bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Randomized Clinical Trial on Combination Use of Sirolimus and Tacrolimus in Renal Transplant: A De novo Immunosuppression Approach
Authors: Hematian Farzaneh , Dalili Nooshin , Ahmadpoor Pedram , Moradi Omid , Pour-reza-gholi Fatemeh , Samadian Shiva , Samadian Fariba , Nafar Mohsen , Firoozan Ahmad , Ziaie Shadi 
Published: January 2020

Abstract
Background: With the introduction of new immunosuppressive agents like Sirolimus (SRL), we could increase long term allograft survival and decrease the use of other agents like calcineurin inhibitors. SRL in combination with other immunosuppressive medications like calcineurin inhibitors can lead to increase graft function and produce better long-term outcomes. Methods : We enrolled 40 kidney transplantation recipients in trial and followed them up for a duration of 6 months in Shahid Labbafinejad Medical Center. These patients were assigned to receive Tacrolimus (TAC) in combination with Mycophenolic acid or SRL, along with glucocorticoids. All kidney transplant recipients were followed up for serum creatinine and glomerular filtration rate and also complications during therapy. Results : There were no significant differences between the two treated groups regarding serum creatinine level ( p -values = 0.075). However, glomerular filtration rate was significantly increased in SRL group than the other one ( p -values = 0.023). There was no difference between the number of biopsies performed in the two treated groups. In biopsies that were done, in TAC/Mycophenolic acid group, acute antibody mediated rejection in four patients and in SRL/TAC group, acute cellular rejection in two patients were reported. Total cholesterol level was significantly increased in patients who received SRL ( p -values = 0.002). Other side effects were not significantly different in two arms. Conclusions : Our study demonstrated that SRL in the immunosuppressive regimen of kidney transplant recipients in de novo approach lead to better renal function. The long-term outcomes of de novo SRL utilization in kidney allograft recipients should further be assessed. Trial registration: The trial was retrospectively registered in the Iranian Registry on Clinical Trials ( www.irct.ir , registration code: IRCT20160412027346N6), by the date of 04/30/2019. ( https://www.irct.ir/trial/22416 ) Key words : Kidney transplantation, Immunosuppressive Agents, Mammalian target of rapamycin, Calcineurin Inhibitors, Graft Rejection, Sirolimus, Tacrolimus.
Incidence of injuries and illness and related risk factors in mountain biking events: A systematic review protocol
Authors: Buchholtz Kim , Lambert Mike , Burgess Theresa 
Published: January 2020

Abstract

Background Cycling is a popular sport and method of transportation globally but is a significant contributor to sports injury admissions in hospital emergency units. Mountain biking events present additional challenges with remote venues, and isolated courses. Most mountain biking events will provide on-site medical care for both injury and illness occurring during races. These data are essential to understand the true incidence of injury and illness in mountain biking events as national health data may not represent these events specifically. Methods This review will follow the preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement. Search engines PubMed, Scopus, CINAHL (EBSCOhost), PEDro and the Cochrane Library will be systematically searched. Gray literature searches of Google Scholar and manual searching of reference lists and congress abstracts from cycling specific congresses will be conducted. Journal articles documenting illness and injury in adults participating in mountain bike cross-country marathon events will be included. A narrative analysis of the types, severity and area of injuries; and illness type and severity will be performed. A quantitative analysis will be performed should there be sufficient studies reported in the same format. Discussion This protocol outlines a systematic review on injury and illness in mountain biking events. Data from hospital records may not adequately represent the burden of injury and illness at events held in remote venues, especially if those treated on site do not require further hospital based treatment. This review will assist with the development of further research in this area, and in preparation of clinicians working in these types of events. Systematic review registration: This protocol has been registered with PROSPERO International prospective register of systematic reviews (No: CRD42019134584).
Short-term recovery of heart rate variability and its relationship with blood pressure after different intensity treadmill exercise
Authors: Wu Liang , Shi Ping , Shao Jiang , Li Anan , Yu Hongliu , Liu Yang 
Published: January 2020

Abstract
Background : Heart rate variability (HRV) provides an opportunity to capture the tiny but early signs that may predict the future cardiovascular risk in healthy individuals and further, helps understand how well the cardiovascular autonomic system works. Aims of this study were to elucidate short-term recovery of HRV and its relationship with blood pressure recovery after different intensity treadmill exercise. Methods : Fifteen healthy participants performed four different conditions (REST; speed 6km/h; speed 8km/h; speed 10km/h), systolic and diastolic blood pressure per 30s (SBP, DBP) and 5-mins consecutive heart beats intervals were measured after each trial. Autonomic nervous regulation was evaluated using HRV time-frequency domain indices and heart rate asymmetry (HRA) indices. Each index was calculated using 5 mins electrocardiogram (ECG) series and consecutive 30-s windows in 5 mins. Results : the vagally related indices (RMSSD, pNN50 and HF) decreased and the indices representing overall variability (SDNN, LF) had different trends as intensity increasing. The sympathetic-vagal balance parameter LF/HF increased, too. HRV indices had strong correlations with DBP but weak with SBP. Meanwhile, heart rate asymmetry vanished after each trial. Conclusions : The findings suggested a vagal withdrawal as soon as the end of treadmill exercise. It could be concluded that sympathetic modulation was stronger as intensity increasing. During recovery period, DBP was mediated by vagal activation and sympathetic withdrawal. The diminished asymmetry in Poincaré plot was the result of sympathetic acceleration and vagal reduction.
Wounds at risk of tetanus: unexpected prevalence of immunization in a patient cohort
Authors: Piccini Gaia Bavestrello , Cavenaile Jean-Christophe , Bressan Maria Antonietta 
Published: January 2020

Abstract
BackgroundTetanus is an acute and potentially fatal disease caused by Clostridium Tetani, an extremely resilient pathogen. The bacterium can contaminate traumatic wounds which account for approximately 5.4% of all visits to the Emergency Department. According to several surveillance programs, the incidence of clinical tetanus in Italy is ten-fold higher than in other industrialised countries. In 2010, Italy accounted for 57 of the 74 confirmed cases reported in the European Union.Methods The study analysed data from 1094 patients who presented to the Emergency Department of the Fondazione IRRCS Policlinico San Matteo between April 2016 and November 2017 with wounds potentially at risk for infection with Clostridium Tetani.Results Data showed that, in conformity with the literature, the elderly (> 60 years old) constitute a high-risk category, with 219 unprotected individuals out of 238. Also, among patients aged more than 60 years old, there was a statistically significant difference between female and male patients. From the comparative analysis of the data however, it was surprisingly found that even younger patients are lacking protective immunity.Conclusions When considering other medical systems, both European and non-European ones, and analysing their guidelines for the prevention of tetanus infection, the necessity of adopting a well-defined algorithm becomes evident. This, also in order to avoid the excessive administration of prophylaxis, as well as to allow to put in place the necessary preventive measures for each patient. This study highlights the need for a better patient and clinician awareness, and an improvement in record keeping and management of the documentation related to the vaccinations. The analysed data also suggests the need for conducting awareness campaigns on the topic of vaccines and vaccine preventable infections. Patients should be made aware of the importance of keeping track of their own immunization status, and of remembering the date of the last administration of the vaccine or, of carrying around their vaccination card.
Episodes Of Violence Suffered By Migrants Transiting Through Libya: A Cross Sectional Study
Authors: reques laura , Aranda-Fernandez E , Rolland C , Grippon A , Reboul C , Godard N , Luhmann N 
Published: January 2020

Abstract
Introduction The Central Mediterranean Route (CMR), passing through Libya, is one of the most dangerous for migrants from Africa. Episodes of violence have been documented but have not been accurately quantified. The objective of the study was to estimate the prevalence of episodes of violence suffered in Libya by migrants consulting Médecins du Monde (MdM) programs in France.Methodology Monocentric cross-sectional study. The inclusion criteria included all migrants over the age of 18 who had passed through Libya, who arrived in Europe from 2017 and consulted at the MdM health centre in Paris. The presence of psycho-traumatic events was considered as exclusion criteria. The study was implemented from February to May 2019. An ad-hoc questionnaire was created. The proportion, frequency and factors associated to physical, deprivation and sexual violence were estimated, as well as access to health care and need for psychosocial support.Results 98 people were recruited and 72 were interviewed (17 refused to participate and 9 were excluded). 76.4% were men, the average age was 31.9 years, 76.4% had a low level of education, 66.7% came from Ivory Coast and 59.7% had left their country for security reasons. The median length of stay in Libya was 180 days. The overall proportion of persons having suffered violence was 96.4% for men and 88.2% for women. The prevalence of physical, deprivation and sexual violence was 94.2%, 81.7% and 18.% for men and 80.0%, 86.7% and 53.3% for women, respectively. No statistical differences by other variables were found. Access to health care in Libya was non-existent. 63.9% of participants were oriented for psychosocial support.Conclusions The vast majority of migrants report having been victims of violence during their transit in Libya. Women are at particular risk of sexual violence. Mental health support for these populations is urgent.
Tryptophan-like fluorescence as a fingerprint of urban river water intrusion into storm drainage system
Authors: Yin Hailong , Wang Yue , Yang Yang , Huang Jingshui , Xu Zuxin 
Published: January 2020

Abstract
Inappropriate dry-weather misconnections into storm drainage system is a demanding environmental problem worldwide. Especially river water intrusion into storm drains may cause the overloading of storm pipes and unexpected serious dry-weather discharge. In this study, we evaluated the possibility of quantifying proportional source contribution in a storm drainage system with dry-weather misconnections from domestic sewage and river water inflow, using rapid and low-cost fluorescence spectroscopy methods. For this purpose, samples of both misconnection sources and outflows of storm drainage system were collected and analyzed in a downtown catchment of Shanghai, China. Results showed that fluorescent peak intensity of tryptophan-like T1 in domestic sewage (802±126 a.u.) was significantly higher than that in urban river water (57±12 a.u.), while fluorescent peak intensities of tryptophan-like T2 in urban river water (998±187 a.u.) was much higher than that in domestic sewage (241±72 a.u.) due to increased phytoplankton or algal activity in the polluted water. However, only Peak T2 passed the conservative behavior test in the incubation experiments, which could be used as a fingerprint for quantitatively identifying the misconnections of urban river water intrusion. We further developed a Bayesian fluorescence mass balance model (FMBM) to infer the percentage of dry-weather misconnections into the storm drainage system as a function of fluorescence intensities of Peak T2 in the samples of sources and outflows. It was found that the maximum posteriori probability estimate of the percentage of river water intrusion into the storm drains was up to 20.8% in this site, which was validated by the results of on-site investigation. Our findings implied that in-situ fluorescent sensors and Bayesian FMBM for the fingerprint fluorescence peak could be applied to fast track urban river water intrusion into storm drainage system from both qualitative and quantitative perspective with low costs.
Emission Inventory and Spatial Distribution of Particulate Matter from Dust Sources in Zhengzhou City, China
Authors: Yang Huan , Song Xuan , Song Jiarui , Zhang Qi , Cui Jian , Yin Shasha 
Published: January 2020

Abstract
Background: With the rapid development of society and economy, Zhengzhou city, a new first-tier city in central China, is facing high levels of particulate matter (PM) pollution. Dust source has been generally recognized as one of the major source of PM emission that cannot be ignored. In this study, we aimed to establish an emission inventory of PM from dust source and characterize its spatial pattern in Zhengzhou, China. Methods: A GIS＆RS based approach was proposed to establish the emission inventory of total suspended particles (TSP), particulate matter 10 (PM 10 ) and particulate matter 2.5 (PM 2.5 ) from dust source. Bare ground, construction sites and paved roads in 2016 was recognized with high resolution remote sensing data.Technical Guidelines for Emissions Inventory of Particulate Matter Emitted from Dust Source recommended by the Ministry of Ecological Environment (MEP) was used to estimate PM emission, and a spatial grid of 3km×3km resolution was established to display the distribution of PM emission from different dust sources. Results: The total emission of TSP, PM 10 and PM 2.5 in Zhengzhou was 237.5 kt·a -1 , 103.7 kt·a -1 and 22.4 kt·a -1 , respectively in 2016. Compared to other cities in China, the PM emission in Zhengzhou was at a relatively high level. Construction dust source was the main emission source in Zhengzhou, the TSP, PM 10 and PM 2.5 emission of which account for 76.42%, 89.68% and 88.39%, respectively of the total emissions, followed by road dust source and soil dust source. Spatially, total TSP, PM 10 , PM 2.5 emission were larger in main urban areas including Jinshui, Zhongyuan, Erqi, Jingkai and other urban districts. Zhongmou, Xingyang and Xinzheng, which bordering with the main urban area, were also the area with high PM emission, while Dengfeng, Gongyi and other remote areas had relatively small emission of PM. Conclusions: The GIS＆RS based approach has good applicability for identifying the emission characteristics in urban area, and it is urgent for Zhengzhou city to take specific measures for the prevention and control of atmospheric pollution under the severe situation of high- level PM emission.
Quantitative analysis of the effect of fraction of inspired oxygen on peripheral oxygen saturation in healthy volunteers
Authors: Bang Ji-Yeon , Cho Changhun , Lee Eun-Kyung , Choi Byung-Moon , Noh Gyu-Jeong 
Published: January 2020

Abstract
Background The international organization for standardization (ISO) 80601-2-61 dictates that the accuracy of a pulse oximeter should be assessed by a controlled desaturation study. We aimed to characterize the relationship between the fraction of inspired oxygen (FiO 2 ) and peripheral oxygen saturation (SpO 2 ) using a turnover model by retrospectively analyzing the data obtained from previous controlled desaturation studies. We also measured the changes in biomarkers expected to be related to hypoxia (i.e., lactate, carboxyhemoglobin (COHb), and methemoglobin (MetHb)) in response to short-term exposure to hypoxia.Methods Volunteers were exposed to various levels of induced hypoxia over 70−100% arterial oxygen saturation (SaO 2 ). The study period consisted of two rounds of hypoxia and the volunteers were maintained in room air between each round. FiO 2 and SpO 2 were recorded continuously during the study period. A population pharmacodynamic analysis was performed with the NONMEM VII level 4 (ICON Development Solutions, Ellicott City, MD, USA). Lactate, COHb, and MetHb were measured using a CO-oximeter.Results In total, 2899 SpO 2 data points obtained from 20 volunteers were used to determine the pharmacodynamic characteristics. The pharmacodynamic parameters were as follows: k out = 0.942 1/min, Imax = 0.802, IC 50 = 85.3%, γ = 27.3. The changes in SpO 2 due to decreases in FiO 2 well explained by the turnover model with inhibitory function as a sigmoidal model. As SpO 2 decreased, lactate and COHb increased as a whole, and COHb showed the best correlation (Pearson’s correlation, R 2 =0.3263, P < 0.0001).Conclusion The potency of FiO 2 required to reduce SpO 2 from 100% to 70% was 14.7%. Carboxyhemoglobin has the potential to be a useful biomarker for acute hypoxia.
A comparative assessment of Rapid Diagnosis Test (RDT) versus microscopy for malaria diagnosis in health care facilities
Authors: Metoh Theresia Njuabe , Fru Chi Tchampo , FonGah Philip , Zhou Xiaonong 
Published: January 2020

Abstract

Background: Management of malaria requires prompt diagnosis of malaria by microscopy, Rapid Diagnostic Tests (RDTs), or other available tools. The objective of this study was to determine the best approach on malaria diagnosis in detection of malaria parasite in the Northwest region, of Cameroon among different population groups. Materials and method: The cross sectional study was conducted on 60 febrile patients who were directed to the laboratory department for blood screening at the Bamenda Regional Hospital after showing signs and symptoms of malaria infection. Blood sample were collected aseptically and dispensed into an EDTA container where RDTs and microscopic examination were performed to assess the presence of malaria parasites. Results from the rapid diagnostic kits were analyzed and compared to those obtained by general microscopy. Results : Of the 60 samples enrolled 37 (61.7%) were found to be positive with blood films examination while in rapid diagnostic test 27 (45%) were positive. Based on frequency of infection by age 20-35 years had 13 (35.1%) as the most vulnerable group, followed by 0 -5 year with 11 (29.7%), 6-19 had 6 (16.2%) while age group of 36-59 had 5 (16.0%) and lastly the age group of 60 and above had least value of 2 (5.4%). The prevalence of malaria obtained through microscopy (62%) was significantly higher than in RDT (45%). Considering microscopy as the gold standard, RDT exhibited high specificity (100%) and sensitivity (73%) with positive predictive and negative predictive values of 100% and 70%, respectively. The sensitivity of RDT increased significantly with increase in P. falciparum parasitaemia which was the plasmodium specie detected in all positive cases. Conclusion: The study, therefore, highlights that the routine microscopy test demonstrated a superior sensitivity compared to RDT method of malaria diagnosis, however, RDT could be a useful tool in individuals suspected to show high degree of disease spectrum for quick intervention in order to avert danger associated with delayed diagnosis.
Expression of VEGF-C and its association with clinicopathological features among patients with gastric cancer undergoing gastric surgery at Tongji medical hospital, China.
Authors: MAWALLA BRIAN , Luo Xiaoxiao , Xianglin Yuan 
Published: January 2020

Abstract
Objectives:
Gastric cancer shows epidemiological variability according to geographic locations, these differences have been demonstrated both regionally and within countries. There is no baseline protocol regarding using VEGF-C as tumor marker in local setting therefore it was necessary to conduct this study, the current study conducted to analyze the correlation exists between VEGF-C and clinicopathological parameters in patients with gastric cancer undergoing a surgical procedure at Tongji medical hospital.
Results:
161samples analyzed were from Chinese patients who had undergone either palliative or curative surgical procedure between October 2015 and September 2017 at Tongji medical hospital. I mmunohistochemistry was method was used to analyses presence of VEGF-C in tissues. Among 161 gastric cancer patients, 101 (62.7%) gastric samples showed strong VEGF-C expression and 60 (37.3%) gastric samples showed weak VEGF-C expression. Using multivariate logistic regression analysis, tumor grade, invasion of lymph nodes and TNM staging were statistically significantly found to associate with strong expression of VEGF-C. VEGF-C strong expression was significantly seen more in adenocarcinoma of gastric cancer, and Therefore, VEGF-C may be used as a biological marker for assessing the biological characteristics of gastric.
Does the position of cage affect the clinical outcome of lateral interbody fusion in lumbar spinal stenosis?
Authors: Qiao Guangxi , Feng Min , Liu Jian , Wang Xiaodong , Ge Miao , Yang Bin , Yue Bin 
Published: January 2020

Abstract
Background: Lateral interbody fusion (LLIF) decompress the neural elements indirectly by increasing the height of disc, instead of resecting the disc or osteophytes herniated to the canal. When performing LLIF, the position of interbody cage is quite important for the outcome of decompression. This study aims to identify the ideal cage position in LLIF and to investigate if the posterior instrumentation would affect the indirect decompression. Methods: This is a retrospective study. Patients underwent 2-stage surgeries: stage I was LLIF and stage II was percutaneous pedicle screws fixation after 1 week. Anterior disc height (ADH), posterior disc height (PDH), left and right foraminal height (FH) and segmental angle (SA) were measured on lateral CT reconstructions. The cross-sectional area of the thecal sac (CSA) was determined by the outlined area of the thecal sac on a T2-weighted axial MRI. The patients were subgroups according to the cage position: the anterior (cage located at the anterior 1/3 of disc space) and posterior groups (cage located at the posterior 2/3 of disc space). P-values <0.05 were considered significant. Results: This study included 46 patients and 71 surgical levels. After stage I LLIF, significant increase in ADH, PDH, bilateral FH was found in both 2 subgroups, as well as the CSA (all p<0.01). SA increased 2.84±3.2° in anterior group after stage I LLIF and increased 0.81±3.1° in posterior group (p=0.013). After stage II surgery, SA was similar between anterior and posterior group (p=0.20). CSA showed no difference between the 2 groups. Conclusion: The anteriorly placed cage may provide better improvement of anterior disc height and segmental angle after stand-alone LLIF surgery. After the second stage posterior instrumentation, the cage position would not affect the segmental angle or foraminal height.