bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Comparation of Anthropometric and Metabolic Indices in the Regulation and Prediction of Fatty Liver: a population-based cross-sectional study in China
Authors: Xie Fangfei , Pei Yuyu , Wang Yun , Li Jiongyan , Xu Xuehua , Zhou Hong , Sun Kangyun 
Published: July 2020

Abstract
Background: The association between anthropometric and metabolic indices and fatty liver (FL) remain not fully elucidated. We aimed to determine the role of these anthropometric and metabolic indices on FL prediction and regulation via cross-sectional study, thus providing clues for further research in FL field. Methods: A total of 658 participants aged over 18 years were included in this study. Anthropometric and metabolic indices (including WC, WHR, BMI, BFM, VFA, TG/HDL, AST/ALT, SBP, DBP and FBG) were measured. Difference analyses, logistic and predictive analyses were used to evaluate the association and discrimination ability between these indices and FL. Results: Compared with non-FL, anthropometric and metabolic indices in FL and mild FL people showed a significant increase after adjustment. In the multivariate ranked logistic regression analysis, WC, TG/HDL, AST/ALT and FBG have a strong association with FL (β = 0.03, 0.19, 0.41, -1.89 and 0.28, P<0.05). And AST/ALT showed the lowest predicted power with an AUC of 0.22 among all indices. WC showed to be the best predictors with an AUC of 0.86 in participants.Conclusions: This is a comprehensive profile for FL related indices. These can enhance our understanding of the mechanisms for hepatic on inflammation and fat and is also important for the prevention and treatment of FL.
The Impact of Socio-Economic and Demographic Factors on Health Seeking Behavior of Urban Households, Bangladesh
Authors: Islam Mohammad Shafiqul , Begum Parvin 
Published: July 2020

Abstract
Aim: As households’ health-seeking behavior depends enormously on socio-economic and demographic factors particularly in developing county like Bangladesh, it contributes differently to health-care seeking behavior varying household to household. This study intends to explore the nature of the health seeking behavior of urban residents in Sylhet city through assessing the socio-economic and socio-demographic factors. Subject and Methods: A 150 household survey has been completed in Sylhet city, using a multistage cluster sampling method. A household survey questionnaire was used to collect data on socio-demographic and socio-economic factors and their impacts on health-seeking behavior. Chi-square test and logistic regression analysis investigate the extent of association between different socio-economic and demographic factors and health-seeking behavior. Results: We found that among the 150 participants, the majority (88%) of household heads are male because gender is significantly associated with priority in choosing health care in the study. The result of binary logistic regression indicates the households who have a minimum level of education (primary or above) are 10.617 more likely to use public health care facilities. Income is statistically associated with the main source of health service. The interference of income in seeking treatment has a relationship with the employment sectors (public or private). Moreover, the reasons for choosing a specific source of health care have a significant relationship with the main source of health care (public or private). Conclusion: This study recommends that government should introduce health insurance policy for city dwellers for reducing the inequalities in health services among city dwellers.
More than 70 Percent of Insured Patients are Paying Informally During Outpatient Visits? Country Wide Evidence from Iran
Authors: Sajadi Haniye Sadat , Sajadi Farkhondeh Alsadat , Yaghoubi Maryam , Majdzadeh Reza 
Published: July 2020

Abstract
The authors have requested that this preprint be removed from Research Square.
The role of Plasminogen Activator Inhibitor 1 in predicting sepsis-associated liver dysfunction: an observational study
Authors: Niesobska Ewa Woznica , Lesnik Patrycja , Woznica Ryszard , Janc Jaroslaw , Zalewska Malgorzata , Lysenko Lidia 
Published: July 2020

Abstract
Background

Sepsis-associated liver dysfunction (SALD) is associated with poor prognosis and an increased mortality in Intensive Care Unit (ICU). Bilirubin is one of the components of Sequential Organ Failure Assessment (SOFA) used in Sepsis−3 criteria. Hyperbilirubinemia is a late and non specific symptom of liver dysfunction. The aim of the study was to identify plasma biomarkers, which could be used for an early diagnosis of SALD.
Methods

A single-centre, prospective observational study was conducted in the ICU of Wroclaw University Hospital. Plasma biomarkers - prothrombin time, INR, antithrombin III, bilirubin, aspartate transaminase (AST), alanine transaminase, albumin, endothelin-1, hepcidin, plasminogen activator inhibitor-1 (PAI-1), thrombin-antithrombin complex and interferon-gamma inducible protein 10 kDa were analysed. Plasma samples were obtained from eligible septic patients within 24 hours after having developed sepsis/septic shock. Enrolled patients were followed for 14 days for developing SALD and 28 days for overall survival.
Results

Seventy-nine patients were enrolled into the study, and 24 (30,4%) of them developed SALD. PAI-1 with cut-off value of 9 ng/ml was shown to be a good predictor of SALD (AUC = 0,727, sensitivity 79,2%; specificity 41,8%; accuracy 53,2%) and of 28-day survival in patients with sepsis/septic shock (log rank test, p = 0,00091). In combination with AST it was also useful in predicting 28-day survival (log rank test, p = 0,00242).
Conclusions

Sepsis-associated hyperbilirubinemia is frequent, but bilirubin is a late and non specific marker of SALD. Measuring PAI-1 serum levels at the onset of sepsis/ septic shock may be useful in predicting the development of SALD. A combination of PAI-1 and AST predicts better the 28-day survival, than PAI-1 alone, but due to low cut-off values of AST it might not be clinically significant.
Differential Leukocyte miRNA Responses Following Pan T Cell, Allorecognition and Allosecretome-Based Therapeutics Activation
Authors: Yang Xining , Toyofuku Wendy M , Scott Mark D. 
Published: July 2020

Abstract
Background Effective immunomodulation of T cell responses is critical in treating both autoimmune diseases and cancer. Our previous studies have demonstrated that secretomes derived from control or methoxypolyethylene glycol (mPEG) mixed lymphocyte alloactivation assays exerted potent immunomodulatory activity that was mediated by microRNAs (miRNA). In this study, the immunomodulatory effects of biomanufactured miRNA-based allo-secretome therapeutics (SYN, TA1, IA1 and IA2) were compared to Pan T cell activators (PHA and anti-CD3/CD28) and alloactivation (MHC-disparate donors; ± mPEG grafting). The differential effects of these activation strategies on resting PBMC were assessed via T cell differentiation and proliferation as well as the differential expression of multiple miRNA.Results Mitogen-induced PBMC proliferation (average of > 85%) significantly exceed that arising from either allostimulation (~ 30%) or the proinflammatory IA1 secretome product (~ 12%). Consequent to stimulation, the ratio of CD4 to CD8 cells of the resting PBMC (CD4:CD8; 1.7 ± 0.1) decreased in the Pan-T cell, allrecognition and IA1 activated cells (average of 1.1 ± 0.2; 1.2 ± 0.1 and 1.0 ± 0.1). These changes arose consequent to the expansion of both CD4+CD8+ and CD4-CD8- populations and the shrinkage of the CD4 subset relative to the expansion of the CD8 T cells. Most importantly, this study demonstrated that these activation strategies exert profoundly unique effects on the differential expression of miRNA within the treated PBMC and that these 'differential patterns of miRNA expression' are associated with significant differences in cellular differentiation and biological function.Conclusions These findings support the concept that the 'differential pattern of miRNA expression', not a change in a single miRNA, governs the biologic immune response in a 'lock and key' manner. The biomanufacturing of miRNA-enriched secretome biotherapeutics may be a successful approach for producing miRNA cocktails (e.g., TA1 and IA1) that replicate the normal biological 'lock and key' miRNA configuration necessary for the systemic treatment of autoimmune diseases (TA1) or enhancing the endogenous immune response to cancer (IA1).
Delay in Hospital Discharge of Trauma Patients: A Prospective Observational Study
Authors: Elabbassy Islam , Hussein Wafaa M. , El-Setouhy Maged , Hirshon Jon Mark , El-Shinawi Mohamed 
Published: July 2020

Abstract
Background: "Delayed discharge" is defined as patients who remain hospitalized beyond the time of being fit for discharge. There is no standardized amount of time defining delayed discharge documented in the literature, and there is a lack of evidence about this topic in Egypt. This study aims to identify the factors associated with discharge delays.Methods: A prospective observational study included all trauma patients admitted to a University Hospital in Egypt over two months. The time of the decision of discharge and actual discharge time were recorded by reviewing patients' medical records. The patients and their caregivers were asked to fill in a questionnaire about the reasons for delayed discharge. Potential reasons for the delayed discharge were classified into system-related, medical and family-related factors. Results: The study included 498 patients with a median age of 41 years (9 – 72). The median time until the actual discharge was three hours. System-related factors were documented in 48.8% of cases, followed by medical factors (36.3%), and family-related factors (28.1%). When controlling for age, gender and injury severity score using a logistic regression analysis, longer time to discharge (≥ 3 hours) showed a stronger association with medical factors [adjusted OR (95% CI) = 5.44 (2.73-10.85)] and family-related factors [adjusted OR (95% CI) = 7.94 (3.40-18.54)] compared to system-related factors [adjusted OR (95% CI) = 2.20 (1.12-4.29)].Conclusion: Although system-related factors were more prevalent, medical and family-related factors appear to be associated with longer discharge delays compared to system-related factors.
The Cost of Breast Cancer: A Comparison Between Private and Public Hospitals
Authors: Afkar Abolhasan , Jalilian Habib , Pourreza Abolghasem , Mir Habibeh , Sigaroudi Abdolhosein Emami , Heydari Somayeh 
Published: July 2020

Abstract
Backgrounds: Breast cancer is the most prevalent cancer among women. Breast cancer imposes a considerable economic burden on the health system. This study aimed to compare the cost of breast cancer among patients who referred to private and public hospitals in Iran (2017). Methods: This was a prevalence-based cost of illness study. A total of 179 patients were selected from private and public hospitals using the census method. The researcher-constructed checklist was used for data collection. Data were analyzed using SPSS software version 22. Results: The estimated total mean ±SD direct cost of patients who referred to the private hospital and the public hospital was $10051.78±19484.61 and $3956.33±6783.02, respectively. Further, the total mean indirect cost of patients who referred to the private hospital was lower than those referring to the public hospital at $1870.89 (%15.69 of total costs) and $22348.5 (%84.95 of total costs), respectively. These differences were statistically significant (P<0.05). Conclusions: Breast cancer imposes a substantial cost on patients, health insurance organizations and the whole society in Iran. Therefore, the adoption of effective measures for the prevention and early diagnosis of breast cancer is urgently needed.
The Effect of Rotator Cuff Repair on the Clinical and Psychological Meaningful Improvement in Patients with Rotator Cuff Tear and Insomnia.
Authors: Tong Yahui , Wu Kailun , Liu An , Zhu Hongxia , Yang Huilin , Guo Jiong Jiong 
Published: July 2020

Abstract
Background: Rotator cuff repair is widely used to treat rotator cuff tear, but its impact on the psychological status in patients with rotator cuff tears and insomnia is still poorly understood.Methods: 240 patients were enrolled who underwent rotator cuff repair at the first affiliated hospital of soochow university from 2014-2018. During the 2-year follow-up period, the patients were assessed preoperatively and postoperatively at 3 months, 6 months, 12 months and 24 months by using Constant, Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), American Shoulder and Elbow Surgeons’ Scale (ASES), Hospital Anxiety and Depression Scale, depression subsection (HADS-D), Hospital Anxiety and Depression Scale, anxiety subsection (HADS-A), and World Health Organization Quality-of-life Scale Abbreviated Version (WHOQOL-BREF).Results: Finally, a total of 240 patients were enrolled in this study and finished the 2 year follow-up.There were 107 men(43.8%) and 133 women(56.2%), and the mean age of the patients was 54.2±7.5 years. With the prolongation of postoperative time, pain, activity of daily life, joint mobility and muscle strength were gradually improved from 4.8 ± 2.2, 7.2 ± 3.4, 14.2 ± 5.5, 7.8 ± 3.5, and 34.0 ± 11.3, respectively, before surgery to 13.2 ± 3.2, 17.8 ± 2.8, 34.0 ± 6.4, 21.0 ± 4.0, and 85.9 ± 12.4, at 2 years after surgery, which was statistically significant (P < 0.001).The scores of ASES and WHOQOL-BREF also increased significantly from 40.5 ± 9.6, 58.3 ± 8.6 before operation to 87.7 ± 10.2, 69.3 ± 7.9 at two years after operation (P < 0.001). HADS-A decreased linearly from 4.8±2.4 before operation to 1.4 ± 1.2 at two years after operation (P < 0.01). The pain scores had a highly positive correlation with the Constant and the ASES scores. The PSQI and the ISI scores had a positive correlation with the HADS-A scores.Conclusion: For the patients with rotator cuff tears and insomnia, rotator cuff repair may contribute to the improvement of clinical outcome and status of anxiety.
Blockage of AMPK-ULK1 Pathway Mediated Autophagy Promotes Cell Apoptosis to Increase Doxorubicin Sensitivity in Breast Cancer (BC) Cells: An in vitro Study
Authors: Yu Libo , Shi Qingtao , Jin Yan , Liu Zhixin , Li Jiaxin , Sun Wenzhou 
Published: July 2020

Abstract
Background: Activation of autophagy flux contributed to resistance of breast cancer (BC) cells to current chemotherapeutic drugs, which seriously limited their therapeutic efficacy and facilitated BC recurrence in clinic. However, the detailed mechanisms are still not fully understood. In the present study, we identified that inactivation of AMPK-ULK1 signaling cascade mediated protective autophagy sensitized BC cells to doxorubicin in vitro. Methods: Cell counting kit-8 (CCK-8) assay and colony formation assay were performed to evaluate cell proliferation abilities. Trypan blue staining assay was used to examine cell viability, and Annexin V-FITC/PI double staining method was conducted to determine cell apoptosis. The autophagosomes in BC cells were observed and photographed by electronic microscope (EM). Western Blot analysis was employed to examine genes expressions at protein levels.Results: The parental doxorubicin-sensitive BC (DS-BC) cells were exposed to increasing concentrations of doxorubicin to establish doxorubicin-resistant BC (DR-BC) cells, and the DR-BC cells were much more resistant to high-dose doxorubicin stimulation compared to the DS-BC cells (P < 0.05). Interestingly, high-dose doxorubicin specifically increased LC3B-II/I ratio, promoted autophagosomes formation and decreased p62 expression levels to facilitate autophagy in DR-BC cells, instead of DS-BC cells (P < 0.05), and the autophagy inhibitor 3-methyladenine (3-MA) enhanced the cytotoxic effects of high-dose doxorubicin on DR-BC cells (P < 0.05). In addition, we proved that high-dose doxorubicin triggered protective autophagy in DR-BC cells by activating AMPK-ULK1 pathway. Functionally, high-dose doxorubicin increased the expression levels of phosphorylated AMPK (p-AMPK) and ULK1 (p-ULK1) to activate AMPK-ULK1 pathway in DR-BC cells (P < 0.05), and the inhibitors for AMPK (compound C) and ULK1 (SBI-0206965) blocked autophagy to promote cell death and slow down cell growth in DR-BC cells treated with high-dose doxorubicin (P < 0.05). Conclusions: Collectively, our in vitro data indicated that blockage of AMPK-ULK1 signaling cascade mediated protective autophagy might be a promising strategy to increase doxorubicin sensitivity for BC treatment.
Phylogenetic study of treatment failure clinical isolates of Leishmania major
Authors: Hatefi Samira , Ramezani Vahid , Tohidfar Masood , Eslami Gilda , Hosseini Saeedeh Sadat , Boozhmehrani Mohammad Javad 
Published: July 2020

Abstract
Background: Molecular characteristics are necessary for designing programs for the control, prevention, and treatment against cutaneous leishmaniasis. In the present study, treatment failure (TF) clinical isolates of Leishmania major were phylogenetically analyzed using the barcode genes of cytochrome oxidase II (COXII) and 13A/B. Methods: Samples were collected from 126 patients referred to the Diagnosis Laboratory Center from October 2017 to December 2019. All TF cases were assessed using COXII and 13A/B, and phylogenetic analysis was created using BLASTn, T-COFFEE, and MEGA 7.0.21. Results: All 126 isolates were L. major, in which 5 isolates were TF. All isolates had successfully amplified by the specific primer for COXII region. The alignment analysis with all the 5 TF isolates and the standard Friedlin strain showed more than 98% similarity. Phylogenetic analysis with 13A/B showed that all 5 TF isolates are clustered in one group, although phylogenetic analysis showed different clustering after comparison of 5 TF isolates with 16 TR isolates and the same regions in other isolates in GenBank, NCBI. Conclusions: All 21 isolates studied in this study, comprising TF and TR isolates, were clustered in near groups. However, 13A/B could differentiate the 5 TF isolates from selected 6 TR isolates, completely.
Numerical Simulation of Arc and Metal Transfer in Arc Welding Based Additive Manufacturing Assisted by External Longitudinal Static Magnetic Field
Authors: Zhou Xiangman , Liu Lian , Wang Boyun , Bai Xingwang , Zhang Haiou , Tian Qihua , Du Yixian 
Published: July 2020

Abstract
The surface quality is one of important quality factors for arc welding based additive manufacturing (AWAM) parts. In this study, AWAM process assisted by an external longitudinal static magnetic field (ELSMF) is applied to improve surface quality of AWAM parts. In order to study the internal mechanism of AWAM process assisted by an external longitudinal magnetic field, a three-dimensional weak coupling model of the arc and metal transport is developed to simulate the arc, molten pool dynamic in AWAM assisted by ELSMF. The simulated results of single-bead deposition show that the ELSMF induces the asymmetrical tangential electromagnetic stirring in arc and molten pool, which can increase molten pool dynamics, drive the molten metal moving to the edge of the molten pool and reduce the temperature gradient. The simulated results of overlapping deposition show that the asymmetrical tangential electromagnetic stirring force can drive the molten metal moving to valley area between overlapping beads, which is beneficial to filling the valley area and improving the surface quality of the AWAM parts. The single-bead deposition experiment shows that the applying of ELSMF can reduce the height as well as increase the width of single weld bead. The multi-bead overlapping and the multi-layer multi-pass deposition experiments demonstrate that the external magnetic field can improve the surface quality of multi-layer part. The conclusions of the above study can provide the reference for AWAM process assisted by magnetic field.
The occurrence of synanthropic triatomines in Bahia, Brazil: what changed after 40 years of the vector-control program?
Authors: Ribeiro Gilmar , Carvalho Cristiane Medeiros Moraes de , Araújo Renato Freitas de , Lanza Fernanda Cardoso , Miranda Diego Lopes Paim , Cunha Gabriel Muricy , Sousa Orlando Marcos Farias de , Santos Carlos G. S. dos , Fonseca Eduardo Oyama Lins , Santos Roberto Fonseca dos , Reis Renato Barbosa , Gurgel-Gonçalves Rodrigo , Reis Mitermayer Galvão 
Published: July 2020

Abstract
Background: This study presents a descriptive analysis of the occurrence of synanthropic triatomine species in the state of Bahia, before and after the implementation of the vector control program. Methods: Occurrence and number of collected specimens in the municipalities were analyzed in two periods: (A) 1957 to 1971, before systematic vector control actions; and (B) 2006 to 2019, after the certification of interruption of Chagas disease transmission by Triatoma infestans. Results: In total, 17 species were recorded during period A and 21 during period B. Panstrongylus megistus was the most frequent species in period A (42%), while Triatoma pseudomaculata (42%) and T. sordida (38%) were more frequent in period B. In period A, T. infestans was found in 26 (9%) municipalities, and in period B it was found in 7 (2%). During period B, most triatomines (88%) were captured at the peridomestic habitats, with a predominance of T. sordida (85%). Species with greatest relative abundance within the household were T. sordida (49%), T. brasiliensis (27%), and T. pseudomaculata (15%). Conclusions: We have observed a clear reduction in the occurrence of P. megistus and T. infestans and an increase in the relative abundance and geographical distribution of T. sordida and T. pseudomaculata after 40 years of the vector-control program. High frequency of other triatomine species in the municipalities of the state of Bahia and a great abundance of T. sordida in recent years, highlight the need to reinforce permanent entomological surveillance actions for Chagas disease.
Epidemiologic Characteristics and Double-buffered Strategy for Patients in Orthopedic Surgery During the Novel Coronavirus Outbreak: Wuhan's Experience
Authors: Zhou Yan , Ming Jianghua , Liu Shiqing 
Published: July 2020

Abstract
Background: The purpose of this article is to summarize the epidemiologic characteristics and double-buffered strategy for patients in orthopedic surgery during the COVID-19 outbreak in Wuhan, China, based on our own experience in our hospital. Methods: A retrospective and comparative study was performed to identify all inpatients at our clinic from February 17, 2020 to April 20, 2020 (epidemic group), and from February 17, 2019 to April 20, 2019 (control group). Epidemiologic characteristics, screening effect, perioperative complications, and nosocomial infection were analyzed. Results: In the epidemic group, 82 patients were identified, a decrease by 76.0% than the 342 patients in the same period in the 2019. Patients in the epidemic group (54.6 ± 20.2 years) were older than those in the control group (49.6 ± 22.5 years). For the epidemic group, the proportion rates of traumatic factures (69.5%) and low-energy injuries (86.0%) were higher than that in the control group, respectively (35.4% and 37.2%). The preoperative waiting time (7.0 ± 2.6 days) in the epidemic group was longer than that in the control group (4.5 ± 2.1 days). The postoperative complication rate (12.2%) in the epidemic group was higher than that in the control group (3.5%). No nosocomial infection of orthopedic staff and patients with COVID-19 was noted in the epidemic group.Conclusion: During the COVID-19 outbreak in Wuhan, China, orthopedic inpatients showed unique epidemiological characteristics. The double-buffered strategy could effectively avoid nosocomial infections among medical staff and patients. Doctors should fully evaluate the perioperative risks and complications.