bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lipoprotein (a) is a residual risk of atherosclerotic renal artery stenosis in hypertensive patients: a hospital-based cross-sectional study
Authors: Hu Xiangming , Yang Xing , Li Xida , Luo Demou , Zhou Yingling , Dong Haojian 
Published: April 2020

Abstract
Background Low-density lipoprotein cholesterol (LDL-c) has been proven to be a risk factor for atherosclerotic cardiovascular disease (CVD), while lipoprotein (a) (Lp(a)) is a residual risk factor for CVD, even though LDL-c is well controlled by statin use. Importantly, the role of Lp(a) in atherosclerotic renal artery stenosis (ARAS) is still unknown. Methods For this hospital-based cross-sectional study, patients who simultaneously underwent coronary and renal angiography were examined. ARAS was defined as a 50% reduction in the cross-sectional (two-dimensional plane) area of the renal artery. Data were collected and compared between ARAS and non-ARAS groups, including clinical history and metabolite profiles. Univariate analysis, three tertile LDL-c-based stratified analysis, and multivariate-adjusted logistic analysis were conducted, revealing a correlation between Lp(a) and ARAS. Results A total of 170 hypertensive patients were included in this study, 85 with ARAS and 85 with non-RAS. Baseline information indicated comparability between the two groups. In the univariate and multivariate analysis, common risk factors for atherosclerosis were not significantly different. Stratified analysis of LDL-c revealed a significant increase in the incidence of ARAS in patients who had high Lp(a) concentrations at low LDL-c levels (odds ratio (OR): 4.77, 95% confidence interval (CI): 1.04-21.79, P = 0.044). Further logistic analysis with adjusted covariates also confirmed the result, indicating that high Lp(a) levels were independently associated with ARAS (adjusted OR (aOR): 6.14, 95%CI: 1.03-36.47, P = 0.046). This relationship increased with increasing Lp(a) concentration based on a curve fitting graph. These results were not present in the low and intermediate LDL-c-level groups. Conclusion In hypertensive patients who present low LDL-c, high Lp(a) was significantly associated with atherosclerotic renal artery stenosis and thus is a residual risk factor.
The Efficacy of Surgery in Advanced Hepatocellular Carcinoma: A Cohort Study
Authors: Chen Lei , Sun Tao , Chen Shi , Ren Yanqiao , Yang Fan , Zheng Chuansheng 
Published: April 2020

Abstract
Background It is still controversial that whether hepatocellular carcinoma (HCC) patients with lymph node invasion should receive surgery treatment. This study aimed to evaluate the efficacy of surgery (liver resection and local tumor destruction treatments[l陈1] ) in HCC patients with regional lymph node metastasis.Methods The study utilized data from the Surveillance, Epidemiology, and End Results-18 (SEER-18) cancer registry. Patients for whom the treatment type was not clear or those with distant metastasis or without regional lymph nodules invasion were excluded. For survival analysis, patients with the survival months coded as 0 and 999 were excluded. [l陈2] All 1434 patients were included in the analysis. Among them, 168 patients were treated surgically and the other 1266 received non-surgery therapy. Propensity Score Matching (PSM) model was used to reduce selection bias.Results Before PSM, the median overall survival (mOS) and median cancer-specific survival (mCSS) of patients treated surgically were longer than that of receiving non-surgery treatment (mOS: 20 months, 95%CI: 15.3-24.7 vs. 7 months, 95%CI: 6.4-7.6, P<0.001; mCSS: 21 months, 95%CI: 115.5-26.5 vs. 6 months, 95%CI: 5.3-6.7, P<0.001). Subgroup analysis found no significant differences in mOS and mCSS between liver resection and non-liver resection surgery cohorts (P=0.886 and P=0.813, respectively).[l陈3] Similar results were obtained in the PSM analysis. The mOS and mCSS in the surgery group were longer than in the non-surgery group (mOS: 20 months vs. 7 months, P<0.001; mCSS: 20 months vs. 6 months, P<0.001). The multivariate analysis documented that surgery was an independent predictor for OS and CSS before and after PSM.Conclusions HCC patients with invasion of regional lymph nodules may get more survival benefit from surgery than other types of treatment.
Frequency-dependent gating of feedforward inhibition in thalamofrontal synapses
Authors: Lee Jungmin , Choi Joonho , Rah Jong Cheol 
Published: April 2020

Abstract
Thalamic recruitment of feedforward inhibition is known to enhance the fidelity of the receptive field by limiting the temporal window during which cortical neurons integrate excitatory inputs. Feedforward inhibition driven by the mediodorsal nucleus of the thalamus (MD) has been previously observed, but its physiological function and regulation remain unknown. Accumulating evidence suggests that elevated neuronal activity in the prefrontal cortex is required for the short-term storage of information. Furthermore, the elevated neuronal activity is supported by the reciprocal connectivity between the MD and the medial prefrontal cortex (mPFC). Therefore, detailed knowledge about the synaptic connections during high-frequency activity is critical for understanding the mechanism of short-term memory. In this study, we examined how feedforward inhibition of thalamofrontal connectivity is modulated by activity frequency. We observed greater short-term synaptic depression during disynaptic inhibition than in thalamic excitatory synapses during high-frequency activities. The strength of feedforward inhibition became weaker as the stimulation continued, which, in turn, enhanced the range of firing jitter in a frequency-dependent manner. We postulated that this phenomenon was primarily due to the increased failure rate of evoking action potentials in parvalbumin-expressing inhibitory neurons. These findings suggest that the MD-mPFC pathway is dynamically regulated by an excitatory-inhibitory balance in an activity-dependent manner. During low-frequency activities, excessive excitations are inhibited, and firing is restricted to a limited temporal range by the strong feedforward inhibition. However, during high-frequency activities, such as during short-term memory, the activity can be transferred in a broader temporal range due to the decreased feedforward inhibition.
Rising trends and persisting inequalities in cesarean section rates in Nepal: evidence from demographic and health surveys 2006-2016
Authors: Acharya Kiran , Paudel Yuba Raj , Dhungana Chandra Mani 
Published: April 2020

Abstract
Background Sustainable development goals require member countries to reduce maternal mortality ratio below 70 per 100,000 live births by 2030. Addressing inequalities in accessing emergency obstetric care is crucial for reducing the maternal mortality ratio. This study was undertaken to examine the time trends and socio-demographic inequalities in the utilization of cesarean section (CS) in Nepal during the period of 2006 and 2016.Methods Data from the Nepal Demographic and Health Surveys (NDHS) 2006, 2011 and2016 were sourced for this study. Women who had a live birth in the last five years of the survey (most recent birth if there were two or more childbirths) were the unit of analysis for this study. Absolute and relative inequalities in CS rates were expressed in-terms of rate difference and rate ratios, respectively. We used binary logistic regression models to assess the rate of cesarean sections by background socio-demographic characteristics of women. Results Age and parity adjusted CS rates were found to have increased almost three-fold (from 3.2%,95% CI:2.1-4.3 in 2006 to 10.5%;95% CI:8.9-11.9 in 2016) over the decade. In 2016, women from Mountain region (3.0%;95% CI:1.1-4.9), those from poorest wealth quintile (2.4%,95% CI:(1.2-3.7) and those living in province 6(2.4%,95% CI:1.3-3.5) had CS rate below 5%. Whereas, women from the richest income quintile (25.1%,95% CI :20.2-30.1), with higher education (21.2%,95% CI:14.7-27.8) and those delivering in private facilities (37.1%,95% CI:30.5-43.7) had CS rate above 15%. Women from the richest income quintile (OR-3.3,95% CI: 1.6-7.0) and those delivered in private/NGO-run facilities (OR-3.6;95% CI:2.7-4.9) were more than three times more likely to deliver by CS compared to women from the poorest income quintile and those delivering in public facilities, respectively. Conclusion To improve maternal and newborn health, strategies need to be revised to address the underuse of C-section in poor, mountain region and province 2, province 5, province 6 and province 7 so that universal access to comprehensive sexual and reproductive health care services is ensured. Simultaneously, there is a pressing need for policies, guidelines and continuous monitoring of CS rates to reduce overuse in rich women, women with higher education and those delivered in private facilities.
Hop tests and psychological PROs provide a demanding and clinician-friendly RTS assessment of patients after ACL reconstruction, a registry study.
Authors: Piussi Ramana , Beischer Susanne , Thomeé Roland , Senorski Eric Hamrin 
Published: April 2020

Abstract
Background There is growing interest in assessing psychological well-being in patients after anterior cruciate ligament (ACL) reconstruction. It is unknown whether an assessment of psychological outcome in addition to tests of muscle function can facilitate decisions on return to sport (RTS). Therefore, the aim of this study was to evaluate passing rates in different physical RTS test batteries, with and without the inclusion of psychological outcome measures 1 year after ACL reconstruction. Method In this cross-sectional cohort study a total of 320 patients (51% men) aged 18-65 years were included 1 year after ACL reconstruction. Passing rates on different muscle function (MF) test batteries (with results presented as Limb Symmetry Index (LSI)), consisting of knee extension and flexion strength tests, 3 hop tests, and 2 psychological patient-reported outcomes (PROs); Quality of Life subscale from the Knee injury and Osteoarthritis Outcome Score (KOOS-QoL) and ACL Return to Sport after Injury (ACL-RSI), were evaluated 1 year after ACL reconstruction. Muscle function test batteries comprised: 2 MF tests (vertical hop and hop for distance; pass=90% LSI); 2 MF tests and 2 PRO (pass=90% LSI, 62.5 on KOOS-QoL and 76.6 on ACL-RSI), 5 MF tests (2 strength and 3 hop tests, pass=90% LSI), and 5 MF tests and 2 PRO (pass=90% LSI, 62.5 on KOOS-QoL and 76.6 on ACL-RSI). Results Passing rates in the different test batteries were 47% for 2 MF tests, 19% for 2 MF tests and 2 PROs, 29% for 5 MF tests and 13% for 5 MF tests and 2 PROs. The use of psychological PROs together with tests of muscle function gave the lowest passing rates (13%). There was a very strong correlation between passing 2 hop tests and 2 PROs and passing 5 MF tests (rφ=0.41) as well as passing 5 MF tests and 2 PROs (rφ=0.79). Conclusion The use of hop tests together with psychological PROs provides a clinician-friendly RTS test battery for assessment 1 year after ACL reconstruction as the passing rate was 19% when using 2 hop-tests combined with 2 PROs, compared with 29% when using 5 tests of MF requiring advanced testing equipment.
High fetal hemoglobin level is associated with increased risk of cerebral vasculopathy in children with sickle cell disease in Mayotte.
Authors: Elenga Narcisse , CHAMOUINE Abdourahim , SAANDI Thoueiba , MUSZLAK Mathias , LARMARAUD Juliette , LAMBRECHT Laurent , POISSON Jean , BALICCHI Julien , PISSARD Serge 
Published: April 2020

Abstract
Background: Understanding the genetics underlying the heritable subphenotypes of sickle cell anemia, specific to each population, would be prognostically useful and could inform personalized therapeutics. The objective of this study was to describe the genetic modulators of sickle cell disease in a cohort of pediatric patients followed up in Mayotte. Methods: In this retrospective cohort study, clinical and biological data, collected between 1 January 2007 and 31 December 2017, in children younger than 18 years, were considered for the analysis. Results: We included 185 children with 72 % SS, 16 % Sβ0-thalassemia and 12 % Sβ+ thalassemia. The mean age was 9.5 years; 10 % of patients were lost to follow up. The Bantu haplotype was associated with an increase in hospitalizations and transfusions. The alpha-thalassemic mutation was associated with a decrease of hemolysis biological parameters (anemia, reticulocytes), and less cerebral vasculopathy. The Single Nucleotide Polymorphisms BCL11A rs4671393, BCL11A rs11886868, BCL11A rs1427407 and HMIP rs9399137 were associated with the group of children with HbF> 10%. The survival analysis without occurrence of cerebral vasculopathy showed that the group of patients with HbF> 10% presented a significant risk of early onset of cerebral vasculopathy. Conclusions: The most remarkable result of our study was the association of SNPs with the phenotypic groups that we aimed to determine. BCL11A rs4671393, BCL11A rs11886868, BCL11A rs1427407 and HMIP rs9399137 were correlated with the HbF group> 10%, which presents a higher risk of cerebral vasculopathy and would be oriented towards the hemolytic sub-phenotype.
Prevalence of human alveolar echinococcosis in China: a systematic review and meta-analysis
Authors: Wang Xuanzhuo , Dai Guodong , Li Min , Jia Wanzhong , Guo Zhongmin , Lu Jiahai 
Published: April 2020

Abstract
Background: Human alveolar echinococcosis (HAE), caused by the larvae of Echinococcus multilocularis，is a severe parasitic disease that is a major public health concern. New HAE cases in China account for 91% of the global HAE burden every year. Although there are a few studies and systematic reviews (SRs) on the prevalence of HAE in China, trends in the prevalence have not been estimated. This study aims to describe the overall variation in the trend of HAE prevalence in China, and provide evidence for preventive measures in the future. Methods: Thirty-five eligible studies were retrieved from PubMed, Web of Science, EMBASE, CNKI, Wanfang Data, and VIP, and included in the SR and meta-analysis. An adjusted Agency for Healthcare Research and Quality checklist was used to evaluate study quality. The arcsine transformation was used to adjust the individual reported prevalence, and the pooled HAE prevalence was calculated. Heterogeneity was evaluated using the chi-square test and I2 statistic. Forest plots were generated for the meta-analysis, and publication bias of the studies was assessed using the Egger’s test and funnel plots. We conducted subgroup analyses, sensitivity analyses, and meta-regression analyses to analyze the source of heterogeneity and factors potentially influencing the prevalence of HAE. Results: The meta-analysis indicated that the pooled HAE prevalence in China was 0.96% (95% CI: 0.71 to 1.25%). Factors potentially influencing HAE prevalence were female sex (OR=1.60, 95% CI: 1.35 to 1.91, P＜0.01), being ≥30 years old (OR=4.72, 95% CI: 2.29 to 9.75, P＜0.01), and being farmers and/or herdsmen (OR=2.54, 95% CI: 1.60 to 4.02, P＜0.01). The results of the meta-regression analysis (R2=38.11%, P < 0.01) indicated that HAE prevalence is on a downward trend.Conclusions: HAE prevalence has decreased over time and maintained low levels after 2005 in China. This decline was influenced by the utilization of One Health strategies as intervention measures. Therefore, these One Health strategies should be used as references to formulate future programs for HAE control. More high-quality epidemiological investigations and surveillance programs should be conducted in order to improve HAE control in the future.
A novel ultra-sensitive method for the detection of FGFR3 mutations in urine of bladder cancer patients – Design of the Urodiag® PCR Kit for surveillance of patients with non-muscle-invasive bladder cancer (NMIBC)
Authors: ROPERCH Jean-Pierre , HENNION Claude 
Published: April 2020

Abstract
Background We have recently developed a highly accurate urine-based test, named Urodiag ® , associating FGFR3 mutation and DNA methylation assays for recurrence surveillance in patients with low-, intermediate-, and high-risk NMIBC. Previously, the detection of four FGFR3 mutations (G372C, R248C, S249C and Y375C) required amplification steps and PCR products were analyzed by capillary electrophoresis (Allele Specific-PCR, AS-PCR), which was expensive and time-consuming. Here, we present the development a novel ultra-sensitive multiplex PCR assay as called “Mutated Allele Specific Oligonucleotide-PCR (MASO-PCR)”, generating cost-effective, simple, fast and clinically applicable assay for the detection of FGFR3 mutations in voided urine. Methods Comparative clinical performances of MASO-PCR and AS-PCR technologies were performed from 263 urine DNA samples (87 FGFR3 mutated and 176 FGFR3 wild-type). In the development of Urodiag ® PCR Kit, we studied the stability and reproducibility of each all-in-one PCR master mix (single reaction mixture including all the necessary PCR components) for MASO-PCR and QM-MSPCR (Quantitative Multiplex Methylation-Specific PCR to co-amplify SEPTIN9 , HS3ST2 and SLIT2 methylated genes) assays. Results Complete concordance (100%) was observed between the MASO-PCR and AS-PCR results. Each PCR master mix displayed excellent reproducibility and stability after 12 months of storage at -20°C, with intra-assay standard deviations lower than 0.3 Ct and coefficient of variations (CV) lower than 1%. The limit of detection (LoD) of MASO-PCR was 5% mutant detection in a 95% of wild-type background. The limit of quantification (LoQ) of QM-MSPCR was 10 pg of bisulfite-converted DNA. Conclusions We developed and clinically validated the MASO-PCR assay, generating cost-effective, simple, fast and clinically applicable assay for the detection of FGFR3 mutations in urine. We also designed the Urodiag ® PCR Kit, which includes the MASO-PCR and QM-MSPCR assays. Adapted to routine clinical laboratory (simplicity, accuracy), the kit will be a great help to urologists for recurrence surveillance in patients at low-, intermediate- and high-risk NMIBC. Reducing the number of unnecessary cystoscopies, it will have extremely beneficial effects for patients (painless) and for the healthcare systems (low cost).
Computerized Adaptive Testing for Sleep Disorders: Development of An Item Bank and Validation in A Simulated Study
Authors: She Menghua , Li Yaling , Tu Dongbo , Cai Yan 
Published: April 2020

Abstract
Background: As more and more people suffer from sleep disorders, developing an efficient, cheap and accurate assessment tool for screening sleep disorders is becoming more urgent. This study developed a computerized adaptive testing for sleep disorders (CAT-SD). Methods: A large sample of 1,304 participants was recruited to construct the item pool of CAT-SD and to investigate the psychometric characteristics of CAT-SD. More specifically, firstly the analyses of unidimensionality, model fit, item fit, item discrimination parameter and differential item functioning (DIF) were conducted to construct a final item pool which meets the requirements of item response theory (IRT) measurement. In addition, a simulated CAT study with real response data of participants was performed to investigate the psychometric characteristics of CAT-SD, including reliability, validity and predictive utility (sensitivity and specificity). Results: The final unidimensional item bank of the CAT-SD not only had good item fit, high discrimination and no DIF; Moreover, it had acceptable reliability, validity and predictive utility. Conclusions: The CAT-SD could be used as an effective and accurate assessment tool for measuring individuals' severity of the sleep disorders and offers a bran-new perspective for screening of sleep disorders with psychological scales.
Increased expression of activating receptors and up-regulated function of natural killer cells in peripheral blood of patients with HBV-related hepatocellular carcinoma
Authors: Pei Yan-tao , Yuan Wen-fang , Zhang Qian , Yue Xin-yan , Chen Xiu-li , Jia Lin 
Published: April 2020

Abstract
Background

This study aimed to investigate and identify the characteristics of peripheral natural killer (NK) cells of hepatocellular carcinoma (HCC) patients who infected with hepatitis B virus.
Methods

Flow cytometry was utilized to identify the frequency and receptors of NK cells, in the meantime, to analyze the killing ability and cytotoxicity of NK cells of patients of which embraced 36 cases of HBV-associated HCC, 34 individuals who suffered in HBV-associated cirrhosis (LC) and 30 non-liver dysfunction healthy individuals as control (HC).
Results

Cell counts for NK and CD56dimNK were reduced in patients with HCC, however, there was no statistically significant. The count of CD56brightNK cells in the HCC subpopulation was remarkably higher than the subset of the HC (P < 0.05). The counts of activated receptors of NKG2D/p30 were elevated in patients with HCC, as well as the NKp44 and the NKp46. There was no statistically meaningful difference of inhibitory receptor expressions such as CD158a/b on peripheral NK cells of patients with HCC and LC and those with HC (P > 0.05). Following an IL-12 stimulation, the production of INF-γ/-α of patients with HCC was less than those produced by HC (P < 0.05). However, killing activity and cytotoxicity, as the primary responsibilities of the natural killer cells, were upregulated in HCC individuals. HBV associated individuals were found lower counts and capability to produce cytokines of natural killer cells. Nevertheless, the killing capacity and cytotoxicity of NK cells were stronger than those of the HC group. This may be associated with the increased activating receptors expression of NK cells.
Conclusions

This study demonstrated that the activating receptors expression and the cytotoxicity of NK cells in the blood were independent predictors of development in HCC patients, and the recovery of NKG2D+CD56dim NK cells could increase the prognostic value.
Clinical manifestations, CT features and outcome of 39 patients with COVID-19: retrospective case analysis
Authors: Lu Haohao , Zheng Chuansheng , Tong Qiaoxia , Tian Jin 
Published: April 2020

Abstract
1. BackgroundTo explore the manifestations and evolution of the pulmonary CT in COVID-19, and to analyze the causes and countermeasures of “Recurrent positive” in discharged patients.2. MethodsData of 39 patients with COVID-19 were collected. RT-PCR was positive at admission.From onset to discharge, pulmonary CT was performed regularly.During the treatment,Blood-RT,CRP and D-dimer were detected.3.ResultFrom the onset to 14 days, the lesions in pulmonary CT increased significantly.After treatment, pulmonary CT before discharge showed that some patients' lesions were completely absorbed, and some residual strip like lesions or ground glass opacity with reduced density.Two weeks after discharge, there were 2 patients with new ground glass opacity.There were 20 patients with D-dimer increased.4.ConclusionIn the early stage of COVID-19, the pulmonary CT has the characteristic manifestations, which is helpful for early diagnosis.In the middle stage, pulmonary lesions changed rapidly.In the recovery stage, some of the patients remained strip like lesions.It is necessary to pay attention to the possibility of pulmonary fibrosis after recovery.The discharge standard of COVID-19 needs to be more strict to avoid “Recurrent positive”,the discharged patients should continue to be observed.D-dimer was increased in some patients, it is safe to use heparin in anticoagulation without contraindications.