bluuebunny/crossref_metadata_2025_split huggingface dataset:
Estimated glomerular filtration rate and postoperative mortality in patients undergoing non-cardiac and non-neuron surgery: a single-center retrospective study
Authors: Luo Xueying , Zheng Sujing , Liu Baoer , Yang Liping , Li Ya , Li Feng , Gao Rui , Hu Haofei , He Jinsong 
Published: November 2020

Abstract
Background：There is limited evidence to clarify the specific relationship between preoperative estimated glomerular filtration rate (preop-eGFR) and postoperative thirty-day mortality in Asian patients undergoing non-cardiac and non-neuron surgery. We aimed to investigate details of this relationship.Methods：We reanalyzed a retrospective analysis of the clinical records of 90,785 surgical patients at the Singapore General Hospital from January 1, 2012 to October 31, 2016. The main outcome was postoperative thirty-day mortality.Results ：The average age of these recruited patients was 53.96 ± 16.88 years, of which approximately 51.64% were female. The mean of preop-eGFR distribution was 84.45 ± 38.56mL/min/1.73m2. Multivariate logistic regression analysis indicated that preop-eGFR was independently associated with thirty-day mortality (adjusted odds ratio: 0.992; 95% confidence interval [CI]: 0.990-0.995; P < 0.001). A U-shaped relationship was detected between preop-eGFR and thirty-day mortality with an inflection point of 98.688(P for log likelihood ratio test <0.001). The effect sizes and confidence intervals on the right and left sides of the inflection point were 1.013 (1.007 to 1.019) [P < 0.0001] and 0.984 (0.981 to 0.987) [P < 0.0001], respectively. Preoperative comorbidities such as congestive heart failure (CHF), type 1 diabetes, ischemic heart disease (IHD),and anemia were associated with the odds ratio of preop-eGFR to thirty-day mortality (interaction P < 0.05).Discussion：The relationship between preop-eGFR and thirty-day mortality is U-shaped. The recommended preop-eGFR at which the rate of the thirty-day mortality was lowest was 98.688mL/min/1.73m2.
Effect of Biomechanical Properties on Myopia: a Study of New Corneal Biomechanical Parameters
Authors: Han Fang , Li Mengdi , Wei Pinghui , Ma Jiaonan , Jhanji Vishal , Wang Yan 
Published: November 2020

Abstract
Background: To investigate assess the corneal stress-strain index (SSI), which is a marker for material stiffness and corneal biomechanical parameters , in myopic eyes. Methods: A total of 105 4 6 myopic patients were included in this study. Corneal v isuali s ation Scheimpflug t echnology Corvis ST was used to measure the SSI. Corneal biomechanics w ere as evaluated assessed using the first and second applanation time s (A1- time and A2-time s ), maximum deflection amplitude (DefAmax), deflection area (HCDefArea) , and peak distance at highest concavity peak distance (HC-PD), HC-time, HC-DefA, and HC-PD), integrated radius (IR) , whole eye movement (WEM), stiffness parameter (SP), biomechanically corrected intraocular pressure (BIOP) , and Corvis b iomechanical i ndex (CBI). Scheimpflug tomography was used to obtain the mean keratometery (Km) and central corneal thickness (CCT). All participants were divided into two groups according to the spherical equivalent (SE) (low myopia: SE ≤ 3.00D and high myopia: SE ≥ 6.00D). Results: The mean SSI value was 0.854±0.004. The SSI ha d a positive correlation with A1-time ((r=0.272), HC-time (r=0.218), WEM (r=0.288), SP (r=0.316) , CBI (r=0.199 ) , CCT (r=0.125), BIOP (r=0.230) , and SE (r=0.313) (all p - values＜0.01) . The SSI had a negative correlation with HCDefA (r=-0.721), HCDefArea (r=-0.665), HC-PD(r=-0.597), IR (r=-0.555), DefAmax (r=-0.564) , and Km (r=-0.103) (all p - values＜0.01). There were significant differences in SSI (t=8.960, p＜0.01) and IR (t=-3.509, p＜0.01) between the low and high myopia groups group and high myopia group . Conclusions: In different grades of myopia, the SSI values were lower in eyes with higher SE spherical equivalent s . It indicates that the mechanical strength of the cornea may be compromise d in high myopia. The SSI was positively correlated with the spherical equivalent , and it It may provide a new way to study the mechanism of myopia.
The Potential Role of Local Pharmacies to Assess Asthma Control: an Italian Cross-sectional Study
Authors: Caminati Marco , Cegolon Luca , Bacchini Marco , Segala Nadia , Dama Annarita , Bovo Chiara , Olivieri Bianca , Furci Fabiana , Senna Gianenrico 
Published: November 2020

Abstract
Background. Asthma control and monitoring still represents a challenge worldwide. Although the international guidelines suggest the interplay with primary care as an effective strategy to control the disease, community pharmacies’ are seldom involved in asthma control assessment. The present cross-sectional study aimed at providing a picture of the relationship between asthma severity and control in community pharmacies of the health district of the city of Verona (Veneto Region, North-Eastern Italy).Methods. A call for participation was launched through the Pharmacists’ Association of Verona. Patients referring to the participating pharmacies with an anti-asthmatic drug medical prescription and an asthma exemption code were asked to complete the Asthma Control Test (ACT) and a brief questionnaire collecting information on their age, sex, smoking status, aerobic physical exercise and usual asthma therapy, which also defined asthma severity. A multinomial logistic regression model was fitted to investigate the risk of uncontrolled as well as poorly controlled vs. controlled asthma (base). Results were expressed as relative risk ratios (RRR) with 95% confidence interval (95%CI).Results. 57 community pharmacies accepted to participate and 584 asthmatic patients (54% females; mean-age: 51 ± 19 years) were consecutively recruited from 1st January to 30th June 2018 (6 months). Based upon ACT score 50.5% patients had a controlled asthma, 22.3% a poorly controlled and 27.2% uncontrolled. A variable proportion of patients with uncontrolled asthma were observed for every level of severity, although more frequently with mild persistent form of asthma. Most patients (92%) reported regular compliance with therapy. At multinomial regression analysis, patients under regular asthma treatment course (RRR=0.33; 95%CI: 0.15; 0.77) were less likely to have an ACT<16 compared to those not taking medications regularly.Conclusions. Overall, our findings highlighted an unsatisfactory asthma control in the general population, independently of the severity level of the disease. Community pharmacies could be a useful frontline interface between patients and the health care services, supporting an effective asthma management plan, from disease assessment and monitoring treatment compliance to referral of patients to specialist medical consultancies.
Improvement of Parent’s Awareness, Knowledge, Perception, and Acceptability of HPV Vaccination After a Structured-educational Intervention
Authors: Sitaresmi Mei Neni , Rozanti Nisrina Maulida , Simangunsong Lamria Besty , Wahab Abdul 
Published: November 2020

Abstract
Background: Regardless of the disease burden of human papillomavirus (HPV), the vaccine has not been included in the Indonesia National Immunization Program. Since 2017 there was a demonstration program of the HPV vaccination in Yogyakarta Province. This vaccine was given free to female primary school students in the 5th and 6th grades (11-13 years old). This study aimed to assess whether a structured-educational intervention focus on HPV increases the parental awareness, knowledge, and perceptions toward HPV and the vaccine acceptability.Methods: We conducted a pre-post structured-educational intervention study from July to August 2017 before the implementation of the HPV vaccination demonstration program, in Kulon Progo District, Yogyakarta Province, Indonesia. Parents of female primary school students grades 5th and 6th were selected using a school-based proportional random sampling. A pediatric resident provided a structured-educational intervention, which consists of the burden and risk of HPV disease, as well as the benefit and safety of the vaccine. Parents were required to complete validated self-administered questionnaires before and after the structured-educational intervention. Results: A total of 506 parents participated. Before receiving the structured-educational intervention, parents' awareness of HPV infection and the vaccines were low. Only 49.2% of parents had heard HPV infection, and 48.8% had heard about the vaccine. After the structured-educational intervention, there were significant improvements in parent’s awareness, knowledge, and perceptions of HPV infection, cervical cancer, and HPV vaccination (all p<0.001). HPV vaccine's acceptability increased from 74.3% to 87.4% (p<0.001). There was a significant correlation between increasing HPV vaccine acceptability with the improvement of awareness, knowledge, and perception toward HPV infection, cervical cancer and HPV vaccination (r=0.32 to 0.53, p<0.001). After the structured-educational intervention, better knowledge and positive perceptions of HPV vaccination were predictive of HPV vaccine's acceptability with OR 1.90 (95%CI:1.40-2.57) and OR 1.31(95%CI:1.05-1.63), respectively. Conclusions: A structured-educational intervention may improve parental awareness, knowledge, and perceptions toward HPV and the acceptability of the vaccine. Further study, a randomized control trial with longer follow-up are needed to evaluate the long-term and actual effectiveness of improving parents’ knowledge, perceptions and HPV vaccine acceptability.
A comparative case study of prescribing and non-prescribing physiotherapists and podiatrists
Authors: Carey Nicola , Edwards Judith , Otter Simon , Gage Heather , Williams Peter , Courtenay Molly , Moore Ann , Stenner Karen 
Published: November 2020

Abstract
BackgroundIncreasing numbers of nurses, pharmacists and allied health professionals across the world have prescribing rights for medicines: over 90,000 of the eligible United Kingdom workforce are qualified as non-doctor prescribers. In order to inform future developments, it is important to understand the benefits and impact of prescribing by allied health professionals including physiotherapists and podiatrists.Aim: to compare outcomes of physiotherapist and podiatrist Independent Prescriber (PP- IP) patients with those of physiotherapist and podiatrist non-prescribers (PP-NPs). Outcome measures included patient satisfaction, ease of access to services, quality of life and cost implications.Design: a mixed method comparative case study Methods: Using mixed methods of data collection, outcomes were compared between 7 sites where care was provided from a PP-IP (3 podiatrist and 4 physiotherapist IPs) and 7 sites from a PP-NP (3 podiatrist and 4 physiotherapist NPs). Patients were followed up for 2 months (2015-2016). Results: 489 patients were recruited: n=243 IP sites, and n=246 NP sites. Independent prescribing was found to be highly acceptable, and equivalent in terms of quality of life (p>0.05) and patient satisfaction (p≤0.05) compared to care provided by NPs. PP-IP care delivery was found to be more resource intensive than PP-NP, with longer consultation duration for IPs (around 6.5 mins), and a higher proportion of physiotherapy patients discussed with medical colleagues (around 9.5 minutes). ConclusionThis study provides new knowledge that PP-IPs provide high levels of care. PP-IP care delivery was found to be more resource intensive. Further research is required to explore cost effectiveness. A more focussed exploration within each profession using targeted outcome measures would enable a more robust comparison, inform future developments around the world and help ensure non-doctor prescribing is recognised as an effective way to alleviate shortfalls in the global workforce.
Preoperative risk grade predicts the long-term prognosis of intrahepatic cholangiocarcinoma: a retrospective cohort analysis
Authors: Zhao Jianping , Chen Yao , Wang Jingjing , Wang Jian , Wang Ying , Chai Songshan , Zhang Yuxin , Chen Xiaoping , zhang wanguang 
Published: November 2020

Abstract
Background: Cumulating evidence indicates that the systemic inflammatory response (SIR) plays a crucial role in the prognosis of various cancers. We aimed to generate a preoperative risk grade (PRG) by integrating SIR markers to preoperatively predict the long-term prognosis of intrahepatic cholangiocarcinoma (ICC).Methods: 468 consecutive ICC patients who underwent hepatectomy between 2010 to 2017 were enrolled. The PRG and a nomogram were generated and their predictive accuracy was evaluated. Results: The PRG consisted of two non-tumor-specific SIR markers platelet-to-lymphocyte ratio (PLR) and albumin (ALB), which were both the independent predictors of overall survival (OS). Multivariate analysis showed that the PRG was significantly associated with OS (PRG =1: Hazard ratio (HR) = 3.800, p < 0.001; PRG = 2: HR = 7.585, p < 0.001). The C-index of the PRG for predicting survival was 0.685 (95% CI: 0.655 to 0.716), which was statistically higher than that of the following systems: American Joint Committee on Cancer (AJCC) 8th edition (C-index 0.645), Liver Cancer Study Group of Japan (LCSGJ) (C-index 0.644) and Okabayashi (C-index 0.633) (p < 0.05). Besides, the C-index of the nomogram only consisting of the tumor-specific factors (serum carcinoembryonic antigen, carbohydrate antigen 19-9, tumor number) could be improved to 0.737 (95% CI: 0.062-0.768) from 0.625 (95% CI: 0.585-0.665) when the PRG was incorporated (p < 0.001).Conclusions: The PRG integrating two non-tumor-specific SIR markers PLR and ALB was a novel method to preoperative predicting the prognosis of ICC.
Identification of Potential Biomarkers for Abdominal Pain in IBS Patients by Bioinformatics Approach
Authors: Lin Zhongyuan , Wang Yimin , Lin Shiqing , Liu Decheng , Mo Guohui , Zhang Hui , dou Yunling 
Published: November 2020

Abstract
Background: Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disease characterized by chronic abdominal discomfort and pain. The mechanisms of abdominal pain, as a relevant symptom, in IBS are still unclear. We aimed to explore the key genes and neurobiological changes specially involved in abdominal pain in IBS.Methods: Gene expression data (GSE36701) was downloaded from Gene Expression Omnibus (GEO) database. Fifty-three rectal mucosa samples from Irritable Bowel Syndrome with diarrhea (IBS-D) patients and 40 samples from healthy volunteers (HV) as controls were included. Differentially expressed genes (DEGs) between two groups were identified using the GEO2R online tool. Functional enrichment analysis of DEGs was performed on the DAVID database. Then a protein-protein interaction (PPI) network was constructed and visualized using STRING database and Cytoscape. Results: The microarray analysis demonstrated a subset of genes (CCKBR, CCL13ACPP, BDKRB2, GRPR, SLC1A2, NPFF, P2RX4, TRPA1, CCKBR, TLX2, MRGPRX3, PAX2, CXCR1) specially involved in pain transmission. Among these genes, we identified GRPR, NPFF and TRPA1 genes as potential biomarkers for irritating abdominal pain of IBS patients.Conclusions: Overexpression of certain pain-related genes (GRPR, NPFF and TRPA1) may contribute to chronic visceral hypersensitivity, therefore be partly responsible for recurrent abdominal pain or discomfort in IBS patients. Several synapses modification and biological process of psychological distress may be risk factors of IBS.
Exosomal miR-29b found in aqueous humour mediates calcium signaling in diabetic patients with cataract
Authors: Gao Chao , Liu Xin , Fan Fan , Yang Jianing , Zhou Xiyue , Mei Hengjun , Lin Xiaolei , Luo Yi 
Published: November 2020

Abstract
Background: Ca2+ was supposed to play an important role in the cataract formation. Exosomal miR-29b from aqueous humour may play an important role in the mechanism of diabetes and cataracts. The purpose of this study was to investigate the role of exosomal miR-29b and Ca2+ in regulating the function of human lens epithelial cells. Methods: Exosomes were isolated from human aqueous humour by ultracentrifugation, and visualized by nanoparticle tracking and transmission electron microscopy. Exosomal miRNA sequencing was performed to identify differentially expressed miRNAs between diabetes and cataracts group (DMC) and age-related cataracts group (ARC). TargetScan was used to predict potential target of certain miRNA. The expression of CACNA1C mRNA was determined by quantitative real-time PCR and CACNA1C protein was determined by Western blotting. Concentration of Ca2+ in human aqueous humour and the culture supernatant of cells was detected by the Calcium Assay Kit. Cell Counting Kit-8 was used to determine cell viability. Results: Exosomes were isolated from human aqueous humour, which had a typical cup-shaped phenotype and a particle size distribution in accordance with micro extracellular vesicles. Exosomal miRNA sequencing revealed that miR-29b was significantly downregulated in diabetes and cataracts group (DMC) compared with age-related cataracts group (ARC). Ca2+ concentration of human aqueous humour in DMC was higher than that in ARC. The culture supernatant of cells transfected with miR-29b inhibitors had a higher concentration of Ca2+ than that transfected with miR-29b mimics. miR-29b reduced the viability of human lens epithelium cells (HLECs) by upregulating CACNA1C expression.Conclusions: Exosomes isolated from human aqueous humour contained abundant miRNAs. A significantly expressed miRNA, miR-29b, could affect the concentration of Ca2+ and regulate HLEC processes by upregulating CACNA1C.
Lameness in fattening pigs – Mycoplasma hyosynoviae, osteochondropathy and reduced dietary phosphorus level as three influencing factors: A case report
Authors: Wegner Birte , Tenhündfeld Jörg , Vogels Johanna , Beumer Marius , Kamphues Josef , Hansmann Florian , Rieger Hanna , Beilage Elisabeth grosse , Hennig-Pauka Isabel 
Published: November 2020

Abstract
BackgroundMultiple diagnostic procedures, their results and interpretation in a case with severe lameness in fattening pigs are described. It is shown that selected diagnostic steps lead to identification of various risk factors for disease development in the affected herd. One focus of this case report is the prioritization of diagnostic steps to verify the impact of the different conditions, which finally led to the clinical disorder. Assessing a sufficient dietary phosphorus (P) supply and its impact on disease development proved most difficult. The diagnostic approach based on estimated calculation of phosphorus intake is presented in detail.Case presentationOn a farrow-to-finishing farm, lameness occurred in pigs with 30-70 kg body weight. Necropsy of three diseased pigs revealed claw lesions and alterations at the knee and elbow joints. Histologic findings were characteristic of osteochondrosis. All pigs were positively tested for Mycoplasma hyosynoviae in affected joints. P values in blood did not indicate a P deficiency, while bone ashing in one of three animals resulted in a level indicating an insufficient mineral supply. Analysis of diet composition revealed a low phosphorus content in two diets, which might have led to a marginal P supply in individuals with high average daily gains with respect to development of bone mass and connective tissue prior to presentation of affected animals. Finally, the impact of dietary factors for disease development could not be evidenced in all submitted animals in this case.ConclusionsMycoplasma (M.) hyosynoviae was identified to be an important etiologic factor for disease. Other, non-infectious factors, such as osteochondrosis and claw lesions might have favored development of lameness. In addition, a relevant marginal P supply for pigs was found in a limited time period in a phase of intense growing, but the potential interaction with infection by M. hyosynoviae is unknown. The presented case of severe lameness in fattening pigs revealed that three different influences presumably act in pathogenesis. Focusing only on one factor and ignoring others might be misleading regarding subsequent decision-making for prevention and therapy. Finally, clinical symptoms disappeared after some changes in diet composition and anti-inflammatory treatment of individual animals.
Epidemiological characteristics of four common respiratory viral infections in children
Authors: Zhu Guohong , Xu Dan , Zhang Yuanyuan , Wang Tianlin , Zhang Lingyan , Gu Weizhong , Shen Meiping 
Published: November 2020

Abstract
Background: Viruses are the main infectious agents of acute respiratory infections (ARIs) in children. We aim to describe the epidemiological characteristics of viral pathogens of acute respiratory tract infections in outpatient children.Methods: From April 2018 to March 2019, the results of viral detection using oral pharyngeal swabs from 103,210 children with acute respiratory tract infection in the outpatient department of the Children’s Hospital, Zhejiang University School of Medicine, were retrospectively analyzed. Viral antigens, including adenovirus (ADV), influenza A (FLUA), influenza B (FLUB) and respiratory syncytial virus (RSV), were detected by the colloidal gold method.Results: At least one virus was detected in 38,355 cases; the positivity rate was 37.2%. A total of 1910 cases of mixed infection with two or more viruses were detected, and the positivity rate of multiple infection was 1.9%. The ADV positivity rate was highest in the 3-6-year-old group (18.7%), the FLUA positivity rate was highest in the >6-year-old group (21.6%), the FLUB positivity rate was highest in the >6-year-old group (6.6%), and the RSV positivity rate was highest in the <1-year-old group (10.6%). There was a significant difference in the positivity rate of viral infection among different age groups (χ2 = 1280.7, P < 0.001). The rate of positive viral infection was highest in winter (47.1%). The ADV infection rate was highest in spring (18.2%). The rates of FLUA and FLUB positivity were highest in winter (28.8% and 3.6%, respectively). The rate of RSV positivity was highest in autumn (17.4%). The rate of positive viral infection in different seasons was significantly different (χ2 = 6459.1, P < 0.001).Conclusions: Viral infection rates in children differ for different ages and seasons. The positivity rate of ADV is highest in the preschool period and that of RSV is highest in infants; that of FLU increases with age. The total positive rate of viral infection in different seasons is highest in winter, as is the rate of FLU positivity.