bluuebunny/crossref_metadata_2025_split huggingface dataset:
Auxora Versus Standard of Care For The Treatment of Severe or Critical COVID-19 Pneumonia: Results From A Randomized Controlled Trial
Authors: Miller Joseph , Bruen Charles , Schnaus Michael , Zhang Jeffrey , Ali Sadia , Lind April , Stoecker Zachary , Stauderman Kenneth , Hebbar Sudarshan 
Published: August 2020

Abstract
BACKGROUND: Calcium release-activated calcium (CRAC) channel inhibitors stabilize the pulmonary endothelium and block proinflammatory cytokine release, potentially mitigating respiratory complications observed in patients with COVID-19. This study aimed to investigate the safety and efficacy of Auxora, a novel, intravenously administered CRAC channel inhibitor, in adults with severe or critical COVID-19 pneumonia METHODS: A randomized, controlled, open-label study of Auxora was conducted in adults with severe or critical COVID-19 pneumonia. Patients were randomized 2:1 to receive three doses of once-daily Auxora versus standard of care (SOC) alone. The primary objective was to assess safety and tolerability of Auxora. Following FDA guidance, study enrollment was halted early to allow for transition to a randomized, blinded, placebo-controlled study. RESULTS: In total, 17 patients with severe and three with critical COVID-19 pneumonia were randomized to Auxora and nine with severe and one with critical COVID-19 pneumonia to SOC. Similar proportions of patients receiving Auxora and SOC experienced ≥1 adverse event (75% versus 80%, respectively). Fewer patients receiving Auxora experienced serious adverse events versus SOC (30% versus 50%, respectively). Two patients (10%) receiving Auxora and two (20%) receiving SOC died in the 30 days after randomization. Among patients with severe COVID-19 pneumonia, median time to recovery with Auxora was five days versus 12 days with SOC; recovery rate ratio was 1.87 (95%CI, 0.72, 4.89). Invasive mechanical ventilation was needed in 18% of patients with severe COVID-19 pneumonia receiving Auxora versus 50% receiving SOC (absolute risk reduction=32%; 95%CI, -0.07, 0.71). Outcomes measured by an 8-point ordinal scale were significantly improved for patients receiving Auxora, especially for patients with a baseline PaO2/FiO2=101-200. CONCLUSIONS: Auxora demonstrated a favorable safety profile in patients with severe or critical COVID-19 pneumonia and improved outcomes in patients with severe COVID-19 pneumonia. These results, however, are limited by the open-label study design and small patient population resulting from early cessation of enrollment in response to regulatory guidance. The impact of Auxora on respiratory complications in patients with severe COVID-19 pneumonia will be further assessed in a planned randomized, blinded, placebo-controlled study. Trial registration: ClinicalTrials.gov, NCT04345614. Submitted 7April2020 - https://clinicaltrials.gov/ct2/show/NCT04345614
Intramedullary nail fixation for the treatment of simple forearm fractures in military combatants
Authors: Wang Hao , Zheng Huayong , He Hongying , Zhang Jianzheng , Liu ZHI , Sun Tiansheng 
Published: August 2020

Abstract
Background: Most of forearm fracture in military combatants are simple fracture. The traditational procedure for adult forearm fracture is open reduction and plate osteosynthesis. However, plate fixation do have the defect of nonunion, stress shielding, skin irritation. Intramedullary nail is believed to be an alternative treatment of adult forearm fractures. However, whether simple forearm fractures in military combatants could be successfully treated by intramedullary nail is not clear.Methods: Patients of military combatants with diagnosis of simple forearm fracture treated by intramedullary nail fixation were identified from 1st January 2016 to 31st November 2018 in this retrospective study. General information of the patients, time of follow-up, time of fracture union post-operation, complications, rotation activity and DASH score 12 month post-operation were recorded to figure out the clinical outcome of simple forearm fracture treated by intramedullary nail in military combatants.Outcome: Twenty male patients were identified in this retrospective study, with average age of 26.5 years old (range 18-36).Fourteen forearm fracture happened in right side and the rest six happened in left side. Single ulna fracture happened in 11 cases, single radius fracture happened in 4 cases , both forearm fracture happened in 5 cases. Classifications of the 20 patients were all OTA type A. All 20 patients got followed, with mean follow-up time of 15.8 months（range 12-18). All patients got fracture union successfully. Average time of fracture union was 2.6 months（range 2-4months）. Partially rupture of extensor pollicis longus tendon happened during operation in one patient and 3 months post-operation in another patient. One patient with both forearm fractures showed linear ossification of interosseous membranes. Average pronation activity 12 months post-operation was 86.9 degrees (range 80-90), average supination activity 12 months post-operation was 86.3 degrees (range 60-90). Average DASH score 12 months post-operation was 6.5（range 0-37).Conclusion: This respective study demonstrated that intramedullary nail achieved excellent results in the treatment of simple fracture of forearm in military combatants.Trial Registration : Not applicable
Healthcare in transition in the Republic of Armenia: A longitudinal mixed-method study of emergency medical systems
Authors: Chekijian Sharon , Truzyan Nune 
Published: August 2020

Abstract
Background Acute life-threatening illness such as trauma, myocardial infarction, and stroke depend on timely recognition and treatment. There is a shift in interest by international agencies and funders in recent years towards the development of emergency care systems (EMS) in low and middle-income countries. Armenia, ex-Soviet Republic in transition since independence in 1991, has made remarkable progress but the healthcare sector, emergency systems development and education have lagged behind the overall development of the nation.Methods This manuscript describes a mixed method study used to derive a comprehensive picture of the state of EMS in Armenia. The quantitative component consists of a survey administered at three intervals over a 5-year period in 2005, 2009 and 2010 to gauge issues with the emergency medical system (EMS). A qualitative assessment of EMS was also performed using focus groups discussion and in-depth interviews.Results The quantitative questionnaire showed a positive trend in trust placed in EMS via the results of two questions “the ambulance team will respond in a timely manner”, and “the ambulance dispatcher will not request payment for services before deciding to respond to the call” (p = 0.04). These positive changes led to a statistically significant systematic increase in the percent of people who will decide to wait for the ambulance rather than to take the patient directly to the hospital in a medical emergency (p = 0.01). In-depth interviews and focus group discussions identified issues with training, timeliness of care and shortages of medications and equipment.Conclusion Nations and communities rely on emergency medical systems to care for conditions that require timely and skilled interventions. There are vital problems with emergency medical systems in Armenia related to both confidence in emergency systems from the public and physicians especially related to timeliness of care provided, training, equipment and medications. Emergency care systems development provides a comprehensive way to efficiently address multiple critical conditions. Armenia benefits from an organized emergency system as well as from the Franco-German model of care with physicians deployed in the field. An investment in training as well as critical medications and updated equipment will be key to improvement in services.
Linear regression correlation of health behaviour factors and fitness skills in the Hungarian Defence Forces
Authors: Novák Attila , Hornyák Beatrix , Rázsó Zsófia , Szalánczi Szabolcs , Sótér Andrea 
Published: August 2020

Abstract
BackgroundThe observance of health behaviour recommendations is particularly important in the armed forces where about a certain level of the different physical abilities has to be given account of regularly during work too. The aim of the research is to analyse certain areas of the soldiers’ lifestyle how much they influence the reached scores on the physical tests used by the Hungarian Defence Forces.Sample and MethodDuring examination we compared the results of the prevention data sheet of the soldiers (n=490) appeared on the annual health screening in 2015 against their points obtained on the annual physical fitness test (PFT). The average age of the sample test was 34,1 years (+ 6,91 years) and the proportion of the women was 13,5%. In the test our participants’ average height was 177,64 cm (+7,49 cm), the average weight was 78,94 kg (+12,07 kg). According to the prevention data sheet we analysed the eating habits, frequency of psychosomatic waist pain, body mass index (BMI), the relationship between age and smoking status in relation to scores obtained by stamina and strength endurance practices. To assess the physical fitness of the cardio-vascular endurance we used the results of the 3200 m flat race and for the strength endurance survey we used the results of the scores from lying on the back sit-up with bent legs and arm bending in push-up performed within 2 minutes in a maximum repeat number.ResultsThe growth of the body mass index with 0,1 meant 2 points loss. Regarding the frequency of vegetable-, fruit-, cereal-, and dairy product consumption we found a significant difference (p <0,05) in correlation of the obtained scores on the PFT. The back pain as a symptom appearing monthly meant an advantage on the strength endurance tests, as for smoking on the physical fitness tests. Age did not influence the results of the physical tests significantly. ConclusionThe detection of the connection between certain health behaviour factors and the physical parameters can be one of the strategic tasks of the military supply service.
Effect of respiratory muscle strengthening with breathing exercises on Ventilatory functions, aerobic fitness and their association with performance in elite rowers
Authors: Perera Dilani Priyashanthi , Ariyasinghe Anoja , kariyawasam Anula 
Published: August 2020

Abstract
ObjectiveRowing is one of the most physically demanding endurance sports requiring high levels of ventilation. The aim of this study was to investigate the effect of RMT on ventilatory parameters, aerobic fitness and rowing ergometer performance among 20 professional rowers (experimental (n = 11) and control (n = 9) aged 20–35 years in Sri Lanka.ResultsRowers in the experimental group were prescribed a RMT program comprising of breathing exercises while control group was prescribed a general exercise program for a 12 weeks. There were significant improvements in PIF, FVC, and VO2maxin the experimental group after 12-weeks (p < 0.05) while only VO2 max improved non-significantly in the control group (p > 0.05).Compared to the control, PIF improved significantly in the experimental group (p < 0.05). The rowers in the experimental group with higher PIF and VO2max performed better at 2000 m and 5000 m ergometer whereas in the control group, only VO2max was associated with better performance in 5000 m ergometer. This suggests that the RMT program had a significant effect in improving some ventilatory parameters and VO2max of the rowers resulting in better performance.Trial registration: Current Controlled Trials UMIN000040345, 08/05/2020. “Retrospectively registered”
HER2 protein expression correlates with Lauren classification and P53 in gastric cancer patients
Authors: Chu Yiming , Li Hongbo , Wu Dan , Guo Qingqu 
Published: August 2020

Abstract
Background and objective: Human epidermal growth factor receptor 2 (HER2) is a key pathological characteristic in gastric cancer patients. However, the clinical significance of HER2 protein expression in gastric carcinoma remains controversial. The purpose of the study is to analyze the clinicopathological characteristics of HER2 protein expression, Lauren classification and P53 expression and evaluate the clinical significance of the HER2 protein expression. Methods: A total of 176 consecutive patients were recruited prospectively between January 2014 and December 2016 in The Second Affiliated hospital of Zhejiang University School of Medicine. Histological analysis was performed on resected tissue for HER2 protein expression by immunohistochemistry (IHC). The patients with IHC grade 2+ were analyzed by fluorescence in situ hybridization (FISH) to assess the expression status of HER2 protein. Moreover, standardized criteria of HER2 protein expression in gastric cancer was used in this study. Additionally, the expression status of HER2 protein and clinicopathological features were analyzed by Chi-square (c2) test. All statistical analyses were conducted using the SPSS 22.0 statistical software program (IBM Corp., SPSS statistics, Chicago, IL).Results: A total of 176 gastric cancer patients were enrolled in this study. Intratumorally heterogeneity of HER2 protein overexpression was 42 of 176 cases with IHC grade 2+ accompanied with FISH positivity and IHC grade 3+. HER2 protein expression correlated with tumor differentiation (p < 0.001), Lauren classification (p = 0.001), Borrmann type (p = 0.003) and P53 expression (p < 0.001). Overall survival (OS) was not analyzed because the follow-up duration was too short and the high rate of missed interview.Conclusions: The overexpression of HER2 protein was determined in 23.9% of the cases and significantly related to Lauren intestinal subtype and P53 expression.
Assessment of nutritional status of hospitalized patients including their food intake and evaluation of food waste, its causes and consequences in some selected Tehran hospitals: a cross-sectional study protocol
Authors: Anari Razieh , Amini Maryam , Nikooyeh Bahareh , Ghodsi Delaralm , Torabi Parisa , Neyestani Tirang R 
Published: August 2020

Abstract
Background: Hospitalization may seriously affect patients’ nutritional status and may occasionally be accompanied by malnutrition development or aggravation. Food intake is often altered during hospitalization, which is tightly connected to malnutrition. On the other hand, a huge amount of plate food wasted by patients, in addition to its health consequences, has enormous economic and environmental expenses for governments and societies. This investigation aims firstly to assess nutritional status of the patients hospitalized in general wards and secondly to evaluate the quantity and financial burden of patients’ food waste along with its possible nutritional outcomes.Methods: A cross-sectional study is performed on 171 adult inpatients with eligibility criteria from medical and surgical wards of three general hospitals in Tehran. Nutritional status of patients is evaluated through the following methods: 1. Assessment of malnutrition using subjective criteria (Mini Nutritional Assessment and Subjective Global Assessment tools); 2. Assessment of protein status using determination of serum albumin, pre-albumin and total protein; and 3. Assessment of certain micronutrient status notably vitamins A and D using serum retinol and 25-hydroxycalciferol assay. Also, oxidative stress and inflammatory status are evaluated using examination of serum β-carotene, total antioxidant capacity, malondialdehyde and highly sensitive C-reactive protein. Anthropometric and demographic data are collected and energy and protein intakes are extracted from a 24-hour food recall. Plate food wastes for selected patients are weighed in breakfast, lunch and snacks for one day. Then, economic cost of food waste is calculated for each meal, patient and ward. Finally, the possible reasons for wasting food in these hospitals will be evaluated through conducting a qualitative study.Discussion: Findings of this study will provide appropriate data regarding health and economic burden of food waste in studied hospitals. These data are especially useful to healthcare authorities and policy makers for planning efficient solutions to decrease food waste and to improve patients' nutritional status.
In Vitro Evaluation of the activity of Ceftazidime-avibactam and Aztreonam-Avibactam against 76 Stenotrophomonas maltophilia isolates from a teaching hospital in Chongqing
Authors: Lin Qiuxia , Zou Hua , Chen Xian , Wu Menglu , Ma Deyu , Yu Hanbing , Niu Siqiang , Huang Shifeng 
Published: August 2020

Abstract
Background: Treatment options for Stenotrophomonas maltophilia (S. maltophilia) infections were limited. We assessed the efficacy of ceftazidime-avibactam (CAZ-AVI) and aztreonam-avibactam (ATM-AVI) against a selection of 76 S. maltophilia out of the 1179 strains isolated from the First Affiliated Hospital of Chongqing Medical University during 2011-2018. Methods: We investigated the antimicrobial resistance profiles of the 1179 S. maltophilia clinical isolates from the first affiliated hospital of Chongqing Medical University during 2011-2018, a collection of 76 isolates of which were available for further study of microbiological characterization. Minimum inhibitory concentrations (MICs) of ceftazidime (CAZ), ceftazidime-avibactam (CAZ-AVI), aztreonam (ATM) and aztreonam-avibactam (ATM-AVI) were determined via the broth microdilution method. We deemed that CAZ-AVI or ATM-AVI was more effective in vitro than CAZ or ATM alone when CAZ-AVI or ATM-AVI led to a category change from “Resistant” with CAZ or ATM alone to “Susceptible” or “Intermediate” with CAZ-AVI or ATM-AVI, or if the MIC of CAZ-AVI or ATM-AVI was at least 2-fold lower than the MIC of CAZ or ATM alone. Results: For the 76 clinical isolates included in the study, MICs of CAZ, ATM, CAZ-AVI and ATM-AVI ranged from 0.03-64, 1-1024, 0.016-64, and 0.06-64 μg/mL, respectively. In combined therapy, AVI was effective at restoring the susceptibility of 48.48% (16/33) and 89.71% (61/68) of S. maltophilia to CAZ and ATM, respectively. Furthermore, CAZ-AVI showed better results in terms of the proportion of susceptible isolates (77.63% vs.56.58%, P<0.001), MIC50 (2μg/mL vs. 8μg/mL, P<0.05), and MIC distribution (P<0.001) when compared to CAZ. According to our definition, CAZ-AVI was more effective in vitro than CAZ alone for 84.21% of the isolates. Similarly, ATM-AVI also showed better results in terms of the proportion of susceptible isolates (90.79%vs. 10.53%, P<0.001), MIC50 (2μg/mL vs. 64μg/mL, P<0.001), and MIC distribution (P<0.001) when compared to ATM. According to our definition, ATM-AVI was also more effective in vitro than ATM alone for 97.37% of the isolates. Conclusions: AVI potentiated the activity of both CAZ and ATM against S. maltophilia clinical isolates in vitro. We demonstrated that CAZ-AVI and ATM-AVI are both useful therapeutic options to treat infections caused by S. maltophilia.
Arthroscopic fixation of humeral greater tuberosity fracture with W-shaped suture
Authors: Lin Xiaocong , Fang Kaibin , Ke Qingfeng , Wu Wenhua , Shi Shaojian , Dai Zhangsheng 
Published: August 2020

Abstract
Background

Patients with a greater tuberosity fracture of the humerus often require surgery. Finding a less invasive and more effective way of doing surgery could help patients better.
Aim

To evaluate the clinical value of w-shaped suture technique under shoulder arthroscopy in the treatment of humerus greater tuberosity fractures.
Methods

A total of 17 patients were included in the study. These fractures are closed, and there is no neurovascular injury. These patients underwent arthroscopically assisted reduction and internal fixation. Fixation was done by means of sighting nails combined with W - shaped suture. The imaging data of the patients were collected. ASES score, Constant-Murley score and VAS score were used to evaluate the efficacy of patients. At the last follow-up (at least one year), the range of motion of the affected and contralateral shoulder joints was compared.
Results

All patients completed the operation successfully. The average follow-up time was 13 months. No complications such as fracture displacement, nonunion and internal fixation failure occurred during the follow-up period. According to the X-ray examination of the patients, we found that all the fractures healed smoothly, the healing time was 10–12 weeks, with an average of 11.5 weeks. After the operation, the patients complained that the shoulder joint pain was obviously relieved, and there was no influence on the activity due to shoulder joint pain and discomfort in daily life. The VAS score of these patients ranged from 0 to 3, with an average of 0.52 ± 0.73. At the last follow-up, the constant murlev score of these patients ranged from 83 to 97, with an average of 92.33 ± 7.55. The ases score of these patients ranged from 81 to 98, with an average of 93.15 ± 6.93. At the last follow-up, there was no significant difference in the range of motion of the unaffected limb。
Conclusion

This study demonstrates that technique of W-shaped suture can effectively fix the fracture of greater tuberosity of humerus. This technique can disperse the shear force and torsion force of suture, and increase the fixed area to promote healing, which is an effective treatment method.
Outcome of Delayed Surgery in Treatment of Acute Traumatic Central Cord Syndrome without Fracture or Instability: A Retrospective Study
Authors: Wang Binbin , Huang Yuemian , Yang Haozhi , Zou Xiaobao , Ni Ling , Ge Su , Zhang Shuang , Chen Yuyue , Ma Xiangyang 
Published: August 2020

Abstract
Background: The optimal surgical timing for acute traumatic central cord syndrome (ATCCS) without fracture or instability has not been established. The purpose of this study is to explore the outcome of delayed surgery in treatment of ATCCS and to investigate potential factors associated with postoperative neurological improvement.
Methods: Patients who underwent delayed surgery for ATCCS with at least 2 year follow up time were retrospectively reviewed. Parameters including age, gender, traumatic mechanism, interval to operation, surgical procedures, and complications were collected. Magnetic resonance imaging was performed to determine levels of spinal cord signal change and concomitant pathology. American Spinal Injury Association (ASIA) classification and Japanese Orthopedic Association (JOA) scores were evaluated and compared at admission and the 2 year follow-up visit for neurologic function assessment. Correlations of neurological improvement and age, traumatic mechanism, interval to operation, surgical procedures, concomitant pathology, and preoperative neurological function were investigated by Spearman ’ s correlation test.
Results: A total of 39 patients (M:F=28:11, mean age 52.2±10.4 yrs) were enrolled into this study. 21 cases were caused by falls followed by 16 by motor-vehicle accidents and 2 by sports. 19 patients presented with preexisting cervical disc herniation (CDH)，12 with spinal canal stenosis (SCS), 5 with OPLL, and 3 with a combined pathology of CDH and CS. 14 samples received ACDF procedure, 8 obtained ACCF, and 17 underwent posterior unilateral open-door laminoplasty. The mean interval from trauma to surgery was 20.8±3.7 days. All cases except three (ASIA B) showed improvement of ASIA grades with a mean improvement of 1.1±0.5 grades at 2-year follow-up. JOA scores significantly improved from 6.3±3.1 points at admission to 11.4±3.9 points at 2-year follow up. No difference of neurological improvement was found between different procedures groups. No correlation was showed between neurological improvement and age, concomitant pathology, traumatic mechanism, interval to operation, surgical procedures, or preoperative neurological function.
Conclusions: Delayed surgery was a feasible and effective therapy for ATCCS without fracture or instability although long-term outcome and more details still need to be investigated.