bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nose ‐To ‐Brain Delivery of Mitochondria for Treatment of Parkinson’s Disease Model Rats With 6-Hydroxydopamine
Authors: Chang Jui-Chih , Chao Yi-Chun , Chang Huei-Shin , Wu Yu-Ling , Chang Hui-Ju , Lin Yong-Shiou , Cheng Wen-Ling , Lin Ta-Tsung , Liu Chin-San 
Published: October 2020

Abstract
BackgroundFeasibility of mitochondrial organelle transport via the olfactory bulb route for Parkinson's disease (PD) therapy was evaluated in the unilateral 6-OHDA-lesioned rats due to the distinct difference based on payload properties. MethodsAn intranasal infusion with 200 μg of allogeneic mitochondria conjugated with Pep-1 (P-Mito) or not (Mito) was executed once a week at the ipsilateral side of lesioned brain for three months of treatments.Results A significant improvement of rotational and locomotor behaviors in PD rats was found in both mitochondria-treating groups in contrast to Sham group or Pep-1 group. There was more than 60% recovery survival of dopaminergic (DA) neurons in substantia nigra (SN) and striatum (ST) of lesioned sides compared to the intact sides in groups of Mito and P-Mito. Treatment effect in P-Mito group was higher in the P-Mito group than Mito group but not significant. The mechanism was associated with the restoration of mitochondrial function and attenuation of oxidative damage in lesioned SN. Notably, Pep-1 modification suppressed the plasma level of inflammatory cytokines induced by infused mitochondria. The 5-bromo-2-deoxyuridine-labelled tracks showed the mitochondrial penetrating into doublecortin-positive neurons of rostral migratory stream (RMS) along with the accessory olfactory bulb in ipsilateral side of lesion and it was expressed in striatal DA neurons, but not in SN, of two cerebral hemispheres via commissural fibers. Conclusion This study showed a promising approach of nose-to-brain delivery for mitochondrial transplantation by confirming the mitochondrial internalization via RMS neurons migration in olfactory bulb for therapeutic action of PD in rats.
A Principal Components Analysis of Factors Associated with Successful Implementation of an LVAD Decision Support Tool
Authors: Kostick Kristin M. , Trejo Meredith , Bhimaraj Arvind , Civitello Andrew , Grinstein Jonathan , Horstmanshof Douglas , Jorde Ulrich P. , Loebe Matthias , Mehra Mandeep R. , Sulemanjee Nasir Z. , Thohan Vinay , Trachtenberg Barry H. , Uriel Nir , Volk Robert J. , Estep Jerry D. , Blumenthal-Barby J. S. 
Published: October 2020

Abstract
Background: A central goal among researchers and policy makers seeking to implement clinical interventions is to identify key facilitators and barriers that contribute to implementation success. Despite calls from a number of scholars, empirical insights into the complex structural and cultural predictors of why DAs become routinely embedded in health care settings remains limited and highly variable across implementation contexts.Methods: We examined associations between “reach”, a widely used indicator (from the RE-AIM model) of implementation success, and multi-level site characteristics of nine LVAD clinics engaged over 18 months in implementation and dissemination of a decision aid for left-ventricular assist device (LVAD) treatment. Based on data collected from nurse coordinators, we explored factors at the level of the organization (e.g. patient volume), patient population (e.g. health literacy; average sickness level), clinician characteristics (e.g. attitudes towards decision aid; readiness for change) and process (how the aid was administered). We generated descriptive statistics for each site and calculated zero-order correlations (Pearson’s r) between all multi-level site variables including cumulative reach at 12 months and 18 months for all sites. We used principal components analysis (PCA) to examine any latent factors governing relationships between and among all site characteristics, including reach.Results: We observed strongest inclines in reach of our decision aid across the first year, with uptake fluctuating over the second year. Average reach across sites was 63% (s.d.=19.56) at 12 months and 66% (s.d.=19.39) at 18 months. Our (PCA) revealed that site characteristics positively associated with reach on two distinct dimensions, including a first dimension reflecting greater organizational infrastructure and standardization (characteristic of larger, more established clinics) and a second dimension reflecting positive attitudinal orientations, specifically, openness and capacity to give and receive decision support among coordinators and patients.Conclusions: Successful implementation plans should incorporate specific efforts to promote supportive and mutually informative interactions between clinical staff members and to institute systematic and standardized protocols to enhance the availability, convenience and salience of intervention tool in routine practice. Further research is needed to understand whether “core predictors” of success vary across different intervention types.
Comparison of Prognostic Models of Spontaneous Intracerebral Hemorrhage: Potential Tools for Personalized Care and Clinical Trial in ICH
Authors: JI RUIJUN , WANG WENJUAN , LIU XINYU , WANG LINLIN , JIANG RUIXUAN , ZHANG RUNHUA , WANG DANDAN , JIA JIAOKUN , FENG HAO , DING ZEYU , LIU YANFANG , LIU GAIFEN , LU JINGJING , JU YI , ZHAO XINGQUAN 
Published: October 2020

Abstract
Background: Several prognostic models have been developed for spontaneous intracerebral hemorrhage (ICH); however, none of them have been consistently used in routine clinical practice or clinical research. In the study, we systematically compared 27 ICH models with regard to mortality and functional outcome at 1-month, 3-month and 1-year after ICH. Methods: The validation cohort was derived from the Beijing Registration of Intracerebral Hemorrhage. Poor functional outcome was defined as modified Rankin Scale score (mRS) ≥3 at 1-month, 3-month and 1-year after ICH, respectively. The area under the receiver operating characteristic curve (AUROC) and Hosmer-Lemeshow goodness-of-fit test were used to assess model discrimination and calibration. Moderate, good, excellent and outstanding discrimination were predefined as AUROC of 0.75-0.79, 0.80-0.84, 0.85-0.89 and above 0.90, respectively.Results: A total number of 1575 patients were included. The mean age was 57.2±14.3 and 67.2% were male. The median NIHSS score on admission was 11 (IQR: 3-21). For predicting mortality at 3-month after ICH, AUROC of 27 ICH models ranged from 0.604 to 0.856. One model showed excellent discrimination; fifteen models demonstrated good discrimination; and seven models demonstrated moderate discrimination. In pairwise comparison, the ICH-FOS (0.856, 95%CI=0.835-0.878, P<0.001) showed statistically better discrimination than other models for mortality at 3-month after ICH (all P<0.05). For predicting poor functional outcome (mRS≥3) at 3-month after ICH, AUROC of 27 ICH models ranged from 0.602 to 0.880. Five models showed excellent discrimination; six models demonstrated good discrimination; and ten models demonstrated moderate discrimination. In pairwise comparison with other prediction models, the ICH-FOS was superior in predicting poor functional outcome at 3-month after ICH (all P<0.001). Several risk models were well calibrated (Hosmer-Lemeshow test P>0.05) for mortality and poor functional outcome at 3-month after ICH, however, the ICH-FOS showed the largest Cox and Snell R-square. Similar results were verified for mortality and poor functional outcome at 1-month and 1-year after ICH. Conclusion: Several risk models are externally validated to be effective for risk stratification and outcome prediction after ICH, especially the ICH-FOS, which would be useful tools for personalized care and clinical trial in ICH.
Sustained Down Regulation of Plasma Tetranectin Contributes to Liver Injury in Pneumonia-Associated Sepsis
Authors: Wang Shuaiwei , Bai Yu , Guo Yu , Bai Qing , Wei Xiangyan , Zhang Yijie , Chen Na , Miller Edmund J. , Li Wei 
Published: October 2020

Abstract
Background: It was recently shown that tetranectin (TN) concentration in the plasma of sepsis patients was significantly lower than healthy control and that exogenous TN reduced the mortality rate in septic mice. The aim of this study is to determine whether the reduction of plasma TN is a sepsis-specific host response and its impact on organ dysfunction in sepsis.Methods: The study was conducted in the Sepsis Laboratory at the Huaihe Hospital of Henan University in China. Thirty-seven healthy, 30 community-acquired pneumonia (CAP) and 363 sepsis with comorbid pneumonia (SWP) subjects were recruited. A murine model of polymicrobial sepsis was used to characterize the role of plasma TN in sepsis pathogenesis.Results: TN concentrations in plasma from both CAP and SWP subjects were lower than healthy controls, but not significantly different between male and female sepsis patients, before and after the occurrence or the resolution of sepsis. In addition, plasma TN was not associated with the occurrence of septic shock or sepsis mortality in both genders. On the other hand, plasma TN negatively correlated with liver injury indicators in moribund SWP subjects. In mice of polymicrobial sepsis, a significant decrease in plasma TN occurred within hours after the ligation and puncture of the cecum. Recombinant human TN induced significant reductions of tissue injury markers of liver, but not other organs. In addition, exogenous TN selectively reduced the level of receptor-interacting protein kinase 3 among a panel of cell death markers in septic mouse liver. Conclusions: The dramatic and persistent down-regulation of plasma TN is not a sepsis-specific host response, but contributes to liver injury in pneumonia-associated sepsis.
„What about the others – differential diagnosis of COVID-19 in a German emergency department“
Authors: Fistera David , Haertl Annalena , Pabst Dirk , Manegold Randi , Holzner Carola , Taube Christian , Dolff Sebastian , Schaarschmidt Benedikt Michael , Umutlu Lale , Kill Clemens , Risse Joachim 
Published: October 2020

Abstract
Background: The ongoing COVID-19 pandemia is a major challenge for worldwide health care systems. Especially an early and safe triage in the emergency department (ED) is crucial for proper therapy. Clinical symptoms of COVID-19 comprise those of many common diseases thus differential diagnosis remains challenging.Method: We performed a retrospective study of 314 ED patients presenting with possible symptoms of COVID-19. All were tested for COVID-19 with SARS-Cov2-nasopharyngeal swab. 47 patients were positive for COVID-19. We analyzed the 267 COVID-19 negative patients for their main diagnosis and compared COVID-19 patients with COVID-19 negative respiratory infections for differences in laboratory parameters, symptoms and vital signs. Results: Among the 267 COVID-19 negative patients 42.7% had respiratory, 14.2% other infectious and 11.2% cardiovascular diseases, followed by 9.0% oncological and 6.7% gastroenterological diagnosis. Compared to COVID-19 negative airway infections, COVID-19 patients showed less dyspnea but more dysgeusia. Their hospital stay was significantly longer and their mortality significantly higher. Conclusion: For many common ED diagnoses COVID-19 should be considered as a differential diagnosis. COVID-19 cannot be distinguished from COVID-19 negative respiratory infections by clinical signs, symptoms or laboratory results. When hospitalization is necessary, the clinical course of COVID-19 airway infections seems to be more severe compared to other respiratory infections.
Bird’s-eye View of Covid-19 Emergency Preparedness Among Emergency Physicians in the Kingdom of Bahrain
Authors: Alghanem Salah , Alqassim Ghada , Zeyad Feras Abu , Isa Ruqaya , Falamarzi Horeya 
Published: October 2020

Abstract
Background: Coronavirus 2019 (COVID-19) has exemplified the crucial role played by emergency physicians on the frontlines, by triaging, quarantining and treating myriad patients in time. Despite this, there exists a dearth of literature comprehensively assessing the knowledge and awareness of these healthcare workers on the disease in the Kingdom of Bahrain. Objectives: This study was designed to evaluate the knowledge, attitude, and practice (KAP) of emergency physicians in the Kingdom of Bahrain towards COVID-19. Methods: This cross-sectional descriptive study included 142 emergency physicians of three major hospitals in Bahrain. A self-designed questionnaire divided into 4 parts which comprised of demographics, knowledge, attitude and practices towards COVID-19 were completed by the emergency physicians working in these hospitals. Analysis of variance (ANOVA), t-test, Chi-square test, and multiple linear regression were employed to evaluate KAP scores. Results: The mean COVID-19 knowledge and practice score was 26.29 for a maximum score of 32 suggesting an overall 82.15% correct rate on the knowledge and practice test. Multiple linear regression analysis highlighted age (p=0.038), genders (p=0.033), marital status (p=0.021), organization (p=0.032), having children (p=0.008), and continuing professional development (CPD) activity (p=0.0001) as significant predictors for knowledge and practice scores. The attitude towards the final success in controlling COVID-19 significantly differed across marital status (p=0.021), organization of participants (p=0.020) and position of participants (p=0.012) respectively.Conclusion: Good knowledge, positive attitude and sufficient safe practice towards COVID-19 were observed in majority of the participants. These findings can foster development of nuanced and salient health management strategies that augment KAP so that proper control and elimination of the disease can be achieved, while prioritizing patient health and satisfaction.
Genotype and Clinical Phenotype Analysis of a Family of Kennedy Disease
Authors: benchi CAI , SUI Zhiyan , Chen Tao 
Published: October 2020

Abstract
Objective: By analyzing the clinical phenotype, genotype and family characteristics of a Kennedy disease family, to explore the clinical and genetic characteristics of the family, and to further improve the understanding of the disease. And through the analysis of genotype and clinical phenotype to draw a pedigree diagram, provide genetic counseling, in order to block the continued inheritance of disease-causing genes. Methods: The research subjects were from a family of Kennedy disease discovered in January 2019. For 5 clinically diagnosed patients including the proband, the Kennedy's disease function rating scale (KD1234) and the spinal cord and bulbar muscular atrophy rating scale (SBMAFRS) were used to assess their condition, and their clinical phenotypes, laboratory tests, and neurological Analysis of electrophysiological results. After the patient's informed consent was obtained, 5ml of venous blood was drawn from the 3 members of the proband, and the CAG repeat sequence of the first exon of the androgen receptor (AR) gene was checked by polymerase chain reaction (PCR), and genetic testing was performed. analysis. Results: 1) Clinical features: The average age of onset of 5 clinical diagnosis members was (30.8±2.85) years, and the average course of disease was (12.3±4.93) years at the age of onset to milestones. This family has gynecomastia as the first symptom, and it is the most significant clinical feature. The lesions mainly involve the medulla oblongata and spinal cord. The testosterone level of 5 cases was in the normal range, and the progesterone was increased. 3 cases of estradiol were slightly elevated. The serum creatine kinase (CK) was significantly increased in 5 cases. Electromyography showed chronic extensive neurogenic damage, abnormal sensory and motor conduction. 2) The results of genetic testing showed that the 3 clinically diagnosed cases underwent genetic testing for 48 CAG repetitions (≥35 times are abnormal), and genetic diagnosis was confirmed, indicating stable inheritance.Conclusion: 1) Gynecomastia is the first symptom of the family. Androgen resistance symptoms are the outstanding clinical manifestations of this family, in addition to gynecomastia, including testicular atrophy, infertility, sexual dysfunction, etc.; 2) Changes in serum creatine kinase may indicate the progress or relief of symptoms; 3) This family There is chronic extensive neurogenic damage, prominent with sensory nerve involvement; 4) Rehabilitation training may delay the progression of muscle wasting symptoms; 5) There is a stable inheritance of CAG repeats in this family; 6) Genetic testing can diagnose the disease , The genotype is consistent with the clinical phenotype; 7) The pedigree diagram drawn according to the clinical phenotype and genotype can be used as an important basis for genetic counseling.
Effectiveness and Safety of Mepolizumab in Combination with Corticosteroids in Patients with Eosinophilic Granulomatosis with Polyangiitis
Authors: Ueno Masanobu , Miyagawa Ippei , Nakano Kazuhisa , Iwata Shigeru , Hanami Kentaro , Fukuyo Shunsuke , Kubo Satoshi , Miyazaki Yusuke , Kawabe Akio , Yoshinari Hiroko , Nakayamada Shingo , Tanaka Yoshiya 
Published: October 2020

Abstract
Objectives: Mepolizumab (MPZ), an anti-interleukin-5 antibody, is effective for treating eosinophilic granulomatosis with polyangiitis (EGPA). However, its effectiveness has not been adequately evaluated in real-world clinical practice. In this study, we assessed the effectiveness and safety of 300 mg MPZ for relapsing/refractory EGPA resistant to corticosteroids (CS) for 1 year in real-world settings. Methods: We administered MPZ (300 mg) to 16 patients with relapsing/refractory EGPA resistant to CS (with-MPZ). We also retrospectively collected data from the same patients for 12 months before administering MPZ (without-MPZ). The primary endpoint was the 12-month remission rate after MPZ administration, and the secondary endpoints were the Birmingham vasculitis activity score (BVAS), vasculitis damage index (VDI), eosinophil count, changes in concomitant CS doses/concomitant immunosuppressant use, MPZ retention rate, and incidence of adverse events. The clinical course was compared between Without-MPZ and With MPZ.Results: The 12-month remission rate after initiating MPZ was 75%. No change was observed in BVAS, eosinophil count, or concomitant CS dose in the without-MPZ, whereas all these parameters were significantly decreased in the with-MPZ. The number of patients on concomitant immunosuppressants also decreased in the with-MPZ. VDI did not increase in both groups. The MPZ retention rate was 100%, and only three patients (18.8%) had infections.Conclusion: This study demonstrated that MPZ is effective and safe for EGPA, furthermore, compared to Without-MPZ, MPZ improves disease activity and possesses a higher remission rate and CS sparing effect.
Identification of Covid-19 suspect cases through a digital triage: a multicenter Italian-Iranian study on
Authors: Abbadessa Gianmarco , Sparaco Maddalena , Ghajarzadeh Mahsa , Cavalla Paola , Signoriello Elisabetta , Valentino Paola , Borriello Giovanna , Clerico Marinella , Lanzillo Roberta , Lavorgna Luigi , Martino Antonio De , Mirmosayyeb Omid , Shaygannejad Vahid , Fratta Mario , Lus Giacomo , Bonavita Simona 
Published: October 2020

Abstract
Objective: To explore, through a digital triage monitoring, the frequency of demographic and clinical characteristics suggestive for COVID-19 among two large samples of people with Multiple Sclerosis (pwMS) and to evaluate the association between demographic and clinical characteristics of pwMS and the likelihood of being identified as COVID-19 suspect. Methods: A Google Forms triage was e-mailed to 3500 pwMS. pwMS suspects for having COVID-19 were: A) patients who reported recent contact with a patient with suspicion or diagnosis of COVID-19 and the presence of at least one symptom suggestive of COVID-19; B) pwMS with at least two symptoms suggestive of COVID-19. Demographics, clinical characteristics, and DMT categories of COVID-19-suspect vs non-suspect pwMS were compared.Results: 1035/1500 questionnaires were fulfilled by Italian pwMS and 1346/2000 by Iranian patients. 4.9% of Iranian and 1,5% of Italian pwMS met our criteria for the COVID-19-suspect case. Only diabetes and heart disease (OR: 5,374, 95%CI: 2,470 – 11,985, p-value<0.001) were independently associated with the likelihood of being suspect for COVID-19.Conclusion: The results of a digital triage system applied to a large Italian-Iranian population of pwMS to identify suspect cases of COVID-19 were discussed. Demographic and clinical characteristics of pwMS suspect for COVID-19 and the factors influencing the likelihood of being COVID-19 suspect are comparable to those of previous studies. Therefore, we encourage the use of the digital triage in patients with this chronic and severely disabling disease to pinpoint suspect case of COVID-19 in order to promptly activate the second phase of the intervention.
Optimizing the Design of a Contraceptive Microarray Patch: A Discrete Choice Experiment on Women’s Preferences in India and Nigeria
Authors: Callahan Rebecca L. , Brunie Aurélie , Lebrun Victoria , Chen Mario , Godwin Christine L. , Lakhwani Kanchan , OlaOlorun Funmilola M. 
Published: October 2020

Abstract
Background: Efforts are underway to develop an easy-to-use contraceptive microarray patch (MAP) that could expand the range of self-administrable methods. This paper presents results from a discrete choice experiment (DCE) designed to support optimal product design.Methods: We conducted a DCE survey of users and non-users of contraception in New Delhi, India (496 women) and Ibadan, Nigeria (two versions with 530 and 416 women, respectively) to assess stated preferences for up to six potential product attributes: effect on menstruation, duration of effectiveness, application pain, location, rash after application, and patch size. We estimated Hierarchical Bayes coefficients (utilities) for each attribute level and ran simulations comparing women’s preferences for hypothetical MAPs with varying attribute combinations.Results: The most important attributes of the MAP were potential for menstrual side effects (55% of preferences in India and 42% in Nigeria) and duration (13% of preferences in India and 24% in Nigeria). Women preferred a regular period over an irregular or no period, and a six-month duration to three or one month. Simulations show that the most ideal design would be a small patch, providing 6 months of protection, that would involve no pain on administration, result in a one-day rash, and be applied to the foot. Conclusions: To the extent possible, MAP developers should consider method designs and formulations that limit menstrual side effects and provide more than one month of protection.