bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biomarkers of sepsis: Time for a Reappraisal
Authors: Pierrakos Charalampos , Velissaris Dimitrios , Bisdorff Max , Marshall John C , Vincent Jean-Louis 
Published: May 2020

Abstract
Introduction : Sepsis biomarkers can have important diagnostic, therapeutic, and prognostic functions. In a previous review, we identified 3370 references reporting on 178 different biomarkers related to sepsis. In the present review, we evaluate the progress in the research of sepsis biomarkers. Methods: Using the same methodology as in our previous review, we searched the PubMed database from 2009 until September 2019 using the terms “Biomarker” AND “Sepsis”. There were no restrictions by age or language and all studies, clinical and experimental, were included. Results: We retrieved a total of 5367 new references since our previous review. We identified 258 biomarkers, 80 of which were new compared to our previous list. The majority of biomarkers have been evaluated in fewer than 5 studies, with 81 (31%) being assessed in just a single study. Apart from studies of C-reactive protein (CRP) or procalcitonin (PCT), only 26 biomarkers have been assessed in clinical studies with more than 300 participants. Forty biomarkers have been compared to PCT and/or C-reactive protein CRP for their diagnostic value; 9 were shown to have a better diagnostic value for sepsis than either or both of these biomarkers. Forty-four biomarkers have been evaluated for a role in answering a specific clinical question rather than for their general diagnostic or prognostic properties in sepsis. Conclusions : The number of biomarkers being identified is still increasing although at a slower rate than in the past. Most of the biomarkers have not been well-studied; in particular the clinical role of these biomarkers needs to be better evaluated.
Surgical treatment of mono-segmental spinal tuberculosis using a combination of debridement and extreme lateral interbody fusion (XLIF): A retrospective study
Authors: Zhan Yi , Chen Ke , Huang Wuliang , Chen Weijian , Lin Yulin 
Published: May 2020

Abstract
Background

This study investigated the clinical efficacy and safety of a combination of debridement and extreme lateral internal fusion (XLIF) for mono-segmental spinal tuberculosis (TB).
Methods

The medical records of 9 patients (aged 21–70 years; 6 males) with mono-segmental spinal TB treated at our hospital between January 2014 and November 2016 were retrospectively reviewed. The involved vertebral bodies included 2 cases each at the T6/7, L2/3 or L3/4 level and 1 case each at the T7/8, T8/9, or T9/10 level.
Results

All patients were successfully treated with a combination of debridement and XLIF. The mean length of the operation was 97.3 ± 20.6 min (range, 65–126 min), and the mean blood loss during surgery was 151.1 ± 25.7 ml (range, 105–185 ml). Two patients experienced sensory disturbance over the left thigh and iliopsoas muscle weakness after surgery. After a mean follow-up of 12.3 ± 3.7 months (range, 6–17 months), the mean Cobb angle decreased from 28.7 ± 6.7 degrees to 12.1 ± 3.7 degrees. The mean VAS pain score decreased from 7.2 ± 1.1 preoperatively to 2.3 ± 0.9 postoperatively. The mean bone graft fusion time was 5.6 months (range, 4.7–7.2 months). At the final follow-up, spinal cord injuries were evaluated as ASIA Grade D in 5 patients and ASIA Grade E in 4 patients.
Conclusions

A combination of debridement and XLIF is effective for the treatment of mono-segmental spinal TB, and is associated with minimal intraoperative trauma, few complications, and an improved quality of life for patients.
Trial registration:

This was a retrospective study. The study was approved by the institutional review board and the committee of our hospital. Informed consent to use their data was obtained from all patients before surgery.
Catastrophic costs among tuberculosis patients in Zimbabwe: a national health facility-based survey
Authors: Timire Collins , Ngwenya Mkhokheli , Chirenda Joconiah , Metcalfe John Z , Kranzer Katharina , Pedrazzoli Debora , Takarinda Kudakwashe Collin , Nguhiu Peter , Madzingaidzo Geshem , Ndlovu Kwenzikweyinkosi , Mapuranga Tawanda , Cornell Morna , Sandy Charles 
Published: May 2020

Abstract
Background: Tuberculosis (TB) has biological and socio-economic dimensions. The socio-economic impact of TB may plunge households into financial catastrophes. The End TB strategy seeks to mitigate socio-economic factors which may act as barriers to accessing TB services. Countries have been encouraged to provide baseline estimates of catastrophic costs by 2020. We sought to determine the prevalence, risk factors and major drivers of catastrophic costs among TB patients in Zimbabwe. Methods: We conducted a nationally representative, health facility-based survey with random cluster sampling among TB patients. We enrolled patients with drug susceptible (DS-TB) and drug resistant TB (DR-TB) consecutively. We administered a standardised questionnaire to capture the costs incurred as well as lost income due to TB illness. Catastrophic costs were measured at a threshold of 20%. We did a sensitivity analysis of indirect costs using the time lost by patients in each phase of treatment. We used multivariable logistic regression to determine the risk factors for experiencing catastrophic costs. Results: A total of 841 patients were enrolled in the survey, weighted to 900 during data analysis. There were 500 (56%) males and 46 (6%) DR-TB patients. Thirty-five (72%) DR-TB patients were HIV co-infected. Overall, 80% (95% CI:77-82%) of TB patients and their households experienced catastrophic costs. The major cost drivers pre-TB diagnosis were direct medical costs. Nutritional supplements were the major cost driver post-TB diagnosis, (median cost US$360 (IQR: 240-600). Post-TB diagnosis costs were three-times higher among DR-TB [US$1,659 (653-2,787)] versus drug susceptible TB (DS-TB) affected households [US$537 (204-1,134)]. Income loss was five-times higher among DR-TB versus DS-TB patients. In multivariable analysis, household wealth was the only covariate that remained significantly associated with catastrophic costs: the poorest households had sixteen times the odds of incurring catastrophic costs compared to wealthiest households [adjusted odds ratio (aOR:15.7 95% CI:7.5-33.1)]. Conclusion: The majority of TB patients enrolled in care experienced catastrophic costs, with the highest burden on DR-TB patients. Since the major cost drivers fall outside the healthcare system, a multi-sectoral approach to TB control and linking TB patients to social protection schemes holds promise for reducing catastrophic costs in Zimbabwe.
Full-endoscopic lumbar decompression versus open posterior interbody fusion for surgical treatment of stable lumbar disc herniation in patients over 65 years: A retrospective cohort study with 2-year follow-up
Authors: Li Tong , Zhu Bin , Liu Xiaoguang 
Published: May 2020

Abstract
Background: In the last decade, full-endoscopic techniques to treat lumbar disc herniation (LDH) have gained popularity in clinical practice. However, few studies have described the safety and efficacy of full-endoscopic lumbar decompression (FELD) in treating older patients with LDH. The aim of this study is to evaluate the safety and efficacy of FELD and open posterior lumbar interbody fusion (O-PLIF) for stable LDH in patients over 65 years of age.Methods: Data of 251 consecutive patients over 65 years received surgical treatment for stable LDH in 2 separated groups (minimally invasive spinal surgical group and open spinal surgical group) in single center between January 2014 and April 2018 were retrospectively analyzed. Patients were categorized into 2 groups (FELD group and O-PLIF group) according to the operative procedure. Clinical outcome evaluations were performed preoperatively, at 3, 6, 12, 24 months postoperatively, including Oswestry disability index (ODI) score and Japanese orthopaedic association (JOA) score for function assessment, visual analog scale (VAS) score for low-back pain and leg pain, MacNab criteria for assessment of life quality. In addition, the surgical information, including operative time, blood loss, hospitalization time, and adverse events were assessed.Results: Among 251 patients, 153 underwent FELD and 98 underwent O-PLIF. There was no significant difference in baseline data between 2 groups (p>0.05). The mean operative time was significantly shorter, blood loss and hospitalization time were significantly reduced in patients having FELD than O-PLIF (p<0.001). The mean ODI, JOA, and VAS postoperative scores were significantly improved over the preoperative scores in both groups (p<0.05). No significant difference was between 2 groups in postoperative ODI, JOA, VAS scores, and MacNab evaluation (p>0.05). The adverse event rate was 5.2% in FELD group, which was significantly lower than that in O-PLIF group (16.3%, p<0.05). The recurrence rate was 7.2% in FELD group and the rate of adjacent segment disc herniation was 6.1% in O-PLIF group.Conclusions: FELD could achieve satisfactory safety and efficacy for the treatment of stable LDH in the patients over 65 years of age. With less trauma, faster recovery, and lower adverse event rate, FELD may be an alternative surgical treatment for stable LDH in elderly patients.
Knowledge About Syphilis and Its Oral Manifestations Among Dental Students: Cross-sectional Study
Authors: Filho Antonio Carlos Pacheco , Garbin Artênio José Isper , Pires Natália Cupertino , Pacheco Karina Tonini dos Santos , Garbin Cléa Adas Saliba 
Published: May 2020

Abstract
Background:Clinical manifestations of the syphilis can occur in the mouth and in the perioral region. This study aimed to investigate the knowledge about syphilis and its oral manifestations among dental students and to discuss the role of the dentist in prevention and control of this disease.Methods:This is a cross-sectional study carried out with dental students from a Public University. Data collection was performed by a semi-structured questionnaire containing 16 questions answered by students in classroom. Analyses of absolute and relative frequency were performed. To perform association among variables, the Chi-square test (or Fisher's exact test with Yates correction) was performed with 5% significance level. Results:Only 40 (46.4%) students correctly answered the question about disease stages. Almost all participants answered that syphilis has oral manifestations; however, only 44 (25.7%) answered the question correctly. Regarding differential diagnoses of other oral lesions, only 63 (37.3%) reported knowledge on this subject. There was a statistically significant association between student’s educational level and knowledge about the etiological agent (p = 0.000), clinical manifestations (p = 0.000), disease stages (p = 0.000), oral manifestations (p = 0.000) and drugs (p = 0.005) related to the disease.Conclusions:Participants showed important gaps in their knowledge about syphilis and its oral manifestations. Our findings, together with the increased number of new cases of the disease in the world, reinforce the need for training dental professionals with knowledge about early diagnosis, effective treatment and follow-up of syphilis cases.
SARS-CoV-2 prevalence in an asymptomatic cancer cohort - results and consequences for clinical routine
Authors: Marschner Sebastian , Corradini Stefanie , Rauch Josefine , Zacharias Richard , Sujic Ana , Mayerle Julia , Petru Raluca , Grabein Béatrice , Keppler Oliver T. , Boelke Edwin , Belka Claus , Niyazi Maximilian 
Published: May 2020

Abstract
Background
Starting in December 2019, the current pandemic caused by the severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) confronts the world with an unprecedented challenge. With no vaccine or drug being currently available to control the pandemic spread, prevention and PCR (Polymerase chain reaction) testing becomes a crucial pillar of medical systems. Aim of the present study was to report on the first results of the measures taken in a large German Department of Radiation Oncology, including PCR testing of asymptomatic cancer patients.
Methods
Pandemic-adapted hygiene regulations and prevention measures for patients and staff were implemented. A visiting ban on both wards was implemented from the beginning and medical staff and patients were required to wear face masks at all times. The waiting rooms were rearranged to ensure distance between patients of at least 1.5 meters. Clinical follow up was mainly done by telephone and all patients had to complete a questionnaire regarding symptoms and contacts with COVID-19 patients before entering our department. Educational documents were created for patients to raise awareness of symptoms and avoidance strategies for interactions with other people. Indications for therapy and fractionation schemes were adapted when possible. In a subsequent step, all new asymptomatic patients were tested via nasopharyngeal swab at our screening station shortly before their simulation CT.
Results
All these measures and implementations have been well accepted. Regarding the PCR testing, only 1 out of 139 asymptomatic patients of our cohort so far tested positive for SARS-CoV-2, reflecting a prevalence of 0.72% in this cancer patient population. Up to this point no staff members was tested positive. The start of the treatment for the PCR-positive patient was deferred for two weeks.
Conclusion
Due to the pandemic-adapted implementations, our department seems well prepared during this crisis. The initial screening helps to identify asymptomatic COVID-19 patients in order to protect other patients and our staff from infection and the observed PCR prevalence is in line with comparable studies. A regular PCR testing (e.g. twice a week) of all patients and staff would in principle be desirable but is limited due to testing capacities at present.
A Parallel, 2-DOF Exoskeleton for the Human Shoulder: Device Characterization and Preliminary Results on Healthy Subjects
Authors: Natividad Rainier , Miller-Jackson Tiana , Chen-Hua Raye Yeow 
Published: May 2020

Abstract
BackgroundHumans are highly reliant on the efficient function of their upper limb. Neuromuscular disorders that impair the function of the shoulder consequently reduce quality of life. Robotic rehabilitation serves as an attractive treatment choice due to its promising results and its ability to alleviate the demands on therapists and clinicians. Nevertheless, current robotic architectures are not optimized for the human shoulder but are more apt for industrial environments. Pneumatically powered soft robotic actuators present an attractive method to create shoulder exoskeletons due to their compliance and relatively low mass. However, current actuators lack the necessary functions to provide support to the entire shoulder’s range of motion.MethodsA modular, fabric pneumatic actuator was constructed. The actuator design allows it to perform three-dimensional (3-D) bends with minimal resistance. Four actuators were combined to create a soft shoulder exoskeleton. Each actuator drives one direction of motion: elevation and depression, rotation of the plane of elevation. The torque output of the actuator was measured using a customized two-axis torque measurement system. Exoskeleton functionality was tested through surface electromyography of relevant shoulder muscles. 10 healthy subjects were recruited and performed arm motions under the assistance of the exoskeleton.ResultsThe actuator can reach full bending (>360°) with low pressures (~10kPA). Its torque output is highly dependent on its geometry. Moreover, torque output is reduced as the bending angles increase. The actuators installed on the exoskeleton output 11.15N-m of torque at the neutral position, and 4.44 N-m at 90° shoulder elevation. The test on healthy subjects showed that use of the exoskeleton reduces muscle activation by up to 65% when performing shoulder elevation, and up to 34% when rotating the plane of elevation. Use of the exoskeleton also resulted in a change in arm trajectory when performing elevation and depression movements.ConclusionsThe reduction in muscle activation highlights the ability of a soft-robotic exoskeleton in supporting arm movements. Moreover, the presented exoskeleton design successfully demonstrated its ability to generate two degree-of-freedom support for the human shoulder.
Association of Clinical Characteristics with the Proportion of the HDL-Cholesterol Subclasses HDL-2b and HDL-3 Among Patients Undergoing Hemodialysis
Authors: Chen Jin-Bor , Lee Wen-Chin , Moi Sin-Hua , Yang Cheng-Hong 
Published: May 2020

Abstract
Background: Altered high-density lipoprotein cholesterol (HDL-C) composition in patients with chronic kidney disease is common. However, reports on the distribution of HDL-C subclasses in patients undergoing hemodialysis (HD) are limited. Objective: We aimed to compare the two main HDL-C subclasses, HDL-2b and HDL-3, in two cohorts of HD patients and healthy individuals and examine their associations with clinical characteristics. Methods: A total of 164 prevalent HD patients and 71 healthy individuals in one hospital-facilitated outpatient clinic were enrolled from May 2019 to July 2019. The HDL-2b and HDL-3 proportions were measured and statistical analysis was performed. Results: The mean ages of HD patients and healthy individuals were 63 and 49.9 years, respectively. HD patients showed lower HDL-2b and HDL-3 proportions compared with those of healthy individuals (23.6% vs. 31.2%, P < 0.001; 31.7% vs. 33.6%, P = 0.137, respectively). The HDL-2b proportion was significantly higher with a high-sensitivity C-reactive protein (hs-CRP) levels of <3 mg/L compared with hs-CRP ≥3mg/L in the HD cohort (P = 0.005). HDL-3 proportion was lower with a hs-CRP level of <3 mg/L compared with hs-CRP ≥3mg/L in the HD cohort (P = 0.022). Sex and diabetes did not influence the HDL-2b and HDL-3 proportions in the HD cohort.Conclusions: HD patients had lower HDL-2b and HDL-3 proportions than those of healthy individuals. The distribution of the HDL-2b and HDL-3 subclasses in HD patients is influenced by proinflammatory status, not by sex and diabetic status.
Computed Tomography and Clinical Features Differentiating Coronavirus Disease 2019 from Seasonal Influenza Pneumonia
Authors: Zhao Shuang , Huang Zixing , Zeng Hanjiang , Chen Zhixia , Luo Fengming , Zhang Chongwei , Song Bin 
Published: May 2020

Abstract
Objectives: To investigate computed tomography (CT) and clinical features could help differentiate coronavirus disease 2019 (COVID-19) from seasonal influenza pneumonia.Methods: We retrospectively evaluated the clinical features and chest CT findings of Chinese patients with COVID-19 and seasonal influenza pneumonia treated during the same period. Results: The 24 patients with COVID-19 (mean age, 41 years; 13 men) and 79 patients with seasonal influenza pneumonia (mean age, 41 years; 50 men) differed significantly in mean temperature, respiratory rate, and systolic blood pressure; in central-peripheral, superior-inferior, and anterior-posterior distribution but not lateral distribution of pulmonary lesions; and patchy ground-glass opacity (GGO), GGO nodules, vascular enlargement in GGO, air bronchogram, bronchiolectasis in GGO or consolidation, interlobular septal thickening, and crazy-paving pattern. Separate regression models were developed with clinical features, CT features (including anatomical distributions), and a combined model informed by the first two. The combined model had the best diagnostic performance for identifying COVID-19: a cut-off value of 0.38 was 74% sensitive and 100% specific and had an area under the receiver operating characteristics curve of 0.94. This model was based on sputum production, vascular enlargement in GGO, and central-peripheral distribution (random vs subpleural). Conclusions: The combination of sputum production, vascular enlargement in GGO, and central-peripheral distribution should be extremely helpful in the differential diagnosis of COVID-19.
In silico virtual screening-based study of nutraceuticals predicts the therapeutic potentials of folic acid and its derivatives against COVID-19
Authors: Kumar Vipul , Jena Manoj 
Published: May 2020

Abstract
The recent outbreak of the novel coronavirus (SARS-CoV-2) in the Wuhan province of China has taken millions of lives worldwide. In this pandemic situation and absence of known drugs and vaccines against novel coronavirus disease (COVID-19), there is an urgent need for the repurposing of the existing drugs against it. So, here we have examined a safe and cheap alternative against this virus by screening hundreds of nutraceuticals compounds against known therapeutic targets of SARS-COV-2 by molecular docking .The virtual screening results were then analyzed for binding energy and interactive residues in the best binding pose. All these analyses of this study strongly predicted the potential of Folic acid and its derivates like Tetrahydrofolic acid and 5-methyl tetrahydrofolic acid against SARS-COV-2. The strong and stable binding affinity of this water-soluble vitamin and its derivatives against the SARS-COV-2, indicating that they could be valuable drugs against the management of this COVID-19 pandemic. This study could serve as the starting point for further investigation of these molecules through in-vitro and in-vivo assays.
The Advances of the Structure and Function of Indoleamine 2, 3- dioxygenase 1 and Its Inhibitors
Authors: Duan Huai-Chuan , Peng Lian-Xin , Hu Yi-Chen , Luo Qing , Liu Xin-Yu , Sun Xin , Liang Li , Gan Ya , Liu Wei , Wan Hua , Shi Hu-Bing , Zhao Gang , Hu Jian-Ping 
Published: May 2020

:
Indoleamine 2, 3-dioxygenase 1 (IDO1) is the only rate-limiting enzyme outside the liver
that catalyzes the oxidation and cracking of indole rings in the tryptophan along the kynurenine pathway
(KP). The overactivation of IDO1 is closely related to the pathogenesis of various human immune
and neurological diseases. As an important target for the treatment of many human serious diseases,
including malignant tumors, the development of IDO1 inhibitors is of great practical significance. In
this work, the structure and function of IDO1 both are summarized from the aspects of the signal
pathway, catalytic mechanism, structural biology, and so on. Moreover, the current development status
of IDO1 inhibitors is also systematically reviewed, which provides assistance for anti-cancer drug
design based on the structure of receptors.