bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transmission Dynamics of SARS-CoV-2 in a Mid-size City of China
Authors: Hongjun Zhao , Lu Xiaoxiao , Li Tiegang , Rao Boqi , Wang Dedong , Wu Di , Qiu Fuman , Yang Zhicong , Lu Jiachun 
Published: June 2020

Abstract
Background: An outbreak of pneumonia associated with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan city and then to other city. It is very urgent to delineate the epidemiological and clinical characteristics of these affected patients. Methods: To investigate the epidemiological characteristics of the COVID-19, we describe a case series of 459 patients with confirmed COVID-19 in WZ of China from January 27 to February 12, 2020.Results: The median age of all patients was 48.0 years, and 46.8% were females. 37.5% of patients had a history of residence in Wuhan. Fever (72.1%) and cough (43.6%) were the most frequent symptoms. In addition, three kinds of unconventional cases were observed, in which included 4.4% confirmed virus carrier who were asymptomatic, 7.8% confirmed patients who had no link to Wuhan city but contact with individuals from Wuhan without any symptoms at the time of contact, and 10.7% confirmed patients who had no link to Wuhan city nor a history of intimate contact with patients or individuals from Wuhan without any symptoms, respectively.Conclusion: Our findings presented the possibility of asymptomatic carriers affected with SARS-CoV-2, and this phenomenon suggested that chances of uncontrollable transmission in the larger population might be higher than formerly estimated, and transmission by these three kinds of unconventional patients in WZ may be one of the characteristics of infection in other Chinese cities outside the Wuhan epidemic area.
Exosomes from normal cartilage endplate stem cells ameliorate intervertebral disc degeneration more effectively than exosomes from degenerated cartilage endplate stem cell by activating the AKT/autophagy pathway
Authors: Luo Liwen , Jian Xiuying , Sun Hui , Qin Jinghao , Wang Yanqiu , Yang Di , Li Changqing , Liu MingHan , Tian Zhiqiang , Zhou Yue 
Published: June 2020

Abstract
Background

Nucleus pulposus cells (NPCs) apoptosis is an important factor in exacerbating intervertebral disc degeneration (IVDD) that can be effectively suppressed by exosomes. The aim of this study was to reaearch whether normal cartilage endplate stem cells (CESCs) derived exosomes (N-Exos) were more conducive to activation of autophagy and inhibition of NPCs apoptosis and IVDD than degenerated CESCs derived exosomes (D-Exos) or not.
Methods

Rat CESCs were isolated and identified, and the exosomes produced by normal CESCs and degenerated CESCs were extracted. The bioinformatics differences between normal CESCs derived exosomes (N-Exos) and degenerated CESCs derived exosome (D-Exos) were analyzed by mass spectrometry, heat map and KEGG enrichment analysis biology. The effects of N-Exos and D-Exos on the inhibition of NPCs apoptosis were examined by TUNEL staining, flow cytometry and western blotting. The involvement of the AKT and autophagy signaling pathways was investigated using the signaling inhibitor LY294002. Magnetic resonance imaging, western blotting and immunofluorescence staining were used to evaluate the therapeutic effects of N-Exos in vivo.
Results

CESCs in the cartilage endplate (CEP) could secrete a large amount of exosomes. N-Exos were more conducive to activation of autophagy than D-Exos. The apoptotic rate of NPCs was decreased obviously after treatment with N-Exos than after D-Exos treatment. N-Exos inhibited NPCs apoptosis or attenuated IVDD in a rat tail model by activating the AKT and autophagy signaling pathways.
Conclusions

It was the first to confirm that CEP could delay the progression of IVDD through exosomes secreted by normal CESCs. The therapeutic effects of N-Exos on inhibiting NPCs apoptosis and slowing IVDD progression was more effective than D-Exos by activating the PI3K/AKT/autophagy pathway, which explained the reason that the incidence of IVDD was increased after inflammation of the CEP.
Short-term Moderate-dose Corticosteroid Plus Immunoglobulin Effectively Reverses Covid-19 Patients Who Have Failed Low-dose Therapy
Authors: Zhou Zhi-Guo , Xie Shu-min , Zhang Jing , Zheng Fang , Liu Ji-Heng , Cai Chun-Lin , Li Hui , Jiang Di-Xuan , Zhang Lei 
Published: June 2020

Abstract
Background: The coronavirus disease-19 (COVID-19) has spread globally with more than 6,750,000 people infected, and nearly 400,000 patients died. Currently, we are in an urgent need for effective treatment strategy to control the clinical deterioration of COVID-19 patients.Methods: The clinical data of 10 COVID-19 patients receiving short-term moderate-dose corticosteroid (160mg/d) plus immunoglobulin (20g/d) were studied in the North Yard of The First Hospital of Changsha, Hunan from January 17th to February 27th, 2020. Epidemiological, clinical, laboratory, radiological findings were analyzed. Results: After treatment with combination of low-dose corticosteroid (40-80mg/d) and immunoglobulin (10g/d), patients’ lymphocyte count (0.88±0.34 vs 0.59±0.18, P<0.05), oxygenation index including SPO2 (94.90±2.51 vs 90.50±5.91, P<0.05) and PaO2/FiO2 (321.36±136.91 vs 129.30±64.97, P<0.05) were significantly lower than pre-treatment, and CT showed that the pulmonary lesion deteriorated in all patients. While after treatment of short-term moderate-dose corticosteroid plus immunoglobulin, patients’ APACHE Ⅱ score (9.10±6.15 vs 5.50±9.01, P<0.05), body temperature (37.59±1.16 vs 36.46±0.25, P<0.05), lymphocyte count (0.59±0.18 vs 1.36±0.51, P<0.05), Lactate dehydrogenase (419.24±251.31 vs 257.40±177.88, P<0.05), and C-reactive protein (49.94±26.21 vs 14.58±15.25, P<0.05) significantly improved compared with post-treatment with low-dose therapy. In addition, oxygenation index including SPO2 (90.50±5.91 vs 97.50±1.18, P<0.05), PaO2 (60.47±14.53 vs 99.07±34.31, P<0.05), and PaO2/FiO2 (129.30±64.97 vs 340.86±146.72, P<0.05) significant improved. Furthermore, CT showed that pulmonary lesions obviously improved in 7 patients. After systematic therapy, 4 out of 10 COVID-19 patients recovered and discharged.Conclusions: Short-term moderate-dose corticosteroid plus immunoglobulin is effective for reversing the continued deterioration of COVID-19 patients who failed to respond to the low-dose therapy.
Distal Adding On In Lenke 2AR Adolescent Idiopathic Scoliosis:risk Factors&nbsp;Analysis and Clinical Assessment
Authors: Dong Yulei , Tang Ning , Wang Shengru , Zhang Jianguo , Zhao Hong 
Published: June 2020

Abstract
Background: Risk factors and clinical outcome associated with distal adding on in Lenke 2AR adolescent idiopathic scoliosis (AIS) are not fully elucidated.Methods: Radiographic data of Lenke 2AR AIS patients treated by posterior pedicle screws in a single institution were retrospectively analyzed. Patients who developed distal adding on were compared with patients who did not. Clinical assessment were carried out by SF-36 and SRS-22 questionnaire. Risk factors of distal adding on were explored by binary logistic regression analysis.Results: A total of 88 patients completed an average of 2.9 (2-12.9) years of follow-up were included. 18 (20.5%) patients met the criterion of distal adding on while the rest of 70 cases did not at follow up.Clinical parameters were comparable before surgery and became lower at follow up in adding on group in dimensions of vitality (63.1±11.4Vs.67.5±11.8,P=0.026), mental health (73.9±9.2Vs.77.8±10.2,P=0.039), self-image (3.9±0.3Vs.4.2±0.3,P=0.021) and satisfaction (4.0±0.3Vs.4.5±0.4,P=0.035). The proportion of selection lowest instrumented vertebra (LIV) higher than last touching vertebra(LTV) was significantly higher in adding on group. (6/18vs 4/70, P=0.004) Binary logistic regression analysis revealed that preoperative main thoracic curve magnitude (OR=1.118,P=0.041), preoperative lumbar lordosis (OR=1.091,P=0.029), and the gap between LIV and LTV(OR=6.123,P=0.043) were independent risk factors associated with adding on.Conclusions: In Lenke 2AR AIS cases, the selection of LIV higher than LTV is closely correlated with the development of adding-on. Patients with minor main thoracic curve and lumbar lordosis are more likely to develop distal adding on. Adding on may cause discontent of patients .
Ovarian Vein Embolization with N-butyl-2 Cyanoacrylate Glubran-2® for the Treatment of Chronic Pelvic Pain Secondary to Pelvic Congestion Syndrome
Authors: Gong Maofeng , He Xu , Zhao Boxiang , Kong Jie , Su Haobo 
Published: June 2020

Abstract
Objective: To evaluate the safety and efficacy of ovarian vein embolization using N- butyl-2 cyanoacrylate (NBCA) Glubran-2® in the treatment of chronic pelvic pain (CPP) secondary to pelvic congestion syndrome (PCS).Materials and Methods: Between January 2013 and June 2019, seven wo-men (mean age, 45.6±15.9 y) presenting with CPP secondary to PCS were evaluated for ovarian vein embolization with Glubran-2®. PCS was initially diagnosed by transva-ginal Doppler Ultrasound or CT and further confirmed by pelvic venography. Medical database was retrospectively reviewed.Results: Glubran-2 was employed as a sole embolic material in two cases, four cases subsequently underwent added microcoils in the opening of varicose ovarian vein trunk during the same procedure. Secondary embolization was achieved in one case due to CPP recurrence one month after initial embolization with microcoils. Technical success of ovarian vein embolization with Glubran-2 was achieved in all patients. There were no Glubran-2 related complications mid procedure and postintervention. With mean 62±40 months (range, 12-102 months) follow-up, neither persistent nor recurrent CPP was observed. Clinical efficacy was evaluated on the 1st, 3rd, 6th, 12th months, complete or slight improvement of CPP after embolization were achieved in all patients. VAS score used to identify preintervention and postintervention significantly decreased (p<0.001). Two patients after Glubran-2 embolization gave birth to a healthy baby during follow-up.Conclusions: Ovarian vein embolization with Glubran-2 is a feasible and safe treatment of CPP secondary to PCS. In particularly, it appears to be a potential and attractive alternative when patients with the desires of symptom relief and reproduction.
The Impact of Implementing Steps of Empowerment Model for Women with Failed Pregnancies on Decisional Conflict for Re-pregnancy: A Randomized Controlled Trial
Authors: Kheirkhah Masoomeh , Salehabadi Mozhgan Zareyee , Esmaeeli Nazanin , Haghani Shima 
Published: June 2020

Abstract
Background: Failed pregnancy is a common and destructive experience. It has physical and psychological effects on both women and families. They may become reluctant to re-pregnancy. Providing the coping strategies can help to adapt to failed pregnancies, and make informed decisions about future pregnancies. This study was designed and performed to determine the effect of implementing steps of empowerment model for women with failed pregnancies on decision conflict for re-pregnancy. Method: This interventional research is a randomized controlled trial with a control group that was conducted in Iran from January 2020 to May 2020. Participants were 80 women who had been hospitalized in a referral center during past 3-6 weeks due to failed pregnancies. The eligible women with random allocation of sealed envelope site were divided into two groups of intervention (n=40) and control (n=40) and a separate code was determined for each person. The intervention was performed in four, 90-minute sessions based on the model steps (threat perception, problem solving, educational participation, and evaluation) for intervention group. O'Connor's decisional conflict scale was completed before and six weeks after intervention by both of groups. Data were analyzed using SPSS edition 16 with the independent T-test, Fisher and chi-squared tests. Results: The score of decisional conflict and, its subscales did not differ between the two groups before the intervention (P = 0.65), but six weeks after the intervention, the decisional conflict and, all its subscales in the intervention group reduced. (P < 0.001).Conclusion: Empowerment education in women with a failed pregnancy improved their decision conflict in re-pregnancy, so empowerment education along with health care services for women with failed pregnancies is recommended. Trial registration: This randomized control trial was registered on the TCTR site with the code TCTR20191226001. Registered on 26 December 2019.
Hospital beds and personal protective equipment planning for COVID-19 pandemic: A computer simulation approach
Authors: Lu Yiruo , Guan Yongpei , Fishe Jennifer , Hogan Thanh , Zhong Xiang 
Published: June 2020

Abstract
Health care systems are at the frontline to fight the COVID-19 pandemic. An emergent question for each hospital is how many general ward and intensive care unit beds are needed and how much personal protective equipment to be purchased. However, hospital pandemic preparedness has been hampered by a lack of sufficiently specific planning guidelines. In this paper, we developed a computer simulation approach to evaluating bed utilizations and the corresponding supply needs based on the operational considerations and constraints in individual hospitals. We built a data-driven SEIR model which is adaptive to control policies and can be utilized for regional forecast targeting a specific hospital’s catchment area. The forecast model was integrated into a discrete-event simulation which modeled the patient flow and the interaction with hospital resources. We tested the simulation model outputs against patient census data from UF Health Jacksonville, Jacksonville, FL. Simulation results were consistent with the observation that the hospital has ample bed resources to accommodate the regional COVID patients. After validation, the model was used to predict future bed utilizations given a spectrum of possible scenarios to advise bed planning and stockpiling decisions. Lastly, how to optimally allocate hospital resources to achieve the goal of reducing the case fatality rate while helping a maximum number of patients to recover was discussed. This decision support tool is tailored to a given hospital setting of interest and is generalizable to other hospitals to tackle the pandemic planning challenge.
Bioactive Nanocomposites Composed of Magnesium Oxide Nanoparticles and 58S Bioactive Glass: Synthesis, Characterization, Bioactivity Evaluation and Antibacterial Activity
Authors: Zaferani Seyed Peiman Ghorbanzade , Nabian Nima , Rabiee Sayed Mahmood 
Published: June 2020

Abstract
One of the main strategies to facilitate bone defect healing is the application of a variety of biological materials such as ceramic-based implants and scaffolds. Bioactive glasses are recognized as the favorable biomaterials in bone tissue engineering since they can quickly form a bond with both hard and soft tissues. In this study, novel bioactive nanocomposites based on 58S bioactive glass in composite with various weight percent of magnesium oxide nanoparticles were prepared. DLS measurements represented that 98.1% of 58S glass particles possessed the particle size between 70 and 200 nm. The bioactivity of nanocomposite powders was evaluated through immersion of samples in the simulated body fluid (SBF) at different time intervals of 14 and 28 days. Moreover, the nanocomposite samples were characterized in terms of morphology, phase structure and functional groups using Scanning electron microscopy (SEM), X-ray diffraction and Fourier transform infrared spectroscopy (FTIR) before and after soaking in the SBF solution. It was found that hydroxyapatite was formed on the surface of all nanocomposites after soaking in the SBF solution, although they bioactivity decreased with an increase in the amount of MgO nanoparticles from 15 wt. % to 25 wt. %. Moreover, antibacterial activity of the produced nanocomposites against MRSA bacteria was investigated and the results showed that 58S-15Mg exhibited the highest bactericidal activity.
Different Outcomes of Three Localized Primary Gastric Amyloidosis Cases
Authors: Liu Xuemei , Di Lianjun , Zhu Jiaxing , Wu Xinglong , Li Hongping , Wu Huichao , Tuo Biguang 
Published: June 2020

Abstract
Background: Localized primary gastric amyloidosis is a rare disorder characterized by the extracellular deposition of insoluble fibrillary protein confined to the stomach, which can mimic various diseases, including gastrointestinal stromal tumors, gastric cancer and ulcers in endoscopic examination. Case presentation: Here, we report a series of 3 cases of localized gastric amyloidosis mimicking gastric mucosa-associated lymphoid tissue (MALT) lymphoma by endoscopic examination that were evaluated over the past ten years in our hospital. The different times of detection of this rare disease resulted in three totally different outcomes, indicating the significant importance of the early detection, diagnosis and treatment of this rare disease. The difficulty of making an accurate diagnosis and differential diagnosis is highlighted, and this report may provide more clinical experience for the diagnosis of localized primary gastric amyloidosis.Conclusions: Localized gastric amyloidosis is a rare metabolic disease that can look like MALT lymphoma. Early detection, diagnosis and treatment of this rare disease results in an excellent prognosis.
Network analysis of Down syndrome and SARS-CoV-2 identifies risk and protective factors for COVID-19
Authors: Toma Ilario De , Dierssen Mara 
Published: June 2020

Abstract
Background: SARS-CoV-2 has spread uncontrollably worldwide while we still ignore how particularly vulnerable populations, such as Down syndrome (DS) individuals are affected by the COVID-19 pandemic. Individuals with DS have more risk of infections with respiratory complications and present signs of auto-inflammation. They also suffer from multiple comorbidities that are associated with poorer COVID-19 prognosis in the general population. All this might place DS individuals at higher risk of SARS-CoV-2 infection or poorer clinical outcomes.Methods: In order to get insight into the interplay between DS genes and SARS-cov2 infection and pathogenesis we retrieved the genes belonging to the molecular pathways involved in COVID-19 and the host proteins interacting with viral proteins from SARS-CoV-2. We therefore analyzed the overlaps of these genes with HSA21 genes, HSA21 interactors and other genes consistently differentially expressed in DS (using public transcriptomic datasets) creating a DS-SARS-CoV-2 network.Results: We detected COVID-19 protective and risk factors that might affect the susceptibility of individuals with DS both at the infection stage and in the progression to acute respiratory distress syndrome.Conclusion: Our analysis suggests that at the infection stage DS individuals might be more susceptible to infection due to triplication of TMPRSS2, that primes the viral S protein for entry in the host cells, even though the anti-viral interferon I signaling is upregulated in DS and this might increase the initial anti-viral response. In the second pro-inflammatory immunopathogenic phase of the infection, the prognosis for DS patients might worsen due to upregulation of inflammatory genes that might favor the typical cytokine storm of COVID-19. We also detected strong downregulation of the NLRP3 gene, critical for maintenance of homeostasis against pathogenic infections, possibly leading to bacterial infection complications.
De novo mutations in GFAP cause Alexander disease: clinical features, fMRI and functional analysis
Authors: Song Xiaoxuan , Jiang Jingwen , Tian Wotu , Zhan Feixia , Zhu Zeyu , Huang Xiaojun , Liu Xiaoli , Li Binyin , Tang Huidong , Cao Li 
Published: June 2020

Abstract
Background: Alexander disease (AxD) is a progressive and fatal neurological disorder characterized by white matter degeneration and Rosenthal fibers inclusions, which was caused by GFAP mutations. Since the first description of AxD, more than 550 cases have been reported. We identified two patients with de novo mutations in GFAP gene causing bulbospinal AxD, and further investigated the pathogenicity of identified variants. Results: Two de novo mutations in GFAP gene were identified (c.214G>A, p.E72K and c.1235C>T, p.T412I) by whole exome sequencing, of which c.1235C>T was the first reported. Clinical assessment revealed that both probands similarly presented bulbar symptoms, pyramidal signs and white matter atrophy in periventricular regions. We conducted a novel data-driven method to analyze fMRI characteristics. Increased brain functional connectivity in occipital and posterior parietal cortex was first discovered in AxD. Grey matter atrophy was also observed in one patient. Functional studies showed that the solubility of p.T412I GFAP was lower than wild type, while p.E72K and p.T412I were at a similar level to wild type, suggesting that mutations located in the tail domain could decrease the solubility of GFAP. Abnormal inclusions of mutant GFAP were colocalized with ubiquitin, 20S proteasome, protein 1 light chain 3-II (LC3-II) and lysosome. Western blotting indicated the ubiquitin-proteasome pathway was blocked while autophagy was activated as a mechanism for degrading aggregates. Conclusions: GFAP mutations identified in our study were associated with AxD and accompanied by protein functional alterations. Our findings further expand the clinical and genetic spectrum of AxD.
Survival Benefit of Patients Aged≥ 75 Years Diagnosed With High-risk Non-metastatic Prostate Cancerafter Definitive Treatmentof the Primary Tumor: A Population-based Study
Authors: Yu JunJie , Xu Bin , Chen Ming 
Published: June 2020

Abstract
Background:The survival benefit of active treatment for high-risk prostate cancer patients aged≥ 75 years remains controversial. We further evaluated the effect of definitive treatment(DT) for those patients in a population-based cohort.Methods:Retrospective analysis of 17848 elderly (≥75 years) men in the Surveillance, Epidemiology, and End Results(SEER) database(2004-2016) who diagnosed non-metastatic high-risk prostate cancer. Kaplan-Meiersurvival curves were used to compare cancer-specific survival (CSS) and overall survival (OS). Propensity-adjusted multivariate Cox regression analysis fitted to identify independent prognostic factors. Logistic regression models were used as a predictor for DT.Results:A total of 17848 patients were identified, 10365 patients receiving DT (including 4284 receiving surgery, 5683 receiving EBRT, 367 receiving BT, 569 receiving EBRT+BT, 92receiving Chemotherapy) and 7473 receiving non-DT. PSM methods wereperformedand compared all baseline factors, including insurance/marital status, age, race,T /N stage, grade, Gleason score(GS),PSA. After PSM, these two groups achieved a median survival time (MST) of 99, 67months for OS, respectively(P<0.01).And older age (age ≥ 80 years) status showed a worse survival benefit (P<0.01). The subgroup analysis illustrated that surgery(MST=122) vsEBRT(MST=111) vs BT(MST=116) vs EBRT+BT(MST=121) subgroups achieved better OS than Chemotherapy group(MST=66)(P<0.01). However, EBRT+BT subgroup had better 3- and 5-year OS (93% and 82.2%). Multivariate Cox proportional hazards model showed unmarried status, older age (age ≥ 80 years), T4 stage, high tumor grade, PSA ≥10 ng/mL were significantly associated with a worse OS, whereas DT (HR, 0.65; p < 0.001) and other race(HR, 0.773; p < 0.001) were associated with a better OS. And logistic regression illustrated that poor differentiated grade was independently predictor (OR=1.427;p=0.022)Conclusions: This study indicated that insurance status, marital status, age, race, T /N stage, grade, GS, PSA and treatment modalities affected OS and CSS in elderly men with non-metastatic high-risk prostate cancer. DT, especially surgery and radiotherapy, might provide favorable OS not CSS compared with NDT for older patients (≥75 years), whereas chemotherapy was not recommended.