bluuebunny/crossref_metadata_2025_split huggingface dataset:
Kinetic changes in virology, specific antibody response and imaging during the clinical course of COVID-19: A descriptive study
Authors: Wang Qiu-jing , Yao Yan-zhen , Song Jun-shuai , Wang Qiao , Xu Li-yun , Bao Zhou-jun , Mao Dai-wen , Zhou Ji-hang , Zhang Zhe-en , Wang Yan , Li Yi-wei , Wang He-ping , Li Lue , Pan Hai-yan , Zhang Guo-qiang , Li Shi-bo 
Published: September 2020

Abstract
Background: To explore the kinetic changes in virology, specific antibody response and imaging during the clinical course of COVID-19.Methods: This observational study enrolled 20 patients with COVID-19, who were hospitalized between January 20-April 6, 2020, in the two COVID-19 designated hospitals of Zhoushan, Zhejiang and Rushan, Shandong, China, The laboratory findings, imaging, serum response to viral infection, and viral RNA level in the throat and stool samples were assessed from onset to recovery phase in patients with COVID-19. Results: SARS-COV-2 RNA was positive as early as day four. It remained positive until day 55 post-onset in the sputum-throat swabs and became negative in most cases (55%) within 14 days after onset. Lymphocytopenia occurred in 40% (8/20) of patients during the peak infection period and returned to normal at week five. The most severe inflammation in the lungs appeared in week 2 or 3 after onset, and this was completely absorbed between week 6 and 8 in 85.7% of patients. All patients had detectable antibodies to the receptor binding domain (RBD), and 95% of these patients had IgG to viral N proteins. The antibody titer peaked at week four. Anti-S IgM was positive in 7 of 20 patients after week three. Conclusions: All COVID-19 patients in this cohort were self-limiting and recovered well though it may take as long as 6-8 weeks. Our findings on the kinetic changes in imaging, serum response to viral infection and viral RNA level may help understand pathogenesis and define clinical course of COVID-19.
Promoting Social Capital, Self-management and Health Literacy in Older Adults Through a Group-based Intervention Delivered in Low-income Urban Areas: Results of the Randomized Trial AEQUALIS
Authors: Blancafort Sergi , Nadal Rosa Monteserín , Moral Irene , Fígols Marta Roqué , Luque Xavier Rojano i , Coll-Planas Laura 
Published: September 2020

Abstract
BackgroundEvidence is scarce on how to promote health and decrease cumulative inequalities for disadvantaged older people. Downstream complex interventions focusing on intermediate factors (self-management, health literacy and social capital) may have the potential to mitigate the inequitable impacts of social determinants in health. The aim of the AEQUALIS study was to assess the effectiveness of a group-based intervention to improve self-perceived health as indicator of health inequality. MethodsPragmatic randomised clinical trial addressed to older adults (≥ 60 years) living in urban disadvantaged areas with low self-perceived health. The intervention was delivered in primary care settings and community assets between 2015-2017 and consisted in 12 weekly sessions. The primary outcome was self-perceived health assessed in two ways: with the first item of the SF-12 questionnaire, and with the EQ-5D visual analog scale. Secondary outcomes were health-related quality of life, social capital, self-management, mental health and use of health services. Outcomes were assessed at baseline, post intervention and follow-up at 9 months after the end of the intervention. Results390 people were allocated to the intervention group (IG) or the control group (CG) and 194 participants and 164 were included in the data analysis, respectively. Self perceived health as primary outcome assessed with SF-12-1 was not specifically affected by the intervention, but with the EQ-5D visual analog scale showed a significant increase at one-year follow-up only in the IG (MD=4.80, 95%CI [1.09, 8.52]). IG group improved health literacy in terms of a better understanding of medical information (-0.62 [-1.10, -0.13]). The mental component of SF-12 improved (3.77 [1.82, 5.73]), and depressive symptoms decreased at post-intervention (-1.26 [-1.90, -0.63]), and at follow-up (-0.95 [-1.62, -0.27]). The use of antidepressants increased in CG at the follow-up (1.59 [0.33, 2.86]), while it remained stable in the IG. ConclusionsThis study indicates that a group intervention with a strong social component, conducted in primary health care and community assets, shows promising effects on mental health and can be used as a strategy for health promotion among older adults in urban disadvantaged areas.Trial registration: ClinicalTrials.gov, NCT02733523. Registered 11 April 2016 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02733523
Repercussions of the COVID-19 Pandemic on the Well-being and Training of Medical Clerks: A Pan-Canadian Survey
Authors: Abbas Myriam , Dhane Malek , Beniey Michèle , Meloche-Dumas Léamarie , Eissa Mohamed , Guérard-Poirier Natasha , El-Raheb Myriam , Lebel-Guay Florence , Dubrowski Adam , Patocskai Erica 
Published: September 2020

Abstract
Background: The COVID-19 pandemic has been an unprecedented and potentially stressful event that inserted itself into the 2019-2020 Canadian medical curriculum. However, its impact on stress and subsequent professional pathways is not well understood. This study aims to assess the impact of the COVID-19 pandemic on the mental well-being, training, and career choices of Canadian medical clerks within the first three months of the pandemic. It also aims to assess their use of university support systems and their appreciation of potential solutions to common academic stressors.Methods: An electronic survey composed of four sections: demographics, stressors experienced during the pandemic, World Health Organization (WHO) well-being index, and stress management and resources was distributed to Canadian clerks. Results: Clerks from 10 of the 17 Canadian medical faculties participated in this study (n=627). Forty-five percent of clerks reported higher levels of stress than usual; 22% reconsidered their residency choice; and 19% reconsidered medicine as a career. The factors that were most stressful among clerks were: the means of return to rotations; decreased opportunities to be productive in view of residency match; and taking the national licensing exam after the beginning of residency. The mean WHO well-being index was 14.8/25 ± 4.5, indicating a poor level of well-being among a considerable proportion of students. Clerks who reconsidered their residency choice or medicine as a career had lower mean WHO well-being indices. Most clerks agreed with the following suggested solutions: training sessions on the clinical management of COVID-19 cases; being allowed to submit fewer reference letters when applying to residency; and having protected time to study for their licensing exam during residency. Overall, clerks were less concerned with being infected during their rotations than with the impact of the pandemic on their future career and residency match. Conclusion: The COVID-19 pandemic had a considerable impact on the medical curriculum and well-being of clerks. A number of student-identified solutions were proposed to reduce stress. The implementation of these solutions throughout the Canadian medical training system should be considered.
Clinical outcomes of acute pulmonary embolectomy as the first-line treatment for massive and submassive pulmonary embolism：a single-centre study in China
Authors: Qimin Wang , Liangwan Chen , Daozhong Chen , Hanfan Qiu , Zhongyao Huang , Xiaofu Dai , Xueshan Huang , Feng Lin , Huabin Chen 
Published: September 2020

Abstract
Background: Acute pulmonary embolism (PE) is one of the most critical cardiovascular diseases. PE treatment ranges from anticoagulation, and systemic thrombolysis to surgical embolectomy and catheter embolectomy. Surgical pulmonary embolectmy (SPE) indications and outcomes are still controversial. Although there have been more favourable SPE reports over the past decades, SPE has not yet been considered broadly as an initial PE therapy and is still considered as a reserve or rescue treatment for acute massive PE when systemic thrombolysis fails. This study aimed to evaluate the early and midterm outcomes of SPE, which was a first-line therapy for acute central major PE in one Chinese single centre. Methods: A retrospective review of patients who underwent SPE for acute PE was conducted .Patients with chronic thrombus or who underwent thromboendarterectomy were excluded. SPE risk factors for morbidity and mortality were reviewed, and echocardiographic examination were conducted for follow-up studies to access right ventricular functionResults: Overall, 41 patients were included; 17 (41.5%) had submassive PE, and 24 (58.5%) had massive PE. Mean cardiopulmonary bypass time was 103.2±48.9 min, and 10 patients (24.4%) underwent procedures without aortic cross-clamping . Ventilatory support time was 78 h (range, 40-336 h), intensive care unit stay was 7 days (range, 3-13 days), and hospital stay was 16 days (range, 12-23 days).Operative mortalities occurred in 3 massive PE patients, and no mortality occurred in submassive PE patients. The overall SPE mortality rate was 7.31% (3/41). If two systemic thrombolysis cases were excluded, SPE mortality was low (2.56%,1/39), evenlthough there were 2 cases of cardiac arrest preoperatively. Patients’ right ventricle function improved postoperatively in follow-ups .There were no deaths related to recurrent PE and chronic pulmonary hypertension in follow-ups, though 3 patients died of cerebral intracranial bleeding, gastric cancer,and brain cancer at 1 year, 3 years, and 8 years postoperatively, respectively. Conclusions: SPE presented with a low mortality rate when rendered as a first-line treatment in selected massive and submassive acute PE patients. Favorable outcomes of right ventricle function were also observed in the follow-ups . SPE should play the same role as ST in algorithmic acute PE treatment.
Plasmacytoid urothelial carcinoma of renal pelvis with positive zinc finger E–box–binding homeobox 1: a case report
Authors: Takada-Owada Atsuko , Nozawa Yumi , Onozaki Masato , Noda Shuhei , Jamiyan Tsengelumaa , Nakazato Yoshimasa , Tokura Yuumi , Kamai Takao , Ishida Kazuyuki 
Published: September 2020

Abstract
BackgroundThe tumor transformation mechanism of a plasmacytoid urothelial carcinoma remains unexplained. We describe the case of a plasmacytoid urothelial carcinoma of the renal pelvis in which the expression of zinc finger E–box–binding homeobox 1 (ZEB1), a key nuclear transcription factor in an epithelial–mesenchymal transition, is involved in tumor transformation.Case presentationThe patient had a left nephrectomy with the clinical diagnosis of left pelvic renal cancer. The resected specimen showed that the tumor surface comprised a noninvasive papillary urothelial carcinoma with the carcinoma in situ, and the invasive area comprised a plasmacytoid urothelial carcinoma characterized by the presence of single dyscohesive malignant cells that resembled plasma cells in a loose myxoid stroma. The noninvasive urothelial carcinoma was positive for cytokeratin and E–cadherin, and negative for vimentin and ZEB1. In contrast, the invasive plasmacytoid urothelial carcinoma was positive for cytokeratin and also vimentin and ZEB1, and negative for E–cadherin. Additionally, this component was immunoreactive for CD138 and CD38 that are immunohistochemical markers for plasma cells.ConclusionWe suggest that ZEB1 is involved in the plasmacytoid transformation by repressing the E–cadherin in a plasmacytoid urothelial carcinoma.
Noise Sensitivity Associated with Nonrestorative Sleep in Chinese Adults: A cross-sectional Study
Authors: Li Sha , Fong Daniel Yee Tak , Wong Janet Yuen Ha , McPherson Bradley , Lau Esther Yuet Ying , Huang Lixi , IP Mary Sau Man 
Published: September 2020

Abstract
Background: Nonrestorative sleep (NRS) is associated with various psychological and physical health issues. Noise exposure and noise sensitivity have been proposed to contribute to NRS. This study aimed to examine the relationship between noise, noise sensitivity, NRS, and physiological sleep parameters among Chinese adults.Methods: A cross-sectional household study was conducted with Chinese adults in Hong Kong. We administered a battery of questionnaires, including the Nonrestorative Sleep Scale and the Weinstein Noise Sensitivity Scale for assessing NRS and noise sensitivity, respectively, as well as other instruments for assessing sociodemographics, lifestyle factors, social support, somatic symptoms, stress, anxiety, and depression. Nocturnal noise level was measured for one week by a noise dosimeter. Physiological sleep parameters were also measured by actigraphy during the night-time for a week.Results: A total of 500 (66.4% female) adults with an average age of 39 years participated in this study. There was no significant association between nocturnal noise and NRS (b = -0.09, 95% CI: -0.28, 0.10). However, one unit increase of noise sensitivity was associated with 0.08 increase in NRS (95% confidence interval [CI]: 0.01, 0.15), both on a 0–100 scale, after adjusting for sociodemographics, lifestyle factors, nocturnal noise, social support, somatic symptoms, stress, anxiety, and depression. This relationship remained after adjusting for sleep parameters. Nevertheless, nocturnal noise was significantly negatively associated with total time in bed (b = -1.46, 95% CI: -2.51, -0.40), and total sleep time (b = -1.26, 95% CI: -2.18, -0.34). None of the obtained physiological sleep parameters were associated with NRS.Conclusions: NRS was associated with noise sensitivity while physiological sleep parameters were influenced by nocturnal noise level.
Identification of potential prognostic markers for osteosarcoma by integrated analysis
Authors: Ge Yuxiang , Ding Wang , Bian Chong , Gu Huijie , Xu Jun , Yin Xiaofan 
Published: September 2020

Abstract
Background: Osteosarcoma (OS), one of the utmost common and malignant cancer, accounts for over 30% among skeletal sarcomas. Although great efforts have been made, the mechanism of OS still remains largely unknown. Here, we intend to identify gene modules and candidate biomarkers for clinical diagnosis of patients with OS, and reveal the mechanisms of OS progression.Methods: Weighted gene co-expression network analysis (WGCNA) was conducted to build a co-expression network and investigate the relationship between modules and clinical traits. Functional enrichment analysis was performed on module genes. Protein-protein interaction (PPI) network was constructed to identify the hub gene and the expression level of hub genes was validated based on another dataset.Results: A total of 9854 genes were included in WGCNA, and 17 gene modules were constructed. Gene module related with OS in sacrum was mainly enriched in skeletal system development, bone development and extracellular structure organization. Furthermore, we screened the top 10 hub genes and further validated 5 of the 10 (MMP13, DCN, GNG2, PCOLCE and RUNX2), the expression of which were upregulated as compared with normal tissues.Conclusion: The hub gene we identified show great promise as prognostic markers for the management of OS and our findings also provide new insight for molecular mechanism of OS.
Individualized flow-controlled ventilation compared to best clinical practice pressure-controlled ventilation: a prospective randomized porcine study.
Authors: Spraider Patrick , Martini Judith , Abram Julia , Putzer Gabriel , Glodny Bernhard , Hell Tobias , Barnes Tom , Enk Dietmar 
Published: September 2020

Abstract
Background: Flow-controlled ventilation is a novel ventilation method which allows to individualize ventilation according to dynamic lung mechanic limits based on direct tracheal pressure measurement at a stable constant gas flow during inspiration and expiration. The aim of this porcine study was to compare individualized flow-controlled ventilation (FCV) and current guideline-conform pressure-controlled ventilation (PCV) in long-term ventilation.Methods: Anesthetized pigs were ventilated with either FCV or PCV over a period of ten hours with a fixed FiO2 of 0.3. FCV settings were individualized by compliance-guided positive end-expiratory pressure (PEEP) and peak pressure (Ppeak) titration. Flow was adjusted to maintain normocapnia and the inspiration to expiration ratio (I:E ratio) was set at 1:1. PCV was performed with a PEEP of 5 cm H2O and Ppeak was set to achieve a tidal volume (VT) of 7 ml/kg. The respiratory rate was adjusted to maintain normocapnia and the I:E ratio was set at 1:1.5. Repeated measurements during observation period were assessed by linear mixed-effects model.Results: In FCV (n=6) respiratory minute volume was significantly reduced (6.0 vs 12.7, MD -6.8 (-8.2 to -5.4) l/min; p<0.001) as compared to PCV (n=6). Oxygenation was improved in the FCV group (paO2 119.8 vs 96.6, MD 23.2 (9.0 to 37.5) torr; 15.97 vs 12.87, MD 3.10 (1.19 to 5.00) kPa; p=0.010) and CO2 removal was more efficient (paCO2 40.1 vs 44.9, MD -4.7 (-7.4 to -2.0) torr; 5.35 vs 5.98, MD -0.63 (-0.99 to -0.27) kPa; p=0.006). Ppeak and driving pressure were comparable in both groups, whereas PEEP was significantly lower in FCV (p=0.002). Computed tomography revealed a significant reduction in non-aerated lung tissue in individualized FCV (p=0.026) and no significant difference in overdistended lung tissue, although a significantly higher VT was applied (8.2 vs 7.6, MD 0.7 (0.2 to 1.2) ml/kg; p=0.025).Conclusion: Our long-term ventilation study demonstrates the applicability of a compliance-guided individualization of FCV settings, which resulted in significantly improved gas exchange and lung tissue aeration without signs of overinflation as compared to best clinical practice PCV.
Heart Rate at Discharge in Patients with Acute Decompensated Heart Failure is a Predictor of Mortality
Authors: Vollmert Thomas , Hellmich Martin , Gassanov Natig , Er Fikret , Yücel Seyrani , Erdmann Erland , Caglayan Evren 
Published: September 2020

Abstract
Aims Heart failure is a syndrome with increasing prevalence in concordance with the aging population and better survival rates from myocardial infarction. Morbidity and mortality are high in chronic heart failure patients, particularly in those with hospital admission for acute decompensation. Several risk stratification tools and score systems have been established to predict mortality in chronic heart failure patients. However, identification of patients at risk with easy obtainable clinical factors that can predict mortality in acute decompensated heart failure (ADHF) are needed to optimize the care-path. Methods and Results We retrospectively analyzed electronic medical records of 78 patients with HFrEF and HFmrEF who were hospitalized with ADHF in the Heart Center of the University Hospital Cologne in the year 2011 and discharged from the ward after successful treatment. 37.6±16.4 months after index hospitalization 30 (38,5%) patients had died. This mortality rate correlated well with the calculated predicted survival with the Seattle Heart Failure Model (SHFM) for each individual patient. In our cohort, we identified elevated heart rate at discharge as an independent predictor for mortality (p=0.016). The mean heart rate at discharge was lower in survived patients compared to patients who died (72.5±11.9 bpm vs. 79.1±11.2 bpm. Heart rate of 77 bpm or higher was associated with an almost doubled mortality risk (p=0.015). Heart rate elevation of 5 bpm was associated with an increase of mortality of 25% (p=0.022).Conclusions Patients hospitalized for ADHF seem to have a better prognosis, when heart rate at discharge is <77 bpm. Heart rate at discharge is an easily obtainable biomarker for risk prediction of mortality in HFrEF and HFmrEF patients treated for acute cardiac decompensation. Taking into account this parameter could be useful for guiding treatment strategies in these high-risk patients. Prospective data for validation of this biomarker and specific intervention is needed.
Biomechanical Study of the C5-C8 Cervical Extraforaminal Ligaments
Authors: Zhao Qinghao , Yang Yemei , Wu Penghuan , Huang Chengyan , Zhang Rusen , Li Qingchu , Shi Benchao 
Published: September 2020

Abstract
Background

The anatomical distribution of the extraforaminal ligaments in the cervical intervertebral foramina has been well studied. However, detailed descriptions of the biomechanical characteristics of these ligaments are lacking.

Methods

The paravertebral muscles were dissected, and the extraforaminal ligaments and nerve roots were identified. The C5 and C7 or C6 and C8 cervical nerve roots on both sides were randomly selected, and a window was opened on the vertebral lamina to expose the posterior spinal nerve root segments. Five needles were placed on the nerve root and the bone structure around the intervertebral foramen; the distal end of the nerve root was then tied with silk thread, and the weights were connected across the pulley. A weight load was gradually applied to the nerve root (50 g/ time, 60 times in total). At the end of the experiment, segments of the extraforaminal ligaments were selectively cut off to compare the changes in nerve root displacement.

Results

The displacement of the C5, C6, C7, C8 nerve roots increases with an increasing traction load, and the rate of change of nerve root displacement in the intervertebral foramen is smaller than that in the nerve root on the outside area (p <0.05). Extraforaminal ligaments can absorb part of the pulling load of the nerve root; the C5 nerve root has the largest load range.

Conclusions

Cervical extraforaminal ligaments can disperse the tension load on the nerve root and play a role in protecting the nerve root. The protective effect of the C5 nerve root was the strongest, and this may anatomically explain why the C5 nerve roots are less prone to simple avulsion.