bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using the Kano model to associate the number of confirmed cases of COVID-19 in a population of 100,000 with case fatality rates: an observational study
Authors: Su Shih-Bin , Kan Wei-Chih , Lin Jui-Chung John , Yeh Yu-Tsen , Chien Tsair-Wei 
Published: April 2020

Abstract
Background: One of the key factors to understand the spread of COVID-19 is the case fatality rate(CFR) rates for counties/regions. However, many merely reported those CFRs on the basis of total confirmed cases(TCC) instead of per population of 100, 000. As such, the disparate definitions of CFR yield inconsistent results in COVID-19 situations. Whether both incident rate and the CFR can be indicators to identify a country/region hit by COVID-19 under(or out of) control is still unclear. This study aims to (1) develop a diagram to disperse both TCC and CFR on a population base of 100,000(namely TCC100 and CFR100, respectively) using the Kano model, (2)discuss selected countries/regions with success on preventative measures to keep COVID-19 under control(i.e., relatively lower TCC100 and CFR100 or CFR), and (3) design an app to display both TCC100 and CFR100 or CFR for all infected countries/regions. Methods: We downloaded the COVID-19 data of confirmed cases and deaths in countries/regions on a daily basis from the Github website. Three values, TCC100, CFR100, and CFR, were computed for each country/region and displayed on the Kano model. The lower TCC100 and CFR values were deemed as having the COVID-19 situation more under control. An app was developed to display both TCC100 and CFR100 on Google Maps. Results: The correlation coefficient(CC) between TCC100 and CFR100 is 0.92(t=37.87) based on 285 count data (i.e., 12, 225, and 48 dispersed on the Kano diagram) obtained in comparison to the pair of TCC100 and CFR with the CC=-0.02(t=-0.25) and counts(i.e., 56, 145, and 84 on the Kano diagram). The state of Washington, USA, was found having the highest TCC100(=3498.15), CFR100 (=16548.96) and CFR(=5%) in comparison to (1)Taiwan[TCC100(=1.65), CFR100 (=2.17), CFR(=1%)] and (2)South Korea[TCC100(=20.34), CFR100 (=39.8), CFR(=2%)] on April 12,2020. Conclusion: We illustrated both TCC100 and CFR along with CFR100 to compare countries/regions on a Kano diagram to understand the COVID-19 situations better. A larger TCC100 value was strongly associated with a larger CFR100 value that needs further verifications in the future. An app was developed to display both TCC100 and CFR for countries/regions on a dashboard laid over Google Maps.
Bacteria-induced expression of the pig-derived protegrin-1 transgene specifically in the respiratory tract of mice enhances resistance to airway bacterial infection
Authors: zeng fang , Zhao Chengcheng , Wu Xiao , Dong Rui , Li Guoling , Zhu Qingchun , Zheng Enqin , Liu Dewu , Yang Jinzeng , Moisyadi Stefan , Urschitz Johann , Li Zicong , Wu Zhenfang 
Published: April 2020

Abstract
Background About 70% of all antibiotics produced in the world are used in the farm animal industry. The massive usage of antibiotics during farm animal production has caused rapid development of antibiotic resistance in bacteria, which poses a serious risk to human and livestock health when treating bacterial infections. Protegrin-1 (PG-1) is a potent antimicrobial peptide (AMP), initially identified in pig leukocytes with a broad-spectrum antibacterial and antiviral activity, and a low rate of inducing bacterial resistance. Results To develop genetic approaches for reducing the use of antibiotics in farm animal production, we produced transgenic mice carrying a bovine tracheal AMP gene promoter-controlled PG-1 transgene. The PG-1 transgene was specifically expressed in the respiratory tract of transgenic mice upon induction by bacterial infection. These PG-1 transgenic mice exhibited enhanced resistance to nasal bacterial infection as the infected transgenic mice showed a higher survival rate, lower bacterial load and milder histological severity than the infected wild-type control littermates. Conclusions The present study provides a promising genetic strategy to prevent airway bacterial infections in animals by bacteria-inducible tissue-specific expression of PG-1 transgene, an approach which may also be helpful for reducing the possibility of inducing bacterial resistance.
Diameter of Superior Rectal Vein – CT Predictor of KRAS mutation in Rectal Carcinoma
Authors: Song Chenyu , Shen Bingqi , Dong Zhi , Fan Zhenzhen , Xu Ling , Li Zi-Ping , Li Yin , Feng Shi-Ting 
Published: April 2020

Abstract
Background The purpose of this study was to investigate the feasibility of CT parameters to predict the presence of KRAS mutation in rectal cancer patients. The relationship between KRAS mutation and pathological findings was evaluated simultaneously.Methods 89 patients (29 females, 60 males, age 27–90, mean 59.7 ± 12 years) with pathologically proven rectal cancer were enrolled. KRAS mutation test was completed following surgery. Parameters evaluated on CT included the diameter of superior rectal vein (SRV) and inferior mesenteric vein (IMV), the presence of calcification, ulceration, lymph node enlargement (LNE), distant metastasis, tumor growth pattern (single nodule or annular thickening), enhanced pattern (homogeneous or heterogeneous), CT ratio and the length of tumor (LOT). Pathological findings included lymphovascular emboli, signet ring cell, peripheral fat interval infiltration, focal ulcer, lymph node metastasis, tumor pathological type and differentiation extent. The correlations between KRAS status and CT parameters, KRAS status and pathological findings were investigated. The accuracy of CT characteristics for predicting KRAS mutation was evaluated.Results KRAS mutation was detected in 42 cases. On CT image, the diameter of SRV was significantly increased in KRAS mutation group than in KRAS wild-type group (4.6 ± 0.9 mm vs. 4.2 ± 0.9 mm, p = 0.02). And LNE was more likely to occur in KRAS mutation group (73.3% vs. 26.7%, p = 0.03). There was no significant difference between KRAS mutation group and KRAS wild-type group on the other CT parameters (IMV, calcification, ulcer, distant metastasis, tumor growth pattern, enhanced pattern, CT ratio and LOT). In pathological findings, KRAS mutation was more likely to occur in middle differentiation group (p = 0.03). No significant difference was found between KRAS mutation group and KRAS wild-type group in the presence of lymphovascular emboli, signet ring cell, peripheral fat interval infiltration, focal ulcer, lymph node metastasis, tumor pathological type. The AUC of SRV to predict KRAS mutation was 0.63.Conclusion It was feasible to use the diameter of SRV to predict KRAS mutation in rectal cancer patients, and LNE also can be regarded as an important clue on preoperative CT images.
Performance of SwiftScan planar and single photon emission computed tomography technology using low-energy high-resolution and sensitivity collimator
Authors: Shibutani Takayuki , Onoguchi Masahisa , Yoneyama Hiroto , Konishi Takahiro , Nakajima Kenichi 
Published: April 2020

Abstract
Background

A new low-energy high-resolution-sensitivity (LEHRS) collimator was developed by General Electric Healthcare. SwiftScan planar and SPECT system using LEHRS collimator were formulated to achieve the low-dose and/or short-term acquisition. We demonstrated the performance of SwiftScan planar and SPECT system with LEHRS collimator using phantoms.
Methods

Line source, cylindrical and flat plastic dish phantoms were used to evaluate the performance of planar and SPECT images for four patterns of Siemens LEHR, GE LEHR, GE LEHRS and SwiftScan using two SPECT-CT scanners. Each phantom was filled with 99mTc solution, and the spatial resolution, sensitivity and image uniformity were calculated from the planar and SPECT data.
Results

The full-width at half maximum (FWHM) values as system spatial resolution of Siemens LEHR, GE LEHR and GE LEHRS were 7.3, 7.5 and 7.3 mm, respectively. GE LEHRS showed the lower FWHM value by increasing the blend ratio in Clarity 2D processing. The system sensitivities of Siemens LEHR, GE LEHR and GE LEHRS were 88.4, 67.6 and 89.8 cps/MBq, respectively. The system sensitivity of GE LEHRS increased by approximately 30% compared with that of GE LEHR and was similar to that of Siemens LEHR. The FWHM values of SPECT with an FBP method were 10.3, 10.4, 10.4 and 10.3 mm (p = n.s.). The FWHM values of the OSEM method were better with an increase in iteration values. The differential uniformities of Siemens LEHR, GE LEHR, GE LEHRS and GE SwiftScan were 15.3%, 15.1%, 15.4% and 14.6%, respectively, using the FBP method. The differential uniformity of OSEM method was higher with an increase in iteration value.
Conclusion

The SwiftScan planar and SPECT have a high sensitivity while maintaining the spatial resolution compared with the conventional system.
Features for deep vein thrombosis in the uninjured limbs of lower extremity fractures: a retrospective study 1454 patients
Authors: Qu Shuang-Wei , Cong Yu-Xuan , Wang Peng-Fei , Fei Chen , Li Zhi , Yang Kun , Shang Kun , Ke Chao , Huang Hai , Zhuang Yan , Zhang Bin-Fei , Zhang Kun 
Published: April 2020

Abstract
Objective: The purpose of this study was to investigate the incidence of and independent risk factors for deep venous thrombosis (DVT) in the uninjured limb, before and after operation, in patients with lower extremity fractures.Methods: We collected the clinical data of patients with lower extremities fractures who presented at Xi’an Honghui Hospital between 1 July, 2015 and 31 October, 2017. Doppler ultrasonography was used to diagnose the DVT. Patients were examined pre- and postoperatively. The patients were then divided into a thrombosis group and a no thrombosis group according to the preoperative and postoperative ultrasonography results. The thrombosis group was defined as patients admitted to our hospital with DVT in the uninjured limb and the no thrombosis group was defined as patients without DVT in the uninjured limb.Results: This study enrolled 1454 patients who met the inclusion criteria. The incidence of preoperative DVT in the uninjured limb was 9.63% whereas the postoperative incidence was 20.29%. Age (OR=0.965, 95 CI%: 0.954 - 0.977; P=0.000) and gender (OR=0.667, 95% CI: 0.451-0.986, P=0.042) were independent risk factors for preoperative DVT in the uninjured limb. Blood loss (OR=0.997, 95 CI%: 0.995-1.000; P=0.020), D-dimer levels at admission (OR=0.941, 95 CI%: 0.887-0.999; P=0.045), and postoperative day 5 D-dimer levels (OR=0.889, 95 CI%: 0.819-0.965; P=0.005), were independent risk factors for postoperative DVT in the uninjured limb.Conclusion: In conclusion, the actual incidence of DVT in the uninjured lower extremity after fracture may currently be underestimated and should be pay more attention.
TM4SF1 promotes EMT and cancer stemness via Wnt/β-catenin/SOX2 pathway in colorectal cancer
Authors: TANG QIANG , Chen Jinghuang , Di Ziyang , Yuan Wenzheng , Zhou Zili , Liu Zhengyi , Han Shengbo , Liu Yanwei , Di Maojun , Shu Xiaogang 
Published: April 2020

Abstract
The authors have requested that this preprint be removed from Research Square.
AML Risk Stratification Models Utilizing ELN-2017 Guidelines and Additional Prognostic Factors: A SWOG Report
Authors: Pogosova-Agadjanyan Era L , Moseley Anna , Othus Megan , Appelbaum Frederick R. , Chauncey Thomas R. , Chen I-Ming L. , Erba Harry P. , Godwin John E. , Jenkins Isaac C. , Fang Min , Huynh Mike , Kopecky Kenneth J. , List Alan F. , Naru Jasmine , Radich Jerald P. , Stevens Emily , Willborg Brooke E. , Willman Cheryl L. , Wood Brent L. , Zhang Qing , Meshinchi Soheil , Stirewalt Derek L. 
Published: April 2020

Abstract
Background The recently updated European LeukemiaNet risk stratification guidelines combine cytogenetic abnormalities and genetic mutations to provide the means to triage patients with acute myeloid leukemia for optimal therapies. Despite the identification of many prognostic factors, relatively few have made their way into clinical practice.Methods In order to assess and improve the performance of the European LeukemiaNet guidelines, we developed novel prognostic models using the biomarkers from the guidelines, age, performance status and select transcript biomarkers. The models were developed separately for mononuclear cells and viable leukemic blasts from previously untreated acute myeloid leukemia patients (discovery cohort, N = 185) who received intensive chemotherapy. Models were validated in an independent set of similarly treated patients (validation cohort, N = 166).Results Models using European LeukemiaNet guidelines were significantly associated with clinical outcomes and, therefore, utilized as a baseline for comparisons. Models incorporating age and expression of select transcripts with biomarkers from European LeukemiaNet guidelines demonstrated higher area under the curve and C-statistics but did not show a substantial improvement in performance in the validation cohort. Subset analyses demonstrated that models using only the European LeukemiaNet guidelines were a better fit for younger patients (age < 55). Models integrating age and European LeukemiaNet guidelines visually showed more separation between risk groups in older patients. Models, which excluded results for ASXL1, CEBPA, RUNX1 and TP53, demonstrated a limited overall contribution to risk stratification across the entire population, given the low frequency of mutations and confounding risk factors.Conclusions While European LeukemiaNet guidelines remain a critical tool for triaging patients with acute myeloid leukemia, the findings illustrate the need for additional prognostic factors, including age, to improve risk stratification.
Psychometric Properties of a New Self-Report Measure of Medical Student Stress using Classic and Modern Test Theory Approaches
Authors: Mosquera Matthew Joseph , Kaat Aaron , Ring Melinda , Agarwal Gaurava , Glickson Sydney , Victorson David 
Published: April 2020

Abstract
Background.
Medical students face significant stressors related to the intense rigors of their training and education. Accurate measurement of their stress is important to quickly identify, characterize and ameliorate these challenges. Existing measures have limitations that modern measurement approaches, such as item response theory (IRT), are able to address. This study presents the calibration and validation of a new IRT-based measure called the Medical Student Stress Scale (MSSS).
Methods.
Following rigorous measurement development procedures described elsewhere, the authors created and tested a pool of 35 items with 348 1st – 4th year medical students along with demographic and external validity measures. Psychometric analysis included exploratory and confirmatory factor analyses, IRT modeling, and correlations with legacy measures.
Results.
Of the original 35 items, 22 were retained based on their ability to discriminate, provide meaningful information, and perform well against legacy measures. The MSSS differentiated stress scores between male and female students, as well as between year in school.
Conclusion.
Developed with input from medical students, the MSSS represents a student-centered measurement tool that provides precise, relevant information about stress and holds potential for screening and outcomes-related applications.
Assessing the acceptability of a text messaging service and smartphone app to support patient adherence to medications prescribed for high blood pressure: a pilot study.
Authors: Kassavou Aikaterini , Court Charlotte A , Chauhan Jagmohan , Brimicombe James , Bhattacharya Debbi , Naughton Felix , Hardeman Wendy , Mascolo Cecilia , Sutton Stephen 
Published: April 2020

Abstract
Aims and objectives. This paper describes the pilot study of a highly tailored text message and smartphone app intervention to increase adherence to anti-hypertensive medication in primary care. The aim of this study was to evaluate the acceptability of the intervention and obtain patients views about the intervention content, the delivery mode, and the mechanisms by which the intervention supported medication adherence. Methods. Patients diagnosed with hypertension were invited to the study via general practice text message invitation and recruited face to face by the researcher team. Participants tested the text message intervention for 28 or the text message followed by the app for 56 days. Participants completed baseline and follow up questionnaires and took part in a weekly or end of intervention telephone interviews. Digital log files captured patients’ usage of the intervention. Participant transcripts were analysed using thematic analysis. Descriptive statistics were used to summarize data from questionnaires and log files. A mixed methods analysis generated data to respond to the research questions. Results. 79 patients expressed their interest to participate in this study and 23 of these patients were recruited to take part. With one drop-out, 22 participants tested the text message delivery mode (with 20 being interviewed) and four requested to switch to the app (with 3 being interviewed). All participants used and engaged with the text message and app notifications, and most participants found the intervention content and delivery mode acceptable. They also self-reported that the intervention supported them to take their medications as prescribed. Conclusion. This study provides evidence that the digital intervention is acceptable by hypertensive patients recruited in primary care, thus it should be tested for its effectiveness using rigorous research methods. ISRCTN12805654 https://doi.org/10.1186/ISRCTN12805654
Extended doxycycline treatment versus salpingectomy in the management of patients of hydrosalpinx undergoing IVF-ET
Authors: Fouda Usama , Elshaer Hesham , Youssef Mohamed , Darweesh Fatma 
Published: April 2020

Abstract
Background
The aim of this study was to determine whether the treatment with doxycycline before and after oocyte retrieval is as effective as salpingectomy in minimizing the detrimental effect of hydrosalpinx on the outcomes of IVF-ET.
Methods
A retrospective analysis was done for the outcomes of the IVF-ET cycles of patients with hydrosalpinx who underwent laparoscopic salpingectomy prior to IVF cycle ( n = 260 ) or were treated with extended doxycycline treatment during the IVF cycle (n = 45).In doxycycline group, doxycycline (100 mg twice daily ) was started one week before anticipated oocyte retrieval and was continued for one week after oocyte retrieval. In salpingectomy group, the mesosalpinx was coagulated as close as possible to the fallopian tube.
Results
The implantation, clinical pregnancy, ongoing pregnancy and live birth rates were significantly higher in the salpingectomy group ( 20.87% Vs. 9.91%, P value = 0.007, 44.62% Vs. 20% P value = 0.002, 39.62% Vs. 17.78%,P value = 0.005 and 37.31% Vs. 15.56% P value = 0.005 respectively).
Conclusion
Salpingectomy is more effective than extended doxycycline treatment in improving the outcomes of IVF-ET in patients with hydrosalpinx undergoing IVF-ET. Further, larger well designed randomized controlled trials should be conducted to confirm the findings of this study.
The Association between Dietary Total Antioxidant Capacity and Risk of Non Alcoholic Fatty Liver Disease (NAFLD) in Adults: A Case-Control Study
Authors: Sohouli Mohammadhassan , Fatahi Somaye , Shidfar Farzad 
Published: April 2020

Abstract
ObjectiveDietary total antioxidant capacity (TAC) has been assumed as a useful tool to assess the relationship between the cumulative antioxidant food capacity and several chronic disorders. However, the relationship between the total antioxidant capacity of the diet (TAC) and the risk of NAFLD has not been previously examined. The aim of this study was to evaluate the association between DTAC and risk of NAFLD in a case-control study.MethodsThis case-control study was carried out among 158 patients with NAFLD and 357 healthy subjects aged 18–55 years. Dietary data were collected using a validated 168- items quantitative food frequency questionnaire. DTAC was calculated based on the ferric reducing-antioxidant power (FRAP) values that reported by US Department of Agriculture.ResultsThe mean age and BMI of the study participants were 43.9 years and 30.5. The NAFLD patients had higher BMI and female’s percentage compared with controls. Also, compared with the control, the NAFLD cases have a higher level of Smoking, biochemical parameters, and DTAC score. Whereas, patients with NAFLD had a lower HDL and physical activity then the control groups. The highest tertiles of DTAC showed lower risk of NAFLD compared to the lowest tertiles. Also, this association was significant after controlling for potential confounders.ConclusionsOur findings showed that a high DTAC was associated with a reduced risk of NAFLD in adult, suggesting that promoting a naturally elevated antioxidant capacity might help prevent the development of NAFLD. Further prospective studies should be conducted in this regard.
Effects of a sugar-reduction intervention on diet and continuous blood glucose in adolescents on the remote Pacific island of Kiritimati: a pilot randomized controlled trial
Authors: Plows Jasmine F , Rios Claudia , Berger Paige K , Jones Roshonda B , Alderete Tanya L , Steinberg Skylar , Bangao Teraira , Beale Elizabeth , Goran Michael I 
Published: April 2020

Abstract
Background

Kiritimati is a remote Pacific Island estimated to have high rates of overweight/obesity (~ 81%) and type 2 diabetes (T2DM; ~27%), potentially related to high sugar consumption starting early in life. We aimed to determine the feasibility and effectiveness of a short-term dietary sugar-reduction intervention on sugar consumption and glucose control in Kiritimati adolescents.
Methods

A school-based pilot randomized controlled trial over two weeks. The two high schools on Kiritimati were randomized to the control school and the intervention school. Inclusion criteria was enrollment at one of the two high schools on the island. Exclusion criteria was age > 18 years. 63 students enrolled (n = 26 control; n = 37 intervention). The intervention consisted of installing a water filter at the school, providing reusable water bottles, and a 30-minute group dietary education session. Beverage frequency questionnaires and 24-hour diet recalls were conducted at baseline and follow-up. Continuous blood glucose monitors (CGMs; FreeStyle Libre Pro) measured indices of blood glucose control over 14 days (one-week pre-intervention, one-week post-intervention). A statistically significant effect of the intervention was considered a time x group interaction term of p < 0.05.
Results

The total sample at baseline was 16.5 ± 1.2 years old of which 45.5% were male and 60.3% had overweight or obesity. Added sugar consumption decreased in the intervention group (131 ± 77 to 47 ± 49 g/day), with no change in the control group (pinteraction=0.001). However, there were no significant effects of the intervention on any of the CGM measures, which were normal at baseline. No adverse events were noted.
Conclusions

A 7-day sugar-reduction intervention significantly reduced sugar intake but had no effects on CGM measures in Kiritimati adolescents at high risk for obesity and T2DM. This pilot study suggests a simple sugar-reduction intervention could improve diet quality in adolescents on Pacific Islands with high rates of obesity/T2DM.
Trial Registration:

ClinicalTrials.gov NCT04319003. Registered March 24 2020 – retrospectively registered, clinicaltrials.gov/ct2/show/NCT04319003