bluuebunny/crossref_metadata_2025_split huggingface dataset:
Type of the Paper: Article Homogenous Gamma-Irradiation by a Linear Accelerator for Inactivation of viruses in Plasma Samples, a Pilot Study with HIV-1-Infected Plasma
Authors: Tonino Rik , Franken Eric , Elzakker Erika van , Gescher Frank , Schipperus Martin 
Published: May 2020

Abstract
BACKGROUNDThe risk of the transmission of (emerging) infectious diseases via blood products is a major public health concern. Therefore, it has been a long-sought goal to find a cost-effective way to sterilise blood after collection. No pathogen inactivation (PI) techniques are available for red blood cells on the market yet, though phase III trials are currently performed. γ-irradiation could theoretically inactivate viruses in red blood cells (RBCs). The dose of γ-irradiation needed to achieve sterility causes irreversible damage to the red blood cells and is therefore not suitable for PI of RBC concentrates. Inhomogeneous irradiation has always been used in the past, but leads to inconsistent measurements and uncertainty of results. By contrast, homogeneous irradiation may achieve the sterility assurance level (SAL) at much lower doses. If a maximum of 25 Gy of homogeneous γ-irradiation is able to sterilise blood products, this would be a very attractive PI method for RBC products. METHODSThis proof-of-concept study aims to sterilise HIV-1 infected plasma using homogeneous γ-irradiation. Six HIV-1 infected plasma samples were irradiated with 25 Gy of homogeneous γ-irradiation. HIV-1 RNA-loads before and after were compared.RESULTSNo difference was found in the HIV-1 RNA loads within the limitations of the test used before and after the irradiation. Therefore, homogeneous γ-irradiation appears not to be feasible as a PI-technique for HIV-1 in RBC products. CONCLUSIONThis inevitably means SAL will not be achieved for all viruses with up to 25 Gy of homogeneous γ-irradiation.
Outcomes After Transcatheter Aortic Valve Replacement in Cancer Survivors with Prior Chest Radiation Therapy: A Systematic Review and Meta-Analysis
Authors: Zafar Meer Rabeel , Mustafa Syed Farrukh , Miller Timothy W , Alkhawlani Talal , Sharma Umesh C 
Published: May 2020

Abstract
Background: Cancer survivors with prior chest radiation therapy (C-XRT) frequently present with aortic stenosis (AS) as the first manifestation of radiation-induced heart disease. They are considered high-risk for surgical valve replacement. Transcatheter aortic valve replacement (TAVR) appears as an attractive option for this patient population but the outcomes are not well established in major clinical trails. The authors performed a systemic review and meta-analysis of clinical studies for the outcomes after TAVR in cancer survivors with prior C-XRT.Methods: Online databases were searched from inception to April 2020 for studies evaluating the outcomes of TAVR in patients with and without C-XRT. We analyzed the pooled estimates (with their 95% confidence intervals) of the odds ratio (OR) for the all-cause mortality at 30-day and 1-year follow-ups, 4-point safety outcomes (stroke, major bleed, access-related vascular complications and need for a pacemaker), a 2-point efficacy outcome (mean aortic valve gradient and left ventricular ejection fraction) and worsening of congestive heart failure (CHF). Four studies were included following 2054 patients with and without prior C-XRT exposure (164 patients and 1890 patients respectively).Results: The C-XRT group had similar 30-day mortality compared to the control group (OR 1.29, 95% CI 0.64 to 2.58, p=0.48). The 1-year mortality was higher in the C-XRT group (OR 1.97, CI 1.15 to 3.39, p=0.01). Apart from higher congestive heart failure (CHF) exacerbation in the C-XRT group (OR 2.03, CI 1.36 to 3.04, p=0.0006), TAVR resulted in similar safety and efficacy outcomes in both groups.Conclusion: TAVR in the C-XRT group has similar 30-day mortality, safety, and efficacy outcomes compared to the control group; however, they have higher 1-year mortality and CHF exacerbation. The quality of analyzed data is low, warranting randomized trials to assess the true benefits of TAVR in these patients.
Development and validation of a novel stem cell subtype for bladder cancer based on stem genomic profiling
Authors: Tang Chaozhi , Ma Jiakang , Liu Xiuli , Liu Zhengchun 
Published: May 2020

Abstract
Background

Bladder cancer is the fifth most common type of cancer worldwide, with high recurrence and progression rates. Although considerable progress has been made in the treatment of bladder cancer through accurate typing of molecular characteristics, little is known about the various genetic and epigenetic changes that have evolved in stem and progenitor cells. Thus, we developed a novel stem cell typing method to fill this gap.

Methods

Based on six published genomic data sets, we used 26 stem cell gene sets to classify each data set. Unsupervised and supervised machine learning methods were used to perform the classification.

Results

We classified BLCA into three subtypes—high stem cell enrichment (SCE_H), medium stem cell enrichment (SCE_M), and low stem cell enrichment (SCE_L)—based on multiple cross-platform data sets. The stability and reliability of the classification were verified. The stemness index obtained from the one-class logistic regression machine learning method showed that the degree of tumor stem cell enrichment was not proportional to the stemness index. Compared with the other subtypes, SCE_H showed the highest degree of cancer stem cell concentration, lowest stemness index, and highest level of immune cell infiltration and was the most sensitive to predicted immune checkpoint inhibitor treatment. However, this group showed the worst prognosis. Comparison of gene set enrichment analysis results for pathway enrichment of various subtypes revealed that the SCE_H subtype activates some important pathways regulating cancer occurrence, development, and even poor prognosis, including epithelial mesenchymal transition, hypoxia, angiogenesis, KRAS signal up-regulation, the interleukin 6-mediated Jak-STAT signaling pathway, and inflammatory response. Two identified pairs of transcription factors, GRHL2 and GATA6 and IRF5 and GATA3 , likely have opposite regulatory effects on SCE_H and SCE_L, respectively.

Conclusions

The identification of BLCA subtypes based on cancer stem cell gene sets revealed the complex mechanism of carcinogenesis causing BLCA and provides a new direction for the diagnosis and treatment of BLCA.
Geographic Variations in Stroke Inpatient Healthcare Utilization and Hospital Expenditure Equity in China
Authors: Yang Yong , Nicholas Stephen , Maitland Elizabeth , Huang Zhengwei , Chen Xiaoping , Ma Yong , Shi Xuefeng 
Published: May 2020

Abstract
Background: Stroke is a devastating disease that imposes a heavy financial burden on patients and their families and a significant economic cost on a nation’s healthcare system. Under China’s fragmented health insurance system, it was unclear whether geographic variations in healthcare utilization and hospital expenditures lead to healthcare inequities for stroke inpatients. This study assesses the geographic variations in stroke patients’ healthcare utilization and hospital expenses and the potential geographical influencing factors. Methods: Covering all municipalities and provinces in mainland China, our main data were a 5% random sample of stroke claims from the Urban Employees Basic Medical Insurance (UEBMI) and Urban Residents Basic Medical Insurance (URBMI) schemes from 2013 to 2016, totaling 217969 inpatients and 280804 admissions. The Theil index was employed to evaluate the (in)equity in healthcare utilization and hospital expenditures across all 31 mainland Chinese provinces. Using multiple linear regression analysis, the geographic influencing factors, comprising ability to deliver healthcare, geographical accessibility of health services, healthcare-seeking and economic factors, were explored.Results: UEBMI stroke inpatients had higher hospital costs and longer ALOS, but lower OOP expenses than those with URBMI. UEBMI insurance had a lower Theil index value than the URBMI scheme. Stroke patients’ healthcare utilization and hospital expenditures showed significant differences both within and between regions. The intra-region Theil (in)equality index value was higher than the inter-region Theil index, with the Theil index highest within eastern China, China’s richest and most developed region. The ability to deliver healthcare, the enabling factors and the provincial-level economic factors had significant effects (P<0.05) on healthcare utilization and hospital expenses.Conclusions: Our data revealed significant geographic variation in healthcare utilization and hospital expenditures for stroke patients. In addition to differences in the coverage and reimbursements of the UEBMI-URBMI schemes, disparities within regions were associated with the ability to deliver healthcare (open hospital beds per 100 patients), the enabling factors (regional reimbursement rate and regional education level) and the provincial-level economic factors (GDP per capita). China’s fragmented urban health insurance schemes require further reform to ensure better equity in healthcare utilization and hospital expenses.
Malaria Intermittent Preventive Treatment in Nigeria: A Qualitative study to explore barriers and facilitators
Authors: Mahmud Fatima Muhammad , Nedjat Saharnaz , Sajadi Haniye Sadat , Parseian Mahbubeh , Majdzadeh Reza 
Published: May 2020

Abstract
Background : Sulphadoxine pyrimethamine (SP) used as a preventive treatment for malaria is low among pregnant women in Nigeria. However, there is limited evidence on the barriers and facilitators of intermittent preventive treatment (IPTp) use in pregnant women. This study aimed to explore the barriers and facilitators of IPTp use among pregnant women in Kano state, Nigeria. Methods: This qualitative study used a conventional content analysis method. Purposive sampling strategy was used to select study participants. A total of 14 key informant interviews were conducted with policy makers, malaria experts and health care providers. Three focus group discussions (FGD) were also conducted among pregnant women. Furthermore, separate three FGDs were conducted among husbands whom were selected using opportunistic maximum variation sampling method. MaxqDA 10 software was used for data analysis, i.e., to develop categories, subcategories and themes. Results: Malaria policy implementation, antenatal care attendance, accessibility of intermittent preventive treatment in the communities, strengthening IPTp service delivery were the facilitators of IPTp use while political reluctance, high population density, inadequate budget to implement IPTp related policies emerged as barriers to IPTp use. Conclusion: The political will to allocate sufficient budget could help improve service delivery and IPTp use among pregnant women and facilitate the achievement of the Sustainable Development Agenda to end malaria in 2030. Key words: Malaria , Intermittent preventive treatment, Equity, Pregnant women, Nigeria.
Epidemiology of cutaneous leishmaniasis in a newly emerging focus in Gampaha district, Western province of Sri Lanka
Authors: Mallawarachchi Chandana Harendra , Chandrasena Nilmini T. G. A. N , Wijerathna Tharaka , Dalpadado Rasika C.P.D. , Mallawarachchi Maleesha S.M.N.S. , G.A Gunarathna , Gunathilaka Nayana 
Published: May 2020

Abstract
Background Cutaneous leishmaniasis (CL) appears to be spreading to previously non-endemic regions of Sri Lanka. The aim of this study was to describe a newly emerging focus of CL in the district of Gampaha, in Western Sri Lanka. Methods A case based descriptive study was carried out from January 2018 to April 2019 in the Mirigama Medical Officer of Health (MOH) area, which reported the highest number of CL cases in Gampaha District. Laboratory confirmed cases were traced and socio-demographic and clinical data were collected via a validated questionnaire and clinic records respectively. The quality of life (QOL) of study participants was measured using the Dermatology Life Quality Index (DLQI). Global Positioning System (GPS) coordinates of patient residences were recorded using handheld GPS receivers. Sand-flies were collected from four selected sites, using Indoor Hand Collection (IHC) (162 units) and Cattle Baited Net Traps (CBNT) (n=3) and a battery-operated aspirator. Results Of 73 patients identified in this study, 58.9% were males, with a mean age of 43.6 years (SD 20.1). The lesions included nodules (52.05%) and ulcers (47.9%). Single lesions were seen in 69.86%, while 30.1% had multiple. Except for one mucosal lesion, all others were on skin. Treatment varied from sodium stibogluconate (SSG) + cryotherapy (46.57%), SSG (45.2%) and cryotherapy (8.2%). Patients with multiple lesions were more likely to be treated with combined SSG + cryotherapy (p< 0.05). The mean DLQI score was 8.14 (SD=7). Most patients engaged in outdoor activities that exposed them to the risk of sand-fly bites Workplaces of 81.1% (27/33) were located within the district. Housing conditions of study participants were of moderate (59%), good (35.6%) and poor (5%) quality. Four households reported multiple cases. Spatial distribution of cases indicated notable clustering in seven adjacently located Public Health Inspector (PHI) areas. Phlebotomus argentipes was detected in all CBNTs and 35.28% of IHC units surveyed. Conclusions CL is emerging in Gamapha district with Mirigama MOH area being the epicentre of infection. The disease had a moderately negative impact on QOL of patients. Minimal migration of cases, clustering of cases within households and in the locality indicates local transmission with P. argentipes as the probable vector.
Comprehensive analyses reveal three-gene signatures in ovarian cancer
Authors: Li Chuang , Lyu Yuan , Liu Caixia 
Published: May 2020

Abstract
Background: Ovarian cancer is a common cancer that affects the quality of women’s life. With the limitation of the early diagnosis of the disease, ovarian cancer has a high mortality rate worldwide. However, the molecular mechanisms underlying tumor invasion, proliferation, and metastasis in ovarian cancer remain unclear. We aimed to identify, using bioinformatics, important genes and pathways that may serve crucial roles in the prevention, diagnosis, and treatment of ovarian cancer. Methods: Three microarray datasets (GSE14407, GSE36668, and GSE26712) were selected for whole-genome gene expression profiling , and differentially expressed genes were identified between normal and ovarian cancer tissues. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses were performed using DAVID. Additionally, a protein-protein interaction network was constructed to reveal possible interactions among the differently expressed genes. The prognostic values of the hub genes were investigated using Gene Expression Profiling Interactive Analysis (GEPIA) and the KM plotter database. Meanwhile, the mRNA expression analysis of the hub genes was performed using the GEPIA database. Results: We obtained 247 upregulated and 530 downregulated differently expressed genes, and 52 hub genes in the significant gene modules. Enrichment analysis revealed that the hub genes were significantly ( P < 0.05) associated with proliferation. Additionally, BIRC5, CXCL13, and PBK were revealed to be significantly associated with the clinical prognosis of patients with ovarian cancer. Immunohistochemical staining results obtained from the Human Protein Atlas revealed that BIRC5, PBK, and CXCL13 were highly expressed in ovaria cancer tissues. Conclusion Three-gene signatures ( BIRC5, CXCL13 , and PBK ) are associated with the occurrence, development, and prognosis of OC, and may therefore serve as biological markers of the disease.
Multisensory cueing facilitates naming in aphasia
Authors: Grechuta Klaudia , Ballester Belén Rubio , Munné Rosa Espín , Bernal Teresa Usabiaga , Hervás Begoña Molina , Mohr Bettina , Pulvermüller Friedemann , Segundo Rosa San , Verschure Paul FMJ 
Published: May 2020

Abstract
Background: Impaired naming is a ubiquitous symptom in all types of aphasia, which often adversely impacts independence, quality of life, and recovery of affected individuals. Previous research has demonstrated that naming can be facilitated by phonemic and semantic cueing strategies that are largely incorporated into the treatment of anomic disturbances. Beneficial effects of cueing, whereby naming becomes faster and more accurate, are often attributed to the priming mechanisms occurring within the distributed language network. Objective: We proposed and explored two novel cueing techniques: (1) Silent Visuomotor Cues (SVC), which provided articulatory information of target words presented in the form of silent videos, and (2) Semantic Auditory Cues (SAC), which consisted of acoustic information semantically relevant to target words (ringing for “telephone”). Grounded in neurophysiological evidence, we hypothesized that both SVC and SAC might aid communicative effectiveness possibly by triggering activity in perceptual and semantic language regions, respectively. Methods: Ten participants with chronic non-fluent aphasia were recruited for a longitudinal clinical intervention. Participants were split into dyads (i.e., five pairs of two participants) and required to engage in a turn-based peer-to-peer language game using the Rehabilitation Gaming System for aphasia (RGSa). The objective of the RGSa sessions was to practice communicative acts, such as making a request. We administered SVCs and SACs in a pseudorandomized manner at the moment when the active player selected the object to be requested from the interlocutor. For the analysis, we compared the times from selection to the reception of the desired object between cued and non-cued trials. Results: Naming accuracy, as measured by a standard clinical scale, significantly improved for all stimuli at each evaluation point, including the follow-up. Moreover, the results yielded beneficial effects of both SVC and SAC cues on word naming, especially at the early intervention sessions when the exposure to the target lexicon was infrequent. Conclusions. This study supports the efficacy of the proposed cueing strategies which could be integrated into the clinic or mobile technology to aid naming even at the chronic stages of aphasia. These findings are consistent with sensorimotor accounts of language processing, suggesting a coupling between language, motor, and semantic brain regions. Trial registration: NCT02928822. Registered 30 May 2016
Autism Spectrum Disorders in Mali: Parental concerns about child developmental milestones and late diagnostic age
Authors: Sangare Modibo , Diarra Ya , Konate Djeneba , Haidara Mohamed S , Karembe Adama , Keita Boureima , Dolo Housseini , Kouyate Modibo , Doumbia Fatoumata , Sidibe Oumar , Diakite Seidina , Kayentao Kassoum , Traore Drissa , Toure Amadou , Doumbia Seydou , Diakite Mahamadou , Kim Hyung-Goo , Awandare Gordon A 
Published: May 2020

Abstract
Background In Mali, the health facility-based prevalence of autism spectrum disorders (ASD) was 4.5% (105/2,343) and the age of first medical visit for autistic children was around 7 years old in 2018. Parental recognition of developmental abnormalities initiates the early autism detection and diagnosis. Our aim was to investigate if parental concerns were associated with early first medical visits and subsequent ASD diagnostic in Mali. Methods We conducted a pilot study from November 2017 to July 2019. We surveyed parents of 57 autistic children aged 3-14 years old. Results Parents were concerned over verbal communication in 54.1% and reciprocal social interaction in 43.8%. Children with ASD had their first medical visit after 18 months old in 66.7%, ≥ two medical visits in 87.7%, and were identified after 36 months old in 76.8%.Conclusion: Parental concerns were not significantly associated with early first medical visit and ASD identification. A full scale study will be conducted for more consistent results.
Cluster analysis in 975 patients with current cough identifies a phenotype with several cough triggers, many background disorders, and low quality of life
Authors: Koskela Heikki Olavi , Selander Tuomas A , Lätti Anne M 
Published: May 2020

Abstract
Background: Recognition of disorder phenotypes may help to estimate prognosis and to guide the clinical management. Current cough management guidelines classify patients according to the duration of the cough episode. However, this classification is not based on phenotype analyses. The present study aimed to identify cough phenotypes by clustering.Methods: An email survey among employed, working-age subjects identified 975 patients with current cough. All filled in a comprehensive 80-item questionnaire including the Leicester Cough Questionnaire. Phenotypes were identified utilizing K-means partitional clustering. A subgroup filled in a follow-up questionnaire 12 months later to investigate the possible differences in the prognosis between the phenotypes.Results: Two clusters were found. The cluster A included 608 patients (62.4 % of the population) and the cluster B 367 patients (37.6 %). The three most important variables to separate the clusters were the number of the triggers of cough (mean 2.63 (SD 2.22) vs. 6.95 (2.30), respectively, p<0.001), the number of the cough background disorders (chronic rhinosinusitis, current asthma, gastroesophageal reflux disease, 0.29 (0.50) vs. 1.28 (0.75), respectively, p<0.001), and the Leicester Cough Questionnaire physical domain (5.33 (0.76) vs. 4.25 (0.84), respectively, p<0.001). There were significant interrelationships between these three variables (each p<0.001). Duration of the episode was not among the most important variables to separate the clusters. At 12 months, 27.0 % of the patients of the cluster A and 46.1 % of the patients of the cluster B suffered from cough that had continued without interruptions from the first survey (p<0.001).Conclusions: Two cough phenotypes could be identified. Cluster A represents phenotype A, which includes the majority of patients and has a tendency to heal by itself. The authors propose that cluster B represents phenotype TBQ (Triggers, Background disorders, Quality of life impairment). Given the poor prognosis of this phenotype, it urges a prompt and comprehensive clinical evaluation regardless of the duration of the cough episode.