bluuebunny/crossref_metadata_2025_split huggingface dataset:
Critical Illness Polyneuropathy and Myopathy in COVID-19 Patients: A Prospective Observational Intensive Care Unit Cross-Sectional Cohort Study
Authors: Frithiof Robert , Rostami Elham , Kumlien Eva , Virhammar Johan , Fällmar David , Hultström Michael , Lipcsey Miklós , Ashton Nicholas , Blennow Kaj , Zetterberg Henrik , Punga Anna Rostedt 
Published: September 2020

Abstract
Background: Several reports on neurological complications associated with SARS-CoV-2 infection have been published. However, systematic description on intensive care unit acquired weakness (ICUAW) are still missing. Methods: The objective was to determine the incidence and characteristics of critical illness polyneuropathy (CIN) and myopathy (CIM) in patients with severe COVID-19. We also aimed to describe the electrophysiological features and their relation to plasma biomarkers for neuronal injury. This was a prospective observational intensive care unit cohort study. All adult patients admitted to the general intensive care unit (ICU) at Uppsala University Hospital, Uppsala, Sweden, between March 13 and June 8, 2020 were screened for inclusion. Patients with PCR confirmed COVID-19 were included. All patients were admitted to intensive care treatment due to severe COVID-19, including intravenous anaesthesia, opioid anaelgesia, neuromuscular blockade and mechanical ventilation. Associations of clinical, electrophysiological (sensory and motor conduction studies and electromyography) and biomarker data [neurofilament light chain (NfL), glial fibrillary acidic protein (GFAp) and tau] were studied between COVID-19 patients who developed CIN/CIM and those who did not. Results: 111 COVID-19 patients were included, 11 (11 males, mean age: 64 years) developed CIN/CIM whereas 100 (74 males, mean age: 61 years) did not (non-CIN/CIM). The CIN/CIM incidence was higher in COVID-19 patients compared to a general ICU-population treated during 2019 (9.9% vs 3.4%). In particular CIN was more frequent in the COVID-19 ICU cohort (50%) compared with the non-COVID-19 ICU cohort (0%, p=0.008). NfL and GFAp levels were higher in the CIN/CIM group both at the early (<9 days) and late time points (>11 days) compared with the non-CIN/CIM group (both p=0.001) and correlated with nerve amplitudes. Conclusions: CIN/CIM, in particular CIN, were more prevalent among COVID-19 patients than an ICU treated control cohort and should be considered in the differential diagnostic workup and the further rehabilitation of COVID-19 patients. COVID-19 patients who later developed ICUAW had significantly higher NfL and GFAp in the early phase of ICU care, which suggests their potential as predictive biomarkers. Trial registration: The study protocol was registered (ClinicalTrialsID:NCT04316884). Mechanisms for Organ Dysfunction in Covid-19 (UMODCOVID19) March 18, 2020.
Design of the Pilot, Proof of Concept REMOTE-COVID Trial: Remote Monitoring Use in Suspected Cases of COVID-19 (SARS-CoV 2) A Trial Protocol
Authors: Iqbal Fahad Mujtaba , Joshi Meera , Davies Gary , Khan Sadia , Ashrafian Hutan , Darzi Ara 
Published: September 2020

Abstract
BackgroundThe outbreak of SARS-CoV-2 (coronavirus, COVID-19), declared a pandemic by the World Health Organisation (WHO) is global health problem with ever-increasing attributed deaths. Vital sign trends are routinely used to monitor patients with changes in these parameters often preceding an adverse event. Wearable sensors can measure vital signs continuously (e.g. heart rate, respiratory rate, temperature) remotely and can be utilised to recognise early clinical deterioration. MethodsWe describe the protocol for a pilot, proof-of-concept, observational study to be conducted in an engineered hotel near London airports, United Kingdom. The study is set to continue for the duration of the pandemic. Individuals arriving to London with mild symptoms suggestive of COVID-19 or returning from high risk areas requiring quarantine, as recommended by Public Health England, or healthcare professionals with symptoms suggestive of COVID-19 unable to isolate at home will be eligible for a wearable patch to be applied for the duration of their stay. Notifications will be generated should deterioration be detected through the sensor and displayed on a central monitoring hub viewed by nursing staff, allowing for trend deterioration to be noted. The primary objective is to determine the feasibility of remote monitoring systems in detecting clinical deterioration for quarantined individuals in a hotel. DiscussionThis trial should prove the feasibility of a rapidly implemented model of healthcare delivery through remote monitoring during a global pandemic at a hotel, acting as an extension to a healthcare trust. Potential benefits would include reducing infection risk of COVID-19 to healthcare staff, with earlier recognition of clinical deterioration through ambulatory, continuous, remote monitoring using a discrete wearable sensor. We hope our results can power future, robust future randomised trials.Trial registrationClinicalTrials.gov Identifier: NCT04337489
Successes, Challenges and Opportunities Towards Universal Health Coverage for Maternal and Child Health in South East Asian Countries: A Systematic Review
Authors: perera Upuli Amaranganie Pushpakumari , Gilks Charles , Alemu Yibeltal 
Published: September 2020

Abstract
Background: Sustainable Development Goal 3 (SDG-3) aims to ensure healthy lives and promote wellbeing for all. Universal Health Coverage (UHC) assures delivering health services to all who need without suffering from financial hardships. This paper aims to identify the successes, challenges and opportunities towards achieving UHC for maternal and childcare in countries in the World Health Organization, South East Asian Region (SEAR). Methods: We conducted a systematic review of the literature. We searched PubMed, Embase, Scopus, CINAHL, PsycINFO, WHO research portal and Google scholar for studies published in English from 2010 to 2020. We included studies conducted in maternal and childcare focusing on challenges, opportunities or successes towards UHC in countries in SEAR. Data was synthesized and presented as a narrative description, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.Results: We identified 62 studies with different study designs from eight SEAR countries , majority were from India. We observed successes or opportunities in access and quality in MCH with government cash transfer schemes and private sector contribution in India, Bangladesh and Indonesia. Politically prioritized MCH care was identified as an opportunity in a state of India. Inadequate healthcare infrastructure including trained human resources, medical products and other supplies were identified as the main challenges in the region. Facilities are overcrowded in Bangladesh and Indonesia. From provider perspective, health care workers’ knowledge and skills as well as attitudes and behaviors were also identified as issues in the region. Lack of health literacy, misconceptions and cultural barriers are identified as challenges from clients’ side. Difficulties in geographical distribution and transport were contributing to poor healthcare access in four countries. Deficiencies in government policies and administration were identified in some fields. Poverty was detected as an overarching barrier.Conclusions: SEAR countries have demonstrated improvements in access, quality and equity on MCH towards UHC. There are, however, challenges related to human and other resources, health care facilities and socio-economic determinants of health. Regional bodies as well as authorities in individual countries should work on these issues to address challenges to achieve UHC.Registration: PROSPERO: CRD42020166404
Identiﬁcation and Validation of Two Prognostic Autophagy-related Models in Clear Cell Renal Cell Carcinoma
Authors: Sun Xiong-Lin , Zhu Jun-Ming , Lin Fei , Ke Zhi-Bin , Li Xiao-Dong , Cai Hai , Huang Fei , Xue Xue-Yi , Zheng Qing-Shui , Chen Shao-Hao , Xu Ning 
Published: September 2020

Abstract
Background: Clear cell renal cell carcinoma (ccRCC) is one of the most frequent malignancies. Increasing evidence has highlighted the critical roles of autophagy-related genes and autophagy-related long non-coding RNA (lncRNA) in ccRCC development and progression. Therefore, it is necessary to identify novel biomarkers associated with autophagy in ccRCC.Methods: A total of 507 ccRCC patients were included in our study and then randomly divided into a training cohort (n=255) and testing cohort (n=252). Univariate Cox regression models, Lasso regression analyses and multivariate Cox regression models were successively used for constructing gene model and lncRNA model. Receiver-operating characteristic (ROC) curve analysis, Kaplan-Meier (K-M) analysis and more functional analyses were applied for verifying the accuracy of the two models.Results: The autophagy-related genes (ARGs) prognostic model was constructed based on the six ARGs (EIF4EBP1, IFNG, BID, BIRC5, CX3CL1 and RAB24) and five autophagy-related lncRNAs (AC093278.2, AC010326.3, AC099850.3, AC016773.1 and AC009549.1) and then ccRCC patients were significantly stratified into high- and low-risk groups in terms of overall survival (OS). K-M survival analyses indicated that low-risk group had a lower mortality rate than high-risk group in the six-gene prognostic risk model (training cohort: P=4.138e-07; testing cohort: P=1.125e-03) and the same results were obtained in the case of the five-lncRNA prognostic risk model (training cohort: P=4.564e-09; testing cohort: P=2.485e-03). The results of time-dependent ROC curves revealed six-gene prognostic risk model had a higher area under curve (AUC) of 0.765 than the five-lncRNA prognostic risk model at an AUC of 0.759. Therefore, the gene model is an indicator as good as the model constructed by lncRNAs. In addition, further functional analysis indicated these genes were functionally involved in regulation of endopeptidase activity, regulation of peptidase activity, autophagy, human cytomegalovirus infection, shigellosis, autophagy-animal and HIF-1 signaling pathway.Conclusions: A total of six OS-related ARGs and five autophagy-related lncRNA were identified in our current study. The two autophagy-related prediction models including genes and lncRNAs are reliable prognostic and predictive biomarkers for ccRCC.
An Evaluation of the Patient Clinical Complexity Level (PCCL) Method for the Complexity Adjustment in the Korean Diagnosis-Related Groups (KDRG)
Authors: Kim Sujeong , Choi Byoongyong , Lee Kyunghee , Lee Sangmin , Kim Sukil 
Published: September 2020

Abstract
ObjectiveTo evaluate the performance of the Patient Clinical Complexity Level (PCCL) mechanism, which is the patient level complexity adjustment factor within the Korean Diagnosis-Related Groups (KDRG) patient classification system, for explaining the variation of resource consumption within Age Adjacent Diagnosis-related groups (AADRGs).MethodsWe used the inpatient claims data from a public hospital in Korea from January 1, 2017 to June 30, 2019, with 18,846 claims and 138 Age Adjacent Diagnosis-related groups (AADRGs). The differences in the total average payment between the four PCCL levels for each AADRG was tested using ANOVA and Duncan’s post-hoc test. The three patterns of the differences with R-squared were: the PCCL reflected the complexity well (Valid); the average payment of PCCL 2, 3, 4 was greater than PCCL 0 (Partially Valid); the PCCL did not reflect the complexity (Not Valid).ResultsThere were 9 (6.52%), 26 (18.84%), and 103 (74.64%) ADRGs included in VALID, PARTIALLY VALID and NOT VALID, respectively. The average R-squared in VALID, PARTIALLY VALID, and NOT VALID was 32.18%, 40.81%, and 35.41% respectively, with the average R-squared for all patterns of 36.21%.ConclusionsAdjusting using PCCL in the KDRG classification system exhibited low performance to explain the variation of resource consumption within Age Adjacent Diagnosis-related groups (AADRGs). As the KDRG classification system is used for reimbursement under the New DRG-based PPS pilot project with plans for expansion, there should be an overall review of the validity of the complexity and rationality of using the KDRG classification system.
Thromboprophylaxis, Delta Sofa and Main Outcomes in Ventilated Patients: an Analysis of the MIMIC-III&nbsp;Clinical Database
Authors: Bastola Mrigendra Mani , Locatis Craig , Fontelo Paul 
Published: September 2020

Abstract
Introduction: Critical care patients are at higher risk for thromboembolic disorders. There are limited studies regarding the effect of Heparin, Warfarin, Enoxaparin and Aspirin on ventilated patients, who are likely to both benefit from prophylaxis and suffer from adverse effects of blood thinners. Methods: This study analyzed the MIMIC-III clinical database on 4192 ventilated patients using Statistical Analysis Software (SAS, Version 9.4). Relevant data was systematically analyzed on the thromboprophylaxis agents and their effects on major treatment outcomes. Parameters studied were the length of ventilation, length of Intensive Care Unit (ICU) stays, ICU mortality, inpatient mortality, improvement in SOFA score, and occurrence of major thromboembolic events such as pulmonary embolism (PE) and deep venous thrombosis (DVT). Results: Except Aspirin, all thromboprophylactic agents showed statistically significant reduction on ICU mortality. None of the blood thinners showed statistically significant reduction in occurrences of pulmonary embolism and deep venous thrombosis. Heparin, Warfarin and Enoxaparin had adjusted Odds ratios of 0.59(p<0.01, 0.47-0.77), 0.23(p<0.05, 0.1-0.57) and 0.36(P<0.05, 0.16-0.83) for ICU mortality. Heparin, Warfarin and Enoxaparin had adjusted Odds ratios of 0.51(p<0.01, 0.38-0.68), 0.19(p<0.01, 0.06-0.59) and 0.42(P=0.06, 0.17-1.05) for overall ventilated patient hospital mortality, including after transfers to the inpatient ward.. Only Heparin (P<0.05, OR 1.52(1.07-2.15)) was associated with thrombocytopenia, which required platelet transfusion. None of the drugs showed statistically significant relationships with development of thromboembolic events after thromboprophylaxis. Only Heparin had mild effect on improvement in sequential organ failure assessment (delta SOFA) scores at 7 and 10 day after ICU admission (P<0.05, OR 1.17 (1.03-1.32)). Conclusion: Although the results supported the use of thromboprophylaxis in ventilated patients to improve treatment outcomes and decrease thromboembolic events, no benefits were indicated for using newer blood thinners (Enoxaparin) than older ones (Heparin & Warfarin). Heparin is related to both higher episodes of platelets transfusion and improvement of delta SOFA scores at end of first week of ICU admission. If validated by future research, the findings of this study might help practitioners and researchers to better understand thromboprophylaxis in ventilated patients.
Application of 99mTc-3PRGD2 Imaging for Early Prediction of Pathological Response to Neoadjuvant Chemotherapy in Breast Tumors and Axillary Lymph Nodes
Authors: Chen Zhenying , Fu Fangmeng , Lin Junyu , Huang Chao , Zheng Shan , Wang Chuan , Miao Weibing 
Published: September 2020

Abstract
Background and PurposeTechnetium 99m-dimeric cyclic RGD peptides with three polyethylene glycol spacers (99mTc-3PRGD2) had a good performance for diagnosing breast cancer. The prospective study was to assess the performance of 99mTc-3PRGD2 tumor imaging for predicting pathological complete response (pCR) outcomes to neoadjuvant chemotherapy (NAC) in breast cancer patients.Materials and MethodsForty-one patients were examined using both 99mTc-3PRGD2 and 18F-fluoro-deoxy-glucose (18F-FDG) imaging before NAC (baseline), and after the first and fifth NAC cycle. The tumor-to-background (T/B) ratios for 99mTc-3PRGD2 imaging and the maximum standardized uptake values (SUVmax) from the 18F-FDG imaging in breast tumors and axillary lymph node (ALN) metastases were separately calculated and analyzed—based on receiver operating characteristic (ROC) analysis. ResultsFinally, pCR was achieved in 13 of 41 patients after NAC. The area under curve (AUC) of T/B changes (ΔT/B) in breast tumors for predicting pCR after first and fifth cycle were 0.827 and 0.687, and 0.859 and 0.778 in ALN metastases, respectively. For SUVmax changes (ΔSUVmax), the ROC-AUC were 0.859 and 0.713, as well as 0.572 and 0.802, respectively. In breast tumors, the AUCs of ΔT/B1 and ΔSUVmax1 had no significant difference (P > 0.05). However, the AUC of ΔT/B1 was significantly higher than for ΔSUVmax1 in ALN metastases (Z = 2.10, P = 0.035). Additionally, the T/B1 trends for breast tumor and ALN in pCR group were higher than for non-pCR group in HER2-positive patients (P﹤0.05). ConclusionsCompared with 18F-FDG imaging, our study shows that use of 99mTc-3PRGD2 imaging offered a similar level of predictive performance for breast cancer pCR to NAC, and early T/B1 trends of ALN showed an higher performance for predicting pCR.Trial RegistrationClinicalTrials.gov ID: NCT02742168.
ZEB1 as an additional predictor of tumor progression in Ewingʼs sarcoma. Results of a morphological study on a population of children and adolescents
Authors: Kit O. I. , Yurchenko D. Yu. , Ulyanova E. P. , Burtsev D. V. , Kuznetsov S. A. , Sagakyants A. B. , Frantsiyants E. M. , Mkrtchyan G. A. , Pak E. Ye. , Starzhetskaya M. V. , Bespalova A. I. , Popovyan O. P. 
Published: September 2020

Relevance. Ewingʼs sarcoma (ES) is a classic representative of the extensive family of ES tumors, which occupies one of the leading positions among the malignant pathology of the musculoskeletal system in children and adolescents. This group is characterized by an extremely large variety of morphological, immunohistochemical, and molecular genetic characters among its representatives. The absence of specific pathognomonic markers for ES, as well as the presence of wide variability of clinical manifestations complicates the differential diagnosis. Materials and methods. The study included patients of childhood and adolescence with a localized and generalized form of ES/PNEТ of various localizations undergoing treatment in the conditions of the Department of Pediatric Oncology of the Federal State Budgetary Research Center for Oncology from 2009 to 2019. As the material, the tissue of the primary tumor of ES/PNEТ from paraffin blocks was used, obtained from 67 patients during the primary biopsy, as well as after the surgical stage as part of a combined or complex treatment. The expression of ZEB1 was determined immunohistochemically.Results. The highest average level of expression of ZEB1 protein was observed in group 4 with a generalized form of ES (surgical material) and amounted to 60.8 ± 2.2 %, the minimum level was detected in group 2 with a localized form of ES (surgical material) and amounted to 29.2 ± 3.0 %. Between groups 2 (localized form) and 4 (generalized form) statistically significant differences were noted (p = 0.026).Conclusion. As a result of an immunohistochemical study, the ZEB1 protein showed its prognostic significance when comparing groups with a localized and generalized form of ES (p = 0.026). The predominance of the expression level of ZEB1 protein in the group with the generalized form statistically significantly increased the chances of metastasis by 3.6 times (95 % CI 1.13-11.8).
Mass Spectrometry Techniques: Principles and Practices for Quantitative Proteomics
Authors: Rotello Rocco J. , Veenstra Timothy D. 
Published: September 2020

:
In the current omics-age of research, major developments have been made in technologies
that attempt to survey the entire repertoire of genes, transcripts, proteins, and metabolites present
within a cell. While genomics has led to a dramatic increase in our understanding of such
things as disease morphology and how organisms respond to medications, it is critical to obtain information
at the proteome level since proteins carry out most of the functions within the cell. The
primary tool for obtaining proteome-wide information on proteins within the cell is mass spectrometry
(MS). While it has historically been associated with the protein identification, developments
over the past couple of decades have made MS a robust technology for protein quantitation
as well. Identifying quantitative changes in proteomes is complicated by its dynamic nature and the
inability of any technique to guarantee complete coverage of every protein within a proteome sample.
Fortunately, the combined development of sample preparation and MS methods have made it
capable of quantitatively comparing many thousands of proteins obtained from cells and organisms.
Anti-BVDV Activity Evaluation of Naphthoimidazole Derivatives Compared with Parental Imidazoquinoline Compounds
Authors: Ibba Roberta , Piras Sandra , Delogu Ilenia , Loddo Roberta , Carta Antonio 
Published: September 2020

Background:

Pestivirus genus includes animal pathogens which are involved in economic impact for the livestock industry. Among others, Bovine Viral Diarrhoea Virus (BVDV) establish a persistent infection in cattle causing a long list of symptoms and a high mortality rate. In the last decades, we synthesised and reported a certain number of anti-BVDV compounds.

Methods:
In them, imidazoquinoline derivatives turned out as the most active. Their mechanism of actions has been deeply investigated, BVDV RNA-dependent RNA polymerase (RpRd) resulted as target and the way of binding was predicted in silico through three main H-bond interaction with the target.
The prediction could be confirmed by target or ligand mutation. The first approach has already been performed and published confirming the in silico prediction.

Results:
Here, we present how the ligand chemical modification affects the anti-BVDV activity. The designed compounds were synthesised and tested against BVDV as in silico assay negative control.

Conclusion:
The antiviral results confirmed the predicted mechanism of action, as the newly synthesised compounds resulted not active in the in vitro BVDV infection inhibition.
A Case Report: Type II Abernethy Malformation Complicated with Congenital Polydactyly and Enlargement of all Cardiac Chambers
Authors: Zhu Cheng , Wang Min , Hao Qian 
Published: September 2020

Background:
Abernethy malformation is a kind of congenital malformation of the portal vein system caused by abnormal portacaval shunts. It can be in combination with many other congenital malformations. There has been a limited number of patients since the first patient was reported, leading to limited knowledge of this kind of disease.

Methods:
In August 2018, we treated a patient diagnosed with type II Abernethy malformation complicated with both congenital polydactyly and enlargement of all cardiac chambers, which is extremely rare and can be supplementary to the existing cases. According to a comprehensive and adequate assessment of patients' condition, we treated him with oral silybin (70 mg every time and 3 times a day) for 3 months, and advised him to make follow-up visits.

Results:
At the latest follow-up, we knew the health condition of this patient was generally satisfactory, whether in terms of laboratory test results or his daily life experience.

Conclusion:
Although the major therapy for Abernethy malformation is surgery, this case suggests that simple conservative treatment with regular follow-up visits can be suitable for certain patients.