bluuebunny/crossref_metadata_2025_split huggingface dataset:
Addressing the Problems and Challenges of Medical Research During the Syrian Crisis
Authors: Alhaffar MHD Bahaa Aldin , Albarshah Marwah , alhaffar MHD ALAA ALDIN 
Published: May 2020

Abstract
Introduction : The Syrian crisis started 9 years ago causing substantial damage to the country’s infrastructure, and the consequences of this tragedy have further stunted the underdeveloped research environment in Syria. This paper aims to address the challenges of conducting medical research among Syrian academics during the Syrian crisis. Methods: The data were collected from (471) Syrian researchers (MsC or PhD students, university professors) from 13 universities and hospitals, covering 10 governates. A questionnaire was developed to collect the data and 52 factors were identified as research challenges. Results: The main institutional challenges are: (94%) insufficient funding, (80.3%) difficulties in acquiring supplies and equipment, (79.6%) lack of neutrality in approving research proposals. In regards to the personal challenges, (70.1%) expressed a high level of motivation to carry out research but only (33.4%) are confident that they have enough knowledge, (53.1%) do not have academic writing skills, (73.5%) do not have the basic information about medical statistics. For the crisis related factors, (83.5%) cite collecting data and reaching the sources of data as the main challenge, (80.4%) for losing contact with the patients because of the war situation, (76.3%) for lack of governmental support for the research during the crisis. Conclusion: Syrian medical researchers continue to face a number of challenges and the Syrian crisis has brought more problems and obstacles to the surface. However, despite those numerous challenges, researchers from Syrian institutes are still working on research projects.
Longitudinal Imaging-Based Clusters in Former Smokers of the COPD Cohort Associate with Clinical Characteristics: the SubPopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS)
Authors: Zou Chunrui , Li Frank , Choi Jiwoong , Haghighi Babak , Choi Sanghun , Rajaraman Prathish K. , Comellas Alejandro P. , Newell John D. , Lee Chang Hyun , Barr R. Graham , Bleecker Eugene , Cooper Christopher B. , Couper David , Han MeiLan , Hansel Nadia N. , Kanner Richard E. , Kazerooni Ella A. , Kleerup Eric C. , Martinez Fernando J. , O’Neal Wanda , Paine Robert , Rennard Stephen I , Smith Benjamin M. , Woodruff Prescott G , Hoffman Eric A. , Lin Ching-Long 
Published: May 2020

Abstract
Background: Quantitative CT (qCT) imaging-based cluster analysis identified clinically meaningful COPD former-smoker subgroups (clusters) based on cross-sectional data. We aimed to identify progression clusters for former smokers using longitudinal data.Patients and Methods: We selected 472 former smokers from SPIROMICS with a baseline visit and a one-year follow-up visit. A total of 150 qCT imaging-based variables, comprising 75 variables at baseline and their corresponding progression rates, were derived from the respective inspiration and expiration scans of the two visits. The COPD progression clusters identified were then associated with subject demography, clinical variables and biomarkers.Results: COPD severities at baseline increased with increasing cluster number. Cluster 1 patients were an obese subgroup with rapid progression of functional small airway disease percentage (fSAD%) and emphysema percentage (Emph%), and preserved FEV1%predicted but impairment of FEV1/FVC ratio over one year. Cluster 2 exhibited a decrease of fSAD% and Emph%, an increase of tissue fraction at total lung capacity, airway narrowing, and a reduced post-bronchodilator FEV1%predicted but preserved FEV1/FVC ratio over one year. Cluster 3 showed rapid expansion of Emph% and an attenuation of fSAD%. Cluster 4 demonstrated severe emphysema and fSAD and significant structural alterations at baseline with rapid progression of fSAD% over one year. Subjects with different progression patterns in the same cross-sectional cluster were identified by longitudinal clustering.Conclusions: qCT imaging-based metrics at two visits for former smokers allow for the derivation of four statistically stable clusters associated with unique progression patterns and clinical characteristics. Use of baseline variables and their progression rates enables identification of longitudinal clusters, resulting in a refinement of cross-sectional clusters.
Acute Respiratory Infection of under-five children associated with place of food cooking in Ethiopia: Multilevel Analysis of 2005-2016 Ethiopian Demographic Health Survey data
Authors: Geremew Abraham , Gebremedhin Selamawit , Mulugeta Yohannes , Assebe Tesfaye 
Published: May 2020

Abstract
Background: Acute respiratory infection is the leading causes of under-five child mortality globally especially in least income countries. Exposure to toxic pollutants from solid biomass fuel in the indoor environment is the main risk factor. In Ethiopia, where more than 90% of population use this energy source and the disease is one of the top health problems, there is a paucity of evidence on the association of cooking places with the disease based on nationally representative data. Therefore, the current study is intended to at assess the association of food cooking places with acute respiratory infection based on a large-scale and time varying data.Methods: The data of Ethiopian Demographic and health surveys collected in 2005, 2011 and 2016 were used for this study. The data were obtained via online registration and analyzed using a multilevel analysis. The “svy” command in Stata was used to weight the data to adjust for cluster sampling design. Result: The total number of children included in the analysis was 30895, with 9,517 from 2005, 11,176 from 2011 and 10, 291 from 2016 survey. In total, 11.9% of children had an acute lower respiratory infection with 12.7%, 11.9% and 11.1% respectively in 2005, 2011 and 2016. In 2005, 71% of mothers cooked food inside the house and it declined to 43% in 2016. The risk of the infection to children whose mother cooked food outside the house compared to inside the house was 68% less likely (AOR = 0.32, 95% CI= 0.10, 0.98). Watching television at least once in a week had also reduced the risk of infection (AOR=0.60, 95% CI =0.38, 0.94). There was a statistically a significant difference among the children of within survey to have an infection and no difference among the children of between surveys.Conclusion: The mothers’ cooking of food outside the house lessen the risk of children to have acute respiratory infection. No difference among different surveys on the infection suggests the rareness of progress in the practices that could minimize the risk therefore measures like encouraging to cook in indoor environment of well-ventilated needs to be taken.
Comparison of the metabolic profiles of rice cultivars with different eating qualities during grain development and the post-harvesting process
Authors: Chen Yi-Bo , wang zhidong , wang chongrong , Li Hong , Huang Daoqiang , Zhou Degui , Wu Yukun , Zhao Lei , Gong Rong , Pan Yangyang , Zhou Shaochuan 
Published: May 2020

Abstract
Background: Rice eating quality and nutritional quality is affected by both grain development and the post-harvesting process, but the dynamic metabolite changes among rice cultivars during these processes are unclear.Results: We successfully identified 623 metabolites in four indica cultivars with different eating qualities using a widely-targeted metabolomics approach, and found that the metabolic variation became increasingly smaller and differed according to the stage and cultivar during grain development and post-harvesting. Our results suggested that the levels of sugars, amino acids, lipids, and flavones demonstrated cultivar-specific changes during grain development, and sufficient carbon supply during grain development may contribute to the formation of excellent eating quality. We further found that most of the metabolites, especially the nutritional metabolites, decreased significantly or even lost, whereas only few increased during post-harvesting, further indicating that the post-harvesting process reduced the metabolic molecular differences between rice cultivars with different eating qualities, and had an even greater influence on metabolites than genetic factors.Conclusions: We found that a large number of metabolites changed significantly in the rice cultivars during grain development and the post-harvesting process, which facilitates further study of rice quality formation and has potential application in eating quality and nutritional quality improvement.
Yield and Yield-reduction Predictors in Drought: A Review of Recent Drought Years in a Highland and Lowland in Southern Tigray, Northern Ethiopia
Authors: Eze Emmanuel 
Published: May 2020

Abstract
The consequences of prolonged precipitation-deficient periods are primarily substantial water deficit, with the spatial characteristics of a place being (semi)arid, and various socioeconomic factors worsening its impacts and deepening poverty among agrarian communities.This study utilizes a combination of climate, remote sensing and field survey data from farmers to obtain a first-hand information on the impacts of recent (2015 and 2017) droughts on crop yield in Raya Azebo and Endamehoni woredas in Ethiopia. Annual rainfall, kiremt rainfall, annual NDVI and Dev-NDVI, kiremt season Dev-NDVI, monthly Dev-NDVI (for June to October), and monthly SPI-1, SPI-3 and SPI-12 (for June to October) were considered as likely factors that could relate with yield and yield loss in the area. Correlation and multiple linear stepwise regression statistical techniques were used to determine drought-yield relationships, and identify more accurate predictors of yield and yield losses in each of the drought years.Results obtained show droughts as having spatiotemporal variations and impacts, with its primary and common reflection being reduced vegetation amount, translating to crop failures, food shortages and reduced income of smallholders.Spate irrigation should be further popularized in the low-lying areas of Raya Azebo to augment for future deficiencies in the kiremt rainfall.
COVID-19 Exposure Risk of Healthcare Personnel in Digestive Endoscopy: A Prospective Study
Authors: Dioscoridi Lorenzo , Carrisi Chiara 
Published: May 2020

Abstract
Background: Of many descriptive papers about healthcare workers’ (HW) COVID-19 infection, asymptomatic cases have not yet considered. Aims: The present study calculated the numbers of COVID-19 patients afferent to GI endoscopy and the number of positive HW using nasopharyngeal swabs (NS), serological rapid IgM/IgG tests (SRT) and serological quantitative IgG test (SQT).Methods: The study was conducted from 2ndto 30thApril 2020. All the recommended national and international indications on infection control measures were followed. Out of 1227 patients accepted, 1009 were included in the study. 38 HW were tested by NS, SRT and SQT. Descriptive statistical analyses were used to summarize the data.Results: 17 patients were diagnosed COVID-19 positive at NS. 9 patients were known positive at the time of the endoscopy and 8 were diagnosed COVID-19 positive after the procedure. Of the 38 HW, 2 were positive both to NS and SRT with IgM/IgG lines; 7 showed IgG line only at SRT, confirmed by SQT with negative NS. Other 7 HW showed not well-defined line of IgG at SRT, confirmed negative by SQT. The two cases positive to NS and IgM/IgG SRT were asymptomatic. The crude contagion’s rate (R0)was 0.41 and 1.7% of COVID-19 patients caused 19% of positive cases in HW.Conclusions: Not previously diagnosed COVID-19 patients expose HW to additional and incalculable risk of contamination. Association between different tests reduced the variability related to possible confounding factors and increases the accuracy. Since most cases in HW seem to go asymptomatic, large-scale tests using both NS and SRT for both HW and patients should be recommended to minimize the risk of in-hospital infection’s relapses.
Telemedicine implementation on a bariatric outpatient clinic during COVID-19 pandemic in Italy: an unexpected hill-start.
Authors: F.A Matteo Runfola M.D. , Fantola Giovanni , Pintus Stefano , Iafrancesco Mauro , Moroni Roberto 
Published: May 2020

Abstract
Background SARS-CoV2 outbreak has challenged NHS of many countries. Generalized restriction of movement, together with the unprecedented pressure on the Health System, disrupted routine care for non-COVID-19 patients. Telemedicine has been promoted to reduce the risk of infections and to offer medical assistance to the restricted population. This paper is aimed to evaluate the impact of tele-consulting technology in a single bariatric surgical center.Study DesignOur outpatient clinic reorganized the service from on-site to long-distance video-consultations. All patients received a multiple-choice satisfaction questionnaire. The main goals were to evaluate patient compliance to the video consultations and to assess patient satisfaction. ResultsThe preliminary results show a drop-out rate of 42.4%. No significant differences were found between participants and non-participants in terms of age and gender ratio. Urban area residents were 57.9% in Participants group versus 42.8% in Non-participants group. Slightly more than half of participants (52.6%) completed the survey reporting levels of satisfaction between high and very high. ConclusionTelemedicine has been advocated as a useful tool to relieve pressure on the overwhelmed Health Systems during the COVID-19 pandemic. However, e-health technologies are not yet widely adopted. Our initial experience, also compared with national data relating to the digital divide, suggests that the absence of basic computer skills and the lack of confidence with video-call systems may be patient-specific barriers for the implementation of telemedicine. In this context, telemedicine implementation can run up against various patient-related barriers and several challenges remain for e-health to be integrated into outpatient practice
Shortlisting Phytochemicals Exhibiting Inhibitory Activity against Major Proteins of SARS-CoV-2 through Virtual Screening
Authors: Nallusamy Saranya , Mannu Jayakanthan , Ravikumar Caroline , Angamuthu Kandavelmani , Nathan Bharathi , Nachimuthu Kumaravadivel , Ramasamy Gnanam , Muthurajan Raveendran , Subbarayalu Mohankumar , Neelakandan Kumar 
Published: May 2020

Abstract
Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) declared as a pandemic by WHO that has affected more than 40 lakh peoples and caused death of more than 2 lakh individuals across the globe. Limited availability of genomic information of SARS-CoV-2 and non-availability of vaccines and effective drugs are major problems responsible for the ineffective control and management of this pandemic. Several attempts have been made to explore repurposing existing drugs known for their anti-viral activities, and test the traditional herbal medicines known for their health benefiting and immune boosting activity against SARS-CoV-2.In this study, efforts were made to examine the potential of 721 phytochemicals of 37 plant species in inhibiting major protein targets namely, spike glycoprotein, main protease (MPro), NSP3, NSP9, NSP15, NSP10-NSP16 and RNA dependent RNA polymerase of SARS-CoV-2 through virtual screening approach. Results of our experiments revealed that SARS-CoV-2 MPro shared significant dissimilarities against SARS-CoVMPro and MERS-CoVMPro indicating the need for discovering novel drugs. This study has identified the phytochemical cyanin (Zingiber officinale) exhibiting broad spectrum inhibitory activity against main proteases of all the three Coronaviruses. Amentoflavone, agathisflavone, catechin-7-o-gallate and chlorogeninwere shown to exhibit multi target inhibitory activity. This study has identified Mangifera indica, Anacardium occidentale, Vitex negundo, Solanum nigrum, Pedalium murex, Terminalia chebula, Azadirachta indica, Cissus quadrangularis, Clerodendrum serratum and Ocimum basilicum as potential sources of phytochemicals combating nCOVID-19. More interestingly, this study has generated evidences for the anti-viral properties of the traditional herbal formulation “Kabasura kudineer” recommended by AYUSH, a unit of Government of India. Testing of short listed phytochemicals through clinical trials will help in developing effective formulation for management of this pandemic disease. Genomic analysis of identified herbal plants will help in unravelling molecular complexity of therapeutic and anti-viral properties and will pave way for designing synthetic drugs.
Feasibility of iodine-123-mIBG SPECT/CT quantification in neuroblastoma using CZT and NaI detectors
Authors: Rogasch Julian MM , Bluemel Stephanie , Grosser Oliver S. , Albers Josefine , Spreckelmeyer Sarah , Eggert Angelika , Amthauer Holger , Schatka Imke 
Published: May 2020

Abstract
Background

In [ 123 I]mIBG SPECT/CT for neuroblastoma, lesion uptake quantification could improve therapy monitoring. This study compared quantitative accuracy of a CZT (WEHR45) and NaI (LEHR) system (GE Discovery 670).

Methods

Volume sensitivity VS hom was estimated from a homogenous cylindrical phantom (811 ml) acquired with body contour or fixed 27 cm detector radius. Relative accuracy of VS hom to retrieve true background activity concentration (AC) in an IEC body phantom was calculated. Maximum/peak contrast recovery (CR) of the sphere inserts used VS IEC estimated from the IEC phantom. In 16 children with 37 [ 123 I]mIBG SPECT/CTs (range, 1-6 per patient; CZT, 12; NaI, 25), normal organ SUVmean (liver r/l, spleen, myocardium, blood pool, spine, muscles) were calculated using VS hom and VS IEC . Iterative reconstruction (Q.Metrix) used resolution recovery with/without scatter correction (SC) by dual energy window (DEW; 159 ± 10% and 130 ± 10% keV). In 20 exams, metabolic tumor volume (MTV)*SUVmax changes of primary tumors were correlated with changes of MRI tumor volume in serial scans (Pearson).

Results

VS hom (cts * MBq -1 * s -1 ) using SC was slightly lower for 27 cm radius vs. body contour with CZT (48 vs. 50, p<0.001) but comparable with NaI (59 vs. 61, p=0.18). Relative error in IEC phantom AC based on VS hom for CZT vs. NaI was -1.3% vs. +4.1% with SC (p=0.22). Acquisition time reduction by 50% (CZT) showed similar VS hom and relative error. CRmax/peak overestimated true AC in largest spheres (diameter, 22-37 mm) with SC and underestimated it without SC. Average SUVmean in liver and myocardium of CZT vs. NaI patients were similar. In the remaining organs (high estimated scatter proportions of >60% [CZT] or >40% [NaI]), average SUVmean differed between CZT and NaI, and coefficient of variation was significantly higher in SC vs. non-SC with CZT. MTV*SUVmax changes correlated with MRI volume changes with r=0.62 (non-SC) or r=0.59 (SC).

Conclusions

In principle, both CZT and NaI allow quantification in [ 123 I]mIBG SPECT/CT, but quantitative accuracy remains limited if using DEW for SC due to effects from source geometry (e.g. phantoms and organs) on scatter. Detector radius and acquisition time showed minor effects. MTV*SUVmax changes might be surrogate of response to therapy.
Early neuromuscular blockade for acute respiratory distress syndrome: a systematic review with meta-analysis and trial sequential analysis
Authors: Zhang Xinchang , Liu Dekang , Ge Feifei , Xu Xiuping , Guan Xiaowei 
Published: May 2020

Abstract
Background

To assess the effect of neuromuscular blockade on outcomes in adults with acute respiratory distress syndrome who are receiving mechanical ventilation.Methods

We searched from inception to 24 may 2019 in MEDLINE, EMBASE and CENTRAL. We included randomized clinical trials comparing early neuromuscular blockade to placebo or usual care in adults with moderate to severe ARDS (PaO2/FiO2≤150mmHg). The primary outcome was 90-day and 28-day mortality. Secondary outcomes included oxygenation, driving pressure, incidence of barotrauma and pneumothorax, ventilator-free days at 28 days and ICU-acquired weakness by 28 days. In addition, a trial sequential analysis was performed.Results

Four trials were included with a total of 1437 patients. For the primary outcomes, there was no effect of neuromuscular blocking agent (NMBA) on 90-day mortality [relative risk (RR) 0.91, 95%CI 0.72-1.15, p=0.41] or 28-day mortality [RR 0.55, 95%CI 0.22-1.12, p=0.08], or ventilator-free days at 28 days [mean difference (MD) 0.86, 95%CI -0.61-2.33, p=0.25]. NMBA improved PaO2/FiO2 at 72h [MD 15.21, 95%CI 1.90-28.52, p=0.03]. NMBA reduced the incidence of barotrauma [RR 0.55, 95%CI 0.35-0.85, p=0.007] and pneumothorax [RR 0.46, 95%CI 0.28-0.76, p=0.002] and increased the driving pressure at 24 hours [MD 0.75, 95%CI 0.24-1.26, p=0.004] and 48 hours [MD 0.75, 95%CI 0.08-1.43, p=0.03]. There is no statistically significant difference in ICU-acquired weakness by 28 days [RR 1.20, 95%CI 0.72-1.98, p=0.49].Conclusions

In adults with moderate to severe ARDS treated with early neuromuscular blockade, oxygenation increase, incidence of barotrauma and pneumothorax are reduced, ICU-acquired weakness are not increased, but 90-day and 28-day mortality are not decreased. Further large-scale, multicenter studies are needed to confirm our results.Trial Registry

PROSPERO (ID: CRD42019137832)
Children with COVID-19 behaving milder may challenge the public policies: A Systematic Review and Meta-Analysis
Authors: Liu Chan , He Yu , Liu Lian , Li Fang , Shi Yuan 
Published: May 2020

Abstract
Background: The emerging virus is rampaging globally. Great efforts are needed to cut down the transmission. Clinical characteristics of infected children have been described previously. No meta-analysis on this subgroup have been published.Methods: A single-arm meta-analysis was conducted. We searched PubMed, Google Scholar, Web of Science, three preprints websites and other Chinese database for studies presenting characteristics of children confirmed with Coronavirus Disease 2019 (COVID-19) from December 1 2019 to March 28 2020. Quality Appraisal of Case Series Studies Checklist was used to assess quality and publication bias was analyzed by Egger’s test. Random-effect model was used to calculate the pooled incidence rate (IR) or mean difference (MD) with 95% confidence intervals (CI), or a fixed model instead when I2<50%. We conducted subgroup analysis according to geographic region. Additionally, we searched United Nations Educational Scientific and Cultural Organization to see how different countries act to the education disruption in COVID-19.Results: 14 studies (two unpublished) with 361 pediatric patients were included. The mean age was 5.5 (95% CI: 0.344–0.765) years old. 23.4% of children were asymptomatic (95%CI: 0.112-0.377). 32.3% (95%CI: 0.163-0.503) showed normal computed tomography imaging, besides, four children were admitted in intensive care units (0, 95%CI: 0.000-0.001) and one death was reported (0, 95%CI: 0.000-0.001). Up to 191 countries have implemented nationwide school closures, affecting over 91% of the world’s students.Conclusion: Children were also susceptible to SARS-CoV-2, while critical cases or death were rare. Characterized by mild presentation, the dilemma that children may become a potential spreader in the pandemic, while strict managements like prolonged school closures, may undermine their well-beings. Thus, the public policies are facing challenge.