bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in clinicopathological features of primary nephrotic syndrome in children over a 10 years period: Research Paper
Authors: Guo Haiyan , Li Qian , Yu Lichun , Chen Yuan , Wang Jing , Su Yue , Sun Shunzhen 
Published: May 2020

Abstract
Background

Primary nephrotic syndrome (PNS) is a common chronic disease in childhood and results in heavy illness burden. The aim of this study is to investigate the change in the clinicopathological features of children with NS worldwide.
Methods

Children with PNS were divided into two groups according to the date of admission. Group A was admitted from January 1, 2006 to December 31, 2010 and group B from January 1, 2011 to December 31, 2015. Clinical manifestations and pathological features of the children in both groups were retrospectively analyzed.
Results

This study includes 1072 patients. There were 783 cases of steroid-sensitive nephrotic syndrome (SSNS), 241 cases of steroid-resistant nephrotic syndrome (SRNS), and 48 cases of unknown steroid effects. The incidence of complications in group B was significantly higher than that in group A, especially for infections. A total of 136 (12.96%) patients underwent renal biopsy. The most common lesions were minimal change disease (44.12%). The rate of mesangial proliferative glomerulonephritis (MsPGN) significantly decreased and that of membranous nephropathy (MN) increased over the years. A total of 292 (27.24%) patients were administered immunosuppressants. The administration of Tripterygium was decreased, whereas the using of Tacrolimus increased over the years.
Conclusion

There have been changes in the incidence of complications, pathological features, and immunosuppressants in children with PNS over 10 years.
Causal association pathways between fetuin-A and kidney function: A mediation Analysis
Authors: Bassey Philip Etabee Macdonald , Numthavaj Pawin , Rattanasiri Sasivimol , Srit Piyamitr , McEvoy Mark , Thakkinstian Ammarin 
Published: May 2020

Abstract
BackgroundBody mass index (BMI), uric acid (UA) diabetes mellitus (DM) and hypertension (HT) are known risk factors of declined kidney function, and are associated with fetuin-A. However, the causal pathways of these associations are unclear. We therefore used cohort data to explore possible causal pathways of fetuin-A and kidney function. MethodologyWe used data of the Electricity Generating Authority of Thailand cohort 2009 (n= 2305). A causal pathway was constructed, which considered fetuin-A as study factor, BMI, UA, DM, and HT as mediators, and eGFR as the outcome. A generalized-structural equation model (GSEM) with 1000-replication bootstrapping was applied to assess the causal effects adjusting for covariates. ResultsThe fetuin-A → eGFR pathway showed a direct association of fetuin-A on eGFR with the coefficient of -0.0072 (95% CI: -0.0119, -0.0025). In addition, the indirect effects of fetuin-A→ BMI → eGFR was also significant with the coefficient of 0.00086 (0.00025, 0.0016; implying that every one unit of BMI increased, resulting from increasing fetuin-A, would significantly increase eGFR 0.00086 (0.00025, 0.0016) mL/min/1.73m2. There was a negative effect of fetuin-A on eGFR through BMI and UA pathway (Fetuin-A→BMI→UA→eGFR ) as well as the HT pathway (Fetuin-A→BMI→HT→eGFR ) with average casual mediation effects (ACME) of -0.00132 (-0.00177, -0.00092) and -0.00139 (-0.00237, -0.00069). Fetuin-AàDMàHTàeGFR was also statistically significant with the ACME of -0.00223 (-0.00535, -0.00066).ConclusionOur study has shed some light on the possible role of fetuin-A in the etiology of declining renal function through the mediatory roles of BMI, UA, DM and HT in the various complex causal pathways leading to declining kidney function in our study cohort. Further studies are however recommended to examine the pathomechanisms involved in the mediational processes of these studied risk factors in the etiology of declining kidney function.
Role of MMP-9 in Epithelial-Mesenchymal Transition of Thyroid Cancer
Authors: Li Yuanchun , He Jing , Wang Feng , Wang Xin , Yang Fan , Zhao Chunyang , Feng Chunling , Li Tiejun 
Published: May 2020

Abstract
Background The purpose of this study is to explore the role and mechanism of MMP-9 in the EMT process of thyroid cancer (TC), so as to provide a basis for clinical exploration of invasion and metastasis process of TC, looking for biological markers of tumor metastasis and molecular intervention therapy.Methods Western Blot and RT-PCR were employed to detect the expression of MMP-9 in human normal thyroid cell line HT-ori3 and human TC cell lines IHH-4 (PTC), FTC-133 and 8505C. Expression levels of EMT-related markers: epithelial cell marker E-cadherin and stromal cell marker Vimentin in TGF-1-induced TC cell lines were detected by Western Blot and RT-PCR, respectively. The effects of MMP-9 down-regulation on cell invasion and metastasis were investigated by wound-healing assay and cell invasion experiment.Results The protein and mRNA expression levels of MMP-9 in TC cell lines were increased compared with human normal thyroid cell line HT-ori3. When TGF-β1 was added, the expression of EMT and Vimentin increased while the expression of E-cadherin decreased. Compared with the control group, the TC cells stably transfected with MMP-9 shRNA showed inhibited EMT, decreased Vimentin expression and increased E-cadherin expression. The induction of TGF-β1 did not promote the occurrence of EMT in TC cells which were stably transformed with MMP-9 shRNA. The addition of TGF-β1 to TC cells increased the ability of the cells to migrate and invade. Compared with the control group, the migration and invasion ability of TC cells stably transfected with MMP-9 shRNA was significantly reduced, and the induction of TGF-β1 could not restore the migration and invasion ability of cells without MMP-9.Conclusions In conclusion, we found that MMP-9 can be used as a biomarker for TC, which can promote the EMT process of TGF-β1 induced TC, and thus affecting the cell migration and invasion ability.
The accuracy and safety of CT-guided iodine-125 seeds implantation assisted by 3D non-coplanar template for retroperitoneal recurrent carcinoma.
Authors: Jiang Weijuan , Jiang Ping , Wei Shuhua , Jiang Yuliang , Ji Zhe , Sun Haitao , Fan Jinghong , Li Weiyan , Shao Yuxia , Wang Junjie 
Published: May 2020

Abstract
Purpose
To investigate the accuracy, dosimetric parameters and safety of 3D-printing non co-planar template (3D-PNCT) assisted CT-guidance for radioactive iodine-125 (125I) seed implantation brachytherapy (RSI-BT) for retroperitoneal recurrent carcinomas.
Methods and materials:
We enrolled 15 patients with 17 retroperitoneal recurrent carcinomas after external beam radiotherapy (EBRT). All patients received CT-guided 125I RSI-BT assisted by 3D-PNCT successfully. We compared the original needles insertion position, angular and the needle tips distance deviations of preoperative plan with that of intra-operative in brachytherapy treatment-planning system (B-TPS). The dosimetric parameters of RSI-BT were evaluated on preoperative plan, intra-operative real-time plan and postoperative plan, including D90, D100, V100, V150 and V200. The quality assurance of RSI-BT evaluated on conformal index (CI), external index (EI), homogeneity index (HI) of the targets were compared among preoperative plan, intra-operative real-time plan and postoperative plan. The peri-operation complications and re-radiation related toxicity were assessed.
Results
The median follow-up was 8.2 months (range 1-18.5months). One patient lost follow-up after RSI-BT. 14 patients were assessed for response rate and toxicity. The mean entrance point distance deviation for all 165 needles was 4.50 ± 4.10 mm (range, 0–30). The mean angular deviation was 2.70 ± 3.00 degrees (range, 0–20). The needles tip distances deviation was 6.90 ± 6.00 mm (range, -30-28). D90 for preoperative plan, intra-operative plan and postoperative plan were 140.55 ± 23.93, 124.25 ± 28.04,128.98 ± 22.75. There was significant difference between D90 of preoperative plan with that of intraoperative plan (p = 0.036). Four patients reached CR, three patients reached PR, three patients were SD and three patients was PD. Four patients with middle pain became moderate, two with moderate pain relived completely after RSI-BT. The others parameters showed no differences among preoperative plan, intraoperative plan and postoperative plan. The perioperative complications were observed in four patients, including three patients of grade 1 and one patient of grade 2. No ≥ grade 3 side-effects were observed.
Conclusion
CT-guided 125I RSI-BT assisted by 3D-PNCT was a safe, accurate and feasible strategy for recurrent carcinomas located in retroperitoneal regions.
Mechanical Chest Compression Devices in the Helicopter Emergency Medical Service in Switzerland
Authors: Pietsch Urs , Reiser David , Wenzel Volker , Knapp Jürgen , Tissi Mario , Theiler Lorenz , Rauch Simon , Albrecht Roland 
Published: May 2020

Abstract
Background
Over the past years, several emergency medical service providers have introduced mechanical chest compression devices (MCDs) in their protocols for cardiopulmonary resuscitation (CPR). Especially in helicopter emergency medical systems (HEMS), which have limitations regarding loading weight and space and typically operate in rural and remote areas, whether MCDs have benefits for patients is still unknown. The aim of this study was to evaluate the use of MCDs in a large Swiss HEMS system.
Materials and Methods
We conducted a retrospective observational study of all HEMS missions of Swiss Air rescue Rega between January 2014 and June 2016 with the use an MCD (Autopulse®). Details of MCD use and patient outcome are reported from the medical operation journals and the hospitals’ discharge letters.
Results
MCDs were used in 626 HEMS missions and 590 patients (94%) could be included. 478 (81%) were primary missions and 112 (19%) were interhospital transfers. 49 of the patients in primary missions were loaded under ongoing CPR with MCDs. In the patients loaded after return of spontaneous circulation (ROSC), 20 (7%) experienced a second CA during the flight. In interhospital transfers 102 (91%) only needed standby use of the MCD. Five (4.5%) patients were loaded into the helicopter with ongoing CPR. Five (4.5%) patients went into CA during flight and the MCD had to be activated.
Conclusion
We conclude that equipping HEMS with MCDs may be beneficial, with non-trauma patients potentially benefitting more than trauma patients.
Willingness to Perform Induced Abortion and Associated Factors Among Graduating Midwifery, Medical, Nursing, and Public Health Officer Students of University of Gondar, Northwest Ethiopia: Institution based Cross sectional study
Authors: Enyew Mihretu Molla 
Published: May 2020

Abstract
Background: In developing countries, abortion is often unsafe and a signiﬁcant cause of maternal morbidity and mortality accounting for about 8% (4.7%–13.2%) of maternal mortality worldwide. Internationally, safe abortion services are recognized as reducing maternal mortality, and liberalized abortion laws are associated with reduced mortality resulting from unsafe abortion procedures. However, health care providers have moral, social and gender-based reservations that affects their willingness towards providing induced abortion services. The purpose of this study was to assess willingness to perform induced abortion and associated factors among graduating Midwifery, Medical, Nursing, and Public health officer students of University of Gondar. Methods: Institution based cross sectional study was conducted from March 29 to May 30, 2019. All graduating students available during data collection period were considered as study population. Stratified simple random sampling technique was used to select 424 study participants. Pre tested, semi- structured, self-administered questionnaire was used to collect data. Data analysis was done using SPSS version 20. Ethical clearance was obtained from School of midwifery under the delegation of institutional review board of university of Gondar.Results: 290 students out of 424 students were willing to perform induced abortion for indications supported by Ethiopian abortion law, making a proportion of 68.4% (95%Cl: 64.2, 72.9). Sex (Being male (AOR = 4.89, 95%CI: 3.02, 7.89)), religion (being orthodox than protestant (AOR = 10.41, 95%CI: 3.02, 21.57)), being Muslim than protestant (AOR = 5.73, 95%CI: 1.37, 15.92)) and having once or less a week religious attendance (AOR=2.00, 95% CI: 1.20, 3.34) were factors associated with willingness towards performing induced abortion.Conclusions: According to this study willingness of students towards providing induced abortion services was good. However female students, protestant followers and those students with more than once a week religious attendance should be encouraged in abortion care provisions.
Inhaler devices in asthma and COPD patients – A prospective cross-sectional study on inhaler preferences and error rates
Authors: Schreiber Jens , Roessler Tina , Luecke Eva 
Published: May 2020

Abstract
Background: Inhalation therapy is the backbone of asthma and COPD control. However, inhaler adherence and device mishandling continue to be a problem in real life. Some studies have shown that using a patient-preferred inhaler may reduce device handling errors and improve adherence to prescribed chronic inhaler drug therapy. The aim of this study was to compare the preferences for commonly used inhaler devices in Germany in patients with chronic obstructive respiratory disease. We also pursued the question which properties of an inhaler device are particularly important to the user and what effects age, gender and type of disease (asthma or COPD) may have on device preference and handling errors.Methods: Prospective, open-label cross-sectional study in which 105 patients with asthma (58%) or COPD (42%) participated. Validated checklists were used to objectively assess inhaler technique and errors with 10 different placebo devices. For each device, patients were asked to test the handling, to assess the device properties and to name the device that they would most or least prefer.Results:Across the 10 placebo inhaler devices tested, patients needed an average of 1.22 attempts to error-free use. The device with the lowest mean number of attempts was the Turbohaler® (1.02), followed by the Nexthaler® (1.04), the Diskus® (1.07) and the Spiromax® (1.10). Patients over 60 years vs. younger age (p=0.002) and COPD vs. asthma patients (p=0.016) required more attempts to ensure correct use. 41% of the study participants chose one of the devices they already used as the most preferred inhaler. Overall, 20% opted for the Spiromax®, 15% for the Nexthaler® and 14% for the Turbohaler® or a pMDI. The least preferred device was the Elpenhaler® (0%). From a selection of 7 predefined inhaler attributes, patients stated easy handling as the most important for them. This was followed by short inhalation time and low inhalation resistance. Conclusions: Patient preference may vary between inhaler devices. The lowest number of attempts to error-free use was reported for the Turbohaler® and the Nexthaler®. The Spiromax® and the Nexthaler® achieved the best overall ratings and were the devices most preferred by patients.
In vitro biosynthesis of Ag, Au and Te-containing nanostructures by Exiguobacterium cell-free extracts
Authors: Orizola J. , Ríos-Silva M. , Muñoz-Villagrán C. , Vargas E. , Vásquez C. , Arenas Felipe 
Published: May 2020

Abstract
Background: The bacterial genus Exiguobacterium includes several species that inhabit environments with a wide range of temperature, salinity, and pH. This is why the microorganisms from this genus are known generically as polyextremophiles. Several environmental isolates have been explored and characterized for enzyme production as well as for bioremediation purposes. In this line, toxic metal(loid) reduction by these microorganisms represents an approach to decontaminate soluble metal ions via their transformation into less toxic, insoluble derivatives. Microbial-mediated metal(loid) reduction frequently results in the synthesis of nanoscale structures—nanostructures (NS) —. Thus, microorganisms could be used as an ecofriendly way to get NS.Results: We analyzed the tolerance of Exiguobacterium acetylicum MF03, E. aurantiacum MF06, and E. profundum MF08 to silver(I), gold(III), and tellurium(IV) compounds. Specifically, we explored the ability of cell-free extracts from these bacteria to reduce these toxicants and synthesize NS in vitro, both in the presence or absence of oxygen.All isolates exhibited higher tolerance to these toxicants in anaerobiosis. While in the absence of oxygen they showed high tellurite- and silver-reducing activity at pH 9.0, whereas AuCl4- which was reduced at pH 7.0 in both conditions. Given these results, cell-free extracts were used to synthesize NS containing silver, gold or tellurium, characterizing their size, morphology and chemical composition. Silver and tellurium NS exhibited smaller size under anaerobiosis and their morphology was circular (silver NS), starred (tellurium NS) or amorphous (gold NS). Conclusions: This nanostructure-synthesizing ability makes these isolates interesting candidates to get NS with biotechnological potential.
Allergic rhinitis, asthma and gastro-esophageal reflux disease: a cross-sectional study on their reciprocal relations
Authors: Kakaje Ameer , Alhalabi Mohammad Marwan , Alyousbashi Ayham , Ghareeb Ayham 
Published: May 2020

Abstract
Allergic rhinitis (AR) is a very common medical condition worldwide which affects the quality of life of many for long periods throughout the year. It has many symptoms such as sneezing, a sore throat, globus pharyngeus, rhinorrhoea, congestion, and postnasal drip that may overlap with laryngopharyngeal reflux (LPR) which is a different medical condition. LPR can be considered as an extra oesophageal manifestation of gastro-oesophageal reflux disease (GORD) or a different entity altogether. LPR can go under-diagnosed as there is no definitive diagnostic tool. LPR can impose a real challenge as it may occur for years without diagnosis which can affect the quality of life even more. Having AR can also increase the chance of having asthma which is also in turn correlated with having GORD. Although AR and LPR are not life-threatening, they are persistent medical conditions, meaning they affect the everyday life and causing unnecessary distress. In this study we evaluate their correlation in Syria in the Middle East as there are not many studies on this topic. We found responders with LPR symptoms do have more AR symptoms (P<0.001) and that AR and LPR are correlated with having asthma. We also found that AR and LPR correlation is independent from having asthma P<0.0001 but with subjects with asthma, no such a correlation was found.
Evolution of SARS-CoV-2 spike glycoprotein
Authors: Wrobel Antoni , Benton Donald , Xu Pengqi , Roustan Chloë , Martin Stephen , Rosenthal Peter , Skehel John , Gamblin Steven 
Published: May 2020

Abstract
The spike glycoprotein (S) of SARS-CoV-2 mediates attachment of the virus to cell surface receptors and fusion between virus and cell membranes1. The receptor for SARS-CoV-2, like that for SARS-CoV, is the human cell-surface membrane protein ACE22–4. Membrane fusion activity, as for other class-1 fusion glycoproteins, requires S to be proteolytically cleaved into S1 and S2 that remain associated following cleavage4–7. SARS-CoV-2 is thought to have emerged from bats, possibly via a secondary host8,9. To better understand the transmission of SARS-CoV-2 we have determined the structure of its furin-cleaved S by cryoEM, which shows that cleavage at this polybasic amino-acid site increases the structural plasticity of the receptor binding region and facilitates the adoption of an open conformation that is required for it to bind to the ACE2 receptor. To investigate relationships between S proteins of SARS-CoV-2 and of the most closely related bat virus, RaTG138, we have determined and compared their structures and characterised biochemically their affinities for ACE2 and their relative stabilities. Whilst the overall structures are similar, there are key differences likely pertinent to virus infectivity. These include a more stable pre-cleavage form of human S, about 1000-fold tighter binding of SARS-CoV-2 to human receptor, and a higher proportion of S in the conformation required for binding ACE2 upon protease cleavage.
Solar Cycle Related Variation in Solar Differential Rotation and Meridional Flow in Cycle 24
Authors: Imada Shinsuke , Matoba Kengo , Fujiyama Masashi , Iijima Haruhisa 
Published: May 2020

Abstract
We studied temporal variation of the differential rotation and poleward meridional circulation during solar cycle 24 using the magnetic element feature tracking technique. We used line-of-sight magnetograms obtained using the Helioseismic and Magnetic Imager aboard the Solar Dynamics Observatory from May 01, 2010 to March 26, 2020 (for almost the entire period of solar cycle 24, Carrington Rotation from 2096 to 2229) and tracked the magnetic element features every 1 hour. We also estimated the differential rotation and poleward meridional flow velocity profiles. The observed profiles are consistent with those of previous studies on different cycles. Typical properties resulting from torsional oscillations can also be observed from solar cycle 24. The amplitude of the variation was approximately $\pm$10 m s$^{-1}$. Interestingly, we found that the average meridional flow observed in solar cycle 24 is faster than that observed in solar cycle 23. In particular, during the declining phase of the cycle, the meridional flow of the middle latitude is accelerated from 10 to 17 m s$^{-1}$, which is almost half of the meridional flow itself. The faster meridional flow in solar cycle 24 might be the result of the weakest cycle during the last 100 years.
Laryngopharyngeal Reflux Disease in War-torn Syria and its Association with Smoking and other Risks.
Authors: Kakaje Ameer , Alhalabi Mohammad Marwan , Alyousbashi Ayham , Hamid Aya , Mahmoud Yousef 
Published: May 2020

Abstract

Backgrounds: Syria has entered its ninth year of conflict and as its medical sector facing major hurdles, laryngopharyngeal reflux (LPR) is often overlooked although it has an association with worsening quality of life and affecting many aspects as it is chronic and left untreated although it can lead to many complications such as dysphonia. This study is to evaluate LPR prevalence and its association with different aspects such as cigarette, and shisha smoking, and the effect of war on LPR.Methods: Cross-sectional study by using online questionnaires that included demographics, smoking, war related questions and reflux symptom index (RSI) were used online in many cities around Syria.Findings: This research included 734 responders with 75.5% being female and the mean age being 23.97 years. 31.9% of subjects had symptoms suggestive of LPR. Participants were Syrians and we included every responder who agreed and did not neglect any question. We only found that being distressed from war noises was associated with positive LPR symptoms [P=0.009 (OR, 1.562; 95% CI 1.117-2.183)], but losing someone or changing place of living due to war were not associated with LPR. LPR was associated with cigarette smoking (P<0.05). Finally, having asthma, and male gender in the younger population were associated with LPR (P<0.05). No clear association with age, or shisha and no significant associations were found with consanguinity, marital status, educational level and SES.Interpretations: About one third had LPR symptoms. War distress from war noise, cigarette smoking, asthma, and allergic were significantly correlated with LPR.