bluuebunny/crossref_metadata_2025_split huggingface dataset:
Performance of The Modified Heart Score In An Asian Population
Authors: Sajeed Shanaz , De Dios Michael , Jun Dan Ong Wei , Punyadasa Amila Clarence 
Published: April 2020

Abstract
INTRODUCTION Chest pain is the most common potentially life threatening presentation to the emergency department (ED). Furthermore, the identification of acute coronary syndrome (ACS) including its risk stratification and subsequent disposition can be challenging. The original HEART score was derived as a predictive tool to risk stratify patients presenting with undifferentiated chest pain (CP) and aid physician decision-making. However, it utilized conventional Troponins as its cardiac biomarker component. Our study aims to assess the utility of the modified HEART score with highly sensitive troponins in an Asian setting with mixed ethnicity to determine if it corroborates the findings of the another recent Chinese study by Chun-Peng MA et al[7]. METHODS Clinical data from 413 patients presenting to the ED for evaluation of chest pain were analyzed. The predictive value of the modified HEART score for determining MACE was then evaluated. RESULTS 49 patients (11.9%) had a MACE: 31 patients (7.5%) underwent PCI, and 1 patient (0.2%) underwent CABG. There were 17 (4.1%) deaths. Three risk groups were elucidated based on MACE. In the low risk group (0-2), there were 72 patients (17.4%), with a MACE rate of 1.4%. In the intermediate risk group (3-5), there were 233 patients (56.4%), with a MACE rate of 5.2%. In the high risk group (6-10), there were 108 patients (26.2%), with a MACE rate of 33.3%. CONCLUSION The modified HEART score is an effective risk stratification tool in an ethnically diverse Asian population. Furthermore, it identifies low risk patients who are candidates for early discharge from a local emergency department.
Corneal biomechanical properties in myopic eyes evaluated via Scheimpflug imaging
Authors: Yu A-Yong , Shao Hui , Pan Anpeng , Wang Qinmei , Huang Zixu , Song Benhao , McAlinden Colm , Huang Jinhai , Chen Sisi 
Published: April 2020

Abstract
Background To investigate the biomechanical properties of the cornea in myopic eyes using corneal visualization scheimpflug technology (Corvis ST). The relationships between the biomechanical properties of the cornea and the degree of myopia were also investigated.Methods 265 eyes of 265 subjects were included. According to spherical equivalent (SE) in diopters (D), participants were divided into four groups: low myopia/control group (SE: -0.50 to -3.00D), moderate myopia group (SE: -3.00 to -6.00D), high myopia group (SE: -6.00 to -10.00D) and severe myopia group (SE greater than -10.00D). Axial length (AL), anterior segment parameters, and corneal biomechanical properties were obtained with the Lenstar LS900, Pentacam HR and Corvis ST, respectively. Results Mean (±SD) SE was -7.29±4.31D (range: -0.63 to -25.75D). Mean AL was 26.31±1.82mm (range: 21.87 to 31.94mm). Significant differences were detected within the four groups in terms of six corneal biomechanical parameters: deformation amplitude (DA), time from start until second applanation (A2-time), length of flattened cornea at the second applanation (A2-length), corneal velocity during the first and second applanation (A2-velocity), time from start to highest concavity (HC-time), and central curvature at highest concavity (HC radius). DA was positively correlated with AL ( r =0.16, P =0.009) and negatively correlated with SE ( r =-0.20, P =0.001). A2-time, A2-velocity, A2-length and HC-time were positively correlated with SE and negatively correlated with AL.Conclusions The alterations in corneal biomechanics may be associated with the degree of myopia. DA and A2-velocity may be useful corneal biomechanical indicators in patients with myopia.
Prognostic and clinical significance of long non-coding RNA SNHG12 expression in various cancers
Authors: Zhang Chenghao , Tu Chao , Ren Xiaolei , Zhang Wenchao , He Lile , Qi Lin , Chen Ruiqi , Li Zhihong 
Published: April 2020

Abstract
Background: Recently, dysregulation of lncRNA SNHG12 has been determined in kinds of cancers. However, definite prognostic value of SNHG12 remains unclear. We conducted this meta-analysis to evaluate the association between SNHG12 expression levels and caner prognosis.Methods: A literature retrieval was conducted by searching kinds of databases. The meta-analysis of prognostic and clinicopathological parameters was performed by using Revman 5.2 and Stata 12.0 software. Besides, The Cancer Genome Atlas dataset was analyzed to validate the results in our meta-analysis via using Gene Expression Profiling Interactive Analysis.Results: High SNHG12 expression significantly predicted worse overall survival (HR=1.97, 95%CI 1.56-2.48, P<0.01) and recurrence-free survival (HR=1.71, 95%CI 1.05-2.78, P<0.01). Tumor type, sample size, survival analysis method, and cut-off value did not alter SNHG12 prognosis value according to stratified analysis results. Additionally, patients with elevated SNHG12 expression were more prone to unfavorable clinicopathological outcomes, including larger tumor size, lymph node metastasis, distant metastasis, advanced clinical stage. Online cross-validation in TCGA dataset further proved that cancer patients with upregulated SNHG12 expression had worse overall survival and disease-free survival.Conclusion: Elevated SNHG12 expression was associated with poor survival and unfavorable clinicopathological features in various cancers, and therefore might be a potential prognostic biomarker in human cancers.
Asthma and Keratoconus: An analysis of the risk factors association with the severity of keratoconus
Authors: Sahebjada Srujana , Chan Elsie , Xie Jing , Snibson Grant , Daniel Mark , Baird Paul 
Published: April 2020

Abstract
Background: A cross-sectional study was undertaken in Australia to explore a wide range of risk factors associated with keratoconus. A questionnaire addressing age, gender, educational background, ocular and medical history, smoking and alcohol consumption, and physical examination comprising anthropometric measurements was collected; eye examination was undertaken. The associations between a range of risk factors and keratoconus was determined using univariate and multivariable linear regression analyses.Main Text: A total of 260 keratoconus subjects were included in this study. Mean age of subject was 35.5 (SD= 14.8) years and the majority of the subjects were European 171 (68.2%). Initial univariate regression analysis identified the following risk factors at the p<0.1 level with keratoconus: higher body mass index, smoking cigarettes, diabetes, rheumatoid arthritis and asthma were associated with increased severity of keratoconus, whereas eczema was associated with less severe keratoconus. Following multivariable regression analysis, only asthma remained as a significant risk factor associated with 2.2 diopters (D) steeper average mean keratometry compared to keratoconus subjects having no asthma [p = 0.03; β= 2.18; 95% confidence intervals: 1.22, 4.14].Conclusion: Our study describes the comprehensive assessment of all the known risk factors in a large keratoconus cohort recruited in Australia. Our study has reported asthma as the only risk factor found to be significantly associated with keratoconus. The results of this study allow us to better understand the aetiology of keratoconus and such a knowledge could be useful in instigate systemic management of patients to slow or prevent keratoconus.
Design a Novel Integrated Screw for Minimally Invasive Atlantoaxial Anterior Transarticular Screw Fixation: A Finite Element Analysis
Authors: Zhang YingKai , Li Cheng , Li Lei , Sun Yanyan , Li Zeqing , Mei Yunli , Feng Xinyuan 
Published: April 2020

Abstract
Purpose : To design a new type of screw for minimally invasive atlantoaxial anterior transarticular screw (AATS) fixation with a diameter that is significantly thicker than that of traditional screws, threaded structures at both ends, and a porous metal structure in the middle. The use of a porous metal structure can effectively promote bone fusion and compensate for the disadvantages of traditional AATSs in terms of insufficient fixation strength and difficulty of bone fusion. The biomechanical stability of this screw was verified through finite element analysis. This instrument may provide a new surgical option for the treatment of atlantoaxial disorders. Methods: According to the surgical procedure, the new type of AATS was placed in a three-dimensional atlantoaxial model to determine the setting of relevant parameters such as the diameter, length, and thread to porous metal ratio of the structure. A finite element model of the upper cervical vertebrae was established, and the validity of the model was verified. Then, finite element-based biomechanical analysis was performed using three models, i.e., atlantoaxial posterior pedicle screw fixation, traditional atlantoaxial AATS fixation, and atlantoaxial AATS fixation with the new type of screw, and the biomechanical effectiveness of the novel AATS was verified. Results: By measuring the atlantoaxial parameters, the design parameters of the new screw were determined as follows: diameter, 6-7 mm; length of the head thread structure, 8-10 mm; length of the middle porous metal structure, 8 mm (a middle porous structure containing an annular cylinder with an outer diameter of 3 mm and an inner diameter of 1 mm, which facilitated the placement of the guide wire); length of the tail thread structure, 6-8 mm; and total length, 22-26 mm.Apply the same load conditions to the atlantoaxial complex along different directions in the established finite element models of the three types of atlantoaxial fusion modes, the immediate stability of the new AATS is similar with Atlantoaxial posterior pedicle screw fixation.They are both superior to traditional atlantoaxial anterior screw fixation.The maximum local stress on the screw head in the atlantoaxial anterior surgery were less than those of traditional atlantoaxial anterior surgery. Conclusions : By measuring relevant atlantoaxial data, we found that screws with a larger diameter can be used in AATS surgery, and the new AATS can make full use of the atlantoaxial lateral mass space and increase the stability of fixation. The finite element analysis and verification revealed that the biomechanical stability of the new AATS was superior to the AATS used in traditional atlantoaxial AATS fixation. The porous metal structure of the new AATS may promote fusion between atlantoaxial joints and allow more effective bone fusion in the minimally invasive anterior approach surgery.
Locked in permanent employment – longitudinal associations with depressive and functional somatic symptoms
Authors: Virtanen Pekka , Hammarström Anne , Janlert Urban 
Published: April 2020

Abstract
Background Rapidly changing industrial structures evidently increase individuals’ perceptions of not being in the preferred job, and also being ‘locked’ in the current post. The research on longitudinal associations of such locked-in situations with mental health is still scant, and there are controversial findings. The present study explored five hypotheses about mental health as a precedent and an outcome of different locked-in situations among permanently employed individuals. Methods Survey data on depressive and functional somatic symptoms from age 16 to 43 and on locked-in situations (permanently employed in non-preferred job) at age 30 and age 43 were collected from 479 participants of the Northern Swedish Cohort Study. Based on these two measurements, the locked-in history was classified as ‘never’ (not locked-in at both ages), ‘early’ (locked-in at age 30 only), ‘late’ (locked-in at age 42 only) and ‘long’ (locked-in at both ages). Analysis of variance for repeated measures was used to compare the changes in mental health of the four subcohorts defined by the locked-in history. Results Earlier evidence on the cross-sectional association between feeling locked-in and having poor mental health was confirmed. Longitudinal analyses revealed that those with poor baseline mental health at age 16 tend to get into a locked-in situation in the early middle age, that getting out of a locked-in situation in is associated with improving and getting into a locked-in situation is associated with worsening mental health, and that the worsening is more pronounced and the improvement less pronounced in white-collar than in blue-collar employees. Conclusions The findings clarify the bidirectional causal associations between locked-in situation and poor mental health, as well as the importance of common methods bias and social class in studying these associations. With respect to labour policy, locked-in perceptions could be reduced by means of labour legislation, collective agreements and human resource management that enable smooth transitions between workplaces and occupations. Key terms permanent employment; ANOVA for repeated measurements; occupational class
How do private practitioners in Pakistan manage children suspected having tuberculosis?
Authors: Yaqoob Aashifa , Hinderaker Sven , Fatima Razia , Najmi Hina , Haq Anwar 
Published: April 2020

Abstract
Background: Private providers provide a large portion of health care in Pakistan, including tuberculosis (TB). All TB patients are supposed to be reported to the National Tuberculosis Program (NTP), which provides drugs free of charge in addition to monitoring, supervision and support. It is difficult to confirm the diagnosis of TB in children. We aimed to assess the private health care provider investigation practices and management of childhood TB. Methods: This cross sectional study was based on a national survey that measured under-reporting of children with TB in 12 selected districts in Pakistan from Apr-Jun, 2016. We explored the practices of private health care providers involved in the diagnosis of TB in children under 15 years for investigating and managing children suspected having TB, like general practitioners, pediatricians, pulmonologists and chest specialists. Results: Among 6519 presumptive child TB cases, a total of 5193(79.7%) children under the age of 15 years were diagnosed as TB by private health care providers during second quarter, 2016. Out of all diagnosed TB cases, only 187(3.6%) were notified to NTP. The majority of presumptive child TB cases reported cough, fever, and failure to thrive; few had TB contacts with pulmonary TB patients. For further diagnostic tests, private providers relied on chest X-ray in 41.7% of 0-4 years and 48.2% of 5-14 years. Utilization of Tuberculin skin test and Gene-Xpert MTB/RIF testing was very low. Bacteriological confirmation was present in 9.6%, and clinical assessment was the only basis for diagnosis in 39.3%. Of children with presumptive TB, 3121(47.9%) cases were referred for diagnosis and 2443(37.5%) were referred after diagnosis for treatment; among all the referred, 3812(68.5%) were sent for investigations to District TB Centre(NTP). Conclusion: This study showed that many private providers referred children suspected having TB to laboratories for further diagnosis, but cases identified in investigations were often not notified to the NTP. This problem needs to be resolved by strengthening the referral linkages between private health providers, NTP laboratories and treatment centres through capacity building and training of their staff.
Relationships between menstrual status and obesity phenotypes in women : a cross-sectional study in northern China
Authors: Chen Xueyu , Liu Huamin , Liu Weihua , Chen Yanru , Wang Xiaohui , Zhang Wenran , Shi Fengxue , Sui Xinxia , Wang Xiaojun , Zhang Haitao , Ji Long , Xi Hui , Li Dong 
Published: April 2020

Abstract
Background: One of most important concerns of postmenopausal women is obesity. The relationships between menstruation status and different obesity phenotypes are unclear.This study aimed to assess the associations between menstrual status and different obesity phenotypes in women. Methods: In total, 5373 women aged ≥40 years were recruited from the Jidong and Kailuan communities. Basic information was collected via clinical examination, laboratory testing and standardized questionnaires. The women were stratified into the following three groups: menstrual period, menopausal transition period and postmenopausal period. General obesity was defined as a body mass index (BMI) of >30 kg/m 2 . Central obesity was defined as a waist-to-hip ratio (WHR) of > 0.85. Visceral obesity was defined as the presence of nonalcoholic fatty liver disease (NAFLD) and increased pericardial fat volume (PFV). Results: The numbers of women in the menstrual, menopausal transition, and postmenopausal periods were 2807 (52.2%), 675 (12.6%) and 1891 (35.2%), respectively. The adjusted odds ratio (OR) and 95% confidence interval (CI) for central obesity among women in the menopausal transition and postmenopausal periods compared with women in the menstrual period were 1.34 (0.87-2.05) and 0.87 (0.57-1.33), respectively. The OR for NAFLD among postmenopausal women was 1.78 (1.44-2.20). The adjusted β-coefficient (standard error, SE) for PFV among postmenopausal women was 41.25 (SE=7.49). The adjusted OR for general obesity among postmenopausal women was 0.87 (0.57-1.33). Conclusions: This study demonstrated that menopause is an independent risk factor for central and visceral obesity but not general obesity.
A family of partial-linear single-index models for analyzing complex environmental exposures with continuous, categorical, time-to-event, and longitudinal health outcomes
Authors: Wang Yuyan , Wu Yinxiang , Jacobson Melanie , Lee Myeonggyun , Jin Peng , Trasande Leonardo , Liu Mengling 
Published: April 2020

Abstract
Background: Statistical methods to study the joint effects of environmental factors are of great importance to understand the impact of correlated exposures that may act synergistically or antagonistically on health outcomes. This study proposes a family of statistical models under a unified partial-linear single-index (PLSI) modeling framework, to assess the joint effects of environmental factors for continuous, categorical, time-to-event, and longitudinal outcomes. All PLSI models consist of a linear combination of exposure factors into a single index for practical interpretability of relative direction and importance, and a nonparametric link function for modeling flexibility. Methods: We presented PLSI linear regression and PLSI quantile regression for continuous outcome, PLSI generalized linear regression for categorical outcome, PLSI proportional hazards model for time-to-event outcome, and PLSI mixed-effects model for longitudinal outcome. These models were demonstrated using a dataset of 800 subjects from NHANES 2003-2004 survey including 8 environmental factors. Serum triglyceride concentration was analyzed as a continuous outcome and then dichotomized as a binary outcome. Simulations were conducted to demonstrate the PLSI proportional hazards model and PLSI mixed-effects model. The performance of PLSI models was compared with their counterpart parametric models. Results: PLSI linear, quantile, and logistic regressions showed similar results that the 8 environmental factors had both positive and negative associations with triglycerides, with a-Tocopherol having the most positive and trans-b-carotene the most negative association. For the time-to-event and longitudinal settings, simulations showed that PLSI models could correctly identify directions and relative importance for the 8 environmental factors. Compared with parametric models, PLSI models got similar results when the link function was close to linear, but clearly outperformed in simulations with nonlinear effects. Conclusions: We presented a unified family of PLSI models to assess the joint effects of exposures on four commonly-used types of outcomes in environmental research, and demonstrated their modeling flexibility and effectiveness, especially for studying environmental factors with mixed directional effects and/or nonlinear effects. Our study has expanded the analytical toolbox for investigating the complex effects of environmental factors. A practical contribution also included a coherent algorithm for all proposed PLSI models with R codes available.
Kinesin superfamily protein 21B acts as an oncogene in non-small cell lung cancer
Authors: Sun Zhi-Gang , Pan Feng , Shao Jing-Bo , Yan Qian-Qian , Lu Lu , Zhang Nan 
Published: April 2020

Abstract
Background Kinesin superfamily proteins (KIFs) serve as microtubule-dependent molecular motors, and are involved in the progression of many malignant tumors. In this study, we aimed to investigate the expression pattern and precise role of KIF21B in non-small cell lung cancer (NSCLC). Methods KIF21B expression in 72 cases of NSCLC tissues was measured by immunohistochemical staining (IHC). We used shRNA-KIF21B interference to silenced KIF21B in NSCLC cells. The biological roles of KIF21Bin the growth and metastasis abilities of NSCLC cells were measured by CCK8, colony formation and Hoechst/PI, wound-healing, and Transwell assays. The effect of KIF21B on tumor growth in vivo was examined using nude mice model. Results KIF21B was up-regulated in NSCLC tissues and correlated with pathological lymph node and pTNM stage, its high expression was predicted a poor prognosis of patients with NSCLC. Silencing of KIF21B mediated by lentivirus-delivered shRNA significantly inhibited the proliferation ability of H1299 cells. Moreover, KIF21B knockdown increased H1299 cell apoptosis through modulating the Bcl-2/Bax and active Caspase 3 expression. KIF21B knockdown decreased p-Akt expression and Cyclin D1 expression in H1299 cells. In addition, silencing of KIF21B impeded H1299 cell migration and invasion. Further, silencing of KIF 21B dramatically inhibited xenograft growth in BALB/c nude mice. Conclusions These results reveal that KIF21B is up-regulated in NSCLC and acts as an oncogene in the NSCLC progression.
Social and environmental risk factors for accidental drowning of children under five in China
Authors: Author) Meixian Wang(Former Corresponding , Liu Yuxi , Kang Leni , He Chunhua , Miao Lei , Huang Jianwen , He Xiaoyan , Zhu Jun , Liang Juan , Li Qi , Author) Yanping Wang(New Corresponding , Liu Hanmin 
Published: April 2020

Abstract
Background: Accidental drowning of children under five is a serious problem in China. This study analyzed data on environmental, sociodemographic factors, and primary caregivers of drowned children in order to understand factors that may contribute to this problem. Methods: This study collected information on 563 cases of drowning that appears involving children under five from October 1, 2015 to September 30, 2016 in 334 sampling districts in China. Primary caregivers were interviewed one-on-one based on the Drowning Mortality among Children under 5 Questionnaire. Results: The majority of drowned children under five years old were boys, and 71.58% lived within 100 m of a water body. The drownings occurred mainly in ponds, canals, rivers, and wells, while over 90% of these water bodies had no safety measures. There were 28.06% of primary caregivers did not provide full-time care for the children, and 83.13% of them had no knowledge of first aid skills for drowning. Conclusion: Encouraging kindergarten enrollment and providing safety education for children may reduce drowning among children under five years of age. Public water body protection measures should be strengthened to prevent children from drowning. Encouraging primary caregivers to care full-time for their children，and learning first aid skills against drowning could also help reduce fatalities.