bluuebunny/crossref_metadata_2025_split huggingface dataset:
­­Assessment of Viral RNA in Idiopathic Pulmonary Fibrosis Using RNA-seq
Authors: Yin Qinyan , Strong Michael J , Zhuang Yan , Flemington Erik K , Kaminski Naftali , de Andrade Joao , Lasky Joseph A 
Published: February 2020

Abstract
Background Numerous publications suggest an association between herpes virus infection and idiopathic pulmonary fibrosis (IPF). These reports have employed immunohistochemistry, in situ hybridization and/or PCR, which are susceptible to specificity artifacts. Methods We investigated the possible association between IPF and viral RNA expression using next-generation sequencing, which has the potential to provide a high degree of both sensitivity and specificity. We quantified viral RNA expression for 740 viruses in 28 IPF patient lung biopsy samples and 20 age-matched controls. Key RNA-seq results were confirmed using Real-time RT-PCR for select viruses (EBV, HCV, herpesvirus saimiri and HERV-K). Results We identified sporadic low-level evidence of viral infections in our lung tissue specimens, but did not find a statistical difference for expression of any virus, including EBV, herpesvirus saimiri and HERV-K, between IPF and control lungs. Conclusions To the best of our knowledge, this is the first publication that employs RNA-seq to assess whether viral infections are linked to the pathogenesis of IPF. Our results do not address the role of viral infection in acute exacerbations of IPF, however, this analysis patently did not support an association between herpes virus detection and IPF.
Neoadjuvant chemotherapy-induced decrease of prognostic nutrition index predicts poor prognosis in patients with breast cancer
Authors: Oba Takaaki , Maeno Kazuma , Takekoshi Daiya , Ono Mayu , Ito Tokiko , Kanai Toshiharu , Ito Ken-ichi 
Published: February 2020

Abstract
Background: The prognostic nutritional index (PNI), which is an easily calculated nutritional index, is significantly associated with patient outcomes in various solid malignancies. This study aimed to evaluate the prognostic impact of PNI changes in patients with breast cancer undergoing neoadjuvant chemotherapy (NAC). Methods: We reviewed patients with breast cancer who underwent NAC and a subsequent surgery for breast cancer between 2005 and 2016. PNI before and after NAC were calculated using the following formula: 10 × serum albumin (g/dl) + 0.005 × total lymphocyte count/mm 3 . The relationship between PNI and prognosis was retrospectively analyzed. Results: In total, 191 patients were evaluated. There was no significant difference in disease-free survival (DFS) between the pre-NAC PNI high group and the pre-NAC PNI low group (cutoff: 53.1). However, PNI decreased in 181 patients (94.7%) after NAC and the mean PNI also significantly decreased after NAC from 52.6 ± 3.8 pre-NAC to 46.5 ± 4.4 post-NAC ( p < 0.01). The mean ΔPNI, which was calculated as pre-NAC PNI minus post-NAC PNI, was 5.4. The high ΔPNI group showed significantly poorer DFS than the low ΔPNI group (cut off: 5.26) ( p = 0.015). Moreover, high ΔPNI was an independent risk factor of DFS on multivariate analysis ( p = 0.042). Conclusions: High decrease of PNI during NAC predicts poor prognosis. Thus, maintaining the nutritional status during NAC may result in better treatment outcomes in patients with breast cancer.
Prevalence Of Syphilis, Neurosyphilis And Associated Factors In a Cross-Sectional Analysis Of HIV Infected Patients Attending Bugando Medical Centre Mwanza Tanzania
Authors: Haule Adeodatus Richard , Msemwa Betrand , Mgaya Evarista , Masikini Peter , Kalluvya Samuel 
Published: February 2020

Abstract
BACKGROUND HIV-syphilis co-infection is a combination that enhances rapid progression of early syphilis or late latent syphilis to neurosyphilis and can cause catastrophic neurological complications. In studies in Mwanza, syphilis affects ~8% of healthy outpatients, and older studies have suggested that up to 23.5% of HIV-syphilis co-infected patients also have neurosyphilis
Resources Utilisation and Economic Burden of Percutaneous Vertebroplasty or Percutaneous Kyphoplasty for Treatment of Osteoporotic Vertebral Compression Fractures in China: A Retrospective Claim Database Study
Authors: Yang Dehong , Zhang Yanlei , Ma Xiao , Huo Li , Li Liran , Gao Yue , Xuan Jianwei 
Published: February 2020

Abstract
Background: Osteoporotic vertebral compression fractures (OVCF) is a common and often debilitating complication of osteoporosis, leading to significant morbidity and increased mortality. Percutaneous vertebroplasty (PVP) and Percutaneous kyphoplasty (PKP) are recommendable surgical treatments for OVCF.

Objective: To evaluate PVP/PKP utilisation and their related direct medical costs for OVCF treatment in China from the payer perspective.

Methods: A population-based medical claims database of a metropolitan city in China was analysed from the payer perspective, which included all inpatient claims from 01/01/2015 to 31/12/2017. All vertebral fractures patients that met the eligibility criteria (aged ≥50 years old, having vertebral fracture diagnosis, without unrelated diseases diagnoses such as tumour and scoliosis, received PVP/PKP) were deemed as OVCF patients. Baseline characteristics, surgery rate, length of stay in hospital, time to re-surgery, and costs (including costs per hospitalisation and annual costs) were described. Survival analysis function was used to estimate and re-surgery rate.

Results: Of the 50,686 patients with OVCF identified, 14,527 (28.66%) received a total number of 15,599 records of PVP/PKP surgeries from 2015 to 2017. Mean age was 75 at the first surgery captured in the database analysis period; females accounted for 79.54% of all cases. The median length of surgery stay was 9 days. Cumulative re-surgery rates were 1.22% in 30 days, 2.58% in 90 days, 3.61% in 183 days, 5.42% in one year, and 7.95% in two years. There was no significant difference in re-surgery rate between PVP and PKP (p=0.3897). The median time to the re-surgery was 139 days. Mean costs per PVP/PKP-related hospitalisation were 35,906 CNY/5,122 USD (34,195 CNY/4,878USD for PVP, 44,414 CNY/6,336 USD for PKP, p<0.01). The overall costs of hospitalisation averaged 186.61 million CNY (26.62 million USD) per year in this metropolitan city.

Conclusion: From 2015 to 2017, nearly one-third of OVCF inpatients received PVP/PKP and the re-surgery rate was 7.95%. PVP/PKP procedures for OVCF place a high economic burden for both the healthcare system and patients. Early detection and treatment of patients with osteoporosis are critical in China.

Keywords: OVCF; percutaneous vertebroplasty; percutaneous kyphoplasty; surgery; costs
Characterization of the Interleukin-17 Effect on Articular Cartilage in a Translational Model. An Explorative Study
Authors: Sinkeviciute Dovile , Aspberg Anders , He Yi , Bay-Jensen Anne-Christine , Önnerfjord Patrik 
Published: February 2020

Abstract
Background
Osteoarthritis (OA) is a progressive, chronic disease characterized by articular cartilage destruction. The pro-inflammatory cytokine IL-17 levels have been reported elevated in serum and synovial fluid of OA patients and correlated with increased cartilage defects and bone remodeling. The aim of this study was to characterize an IL-17-mediated articular cartilage degradation ex-vivo model and to investigate IL-17 effect on cartilage extracellular matrix protein turnover.
Methods
Full-depth bovine femoral condyle articular cartilage explants were cultured in serum-free medium for three weeks in the absence, or presence of cytokines: IL-17A (100 ng/ml or 25 ng/ml), or 10 ng OSM combined with 20 ng/ml TNFα (O+T). RNA isolation and PCR analysis were performed on tissue lysates to confirm IL-17 receptor expression. GAG and ECM-turnover biomarker release into conditioned media was assessed with dimethyl methylene blue and ELISA assays, respectively. Gelatin zymography was used for matrix metalloproteinase (MMP) 2 and MMP9 activity assessment in conditioned media, and shotgun LC-MS/MS for identification and label-free quantification of proteins and protein fragments in conditioned media. Western blotting was used to validate MS results.
Results
IL-17RA mRNA was expressed in bovine articular cartilage and the treatment with IL-17A did not interfere with metabolic activity of the model. IL-17A induced cartilage breakdown; conditioned media GAG levels were 3.6-fold-elevated compared to untreated. IL-17A [100 ng/ml] induced ADAMTS-mediated aggrecan degradation fragment release (14-fold increase compared to untreated) and MMP-mediated type II collagen fragment release (6-fold-change compared to untreated). MS data analysis revealed 16 differentially expressed proteins in IL-17A conditioned media compared to untreated. CHI3L1 upregulation in conditioned media in response to IL-17A was confirmed by Western blotting.
Conclusions
We showed that IL-17A has cartilage modulating potential. It induces collagen and aggrecan degradation indicating an upregulation of MMPs. This was confirmed by zymography and mass spectrometry data. We also showed that the expression of other cytokines is induced by IL-17A, which provide further insight to the pathways that are active in response to IL-17A. This exploratory study confirms that IL-17A may play a role in cartilage pathology and that the applied model may be a good tool to further investigate it.
Specific humoral response in cancer patients treated with a VEGF-specific active immunotherapy procedure within a compassionate use program.
Authors: Ramírez Javier Sánchez , Díaz Yanelys Morera , Bequet-Romero Mónica , Hernández-Bernal Francisco , Bauta Yenima Martín , Bernal Katty-Hind Selman-Housein , Santos Ana Victoria de la Torre , Iglesia Mariela Pérez de la , Lorenzo Lian Trimiño , Program Team of Investigators of Compassionate use , Avila Marta Ayala 
Published: February 2020

Abstract
Background: CIGB-247 is a cancer therapeutic vaccine that uses as antigen a variant of human vascular endothelial growth factor (VEGF) mixed with the bacterially-derived adjuvant VSSP. CIGB-247 has been already evaluated in two phase I clinical trials (CENTAURO and CENTAURO-2), showing to be safe and immunogenic in advanced cancer patients selected under well-defined and controlled clinical conditions. Surviving patients were submitted to monthly re-immunizations and some of them showed objective clinical benefits. Based on these results, a compassionate use program (CUP) with CIGB-247 was initiated for patients that did not meet the strict entry criteria applied for the CENTAURO and CENTAURO-2 clinical trials, but could potentially benefit from the application of this cancer therapeutic vaccine.
Results: Polyclonal IgM, IgA and IgG antibodies specific for VEGF were detected by ELISA in serum samples from patients vaccinated with 400 µg of antigen combined with 200 µg of VSSP. Polyclonal antibody response showed no cross reactivity for other VEGF family member molecules like VEGF-C and VEGF-D. Serum from immunized individuals was able to block the binding of VEGF to its receptors VEGFR2 and VEGFR1. IgG fraction purified from immune sera shared the aforementioned characteristics and also inhibited the interaction between VEGF and the therapeutic recombinant antibody bevacizumab, an anti-angiogenic drug approved for the treatment of different tumors. No serious adverse events attributable to CIGB-247 have been documented yet in participants of the CIGB-247 CUP.
The present paper is a first report of our findings concerning the humoral response and safety characteristics in treated CIGB-247 CUP cancer patients. The study has provided the unique opportunity of not only testing CIGB-247 in a broader clinical spectrum sample of Cuban cancer patients, but also within the context of the day-to-day clinical practice and treatment settings for these diseases in Cuban medical institutions.
Conclusions: The CIGB-247 CUP has demonstrated that immunization and follow-up of a variety of cancer patients, under day-to-day clinical practice conditions in several Cuban medical institutions, replicate our previous findings in clinical trials: CIGB-247 is safe and immunogenic.
In search of universal health coverage – highlighting the accessibility of health care to students with disabilities in Ghana: a qualitative study
Authors: Abodey Eric , Vanderpuye Irene , Mensah Isaac , Badu Eric 
Published: February 2020

Abstract
Background: Accessibility of health care to students with disabilities is a global concern. This is no less important in Ghana, however, to date, no study has been undertaken regarding access to health care to students with disabilities. This study, therefore, aims to explore the accessibility of health care to students with disabilities, in the quest of achieving universal health coverage in Ghana.
Methods: Qualitative methods, involving in-depth interviews were employed to collect data from 54 participants (29 students with disabilities, 17 health workers and 8 school mothers), selected through purposive sampling. Thematic analysis was used to analyze the data.
Results : The study identified three themes – accessibility, adequacy, and affordability. The study findings highlighted that universal health coverage for students with disabilities has not been achieved due to barriers in accessing health care. The barriers faced by students with disabilities were unfriendly physical environments, structures, equipment, limited support services and poor health insurance policy to finance health care.
Conclusion : The study concludes that the government should prioritize disability-related issues in health policy formulation, implementation and monitoring. The current provisions and requirements in the disability act should be prioritized, enforced and monitored to ensure adequate inclusion of disability issues in health services. Further, the current exemption policy under the National Health Insurance Scheme should be revised to adequately address the needs of people with disabilities.
Serum osteocalcin level is associated with the mortality in Chinese patients with Fibrodysplasia ossificans progressiva aged ≤18 years at diagnosis
Authors: She Dunmin , Li Ran , Fang Ping , Zong Guannan , Xue Ying , Zhang Keqin 
Published: February 2020

Abstract
Background Fibrodysplasia ossificans progressive (FOP) is an ultra-rare genetic disorder characterized by extraskeletal heterotopic ossification. It is well recognized that FOP can lead to a devastating condition of disability. However, the mortality rate of FOP patients in China and risk factors for mortality are still largely unclear.
Methods We conducted a retrospective research on a cohort of 65 cases of FOP patients in China from 2008 to 2018. We reviewed medical records of these FOP patients to retrieve information such as date of birth/death, gender, clinical features, genotypes and biochemical parameters and analyze the correlation of these parameters with the mortality.
Results 92.3% (60/65 cases) patients were classic FOP patients, 3.1% (2/65 cases) were FOP-plus and 4.6% (3/65 cases) were FOP variants. 9 cases of this cohort were dead during the ten-year period, and the overall mortality rate was 13.8%. c.617G>A mutation was confirmed in all non-survivors. In FOP patients≤18 years at diagnosis, non-survivors demonstrated significantly lower blood osteocalcin and alkaline phosphatase levels compared with survivors ( P <0.05), and spearman correlation and logistic regression analysis indicated that serum osteocalcin and alkaline phosphatase levels were negatively correlated with the mortality. Furthermore, the receiver-operating characteristic curve analysis showed serum osteocalcin had the largest area under the curve of 0.855 among four biochemical parameters, and serum osteocalcin < 65.9 ng/ml displayed a good capacity to discriminate the non-survivors from survivors in FOP patients aged 18 years and younger at diagnosis.
Conclusions Our findings showed that the mortality rate of FOP was 13.8% in China. Serum OC level was negatively correlated with the mortality in Chinese FOP patients ≤18 years at diagnosis.
【 Key words 】Fibrodysplasia ossificans progressive (FOP); mortality; risk factors; osteocalcin
Comparison of videolaryngoscopy and direct laryngoscopy by German paramedics during out-of-hospital cardiopulmonary resuscitation. An observational prospective study.
Authors: Risse Joachim , Volberg Christian , Kratz Thomas , Plöger Birgit , Jerrentrup Andreas , Pabst Dirk , Kill Clemens 
Published: February 2020

Abstract
Introduction: Videolaryngoscopy (VL) has become a popular method of intubation (ETI). Although VL may facilitate ETI in less-experienced rescuers there are limited data available concerning ETI performed by paramedics during CPR. The goal was to evaluate the impact VL compared with DL on intubation success and glottic view during CPR performed by German paramedics. We investigated in an observational prospective study the superiority of VL by paramedics during CPR compared with direct laryngoscopy (DL). Methods: In a single Emergency Medical Service (EMS) in Germany with in total 32 ambulances paramedics underwent an initial instruction from in endotracheal intubation (ETI) with GlideScope ® (GVL) during resuscitation. The primary endpoint was good visibility of the glottis (Cormack-Lehane grading 1/2), and the secondary endpoint was successful intubation comparing GVL and DL. Results: In total n = 97 patients were included, n = 69 with DL (n = 85 intubation attempts) and n = 28 VL (n = 37 intubation attempts). Videolaryngoscopy resulted in a significantly improved visualization of the larynx compared with DL. In the group using GVL, 82% rated visualization of the glottis as CL 1&2 versus 55% in the DL group (p = 0.02). Despite better visualization of the larynx, there was no statistically significant difference in successful ETI between GVL and DL (GVL 75% vs. DL 68.1%, p = 0.63). Conclusions: We found no difference in Overall and First Pass Success (FPS) between GVL and DL during CPR by German paramedics despite better glottic visualization with GVL. Therefore, we conclude that education in VL should also focus on insertion of the endotracheal tube, considering the different procedures of GVL.
A study of Capecitabine Metronomic Chemotherapy is noninferior to Conventional Chemotherapy as Maintenance Strategy in Responders After Induction Therapy in Metastatic Colorectal Cancer
Authors: Shi Min , Ma Tao , Xi Wenqi , Jiang Jingling , Wu Junwei , Zhou Chenfei , Yang Chen , Zhu Zhenggang , Zhang Jun 
Published: February 2020

Abstract
Background: The aim of this study is to demonstrate that capecitabine metronomic chemotherapy is non-inferior to capecitabine conventional chemotherapy as maintenance treatment, who have responded to 16-18 weeks first-line chemotherapy in metastatic colorectal cancer (mCRC).
Methods: The study design is a prospective, randomized, open label, phase II clinical trial. Those mCRC patients who respond well after 16-18 weeks of standard doublet chemotherapy as induction may enrolled into this study, randomly divided into capecitabine metronomic group or standard dosage group. The duration of disease control after randomization and progression free survival from enrollment are primary endpoints. Meanwhile, the overall survival, safety and quality of life are secondary endpoints. The sample size required to achieve the research objectives of this project is 79 cases in each group. The study recently started on 29-01-2018, and will last for 36 months.
Discussion: This project intends to study the efficacy and safety of capecitabine metronomic chemotherapy in the maintenance treatment of advanced colorectal cancer, and to explore the strategy of "low toxicity, high efficiency, economy and individualization" which is suitable for China's national conditions and pharmacoeconomics. It has great clinical application prospects and clear socio-economic value.
Clinicopathological variables influencing overall survival, recurrence and post-recurrence survival in resected stage I non-small-cell lung cancer
Authors: Wang Chengdi , Wu Yuxuan , Shao Jun , Liu Dan , Li Weimin 
Published: February 2020

Abstract
Background: To investigate clinicopathological variables influencing overall survival, overall recurrence, and post-recurrence survival (PRS) in patients who experienced curative-intent surgical resection of stage I non-small-cell lung cancer (NSCLC). Methods: We investigated a series of 1,387 patients with stage I NSCLC who underwent surgical resection from 2008 to 2015. The effect clinicopathological factors on death, recurrence, and PRS were evaluated by Kaplan-Meier estimates and cox regression analysis. Results: Among the 1,387 stage I patients, 301 (21.7%) experienced recurrence. The 5-year cumulative incidence of recurrence (CIR) for all patients was 20.2% and median PRS was 25.5 months. The older age ( P =0.036), p-stage IB ( P =0.001), sublobar resection( P ＜0.001), histology subtype ( P ＜0.001), and lymphovascular invasion (LVI) ( P =0.042) were significantly associated with worse overall survival. Among 301 recurrent patients, univariable analysis indicated that p-stage IB (versus IA) ( P ＜0.001), LVI ( P ＜0.001) and visceral pleural invasion (VPI) ( P ＜0.001) were remarkably correlated with the higher incidence of recurrence. Taking the effect of clinicopathological variables on PRS into consideration, smoking history ( P =0.043), non-adenocarcinoma ( P =0.013), high architectural grade of LUAD ( P =0.019), EGFR wild status ( P =0.002), bone metastasis ( P =0.042) and brain metastasis ( P =0.040) were substantially related with poorer PRS. Multivariate analysis demonstrated that high architectural grade of LUAD (P=0.008), brain metastasis ( P =0.010) and bone metastasis ( P =0.043) were independently associated with PRS. Conclusion: In patients with resected stage I NSCLC, the older age, p-stage IB (versus IA), sublobar resection, histology subtype, and LVI were significantly associated with worse overall survival. P-stage IB (versus IA), LVI, and VPI were significantly correlated with the higher incidence of recurrence. High architectural grade of LUAD, brain metastasis and bone metastasis were independent risk factors with PRS.