bluuebunny/crossref_metadata_2025_split huggingface dataset:
Divergent enhancement of in vitro induced coagulopathy by microparticle subtypes
Authors: Boehm Julia , Schäfer Nadine , Maegele Marc , Stümpges Birgit , Bauerfeind Ursula , Caspers Michael 
Published: July 2020

Abstract
Background
Aggressive fluid therapy of patients following a major trauma may result in hypothermia, acidosis and haemodilution that deteriorates even further towards a trauma-induced coagulopathy. The combination of these three factors is referred as lethal triad (LT) and a progressive course of LT is associated with a worsening or complete failure of haemodynamics and coagulative function. Within the process of coagulation, microparticles (MP) are crucial players at the interface of cellular and plasmatic coagulation. This study aimed at the characterization of coagulative effects originating from MP with different cellular origin and concentration under in vitro simulated traumatic conditions of haemodilution (HD) and LT.
Methods
HD was induced by replacing a blood volume of 33% by crystalloids and for LT, samples were further processed by reducing the temperature to 32 °C and lowering the pH to 6.8. MP were obtained either from platelet concentrates (platelet-derived MP, PDMP) or from cell culture (ECV304 cells for endothelial-derived MP, EDMP) by targeted stimulation. Effects of MP on coagulation depending on concentrations (1.000, 10.000 and 15.000 MP/µl blood) were characterized by flow cytometric platelet activation and by quantification of fibrin clot propagation and spontaneous clotting using Thrombodynamics® technology.
Results
MP originated from platelets and endothelial cell culture affected blood coagulation in a concentration-dependent manner. Particularly, high PDMP quantities significantly induced platelet activation and fibrin clot growth and size in HD conditions. In LT conditions, the highest PDMP concentration enhanced platelet activation, clot growth and size. In contrast, EDMP supplementation did not affect platelet activation, but resulted in enhanced formation of spontaneous clots, irrespective of simulated condition. With increasing EDMP concentration, the time until the onset of spontaneous clotting decreased in both HD and LT conditions.
Discussion
The study demonstrates the essential role of MP within the coagulation process in the simulated traumatic conditions. While PDMP affected platelets promoting clot formation likely by providing a surface enlargement, EDMP presumably affected clotting factors of the plasmatic coagulation resulting in an increased formation of spontaneous fibrin clots.
Conclusion
The diverse effects of in vitro generated MP from different cellular origin indicate a divergent mechanism of action exhibiting distinct functions within the coagulation process.
Giant Left Atrial Myxoma Misdiagnosed As Schizophrenia: A Case Report
Authors: Xu Hongfei , Si Wei , Zhang Yiran , Ni Yiming , Li Weidong 
Published: July 2020

Abstract
Background: Primary cardiac tumors are rare. Myxoma is the most common cardiac tumor and presents in the left atrium. Improvements tend to occur with early diagnosis, and with the help of high-resolution imaging technology, such as transesophageal echocardiography (TEE). Patients typically present with tightness of the chest, fatigue and lassitude. There are also cases of misdiagnosis and missed diagnosis. Case presentation: A 59-year-old Chinese woman complained of tightness in her chest, fatigue and lassitude for eight years. She had been misdiagnosed with schizophrenia by the local rural hospital. Computed tomography (CT) confirmed a giant mass in the left atrium, and transthoracic echocardiography (TTE) revealed left atrial enlargement with an occupying lesion. For this patient, we performed tumor resection surgery with a cardiopulmonary bypass. The giant tumor was partially detached during the operation, and the thrombus was removed successfully. After the operation, the mental health department of our hospital thought that the patient's diagnosis of schizophrenia was misdiagnosed. The patient recovered well and appeared rejuvenated after the operation. A two-year follow-up found no adverse events since the operation. Conclusions: When making a diagnosis for a patient who presented with tightness of the chest, we need to administer a cardiac physical examination and echocardiography. The physician diagnosing schizophrenia needs to first rule out any organic diseases. A careful and complete resection of the cardiac myxoma is a vital operation, due to the risk of thromboembolism.
Prevalence and Prognostic Value of Elevated Troponins in Patients Hospitalised for Coronavirus Disease 2019: A Systematic Review and Meta-Analysis
Authors: Zhao Bing-Cheng , Liu Wei-Feng , Lei Shao-Hui , Zhou Bo-Wei , Yang Xiao , Huang Tong-Yi , Deng Qi-Wen , Xu Miao , Li Cai , Liu Ke-Xuan 
Published: July 2020

Abstract
Background: The clinical significance of cardiac troponin measurement in patients hospitalised for coronavirus disease-2019 (covid-19) is uncertain. We investigated the prevalence of elevated troponins in these patients and its prognostic value for predicting mortality.Methods: Studies were identified by searching electronic databases and preprint servers. We included studies of hospitalised covid-19 patients that reported the frequency of troponin elevations above the upper reference limit and/or the association between troponins and mortality. Meta-analyses were performed using random-effects models.Results: Forty-four studies were included. Elevated troponins were found in 21.3% (95% confidence interval [CI] 18.0-24.9 %) of patients who received troponin test on hospital admission. Elevated troponins on admission were associated with a higher risk of subsequent death (risk ratio 2.81, 95% CI 2.01-3.93) after adjusting for confounders in multivariable analysis. The pooled sensitivity of elevated admission troponins for predicting death was 0.64 (95% CI 0.58-0.70), and the specificity was 0.88 (0.82-0.92). The post-test probability of death was about 50% for patients with elevated admission troponins, and was about 7% for those with non-elevated troponins on admission. There were significant heterogeneity and publication bias in the analyses, and many included studies were at risk of selection bias due to the lack of systematic troponin measurement and inadequate follow-up.Conclusion: Elevated troponins were relatively common in patients hospitalised for covid-19. Troponin measurement on admission might help in risk stratification, especially in identifying patients at high risk of death when troponin levels are elevated. High-quality prospective studies are needed to validate these findings.Systematic Review Registration: PROSPERO (CRD42020176747).
“Students in public and private schools—which are at higher risk of drug abuse?”: A survey from Iran
Authors: Bahramnejad Ali , Iranpour Abedin , Nakhaee Nouzar 
Published: July 2020

Abstract
Background

Recent evidence from Western countries suggests that private school students are more prone to drug use. Such an evidence is lacking in Muslim countries. The aim of this study was to examine whether the risk of drug use is higher in private schools than public schools.
Methods

This cross sectional study was conducted on 630 randomly selected 10th grade students of Kerman city, the center of largest province of Iran. Well-validated questionnaires regarding current, lifetime substance use, and perceived use by classmates were utilized. Substances included in the questionnaire were waterpipe, cigarette, alcohol, marijuana, opium, methamphetamine, and Naas. Drug Abuse Tendency Scale was used to measure the attitudes of students towards drug use.
Results

More than 82% of sample were public school students (n = 504). Ever use of cigarette, alcohol and marijuana was higher in private schools (27.6%, 39.0%, and 5.7%, respectively) than public schools (15.3%, 25.8%, 2.2%, respectively) (P < 0.05). The drug abuse tendency score was nearly higher in public school students (10.4 ± 9.4) than private schools (12.1 ± 9.9) (P = 0.090). Perceived prevalence of cigarette and marijuana use by classmates was higher among private school students.
Conclusion

Despite the popular belief that private schools are better than public schools regarding the risk of substance use, students who attend private schools are at a higher risk of turning to some drugs comparing to public schools in Iran.
Gastrointestinal Anastomosis (GIA) Stapler as a safe and efficacious damage control tool for High-Grade Liver Injury in Hemodynamically Unstable Patient- A Case Report
Authors: Saqib Sabah uddin , Iftekhar Wafa , Zafar Hasnain 
Published: July 2020

Abstract
Background: Liver injury occurs in approximately 5% of all trauma admissions. The large size of the liver and its location makes it more susceptible to injuries. Nowadays, the majority of isolated liver injuries are successfully managed with non-operative methods, however, operative management is still the mainstay of treatment for hemodynamically unstable patients. There are many traditional ways of controlling hemorrhage from the liver and here we report a case in which a GIA 75 stapler was successfully used to manage Grade IV liver injury in a hemodynamically unstable patient.Case presentation: 45 years old policeman presented in the emergency, within 20 minutes after sustaining a gunshot injury to his abdomen. At presentation, he was hemodynamically unstable with a heart rate of 100 beats/min and blood pressures of 70/35 mm Hg. On examination, he had a single entry wound in the epigastrium with no exit wound and had generalized peritonitis. He was paraplegic and had a sensory level. He was rushed to the operating room (OR) for exploratory laparotomy which revealed a shattered left lobe of the liver. Gastrointestinal anastomosis 75 stapler device was used for non-anatomical left segmentectomy (segments I and II). Active bleeding from tributaries of left hepatic vein and small branches opening into retrohepatic inferior vena cava (IVC) was identified and the vessels were suture ligated. Perihepatic packing was done and the patient shifted to the surgical intensive care unit(SICU). His improved hemodynamically and was re-explored within 24 hours. No active bleeding was seen after the packs were removed and the abdomen was closed. The next day he was moved out of SICU and the rehabilitation program was initiated for his spine injury. He was discharged on the 10th day of admission.Discussion: Grade IV liver injuries are often very complex and challenging to manage in a hemodynamically unstable patient. The role of GIA staplers for hepatic resection is quite common and safe in elective settings but their similar use in the context of trauma is less described. The concept of damage control surgery rests on quick control of life-threatening bleeding and a GIA stapler can be effectively used for rapid non-anatomical resection of the liver in trauma. This can prevent the depletion of physiological reserves and the life-threatening death triad. Conclusion: GIA stapler device is an effective, safe, and rapidly deployable tool for managing high grade live injury in a hemodynamically unstable patient. It controls bleeding without any concomitant chances of bile leak and also resection of the shattered liver gives good access for inspecting the rest of the bleeding sites.
Cerebrospinal Fluid Microglial Activation Markers in Patients With Neuromyelitis Optica
Authors: Chen Jinyu , He Yan , Luo Ying , Guan Hongbin , An Hongwei , Wang Honghao 
Published: July 2020

Abstract
Aim: Microglia, the resident immune cells in the brain can activated by inflammation in the central nervous system (CNS), then become significant sources of inflammatory mediators. However, little is known about that whether microglia activation in neuromyelitis optica (NMO). The aims of this pilot study were to investigate the levels of the biomarkers of microglia activation, YKL-40, sCD163 and sCD14 in patients with NMO，and the possible associations between those and Expanded Disability Status Scale EDSS scores. ﻿Methods: We found significantly higher CSF YKL-40, sCD163 and sCD14 levels in NMO patients. The level of neurological disability was assessed by the EDSS scores.Results: The levels of microglia biomarkers in NMO patients were positively correlated with Expanded Disability Status Scale (EDSS) scores, but not in MS and GFAP groups. Finally, we showed levels of CSF YKL-40, sCD163 and sCD14 were higher in NMO patients and positive relationship with disease severity of NMO. Conclusion: These finding suggesting that microglial activation, may be implicated in the pathogenesis of NMO.
Peripheral Nerve Activity Potential Difference Among TaiYang, TaiYin, ShaoYang and ShaoYin
Authors: JIN Li-yan , JIN Chun-yu , JIANG Jin-long , ZHENG Dao-xuan 
Published: July 2020

Abstract
Objects Explain the mechanism of PNAP Characteristic changes for each Korean Medicine Sasang typology. Methods By ways of question form and expert’s deliberation, 1000 healthy volunteers are distinguished into corresponding Sasang types, then detect median, ulnar, peroneal, tibial nerves’ CMAP and F-Wave, to analyze nerve conduction’s characteristic changes between groups or within group. Results ① Within group, TaiYin: Median nerve’s right side MCV is declined than left side; Ulnar and Peroneal and tibial nerve’s left side MCV is declined than right side. ShaoYang: Ulnar and tibial nerve’s left side MCV is declined than right side. ( P <0.05 ). ② Between groups, TaiYin & ShaoYang: About median and tibial nerve’s Distal Amlitude ( DA ), MCV, TaiYin is declined than that of ShaoYang; TaiYin & ShaoYin: About tibial nerve’s DA, MCV, The shortest latency of F-wave ( FL ), TaiYin is declined or extended than that of ShaoYin; ShaoYang & ShaoYin: For median nerve’s MCV, FL, ShaoYin is declined or extended than that of ShaoYang ( P < 0.05 ). ③ Nerve amount rate of FL ≥ 2SD ( ShaoYang as standard), for peroneal and tibial nerves, TaiYin is greater than ShaoYang and ShaoYin ( P < 0.01). ④ Nerve amount rate which conduction is under-activity, for tibial nerve, TaiYin is greater than ShaoYin ( right ) and ShaoYang ( left ) ( P < 0.01). ⑤ AMP. / DUR. rate of median nerve: ShaoYin > ShaoYang > TaiYin ( P < 0.05 ). Conclusions Median nerve’s left side has advantage than right side, however the ulnar and tibial nerve’s right side is well than left side, this characteristic is much more obvious in TaiYin; PNAP of ShaoYang is well than TaiYin and ShaoYin; AMP. / DUR. rate of median nerve shows sensitively about constitutional differences. Significance Provide foundation of clinical diagnosis and treatment on a constitutional basis.
Serum S100B protein as a marker of severity in Covid-19 patients
Authors: Aceti Antonio , Margarucci Lory Marika , Scaramucci Elena , Orsini Massimiliano , Salerno Gerardo , Sante Gabriele Di , Gianfranceschi Gianluca , Liddo Rosa Di , Valeriani Federica , Ria Francesco , Simmaco Maurizio , Parnigotto Pier Paolo , Vitali Matteo , Spica Vincenzo Romano , Michetti Fabrizio 
Published: July 2020

Abstract
SARS-CoV-2 infection shows a wide-ranging clinical severity, requiring prognostic markers. We focused on S100B, a calcium-binding protein present in biological fluids, being a reliable biomarker in disorders having inflammatory processes as common basis and RAGE as main receptor. Since Covid-19 is characterized by a potent inflammatory response also involving RAGE, we tested if S100B serum levels were related to disease severity.Serum samples (n=74) were collected from hospitalized SARS-CoV-2 positive patients admitted to Covid center. Illness severity was established by admission clinical criteria and Covid risk score. Treatment protocols followed WHO guidelines available at the time. Circulating S100B was determined by ELISA assay. Statistical analysis used Pearson’s χ2 test, t-Test, and ANOVA, ANCOVA, Linear Regression.S100B was detected in serum from Covid-19 patients, significantly correlating with disease severity as shown both by the level of intensity of care (p<0.006) as well by the value of Covid score (Multiple R-squared: 0.3751); the correlation between Covid-Score and S100B was 0.61 (p<0.01). S100B concentration was associated with inflammation markers (Ferritin, C-Reactive Protein, Procalcitonin), and organ damage markers (Alanine Aminotransferase, Creatinine). Serum S100B plays a role in Covid-19 and can represent a prognostic marker in Sars-CoV-2 infected patients.
Unmet Need for Healthcare Among People with Hypertension in Indonesia
Authors: Ainy Asmaripa , Rosyada Amrina , Idris Haerawati , Maharani Asri 
Published: August 2020

Abstract
Background: Hypertension is a leading global public health problem in both developed and developing countries including Indonesia, mainly due to its high frequency and risks of cardiovascular diseases. Prevalence of hypertension in the Indonesian population aged> 18 years in 2018 was 34.11%. Unmet need for healthcare generally has been explored, but limited empirical study explores it among people with hypertension. The objective of this study is to investigate the determinants of unmet need for healthcare among people with hypertension. Methods: The design of this study is cross-sectional, using the data from the Indonesia Family Life Survey wave 5 (IFLS-5). The sample of the survey was 6,302 adults age >40 years old, stratified by rural/urban status. Three-level multilevel analysis was performed to estimate the individual level, household level, and community-level determinants of unmet needs for hypertension care. Results: The data shows that 78.4% of respondents with hypertension reported an unmet need for healthcare. Age, female, single, income, having insurance, living in the urban area, and the number of health posts for elderly (Posyandu Lansia) are significantly associated with meet needs for health care utilization among hypertension, while education and employment status shows no association with them. Conclusion: Improving access to healthcare and reducing health inequality are required to address this problem.
Novel uses of three-parameter logistic models and first-derivative models for the Coronavirus Disease (COVID-19) epidemic in the United States, in three distinct scenarios
Authors: Samuel Bishoy T. 
Published: August 2020

Abstract
Background: Forecasting the current coronavirus disease (COVID-19) epidemic in the United States necessitates novel mathematical models for accurate predictions. This paper examines novel uses of three-parameter logistic models and first-derivative models through three distinct scenarios that have not been examined in the literature as of July 14, 2020.Methods: Using publicly available data, statistical software was used to conduct a non-linear least-squares estimate to generate a three-parameter logistic model, with a subsequently generated first-derivative model. In the first scenario a logistic model was used to examine the natural log of COVID-19 cases as the dependent variable (versus day number), on July 11 and May 1. Independent t-test analyses were used to test comparative coefficient differences across models. In the second scenario, a first-derivative model was derived from a base three-parameter logistic model for April 27, examining time to peak mortality and decrease in case fatality rate. In the third scenario, a first-derivative model of mortality through July 11 as the dependent variable, versus confirmed cases, was generated to look at case fatality rate relative to increasing cases.Results: All models generated were statistically significant with R2 > 99%. The logistic models in the first scenario best predicted time to growth deceleration in the natural log of cases in the U.S. (slowing of exponential growth), estimated at March 11, 2020. For the May 1 data, independent t-test analyses of comparative coefficients across models were useful to track improvements from implemented public health measures. The first-derivative model in the second scenario on April 27, when the epidemic was more controlled, showed peak mortality around April 12-13, with a case fatality rate of < 1,000 deaths and trending down. The first-derivative model in the third scenario estimated a near-zero case fatality rate to occur at 4 million confirmed cases. It has not been affected by fluctuations in mortality from June 29 through July 11.Conclusion: Three-parameter logistic models and first-derivative models have utility in predicting time to growth deceleration, and case fatality rates relative to cases. They can objectively assess improvements of implemented epidemiologic measures and have applicable public health safety implications.
Inhibition of Rac1 Attenuates Radiation-Induced Lung Injury while Sensitizes Lung Tumor to Radiotherapy
Authors: An Ni , Li Zhenjie , Yan Xiaodi , Zhao Hainan , Yang Yajie , Liu Ruling , Yang Yanyong , Gao Fu , Li Bailong , Cai Jianming , Liu Hu , Yuan Hongbin 
Published: August 2020

Abstract
Backgrounds: There is still little progress in the effective treatment of radiation-induced lung injury (RILI), a key dose-limiting factor for thoracic radiotherapy. Ras-related C3 botulinum toxin substrate1, Rac1, is a small guanosine triphosphatase involved in various mechanisms of radiation-induced damage and is over-expressed/mutated in various tumors. The gain-of-function mutation of Rac1 mediates tumor cells’ resistance to radiotherapy. Therefore, inhibiting Rac1 has the potential of protecting normal tissues from radiation-induced injury, and at the same time, sensitizing tumor to radiation therapy, which makes it a promising ideal target for radiation protection. To investigate the protective effects and mechanisms of Rac1 inhibition on RILI, and explore the possible mechanisms that mediate the differential effects of Rac1 inhibition on normal lung tissue and tumor cells.Methods: 60Co radioactive source was used for ionizing radiation (IR). RILI mouse model was constructed. Influence of Rac1 inhibition which was achieved by Rac1-specific inhibitor, NSC23766, on RILI were studied by H & E and Masson staining, and immunohistochemical staining of vimentin, TGF-βand γ-H2AX. Normal mouse lung epithelial cell line, MLE-12, and mouse lung cancer cell line, LLC, were used to study the effects of Rac1 inhibition on the cellular level. RNA-seq analysis was used for screening differential gene expression caused by Rac1 knockdown. The molecular mechanisms of Rac1 inhibition were studied at the cellular level. Subcutaneous tumor-bearing nude mouse model and orthotopic lung tumor-bearing mouse model were constructed to verify the bidirectional effects of Rac1 inhibition in vivo. Results: RILI of mouse was alleviated by intraperitoneal injection of NSC23766. Rac1 inhibition/knockdown reduced the radiation-induced damage of MLE-12 while aggravated that of LLC. Rac1 translocated from cytoplasm to nucleus after radiation. Tumor protein p53-inducible nuclear protein 1, Trp53inp1, was down-regulated by Rac1 knockdown. In vivo study further proved the differential effects of Rac1 inhibition. Rac1 was over-expressed and mutated in LLC cells, and the expression level of Trp53inp1 significantly lower, compared with that of MLE-12.Conclusion: Rac1 inhibition reduced the radiation-induced damage of normal lung epithelial cells, thereby alleviating RILI of mouse. These effects were partially mediated by down-regulating the expression of Trp53inp1. However, Rac1 inhibition significantly increased the sensitivity of LLC to radiation damage and inhibited its growth. The over-expression and mutation of Rac1, and the significant low expression of Trp53inp1 in LLC, may be the fundamental reasons mediating the differential effects of Rac1 inhibition.