bluuebunny/crossref_metadata_2025_split huggingface dataset:
Coronavirus disease 19 in minority populations of Newark, New Jersey
Authors: Okoh Alexis K. , Sossou Christoph , Dangayach Neha S. , Meledathu Sherin , Phillips Oluwakemi , Raczek Corinne , Patti Michael , Kang Nathan , Hirji Sameer A. , Cathcart Charles , Engell Christian , Cohen Marc , Nagarakanti Sandhya , Bishburg Eliahu , Grewal Harpreet S. 
Published: June 2020

AbstractBackgroundThe purpose of this study is to report the clinical features and outcomes of Black/African American (AA) and Latino Hispanic patients with Coronavirus disease 2019 (COVID-19) hospitalized in an inter-city hospital in the state of New Jersey.MethodsThis is a retrospective cohort study of AA and Latino Hispanic patients with COVID-19 admitted to a 665-bed quaternary care, teaching hospital located in Newark, New Jersey. The study included patients who had completed hospitalization between March 10, 2020, and April 10, 2020. We reviewed demographics, socioeconomic variables and incidence of in-hospital mortality and morbidity. Logistic regression was used to identify predictor of in-hospital death.ResultsOut of 416 patients, 251 (60%) had completed hospitalization as of April 10, 2020. The incidence of In-hospital mortality was 38.6% (n = 97). Most common symptoms at initial presentation were dyspnea 39% (n = 162) followed by cough 38%(n = 156) and fever 34% (n = 143). Patients were in the highest quartile for population’s density, number of housing units and disproportionately fell into the lowest median income quartile for the state of New Jersey. The incidence of septic shock, acute kidney injury (AKI) requiring hemodialysis and admission to an intensive care unit (ICU) was 24% (n = 59), 21% (n = 52), 33% (n = 82) respectively. Independent predictors of in-hospital mortality were older age, lower serum Hemoglobin < 10 mg/dl, elevated serum Ferritin and Creatinine phosphokinase levels > 1200 U/L and > 1000 U/L.ConclusionsFindings from an inter-city hospital’s experience with COVID-19 among underserved minority populations showed that, more than one of every three patients were at risk for in-hospital death or morbidity. Older age and elevated inflammatory markers at presentation were associated with in-hospital death.
X-ray induced photodynamic therapy (PDT) with a mitochondria-targeted liposome delivery system
Authors: Gu Xuefan , Shen Chao , Li Hua , Goldys Ewa M. , Deng Wei 
Published: June 2020

AbstractIn this study, we constructed multifunctional liposomes with preferentially mitochondria-targeted feature and gold nanoparticles-assisted synergistic photodynamic therapy. We systemically investigated the in vitro X-ray triggered PDT effect of these liposomes on HCT 116 cells including the levels of singlet oxygen, mitochondrial membrane potential, cell apoptosis/necrosis and the expression of apoptosis-related proteins. The results corroborated that synchronous action of PDT and X-ray radiation enhance the generation of cytotoxic reactive oxygen species produced from the engineered liposomes, causing mitochondrial dysfunction and increasing the levels of apoptosis.
Oral health status and oral health-related quality of life among patients with type 2 diabetes mellitus in the United Arab Emirates: a matched case-control study
Authors: Khalifa Nadia , Rahman Betul , Gaintantzopoulou Marianna D. , Al-Amad Suhail , Awad Manal M. 
Published: June 2020

Abstract
Background
Nearly a quarter of the population in the UAE has type 2 diabetes mellitus (T2DM), and this medical condition is associated with poorer oral health. The effects on oral health-related quality of life (OHRQoL), however, have not been examined in this population. Therefore, the objective of this study was to assess the impact of oral health problems, such as caries and periodontitis, on OHRQoL among Arab patients with and without T2DM.

Methods
This matched case-control study included 88 diabetic and 88 non-diabetic participants recruited from University Dental Hospital Sharjah and University Hospital Sharjah, UAE. Participants completed a sociodemographic questionnaire as well as the Oral Health Impact Profile short form (OHIP-14), which measures OHRQoL. Clinical examinations were conducted to assess participants’ dental caries status, using the Decayed Missing Filled Teeth (DMFT) Index, and periodontal condition, via clinical attachment loss (CAL) dichotomized to CAL < 3 mm and CAL ≥3 mm. Linear regression models were used to identify the association among OHIP domains, clinical attachment loss, DMFT scores, and diabetes status.

Results
The mean age of participants was 43.0 years. A significantly (p = 0.01) higher proportion of diabetic patients (23%) had a CAL ≥3 mm than non-diabetic patients (10%). No significant differences in OHIP scores were observed between diabetic and non-diabetic patients. The results of the linear regression suggested that irrespective of diabetic status, DMFT scores were significantly associated with physical disability, physical pain, psychological discomfort, and psychological disability, as well as total OHIP scores. CAL was significantly associated with the handicap domain. Among non-diabetic patients, OHIP scores were significantly associated with DMFT scores in five OHIP domains (functional limitation, physical disability, physical pain, psychological discomfort, psychological disability), as well as total OHIP scores. Among diabetic patients, CAL was significantly associated with both the social disability and handicap domains, while only the handicap domain reached statistical significance among non-diabetic patients.

Conclusions
Participants who had decayed teeth, irrespective of their diabetic status, reported substantial physical and psychological impacts on OHRQoL. CAL also had a significant impact on OHRQoL, being primarily associated with the OHIP handicap domain in both diabetic and non-diabetic patients.
Validation of the Greek translation of the multicultural quality of life index (MQLI-gr)
Authors: Kokaliari Effrosyni D. , Roy Ann W. 
Published: June 2020

AbstractBackgroundThe aim of the current study was to examine the internal structure and convergent and discriminant validity of theMulticultural Quality of Life Index(MQLI) in a Greek sample of community-dwelling adults in a major Greek city.MethodsThe authors developed a Greek version of theMulticultural Quality of Life Index(MQLI-Gr). It was translated following cross-cultural adaptation procedures for self-report measures and administered to community members (N = 884). Participants completed abrief demographic survey, theMQLI-Gr, and theDepression Anxiety Stress Scales(DASS-42).ResultsTheMQLI-Gris brief, easy to use, and demonstrates strong internal consistency (Cronbach alpha = .90). In terms of internal structure there were mixed results. In terms of discriminant validity, statistically significant differences in meanMQLI-Grscores were observed between two groups: those withnone-mildsymptoms versus those withsevere symptomsof depression, anxiety, and stress (p < .05). TheMQLI-Grwas also able to discriminate among groups assumed to vary on quality of life; marital status, income, and employment. In terms of convergent validity, results were in the expected direction, with participants reporting high levels of depression, anxiety, and stress, also reporting lower quality of life on theMQLI-Gr(p < .001).ConclusionConsistent with other translations, theMQLI-Grdemonstrated feasibility, strong internal consistency, and good convergent and discriminant validity. This is the first step in the development of a psychometrically sound measure to assessquality of lifein a community-dwelling population in Greece. With the addition of further validation studies, this measure will be a useful tool for assessing thequality of lifein the Greek community.
Analysis of adherence to HIV-positive quality of care indicators and their impact on service quality perceptions in patients: a Spanish cross-sectional study
Authors: Gimeno-García A. , Franco-Moreno A. , Montero-Hernández C. , Arponen S. , García-Carrasco E. , Alejos B. , Corps-Fernández D. , Gaspar-García E. , Galindo-Jara P. , García-Navarro M. , Varillas-Delgado D. 
Published: June 2020

Abstract
Background
Since the identification of human immunodeficiency virus (HIV) infection, there have been significant advances in its diagnosis and treatment, but there have been few contributions to the area of care quality. In 2010, the Spanish AIDS Study Group (GeSIDA) published the document “Health quality indicators of GeSIDA for the care of people infected with HIV/AIDS” in which standards are proposed for the purpose of improving and standardizing the assistance provided to people infected with HIV. The purpose of this study was to evaluate the degree of compliance with these indicators and to analyse whether adherence to the standards improves patient perception of care quality in terms of their satisfaction with the health care they have received.

Methods
Compliance with GeSIDA indicators was analysed within a cohort of people living with HIV (PLHIV) in a hospital in the Madrid region. To evaluate patient perception, the External Consultation User Satisfaction Questionnaire (SUCE) was used, which is a tool that was previously validated in the Spanish population.

Results
A total of 334 patients were included. The level of adherence to the indicators was 74.46%. The score on the SUCE questionnaire was 9.04 out of 10 (CI 95%: 8.90–9.19). Of the 47 indicators assessed, only 4 were related to satisfaction with health care.

Conclusions
The levels of compliance with the indicators and patient satisfaction with health care were high. Adherence to quality indicators showed little relation to patient-reported satisfaction.
Validity and reliability of subjective methods to assess sedentary behaviour in adults: a systematic review and meta-analysis
Authors: Bakker Esmée A. , Hartman Yvonne A. W. , Hopman Maria T. E. , Hopkins Nicola D. , Graves Lee E. F. , Dunstan David W. , Healy Genevieve N. , Eijsvogels Thijs M. H. , Thijssen Dick H. J. 
Published: June 2020

Abstract
Background
Subjective measures of sedentary behaviour (SB) (i.e. questionnaires and diaries/logs) are widely implemented, and can be useful for capturing type and context of SBs. However, little is known about comparative validity and reliability. The aim of this systematic review and meta-analysis was to: 1) identify subjective methods to assess overall, domain- and behaviour-specific SB, and 2) examine the validity and reliability of these methods.

Methods
The databases MEDLINE, EMBASE and SPORTDiscus were searched up to March 2020. Inclusion criteria were: 1) assessment of SB, 2) evaluation of subjective measurement tools, 3) being performed in healthy adults, 4) manuscript written in English, and 5) paper was peer-reviewed. Data of validity and/or reliability measurements was extracted from included studies and a meta-analysis using random effects was performed to assess the pooled correlation coefficients of the validity.

Results
The systematic search resulted in 2423 hits. After excluding duplicates and screening on title and abstract, 82 studies were included with 75 self-reported measurement tools. There was wide variability in the measurement properties and quality of the studies. The criterion validity varied between poor-to-excellent (correlation coefficient [R] range − 0.01- 0.90) with logs/diaries (R = 0.63 [95%CI 0.48–0.78]) showing higher criterion validity compared to questionnaires (R = 0.35 [95%CI 0.32–0.39]). Furthermore, correlation coefficients of single- and multiple-item questionnaires were comparable (1-item R = 0.34; 2-to-9-items R = 0.35; ≥10-items R = 0.37). The reliability of SB measures was moderate-to-good, with the quality of these studies being mostly fair-to-good.

Conclusion
Logs and diaries are recommended to validly and reliably assess self-reported SB. However, due to time and resources constraints, 1-item questionnaires may be preferred to subjectively assess SB in large-scale observations when showing similar validity and reliability compared to longer questionnaires.

Registration number
CRD42018105994.
Orexin A alleviates neuroinflammation via OXR2/CaMKKβ/AMPK signaling pathway after ICH in mice
Authors: Li Tao , Xu Weilin , Ouyang Jinsong , Lu Xiaoyang , Sherchan Prativa , Lenahan Cameron , Irio Giselle , Zhang John H. , Zhao Jianhua , Zhang Yongfa , Tang Jiping 
Published: June 2020

AbstractBackgroundOrexins are two neuropeptides (orexin A, OXA; orexin B, OXB) secreted mainly from the lateral hypothalamus, which exert a wide range of physiological effects by activating two types of receptors (orexin receptor 1, OXR1; orexin receptor 2, OXR2). OXA has equal affinity for OXR1 and OXR2, whereas OXB binds preferentially to OXR2. OXA rapidly crosses the blood-brain barrier by simple diffusion. Many studies have reported OXA’s protective effect on neurological diseases via regulating inflammatory response which is also a fundamental pathological process in intracerebral hemorrhage (ICH). However, neuroprotective mechanisms of OXA have not been explored in ICH.MethodsICH models were established using stereotactic injection of autologous arterial blood into the right basal ganglia of male CD-1 mice. Exogenous OXA was administered intranasally; CaMKKβ inhibitor (STO-609), OXR1 antagonist (SB-334867), and OXR2 antagonist (JNJ-10397049) were administered intraperitoneally. Neurobehavioral tests, hematoma volume, and brain water content were evaluated after ICH. Western blot and ELISA were utilized to evaluate downstream mechanisms.ResultsOXA, OXR1, and OXR2 were expressed moderately in microglia and astrocytes and abundantly in neurons. Expression of OXA decreased whereas OXR1 and OXR2 increased after ICH. OXA treatment significantly improved not only short-term but also long-term neurofunctional outcomes and reduced brain edema in ipsilateral hemisphere. OXA administration upregulated p-CaMKKβ, p-AMPK, and anti-inflammatory cytokines while downregulated p-NFκB and pro-inflammatory cytokines after ICH; this effect was reversed by STO-609 or JNJ-10397049 but not SB-334867.ConclusionsOXA improved neurofunctional outcomes and mitigated brain edema after ICH, possibly through alleviating neuroinflammation via OXR2/CaMKKβ/AMPK pathway.
Impact of elastic ankle exoskeleton stiffness on neuromechanics and energetics of human walking across multiple speeds
Authors: Nuckols Richard W. , Sawicki Gregory S. 
Published: June 2020

Abstract
Background
Elastic ankle exoskeletons with intermediate stiffness springs in parallel with the human plantarflexors can reduce the metabolic cost of walking by ~ 7% at 1.25 m s− 1. In a move toward ‘real-world’ application, we examined whether the unpowered approach has metabolic benefit across a range of walking speeds, and if so, whether the optimal exoskeleton stiffness was speed dependent. We hypothesized that, for any walking speed, there would be an optimal ankle exoskeleton stiffness - not too compliant and not too stiff - that minimizes the user’s metabolic cost. In addition, we expected the optimal stiffness to increase with walking speed.

Methods
Eleven participants walked on a level treadmill at 1.25, 1.50, and 1.75 m s− 1 while we used a state-of-the-art exoskeleton emulator to apply bilateral ankle exoskeleton assistance at five controlled rotational stiffnesses (kexo = 0, 50, 100, 150, 250 Nm rad− 1). We measured metabolic cost, lower-limb joint mechanics, and EMG of muscles crossing the ankle, knee, and hip.

Results
Metabolic cost was significantly reduced at the lowest exoskeleton stiffness (50 Nm rad− 1) for assisted walking at both 1.25 (4.2%; p = 0.0162) and 1.75 m s− 1 (4.7%; p = 0.0045). At these speeds, the metabolically optimal exoskeleton stiffness provided peak assistive torques of ~ 0.20 Nm kg− 1 that resulted in reduced biological ankle moment of ~ 12% and reduced soleus muscle activity of ~ 10%. We found no stiffness that could reduce the metabolic cost of walking at 1.5 m s− 1. Across all speeds, the non-weighted sum of soleus and tibialis anterior activation rate explained the change in metabolic rate due to exoskeleton assistance (p < 0.05; R2 > 0.56).

Conclusions
Elastic ankle exoskeletons with low rotational stiffness reduce users’ metabolic cost of walking at slow and fast but not intermediate walking speed. The relationship between the non-weighted sum of soleus and tibialis activation rate and metabolic cost (R2 > 0.56) indicates that muscle activation may drive metabolic demand. Future work using simulations and ultrasound imaging will get ‘under the skin’ and examine the interaction between exoskeleton stiffness and plantarflexor muscle dynamics to better inform stiffness selection in human-machine systems.
Hepatitis E virus infection during pregnancy
Authors: Wu Chunchen , Wu Xiaoxue , Xia Jianbo 
Published: June 2020

AbstractBackgroundHepatitis E virus (HEV) generally causes self-limiting viral hepatitis. However, in pregnant women, HEV infection can be severe and has been associated with up to 30% mortality in the third trimester. Additionally, HEV infection in pregnancy is also associated with high rates of preterm labor and vertical transmission.Main bodyHEV is now recognized as a global health problem in both developing and industrialized countries. HEV can be transmitted via the fecal-oral route, zoonotic route, and blood transfusion route. An altered immune status, hormonal levels, and viral factors may be related to the severity of the disease. Currently, no established treatment is available for HEV in pregnant women. A Chinese vaccine has been demonstrated to be protective against HEV in the general population and seems to be safe in pregnancy; however, its safety and efficacy in a large population of pregnant women remain to be determined.ConclusionThis review summarizes the current knowledge about HEV infection during pregnancy and focuses on the epidemiology, clinical manifestations, mechanisms underlying severe liver injury, and management and prevention of HEV infection during pregnancy. Considering that HEV infection during pregnancy may result in poor outcomes, screening for and monitoring HEV infection early in pregnancy should be taken into account. In addition, a better understanding of the pathogenesis will help to develop potential treatment strategies targeting HEV infection in pregnancy.
WSES guidelines updates
Authors: Ceresoli Marco , Coccolini Federico , Biffl Walter L. , Sartelli Massimo , Ansaloni Luca , Moore Ernest E. , Di Saverio Salomone , Kluger Yoram , Catena Fausto 
Published: June 2020

AbstractThe World Society of Emergency Surgery promotes training and continuing medical education in the field of emergency surgery and trauma. One of the most important activities of the society is the development of guidelines. The debate about the process of developing and updating guidelines is very active with no clear consensus and different policies among scientific societies. The present commentary provides the position of the World Society of Emergency Surgery on guideline development process and their update.
Characterization of clinical and genetic spectrum of Chinese patients with cystic fibrosis
Authors: Liu Keqiang , Xu Wenshuai , Xiao Meng , Zhao Xinyue , Bian Chun , Zhang Qianli , Song Jiaxing , Chen Keqi , Tian Xinlun , Liu Yaping , Xu Kai-Feng , Zhang Xue 
Published: June 2020

Abstract
Background
Cystic fibrosis (CF) is a rare autosomal recessive disorder caused by biallelic mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. The clinical features and mutation spectrum of CF have been well characterized in Caucasians, while limited studies were conducted in Chinese patients.

Subjects and methods
A total of 20 individuals from 19 families were diagnosed with CF in this study. We analyzed the clinical features and screened all coding exons of CFTR using a combination of Sanger sequencing and multiplex ligation-dependent probe amplification analysis.

Results
The median age at onset was 9.3 years in our cohort, while the median age at diagnosis was 19 years. The respiratory system was most frequently affected in this study: all patients (100%, 19/19) presented diffuse bronchiectasis and 61.1% (11/18) of patients showed a forced expiratory volume in 1 s below 80% predicted. Six patients (6/20, 30%) exhibited allergic bronchopulmonary aspergillosis (ABPA). Only 4 (4/20, 20%) patients presented pancreatic exocrine insufficiency (PI). Three adult male patients receiving examinations for congenital bilateral absence of the vas deferens were all found positive for the condition. A total of 22 distinct mutations were detected in this cohort, with the variant p.G970D as the most common variant (12/38 alleles, 31.6%). Four variants (p.Y109D, p.I203F, p.D572E, and exon 2–3 deletion) were novel, which expanded the mutation spectrum of Chinese CF patients.

Conclusions
Chinese CF patients showed different clinical features and a distinct CFTR mutation spectrum compared with Caucasians. There is a significant diagnosis delay, suggesting the current underdiagnosis of CF in China.
Self-rated worry is associated with hospital admission in out-of-hours telephone triage – a prospective cohort study
Authors: Gamst-Jensen Hejdi , Frischknecht Christensen Erika , Lippert Freddy , Folke Fredrik , Egerod Ingrid , Huibers Linda , Brabrand Mikkel , Tolstrup Janne Schurmann , Thygesen Lau Caspar 
Published: June 2020

Abstract
Objective
Telephone triage manages patient flow in acute care, but a lack of visual cues and vague descriptions of symptoms challenges clinical decision making. We aim to investigate the association between the caller’s subjective perception of illness severity expressed as “degree-of-worry” (DOW) and hospital admissions within 48 h.

Design and setting
A prospective cohort study was performed from January 24th to February 9th, 2017 at the Medical Helpline 1813 (MH1813) in Copenhagen, Denmark. The MH1813 is a primary care out-of-hours service.

Participants
Of 38,787 calls received at the MH1813, 11,338 met the inclusion criteria (caller being patient or close friend/relative and agreement to participate). Participants rated their DOW on a 5-point scale (1 = minimum worry, 5 = maximum worry) before talking to a call handler.

Main outcome measure
Information on hospitalization within 48 h after the call, was obtained from the Danish National Patient Register. The association was assessed using logistic regression in three models: 1) crude, 2) age-and-gender adjusted and 3) age, gender, co-morbidity, reason for calling and caller status adjusted.

Results
A total of 581 participants (5.1%) were admitted to the hospital, of whom 170 (11.3%) presented with a maximum DOW, with a crude odds ratio (OR) for hospitalization of 6.1 (95% confidence interval (CI) 3.9 to 9.6) compared to minimum DOW. Estimates showed dose-response relationship between DOW and hospitalization. In the fully adjusted model, the ORs decreased to 3.1 (95%CI 2.0 to 5.0) for DOW = 5, 3.2 (2.0 to 5.0) for DOW = 4, 1.6 (1.0 to 2.6) for DOW = 3 and 0.8 (0.5 to 1.4) for DOW = 2 compared to minimum DOW.

Conclusion
Patients’ self-assessment of illness severity as DOW was associated with subsequent hospital admission. Further, it may be beneficial in supporting clinical decision making in telephone triage. Finally, it might be useful as a measure to facilitate patient participation in the triage process.