bluuebunny/crossref_metadata_2025_split huggingface dataset:
Community Engaged Approaches to Cervical Cancer Prevention and Control in Sub-Saharan Africa: A Scoping Review Protocol
Authors: Habila Magdiel A , Mantina Namoonga , Kimaru Linda Jepkoech , Musa Jonah , Ingram Maia , Sagay Atiene 
Published: June 2020

Abstract
Introduction Cervical cancer is the fourth leading cause of death in women globally and remains the foremost cause of death in African women in spite of campaigns to increase education and prevention of the disease. The goal of participatory action research or community based participatory research is to engage communities in the research process in order to increase disease awareness and decrease disease mortality as a result of health disparities. The primary objective of this study is to summarize methods of community engagement in research on the prevention and control of cervical cancer in sub-Saharan Africa (SSA). MethodsWe will search through the following electronic databases for potential studies: PubMed, Embase, African Journals Online (AJOL), and African Index Medicus-WHO from inception until the date the last search will be conducted. Articles included will be restricted to those published in English and pertaining to research conducted in SSA. Articles generated from the search will be managed in our database. A narrative synthesis will be performed on the final list of included articles. DiscussionThis scoping review will provide evidence and perspectives on how research studies have engaged community members to bolster the cervical cancer prevention and control efforts. Findings of this review will contribute to the literature by identifying the benefits of community engagement in cervical cancer prevention in SSA and advance the science of cervical cancer prevention in the region and globally.
Separating the Wheat From the Chaff – Covid-19 in a German Emergency Department: A Case-control Study
Authors: Fistera David , Pabst Dirk , Härtl Annalena , Schaarschmidt Benedikt Michael , Umutlu Lale , Dolff Sebastian , Holzner Carola , Kill Clemens , Risse Joachim 
Published: June 2020

Abstract
Background: COVID-19 pandemia is a major challenge to worldwide health care systems. Whereas the majority of disease presents with mild symptoms that can be treated as outpatients, severely ill COVID-19 patients and patients presenting with similar symptoms cross their ways in the Emergency Department. Especially the variety of symptoms is challenging with primary triage. Are there parameters to distinguish between proven COVID-19 and without before? How can a safe and efficient management of these inpatients be achieved?Methods: We conducted a retrospective analysis of 314 consecutive inpatient patients who presented with possible symptoms of COVID-19 in a German emergency department between March and April 2020 and were tested with a SARS-Cov-2 nasopharyngeal swab. Clinical parameters, Manchester Triage System categories and lab results were compared between patients with positive and negative test results for SARS-Cov-2. Furthermore, we present the existing COVID-19 workflow model of the university hospital in Essen which proved to be efficient during pandemia.Results: 43 of the 314 patients (13.7%) were tested positive for COVID-19 by SARS-Cov-2 nasopharyngeal swab. We did not find any laboratory parameter to distinguish safely between patients with COVID-19 and those with similar symptoms. Dysgeusia was the only clinical symptom that was significantly more frequent among COVID-19 patients. Conclusion: Dysgeusia seems to be a typical symptom for COVID-19, which occurred in 14% of our COVID-19 patients. However, no valid parameters could be found to distinguish clinically between COVID-19 and other diseases with similar symptoms. Therefore, early testing, a strict isolation policy and proper personal protection are crucial to maintain workflow and safety of patients and ED staff for the months to come.Trial registration: URL: https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00021675
Zadek osteotomy for the treatment of Haglund’s Syndrome
Authors: Zheng Weixin , Du Junhua , Liang Jingqi , Zhang Yan , Liang Xiaojun , Zhao Hongmou 
Published: June 2020

Abstract
Background

Although several treatment options described in paper, Haglund’s Syndrome (HS) is a challenging common lower extremity disorder. This study reported the clinical outcomes of Zadek osteotomy (ZO) for the treatment of HS.
Methods

This retrospective study included 19 patients who underwent ZO from January 2016 to June 2018. Patients were evaluated using the American Orthopedic Foot Ankle Society ankle-hindfoot scale (AOFAS), Visual Analogue Scale (VAS), ankle range of motion (AROM), and Chauveaux-Liet (CL) angle preoperatively and at final follow-up visit (16.3 ± 4.2) months. Postoperative complications of patients were also recorded.
Results

The ZO exhibited a significant improvement (P༜0.05) in preoperative to postoperative AOFAS (from 53.2 ± 5.4 to 86.4 ± 6.5), VAS ( from 6.3 ± 2.1 to 0.9 ± 1.2 ) scores and CL angle (from 18.2 ± 1.3 to 9.4 ± 2.1 ) degrees, the dorsiflexion of AROM (DAROM) (from 23.4 ± 2.3 to 29.4 ± 1.2) degrees. The planter flexion of AROM (PAROM) (from 32.5 ± 3.5 to 33.2 ± 3.4) degrees (P༞0.05). One postoperative complication was observed: a case of hardware pain in healthy patient. The overall rate of satisfaction after surgery was (94.7%).
Conclusions

ZO is effective and safe procedure for the treatment of HS. This method can be a good option for those patients of HS.
Timing For Closed Reduction of Developmental Dysplasia of the Hip and Failure Analysis
Authors: Zhang Zhiqiang , Li Hao , Li Hai , Zhang Ziming 
Published: June 2020

Abstract
BackgroundIt remains controversial whether the older age at closed reduction (CR) of developmental dysplasia of the hip (DDH), the higher incidence of complications.The aim of this study is to evaluate theMid-term outcome of CR for DDHamongdifference age groups, and to analyze and identify risk factors for the failure of this procedure. Methods Clinical data of DDH patients, who received CR, were retrospectively reviewed. Hips were divided into three groups according to initial age (Group I: <12 months; Group II: 12 months to ≤18 months; Group III: >18 months). The presence of avascular necrosis (AVN),residual acetabular dysplasia (RAD), re-dislocation, further surgeries (FS)and failure of CR were observed. The risk factors were identified for those outcomes abovementioned. Receiver operating characteristics (ROC) curve analysis based on age, pre-op AI and post-op AI for failure was conducted.ResultsA total of 107 patients (156 hips) undergoing CR wereevaluated with a median age at initial reduction of 13.0 months(range, 4 to 28 mo). The incidence of AVN, RADand re-dislocationwas 15.4% (24/156), 17.3% (27/156) and 14.7% (23/156). For AVN, RAD and re-dislocation, the risk factors were pre-op IHDI IV(p=0.033), age≥18 months (p=0.012), and pre-op IHDI IV and walking (p=0.004 and p=0.011), respectively. The areas under the ROC curve of failure were 0.841 (post-op AI), 0.688 (pre-op AI)and 0.650 (age).ConclusionsRAD is a complication that must be carefully considered for severepatients older than 18 months before CR. Re-dislocation is associated with pre-op IHDI IV and walking.Patients, who are older than 12.5 months or have a pre-op AI of 38.7° or a post-op AI of 26.4°, are more likely fail of CR.
Bone Mineral Density Reference Values and Prevalence of Osteoporosis in Singaporean Adults – The Yishun Study
Authors: Chen Kexun , Wee Shiou-Liang , Pang Benedict Wei Jun , Lau Lay Khoon , Jabbar Khalid Abdul , Seah Wei Ting , Sriniva Sivasubramanian , Mallya Jagadish Ullal , Ng Tze Pin 
Published: June 2020

Abstract
Background: While there have been studies in Singapore on the prevalence and economic burden of osteoporotic hip fracture, there is a severe lack of reference data on bone mineral density and prevalence of osteoporosis. The purpose of this study is to establish the reference values for BMD and compare prevalence of osteoporotic conditions using other available reference values so as to better understand the status of bone health in Singaporean adultsMethods: We carried out a population-based cross-sectional study using dual-energy x-ray absorptiometry (Hologic Discovery Wi) to measure the bone mineral density of Singaporean adults aged ³ 21 years. 314 women and 223 men were recruited from the large north-eastern residential town of Yishun. We computed T- scores (denoted by TSG) for each individual in the study. Similar diagnoses were also done based on T-scores provided by the densitometer (TDXA), NHANES database (TNHANES), and China (TCHN), and the differences in prevalence compared. We then compared the concordance between TSG and TDXA in the classification of osteoporosis. Osteoporosis was defined according to criteria by the World Health Organization (WHO).Results: Peak lumbar spine BMD was 1.090±0.168g.cm-2 in women, and 1.041±0.098g.cm-2 for men. Peak whole body BMD was 1.193±0.93g.cm-2 in women at, and 1.224±0.112g.cm-2 for men. Prevalence of osteoporosis based on lumbar spine was 9.3% in women, and 0.7% in men. The percentage difference in prevalence range from 60.5 - 163.6%, when using reference values from TDXA, TNHANES, and TCHN. Among the 28 women who were diagnosed as osteoporotic by TDXA, 16.5% only had osteopenia according to TSG. The kappa statistics was 0.81 for women and 0.85 for men. Conclusion: Our study shows that T-scores provided by DXA manufacturer over-diagnosed osteoporosis in Singaporeans, and the prevalence of osteoporotic conditions is not accurately represented. This over-diagnosis may result in unnecessary treatment in some individuals.
Exosomes From 3d Culture of Marrow Stem Cells Enhances Endothelial Cell Proliferation, Migration, and Angiogenesis via Activation of the Hmgb1/akt Pathway
Authors: Gao Wenling , Liang Tangzhao , He Ronghang , Ren Jianhua , Yao Hui , Wang Kun , Zhu Lei , Xu Yue 
Published: June 2020

Abstract
BackgroundAngiogenesis is an essential step in tissue engineering. MSCexosomes play an important role in angiogenesis. Functional biomolecules in exosomes vested by the culture microenvironment can be transferred to recipient cells and affects their effect. 3D culture can improve the proliferation and activity of MSCs. However, whether exosomes derived from 3D culture of MSCs have an enhanced effect on angiogenesis is unclear. MethodsHerein, we compared the bioactivity of exosomes produced by conventional 2D culture (2D-exos) and 3D culture (3D-exos) of bone marrow stem cells (BMSCs) in angiogenesis. ResultsA series of in vitro and in vivo experiments indicated that 3D-exos exhibited stronger effects on HUVEC cell proliferation, migration, tube formation, and in vivo angiogenesis compared with 2D-exos. Moreover, the superiority of 3D-exos might be attributed to the activation of HMGB1/AKT signaling. ConclusionsThese results indicate that exosomes from 3D culture of MSCs may serve as a potential therapeutic approach for pro-angiogenesis.
High NEMO score values in nailfold videocapillaroscopy are predictive of future development of ischemic digital ulcers in patients with systemic sclerosis
Authors: Papa Nicoletta Del , Pignataro Francesca , Maglione Wanda , Minniti Antonina , Sambataro Domenico , Sambataro Gianluca , Valentini Gabriele , Caporali Roberto , Vitali Claudio 
Published: June 2020

Abstract
BackgroundNailfold videocapillaroscopy (NVC) is a feasible method that allows the observation of the microvascular changes that mark the course of systemic sclerosis (SSc). In previous studies we demonstrated that the NEMO score, i.e., the cumulative number of microhaemorrhages and microthromboses, is a good indicator of the steady state level and overtime changes of disease activity (DA) in SSc.ObjectivesTo verify whether high NEMO scores, which mirror a very active microvascular derangement in the fingers, may predict the subsequent development of ischemic digital ulcers (IDUs).Methods The NEMO score was assessed at baseline (T0) in 98 patients with SSc, all classified according to the ACR-EULAR criteria. Of them, 90 were females, 48 had the limited and 50 the diffuse cutaneous variant of SSc. Afterwards, the patients were closely followed up for two years, and the appearance of new IDUs recorded at any time of the follow up.The T0-NEMO score values of patients who developed IDUs were compared to those of patients who did not. A receiver operating curve (ROC) was constructed, and the area under the curve (AUC) calculated by plotting the sensitivity and 1-specificity of the different NEMO score values in predicting the subsequent development of IDUs.Results During the follow-up 38 out of 98 patients developed one or more IDUs. The NEMO score at T0 was significantly higher in those who developed IDUs with respect to those who did not [median 14.5 (95%CI 11.0-21.5), and 4.5 (95%CI 4.0-6.0), respectively, p<.0001]. The ROC curve derived from different T0-NEMO score values had an AUC of 0.79 (95%CI 0.69-0.86, p<0.0001)]. A NEMO score of ≥12 had a sensitivity of 83.3% (95%CI 71.5-91.7), and a specificity of 63.2% (95%CI 46.0-78.2), with positive (P) and negative (N) predictive (PV) values of 58.9% (95%CI 44.7-72.2), and 85.6% (71.8-94.4), respectively. A NEMO score of ≥16 had a sensitivity of 95.0% (95%CI 86.1-99.0), and a NPV of 93.4% (77.5-99.2).ConclusionsBeing a valid tool to measure DA levels in SSc, the NEMO score also appears to be good predictive instrument to predict future development of IDUs in this disease.
Mild Chronic Hypoxia-Induced HIF-2α Interacts with c-MYC Through Competition with HIF-1α in Hepatocellular Carcinoma Proliferation
Authors: Mu Han , Yu Ge , Li Huikai , Wang Mengmeng , Cui Yunlong , Zhang Ti , Song Tianqiang , Liu Changfu 
Published: June 2020

Abstract
Background: Hepatocellular carcinoma (HCC) has emerged as a major cause of cancer deaths globally, in which hypoxia and activated hypoxia-inducible factors (HIFs) play an important role. The sibling rivalry between HIF-1α and HIF-2α in hypoxic tumor growth and progression is still debated, including in HCC. This may be associated with the regulation of unique target genes, like c-MYC and mTOR. Methods: In the current study, twenty-six corresponding tumor- and non-tumor tissues, taken from patients with HCC, who underwent liver resection, were analyzed. In vitro, co-immunoprecipitation (Co-IP), Western blot, MTT assay, colony formation assay and Annexin V-FITC/PI staining apoptosis Assay were used to elucidate the relationship between HIF-1α and HIF-2α in hypoxic HCC cell proliferation and involved mechanism.Results: HIF-2α, but not HIF-1α, has a positive correlation with the expression of c-MYC in tumor tissues. In vitro, rapid HCC cell proliferation and increased interaction of HIF-2α/c-MYC were observed in mild chronic hypoxia. It was confirmed in situ proximity ligation assay and co-immunoprecipitation assay that although mild hypoxia up-regulated all HIF-1α, HIF-2α, and c-MYC, mTORC2-regulated HIF-2α competed with HIF-1α to bind c-MYC. HIF-2α knockdown, but not HIF-1α knockdown, decreased the expression of downstream c-MYC and mTORC1, suppressed hypoxic cell proliferation, and induced more cell apoptosis. Moreover, the inhibition of upstream protein PI3K by inhibitor Apitolisib counteracted this mechanism of adaptation to mild hypoxia hereby inducing cancer cells to apoptosis in HCC. Conclusions: In summary, this study highlights the role of HIF-2α but not HIF-1α in activating and binding c-MYC in HCC cell proliferation during mild chronic hypoxia response. PI3K/mTORC2/ HIF-2α/c-MYC axis plays a key role in this process. PI3K inhibitor Apitolisib is suggested as a potential treatment option for HCC, especially for rapidly growing HCC in mild chronic hypoxia.
Long-Term Monitoring of Dynamic Changes in Plasma EBV DNA For Improved Prognosis Prediction of Nasopharyngeal Carcinoma
Authors: Li Wanxia , Chen Jing , Liang Bijun , Li Zonghua , Li Junzheng , Yuan Xiaofei , Wu Shuting , Zeng Fangfang , Peng Xinyu , Li Yanfei , Lu Juan , Zhao Feipeng , Liu Xiong 
Published: June 2020

Abstract
Background: This study was performed to investigate whether long-term monitoring of dynamic changes in plasma Epstein-Barr virus (EBV) DNA could improve prognosis prediction of nasopharyngeal carcinoma (NPC).Methods: 1077 non-metastatic NPC patients were recruited to retrospectively analyze the prognostic value of plasma EBV DNA load pre-treatment and 3, 12, 24, and 36 months post-treatment. We also examined the prognostic value of dynamic changes in plasma EBV DNA at various time points.Results: Patients with plasma EBV DNA load above optimal pre- and post-treatment cut-offs had significantly worse five-year progression-free survival, distant metastasis-free survival, locoregional relapse-free survival, and overall survival(OS) at all time points, excluding only OS at 36 months post-treatment due to limited mortalities. Patients with persistently undetectable plasma EBV DNA at the first four time points had the best prognosis, followed by those with positive detection pre-treatment and consistently negative detection post-treatment, those with negative detection pre-treatment and positive detection at one time point post-treatment, and those with positive detection pre-treatment and at one time point post-treatment, whereas patients with positive detection at ≥2 time points post-treatment had the worst prognosis. Cox proportional hazard models identified the dynamic change pattern as an independent prognostic factor, and ROC curve analysis demonstrated that the dynamic change at four time point was more valuable than any single time point for predicting disease progression, distant metastasis, locoregional relapse, and mortality.Conclusions: Dynamic changes in plasma EBV DNA pre- and post-treatment could predict the long-term survival outcome and provide accurate risk stratification in NPC.
Alterations in the host transcriptome in vitro and in vivo following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection
Authors: Lei Xiaomei , Feng Zhijun , Wang Xiaojun , He Xiaodong 
Published: June 2020

Abstract
Background. Exploring alterations in the host transcriptome following SARS-CoV-2 infection is not only highly warranted to help us understand molecular mechanisms of the disease, but also provide new prospective for screening effective antiviral drugs, finding new therapeutic targets, and evaluating the risk of systemic inflammatory response syndrome (SIRS) early.Methods. We downloaded three gene expression matrix files from the Gene Expression Omnibus (GEO) database, and extracted the gene expression data of the SARS-CoV-2 infection and non-infection in human samples and different cell line samples, and then performed gene set enrichment analysis (GSEA), respectively. Thereafter, we integrated the results of GSEA and obtained co-enriched gene sets and co-core genes in three various microarray data. Finally, we also constructed a protein-protein interaction (PPI) network and molecular modules for co-core genes and performed Kyoto encyclopedia of genes and genomes (KEGG) pathway analysis for the genes from modules to clarify their possible biological processes and underlying signaling pathway. Results. A total of 11 co-enriched gene sets were identiﬁed from the three various microarray data. Among them, 10 gene sets were activated, and involved in immune response and inflammatory reaction. 1 gene set was suppressed, and participated in cell cycle. The analysis of molecular modules showed that 2 modules might play a vital role in the pathogenic process of SARS-CoV-2 infection. The KEGG enrichment analysis showed that genes from module one enriched in signaling pathways related to inflammation, but genes from module two enriched in signaling of cell cycle and DNA replication. Particularly, necroptosis signaling, a newly identified type of programmed cell death that differed from apoptosis, was also determined in our findings. Additionally, for patients with SARS-CoV-2 infection, genes from module one showed a relatively high-level expression while genes from module two showed low-level. Conclusions. We identified two molecular modules were used to assess severity and predict the prognosis of the patients with SARS-CoV-2 infection. In addition, these results provide a unique opportunity to explore more molecular pathways as new potential targets on therapy in COVID 19.
Association of ABO blood groups with SARS-COV-2 infection
Authors: Zhou Juan , Tan Yingzheng , Hu Llingli , Li Dan , He Xiaojin , Yuan Ting , Liu Huanhuan , Long Yunzhu 
Published: June 2020

Abstract
In view of the influence of ABO blood group antigens on infectious diseases, we explore the effect of ABO blood types on SARS-COV-2 infection. In this report, demographic data of 80 COVID-19 patients and 26 SARS-COV-2 asymptomatic carriers were collected based on electronic medical records. The results indicated that the distribution of ABO blood group in the confirmed patients was significantly different from asymptomatic carriers; importantly, antigen A carrier have significantly higher risk of developing into severe or critically cases than other types. These data present further evidence for the association of the blood groups to susceptibility to SARS-COV-2 infection.
COVID patients encountered by a general surgeon- 6 unique scenarios.
Authors: Jain Sumita , Mehta Deeksha , Aggarwal Lakshman , Goyal Alka , Sharma Chandra Shekhar , Mangalhara Naresh Kumar , Dadhich Yogendra , Bansal Somendra 
Published: June 2020

Abstract
Background and Objectives :With rising demand of surgical interventions post lockdown due to Corona Virus Infectious Disease(COVID)-19, surgeons need to restart their surgical practice shortly. To increase caution and safety, six scenarios in which a surgeon may encounter COVID patients are hereby highlighted in the present study.Patients and Methods:A hospital based case series analysis of eight surgical patients admitted in past two months was done. Clinical and radiological records of these patients were studied separately and concluded consensually by two surgeons.Results:Six unique scenarios were identified:1. COVID positive patient, with concurrent surgical pathology.2. COVID positive patient incidentally diagnosed with additional surgical pathology.3. A solely surgical patient mimicking COVID positive symptomatology.4. A COVID negative surgical patient acquiring nosocomial COVID infection postoperatively.5. COVID positive surgical patient with false negative COVID report.6. COVID suspected by intraoperative COVID specific intestinal findings and then getting postoperative COVID test positive for the patient.Interpretations:· Deferrable surgeries to be avoided· A stringent institutional protocol for all patients is the essence of current surgical practice.· Minimal surgical or radiological intervention should be sought whenever possible.· The bias towards COVID, should not let us miss a surgical pathology in patients mimicking COVID clinically.· The possibility of a false negative COVID test, should be kept in mind in patients with typical COVID like symptomatology.· Immunocompromised surgical patients susceptible to nosocomial COVID infections should be dealed with extra caution and precaution.