bluuebunny/crossref_metadata_2025_split huggingface dataset:
Laryngeal mask versus endotracheal intubation for pre-hospital emergency airway management: a meta-analysis of randomized control studies
Authors: Li Hao , Duan Ming-da , Zhang Yun-liang , You Shao-hua , Song Yu-xiang , Zhang Xuan , Liu Min , Liu Wen-gang , Hou Ai-sheng , cao jiangbei 
Published: December 2019

Abstract
Background : Pre-hospital emergency airway management plays an important role in pre-hospital care. Laryngeal masks are increasingly employed for the airway management of pre-hospital critical patients and have achieved promising results. Although several randomized controlled trials have reported benefits, the efficacy of laryngeal masks in pre-hospital emergency airway management compared to endotracheal intubation have not been systematically reviewed.
Methods: Electronic databases (PubMed, Cochrane Library, Embase, Scopus and CNKI) were searched up to April 2019 for related randomized studies. Outcome indicators included overall intubation success rates, the success rates of the first intubation, insertion time, resuscitation efficiency rates, SpO2 rise time, the blood gas index and adverse events. Two investigators selected the trials, extracted the data according to inclusion and exclusion criteria, and assessed the quality of the literature according to the Jada score. The meta-analysis was performed using stata14.0 software.
Results: We included 31 human studies. Compared to endotracheal intubation, the application of laryngeal mask for pre-hospital emergencies enhanced the resuscitation efficiency rates [RR=1.20, 95% CI (1.06, 1.35), P<0.001], improved the success of first intubation [RR=1.29, 95% CI (1.18, 1.40), P<0.001] and the patients’ blood gas index, shortened the insertion and SpO2 rise times [SMD=-3.48, 95% CI (-4.17, -2.80), P < 0.001; -2.19, 95% CI (-3.06, -1.32), P < 0.001] and reduced the incidence of adverse events [RR=0.41, 95% CI (0.30, 0.57, P<0.001]. All results were stable and statistically significant.
Conclusions: Laryngeal masks could quickly and effectively improve patient ventilation in pre-hospital emergencies, highlighting its utility for clinical application.
A new approach to characterize postural deficits in chemotherapy-induced peripheral neuropathy and to analyze postural adaptions after an exercise intervention
Authors: Kneis Sarah , Wehrle Anja , Dalin Daniela , Wiesmeier Isabella Katharina , Lambeck Johann , Gollhofer Albert , Bertz Hartmut , Maurer Christoph 
Published: December 2019

Abstract
Background
Postural instability presents a common and disabling consequence of chemotherapy-induced peripheral neuropathy (CIPN). However, knowledge about postural behavior of CIPN patients is sparse. With this pilot study, we used a new approach to i) characterize postural impairments as compared to healthy subjects, ii) allocate possible abnormalities to a set of parameters describing sensorimotor function, and iii) evaluate the effects of a balance-based exercise intervention.
Methods
We analyzed spontaneous and externally perturbed postural control in eight CIPN patients before and after a balance-based exercise intervention by using a modification of an established postural control model. These findings were compared to 15 matched healthy subjects.
Results
Spontaneous sway amplitude and velocity were larger in CIPN patients compared to healthy subjects. CIPN patients’ reactions to external perturbations were smaller compared to healthy subjects, indicating that patients favor vestibular over proprioceptive sensory information. The balance-based exercise intervention up-weighted proprioceptive information in patients.
Conclusions
CIPN patients’ major postural deficit may relate to underuse of proprioceptive information that results in a less accurate posture control as spontaneous sway results indicate. The balance-based exercise intervention is able to partially correct for this abnormality. Our study contributes to a better understanding of postural impairments in CIPN patients and suggests an effective treatment strategy.
Cumulative Incidence of Hepatocellular Carcinoma and Hepatitis B Surface Antigen Seroclearance after Nucleos(t)ide analogue-induced Hepatitis B e Antigen Seroclearance
Authors: Lee Hyun Woong , Lee Jung Il , Kim Saein , Kim Sora , Chang Hye Young , Lee Kwan Sik 
Published: December 2019

Abstract
Background: Hepatitis B e antigen (HBeAg) seroclearance has been considered as the treatment endpoint in HBeAg-positive patients with chronic hepatitis B (CHB). Although HBeAg seroclearance has been accomplished, some aspects are yet unclear. We investigated the cumulative incidence of hepatocellular carcinoma (HCC) and evaluated hepatitis B surface antigen (HBsAg) seroclearance in patients undergoing nucleos(t)ide analogue (NA)-induced HBeAg seroclearance.
Methods: In this retrospective cohort study, 203 patients with CHB were HBsAg and HBeAg seropositive before NA (entecavir or tenofovir) treatment. All patient who experienced NA -induced HBeAg seroclearance were recruited. Patients with documented HBeAg seroclearance were followed-up every 6 months. Baseline characteristics and laboratory results were recorded.
Results: The mean age at HBeAg seroclearance was 40 years (range, 20-84), and the mean follow-up duration was 5 years (range, 2-11). The cumulative incidence of HCC was 1.5% to 11.5% at 1 to 8 years after HBeAg seroclearance. Cirrhosis was the only significant factor for HCC development (hazard ratio [HR], 24.651; confidence interval [CI], 3.018 to 201.365; P = 0.003). The cumulative incidence of HBsAg seroclearance was 3.5% to 18.7% after 1 to 8 years from HBeAg seroclearance.
Conclusions: A significant proportion of patients developed HCC after NA-induced HBeAg seroclearance. The presence of liver cirrhosis at the time of HBeAg seroclearance serves as an independent factor for HCC development. Some patients with NA-induced HBeAg seroclearance achieved HBsAg seroclearance.
Keywords: hepatitis B virus; hepatitis B e antigen seroclearance; hepatitis B s antigen seroclearance; hepatocellular carcinoma
Is Procalcitonin (PCT) a reliable biomarker for preoperative diagnosing of low grade Periprosthetic Joint Infection? A Prospective Study
Authors: Busch André , Jäger Marcus , Engler Harald , Haversath Marcel , Bielefeld Charlotte , Landgraeber Stefan , Wegner Alexander 
Published: December 2019

Abstract
Background: Since a „gold-standard“ is missing, diagnosing periprosthetic joint infection (PJI) remains a challenge in orthopedic surgery. The purpose of this study was to evaluate the accuracy of serum and synovial fluid Procalcitonin (S-PCT and SF-PCT) as a diagnostic parameter and to compare it to the biomarkers recommended in the 2018 Definition of periprosthetic hip and knee infection. Methods: Between August 2018 and July 2019, a prospective cohort study was conducted in 70 patients with painful hip, shoulder and knee arthroplasty. Besides medical history, clinical and laboratory data was gathered. PJI was diagnosed based on the 2018 Definition of periprosthetic hip and knee infection. Preoperative blood and synovial joint fluid were taken for PCT measurement. S-PCT levels were quantified under the use of immunoassay (Centaur, Siemens, Germany). SF- PCT levels were measured using a standard quantitative PCT enzyme immunoassay kit, according to the manufacturers' instructions (Anti-Procalcitonin antibody ab166963, ABCAM, Cambridge,UK). Results: Twenty three patients (33%) were classified as the PJI group and fourty seven patient (67%) as the aseptic group. The mean levels of S-PCT were significantly (p<0.001) higher than those in the aseptic group (PJI 0.05 ng/mL (0.0-1.03) vs. aseptic 0.02 ng/mL (0.0-0.18)). In synovial fluid, the mean PCT values in the aseptic group were significantly higher (p<0.001) than those of PJI group (PJI 2.7 ng/mL (0.53-9.7) vs. aseptic 8.7 ng/mL (0.25-87.9)). S- PCT, with a cut-off level of 0.5 ng/mL, had a sensitivity of 13.0% and a specifity of 91.0%. SF-PCT, with a cut-off level of 5.0 ng/mL, had a sensitivity of 13.0% and a specifity of 52.0%. Conclusion: S-PCT and SF-PCT appeared to be no reliable biomarkers in the differential diagnosis of PJI from aseptic loosening in total joint arthroplasty.
Lapatinib in combination with capecitabine versus continued use of trastuzumab in breast cancer patients with trastuzumab-resistance: a retrospective study for Chinese population
Authors: Yang fan , Huang Xiang , Sun Chunxiao , Li Jianbin , Wang Biyun , Yan Min , Jin Feng , Wang Haibo , Zhang Jin , Fu Peifen , Zeng Tianyu , Wang Jian , Li Wei , Li Yongfei , Yang Mengzhu , Li Jun , Wu Hao , Fu Ziyi , Yin Yongmei , jiang zefei 
Published: December 2019

Abstract
Background: The efficacy and safety of lapatinib plus capecitabine (LC or LX) versus trastuzumab plus chemotherapy in patients with HER-positive metastatic breast cancer who were resistant to trastuzumab is largely unknown. Methods: we retrospectively analyzed breast cancer patients who began the treatment with regimen of lapatinib plus capecitabine (LC or LX) or trastuzumab beyond progression (TBP) at eight hospitals between May 2010 and October 2017. Results: Among 554 patients who had developed resistance to trastuzumab, the median PFS was 6.77 months in the LX group compared with 5.6 months in the TBP group (hazard ratio 0.804; 95% CI, 0.67 to 0.96; P=0.019). The central nervous system progression rate during treatment was 5.9% in LX group and 12.5% in TBP group, respectively (P=0.018). Conclusion: The combination of lapatinib and capecitabine has shown a prolonged PFS compared with TBP in patients who had progressed on trastuzumab.
Successful Control of an Extended-spectrum Beta-lactamase-producing Klebsiella pneumoniae ST307 Outbreak in a Neonatal Intensive Care Unit
Authors: Baek Eun-Hwa , Kim Se-Eun , Kim Sunjoo , Lee Seungjun , Cho Oh-Hyun , Hong Sun In , Do Hyun Jeong , Park Chan-Hoo , Shin Jeong Hwan , Hwang Inyeong , Park Eunhee 
Published: December 2019

Abstract
Background : In this study, we evaluated the genetic relatedness of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae (ESBL-KPN) isolates from an outbreak in a neonatal intensive care unit in August 2017 using pulse-field gel electrophoresis (PFGE) and sequence typing, we implemented an active countermeasure to control this outbreak successfully.
Methods: The incidence of healthcare-associated ESBL-KPN bacteremia was evaluated before and after initiating enhanced infection control (IC) practices in January 2018. Surveillance cultures were set up and monitored for neonates, medical personnel, and NICU environmental samples. Molecular analyses, including pulse-field gel electrophoresis (PFGE), sequence typing, and ESBL genotyping, were performed for the isolated KPN strains.
Results: After implementing the enhanced IC procedures, the healthcare-associated bacteremia rate decreased from 6.0 to 0.0 per 1,000 patient-days. Samples from neonates (n = 11/15, 73.3%), medical personnel (n = 1/41, 2.4%), and medical devices and the environments (6/181, 3.3%) tested positive for ESBL-KPN in the surveillance cultures in December 2017. Active surveillance cultures revealed that 23 of 72 neonates who were screened (31.9%) were colonized with ESBL-KPN between January and March 2018. All the isolates demonstrated closely related PFGE patterns and were identified as ST307 strain carrying the CTX-M-15 gene.
Conclusions: Contaminated neonate environments and medical devices, as well as transmission by medical personnel, appeared to be the source of the outbreak of ESBL-KPN infection. We employed an enhanced IC strategy during January-March 2018 and successfully controlled the clonal outbreak of CTX-M-15-positive KPN. ST307 has emerged as an important bacteremia-causing pathogen in the NICU and should be carefully monitored.
Identification of subclinical tuberculosis in household contacts. The relevance of tuberculosis exposure scores and contact investigations.
Authors: Bekken Gry Klouman , Ritz Christian , Selvam Sumithra , Nelson Jesuraj , Hesseling Anneke C , Doherty Timothy Mark , Grewal Harleen MS , Vaz Mario , Jenum Synne 
Published: December 2019

Abstract
Background The goal of tuberculosis elimination put forward in the End TB Strategy prioritizes diagnosis and treatment of incipient and subclinical TB, recently defined by key stakeholders as an “asymptomatic, early pre-clinical disease during which pathology evolves”. Regarded as indicative of a high risk of TB progression, considerable efforts have been made to identify these cases through exploration of biomarkers. The present study aimed to evaluate simple scoring systems for TB exposure as screening tools for subclinical TB, the only identifiable of the incipient and subclinical disease states, in a contact investigation (CI) setting of low HIV-prevalence. Methods Nested within a large prospective study in household contacts (HHCs) of smear positive pulmonary TB cases in South-India conducted 2010-2012, we assessed 1) the association between the Tuberculosis Contact Score (TCS) and the Infectivity Score with established tools for Mycobacterium tuberculosis (Mtb) infection corrected for established TB risk factors and 2) the capability of the TB exposure scores to identify subclinical TB defined by Mtb-culture positivity in sputum or gastric aspirate (subjects <5 years) specimen. Results Of 525 HHCs, 29 were Mtb-culture positive and 96.6% of these asymptomatic. The TCS and the Infectivity Score associated with positive Tuberculin Skin Test and QuantiFeron TB-Gold In-tube assay (QFT) results in multivariate analyses (TCS: ORTST 1.16, 95%CI: 1.01, 1.33; ORQFT 1.33 95%CI: 1.16, 1.51. Infectivity Score: ORTST 1.39, 95%CI: 1.10, 1.76; ORQFT 1.41 95%CI: 1.16, 1.71). The Infectivity Score showed a moderate capability to identify subclinical TB (AUC of 0.61, 95%CI: 0.52, 0.70). Conclusion Although our results did not identify an easily applicable screening tool for subclinical TB, the present study indicates that focusing on TB-related symptoms in CI settings may be of limited value for early identification of HHCs with high risk for TB progression, one of the goals of the End TB Strategy.
Surgery Outcomes of Lamellar Macular Eyes with or without Lamellar Hole-Associated Epiretinal Proliferation: A Meta-Analysis
Authors: xu hanyue , Qin Ling , Zhang Yifan , Zhang Ming 
Published: December 2019

Abstract
Background:
To compare the visual outcomesand rate of restored ellipsoid zone (REZ) after surgery of lamellar macular hole (LMH) with and without lamellar hole-associated epiretinal proliferation (LHEP). To determine whether all patients with LMH need surgery.
Method:
Publications up to November 2019 that compared the outcomes of LMH patients with and without LHEP who were managed by surgery were included. Forest plots were created using a weighted summary of proportion meta-analysis. A random effects mode was used and I2 heterogeneity estimates were calculated. Sensitivity analysis was carried out to evaluate the stability of the meta-analysis.
Result:
Four pertinent publications studying a total of 157 patients were identified. They were all retrospective studies and had a mean follow-up of at least 6 months. In all studies, the best corrected visual acuity (BCVA) had no significant differences before surgery and improved in both groups, and in two studies the post-operative BCVA had no significant differences between two groups. The rate of REZ were different among studies included. Meta-analytic pooling of the improved BCVA between with and without LHEP groups was 0.15 (95 % CI, 0.02 to 0.27; p=0.02), and the pooled data revealed an odd ratio of 5.79 (95% CI, 1.15 to 29.18; p = 0.03) in the rate of restored ellipsoid zone, comparing the group without LHEP and the group with LHEP.
Patients with LHEP were more likely to gain restored ellipsoid zone after surgery but had lower postoperative BCVA. The surgery of LMH with LHEP appeared to be useless for improving visual acuity.
Improving production of Streptomyces griseus trypsin for its application in processing insulin precursor
Authors: Zhang YunFeng , Liang Qixing , Zhang Chuanzhi , Zhang Juan , Du Guocheng , Kang Zhen 
Published: December 2019

Abstract
Background: Trypsin has a plenty application in food and pharmaceutical manufacture. While, the commercial trypsin is usually extracted from pork pancreas, which has the risk of infectious and immunogenicity. Therefore, the microbial Streptomyces griseus trypsin (SGT) is a prior alternation because it processes efficient hydrolysis activity without the aforementioned risk. The remarkable hydrolysis efficiency of SGT caused its autolysis, and five autolysis sites R21, R32, K122, R153, and R201 were identified from its' autolysate. Results: The tbcf (K101A, R201V) mutant was screened by directed selection approach for improved activity in flask culture (60.85 ± 3.42 U·mL -1 , increased 1.5-fold). From the molecular dynamics simulation, the K101A/R201V mutation shortened the distant between catalytical residues D102 and H57 from 6.5 Å vs 7.0 Å, which afforded the improved specific activity 1527.96 ± 62.81 U·mg -1 . Further, the production of trypsin was increased 302.8% (689.47 ± 6.78 U·mL −1 ) in 3-L bio-reactor, with co-overexpression of chaperones SSO2 and UBC1 in Pichia pastoris. Conclusions: The SGT protein could be an adequate trypsin for insulin production. When working with hydrolysates analysis and direction selection, the tbcf (K101A, R201V) mutant increased 1.5-fold activity. Further, the production of trypsin was improved 3-fold by overexpressing chaperone protein in Pichia pastoris . The future study should be emphasized on the application of SGT in insulin manufacture and pharmaceutical.
Elucidating the mechanism by which regulating spleen and lipid method improves the state of hyperlipidaemic rats
Authors: Liu Guirong , Pan Linlin , Sun Qihui , Wang Song 
Published: December 2019

Abstract
Backgound Hyperlipidemia has been highlighted as global chronic conditions of our time, the regulating spleen and lipid decoction (RSLD) is a traditional Chinese medicine preparation for hyperlipidemia with good therapeutic effect. This study used urinary metabolomics combined with network pharmacology to elucidate the mechanism of RSLD in treating hyperlipidemia.Methods In this study, the network pharmacology was used to dissect the impacts of RSLD on the hyperlipidemia network. Serum samples from hyperlipidaemic rats were collected to quantify biochemical indices, urinary metabolomics was used to evaluate urine samples from control, model, xuezhikang and RSLD groups to shed light on a metabolic mechanism of action.Results The component- target-disease network suggested that the low density lipoprotein receptor (LDLR) target protein, which is associated with hyperlipidemia, is regulated by RSLD. A metabolomics analysis suggested that RSLD can significantly regulates taurine, citric acid, leucine, valine and linoleic acid in amino acid metabolism, fatty acid metabolism and tricarboxylic acid cycle, and that the overall metabolic mechanism is closely related to the target protein LDLR.Conclusions Metabolomics combined with network pharmacology suggested that RSLD can improve hyperlipidemia by enhancing LDLR protein expression to regulate disordered biomarkers and their metabolic pathways. Therefore, we believe that RSLD represents an interesting candidate for further characterization as a treatment for hyperlipidemia.
Magnitude of obesity/overweight and its associated factors among HIV/AIDS patients on antiretroviral therapy in Jimma University Specialized and Teaching hospital, south west Ethiopia: Hospital based Crossectional study
Authors: Yitbarek Getachew Yideg , Engidaw Melaku Tadege , Ayele Belete Achamyelew , Tiruneh Sofonyas Abebaw , Alamir Melkamu Tilahun 
Published: December 2019

Abstract
Background: Obesity is on the rise worldwide, not only in the general population but also in PLWHA. Being overweight and obese are themselves a risk factors for cardiovascular and other diseases. Despite this few studies have been conducted to determine the magnitude of obesity/overweight and its associated factors among HIV/AIDS patients in Ethiopia. This study aimed at determining the magnitude of obesity/overweight and its associated factors among HIV/AIDS patients on HAART at JUSTH, Ethiopia 2019. Method: hospital based cross-sectional study was conducted from January to February in 2019 at JUSTH. WHO STEP wise approach to chronic disease risk factor surveillance (STEPS) questionnaire and document review for HIV related clinical factors was applied. Weight, height and waist circumference and hip circumference were measured. BMI ≥25 kg/m2 was considered overweight, while abdominal obesity was referred to males with waist to hip ratio of greater than 0.95 and greater than 0.85 for females. Data was analyzed using SPSS version 20. Results: A total of 252 participants with a response rate of 95.8% were included. The prevalence of obesity/overweight was 21%. After adjusting for these variables, age category of greater than 50 years [AOR = 0.4, 95%CI (0.2, 0.9), p = 0.03],WHO clinical stage III and above [AOR = 0.04,95% CI (0.002,0.6) ), p = 0.02], presence of mild to moderate physical activity [AOR = 1.3,95% CI,(5.5,33.3)),p=0.00), plasma CD4 count between 351-500 copies/ml [AOR=0.15,95% CI, (0.04,0.6) p=0.024], female sex [AOR = 2.6,95% CI,(1.25,10)p=0.03)] were significantly associated with obesity/overweight Conclusion: There was a high prevalence of obesity/overweight among HIV/AIDS patients. It was found that older age , female sex , early stage of the disease, lower CD4 cunt and absence of mild to moderate physical activity were significant predictor of obesity/overweight. Clinicians should be aware of the health consequence of obesity and consider instituting targeted weight management programs as part of routine HIV care. It is, therefore, vital to encourage intervention strategies that focus on promotion of physical activity among people living with HIV/AIDS.