bluuebunny/crossref_metadata_2025_split huggingface dataset:
Women’s satisfaction and its’ associated factors on institutional delivery services provided by public health facilities of Tanahun district, Nepal
Authors: Pokhrel Amritraj , Yadav Dipendra , Sharma Prabin 
Published: July 2020

Abstract
Background Institutional delivery is one of the important strategies to reduce the maternal related risk at the time of delivery. Satisfaction of women on labor and delivery care services has good influence on their health and results in subsequent utilization of health services. This study was focused to assess women’s satisfaction and its’ associated factors with institution delivery services in public health institutions.Methods Cross- sectional study was conducted among 169 participants from June 2018 to November 2018 among women (having under one year children) residing in Tanahun district. Simple random sampling, face to face interview and semi structured interview schedule was used for the collection of data. Data were entered in Epi-Data and analyzed by SPSS. Ethical approval was obtained from Institutional Review Committee at Pokhara University and maintained during the process of research.Results The age of the participants were between 16 to 40 years with median age 25 years (IQR = 7 Years). Most (93.5%) of the participants were Hindu. Majority of the participants (57.4%) and their husbands (60.4%) had secondary level education. Almost all pregnancies (99.4%) are planned and normal delivery was most common (77.5%). The study shows that 55% of the women performed delivery in public health facilities. The study states high satisfaction score in health status of women after delivery (4.8) and lowest in availability of visitor's bed (2.99). Women's satisfaction and religion was seen to be significantly associated.Conclusion Majority of the participants were satisfied with the services provided by public health facilities. Although, number of birthing centers were increasing, facilities in the health institution is not sufficient as required. Different factors such as cleanliness of delivery room, availability of staffs, medicine, visitor's bed and behavior of staff are some issues to be improved.
Cisplatin induces acute kidney injury and pyroptosis in mice through the exosome miR-122/ELAVL1 regulatory axis
Authors: Zhu Bei , Ye Xiaoshuang , Gao Fei , Bai Yun , Chan Zhouyi , Guo Lulu , Pei Xiaohua , Yong Zhenzhu , Zhao Weihong 
Published: July 2020

Abstract
Background

Although cisplatin is an effective chemotherapeutic drug for the treatment of various cancers, its clinical application is limited due to its side effects, especially nephrotoxicity. Unfortunately, Acute kidney injury (AKI) caused by cisplatin remains one of the main obstacles to cancer treatment. Increasing evidence suggests that renal inflammation and pyroptotic inflammatory cell death of tubular epithelial cells (RTECs) mainly determine the progression and outcome of cisplatin-induced AKI. However, it is not clear how cisplatin regulates the pyroptosis of RTECs cells in AKI. The current study aimed to determine the regulation mechanism of AKI induced by cisplatin. In vivo, cisplatin was used to induce AKI. H&E staining of mouse kidney tissue sections and serological indicators of kidney injury (including BUN, serum creatinine and TNF-α) were detected. The important substrate protein GSDMD and key target caspase-1 of pyroptosis were detected by immunohistochemistry and western blot, respectively. In vitro, cisplatin significantly induces HK-2 cells pyroptosis. Furthermore, Cisplatin transmits HK2 cells pyroptosis signals to surrounding cells in the form of exosomes. Previous studies have shown that exosomes are involved in kidney physiology and the pathogenesis of various kidney diseases/disorders. MicroRNAs (miRNAs) are the main functional components of exosomes.
Results

Further research shows that exosome miR-122 negatively regulates the pyrolysis of HK2 cells. Finally, we elucidated that exosome miR-122 participates in cisplatin induced AKI regulation by regulating ELAVL1 expression.
Conclusions

In conclusion, these results suggest that exosome miR-122 inhibits pyroptosis and AKI by targeting ELAVL1 under cisplatin treatment, which will provide a potential target for the treatment of AKI.
Induction of liver transplant immune tolerance in an outbred rat strain model using tacrolimus Subtitle: Therapeutic effect of tacrolimus in rat orthotopic liver transplantation models
Authors: Park Min-Jung , Na Hyun Sik , Joo Young-Shin , Cho Keun-Hyung , Kim Se-Young , Choi Jeong Won , Baek Jin-Ah , Choi Jong Young , You Young-Kyoung , Cho Mi-La 
Published: July 2020

Abstract
Background: Orthotopic liver transplantation is the only option for patients with end-stage liver disease and hepatocellular carcinoma. Acute rejection occurs in 25–50% of all recipients after liver transplantation. Thus, post-transplant immunosuppressive therapy is important to prevent graft failure. Tacrolimus (FK506) is a main immunosuppressive drug used after liver transplantation. Methods: FK506 and postoperative therapy were administered subcutaneously once or twice daily to transplanted rats. Histopathological and immunohistochemical analyses were conducted for all groups. The regulation of inflammatory cytokine signaling in the spleen was analyzed by flow cytometry. Results: FK506 attenuated allograft rejection and increased survival in rat orthotopic liver transplantation models. The FK506-treated group had reduced serum levels of AST, ALT, and ALP. Furthermore, FK506 decreased the expression of inflammatory cytokines and the activation of pathogenic Th1 and Th17 cells in the liver. Conclusions: These results indicate that the FK506 has potential as a therapeutic drug following liver transplantation.
Are HE4 and CA 125 suitable to detect a Paget disease of the vulva?
Authors: Dellino Miriam , Gargano Giulio , Carriero Carmine , Minoia Carla , Skrypets Tetania , Silvestris Erica , Loizzi Vera , Paradiso Angelo , Casamassima Porzia , Tufaro Antonio , Cormio Gennaro , Garrisi Vito Michele 
Published: July 2020

Abstract
Background: Paget disease is a rare neoplasia, most commonly diagnosed in postmenopausal women and which can be identified in the breast (mammary Paget disease) or in other locations (extramammary Paget’s disease) such as ano-genital skin (Paget disease of the vulva -PVD). This condition is associated with low mortality, but a late diagnosis and recurrence can negatively impact the prognosis. Therefore, the main objective of this study is to evaluate if the human epididymis protein 4 (HE4) and cancer antigen125 (CA125) can promote recognition of PVD in early stages and during the relapses.Materials and Methods: we have conducted a prospective, observational and laboratory-based study, that included 50 patients, whose 25 healthy women represented the control group and 25 PVD patients, which have been operated in our Oncology Institute, from May 2017 to September 2019. Both in control group and in PVD patients, the CA-125 and HE4 were evaluated before surgery and after 6 months. Finally, a comparison of markers serum level, both between before/after surgery and with control group, and a ROC (Receiver Operating Characteristic) curve were performed.Results: Dosing the markers in PVD patients, 3/25 (12%) showed a higher value of CA125 and 11/25 (44%) an increased HE4. In addition, after surgical treatment there were no statistically significant difference between levels of CA-125 (p= 0.3) and HE4 (p=0.19). On the other hand, comparing HE4 in PVD patients with the control group, a statistically significant difference was found (p-value= 0.0036). Contrary, comparing CA-125 in PVD patients with the control group (p-value= 0.1969), no statistically significant difference was evidenced. Moreover, ROC (Receiver Operating Characteristic) curve showed low sensitivity and specificity for CA125 with area under curve (AUC) =0.5608. Instead, the ROC curve of HE4 revealed a sensitivity and specificity of 76% and 88% respectively (AUC= 0.7408) using a cut-off at 90 pmol/L.Conclusions: Despite the limited cases, our data showed that CA125 is not a sensitive marker for PVD. On the other hand, in 44% of PVD we’ve seen an increase in HE4. So, this could be a starting point for further research that could confirm the possibility to use this marker in order to support PVD early identification.
Targeting the eCIRP/TREM-1 Interaction with a Small Molecule Inhibitor Improves Cardiac Dysfunction in Neonatal Sepsis
Authors: Denning Naomi-Liza , Aziz Monowar , Diao Li , Prince Jose M , Wang Ping 
Published: July 2020

Abstract
Background: Neonatal sepsis and the associated myocardial dysfunction remain a leading cause of infant mortality. Extracellular cold-inducible RNA-binding protein (eCIRP) acts as a ligand of triggering receptor expressed on myeloid cells-1 (TREM-1). M3 is a small CIRP-derived peptide that inhibits the eCIRP/TREM-1 interaction. We hypothesize that the eCIRP/TREM-1 interaction in cardiomyocytes contributes to sepsis-induced cardiac dysfunction in neonatal sepsis, while M3 is cardioprotective. Methods: Serum was collected from neonates in the Neonatal Intensive Care Unit (NICU). 5-7-day old C57BL/6 mouse pups were used in this study. Primary murine neonatal cardiomyocytes were stimulated with recombinant murine (rm) CIRP with M3. TREM-1 mRNA and supernatant cytokine levels were assayed. Mitochondrial oxidative stress, ROS, and membrane potential were assayed. Neonatal mice were injected with rmCIRP and speckle-tracking echocardiography was conducted to measure cardiac strain. Sepsis was induced by i.p. cecal slurry. Mouse pups were treated with M3 or vehicle. After 16 h, echocardiography was performed followed by euthanasia for tissue analysis. A 7-day survival study was conducted. Results: Serum CIRP levels were elevated in septic human neonates. rmCIRP stimulation of cardiomyocytes increased TREM-1 gene expression. Stimulation of cardiomyocytes with rmCIRP upregulated TNF-α and IL-6 in the supernatants, while this upregulation was inhibited by M3. Stimulation of cardiomyocytes with rmCIRP resulted in a reduction in mitochondrial membrane potential (MMP) while M3 treatment returned MMP to near baseline. rmCIRP caused mitochondrial calcium overload; this was inhibited by M3. rmCIRP injection impaired longitudinal and radial cardiac strain. Sepsis resulted in cardiac dysfunction with a reduction in cardiac output and left ventricular end diastolic diameter. Both were improved by M3 treatment. Treatment with M3 attenuated serum, cardiac, and pulmonary levels of pro-inflammatory cytokines compared to vehicle-treated septic neonates. M3 dramatically increased sepsis survival. Conclusions: Inhibition of eCIRP/TREM-1 interaction with M3 is cardioprotective, decreases inflammation, and improves survival in neonatal sepsis. Trial registration: Retrospectively registered.
Ultrasound image patterns right after birth can predict healthy neonates – a nested case-control study
Authors: Xi Guannan , Dai Jiale , Wang Xuefeng , Luo Fei , Lu Chenggqiu , Yang Yun , Wang Jimei 
Published: July 2020

Abstract
Background Lungultarsound(LUS) is widely used to diagnose neonatal lung diseases, yet image patterns on intrauterine to extrauterine stage(right after birth), of which impairment is well related to lung disease, remains unclear. Objectives To identify these image patterns that can distinguish healthy infants from infants with lung disease.Methods This is a nested case-control study in a top-ranking obstetrics hospital in China, between 1 January 2020 to 1 April 2020. Infants transferred to the NICU after birth who had LUS obtained at 0.5, 1, 2, 4, 6 hours time intervals were enrolled. Confirmed by 3-day follow-up, case and control groups contains 22 patients and 473 healthy infants. Their GA ranges from 33.5 to 41.0 weeks. A newly designed protocol was used to capture the LUS image. The image patterns and their variations were shown and categorized as high and low-risk groups. The predictive value for healthy infants and patients were calculated. Rsults Low-risk patterns, accompanied with no high-risk ones, typically appeared in healthy infants (specificity=86.4%, PPV=99.0%), whereas four high-risk patterns could be seen in both healthy infants and patients (specificity=62.4%, PPV=9.6%). High-risk patterns were more likely to be pathological signs when appearing at the oxter and lower back and to be physiological signs when appearing at the prothorax. Conclusions LUS is valid to differentiate healthy infants from potential patients shortly after birth. Infants with low-risk patterns only are highly likely to be healthy, whereas infants with high-risk patterns have a risk for respiratory issues but need prolonged monitoring to confirm.
Cumulative oxygen deficit is a novel biomarker for the timing of invasive mechanical ventilation in COVID-19 patients with respiratory distress: a time-dependent propensity score analysis
Authors: Ge Huiqing , Zhou Jiancang , Lv Fangfang , Zhang Junli , Yi Jun , Yang Changming , Zhang Lingwei , Zhou Yuhan , Pan Qing , Zhang Zhongheng 
Published: July 2020

Abstract
Background and objectives: The timing of invasive mechanical ventilation (IMV) is controversial in COVID-19 patients with acute respiratory hypoxemia. The study aimed to develop a novel biomarker called cumulative oxygen deficit (COD) for the initiation of IMV.Methods: The study was conducted in four designated hospitals for treating COVID-19 patients in Jingmen, Wuhan, from January to March 2020. COD was defined to account for both the magnitude and duration of hypoxemia. A higher value of COD indicated more oxygen deficit. The predictive performance of COD was calculated in multivariable Cox regression models. Time-dependent propensity score matching was performed to explore the effectiveness of IMV versus other non-invasive respiratory supports on survival outcome.Results: A number of 111 patients including 80 in the non-IMV group and 31 in the IMV group were included. Patients with IMV had significantly lower PaO2 (62 (49, 89) vs. 90.5 (68, 125.25) mmHg; p < 0.001), and higher COD (-6.87 (-29.36, 52.38) vs. -231.68 (-1040.78, 119.83)) than patients without IMV. As compared to patients with COD < 0, patients with COD > 30 had higher risk of fatality (HR: 3.79, 95% CI: 2.57 to 16.93; p = 0.037) , and those with COD > 50 were 10 times more likely to die (HR: 10.45, 95% CI: 1.28 to 85.37; p = 0.029). The Cox regression model performed in the time-dependent propensity score matched cohort showed that IMV was associated with half of the hazard of death than those without IMV (HR: 0.56; 95% CI: 0.16 to 1.93; p = 0.358).Conclusions: The study developed a novel biomarker COD which considered both magnitude and duration of hypoxemia, to assist the timing of IMV in patients with COVID-19. We suggest IMV should be the preferred ventilatory support once the COD reaches 30.
Lesions of the Lumbar Region in Asymptomatic Young Soccer Players: A Cross-Sectional Study
Authors: Júnior Charbel Jacob , Amorim Gabriel Donato , Vidal Pâmela Reis Reis , Lourenço Rafael Burgomeister , Junior Marcos Rosa , Hochhegger Bruno , Mattiello Rita 
Published: July 2020

Abstract
Background: Athletes generally exceed the limits of the body, which can result in various lesions. The pediatric musculoskeletal system is particularly susceptible to lesions through overuse for various reasons including an immature growth plate. While spinal column lesions are relatively rare, they can lead to permanent disability. Studies on spinal lesions in young athletes are rare. To assess abnormalities frequency of the lumbar region in asymptomatic young soccer players.Methods: Cross-sectional study. Male adolescents from schools of grassroots soccer clubs and non-practicing activity controls were included by convenience. The abnormalities frequency. of the lumbar region was evaluated by magnetic resonance imaging (MRI), performed using 1.5T devices with multi-channel coils in model equipment models. The types of lesions evaluated were general, warning signs, instituted, anterior and posterior, and of the column. Comparisons between groups and the relative percentage of each lesion type were compared by Pearson’s chi-squared test and Fischer’s exact test. The inter and intra-observer analyses were compared by the Kappa test.Results: Forty-five adolescents were included, of whom 25 (56%) were soccer-practicing teenagers. No significant differences were identified between the variables age (P=0.960) and the body mass index (BMI) Z-score (P=0.540) between the group of soccer players and the controls. However, the percentages of lesions (general, instituted, anterior and posterior, and in the spinal column) were significantly higher in the practicing football group than in the control group (P=0.002, P<0.001, P= 0.012, and P=0.006, respectively).Conclusion: Young adolescent asymptomatic soccer players have more lumbar spine lesions than less active controls who do not practice sports regularly.
AIDS and COVID-19 are two diseases separated by a common lymphocytopenia
Authors: Sciacchitano Salvatore , Giovagnoli Simonetta , Amodeo Rachele , Santino Iolanda , Simmaco Maurizio , Anibaldi Paolo , French Deborah , Mancini Rita , Vitis Claudia De , D'Ascanio Michela , Ricci Alberto , Pennica Alfredo , Aceti Antonio 
Published: July 2020

Abstract
HIV and SARS-CoV-2 are responsible for two of the most dangerous and life-threatening infectious diseases of our times. To better analyze the difference in the immunological response elicited by the two infections, we compare the alterations in the lymphocyte subpopulations, measured by flow cytometry analysis (FCA) in both AIDS and COVID-19 patients, referred to our University Hospital. A total of 184 HIV infected patients were retrospectively examined and the results of FCA collected and compared to those obtained in 110 SARS-CoV-2 infected patients, examined during the actual outbreak. We observe a comparable reduction in B cells in both diseases and a more severe reduction in the total amount of T cells in COVID-19 as compared to AIDS patients. The analysis of the T cells subpopulations indicates that there is a comparable reduction in the CD4+ cells count. Conversely, a remarkable difference between them is observed in the CD8+ counts. In AIDS patients the CD8+ cells are slightly higher than normal, while in COVID-19 patients the CD8+ cell count is markedly reduced. As a result, the CD4+/CD8+ ratios, is very low in AIDS and higher than normal in COVID-19 patients. The NK cells are reduced in both diseases, but SARS-CoV-2 infection causes a more severe reduction compared to HIV infection. In conclusion, both HIV and SARS-CoV-2 viruses induce major changes in the lymphocytes count, with remarkable similarities and differences between them. The total absolute numbers of T cells and, in particular of the CD8+ subpopulation, are lower in COVID-19 patients compared to AIDS ones, while the CD4+ are reduced in both at similar levels. These results indicate that the host immune system reacts differently to the two infection, but they are responsible of a comparable dropping effect on the serum levels of CD4+ T cell population. The meaning of the similarities and of the differences in terms of T cells activation and serum depletion are discussed. The knowledge on how the immune system reacts to these two infections will be useful to better define their mechanism of action and to design specific preventive and therapeutic approaches.
Changes in lipid metabolism in patients with severe COVID-19
Authors: Li Yi , Zhang Yan , Dai Minhui , Shen Minxue , Zhang Jianchu , Cui Yanhui , Liu Ben , Lin Fengyu , Chen Lingli , Han Duoduo , Fan Yifei , Zeng Yanjun , Li Wen , Li Sha , Chen Xiang , Pan Pinhua 
Published: July 2020

Abstract
Background: Dyslipidemia plays an important role in the pathogenesis and evolution of critical illness, but limited information exists regarding the lipid metabolism of severe coronavirus disease 2019 (COVID-19) patients. The aim of this study was to investigate role of dyslipidemia in patients with severe COVID-19Methods: We retrospectively reviewed 216 severe COVID-19 patients with clarified outcomes (discharged or deceased), admitted to the West Court of Union Hospital in Wuhan, China, between February 1 and March 31, 2020. The dynamic changes of lipid profiles and their relationships with disease severity and clinical outcomes were analyzed.Results: A total of 216 severe COVID-19 patients, including 24 non-survivors and 192 survivors, were included in the final analyses. The levels of high-density lipoprotein cholesterol (HDL-C) and apolipoprotein AI (Apo-AI) on admission were significantly lower in non-survivors compared to survivors. During hospitalization, low-density lipoprotein cholesterol (LDL-C), total cholesterol(TC), HDL-C and Apo-AI were shown an increasing trend in survivors, but maintained lower levels or shown downward trend in non-survivors. The serum levels of HDL-C and Apo-AI were inversely correlated with C-reactive protein (CRP), length of hospital stay of survivors and disease severity. The receiver operating characteristic (ROC) curve analysis identified a CRP/ HDL-C ratio cut-off value of 62.54 as the predictor for in-hospital mortality (AUC=0.823, Sensitivity=83.3%, Specificity=70.8%). Logistic regression analysis demonstrated that hypertension, neutrophils-to-lymphocytes ratio(NLR), platelet count and high CRP/ HDL-C ratio (>62.54) were independent factors to predict in-hospital mortality.Conclusions: The results demonstrated that dyslipidemia was associated with the inflammatory response, disease severity and poor prognosis of COVID-19. High CRP/ HDL-C ratio may serve as an independently potential predictor for hospital mortality among patients with severe COVID-19.
Procalcitonin and COVID-19: A Reliable Clinical Tool
Authors: Bass Jessica , Singh Anshika , Williams Robin , Lindner David H. 
Published: July 2020

Abstract
BACKGROUND: A procalcitonin (PCT) level is commonly ordered to distinguish between bacterial and viral etiologies of lower respiratory tract infections as it is typically negative in the absence of inflammatory conditions and bacterial infections. With COVID-19 causing an influx of patients presenting with respiratory symptoms, clinicians are in need of useful tools to guide management of these patients. Given the inflammation that is caused by COVID-19, it is currently unknown whether PCT continues to be a reliable or useful test in suspected and confirmed cases of COVID-19 pneumonia. OBJECTIVE: To determine whether PCT remains a clinically useful test in patients who present with lower respiratory tract symptoms in the era of COVID-19. DESIGN: Single-center retrospective cohort studyPARTICIPANTS: 243 adults with lower respiratory tract symptoms who presented to the hospital through the emergency department between April 11, 2020 and May 18, 2020 who received both a COVID-19 test as well as a PCT level. MAIN MEASURES: COVID-19 positivity/negative, PCT level KEY RESULTS: It was found that patients with COVID-19 consistently had negative procalcitonin levels (<0.25ng/mL). Based on the odds ratio, a patient with a positive PCT level was 3.4 times more likely to test negative for COVID than a patient with a PCT level <0.25ng/mL. (1)=13.895, p<0.001. CONCLUSIONS: There is a highly significant association between a negative procalcitonin and positive COVID-19 infection, thus supporting the continued use of PCT in the COVID-19 era.