bluuebunny/crossref_metadata_2025_split huggingface dataset:
Paediatric Invasive Pneumococcal Disease : A 5-year Experience and Review of Hospital-Based Studies in Malaysia
Authors: Rengasamy Sithra , Othman Norlijah 
Published: September 2020

Abstract
Background: Invasive pneumococcal disease (IPD) is a serious preventable disease-causing significant mortality and morbidity among children below five years of age.Methods: A five-year retrospective study involving hospitalised children aged below 14-years-old with IPD to two tertiary centres of two different states in Malaysia were conducted between year 2012- 2016. IPD was defined as isolates of Streptococcus pneumoniae from normally sterile body sites. This article reviewed previous hospital-based studies on paediatric IPD in Malaysia to provide an overview of the disease over the last three decades. A comparison was also made with the current study. Results: A total of 54 children were identified with IPD in this study. Sixty per cent of the study population was below the age of two-years-old. A significantly higher number of IPD cases were found among the indigenous group. Both spectrums of malnourished children were also susceptible to the infection. This study found that the majority of children developed septicaemia (43/54, 80%), followed by pneumonia (34/54, 63%) and meningitis (13/54, 24%). Pneumonia (p=0.001) and meningitis p=0.03) were more likely to occur in children less than one-year old. The study also showed that meningitis (p=0.01) was significantly associated with fatal cases. The second component of this article focussed on the review of the disease in Malaysia. There were 8 articles included, of which four each were clinical and microbiological studies. The review concurred that the young ones were vulnerable to the disease. The overall antibiotic resistance in Malaysia was low but on an increasing trend (10-30%). The mortality documented were only from the clinical studies, which showed a disparity of fatality rates in the different regions studied. The rate was low in Selangor (0-11%), in contradiction of a higher rate in Perak, the less developed area (26%). Conclusions: The study highlighted that the younger age group, extremes of nutritional status and indigenous children were at risk of IPD. On the literature review of paediatric IPD in Malaysia, there was inadequate information on the disease. A concerted effort to better describe the disease is needed.
Fabrication and Sustained Release of Chlorogenic Acid from Poly(vinyl alcohol)/Poly(γ-glutamic Acid) Blends Electrospun Mats
Authors: Sandova-Herrera I. E. , Ledezma-Pérez A. , De-León A. , Alvaro-Canche C. , Torres-Lubian R. , Romero-García J. 
Published: September 2020

Abstract
Background: Diabetic foot is a condition that is caused by high levels of glucose in the blood. Poly (γ-glutamic acid) [γ-PGA]/polyvinyl alcohol [PVA] electrospun biopolymers and their use in the release of chlorogenic acid (CGA) is a promising system, thanks to their biocompatibility and the use of (CGA) in the treatment of certain symptoms of diabetic conditions. The use of CGA was reported in 2005 as a capable substance in the treatment of lesions caused by diabetic foot ulcers, thanks to the fact that it has no toxic effects.Methods: In this work, was carried out the bio-synthesis of γ-PGA producing by the Bacillus liqueniformis ATCC-9945a. This material was utilized in the preparation of electrospun nanofibers with solutions of polyvinyl alcohol [PVA] to 10% p/v mixed with γ-PGA to 5 and 10% p/v. These solutions were loaded with chlorogenic acid (CGA) like an active hypoglycemic agent.Results: The morphological analysis shows a size decrease for the fiber with PVA/ γ -PGA, compared to PVA nanofibers; this could be attributed to the hydrogen bonding interactions between γ-PGA and PVA. The use of glutaraldehyde vapors permit the nanofibers crosslinking to maintain a stable structure and allows the CGA release. The in vitro release analysis shows that the PVA membranes reach 28% of delivery after the first 24 hours. Instead of, for the nanofiber mat with PVA blended with γ-PGA at 5% goes up to 57% and nanofiber PVA/γ-PGA at 10% reach to 66% in the same time, the rate constant for release kinetics shows that PVA/γ-PGA at 5% it's higher than the others, being the first in reach the saturation.Conclusions: Biodegradable polymer meshes were fabricated by electrospinning of PVA and PVA/γ-PGA polymer and loaded with CGA. The presence of γ-PGA into PVA solutions increases the in vitro drug release from electrospun fiber mats. The maximal release of CGA was reached at 10% of γ-PGA introduced in the PVA solution, which was 82% release from the electrospun polymer fiber mats. Finally, the use of Peppas and Weibull models indicates the released kinetics of CGA from PVA, PVA/γ-PGA 5, and PVA/γ-PGA 10 electrospun fiber mats are driven by diffusion mechanism.
Reexamining Ophthalmic Drugs, Safety and Tolerability in Phase 1 Clinical Trials
Authors: Villegas Patricia del Carmen Muñoz , Navarro-Sánchez Andrea Anaid , Sánchez-Ríos Alejandra , Olvera-Montaño Oscar , Baiza-Durán Leopoldo Martin 
Published: September 2020

Abstract
Background: The purpose of this study was to evaluate the safety and tolerability profile of drugs used for treating common eye disorders when applied to normal healthy volunteers (NHV) as explored in phase 1 trials. Methods: A total of 166 NHV were identified in six phase 1 trials. These included the exposure to lubricant (n=88), hypotensive (n=48) or antibiotic (n=30) ophthalmic drugs, examined in a retrospective analysis. The primary endpoints were visual comfort, assessed by the ocular comfort index (OCI); and safety, evaluated through laboratory evaluations, vital signs, visual acuity (VA), intraocular pressure (IOP), lissamine green and fluorescein staining, conjunctival hyperemia, chemosis, and the incidence of adverse events (AE). Other measured parameters included discomfort (assessed by burning, itching and foreign body sensation) and conjunctival impression cytology. Results: Compared to baseline, 72.3%, 39.6% and 66.7% of participants (for lubricant, hypotensive and antibiotic treatments, respectively), improved their OCI score by their final visit (p=0.001). As expected for NHV, laboratory evaluations and vital signs were within normal ranges in 88% of NHV, with no significant differences observed between treatments. Similar results were found for VA, corneal and conjunctival staining and chemosis. IOP decreased significantly in the hypotensive agents group (p=0.001), trace to mild hyperemia was reported in 20.7%, 26% and 5.2% of NHV in each group (p=0.006). Additionally, lubricant and hypotensive investigational drugs (ID) had a lower risk of incidence of AE than approved drugs (AD) of these groups (OR 0.856, 95% CI [0.365, 1.999], and OR 0.636, 95% CI [0.096, 4.195], respectively). Meanwhile, on antibiotic drugs the risk for ID related AE was higher (OR 1.313, 95% CI [0.309, 5.583]). Conclusions: Phase 1 trials are important in order to ensure the safety and tolerability of ophthalmic medications. This study demonstrates that NHV do not face a significant risk of harm in these studies, since 98% of the reported AE were mild, and all AE were resolved by the end of the study in which they appeared. Furthermore, it was also demonstrated that the instillation of ID is as safe and tolerable as that of AD in NHV.Trial registration: The studies were registered at clinicaltrials.gov as follows: NCT04081610, NCT03524157, NCT03520348, NCT03966365, NCT03965052 and, NCT03519516.
Giant Intrapericardial Thymic Carcinoma Invading Superior Vena Cava and Right Atrium: A Case Report
Authors: Zhu Kai , Chen Weijie , Liu Guobing , Zhao Yun , Zhang Hongqiang , Pan Sun , Wang Chunsheng 
Published: September 2020

Abstract
Background: Thymic carcinoma is an epithelial malignant tumour that rarely presents in the pericardial cavity.Case presentation: Herein, we describe a patient who suffered giant intrapericardial mass with infiltration of the superior vena cava (SVC) and right atrium (RA). The mass was evaluated by multimodality imaging. Surgeons performed en bloc resection of mass and reconstruction of SVC and RA. Pathological results supported a diagnosis of thymic carcinoma.Conclusions: To our knowledge, this was the largest pericardial thymic carcinoma ever to be reported in the literature. This case demonstrates the utility of multimodality imaging in evaluating the pericardial mass and the validity of surgery for the giant pericardial thymic carcinoma.
Comparison of the Impact of Propofol and Sevoflurane on Early Postoperative Recovery in Living Donors After Laparoscopic Donor Nephrectomy: A Prospective Randomized Controlled Study
Authors: Han Sangbin , Park Jaesik , Hong Sang Hyun , Lim Soojin , Park Yong Hyun , Chae Min Suk 
Published: September 2020

Abstract
Background: Enhancing postoperative recovery of the donor is important to encourage living kidney donation. We investigated the effects of anesthetic agents (intravenous [IV] propofol versus inhaled [IH] sevoflurane) on the quality of early recovery of healthy living kidney donors after hand-assisted laparoscopic nephrectomy (HALN) under analgesic intrathecal morphine injection. Methods: This single-center, prospective randomized controlled study enrolled 80 living donors undergoing HALN from October 2019 to June 2020 at Seoul St. Mary’s hospital. Donors were randomly assigned to the IV propofol group or IH sevoflurane group. To measure the quality of recovery, we used the Korean version of the Quality of Recovery-40 questionnaire (QoR-40K) on postoperative day (POD) 1, and ambulation (success rate, number of footsteps) 6–12 hours after surgery and on POD 1. The pain score for the wound site, IV opioid requirement, postoperative complications including incidence of nausea/vomiting, length of in-hospital stay were also assessed.Results: The global QoR-40K score and all subscale scores (physical comfort, emotional state, physical independence, psychological support, and pain) were significantly higher in the IV propofol group than in the IH sevoflurane group. The numbers of footsteps at all timepoints were also higher in the IV propofol group. The donors in the IV propofol group had a lower incidence of nausea/vomiting, and a shorter hospitalization period.Conclusions: Total IV anesthesia with propofol led to better early postoperative recovery than that associated with IH sevoflurane.Trial registration: Clinical Research Information Service, Republic of Korea (approval number: KCT0004351) on October 18, 2019.https://cris.nih.go.kr/cris/search/search_result_st01_kren.jsp?seq=15768&sLeft=2&ltype=my&rtype=my
Metabolic Syndrome in patients with type 2 diabetes and atherosclerotic cardiovascular disease: A post hoc analyses of the EMPA-REG OUTCOME trial
Authors: Ferreira João Pedro , Verma Subodh , Fitchett David , Ofstad Anne Pernille , Lauer Sabine , Zwiener Isabella , George Jyothis , Wanner Christoph , Zinman Bernard , Inzucchi Silvio 
Published: September 2020

Abstract
Background
Patients with type 2 diabetes (T2D) and metabolic syndrome (MetS) are at greater cardiovascular risk than those with T2D without MetS. In the current report we aim to study the characteristics, cardio-renal outcomes and the effect of empagliflozin in patients with MetS enrolled in the EMPA-REG OUTCOME trial.
Methods
A total of 7020 patients with T2D and atherosclerotic cardiovascular disease were treated with empagliflozin (10 mg or 25 mg) or placebo for a median of 3.1 years. The World Health Organization MetS criteria could be determined for 6985 (99.5%) patients. We assessed the association between baseline MetS and multiple cardio-renal endpoints using Cox regression models, and we studied the change in the individual component over time of the MetS using mixed effect models.
Results
MetS at baseline was present in 5740 (82%) patients; these were more often white and had more often albuminuria and heart failure, had lower eGFR and HDL-cholesterol, and higher blood pressure, body mass index, waist circumference, and triglycerides. In the placebo group, patients with MetS had a higher risk of all outcomes including cardiovascular death: HR = 1.73 (95%CI = 1.01–2.98), heart failure hospitalization: HR = 2.64 (95%CI = 1.22, 5.72), and new or worsening nephropathy: HR = 3.11 (95%CI = 2.17–4.46). The beneficial effect of empagliflozin was consistent on all cardio-renal outcomes regardless of presence of MetS.
Conclusions
A large proportion of the EMPA-REG OUTCOME population fulfills the criteria for MetS. Those with MetS had increased risk of adverse cardio-renal outcomes. Compared with placebo, empagliflozin improved cardio-renal outcomes in patients with and without MetS.
Clinical Trial Registration:
URL: https://www.clinicaltrials.gov. Unique identifier: NCT 01131676.
Serum alkaline phosphatase levels and the risk of new-onset diabetes in hypertensive adults
Authors: Zhang Yuanyuan , Zhou Chun , Li Jianping , Zhang Yan , Xie Di , Liang Min , Wang Binyan , Song Yun , Wang Xiaobin , Huo Yong , Hou Fan Fan , Xu Xiping , Qin Xianhui 
Published: September 2020

Abstract
Background: The association between alkaline phosphatase (ALP) and incident diabetes remains uncertain. Our study aimed to investigate the prospective relation of serum ALP with the risk of new-onset diabetes, and explore possible effect modifiers, in hypertensive adults. Methods: A total 14,393 hypertensive patients with available ALP measurements and without diabetes and liver disease at baseline were included from the China Stroke Primary Prevention Trial (CSPPT). The primary outcome was new-onset diabetes, defined as physician-diagnosed diabetes or use of glucose-lowering drugs during follow-up, or fasting glucose ≥7.0mmol/L at the exit visit. The secondary study outcome was new-onset impaired fasting glucose (IFG), defined as FG <6.1mmol/L at baseline and ≥6.1 but <7.0mmol/L at the exit visit.Results: Over a median of 4.5 years follow-up, 1,549 (10.8%) participants developed diabetes. Overall, there was a positive relation of serum ALP and the risk of new-onset diabetes (per SD increment, adjusted OR, 1.07; 95%CI: 1.01, 1.14) and new-onset IFG (per SD increment, adjusted OR, 1.07; 95%CI: 1.02, 1.14). Moreover, a stronger positive association between baseline ALP (per SD increment) with new-onset diabetes was found in participants with total homocysteine (tHcy) <10μmol/L (adjusted OR, 1.24; 95%CI: 1.10, 1.40 vs. ≥10μmol/L: adjusted OR, 1.03; 95%CI: 0.96, 1.10; P-interaction=0.007) or FG ≥5.9mmol/L (adjusted OR, 1.16; 95%CI: 1.07, 1.27 vs. <5.9mmol/L: adjusted OR, 1.00; 95%CI: 0.93, 1.08; P-interaction =0.009)Conclusions: In this non-diabetic, hypertensive population, higher serum ALP was significantly associated with the increased risk of new-onset diabetes, especially in those with lower tHcy or higher FG levels.Clinical Trial Registration-URL: Trial registration: NCT00794885 (clinicaltrials.gov). Retrospectively registered November 20, 2008.
Learning From COVID-19: A Systems Approach for Public Health Governance
Authors: Liu Jieling , Wu Yurong , Huang Cunrui 
Published: September 2020

Abstract
The COVID-19 spread very quickly worldwide, which has resulted in a global pandemic. All countries in the world have taken measures for the purpose of preventing and controlling the epidemic. China for example, has control the spread effectively, while the Unite States, Brazil and India are still striving to cope with the increasing COVID-19 confirmed cases. The epidemic has impacted the whole world, also revealing quite a lot problems of urban health governance in different countries. This commentary reviews the pandemic response measures in selected countries such as China, Italy, America, Brail and India. On the basis of critical reflection on the problems incurred in each country's pandemic response, we further provide a theoretical framework to reconceptualise public health as multiple types of economic goods. We couple this reconceptualisation with the systems approach to urban health and wellbeing to offer new thinking on the governance of public health. Finally, we propose suggestions for better, preventative and comprehensive epidemic prevention and public health governance.
The Relationship Between Leptin Levels and CPAP Treatment: A Cluster Analysis
Authors: Kozu Yutaka , Hirata Akifumi , Morita Hiroyuki , Kurosawa Yusuke , Yamada Shiho , Fukuda Asami , Mari Hikichi , Okamoto Shinichi , Shikano Sotaro , Hisato Hiranuma , Akahoshi Toshiki , Maruoka Shuichiro , Gon Yasuhiro 
Published: September 2020

Abstract
Background: Leptin is an appetite-suppressing hormone, released by adipose tissues, that plays an important role in severe obstructive sleep apnea syndrome (OSAS). However, it is unclear whether leptin levels are a useful OSAS biomarker. This study assessed the effect of continuous positive airway pressure (CPAP) treatment for OSAS according to leptin levels using a cluster classification based on OSAS clinical features. Methods: Hierarchical cluster analysis was performed on 97 patients with OSAS who had been diagnosed via polysomnography. We also evaluated the adherence of CPAP data after 6 months of CPAP administration. Results: Cluster 1 (49 subjects, 50.5%) had severe OSAS, were obese, and had normal leptin levels. Cluster 2 (6 subjects, 6.2%) had the most severe OSAS, were obese, normal leptin levels, and high adiponectin levels. Cluster 3 (11 subjects, 11.3%) had the most severe OSAS, severe obesity, and the highest leptin levels. Cluster 4 (31 subjects, 32%) had the most severe OSAS, severe obesity, and high leptin levels. After CPAP treatment, EDS improved in all clusters. In Clusters 3 and 4, leptin levels were significantly reduced after treatment. Conclusions: To establish if leptin can be a biomarker for CPAP treatment, it is necessary to elucidate the mechanisms of lipid metabolism, leptin, and ventilatory responses in OSAS patients, for which further studies are necessary.
Prevalence Estimates of COVID-19 by Web Survey Compared to Inadequate Testing
Authors: Ku David N , Ku Ben , Leong Traci , Liu Zixiang 
Published: September 2020

Abstract
Background: Current prevalence of COVID-19 drives many policy decisions, but is hampered by ambiguities in testing and reporting. We propose an alternative method for estimating community prevalence that is inexpensive and timely. We test the Hypothesis that the survey sampling provides a quantitative prevalence that is similar to widespread genomic or serological testing. Methods: We have built a simple, web-based survey of signs and symptoms for COVID-19 based on six questions. No personally identifiable information is collected to maintain privacy. Sampling can be directed to a population of interest such as a company, or broadcast widely to get geographic sampling. Data reporting can be real-time and plotted onto zipcode maps. Rates of prevalence were calculated from presumed COVID cases and respondents, with confidence intervals based on the Blaker method.Results: The website was created quickly, and survey results were quantitatively useful after only a few days. Analyzing 3161 cases from CountCOVID.org, we found a community prevalence of 7% in Georgia that was much greater than the reported confirmed cases. Our prevalence estimate of 21% in New York City was similar to the reported 19.6% by surveillance antibody serotesting. Our estimates are validated by five other community surveillance studies using genomic or antibody testing.Conclusions: Prevalence and incidence of COVID-19 symptoms in the community can be estimated by a crowd-sourced website at considerably less expense than widespread testing.
Construction of a risk prediction model for subsequent bloodstream infection in intestinal carriers of carbapenem-resistant Enterobacteriaceae: a retrospective study in hematology department and intensive care unit
Authors: Wang Yue , Lin Qun , Chen Ju Zhong , Hou Yan Hong , Shen Na , Wang Feng , Sun Ziyong 
Published: September 2020

Abstract
Background
To establish a risk prediction model for carbapenem-resistant Enterobacteriaceae (CRE) bloodstream infection (BSI) in intestinal carriers.
Methods
CRE screenings were performed every two weeks in hematology department and intensive care unit (ICU). Patients with positive CRE rectal swab screening were identified using electronic healthcare records from 15 May 2018 to 31 December 2019. All CRE strains were collected and identified. Carriers who developed CRE BSI were compared with those who did not develop CRE infection. The control group 1:1 stratified randomly matched the case group. Univariate logistic analysis, multivariate logistic analysis and stepwise regression analysis were carried out.
Results
A total of 42 cases were included. Multivariate analysis showed that gastrointestinal injury (OR 86.82, 95%CI 2.58-2916.59, P = 0.013), tigecycline exposure (OR 14.99, 95%CI 1.82-123.74 P = 0.012) and carbapenem resistance score (OR 11.24, 95% CI 1.81–69.70, P = 0.009) were independent risk factors for CRE BSI in intestinal carriers (P < 0.05). They were included in the Logistic regression model to predict BSI. According to receiver operating characteristic (ROC) curve analysis, the cut-off value of the model was 0.72, and the sensitivity, specificity and area under the curve (AUC) were 90.5%, 85.7% and 0.92, respectively.
Conclusions
The risk prediction model based on gastrointestinal injury, tigecycline exposure and carbapenem resistance score of colonizing strain can effectively predict CRE BSI in patients with CRE colonization. Early CRE screening and detection for inpatients in key departments may early warning and reduce the risk of nosocomial infection of CRE.
Effect of sildenafil citrate in women undergoing assisted reproduction: a meta-analysis based on randomized controlled trials
Authors: Rouholamin Safoura , Sepidarkish Mahdi , Razavi Maryam , Nabati Azar , Maroufizadeh Saman , Rezaeinejad Mahroo 
Published: September 2020

Abstract
Background
to evaluate whether the sildenafil citrate in women undergoing assisted reproduction ameliorate the clinical outcomes.
Methods
We performed a comprehensive literature search for published randomized controlled trials (RCT) in Medline, Embase, Scopus, Web of Science and Cochrane Central Register of Controlled Trials from inception to 25 Jun 2020. Literature screening, selection of relevant studies, assessment risk of bias and data extraction was conducted independently by two reviewers. We combined study data using the random-effects model.
Results
Sixteen trials including 1,589 women (771 cases and 818 controls) were included in meta-analysis. Pooling results from five trials, which compared clinical pregnancy between sildenafil citrate and placebo, showed a significantly higher probability of clinical pregnancy in sildenafil citrate group (RR: 1.57, 95% CI: 1.05, 2.36, I2 = 0%). The probability of clinical pregnancy was significantly higher in women who received the combination of sildenafil citrate and clomiphene citrate compared with clomiphene citrate alone (RR: 1.31, 95% CI: 1.12, 1.53, I2 = 0%). Following the intervention, clinical pregnancy significantly increased in women who received the combination of estradiol valerate and sildenafil citrate compared to estradiol valerate (RR: 1.59, 95% CI: 1.05, 2.43, I2 = 0%). Following the intervention, endometrial thickness (ET) increased in women who received sildenafil citrate compared to women who received placebo (SMD: 1.32, 95% CI: 0.30, 2.34, I2 = 92.41%). The mean of ET was significantly higher in women who received the combination of sildenafil citrate and clomiphene citrate compared to women who received clomiphene citrate (SMD: 0.92, 95% CI: 0.49, 1.36).
Conclusion
Our systematic review and meta-analysis showed that luteal supplementation of sildenafil citrate (oral or vaginal), alone or adjuvant therapy can be used for improving the EM and clinical pregnancy rate in women undergoing assisted reproduction. However, given the methodological limitations the current evidence does not support its use in clinical practice yet.