bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rapid Detection of Babesia motasi Responsible for Human Babesiosis by Cross-priming Amplification Combined with a Vertical Flow
Authors: Wang Jinming , Gao Shandian , Zhang Shangdi , He Xin , Liu Junlong , Liu Aihong , Li Youquan , Liu Guangyuan , Luo Jianxun , Guan Guiquan , Yin Hong 
Published: June 2020

Abstract
Background: Babesia motasi is known as an etiological agent of human and ovine babesiosis. Diagnosis of babesiosis is traditionally performed by microscopy, examining Giemsa-stained thin peripheral blood smears. Rapid detection and accurate identification of species are desirable for clinical care and epidemiological studies. Methods: An easy to operate molecular method, which requires less capital equipment and incorporates cross priming amplification combined with a vertical flow (CPA-VF) visualization strip for rapid detection and identification of B. motasi. Results: The CPA-VF targets the 18S rRNA gene and has a detection limit of 50 fg per reaction; no cross reaction was observed with other piroplasms infective to sheep or Babesia infective to humans. CPA-VF and real-time (RT)-PCR had sensitivities of 95.2% (95% confidence interval [CI], 78.1-99.4%) and 90.5% (72-97.6%) and specificities of 95.8 (80.5-99.5%) and 97.9 (83.5-99.9%), respectively, versus microscopy and nested (n) PCR combined with gene sequencing. The clinical performance of the CPA-VF assay was evaluated with field blood samples from sheep (n = 340) in Jintai county, Gansu Province, and clinical specimens (n = 492) obtained from patients bitten by ticks. Conclusions: Our results indicate that the CPA-VF is a rapid, accurate, nearly instrument-free molecular diagnostic approach for identification of B. motasi. Therefore, it could be an alternative technique for epidemiological investigations and diagnoses of ovine and/or human babesiosis caused by B. motasi, especially in resource-limited regions.
Long-term survival of elderly patients after intensive care unit admission for acute respiratory infection: a population-based, propensity-score matched cohort study.
Authors: Guillon Antoine , Hermetet C. , Barker K. A. , Jouan Y. , Gaborit C. , Ehrmann S. , Manach Y. Le , Dequin P F , Grammatico-Guillon L. 
Published: June 2020

Abstract
Background Intensive care unit (ICU) hospitalisations of elderly patients with acute respiratory infection have increased, yet the long-term effects of ICU admission among elderly individuals remain unknown. We examined differences over the two years after discharge in mortality, healthcare utilization and frailty score between elderly survivors of ARI in the ICU and an elderly control population.Methods We used 2009-2017 data from 39 hospital discharge databases. Patients ≥80 years old discharged alive from ICU-hospitalisation for acute respiratory infection were propensity-score matched with controls (cataract surgery) discharged from the hospital at the same time and adjusted for age, sex and comorbidities present before hospitalisation. We reported 2-year mortality and compared healthcare utilization and frailty scores in the 2-year periods before and after ICU-hospitalisation.Results 1,220 elderly survivors of acute respiratory infection in the ICU were discharged, and 988 were successfully matched with controls. After discharge, patients had a 10.1-fold [95%CI, 6.1-17.3] higher risk of death at 6 months and 3.6-fold [95%CI, 2.9-4.6] higher risk of death at 2 years compared with controls. They also had a 2-fold increase in both healthcare utilization and frailty score in the 2 years after hospital discharge, whereas healthcare utilization and frailty scores among controls were stable before and after hospitalisation.Conclusions We observed a substantially increased rate of death in the years following ICU-hospitalisation for elderly patients along with elevated healthcare resource use and accelerated age-associated decline as assessed by frailty score. These findings provide data for better informed goals-of-care discussions and may help target post-ICU discharge services.Funding: None
Metapristone (RU486 derivative) inhibits endometrial cancer cell progress through regulating miR-492/Klf5/Nrf1 axis
Authors: Chang Yue , Hao Min , Jia Ru , Zhao Yihui , Cai Yixuan , Liu Yun 
Published: June 2020

Abstract
Background: Endometrial cancer is the prevalent invasive gynecological cancer in the world. The pathogenesis of endometrial cancer involves many signaling pathways which are related with transcription factors or microRNAs. Metapristone is a hormone related drug and widely used in endometrial cancer clinical therapeutics. However, the deep regulatory mechanism of metapristone is not clear. In this research, we aimed to figure out the specific molecular mechanism during the treatment of endometrial cancer with metapristone.Methods: In this study, RL95-2 cells and Ishikawa cells were used as the endometrial cancer cell models. miR-492 was transfected into RL95-2 cells and Ishikawa cells. The miRNA expression was measured by qRT-PCR. Moreover, the mice tumor model was used to confirm the function of metapristone and the regulating process by miR-492/Klf5/Nrf1 axis in vivo. The protein expression was measured by western blot. Cell proliferation and apoptosis was monitored using the MTT assay, cell colony formation assay and EdU assay.Results: Firstly, the results indicated that metapristone as a kind of hormone-related drugs could significantly inhibit the endometrial cancer cell growth through regulating cell apoptosis-related gene expression. Meanwhile, miR-492 was detected to be highly expressed in the endometrial cancer cell lines. Overexpression of miR-492 could promote the cell proliferation and inhibit the cell apoptosis. Furthermore, the results demonstrated that the downstream target genes of miR-492 were Klf5 and Nrf1, which were inhibited by metapristone. At the animal level, metapristone also inhibited the endometrial cancer cell growth through down-regulating the expression of miR-492 and decreasing the protein level of Klf5 and Nrf1. Conclusion: Taken together, this study indicated that metapristone inhibited the endometrial cancer cell growth through regulating the cell apoptosis related signaling pathway and the expression of miR-492 and its downstream target genes (Klf5 and Nrf1), which provided the theoretical basis of endometrial cancer in clinical treatment.
Understanding access to professional healthcare among asylum seekers facing gender-based violence: a qualitative study from a stakeholder perspective
Authors: Sapia Mirjam Rodella , Wangmo Tenzin , Dagron Stéphanie , Elger Bernice S. 
Published: June 2020

Abstract
Background: When it comes to gender-based violence (GBV), migrant women and girls represent the most vulnerable group. GBV can happen at any stage of migrants’ flight and/or during the asylum process. It has severe consequences on their life and health. Victims therefore need timely access to healthcare. This study explores the context GBV victims face when they seek refuge in Switzerland. Methods: Qualitative methodology was used where we conducted five semi-structured focus groups and three interviews. A total of sixteen stakeholders participated in the study. They were either involved in the asylum process or provided healthcare to asylum seekers. We analyzed the data using framework analysis.Results: Study participants noted lack of confidence of the GBV victims in the legal and in the healthcare systems as major barriers to disclosure of GBV. Since only GBV exerted before fleeing the home country gives the right to asylum, they pointed out that victims do not disclose GBV that took place after they left their home country. Language was identified as a barrier to disclosure of GBV as well as to healthcare access. Continuity of care at the moment of transfer from federal to cantonal (i.e. state) accommodations is another issue that was deemed critical. Study participants felt that health professionals must be trained to identify GBV victims. The first-contact caregiver available to these victims was deemed as the most competent professional that could act as a “GBV coordinator”.Conclusion: In Switzerland, access to healthcare is guaranteed to all asylum seekers on a legal and structural level. Yet, health seeking by GBV survivors is hindered by factors such as lack of confidence in the legal system, trust in health providers, and continuity of care during the asylum process. Building trust in legal institutions, health structures, and professionals should be enhanced to facilitate disclosure and to strengthen resilience. This includes a healthcare system with competent professionals, support with language and cultural needs, as well as seamless continuity of care beyond cantonal borders.
Enrichment differentiation of human induced pluripotent stem cells into sinoatrial node-like cells by combined modulation of BMP, FGF and RA signaling pathways
Authors: Liu Feng , Fang YiBing , Hou XiaoJie , Yan Ying , Xiao HaiYing , Zuo DongChuan , Wen Jing , Wang LinLi , Zhou Zhichao , Dang XiTong , Zhou Rui , Liao Bin 
Published: June 2020

Abstract
Background: Biological pacemakers derived from pluripotent stem cell (PSC) have been considered as a potential therapeutic surrogate for sick sinus syndrome. So it’s essential to develop high efficient strategies for enrichment of sinoatrial node-like cells (SANLC) as seed cells for biological pacemakers. It has been reported that BMP, FGF and RA signaling pathways are involved in specification of different cardiomyocyte subtypes, pacemaker, ventricular, and atrial cells. We aimed to investigate whether combined modulation of BMP, FGF and RA signaling pathways could enrich the differentiation of SANLC from human pluripotent stem cell (hiPSC).Methods: During the differentiation process from human-induced pluripotent stem cell to cardiomyocyte through small molecule based temporal modulation of the Wnt signaling pathway, signaling of BMP, FGF and RA was manipulated at cardiac mesoderm stage. qRT-PCR, immunofluorescence, flow cytometry and whole cell patch clamp were used to identify the SANLC. Results: qRT-PCR results showed that manipulating each one of bone morphogenetic protein (BMP), fibroblast growth factor (FGF) and retinoid acid (RA) signaling was effective for the upregulation of SANLC markers. Moreover, combined modulation of these three pathways displayed the best efficiency for the expression of SANLC markers, which was further confirmed at protein level using immunofluorescence and flow cytometry. Finally, the electrophysiological characteristics of upregulated SANLC were verified by patch clamp method.Conclusion: An efficient transgene-independent differentiation protocol for generating SANLC from hiPSC was developed, in which combined modulating BMP, FGF and RA signaling at cardiac mesoderm stage generates SANLC at high efficiency. This may serve as a potential approach for biological pacemaker construction.
Juvenile Spondyloarthritis: focus on uveitis.
Authors: Marino Achille , Weiss Pamela F. , Brandon Timothy G. , Lerman Melissa Ann 
Published: June 2020

Abstract
Background Juvenile spondyloarthritis (JSpA) represents a group of inflammatory arthritides with several distinctive features (enthesitis, involvement of spine and sacroiliac joint, HLA-B27 association and development of uveitis). There are limited data on the course of uveitis in children with JSpA. This study aims to estimate the prevalence of uveitis and to look at the presence of HLA-B27 in relation to uveitis occurrence and ocular symptoms in a cohort of JSpA patients.Findings This is a cross sectional/retrospective study involving patients with JSpA followed in a tertiary referral hospital. Two hundred twenty-three patients were enrolled in the study. The prevalent diagnosis was enthesitis-related arthritis (ERA) (62%) followed by juvenile psoriatic arthritis (PsA), undifferentiated arthritis (UA), and the arthropathies associated with inflammatory bowel disease (IBD-A) (18%, 14%, 6%, respectively). Uveitis was reported in twenty-four patients (11%) of the JSpA cohort (JSpA-U). ERA patients had the highest uveitis prevalence (ERA-U) (13%) with similar prevalences in UA, PsA and in IBD-A (7% each). The prevalence of HLA-B27 positivity was similar amongst the entire JSpA-U cohort (N=22, 45%) and those with ERA-U (N=8, 44%). The overall prevalence of symptomatic uveitis was 79%. Neither the likelihood of uveitis, nor of symptomatic uveitis, varied by HLA-B27 status either in the entire cohort nor in those with ERA.Conclusions About one-tenth of patients developed uveitis, the majority of which was symptomatic. Fewer than half of the patients with uveitis were HLA-B27 positive. HLA-B27 status was not statistically associated with either the development of uveitis or symptomaticity of uveitis.
Validation of an e-health readiness assessment framework for developing countries
Authors: Mauco Kabelo Leonard , Scott Richard E , Mars Maurice 
Published: June 2020

Abstract
Background: Studies document e-health as having potential to improve quality of healthcare services, resulting in both developed and developing countries demonstrating continued interest in e-health uptake and use. e-Health implementations are not always successful as high failure rates have been reported in both developed and developing countries. These failures are often a result of lack of e-health readiness. e-Health readiness has been defined as the preparedness of healthcare institutions or communities for the anticipated change brought by programs related to information and communication technologies. As such it is critical to conduct an e-health readiness assessment prior to implementation of e-health innovations so as to reduce chances of project failure. Noting the absence of an adequate e-health readiness assessment framework (eHRAF) suitable for use in developing countries, the authors conceptualised, designed, and created a developing country specific eHRAF to aid in e-health policy planning. The aim of this study was to validate the developed eHRAF and to determine if it required further refinement before empirical testing. Methods: Published options for a framework validation process were adopted, and fifteen globally located e-health experts engaged. Botswana experts were engaged using saturation sampling, while international experts were purposively selected. Responses were collated in an Excel spreadsheet, and NVivo 11 software used to aid thematic analysis of the open ended questions.Results: Analysis of responses showed overall support for the content and format of the proposed eHRAF. Equivocal responses to some open ended questions were recorded, most of which suggested modifications to terms within the framework. One expert from the developed world had alternate views.Conclusions: The proposed eHRAF provides guidance for e-health policy development and planning by identifying, in an evidence based manner, the major areas to be considered when preparing for an e-health readiness assessment in the context of developing countries.
Neurological outcome after extracorporeal cardiopulmonary resuscitation for in-hospital cardiac arrest: a systematic review and meta-analysis
Authors: Gravesteijn Benjamin , Schluep Marc , Disli Maksud , Garkhail Prakriti , Miranda Dinis Dos Reis , Stolker Robert-Jan , Endeman Henrik , Hoeks Sanne Elisabeth 
Published: June 2020

Abstract
Background In hospital cardiac arrest (IHCA) is a major adverse event with a high mortality rate if not treated appropriately. Extracorporeal cardiopulmonary resuscitation (ECPR), as adjunct to conventional cardiopulmonary resuscitation (CCPR) is a promising technique for IHCA treatment. Evidence pertaining to neurological outcomes after ECPR is still scarce. Methods We performed a comprehensive systematic search of all studies up to December 20 th 2019. Our primary outcome was neurological outcome after ECPR at any moment after hospital discharge, defined by the Cerebral Performance Category (CPC) score. A score of 1 or 2 was defined as favourable outcome. Our secondary outcome was post-discharge mortality. A fixed-effects meta-analysis was performed. Results Our search yielded 1215 results, of which 19 studies were included in this systematic review. The average survival rate was 32% (95% CI: 29-34%, I2=0%, p=0.16). In the surviving patients, the pooled percentage of favourable neurological outcome was 82% (95% CI: 77- 85%, I2=60%, p=0.12). Conclusion ECPR as treatment for in-hospital cardiac arrest is associated with a large proportion of patients with good neurological outcome. The large proportion of favourable outcome could potentially be explained by the selection of patients for treatment using ECPR. Moreover, survival is higher than described in the conventional CPR literature. As indications for ECPR might extend to older or more fragile patient populations in the future, research should focus on increasing survival, while maintaining optimal neurological outcome.
”Side effects--part of the package”: A mixed methods approach to adverse events among patients being programmatically treated for DR-TB in Gujarat, India
Authors: Jakasania Arjunkumar Hardas , shringarpure Kalpita , Kapadia Dixit , Sharma Radhika , Mehta Kedar , Prajapati Arpit , Soundappan Kathirvel 
Published: June 2020

Abstract
Background Unsuccessful treatment outcomes among patients with drug resistant tuberculosis (DR-TB) are due to high rates of adverse events (AEs). However, information related to AEs is not systematically collected and managed under programmatic setting. The present study assessed the a) incidence and pattern of adverse events in first three months of DR-TB treatment initiation; b) treatment seeking behaviour for AE management; and c) explore the challenges in seeking treatment and reporting AEs.Methods This mixed methods study included all patients diagnosed and initiated on treatment under RNTCP during July-September 2018 at Ahmedabad DR-TB centre. The patients were interviewed telephonically and assessed for all AEs experienced by them. In-depth interviews and key-informant interviews were conducted among patients, DOTS supervisors and programme staffs (treatment supervisors, medical officer and district program manager). Results Total 207 AEs were reported by the 74 DR-TB patients. All patients experienced at least one AE during initial treatment period. Incidence rate of AEs (experienced) was 3.11 (1st month-4.6, 2nd month-2.7, 3rd month-2.02) per 100 person days. Of the 207 AEs, gastro-intestinal (59, 28.3%), ophthalmic (32, 15.4%) and otolaryngology (25, 11.9%) system related AEs were commonly experienced. Treatment was not sought in two-fifths of the AEs. Themes and sub-themes related to challenges in treatment seeking or reporting of AEs were 1) Patient related-Misconceptions, accessibility and affordability of management, lack of counselling support, stigma and discrimination, and past treatment experience; 2) Health system related- lack of guidelines and training for AE management, 3) Poor coordination between hospital and tuberculosis centre. Conclusion The incidence of AEs was high among patients with DR-TB in the first three months of treatment and treatment seeking/reporting was low. Adequate health education and counselling of the patient and orientation of the health systems are the need of the hour. An efficient real-time reporting and management of AE can be developed and tested for effective DR-TB control.
Symptoms of ocular surface disease in construction workers: comparative study with office workers
Authors: Hernandez-Llamas Sergio , Paz-Ramos Ana Karen , Marcos-González Patricio , Amparo Francisco , Garza-Leon Manuel 
Published: June 2020

Abstract
Background: To investigate and contrast the prevalence of dry eye symptoms in construction workers and office workers using the OSDI questionnaire.Methods: A cross-sectional, observational study was conducted using the OSDI questionnaire to evaluate dry eye symptoms and associated risk factors. Sampled size calculation with a power of 80% and a 95% degree of confidence suggested the inclusion of 298 participants. Results: We studied 304 subjects (149 construction workers and 155 office workers). More than half (55%) of the participants presented dry eye symptoms (OSDI > 12). The average OSDI score was 21.30 ± 22.20 points, being lower in the group of construction workers (12.45±17.50) than in-office workers (28.51±22.99) (p <0.001). Considering participants who had moderate and severe symptoms (23 to 100 points in OSDI), office workers presented dry eye symptoms 4.15 times more frequently than construction workers (OR 4.15, 95% CI 2.52, 6.85). Women presented statistical evidence of higher OSDI scores than men (32.47 ± 23.72 vs. 14.87 ± 18.48, respectively). Conclusions: construction workers have four times less risk of presenting dry eye symptoms than people working in the average office space. This highlights the pernicious effects on the ocular surface of the office environment, which poses a significant risk for the development or worsening of dry eye symptoms.
DLBCL with amplification of JAK2/PD-L2 exhibits PMBCL-like CNA pattern and worse clinical outcome resembling those with MYD88 L265P mutation
Authors: Xue Xuemin , Huang Wenting , Qiu Tian , Guo Lei , Ying Jianming , Lv Ning 
Published: June 2020

Abstract
Background: Recently, copy number alteration (CNA) of 9p24.1 were demonstrated in 10% of diffuse large b-cell lymphoma (DLBCL), with gene expression and mutation profiles that were similar to those of primary mediastinal large B-cell lymphoma(PMBCL). However, their CNA-based profile and clinical impact still remain unclear. Methods: Multiplex ligation-dependent probe amplification were employed to investigate the prevalence of JAK2/PD-L2 amplification in DLBCL and their CNA-based pattern of driver genes. The clinical outcome and characteristics were also analyzed. Results: Using unsupervised hierarchical clustering, a small group of DLBCL (10.5%, 8/76) was clustered together with PMBCL as Cluster_2, demonstrating amplification of JAK2 (100%,8/8) and PD-L2 (75.0%,6/8). This subgroups of DLBCL demonstrated significant higher expression of PD-L1 than those with MYD88 L265P mutation(p=0.024). And they exhibited dismal OS and PFS as compared with DLBCL_others(p=0.003 and 0.001, respectively), which is similar to DLBCL with MYD88 L265P mutation. Conclusions: DLBCL with amplification of JAK2/PD-L2 exhibits CNA pattern that is similar to PMBCL, and demonstrates unfavorable clinical outcome that resembles those with MYD88 L265P mutation. It is essential to identify this subgroup of DLBCL who may acquire more benefits from the JAK2 and PD-L1 signaling inhibition.