bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical utility of cycle threshold values in the context of COVID-19
Authors: Rao Sonia N. , Manissero Davide , Steele Victoria , Pareja Josep 
Published: July 2020

Abstract
BackgroundThe ability to predict likely prognosis and infectiousness for patients with COVID-19 would aid patient management decisions. Diagnosis is usually via real-time PCR and it is unclear whether the semi-quantitative capability of this method, determining viral load through cycle threshold (Ct) values, can be leveraged.ObjectivesWe aim to review available knowledge on correlations between SARS-COV-2 Ct values and patient- or healthcare-related outcomes to determine whether Ct values provide useful clinical information.SourcesA PubMed search was conducted on 1st June 2020 based on a search strategy of (Ct value OR viral load) AND SARS-CoV-2. Data was extracted from studies reporting on the presence or absence of an association between Ct values, or viral loads determined via Ct value, and clinical outcomes.ContentData from 18 studies were relevant for inclusion. One study reported on the correlation between Ct values and mortality and one study reported on the correlation between Ct values and progression to severe disease; both reported a significant association (p < 0.001 and p = 0.008, respectively). Fourteen studies reported on the correlation between Ct value or viral loads determined via Ct value and disease severity and an association was observed in 8 (57%) studies. Studies reporting on the correlation of viral load with biochemical and haematological markers showed an association with at least one marker, including increased lactate dehydrogenase (n = 4), decreased lymphocytes (n = 3) and increased high-sensitivity troponin I (n = 2). Two studies reporting on the correlation with infectivity showed that lower Ct values were associated with higher viral culture positivity.ImplicationsData suggest that lower Ct values may be associated with worse outcomes, and that Ct values may be useful in predicting the clinical course and prognosis of patients with COVID-19; however, further studies are warranted to confirm clinical value.
Adherence predictor variables in AIDS patients: An empirical study using the data mining-based RFM model
Authors: Li Min , Wang Qunwei , Shen Yinzhong 
Published: July 2020

Abstract
Background
Highly active antiretroviral therapy (ART) is still the only effective method to stop the disease progression in acquired immunodeficiency syndrome (AIDS) patients. However, poor adherence to the therapy makes it ineffective. In this work, we construct an adherence prediction model of AIDS patients using the classical recency, frequency and monetary value (RFM) model in the data mining-based customer relationship management model to obtain adherence predictor variables.
Methods
We cleaned 257305 diagnostic data elements of AIDS outpatients in Shanghai from August 2009 to December 2019 to obtain 16440 elements. We tested the RFM and RFm (R: recent consultation month, F: consultation frequency, M/m: total/average medical costs per visit) models, three clustering methods (K-means, Kohonen and two-step clustering) and four decision algorithms (C5.0, the classification and regression tree, Chi-square Automatic Interaction Detector and Quick, Unbiased, Efficient, Statistical Tree) to select the optimal combination. The optimal model and clustering analysis were used to divide the patients into two groups (good and poor adherence), then the optimal decision algorithm was used to construct the prediction model of adherence and obtain its predictor variables.
Results
The results revealed that the RFm model, K-means clustering analysis and C5.0 algorithm were optimal. After three rounds of k-means clustering analysis, the optimal RFm clustering model quality was 0.8, 10614 elements were obtained, including 9803 and 811 from patients with good or poor adherence, respectively, and five types of patients were identified. The prediction model had an accuracy of 100% with the recent consultation month as an important adherence predictor variable.
Conclusions
This work presented a prediction model for medication adherence in AIDS patients at the designated AIDS center in Shanghai, using the RFm model and the k-means and C5.0 algorithms. The model can be expanded to include patients from other centers in China and worldwide.
A Comparison Of The Bridge-Type Roi-c Interbody Fusion Cage System And Titanium Mesh Graft With Titanium Plate Fixation In 2-Level Anterior Cervical Discectomy And Fusion With Plating And Cage System: A Retrospective Study
Authors: He Shuangjun , Zhou Zhangzhe , Shao Xiaofeng , Zhang Changhao , Zhou Xinfeng , Wu Shuhua , Chen Kangwu , Wang Yaowei , Zhonglai Qian 
Published: July 2020

Abstract
Objective: To explore the clinical efficacy and radioactive results of the bridge-type ROI-C interbody fusion cage (ROI-C) and anterior cervical discectomy and fusion with plating and cage system (ACDF) for cervical spondylopathy.Methods: From January 2014 to January 2018, 45 patients undergoing ACDF were retrospectively analyzed, including 24 cases of ROI-C (group A) and 21 cases of ACDF (group B). The operation time, blood loss, Neck Disability Index (NDI), Japanese Orthopaedic Association score (JOA), postoperative complications, imaging results including cervical Cobb angle and fusion were compared between groups.Results: All patients were successfully treated with surgery, and no cerebrospinal fluid leakage, esophageal fistula, or hoarseness occurred after surgery. The operation time and blood loss in group A were lower than those in group B (P<0.05). During the follow-up period, JOA score increased and NDI score decreased after operation (P<0.05), but there was no significant difference between the groups (P>0.05). The incidence of dysphagia in group A was lower than that in group B at 1 month and 3 months after operation (P<0.05), but the final follow-up results showed that there was no significant difference in the incidence of dysphagia between the two groups (P>0.05). In group A, the fusion rate was 83.3% 3 months after surgery and 100% at the last follow-up. The rate of adjacent level ossification development was 12.5%. In group B, the fusion rate was 85.7% 3 months after surgery and 100% at the last follow-up. The rate of adjacent level ossification development was 23.8%.Conclusion: Both ROI-C and ACDF can achieve satisfactory results, but ROI-C has shorter operation time, less bleeding and lower incidence of dysphagia in the short term.
BTG1 Inhibits Malignancy as a Novel Prognosis Signature in Endometrial Carcinoma
Authors: Li Yibing , Huo Jianing , He Junjian , Zhang Yunzheng , Ma xiaoxin 
Published: July 2020

Abstract
Background: Endometrial carcinoma (EC) is one of the three major malignant tumors of the female reproductive system. In recent years, the incidence and mortality rate of EC have increased. B-cell translocation gene 1 (BTG1) is an anti-proliferation gene that regulates the occurrence and development of a variety of tumors, but there is no research regarding this gene in EC.Methods: Based on The Cancer Genome Atlas (TCGA) database, we used a variety of bioinformatics tools and databases to explore the expression and prognosis of BTG1. We verified expression and prognosis of BTG1 in EC using qRT-PCR and analyzed the relevant clinicopathological parameters. We functionally enriched BTG1 and related genes in EC patients through the bioinformatics website and analyzed miRNA targets of BTG1 and interacting protein networks. Cell proliferation, wound healing, transwell invasion, and cell apoptosis assays were used to detect the effects of BTG1 on the malignant biological behavior of endometrial carcinoma cells (ECCs). The effect of BTG1 on the epithelial-to-mesenchymal transition (EMT) process was detected using western blot.Results: We analyzed the expression and prognosis of BTG1 based on TCGA and found that low expression of BTG1 was associated with poor EC prognosis. The qRT-PCR suggested that BTG1 had low expression in EC. BTG1 expression was significantly correlated with overall survival (OS) shortening. Clinicopathological analysis suggested that expression of BTG1 was related to invasion depth and the International Federation of Gynecology and Obstetrics (FIGO) stage. EC pathological tissue type, fertility history, lymphatic metastasis, menopause, estrogen receptor (ER), progesterone receptor (PR), and age of diagnosis were not related. Functional enrichment analysis showed that BTG1 plays an important role in regulating embryonic development, tumorigenesis, apoptosis, and cell cycle. Biological behavior experiments suggest that BTG1 inhibits proliferation, migration, and invasion of ECCs, and promotes apoptosis of ECCs. Western blot indicated that BTG1 inhibited the EMT process of ECCs.Conclusions: BTG1 plays an important role in the occurrence and development of EC. BTG1, as a tumor suppressor gene, shows low expression in EC, which can inhibit malignant biological behavior and EMT process of ECCs. In addition, BTG1 can be used as a potential prognostic biomarker for EC.
Overexpression of BNIP3 in Rat Intervertebral Disc Cells Can Trigger Autophagy-Related Apoptosis
Authors: Wu Ting-Sheng , Fan Shao-Yong , Zhang Bin , Tao Zhi-Qiang , Hua Hong , Dai Min 
Published: July 2020

Abstract
Background: Intervertebral disc degeneration (IDD) is the important cause of low back pain. Excessive apoptosis of intervertebral disc cells is the primary cause of IDD. BNIP3 is a member of Bcl-2 family and is widely involved in cell autophagy and apoptosis. However, the roles and mechanisms of BNIP3 in intervertebral disc cell autophagy and apoptosis are unclear.Results: In this study, the primary rat intervertebral disc cells were prepared and applied to study the effect of BNIP3 overexpression on their autophagy and apoptosis. RT-PCR and western blotting assay showed that BNIP3 overexpression significantly up-regulated the expression of autophagy and pro-apoptotic related proteins, including HIF-1α, Apaf-1, cleaved caspase 3, LC-3 and Beclin-1, while down-regulated the expression of anti-apoptotic protein Bcl-2. Subsequent cell staining detection of autophagy and apoptosis showed that BNIP3 overexpression significantly increased the autophagy and apoptosis of rat intervertebral disc cells. Furthermore, BNIP3 interference assay revealed that the effects of BNIP3 overexpression can be reversed by BNIP3 interference. Conclusions: The above findings suggested that BNIP3 enhanced autophagy of intervertebral disc cells and further triggered the apoptosis of intervertebral disc cells, eventually led to the development of intervertebral disc degeneration.
Thrombolysis with intra-arterial urokinase for acute superior mesenteric artery occlusion: Outcome analysis
Authors: Lin Being-Chuan , Wu Cheng-Hsien , Wong Yon-Cheong , Hung Sheng-Che , Hsin Ming-Che 
Published: July 2020

Abstract
Background

The aim of this study was to evaluate the outcome of intra-arterial urokinase thrombolysis for acute superior mesenteric artery (SMA) occlusion.
Methods

Ten patients with acute SMA occlusion who underwent intra-arterial urokinase therapy between 2008 and 2019 were retrospectively evaluated.
Results

Among the 10 patients, 7 were men and 3 were women (median age, 75.5 years). The median time from onset of abdominal pain to emergency department admission was 11 hours (interquartile range [IQR], 4.9 hours). None of the patients presented with shock in the triage screening or acute peritonitis on physical examination, and 4 (40%) had bloody stools. On angiography, 6 patients presented with complete SMA occlusion and the other 4 patients had incomplete occlusion. The median time from abdominal pain to attempting urokinase thrombolysis was 15.5 hours (IQR, 8.0 hours). During the course of the urokinase therapy, all the patients showed various degrees of recanalization (near-total, n = 2; partial, n = 8) on follow-up angiography. The median urokinase therapy duration was 39.0 hours (IQR, 48.0 hours). After urokinase therapy, bowel perfusion was restored with bowel preservation in 4 patients; however, in the other 6 patients, bowel perfusion was not restored. Comparison between the 4 patients with restored bowel perfusion and 6 patients with unrestored bowel perfusion revealed that the degree of SMA occlusion was statistically significant (complete vs. incomplete, p = 0.012). Of the 6 patients with complete SMA occlusion, 5 underwent bowel resection, of whom 2 died, and the remaining patient died of shock due to delayed surgery. Of the 4 patients with incomplete SMA occlusions, no bowel resection was performed except a partial omentectomy. Of the 3 deaths, one was attributed to delayed surgery, and the other two developed short bowel syndrome with sepsis and multiple-organ failure, with a 30% in-hospital mortality rate. The median hospital stay was 20.0 days (IQR, 32.0 days).
Conclusion

In our experience, thrombolysis with intra-arterial urokinase may serve as an adjunctive treatment modality to preserve the bowel and obviate surgery for incomplete SMA occlusion. However, it was not suitable for complete SMA occlusion, which requires surgery.
Clinical Significance of D-dimer Level in Refractory Mycoplasma Pneumoniae Pneumonia
Authors: Huang Xia , Li Dan , Liu Feng , Zhao Deyu , Zhu Yifan , Tang Heng 
Published: July 2020

Abstract
Background
Levels of serum D-dimer (D-D) in children with mycoplasma pneumoniae pneumonia (MPP) were assessed to explore the clinical significance of D-D level in refractory MPP(RMPP).
Method:
A total of 430 patients with MPP were enrolled between January 2015 and December 2015, and divided into a genera MPP (GMPP) group (n = 306) and a RMPP group (n = 124). Clinical data, D-D level, white blood cell (WBC) count, C-reactive protein (CRP), blood sedimentation (ESR), and lactate dehydrogenase (LDH) were compared between the two groups.
Results
(1) Hospitalization time, fever duration, WBC, CRP, LDH, ESR, and D-D were significantly higher in the RMPP group than in the GMPP group, (all P < 0.05). (2) Correlation analysis showed that D-D was positively correlated with WBC, CRP, ESR, and LDH, and could be used to jointly evaluate the severity of the disease. (3) The predictive values of WBC, CRP, ESR, LDH, and D-D for RMPP were further compared using area under the receiver operating characteristic curve(AUC) analysis. D-D had the highest predictive power for RMPP (AUC = 0.923, P < 0.01). When the D-D level was > 738 ng/ml, the predicted sensitivity of RMPP occurrence was 79.8% and the specificity was 93.5%. D-D level also had a good ability to predict pleural effusion and liver injury (AUC = 0.740, P < 0.01 and AUC = 0.812, P < 0.01, respectively). (4) After 1 week of treatment, the levels of D-D in both groups were lower than those before treatment (p < 0.01), but remained outside the normal range in 91.4% of participants, and were moderately or severely increased in 27.1% of the participants, all of whom were in the RMPP group.
Conclusion
Serum D-D levels were significantly increased in patients with RMPP, indicating that severe hypercoagulability and vascular endothelial injury with prolonged duration existed in this patient population. Increased levels of serum D-D may be used as an early predictor of RMPP and the occurrence of complications. Our findings provide a theoretical basis for the early diagnosis of RMPP, early intervention of hypercoagulability, and improvement of microcirculation therapy.
Clinical Analysis of Atelectasis Caused by Influenza A in Xiamen Children’s Hospital Between 2017 and 2019
Authors: Yuan Lin , Bai Ding-zhen , Zhuo Zhi-qiang , Wu Xing-dong 
Published: July 2020

Abstract
Background: We aimed to analyze the clinical characteristics of pediatric patients with atelectasis caused by influenza A to provide a reference for reasonable clinical diagnosis and treatment. Methods: We included 79 pediatric patients with atelectasis caused by influenza A diagnosed at Xiamen Children’s Hospital between January 1, 2017 and December 31, 2019. We analyzed their epidemiological characteristics, clinical manifestations, imaging changes, diagnosis, treatment process, and outcomes. Results: Among the 79 included patients (males: 52; females: 27), 70 (88.61%) were > 6 years-old and 54 (68.35%) had atelectasis onset during winter. A majority experienced fever and cough. Among them, 44, 16, 21, 14, and 12 had normal/decreased white blood cells, elevated procalcitonin, abnormal hepatic function, abnormal myocardial enzyme spectrum, Mycoplasma pneumoniae infection, and Streptococcus pneumoniae infection, respectively. Seventy-nine patients presented different atelectasis degrees, including 16 and 29 with atelectasis in the right and left lung, respectively, while 34 had multiple consolidations and atelectasis lesions in both lungs. Fiberoptic bronchoscopy examination of 57 cases revealed mucus plug blockage in 6 cases; among them, 2 cases underwent bronchial cast removal. All patients received oseltamivir or peramivir for antiviral treatment and antibacterial treatment for complicated bacterial infection. All the patients recovered and were eventually discharged. Post-discharge follow-up showed that 77 cases were cured while 2 experienced recurrent respiratory tract infections and post-activity shortness of breath with chest computer tomography showing mosaic perfusion. Conclusion There is a high incidence of atelectasis caused by influenza A during winter among children aged < 6 years. The main manifestations are fever (mostly hyperpyrexia) and cough. Chest imaging shows consolidation and atelectasis occurring in any lung lobe. Some patients present multiple consolidations and atelectasis lesions complicated by mucus plugs or bronchial casts. Timely fiberoptic bronchoscopy and alveolar lavage could shorten the disease course and improve the prognosis.
Influence of the Knot Position on the Union of the Greater Trochanter after Bipolar Hip Arthroplasty via the Modified Dall Approach: A Prospective Non-Randomized Study
Authors: Kataoka Masanao , Fujita Hiroshi , Hara Hiroaki , Harada Hideto , Okutani Yuki , Murotani Yoshiki 
Published: July 2020

Abstract
Background: In our institute, all elderly patients with displaced femoral neck fracture were treated with cemented bipolar hemiarthroplasty (BHA) using the modified Dall approach. To our knowledge, there are no reports on the knot position of the greater trochanter reattachment. The aim of this study was to determine influence of two knot positions (anterior or posterior) on the complications of the greater trochanter.Methods: This is a prospective non-randomized study conducted on 95 elderly patients (95 hips) from September 2013 to December 2017. The knot position was changed from anterior to posterior alternately. The X-ray images obtained immediately after the operation were compared with those obtained at 3 months postoperatively; thereafter, the status of the greater trochanter was classified into three types: type A, no apparent shifting and fracture; type C, over 1-mm shifting of the fragment; and type F, fracture of the greater trochanter.Results: Regarding age at operation, sex, BMI, size of the greater trochanteric fragment, stem type, and surgeon, there was no significant difference between two groups. In the anterior group, 34 hips (72.3%), 5 hips (10.6%), and 8 hips (17.0%) were classified under type A, C, and F, respectively. In the posterior group, 44 hips (91.7%), 1 hip (2.1%), and 3 hips (6.3%) were classified under type A, C, and F, respectively. There were significantly fewer greater trochanteric complications in the posterior group. Conclusions: The posterior knot position improved the union of the greater trochanter after BHA compared with the anterior knot position.Trial registration: We have no trial registration but we had approved IRB at our hospital clinical research review committee. Retrospectively registered.
Auxora Versus Standard of Care for the Treatment of Severe or Critical COVID-19 Pneumonia: Results from a Randomized Controlled Trial
Authors: Miller Joseph , Bruen Charles , Schnaus Michael , Zhang Jeffrey , Ali Sadia , Lind April , Stoecker PharmD Zachary , Stauderman Kenneth , Hebbar Sudarshan 
Published: July 2020

Abstract
BACKGROUNDCalcium release-activated calcium (CRAC) channel inhibitors stabilize the pulmonary endothelium and block proinflammatory cytokine release, potentially mitigating respiratory complications observed in patients with COVID-19. This study aimed to investigate the safety and efficacy of Auxora, a novel, intravenously administered CRAC channel inhibitor, in adults with severe or critical COVID-19 pneumoniaMETHODSA randomized, controlled, open-label study of Auxora was conducted in adults with severe or critical COVID-19 pneumonia. Patients were randomized 2:1 to receive three doses of once-daily Auxora versus standard of care (SOC) alone. The primary objective was to assess safety and tolerability of Auxora. Additional outcomes included changes in clinical status based on an 8-point ordinal scale and the proportion of patients dying or requiring invasive mechanical ventilation in the 30 days after randomization.RESULTSIn total, 17 patients with severe and three with critical COVID-19 pneumonia were randomized to Auxora and nine with severe and one with critical COVID-19 pneumonia to SOC. Similar proportions of patients receiving Auxora and SOC experienced ≥1 adverse event (75% versus 80%, respectively). Fewer patients receiving Auxora experienced serious adverse events versus SOC (30% versus 50%, respectively). Two patients (10%) receiving Auxora and two (20%) receiving SOC died in the 30 days after randomization. Among patients with severe COVID-19 pneumonia, median time to recovery with Auxora was five days versus 12 days with SOC; recovery rate ratio was 1.87 (95%CI, 0.72, 4.89). Invasive mechanical ventilation was needed in 18% of patients with severe COVID-19 pneumonia receiving Auxora versus 50% receiving SOC (absolute risk reduction=32%; 95%CI, -0.07, 0.71). One intubation or death over 30 days would be prevented by treating 2.6 patients with Auxora. Outcomes measured by an 8-point ordinal scale were significantly improved for patients receiving Auxora, especially for patients with a baseline PaO2/FiO2=101-200.CONCLUSIONSAuxora demonstrated a favorable safety profile in patients with severe or critical COVID-19 pneumonia and improved outcomes in patients with severe COVID-19 pneumonia. The impact of Auxora on respiratory complications in patients with severe COVID-19 pneumonia will be further assessed in a planned randomized, blinded, placebo-controlled study.TRIAL REGISTRATIONClinicalTrials.gov,NCT04345614. Retrospectively registered 14April2020 - https://clinicaltrials.gov/ct2/show/NCT04345614