bluuebunny/crossref_metadata_2025_split huggingface dataset:
In-depth Validation of CHERG’S Verbal Autopsy-Social Autopsy (VASA) Tool for Ascertaining Determinants and Causes of Under-Five Child Mortalities in Karachi, Pakistan.
Authors: Siddiqui Muhammad Bilal , Ng Chiu Wan , Low Wah Yun , Ahmed Hassan , Abid Khadijah 
Published: June 2020

Abstract
Background: Globally, child mortality estimates are more clustered among the developing countries where quality data on estimates and determinants of child mortality are compromised. To achieve sustainability in reducing child mortality estimates, the integrated Verbal Autopsy and Social Autopsy (VASA) tool help in estimating prevalence and assigning medical and social causes and determinants of child survival, especially in the developing countries. A validation study of the Child Health Epidemiology Reference Group’s (CHERG) Verbal autopsy/Social Autopsy (VASA) tool has been undertaken for employing in a Karachi VASA Integrated Child Mortality Investigation-ICMI study in its urban slums. Methods: Validity and reliability of the CHERG VASA-tool were tested using face, content, discriminant validation and reliability tests on one hundred randomly selected mothers, with a recent child death event. Data were computed on SPSS (version-21) and R. Results: Testing yielded high I-CVI (>81.43%); high Cronbach's Alpha (0.843); accuracy of between 75% and 100% of the discriminants classifying births to live and stillbirths. The tool showed ICVI (>82.07% and 88.98% respectively) with high accuracy (92% and 97% respectively) for assigning biological and social causes of child deaths respectively. Conclusion: The CHERG VASA questionnaire is valid, reliable, and relevant to the conceptual framework. This valid tool is one of the assets for child health policy as it can assign accurate medical and non-medical causes (pertaining to health-seeking practices) of child mortality cases occurring in Pakistan.
Initial Predictors for Short-termprognosisin Anti-melanoma Differentiation-associated Protein-5 Positive Patients
Authors: Yang Qihua , Li Tianfang , Zhang Xin , Lyu Kunlong , Wu Shujun , Chen Yan , Liu Shengyun , Yu Zujiang 
Published: June 2020

Abstract
Background: Anti-melanoma differentiation-associated protein-5 (anti-MDA5) positive patients are characterized by the high mortality rate caused by interstitial lung disease (ILD). We conducted a retrospective study to summarize the clinical features and identify the initial predictors for death in anti-MDA5 positive patients.Methods:We designed a retrospective cohort of anti-MDA5 positive patients.The demographic and clinical data recorded on first admission, as well as the outcomes during the first six months follow-up were collected. Risk factors for death were identified using multivariate analyses.Results: A total of 90 anti-MDA5 positive patients were included in this study. Eighty-one (90%) patients presentedILD on admission and 35(38.9%) patients developed rapidly progressive ILD (RP-ILD) subsequently.During the first six months of follow-up, 22 (24.4%) patients died of respiratory failure at an average time of 6.6 ± 5.9 weeks.Univariate analysis identified several factors associated with death, including demographic, clinical, laboratory and image variables. Multivariate analysis showed that total CT GGO score≥4(HR 4.8, 95%CI 1.3-17.9,P=0.020), KL-6>1600U/ml (HR3.7, 95%CI 1.5-9.1, P=0.004) and CRP>5.8mg/L (HR3.7, 95%CI 1.0-12.8, P=0.044) were poor prognostic risk factors, however initial combined treatment(HR 0.3, 95%CI 0.1-0.8, P=0.019) predicted good prognosis in anti-MDA5 positive patients.Conclusion: Anti-MDA5 positive patients demonstrated a high prevalence of ILD on admission, leading to a high short-term mortality rate. Higher total GGO score, higher levels of initial KL-6 and CRP predict poor outcome in anti-MDA5 positive patients. However, in tial intensive treatment may improve the prognosis.
Histone Methyltransferase G9a Promotes Invasion of Non-small Cell Lung Cancer Through Enhancing Focaladhesionkinase Activationvia NF-KB Signaling Pathway
Authors: Sun Ting , Zhang Keqiang , Pangeni Rajendra P. , Li Wendong , Du Yong , Chaurasiya Shyambabu , Arvanitis Leonidas , Raz Dan J. 
Published: June 2020

Abstract
BackgroundOverexpression of euchromatic histone methyltransferase 2 (EHMT2 or G9a) is frequently found in a number of human cancers. Potential roles of G9a in invasion and metastasis are not well understood in non-small cell lung cancer (NSCLC). Here we investigated the effect and underlying mechanisms of G9a, and therapeutic implications of targeting G9a in the invasion of NSCLC. MethodsG9a-associated gene sets were identified by RNAseq analysis. Migration and invasion assays were applied to examine the impact of targeting G9a by siRNA knockdown orits specific inhibitor UNC0638 in NSCLC cells. Rescue experiments were designed to investigate the effect of focal adhesion kinase (FAK) and NF-κB inhibitors on the invasion of NSCLC cells overexpressing G9a. Correlation between the protein level of phosphorylated FAK and G9a was analyzed in NSCLC tissues.ResultsKnockdown and inhibition of G9a drastically suppressed in vitro cellular proliferation, migration, and invasion; while overexpression of G9a significantly enhanced proliferation, migration, and invasion of A549 and H1299 NSCLC cells. Targeting G9a led to a significant decrease in the expression of FAK protein and activation of FAK signaling pathway in both A549 and H1299 cells. Additionally, defactinib, a potent FAK inhibitor, partially abolished the enhanced migration and invasion by overexpression of G9a in these NSCLC cells. Furthermore, G9a was found to boost nuclear factor-kappa B (NF-κB) transcriptional activity in NSCLC cells through partially downregulating inhibitor of κB (IκBα), and an NF-κB inhibitor partially abolished the enhanced FAK activation by overexpressed G9a, which suggests that G9a-enhanced invasion and activation of FAK may be mediated by elevated NF-κB activity. Notably, a strong positive correlation between the immunohistochemical staining of G9a and phosphorylated FAK proteins was identified in H1299 xenografts and 159 cases of NSCLC tissues (R = 0.408).ConclusionsThese data strongly demonstrate that G9a may promote invasion and metastasis of NSCLC cells by enhancing FAK signaling pathway via elevating NF-κB transcriptional activity, indicating potential significance and therapeutic implications of these pathways in the invasion and metastasis of NSCLCs that overexpress G9a protein.
Development and Validation of Multiparametric Mri-based Nomogram for Predicting Occult Metastasis Risk in Early Tongue Squamous Cell Carcinoma
Authors: Saenthaveesuk Pensiri , Yang Le , Zeng Bin , Xu Meng , Young Simon , Liao Guiqing , Liang Yujie 
Published: June 2020

Abstract
Background: Nomograms are currently used in predicting individualized outcomes in clinical oncology of several cancers. However, nomograms for evaluating occult nodal metastasis of patients with squamous cell carcinoma of lateral tongue (SCCLT) have not been widely investigated for their functionality. This retrospective cohort study was designed to address this question.Methods: This study was divided into primary and validation cohorts. The primary cohort comprised 120 patients diagnosed between 2012 and 2017, whereas the validation cohort included 41 patients diagnosed thereafter. The diagnostic value of multiparametric MRI, including radiologic tumor thickness threshold (rTTT) in three-dimensions, paralingual distance, and sublingual distance were investigated. A nomogram was developed based on stepwise logistic regression of potential predictors associated with nodal metastasis in the primary cohort and then tested for predictive accuracy in the validation cohort using area under the curve (AUC) and goodness-of-fit tests.Results: Multivariate analysis, tumor size (odd ratio [OR] 15.175, 95% confidence interval [CI] 1.436-160.329, P = 0.024), rTTT (OR 11.528, 95% CI 2.483-53.530, P = 0.002), paralingual distance (OR 11.976, 95% CI 1.981-72.413, P = 0.005), and tumor location (OR 6.311, 95% CI 1.514-26.304, P = 0.011) were included in the nomogram to predict the likelihood of having cervical metastasis. A nomogram cutoff value of 210 points (sensitivity 93.8%, specificity 87.5%) was significantly different to classify the patients metastasis risk group (P< 0.001). Nomogram showed predictive accuracy with AUC 0.881 (95% CI 0.779–0.983, P< 0.001) and good calibration after the validation.Conclusions: A preoperative nomogram incorporating multiparametric MRI demonstrated good prediction and performed adequately in our study. Three-dimensional assessment of occult metastasis risk value obtained from this nomogram can assist in preoperative decision making whether to manage with neck surgery for individual patients with early-stage SCCLT. The probability of nodal metastasis tended to be greater than 20% in patients with high metastasis risk or nomogram total score > 210 points.
Research on Steering Stability Control of Dual In-Wheel Motor-Driven EV
Authors: Guo Xiangrong , Chen Yi , Li Hong 
Published: June 2020

Abstract
The dual in-wheel motor electric vehicle has the advantages of fast response and high flexibility, while its stability and safety are more difficult to control. To study the stability control of the dual in-wheel electric vehicle when turning, firstly, the paper establishes the Ackerman model of the dual in-wheel electric vehicle, and controls the wheel speed and slip rate by the method of logical threshold value; then establishes the linear two degree of freedom model of the double hub electric vehicle, obtains the vehicle yaw moment and ideal yaw rate by using the mathematical formula, and controls the wheel speed and slip rate by the sliding mode control. The moment is distributed so that the actual yaw rate keeps tracking the ideal value. The electronic differential control strategy of wheel slip rate and wheel yaw rate is established. Finally, the control strategy is simulated by MATLAB. The simulation results show that the proposed control strategy of slip rate and yaw rate can make the vehicle drive stably when turning.
Identifying predictive factors of rapid response/code blue: A retrospective study using logistic regression analysis
Authors: Thomas Brittany , Knapp Herschel , Patmon Frances 
Published: June 2020

Abstract
Background: Rapid response calls and cardiac arrests are often preceded by observable signs of clinical deterioration often hours prior to the adverse event.Objectives: The purpose of this retrospective study was to identify risk factors that provide predictive value in determining the likelihood of a Rapid Response Call on adult telemetry patients at a single-centre community hospital.Design: This was a retrospective study based on secondary data analysis. After approval by the Institutional Review Board was obtained (CANV DHIRB-2018-362), we utilized the electronic medical record system to extract de-identified quantitative data from patient medical records.Setting: This study utilized medical records from patients on the Telemetry unit at a single-centre, 230-bed community hospital.Participants: The sample consisted of 250 randomized de-identified medical records from both patients who did and did not require a rapid response between January and December, 2018. Patients who were less than 18 years of age and those who were transferred to another facility or to another hospital were excluded from the analyses.Methods: The variables that were collected included age, gender, race, primary admitting medical diagnosis, hemoglobin, potassium, magnesium, creatinine, lactic acid, and urine output. Additional variables collected in four-hour increments included the vital signs: temperature, heart rate, oxygen saturation, respirations, systolic and diastolic blood pressure, and level of consciousness which was scored using the adult Glasgow Coma Scale. Logistic regression analysis was used to identify which of these variables were statistically significant in predicting patient deterioration.Results: The following predictors were statistically significant (a = 0.05 with 95% Confidence Intervals [CI]): For every one beat increase in heart rate 4 hours prior to a RRT, the odds of a RRT increased by 4.9% (p=0.003) (CI=95% 1.016, 1.084). For every one increase in respirations, the odds of a RRT increased by 42.8% (p=0.004) (95% CI 1.11, 1.82), 8 hours before the RRT, and by 47% (p=0.002) (95% CI 1.15, 1.87), 12 hours before a RRT. African Americans had 20.6 times the odds of experiencing an RRT compared to Caucasians (p<0.001) (95% CI 3.4, 124.6), Hispanics had 56.6 times the odds of experiencing a RRT compared to Caucasians (p<0.001) (95% CI 11.4, 280.4), and other races had 6.3 times the odds of a RRT compared to Caucasians (p=0.044) (95% CI 1.05, 38.5).Conclusions: Such predictors can be used to identify early signs of deterioration that can alert health care providers to early intervention.
Awareness and level of knowledge of Surgical Site Infection among Surgical Staff&nbsp;in King Abdullah Medical City in Hajj-2019: A Cross-Sectional Study
Authors: Bamoosa Eman , Idris Khalid , Alsabbah Rufaydah , Faidah Ghali , Alharbi Shahd , Bar Abdullah , Alahdal Amin 
Published: June 2020

Abstract
Background: Surgical site infection (SSI) is a microbial infection of the surgical wound during 30 days of any procedure or within 1 year after the operation. More than 1,600 operations are performed in Makkah during Hajj every year. Many studies examined SSI awareness internationally but up to our knowledge non studies were conducted in Makkah. The purpose of this study is to assess the level of knowledge about SSI among Surgical staff in KAMC during Hajj. Methods: A cross-sectional study conducted to assess the Awareness and level of knowledge of Surgical Site Infection among Surgical Staff in King Abdullah Medical City those who had been participating in healthcare provider team of Hajj season of 2019 using a 20-item anonymous multiple-choice questionnaire Result: About 39.2% of respondents had poor knowledge, 50% had fair knowledge while only 13.7% had good knowledge. There was a relationship between years of experience and level of knowledge. Surgical subspecialty was not associated with the level of knowledge. Almost 20% of respondents did not recognize the SSI definition. There was no association between surgical subspecialty and the level of knowledge. Doctors were more aware than nurses about epidemiological part questions. Age of Surgical Staff was associated with and level of knowledge.Conclusion: Level of knowledge among Surgical Staff needs reinforcement on a larger scale thus we recommend proper awareness courses regarding SSI.
Co-Existence of Diabetes Mellitus And Pre-Existing Cardiovascular Disease, Diabetes Mellitus, And Pre-Existing Cardiovascular Disease And Mortality in Peritoneal Dialysis Patients
Authors: Zhan Xiaojiang , Wen Yueqiang , Zhou Qian , Feng Xiaoran , Peng FenFen , Wang Niansong , Wang Xiaoyang , Wu Xianfeng 
Published: June 2020

Abstract
Background: Little is known over the effect of co-existence of diabetes mellitus (DM) and pre-existing cardiovascular disease (CVD), DM, and pre-existing CVD on mortality among continuous ambulatory peritoneal dialysis (CAPD) patients.Methods: A retrospective study, with 2939 incident Chinese CAPD patients from five facilities between January 1, 2005 and December 31, 2018, was conducted. The primary and secondary outcomes were all-cause and CVD mortality. The association between these interesting comorbidities and mortality was evaluated using the Cox proportional hazards regression.Results: Over a median of 35.1 months of follow-up, 519 (17.7%) patients died, with 258 (8.8%) CVD mortality. Hypertension was independently associated with co-existence of DM and pre-existing CVD using multinomial logistic regression (odd ratio 13.72, 95% CI 6.14 to 30.63). After adjusting for confounding factors, DM plus CVD, DM, and pre-existing CVD groups had a higher risk of all-cause mortality (HR 2.85, 95% CI 2.18 to 3.72; HR 1.89, 95% CI 1.50 to 2.38; and HR 1.43, 95% CI 1.07 to 1.92) and CVD mortality (HR 2.79, 95% CI 1.91 to 4.08; HR 1.88, 95% CI 1.35 to 2.61; and HR 1.82, 95% CI 1.23 to 2.68), respectively, compared to the control group. Compared with those pre-existing CVD patients, DM patients had 1.44 (95%CI 1.04 to 1.98)-time and 1.11 (95%CI 0.72 to 1.71) risk of all-cause and CVD mortality, respectively. There was no significant interaction between DM and CVD on all-cause and CVD mortality (β=0.203, P=0.292; β=0.281, P=0.123) in the study population. Conclusions: CAPD patients with co-existence of DM and pre-existing CVD at baseline are at highest risk of all-cause and CVD mortality, followed sequentially by DM patients and pre-existing CVD patients, with hypertension as a powerful predictor for co-existence of DM and pre-existing CVD. DM patients have a higher risk of all-cause mortality and similar risk of CVD mortality compared with pre-existing CVD patients.
Community Health Worker Knowledge, Attitudes, and Practices Towards Epilepsy in Mozambique
Authors: Cumbe Vasco Francisco Japissane , Greene M. Claire , Fumo Afonso Mazine Tiago , Fumo Hélder , Mabunda Dirceu , Gouveia Maria Lídia Chaúque , Oquendo Maria A. , Duarte Cristiane S. , Sidat Mohsin , Mari Jair de Jesus , Wainberg Milton L. 
Published: June 2020

Abstract
Background: Epilepsy is the most common neurological disease in the world, affecting 50 million people, with the majority living in low- and middle-income countries (LMICs). A major focus of epilepsy treatment in LMICs has focused on task-sharing identification and epilepsy care by community health workers (CHWs). The present study aimed to assess the KAPs of CHWs towards epilepsy in Sofala province, Mozambique.Methods: One hundred and thirty five CHWs completed a questionnaire that included socio-demographic characteristics and 44-items divided in six subscales pertaining to KAPs towards epilepsy (QKAP-EPI) in nine districts of Sofala Province, Mozambique. The internal consistency and factor structure were examined to evaluate the reliability and construct validity of the QKAP-EPI, respectively. To examine correlates of KAPs toward epilepsy we evaluated the association between sociodemographic variables and QKAP-EPI subscales using linear regression models.Results: CHWs demonstrated adequate knowledge regarding epilepsy for medical treatment details (Mean=1.63, SD=0.28) and epilepsy safety/risks (Mean=1.62, SD=0.59). However, CHWs reported low levels of knowledge related to the causes of epilepsy, espousing stigmatizing attitudes, as well as cultural treatment, which is the perception in different cultures of how epilepsy should be treated. Knowledge about how to manage epilepsy during crisis varied across the different types of emergency care practices. Heterogeneity in the level of knowledge regarding epilepsy was observed among CHWs in the different districts of Sofala Province and when using different local names of epilepsy (Dzumba, Nzwiti).Conclusion: CHWs knowledge of medical treatment and epilepsy safety/risks were adequate. However, information on the causes of epilepsy, stigmatizing attitudes, cultural treatment, and some aspects of epileptic crisis response were low. These areas of poor knowledge should be the focus of educating CHWs in increasing their ability to provide quality care for patients with epilepsy in LMICs.
nCoV-2019 infection induces neurological outcome and manifestation, linking its historical ancestor SARS-CoV &amp; MERS-CoV: A systematic review and meta-analysis
Authors: Prakash Ajay , Singh Harvinder , Sarma Phulen , Bhattacharyya Anusuya , Dhibar Deba Prasad , Balaini Neeraj , Shree Ritu , Goyal Manoj , Modi Manish , MEDHI BIKASH 
Published: June 2020

Abstract
Importance: The first systematic review and meta-analysis to help clinician to identify early the sign and symptoms of neurological manifestation in COVID-19 positive patients which further help in early management of patients. Objective: Present systematic review and meta-analysis aimed to discuss the prevalence of neurological involvement of the 2019-nCoV patients and assess the symptomatic trend of events as compared to the 2002 “SARS” and 2012 “MERS” pandemics.Methods: The articles were systematically screened through several search engine and databases. The articles published or in preprint were included in the study till 15th May 2020. The systematic review done as per the published literatures which included 31 cross sectional, observational studies and case reports which revealed neural sign and symptoms in SARS-COV-2 disease. For meta-analysis, we included 09 observational and cross sectional studies which included COVID-19 positive patients and assessed the predominance of various neurological sign and symptoms in COVID-19 patients relation to SARS-2002 and MERS-2012. Data were analyzed by using the “MedCalc Statistical Software version 19.2.6 and reported as pooled prevalence. Heterogeneity was investigated (standard I2 test). Results: We have collected and screened about a total 2615 articles, finally we have included 31 articles for the systematic review and 09 for meta-analysis as per the inclusion/exclusion criteria. The analysis was made as per the prevalence rate of neurological symptoms during the COVID-19 positive patients. The cumulative neurological outcome of SARS-2002 and MERS-2012 was assessed to get the trends which is next tried to correlate the events with the current pandemic. During the analysis severity and outcome of neurological manifestations range from simple headache to vague non-focal complaints to severe neurologic impairment associated with seizure or meningitis.Conclusion & Relevance: Central and peripheral nervous system (CNS/PNS) manifestations were seen during the SARS-2002, MERS-2012 and COVID-19. However, none of the publication found with the primary or secondary objective of finding the neurological manifestation in the COVID-19 patients and their mechanism which strengthen the importance to start more precise clinical trials.