruptures may be diagnosed by physical examination, ultrasound (US), and magnetic resonance imaging (MRI). The absence of standard guidelines to approach to implant ruptures may cause unnecessary surgical revisions in the absence of radiological confirmation of prosthetic damages.
The purpose of this study was to analyze the diagnostic procedures applied to patients with suspected prosthetic rupture and surgeon choices to perform a revision or to plan a clinical and radiological follow-up.
We conducted a retrospective study on 62 women submitted to revision surgery due to radiological diagnosis of suspected implant rupture, following mastectomy or aesthetic reconstruction, and admitted to a Plastic Surgery Department between 2008 and 2018.
Seventy-three implants, believed to be ruptured, were explanted. One-third of these were intact and unnecessarily explanted. US associated with MRI evaluation resulted in the most helpful diagnostical method.
A standardized clinical and radiological approach is essential to manage breast implant ruptures successfully. An innovative protocol is proposed in order to: ensure the appropriate management of implant ruptures and prevent unnecessary surgical revisions; reduce the risk of claims for medical malpractice in cases of unsatisfactory final aesthetic results or worse than before.
Efficacy and Safety of Remdesivir for COVID-19 Treatment: An Analysis of Randomized, Double-Blind, Placebo-Controlled Trials
Authors: Zhu Yun , Teng Zhaowei , Yang Lirong , Xu Shuanglan , Liu Jie , Teng Yirong , Hao Qinggang , Zhao Dake , Li Xiaolan , Lu Sheng , Zeng Yong 
Published: June 2020

AbstractBACKGROUNDRemdesivir, an inhibitor of viral RNA-dependent RNA polymerases, has been identified as a candidate for COVID-19 treatment. However, the therapeutic effect of remdesivir is controversial.METHODSWe searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials, from inception to June 11, 2020 for randomized controlled trials on the clinical efficacy of remdesivir. The main outcomes were discharge rate, mortality, and adverse events. This study is registered at INPLASY (INPLASY202060046).RESULTSData of 1075 subjects showed that remdesivir significantly increased the discharge rate of patients with COVID-19 compared with the placebo (50.4% vs. 45.29%; relative risk [RR] 1.19 [95% confidence interval [CI], 1.05–1.34], I2 = 0.0%, P = 0.754). It also significantly decreased mortality (8.18% vs. 12.70%; RR 0.64 [95% CI, 0.44–0.92], I2 = 45.7%, P = 0.175) compared to the placebo. Data of 1296 subjects showed that remdesivir significantly decreased the occurrence of serious adverse events (RR 0.77 [95% CI, 0.63–0.94], I2 = 0.0%, P = 0.716).CONCLUSIONRemdesivir is efficacious and safe for the treatment of COVID-19.TRIAL REGISTRATION NUMBERThis study is registered at the International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY202060046).
Barriers to Clinical Trial Efficiency and Patient Access: The Heart Failure Collaboratory Industry Survey
Authors: Sinha Shashank S. , Psotka Mitchell A. , Fiuzat Mona , Barnett Scott D. , Bruckmann Martina , Butler Javed , DeSouza Mary M. , Felker G. Michael , Solomon Scott D. , Stockbridge Norman , Teerlink John R. , Unger Ellis F. , O’Connor Christopher M. , Konstam Marvin A. 
Published: June 2020

ABSTRACTAimsClinical trial inefficiency and lack of patient access to novel therapies have been identified as key barriers to successful heart failure innovation. The Heart Failure Collaboratory (HFC) is a consortium developed to identify and address barriers to bringing drugs and devices to market. The HFC performed an electronic cross-sectional survey of key leaders within industry to collate and interpret a sample of viewpoints on these challenges.Methods and ResultsFrom August to September 2018, self-administered survey data were electronically collected from industry partners. Group comparisons were made via Fisher’s Exact or chi-square test. Respondents most commonly rated the United States Food and Drug Administration (44.2%), Health Canada (39.5%) and European Medicines Agency (32.6%) as efficient. Respondents rated the top 3 areas with the greatest opportunity for regulatory agencies to improve efficiency: ‘improve usefulness of agency feedback’ (48.8%); ‘improved timeliness of agency responses’ (41.9%); and ‘pre-specification of required magnitude of clinical effect’ and ‘limit excessive data requirements’ (32.6%). Respondents rated items of ‘excessive clinical site staff workload’ (55.8%), ‘overly complex case report forms’ (51.2%) and ‘data input errors’ (39.5%) as the top 3 factors influencing data quality. Respondents rated items of ‘onerous prior authorization requirements’ (51.2%), ‘availability of decision-making rationale’ (46.5%) and ‘rationality of access barriers created by payers’ (44.2%) as the top 3 impediments to improving patient access to approved therapies.ConclusionThis broadly distributed survey of industry respondents identified multiple specific barriers to heart failure clinical trial efficiency and patient access, which should help direct efforts toward improvement.
Magnetic resonance imaging for individual prediction of treatment response in major depressive disorder: a systematic review and meta-analysis
Authors: Cohen Sem E. , Zantvoord Jasper B. , Wezenberg Babet N. , Bockting Claudi L.H. , van Wingen Guido A. 
Published: June 2020

AbstractObjectiveNo tools are currently available to predict whether a patient suffering from major depressive disorder (MDD) will respond to a certain treatment. Machine learning analysis of magnetic resonance imaging (MRI) data has shown potential in predicting response for individual patients, which may enable personalized treatment decisions and increase treatment efficacy. Here, we evaluated the accuracy of MRI-guided response prediction in MDD.MethodsWe conducted a systematic review and meta-analysis of all studies using MRI to predict single-subject response to antidepressant treatment in patients with MDD. Classification performance was calculated using a bivariate model and expressed as area under the curve, sensitivity, and specificity. In addition, we analyzed differences in classification performance between different interventions and MRI modalities.ResultsMeta-analysis of twenty-two samples including 957 patients showed an overall area under the bivariate summary receiver operating curve of 0.84 (95% CI 0.81-0.87), sensitivity of 77% (95% CI 71-82), and specificity of 79% (95% CI 73 - 84). Although classification performance was higher for electroconvulsive therapy outcome prediction (n = 285, 80% sensitivity, 83% specificity) than medication outcome prediction (n = 283, 75% sensitivity, 72% specificity), there was no significant difference in classification performance between treatments or MRI modalities.ConclusionPrediction of treatment response using machine learning analysis of MRI data is promising but should not yet be implemented into clinical practice. Future studies with more generalizable samples and external validation are needed to establish the potential of MRI to realize individualized patient care in MDD.PROSPERO registration numberCRD42019137497
The HIV-1 Vpu transmembrane domain topology and formation of a hydrophobic interface with BST-2 are critical for Vpu-mediated BST-2 downregulation
Authors: Khan Nabab , Padhi Siladitya , Patel Paresh , Priyakumar U. Deva , Jameel Shahid 
Published: June 2020

AbstractViruses belonging to the M group of human immunodeficiency virus (HIV-1) are the most virulent among the four HIV-1 groups. One factor that distinguishes the M group HIV-1 from others is Vpu, a membrane localized accessory protein, which promotes the release of virions by neutralizing the antiviral host cell protein BST-2. To investigate if this activity is determined by the topology of Vpu or by conserved amino acid residues, we prepared chimeric forms of Vpu by replacing its transmembrane domain with those from its topological homologs. Although the chimeric Vpu proteins downregulated BST-2, these substantially reduced virus production as well. Molecular modeling studies on Vpu from different HIV-1 groups and the chimeric Vpu proteins showed that shape and the availability of a hydrophobic interface are more important for BST-2 antagonism than conservation of the amino acid sequence. Our data suggest that the HIV-1 Vpu-M protein has evolved topologically to interact with BST-2, and that the Vpu/BST-2 interface can be exploited as a target to limit HIV-1 replication.
The Influence of Time-Limited Immunity on a COVID-19 Epidemic: A Simulation Study
Authors: Kosinski Robert J. 
Published: June 2020

AbstractA series of spreadsheet simulations using SEIS, SEIR, and SEIRS models showed that different durations of effective immunity could have important consequences for the prevalence of an epidemic disease with COVID-19 characteristics. Immunity that lasted four weeks, twelve weeks, six months, one year, and two years was tested with pathogen R0 values of 1.5, 2.3, and 3.0. Shorter durations of immunity resulted in oscillations in disease prevalence. Immunity that lasted from three months to two years produced recurrent disease outbreaks triggered by the expiration of immunity. If immunity “faded out” gradually instead of persisting at full effectiveness to the end of the immune period, the recurrent outbreaks became more frequent. The duration of effective immunity is an important consideration in the epidemiology of a disease like COVID-19.
A new estimation method for COVID-19 time-varying reproduction number using active cases
Authors: Hasan Agus , Susanto Hadi , Tjahjono Venansius , Kusdiantara Rudy , Putri Endah , Hadisoemarto Panji , Nuraini Nuning 
Published: June 2020

ABSTRACTWe propose a new method to estimate the time-varying effective (or instantaneous) reproduction number of the novel coronavirus disease (COVID-19). The method is based on a discrete-time stochastic augmented compartmental model that describes the virus transmission. A two-stage estimation method, which combines the Extended Kalman Filter (EKF) to estimate the reported state variables (active and removed cases) and a low pass filter based on a rational transfer function to remove short term fluctuations of the reported cases, is used with case uncertainties that are assumed to follow a Gaussian distribution. Our method does not require information regarding serial intervals, which makes the estimation procedure simpler without reducing the quality of the estimate. We show that the proposed method is comparable to common approaches, e.g., age-structured and new cases based sequential Bayesian models. We also apply it to COVID-19 cases in the Scandinavian countries: Denmark, Sweden, and Norway, where we see a delay of about four days in predicting the epidemic peak.
“012012 or 111000”: preference for consumption pattern-seeking
Authors: Kim Jungkeun , Cui Yuanyuan (Gina) , Hwang Euejung , Franklin Drew , Seo Yuri 
Published: June 2020

PurposeThis paper aims to examine how consumers make choices when they are faced with a fixed set of available options, consisting of both preferred and less-preferred choices, in the domain of food consumption. Specifically, the paper offers a novel perspective to predict repeated choice decisions in food consumption, which is termed as “pattern-seeking” – a consumption choice pattern that involves a coherent repetitive sequence of sub-groupings or coherently concentrated sub-groupings of options.Design/methodology/approachEight experimental studies that contrast the existing theoretical predictions regarding repeated choices (e.g. primacy effect, recency effect, variety vs consistency) against pattern-seeking were conducted using hypothetical and actual food choices.FindingsThe results of experimental studies show that an explicit decision pattern (i.e. pattern-seeking) emerges as the most significant predictor of repeated choice in the food consumption domain.Research limitations/implicationsThis study offers a novel perspective on how consumers make repeated choices in the domain of food consumption.Practical implicationsThe results show that consumers prefer food consumption with a pattern (vs non-pattern). Thus, it would be better to generate marketing activities that allow customers to satisfy their pattern-seeking more easily.Originality/valueThis study advances the literature on repeated food choices by demonstrating that people possess an inherent preference for patterns in food consumption.
System reliability computation and estimation based on a cumulative damage–threshold–shock model
Authors: Siju K.C. Siju K.C. , Kumar Mahesh 
Published: June 2020

PurposeThis article considers a reliability model where the failure is due to cumulative damage exceeding a threshold level. The concept that the threshold level of cumulative damage at each arrival of shock can change based on whether the magnitude of each shock exceeds its defined threshold level is considered to compute the system reliability.Design/methodology/approachThe stochastic process approach is used to obtain the cumulative damage based on Poisson arrival of shocks. The general expression for reliability is obtained using the conditional probability over each arrival of shock. The method of maximum likelihood estimation is used to obtain the estimators of the parameters and system reliability. A sensitivity analysis is performed to measure the effect of the parameter representing the rate of arrival of shock.FindingsThe maximum likelihood estimates of the reliability approach the actual reliability for increasing sample size. A sensitivity analysis study on the parameter representing the rate of arrival of shock shows that as the values of parameter increase (decrease), the reliability value decreases (increases).Originality/valueObtained a new expression for the cumulative damage–shock model and the findings are positively supported by presenting the general trend of estimated values of reliability approaching the actual value of reliability. The sensitivity analysis also genuinely supports our findings.