bluuebunny/crossref_metadata_2025_split huggingface dataset:
E Health and Electronic Health Record: The Italian experience in the European Context
Authors: Marino Alfonso , Pariso Paolo , Landriani Loris 
Published: June 2020

Abstract
Background In the reform context as declared by the Italian Government Law, related to National Health Service, the country are implementing the Information and Communication Technology such as eHealth and Electronic Health Record (EHR). This study aims at evaluating the degree of diffusion and adoption of the Electronic Health Records in southern Italy.Methods Starting from Italian Regional Inpatient Dataset, that collects data from the hospitals, the study considered several strategic variables in order to assess, within main hospitals of six provincial capitals of southern Italy (Napoli, Bari, Reggio Calabria, Potenza, Palermo, Cagliari), the implementation status of Electronic Health Records. These variables set up Hospital Organizational Indicator and by using SPSS a univariate regression analysis has been developed to obtain descriptive statistics.Results The results provide a preliminary forecast at the Electronic Health Records’ use and suggests that, in their actual implementation, Electronic Health Records have not begun to reach targets and have a smaller impact than expected on hospital organization.Conclusions The study shows how the EHR is in close correlation with E Health policies and how it can affect such policies as well. The nature of the Italian E Health and applied to the Electronic Health Record showed dated and unsolved bottlenecks within southern Italy, highlighting on the one hand a digital divide between the provision of digital services and the patients and, the on the other hand, a weakness linked to the structure of the organizations based only on rules and procedures and not outcomes and results.
Silencing of KNTC1 inhibits hepatocellular carcinoma cells progression via suppressing PI3K/Akt pathway
Authors: Tong Hui , Xie Junjie , Liu Xiaohui , Peng Chenghong , Shen Baiyong , Zhu Zhecheng 
Published: June 2020

Abstract

Background: Kinetochore associated 1 (KNTC1) encodes a kinetochore component in Rod‐Zwilch‐ZW10 (RZZ) complex which is essential for the segregation of sister chromatids during mitosis and participates in the spindle checkpoint. Recent research demonstrated that kinetochore proteins may be potential biomarkers and may contribute to the development of human malignancies. Here, we sought to identify the biological significances of KNTC1 in hepatocellular carcinoma (HCC).Methods: KNTC1 expression was studied in HCC tissues by immunohistochemistry. Lentivirus delivered short hairpin RNA (shRNA) was performed to generate KNTC1 knockdown HCC cell lines. The effects of KNTC1 on HCC cells proliferation, migration, apoptosis and tumor formation was analyzed by MTT assay, colony formation assay, wound‐healing assay, transwell migration assay, annexin V assay in vitro and in nude mouse models in vivo.Results: Our immunohistochemistry experiment showed that KNTC1 was highly expressed in HCC tissues and correlated with terrible prognosis, indicating that KNTC1 acts a pivotal role in HCC development. Furthermore, shRNA KNTC1 (Lv‐shKNTC1) was applied to infect BEL‐7404 and SK‐HEP‐1 to identify roles of KNTC1 on HCC. Lv‐shKNTC1 cells showed reduced proliferation ability, increased apoptosis and decreased migration ability. In vivo experiments suggested that xenografts grow significantly slower upon the silencing of KNTC1. Mechanistically, the protein levels of PIK3CA, p‐Akt, CCND1, CDK6 are all down‐regulated in Lv‐KNTC1 SK‐HEP‐1 cells. Therefore, KNTC1 may affect the biological activity of HCC cells through PI3K/Akt signaling pathway.Conclusions: In summary, the key finding of this report highlighted the significance of KNTC1 in tumor regression of HCC, demonstrating KNTC1 as an innovative target for adjuvant treatment of HCC.
Effect of the Electrode Array-Retina Gap Distance on Visual Function in Patients with the Argus II Retinal Prosthesis
Authors: Naidu Abhishek , Ghani Nimra , Yazdanie Mohammad Saad , Chaudhary Khurram 
Published: June 2020

Abstract
Background
Post-implantation visual outcomes in patients with the Argus II Retinal Prosthesis is dependent on a multitude of factors including the positioning of the electrode array on the retina. The purpose of this study is to determine whether the average electrode array-retina gap distance correlates with objective visual function outcomes and sensitivity detection thresholds in patients implanted with the Argus II Retinal Prosthesis.
Methods
5 patients with implantation of the Argus II Retinal Prosthesis were enrolled in this single-institution retrospective study. Patient demographics were collected from medical records. Visual function data (Square Localization [SL] and Direction of Motion [DOM]) and Optical Coherence Tomography (Cirrus HD-OCT) images were extracted retrospectively from the Argus II Retinal Prosthesis Post-Approval study. Visual function tests were performed with the device OFF and ON at each study visit. Electrode array-retina gap distances were measured at each of the array’s 60 electrodes using the Cirrus HD-OCT software in both the nasotemporal and superoinferior planes. Data was obtained at baseline, and post-operative month 1, month 3, month 6, and year 1. Sensitivity detection thresholds were obtained at the initial programming visit and each reprogramming session.
Results
1 of 5 patients had a significant average improvement in the SL visual function test and 0 of 5 had a significant average improvement in the DOM visual when the device was ON compared to OFF (p < 0.05). Electrode array-retina gap distance did not show a significant correlation with changes in SL visual function (r = 0.20; p = > 0.05) or DOM visual function (r = -0.18; p = > 0.05). In addition, electrode array-retina gap distance did not show a significant correlation with sensitivity detection threshold (r = -0.01; p = 0.98).
Conclusion
Our results demonstrate that the average electrode array-retina gap distance does not correlate with changes in objective visual acuity function or sensitivity detection thresholds in a cohort of patients implanted with the Argus II Retinal Prosthesis. Therefore, complete apposition between the electrode array and retina may not always be necessary to achieve optimal visual outcomes.
Systematic Profiling of Survival-Associated Alternative Splicing Events in Adrenocortical Carcinoma
Authors: Fang Xia , Wan Qin , Long Yang , Teng Fangyuan , Tan Xiaozhen , Guo Man , Jiang Zongzhe , xu yong 
Published: June 2020

Abstract
Background: Aberrant alternative splicing (AS) is involved in many oncogenic processes and systematic analysis of survival-associated aberrant AS events has been reported in many cancers. This study aims to systematic profiling the AS signature in Adrenocortical carcinoma (ACC).Methods: Data of ACC were downloaded from TCGA and TCGA SpliceSeq. Clinical information and AS events data were integrated with the same TCGA ID. Then, we performed univariate Cox analysis to identify survival-related AS events. Lasso regression and multivariate Cox analysis were used to establish prognostic model. In addition, several bioinformatics analyses were conducted to identify pathways enriched by genes of survival-associated AS events and construct splicing-factor-regulated network.Results: A total of 77 patients with complete clinical information and PSI values of AS events were included in the present study. We detected 3781 AS events in 2366 genes were associated with overall survival of ACC patients. All the predictive models showed efficiency in distinguishing good and poor outcomes of ACC patients. All the AUCs of predictive models were greater than 0.7. Functional analysis genes with survival-associated AS events suggested that the POLR2H, TCEB2, PSMA1, PSMD11 and SKP2 ranked at the core. The splicing-factor-regulated network revealed the potential regulatory mechanisms of AS events in ACC.Conclusions: Our systematic profiling of survival-associated AS events in ACC patients provides novel molecular alternations and contributes to decipher the underlying mechanisms of AS in oncogenesis of ACC.
Sick Leaves Pattern in A Tertiary Healthcare Facility in Saudi Arabia
Authors: Elabd Kossay Abdelhamid Ali , Alkhenizan Abdullah , Aldughaither Abdullah S. 
Published: June 2020

Abstract
BACKGROUND : Frequent sick leaves in any healthcare organization is a critical problem that can undermine the patients' care. METHODS : This is a quantitative cross-sectional study looking at the frequency of sick leaves among employees of a large, tertiary healthcare facility in Riyadh. We randomly selected 474 employees, who were seen in family medicine clinics during one-year period. We collected all the data retrospectively from their electronic medical records. Then we reviewed and analyzed all the data using SPSS software. RESULTS : There was no difference in the sick leaves rate between males and females (P-value 0.8618), but we saw a higher rate among younger employees (40 years old or less) compared to those 41 years or older (p-value <0.0001). We also investigated those who took four sick leaves or more during the period of the study, and we found that most of them were mainly nursing staff (31.71%), hospital assistances (24.39%) and housekeepers (14.63%). The commonest cause for taking sick leave in our study was viral upper respiratory tract infection. Therefore, we studied the effect of influenza vaccine on the frequency of sick leaves and we found that those who took the vaccine were less likely to take a leave because of flu (P-value <0.0001, Odd ratio 0.4067 with 95% CI 0.2739-0.608). CONCLUSION : younger employees, nurses, hospital assistants and housekeepers are more likely to take sick leaves. These findings need to be studied further in the future to help us dealing with the problem of absenteeism. Flu is the leading cause for sick leaves and influenza vaccine seemed to reduce its rate. In this study, we also discussed different methods that can be used by any healthcare organization to reduce absence rate.
Trends in prevalence, mortality and morbidity associated with high systolic blood pressure in Brazil from 1990 to 2017: estimates from the “Global Burden of Disease 2017” (GBD2017) study
Authors: Nascimento Bruno Ramos , Brant Luisa Campos Caldeira , Yadgir Simon , Oliveira Gláucia Maria Moraes , Roth Gregory , Glenn Scott Devon , Mooney Meghan , Naghavi Mohsen , Passos Valéria Maria Azeredo , Duncan Bruce Bartholow , Silva Diego Augusto Santos , Malta Deborah Carvalho , Ribeiro Antonio Luiz Pinho 
Published: June 2020

Abstract
Background
Hypertension remains the leading risk factor for cardiovascular disease (CVD) worldwide, and its impact in Brazil should be assessed in order to better address the issue. We aimed to describe trends in prevalence and burden of disease attributable to high systolic blood pressure (HSBP) among Brazilians ≥ 25 years old according to sex and federal units (FU) using the Global Burden of Disease (GBD) 2017 estimates.
Methods
We used the comparative risk assessment developed for the GBD study to estimate trends in attributable deaths and disability-adjusted life-years (DALY), by sex, and FU for HSBP from 1990 to 2017. This study included 14 HSBP-outcome pairs. HSBP was defined as ≥ 140 mmHg for prevalence estimates and a theoretical minimum risk exposure level (TMREL) of 110–115 mmHg was considered for disease burden. We estimated the portion of deaths and DALYs attributed to HSBP. We also explored the drivers of trends in HSBP burden, as well as the correlation between disease burden and sociodemographic development index (SDI).
Results
In Brazil, the prevalence of HSBP is 18.9% (95% uncertainty intervals [UI] 18.5–19.3%), with an annual 0.4% increase rate, while age-standardized death rates attributable to HSBP decreased from 189.2 (95%UI 168.5-209.2) deaths to 104.8 (95%UI 94.9-114.4) deaths per 100,000 from 1990 to 2017. In spite of that, the total number of deaths attributable to HSBP increased 53.4% and HSBP raised from 3rd to 1st position, as the leading risk factor for deaths during the period. Regarding total DALYs, HSBP raised from 4th in 1990 to 2nd cause in 2017. The main driver of change of HSBP burden is population aging. Across FUs, the reduction in the age-standardized death rates attributable to HSBP correlated with higher SDI.
Conclusions
While HSBP prevalence shows an increasing trend, age-standardized death and DALY rates are decreasing in Brazil, probably as results of successful public policies for CVD secondary prevention and control, but suboptimal control of its determinants. Reduction was more significant in FUs with higher SDI, suggesting that the effect of health policies was heterogeneous. Moreover, HSBP has become the main risk factor for death in Brazil, mainly due to population aging.
CERTL Reduces C16 Ceramide, Amyloid-β Levels and Inflammation in a Model of Alzheimer's Disease
Authors: Crivelli Simone Mwenda , Luo Qian , Stevens Jo , Giovagnoni Caterina , Kruining Daan van , Bode Gerard , Hoedt Sandra den , Hobo Barbara , Scheithauer Anna-Lena , Walter Jochen , Mulder Monique T , Exley Christopher , Mielke Michelle M. , De Vries Helga E , Wouters Kristiaan , Hove Daniel L.A. van den , Berkes Dusan , Ledesma María Dolores , Verhaagen Joost , Losen Mario , Bieberich Erhard , Martinez-Martinez Pilar 
Published: June 2020

Abstract
Background: Deregulation of ceramide and sphingomyelinlevels have been suggested tocontribute tothe pathogenesis of Alzheimer’s disease (AD).Ceramide transfer proteins (CERTs) are ceramide carriers, crucial for ceramide and sphingomyelin balance in cells.Extracellular forms of CERTs co-localize with amyloid-β (Aβ) plaques in AD brains. To date, the significance of these observations for the pathophysiology of AD remains uncertain.Methods: The plasmid expressing CERTL, the long isoform of CERTs, was used to study the interaction of CERTLwith amyloid precursor protein (APP) by co-immunoprecipitation and immunofluorescencein HEK cells.The recombinant CERTL protein wasemployed to study interaction of CERTLwith amyloid-β (Aβ), Aβ aggregation process in presence of CERTL, and the resulting changes inAβ toxicity in neuroblastoma cells. CERTLwas overexpressed in neurons by adeno associatedvirus (AAV) in a familial mouse model of familial AD (5xFAD). Ten weeks after transduction animal were challenged with behavior tests for memory, anxiety and locomotion. At week twelve brains were investigated for sphingolipid levels by mass spectrometry, plaques and neuroinflammation by immunohistochemistry, gene expression and/or immunoassay.Results:Here, we report that CERTL, binds to APP, modifies Aβ aggregation and reduces Aβ neurotoxicity in vitro. Furthermore, we show that intracortical injection of AAV, mediating the expression of CERTL, decreases levels of ceramide d18:1/16:0 and increases sphingomyelin levels in the brain of male transgenic mice, modelling familial AD (5xFAD). CERTLin vivo over-expression hasa mild effect on animal locomotion and decreases Aβ formation and modulates microglia by decreasing their pro-inflammatory phenotype.Conclusion: Our results demonstratea crucial role of CERTL in regulatingceramidelevels in the brain, in amyloid plaque formation and neuroinflammation,thereby opening research avenuesfor therapeutic targets of AD and other neurodegenerative diseases.
Declined Maternal GDCA is Correlated With Insulin Resistance and β-Cell Compensation in GDM: A Cross-Sectional Study in Chinese Pregnant Women
Authors: Zhu Bo , Ma Zhixin , Zhu Yuning , Fang Lei , Zhang Hong , Kong Hongwei , Xia Dajing 
Published: June 2020

Abstract
BackgroundGestational diabetes mellitus (GDM) is characterized by glycemia and insulin disorders. Bile acids (Bas) have emerged as vital signaling molecules in glucose metabolic regulation. Bas change in GDM are still unclear, it exerts great significance to illustrate the change of Bas in GDM.MethodsWe organized GDM patient (n = 67) and normal pregnant women (n = 48) around the oral glucose tolerance test (OGTT) screening period, fasting serums were collected for the measurement of Bas. Clinical data were collected and Bas metabolism profiles were analyzed in the GDM and normal glucose tolerance (NGT). Delivery characteristics, delivery gestational age and infant birthweight were abstracted from medical record to illustrate the differences among the groups.ResultsGDM patients exert the distinctive features compared with NGT, including higher BMI, glucose, insulin (both fasting and OGTT) and HbA1c levels. GDM also gained higher insulin resistance index (HOMA-IR) and decreased β-cell compensation (DIo). Total bile acids (TBA) remained stable, but glycodeoxycholic acid (GDCA) and taurodeoxycholic acid (TDCA) declined significantly in GDM. GDCA was inversely correlated with HOMA-IR and positively correlated with DIo. There exists no obvious difference in clinical outcome between GDM and NGT. However, GDM patients with high HOMA-IR and low DIo are inclined to suffering higher cesarean delivery rate and earlier delivery gestational age. ConclusionsGDM with significantly increased insulin resistance and declined DIo elevated the worse clinical outcome, GDCA could be a valuable biomarker to evaluate insulin resistance and DIo in GDM.
Original study Postoperative Urinary Retention: Risk Factors, Speed of Bladder Filling and Time of Catheterization: An Observational Study as Part of a Randomized Controlled Trial
Authors: Brouwer Tammo Allie , Roon Eric N van , Kalkman Cor J , Veeger Nic 
Published: June 2020

Abstract
Background If risk factors for postoperative urinary catheterization are known adverse events to the lower urinary tract may be prevented. Therefore, postoperative surgical patients were assessed for risk factors for urinary catheterization, for speed of bladder filling and for time till catheterization or spontaneous voiding. The individual maximum bladder capacity was used as threshold for urinary catheterization. Methods In this prospective observational study 936 general surgical patients were analyzed for risk factors for urinary catheterization. Patients were 18 years or older and were operated under general or spinal anesthesia without the need for an intra-operative indwelling urinary catheter. The maximum bladder capacity was measured at home by voiding in a calibrated bowl after a strong urge that could no longer be ignored. Postoperatively bladder volumes were hourly assessed with ultrasound. Patients were catheterized after reaching their maximum bladder capacity and being unable to void. Speed of bladder filling and time to catheterization were then calculated. Results Spinal anesthesia was the main independent modifiable risk factor for urinary catheterization (hyperbaric bupivacaine RR 8.1, articaine RR 3.1). Unmodifiable risk factors were a maximum bladder capacity <500mL (RR 6.7), duration of surgery ≥60 minutes (RR 5.5), first scan at Post Anesthesia Care Unit ≥250mL (RR 2.1) and age ≥60 (RR 2.0). Urine production varied between 100mL to 200mL/hour. Catheterization or spontaneous voiding happened around 4 hours postoperatively. Conclusion Using the individual maximum bladder capacity, next to the other risk factors, identifies patients at risk for urinary catheterization. These factors should be taken in account whether or not to catheterize the patient to prevent unnecessary urinary catheterization. Considering urine production and maximum bladder capacities, the bladder should be scanned at least within 3 hours postoperatively to prevent overdistention and damage to the lower urinary tract.
Early Epidemiological Features and Trends of the COVID-19 Outbreak in Southeast Asia: a Population-Level Observational Study
Authors: Zhu Mingjian , Jirapat Kleepbua , Shen Jian , Chew Sien Ping , Tan Joanna Wei Hui , Latthitham Natthjija , Li Lanjuan 
Published: June 2020

Abstract
Background: The global outbreak of coronavirus disease 2019 (COVID-19) has been ongoing in Southeast Asia since 13 January 2020. To guide intervention strategies and summarize beneficial experience, we describe the early epidemiological features and evaluate the trends of the COVID-19 outbreak in Southeast Asia.

Methods: In this population-level observational study, we compiled a list of individual patients with COVID-19 and daily country-level case counts between 13 January 2020 and 16 March 2020 in Southeast Asia. Relevant spatiotemporal distributions, demographic characteristics and short-term trends were assessed.

Results: A total of 1,346 confirmed cases of COVID-19 with 217 (16.1%) recoveries and 18 (1.3%) deaths were reported in Southeast Asia as of 16 March 2020. The early transmission dynamics was fit with an exponential regression model: y=0.30e0.13x (p<0·01, adjusted R2 = 0.96). Using this model, we predicted that the cumulative number of reported COVID-19 cases in Southeast Asia would exceed 10,000 by early April 2020. A total of 74 cities across 8 countries in Southeast Asia were affected by COVID-19 and most of the confirmed cases were located in 5 international metropolitan areas. Demographic analysis conducted on 925 confirmed cases indicated a median age of 44 years and a sex ratio of 1.25. Median age of local patient population was significantly higher than that of general population in corresponding country (p<0·01), whereas sex ratio did not significantly differ.

Conclusions: The situation of COVID-19 endemic in Southeast Asia is intricate and not optimistic in the short-term. Dynamic disease surveillance and targeted intervention strategies are urgent.
A nomogramic model based on clinical and laboratory parameters at admission for predicting the survival of COVID-19 patients
Authors: Ma Xiaojun , Wang Huifang , Huang Junwei , Geng Yan , Jiang Shuqi , Zhou Qiuping , Chen Xuan , Hu Hongping , Li Weifeng , Zhou Chengbin , Gao Xinglin , Peng Na , Deng Yiyu 
Published: June 2020

Abstract
Background and Aim

COVID-19 has become a major global threat. The present study aimed to develop a nomogram model to predict the survival of COVID-19 patients based on their clinical and laboratory data at admission.

Methods

COVID-19 patients who were admitted at Hankou Hospital and Huoshenshan Hospital in Wuhan, China from January 12, 2020 to March 20, 2020, whose outcome during the hospitalization was known, were retrospectively reviewed. The categorical variables were compared using Pearson’s χ2-test or Fisher’s exact test, and continuous variables were analyzed using Student’s t-test or Mann Whitney U-test, as appropriate. Then, variables with a P-value of ≤0.1 were included in the multivariate model, and merely these independent risk factors were used to establish the nomogram model. The discrimination of the nomogram was evaluated using the area under the receiver operating characteristic curve (AUC), and internally verified using the Bootstrap method.

Results

A total of 262 patients (134 surviving and 128 non-surviving patients) were included in the analysis. Seven variables, which included age (odds ratio [OR]: 0.905, 95% confidence interval [CI]: 0.868-0.944; P<0.001), chronic heart disease (CHD, OR: 0.048, 95% CI: 0.013-0.180; P<0.001), the percentage of lymphocytes (Lym%, OR: 1.116, 95% CI: 1.051-1.184; P<0.001), platelets (OR: 1.008, 95% CI: 1.003-1.012; P=0.001), C-reaction protein (OR: 0.982, 95% CI: 0.973-0.991; P<0.001), lactate dehydrogenase (LDH, OR: 0.993, 95% CI: 0.990-0.997; P<0.001) and D-dimer (OR: 0.734, 95% CI: 0.615-0.875; P=0.001), were identified as the independent risk factors. The nomogram model based on these factors exhibited a good discrimination, with an AUC of 0.948 (95% CI: 0.923-0.973).

Conclusion

A nomogram based on age, CHD, Lym%, platelets, C-reaction protein, LDH and D-dimer was established to accurately predict the prognosis of COVID-19 patients. This can be used as an alerting tool for clinicians to take early intervention measures, when necessary.