bluuebunny/crossref_metadata_2025_split huggingface dataset:
Population-based Respiratory Syncytial Virus Hospitalization Disease Burden and Cost Effectiveness of Palivizumab Prophylaxis in Infants with Hemodynamically Significant Congenital Heart Diseases
Authors: Chen Robin Hay-son , Chiu Susan Shui-seng , Lee So-lun , Yung Tak-Cheung 
Published: July 2020

Abstract
Background

Infants with hemodynamically significant congenital heart disease (HsCHD) are at risk of respiratory syncytial virus hospitalization (RSVh) and Palivizumab has been shown to be effective in preventing RSVh in regions with a distinct RSV season. However, the incidence of RSVh in HsCHD patients and the cost-effectiveness of Palivizumab in regions with year-round RSV activity is largely unknown.
Methods

All HsCHD patients < 12 months of age referred to the only tertiary pediatric cardiology center in Hong Kong during 1 Jan 2014 to 31 Dec 2016 were included. RSVh rate, Palivizumab efficacy and cost-effectiveness were assessed using a 5 or 6 monthly dose regimen starting from first hospital discharge.
Results

Twenty-six RSVh (11%) were identified out of 236 HsCHD patients. 222 patients were included for further analysis of Palivizumab efficacy and cost-effectiveness. The number needed to treat to prevent RSVh using 5 and 6 dose regimen was 54.9 and 38, respectively, with a wide year-to-year variation from 25 to 166.6. RSVh cost without Palivizumab was $379,436; while palivizumab program cost for 5 and 6 dose were $727,481 and $849,888 respectively. Incremental cost-effective ratio per hospital admission prevented was $85,937 and $80,419 for 5 and 6 dose regimen, respectively, with a wide year-to-year variation from $40,410 to $277,367.
Conclusion

This is one of the first population-based studies in infants with HsCHD demonstrating a high RSVh burden in a region with round the year circulation of RSV. Palivizumab program was assessed to be not cost-effective in preventing RSVh in such a locality.
Worldwide Trend Analysis and Potential Spread Prediction of SARS-CoV-2
Authors: Jain Arohi , S Aswin , Jose Jais , Nathalia Deepa , Suresh Arjun 
Published: July 2020

Abstract
Covid-19 declared as a pandemic by the World Health Organisation on January 30, 2020, is a major disaster which shook the roots of almost all the economies around the globe. The outbreak began in a city of China, Wuhan majorly due to consumption of bats during December. The symptoms, the ways of spreading of infection are quite similar to that of influenza. The areas with higher pollution levels of particulate matter have reported a higher number of deaths as compared to the number of deaths in the cases from comparatively less polluted areas. The meteorological factors have also played a major role in the extent of spread of disease and the ability of humans living in the area to fight against the disease. Social distancing and lockdown all over the nation have proved to be major weapons to fight against the further spread of disease. The lockdown, on the other hand, has given relief from the high levels of pollution resulting in good air quality and clean rivers. This study focuses on the spread of the novel coronavirus all over the world with the trend in the number of confirmed cases, deaths and the cured from the onset and also highlighting the situations in five countries. The study further gives a prediction of the number of cases for ten days and correlates the values with the actual number of cases reported and throws light on the future aspects of the infection.
Association of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin-receptor blockers (ARBs) with risk of mortality, severity or SARS-CoV-2 test positivity in COVID-19 patients: A systematic review and meta-analysis
Authors: Biswas Mohitosh , Kali Most. Sumaiya Khatun 
Published: July 2020

Abstract
Effects of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) in the treatment of COVID-19 is highly debated. It was aimed to assess aggregated risk by investigating the association of ACEIs/ARBs users against non-users of ACEIs/ARBs with the risk of mortality or severe clinical manifestations or magnitude of SARS-CoV-2 test positivity in COVID-19 patients. Systematic literature search was carried out in different databases for eligible studies. The pooled relative risks (RRs) were measured using RevMan software where P<0.05 was set as statistical significance. In total, 10 studies were included in this analysis. After pooled estimation, it was demonstrated that SARS-CoV-2 positive patients taking ACEIs/ARBs were not associated with increased risk of mortality as compared to those not taking ACEIs/ARBs (RR 0.89; 95% CI 0.64-1.23; P=0.48). Further, the risk of composite severe clinical manifestations was not found significantly different between the positive patients with or without ACEIs/ARBs users (RR 1.29; 95% CI 0.81-2.04; P=0.28). There was no risk difference for SARS-CoV-2 test positivity in patients with or without ACEIs/ARBs users (RR 1.00; 95% CI 0.95-1.05; P=0.91). These findings may augment current professional society guidelines for not discontinuing ACEIs/ARBs in treating COVID-19 patients where it is clinically indicated.
Association between lung injury and cytokine profile in COVID-19 pneumonia
Authors: Chen Li-da , Zhang Zhen-Yu , Wei Xiao-Jie , Cai Yu-Qing , Yao Weng-Zhen , Wang Ming-Hui , Huang Qiu-Fen , Zhang Xiao-Bin 
Published: July 2020

Abstract
Background: Coronavirus disease 2019 (COVID-19) is a systemic disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The purpose of the present study was to investigate the association between lung injury and cytokine profile in COVID-19 pneumonia.Methods: This retrospective study was conducted in COVID-19 patients. Demographic characteristics, symptoms, signs, underlying diseases, and laboratory data were collected. The patients were divided into COVID-19 with pneumonia and without pneumonia. CT severity score and PaO2/FiO2 ratio and were used to assess lung injury.Results: 106 patients with 12 COVID-19 without pneumonia and 94 COVID-19 with pneumonia were included. Compared with COVID-19 without pneumonia, COVID-19 with pneumonia had significant higher serum interleukin (IL)-2R, IL-6, and tumor necrosis factor (TNF)-α. Correlation analysis showed that CT severity score and PaO2/FiO2 were significantly correlated with age, presence of any coexisting disorder, lymphocyte count, procalcitonin, IL-2R, and IL-6. In multivariate analysis, log IL6 was only independent explanatory variables for CT severity score (β=0.397, p<0.001) and PaO2/FiO2 (β=-0.434, p=0.003).Conclusions: Elevation of circulating cytokines was significantly associated with presence of pneumonia in COVID-19 and the severity of lung injury in COVID-19 pneumonia. Circulating IL-6 independently predicted the severity of lung injury in COVID-19 pneumonia.
Assessing SARS-CoV-2 RNA levels and lymphocyte/T cell counts in COVID-19 patients revealed initial immune status as a major determinant of disease severity
Authors: Han Mingfeng , Zhang Yafei , Liu Zhongping , Li Shasha , Xu Mengyuan , He Tengfei , Li Jinsong , Gao Yong , Liu Wanjun , Li Tuantuan , Chen Zixiang , Huang Xin , Cheng Guoling , Wang Jun , Dittmer Ulf , Witzke Oliver , Zou Guizhou , Li Xiuyong , Lu Mengji , Zhang Zhenhua 
Published: July 2020

Abstract
The magnitude of SARS-CoV-2 infection, the dynamic changes of immune parameters in patients with the novel coronavirus disease (COVID-19) and their correlation with the disease severity remain unclear. The clinical and laboratory results from 154 confirmed COVID-19 patients were collected. The SARS-CoV-2 RNA levels in patients were estimated using the Ct values of specific RT-PCR tests. The lymphocyte subsets and cytokines profiles in the peripheral blood were analyzed by flow cytometry and specific immunoassays. 154 confirmed COVID-19 patients were clinically examined up to 4 weeks after admission. The initial SARS-CoV-2 RNA Ct values at admission varied but were comparable in the patient groups classified according to the age, gender, underlying diseases, and disease severity. Three days after admission significant higher Ct values were found in severe cases. Significantly reduced counts of T cells and T cell subsets were found in patients with old age and underlying diseases at admission and were characteristic for the development of severe COVID-19. Severe COVID-19 developed preferentially in patients with underlying compromised immunity and was not associated with initial virus levels. Higher SARS-CoV-2 RNA levels in severe cases were apparently a result of impaired immune control associated with dysregulation of inflammation.
Savable but lost lives when ICU is overloaded: a model from 733 patients in epicenter Wuhan, China
Authors: Zhu Ziwei , Li Yang , Dan Tingting , Chen Xijie , Quan Wuxiu , Hu Yu , Tao Guihua , Zhu Lei , Zhu Jijin , Jin Yuyan , Li Longgeng , Liang Chaokai , Ou Yangming , Cai Hongmin , Wen Hanchun 
Published: July 2020

Abstract
Background. Coronavirus Disease (COVID-19) causes a sudden turn over to bad at some check-point and thus needs intervention of intensive care unit (ICU). This resulted in urgent and large needs of ICUs posed great risks to the medical system. Estimating the mortality of critical in-patients who were not admitted to the ICU (MI-mortality) will be valuable to optimize the management and assignment of ICU.Methods. Retrospective, of the 733 in-patients diagnosed with COVD-19 at Huangpi Hospital of Traditional Chinese Medicine (Wuhan, China), as of March 18, 2020. This study aims to estimate the MI-mortality and build a model to identify the critical in-patients. Demographic, clinical and laboratory results were collected and analyzed. The mortality rate for the patients who failed to receive ICU and unfortunately died was analyzed. To this end, the key factors for prognostic of patients who may need ICU care were found. A prognostic classification model using machine learning was built to identify the patient who may need ICU. Results. Considering the shortage of ICU beds at the beginning of disease emergence, we defined the mortality for those patients who were predicted to be in needing of ICU treatment yet they did not as MI-mortality. Patients who entered the ICU and died were defined as ICU-mortality. To estimate MI-mortality, a prognostic classification model was built to identify the in-patients who may need ICU care based on the medical factors collected in-hospital. Its predictive accuracies on whole patient set (733 [25 708]), training set (586 [20 566]) and testing set (147 [5 142]) dataset were 0.8513, 0.8935 and 0.8288, with the AUC of 0.8844, 0.8941 and 0.9120, respectively. Our analysis had shown that the MI-mortality is 41% and the ICU-mortality is 32%, implying that enough bed of ICU in treating patients in critical conditions. Conclusions. On our cohort of 733 patients, 25 in-patients were admitted to ICU, among them 8 patients died. 25 in-patients who have been predicted by our model that they should need ICU care, yet they did not enter ICU due to lack of shorting ICU wards. The MI-mortality is 41%.
Genetic Landscapes and Prognostic Implications of Circadian Rhythm in Non-small Cell Lung Cancer
Authors: Li Ming , Chen Zhencong , Jiang Tian , Yang Xiaodong , Du Yajing , Liang Jiaqi , Wang Lin , Xi Junjie , Zhan Cheng , Feng Mingxiang 
Published: July 2020

Abstract
Background: Circadian rhythm plays an influential role in the vast majority of behavior and physiology, even of tumorigenesis and development. In this study, we tried to explore the prognostic implication for non-small cell lung cancer (NSCLC) based on the expression profiles of circadian clock-related genes (CCRGs), and describe the changes of immune infiltration and cell functions of related to the circadian rhythm.Methods: Univariate and multivariate Cox proportional hazard regression were performed to determine and construct a CCRGs risk-score significantly correlated with overall survival (OS) of the training set and validation set. GO, KEGG, and GSVA indicated discrepant changes in cellular processes and signaling pathways associated with these CCRGs. Further, immune cell infiltration, mutation rates, and related drugs and pathways analyses were investigated by the online analysis platform and the algorithm provided by works of literature. Results: The risk-score based on ten-gene signatures could independently predict the OS both in TCGA lung adenocarcinoma (p < 0.0001, HR: 2.117, 95% CI: 1.546 to 2.900) and lung squamous cell carcinoma (p < 0.0001, HR: 2.066, 95% CI: 1.552 to 2.751), respectively. The risk-score also had superior accuracy and predictability (LUAD: AUC 0.788; LUSC: AUC 0.738). The prognostic performance of the ten-gene signature was finally validated in validation set based on GEO cohorts. The circadian oscillations driven by CCRGs could disturb the metabolism and cellular functions of cancer cells. We also found that the infiltration level of critical cells in specific anti-tumor immunity process was suppressed apparently. In contrast, the infiltrating of inflammatory cells and immune cells with negative regulatory effects were promoted in the high-risk group. CCRGs were evolutionarily conserved with low mutation rates, which brought difficulties to explore therapeutic targets. Conclusions: We described the landscapes and prognostic implications of CCRGs. The risk-score based on CCRGs was an independent predictor of prognosis and could significantly stratify patient outcomes and immune cell infiltration levels. CCRGs were evolutionarily conserved with low mutation rates, which brought difficulties to explore therapeutic targets.Our study revealed that circadian rhythms might play an influential role in the NSCLC.
Effectiveness of a group functional power training program for frail older adults implemented through neighbourhood senior centres – a randomised controlled study
Authors: Tou Nien Xiang , Wee Shiou-Liang , Seah Wei Ting , Ng Daniella Hui Min , Pang Benedict Wei Jun , Lau Lay Khoon , Ng Tze Pin 
Published: July 2020

Abstract
Background

Several trials have demonstrated the efficacy of resistance training to reduce frailty and improve function of older adults. To narrow the research-practice gap, we designed and evaluated the implementation of a community-delivered group-based functional power training (FPT) program for frail older adults within their neighbourhoods.
Methods

Two-arm, multicentre assessor-blind stratified randomised controlled trial at four local senior activity centres. Older adults (n = 61) with low handgrip strength (HGS) were randomised to intervention (IG) or control (CG) group. The IG underwent the FPT program (power and balance exercises using simple equipments) delivered by a community provider. The 12-week program comprised 2 × 60 mins sessions/wk. CG continued usual activities at the centres. Functional performance (SPPB and TUG), HGS, knee extensor strength (KES), and frailty status were assessed at baseline and 3-month. Program implementation was evaluated using RE-AIM framework.
Results

The program was halted due to Coronavirus Disease 2019 related suspension of senior centre activities. Results are reported from four centres (n = 61), which completed the program. IG showed significant improvement of moderate effect sizes in frailty status (0.36 points, 95CI [0.09, 0.64], p = 0.011) and SPPB (0.51 points, 95CI [0.13, 0.89], p = 0.010). IG improvement in TUG (0.57 s, 95CI [-0.07, 1.20], p = 0.080) did not achieve significance and there were no effects for HGS and KES. Only SPPB showed greater improvement in IG than CG (p = 0.047). The community program exhibited good reach, effectiveness, adoption, and implementation.
Conclusions

FPT is superior to regular activities at local senior centres in improving physical function and can be successfully implemented for frail older adults in their neighbourhoods.
Trial registration:

ClinicalTrials.gov, NCT04438876. Registered 19 June 2020 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04438876?term=NCT04438876
The Segment IV Approach: A Useful Method for Achieving the Critical View of Safety During Laparoscopic Cholecystectomy in Patients With Anomalous Bile Duct
Authors: Fujioka Shuichi , Nakashima Keigo , Kitamura Hiroaki , Takano Yuki , Misawa Takeyuki , Kumagai Yu , Hata Taigo , Akiba Tadashi , Ikegami Toru , Yanaga Katsuhiko 
Published: July 2020

Abstract
Background
The critical view of safety (CVS) method can be achieved by avoiding vasculo-biliary injury resulting from misidentification during laparoscopic cholecystectomy (LC). Although achieving the CVS has become popular worldwide, there is no established standardized technique to achieve the CVS in patients with an anomalous bile duct (ABD). We recently reported our original approach for securing the CVS using a new landmark, the diagonal line of the segment IV of the liver (D-line). The D-line is an imaginary line that lies on the right border of the hilar plate. The cystic structure can be securely isolated along the D-line without any misidentification, regardless of the existence of an ABD. We named this approach the segment IV approach in LC.
Methods
In this study, we adopted the segment IV approach in patients with an ABD. From October 2015 to June 2020, 209 patients underwent LC using the segment IV approach. Among them, three (1.4%) were preoperatively diagnosed with an ABD.
Results
The branching point of the cystic duct was the posterior sectional duct, anterior sectional duct, or left hepatic duct in each patient. The CVS was achieved in all cases without any complications.
Conclusion
The segment IV approach is useful for achieving CVS, especially even for patients with an ABD during LC.
“If you are on Duty, you may be Afraid to Come out to Attend to a Person”: Fear of Crime and Security Challenges in Maternal Acute Care in Nigeria from a Realist Perspective.
Authors: Etiaba Enyi , Manzano Ana , Agbawodikeizu Uju , Ogu Udochukwu , Ebenso Bassey , Uzochukwu Benjamin , Onwujekwe Obinna , Ezumah Nkoli , Mirzoev Tolib 
Published: July 2020

Abstract
Background Maternal and Child Health (MCH) is global priority. Access and utilization of facility MCH services remain challenges in low and middle-income countries (LMICs). Evidence on barriers to providing and accessing services omits information on role of security within facilities. This paper explores the role of security in provision and use of MCH services in primary healthcare (PHC) facilities in Nigeria. Methods Study was carried out in Anambra state, Nigeria. Qualitative data was collected from 35 in-depth interviews (IDIs) and 16 focus group discussions (FGDs) with purposively identified key informants. Information gathered was used to build a program theory that was tested with another round of IDIs and FGDs and the literature. Data analysis and reporting were based on the Context-Mechanism-Outcome heuristic of Realist Evaluation methodology.Results Security elements (presence or lack of security guards, fencing, lighting and staff accommodation) facilitated or constrained provision and uptake of services respectively, by impacting behaviour of staff and patients. Security concerns of facility staff who did not feel safe to let in people into unguarded facilities, mirrored those of pregnant women who did not utilize health facilities because of fear of not being let in and attended to by facility staff.Conclusion Health facility security needs to be key consideration in program planning, to avert staff and women’s fear of crime which currently constrains provision and use of MCH care at health facilities. This, in turn, should contribute to improved MCH outcomes and facilitate achievement of Universal Health Coverage.
Transcriptomic analysis reveals that bromodomain containing 9 controls signaling pathways in gastric cancer
Authors: Wang Yuan , Wang Chen , Mo Yu-Ting , Tan Wen Yi , Yu Xi-Yong 
Published: July 2020

Abstract
Background

According to the Cancer Genome Atlas, gastric cancers involve 30% BRD9 changes. Studying the signaling net controlled by BRD9 is important and provides useful information for the treatment of patients with gastric cancer and BRD9 alteration.
Objective

We performed this study to find the signaling pathways controlled by BRD9 in gastric cancer cells.
Methods

MGC-803 and AGS cells were selected as BRD9 overexpression and normal expression models, respectively, and added with BRD9 inhibitors BI9564 and BI7273, respectively. RNA-seq and limma R language were used to obtain differentially expressed genes (DEGs), and heatmap R language was employed for cluster analysis. Database for Annotation, Visualization and Integrated Discovery (DAVID) was applied to identify the gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichments, and STRING database was utilized to construct the protein–protein interaction (PPI) networks. Analysis was performed through Cytoscape software to determine the possible signaling pathway and target genes.
Results

Group MGC-803: 1204 and 1338 DEGs were found in MGC-803 cells added with BI9564 and BI7273, respectively, and 425 DEGs were found in the intersection of these two sets. AGS group: 974 and 1006 DEGs were found in AGS cells added with BI9564 and BI7273, respectively, and 382 DEGs were found in the intersection of these two sets. The DEG number in the intersection of groups MGC-803 and AGS was only 12, and only 3 of which showed the same regulation direction. Hence, these two types of gastric cancers are greatly altered in the signaling network. GO enrichment and KEGG signaling pathway analyses showed that in group MGC-803, BRD9 mainly controls cell adhesion molecule (CAM) pathway, and genes SPP1 and GNAO1 may play important an important role in the BRD9 controlling network. In group AGS, BRD9 mainly controls protein digestion and absorption pathway, and genes AR and GNGT2 have an important function in the BRD9 controlling network.
Conclusion

Comprehensive bioinformatics analyses were conducted to screen the DEGs and signaling pathways controlled by BRD9 in different gastric cancer cells. The findings provide a theoretical basis in curing patients with clinical gastric cancer.
Geographic Monitoring for Early Disease Detection (GeoMEDD)
Authors: Curtis Andrew , Ajayakumar Jayakrishnan , Curtis Jacqueline , Mihalik Sarah , Purohit Maulik , Scott Zachary , Muisyo James , Labadorf James , Vijitakula Sorapat , Yax Justin , Goldberg Daniel W. 
Published: July 2020

Abstract
Identifying emergent patterns of coronavirus disease 2019 (COVID-19) at the local level presents a geographic challenge that is not ideally addressed using traditional spatial clustering approaches. The need is not only to identify statistically significant spatial patterns, but also develop a surveillance system to identify small numbers of cases emerging in vulnerable settings. This paper presents an approach that has been used to provide near-real time assessments of emergent disease to guide a hospital system’s intervention strategy: Geographic Monitoring for Early Disease Detection (GeoMEDD). Through integration of a spatial database and two types of clustering algorithms, GeoMEDD has the flexibility to scale in terms of required minimum members, connecting distance between cases, and time frame under consideration. GeoMEDD, has proven effective in revealing different cluster influencers and accelerators that give insight as to why the cluster exists where it does, and why it expands.