bluuebunny/crossref_metadata_2025_split huggingface dataset:
The ferroptosis and iron-metabolism signature robustly predicts clinical diagnosis, prognosis and immune microenvironment for hepatocellular carcinoma
Authors: Ji Jiansong , Tang Bufu , Zhu Jinyu , Li Jie , Fan Kai , Gao Yang , Cheng Shimiao , Kong Chunli , Zheng Liyun , Wu Fazong , Weng Qiaoyou , Lu Chenying 
Published: June 2020

Abstract
Background : In this study, we comprehensively analyzed genes related to ferroptosis and iron metabolism to construct diagnostic and prognostic models and explore the relationship with the immune microenvironment in HCC. Methods : Integrated analysis, cox regression and the least absolute shrinkage and selection operator (LASSO) method of 104 ferroptosis- and iron metabolism-related genes and HCC-related RNA sequencing were performed to identify HCC-related ferroptosis and iron metabolism genes. Results : four genes (ABCB6, FLVCR1, SLC48A1 and SLC7A11) were identified to construct prognostic and diagnostic models. Poorer overall survival (OS) was exhibited in the high-risk group than that in the low-risk group in both the training cohort (P < 0.001, HR = 0.27) and test cohort (P < 0.001, HR = 0.27). The diagnostic models successfully distinguished HCC from normal samples and proliferative nodule samples. Compared with low-risk groups, high-risk groups had higher TMB; higher fractions of macrophages, follicular helper T cells, memory B cells, and neutrophils; and exhibited higher expression of CD83, B7H3, OX40 and CD134L. As an inducer of ferroptosis, erastin inhibited HCC cell proliferation and progression, and it was showed to affect Th17 cell differentiation and IL-17 signaling pathway through bioinformatics analysis, indicating it a potential agent of cancer immunotherapy. Conclusions: The prognostic and diagnostic models based on the four genes indicated superior diagnostic and predictive performance, indicating new possibilities for individualized treatment of HCC patients.
Importance of lipid ratios for predicting intracranial atherosclerotic stenosis
Authors: Yang Wen-Song , Li Rui , Shen Yi-Qing , Wang Xing-Chen , Liu Qing-Jun , Wang Hai-Yang , Li Qi , Yao Guo-En , Xie Peng 
Published: June 2020

Abstract
Background: This study aims to investigate the association of lipid ratios with intracranial atherosclerotic stenosis (ICAS) in a Chinese population.Methods: This cross-sectional study included 658 consecutive patients with ischemic stroke. Intracranial and extracranial arteries were evaluated for atherosclerotic stenosis using digital subtraction angiography or computed tomography angiography. Lipid ratios [total cholesterol (TC)/high-density lipoprotein-cholesterol (HDL-C), triglycerides (TG)/HDL-C, low-density lipoprotein-cholesterol (LDL-C)/HDL-C, non-high-density lipoprotein-cholesterol (non-HDL-C)/HDL-C, remnant cholesterol (RC)/HDL-C, apolipoprotein B (apo B)/apolipoprotein A-I (apo A-I), and apo B/HDL-C] were calculated.Results: The TC/HDL-C, LDL-C/HDL-C, RC/HDL-C, non-HDL-C/HDL-C, apo B/HDL-C and apo B/apo A-I ratios (all P <0.05) were significantly associated with ICAS but not with extracranial atherosclerotic stenosis after adjustment for confounding factors. Receiver operating characteristic (ROC) curves analyses revealed that the apo B/apo A-I ratio had the largest area under the ROC curve (AUC) among lipid levels alone and for lipid ratios (AUC = 0.588). Lipid ratios had higher AUC values than those for lipid levels alone for the identification of ICAS.Conclusion: The TC/HDL-C, LDL-C/HDL-C, RC/HDL-C, non-HDL-C/HDL-C apo B/HDL-C, and apo B/apo A-I ratios were significantly related to ICAS risk. Compared with the other variables tested, the apo B/apo A-I ratio appeared to be a better discriminator for identifying ICAS risk in stroke patients. Take home message: Several lipid ratios were significantly related to ICAS risk and have several differences between men and women in stroke patients.
Tuberculosis registration rates analysis and prediction based on exponential smoothing model: could tuberculosis control milestones be achieved in 2020, 2025 in Henan province, China?
Authors: Zhang Yanqiu , Li Xinxu , Li Weibin , Jiang Jianguo , Zhang Guolong , Zhuang Yan , Xu Jiying , Shi Jie , Sun Dingyong 
Published: June 2020

Abstract
Background: The World Health Organization (WHO) End TB Strategy meant that compared with 2015 baseline, the reduction in pulmonary tuberculosis (PTB) incidence should be 20% and 50% in 2020 and 2025, respectively. The case number of PTB in China accounted for 9% of the global total in 2018, which ranked the second high in the world. From 2007 to 2019, 854,672 active PTB cases were registered and treated in Henan Province, China. We need to assess whether the WHO milestones could be achieved in Henan Province.Methods: The active PTB numbers in Henan Province from 2007 to 2019, registered in Chinese Tuberculosis Information Management System (CTIMS) were analyzed to predict the active PTB registration rates in 2020 and 2025, which is conductive to early response measures to ensure the achievement of the WHO milestones. The time series model was created by monthly active PTB registration rates from 2007 to 2016, and the optimal model was verified by data from 2017 to 2019. Monthly active PTB registration rates and 95% confidence interval (CI) from 2020 to 2025 were predicted.Results: High active PTB registration rates in March, April, May and June showed the seasonal variations. The exponential smoothing winter’s multiplication model was selected as the best-fitting model. The predicted values were approximately consistent with the observed ones from 2017 to 2019. The annual active PTB registration rates were predicted as 49.1 (95% CI: 36.2-62.0) and 34.4 (95% CI: 18.6-50.2) per 100,000 population in 2020 and 2025, respectively. Compared with the active PTB registration rate in 2015, the reduction will reach 23.7% (95% CI: 3.2%-44.1%) and 46.8% (95% CI: 21.4%-72.1%) in 2020 and 2025, respectively.Conclusions: The high active PTB registration rates in spring and early summer indicate that high risk of tuberculosis infection in late autumn and winter in Henan Province. Without regard to the confidence interval, the first milestone of WHO End TB Strategy in 2020 will be achieved. However, the second milestone in 2025 will not be easily achieved unless there are early response measures in Henan Province, China.
Intra-tumoral genomic heterogeneity in rectal cancer: mutational status is dependent on preoperative biopsy depth and location.
Authors: Vuijk Floris A. , de Water Carlijn van , Vliet Shannon van Lent - van , Valk Maxime J.M. van der , de Velde Cornelis J.H. van , Vahrmeijer Alexander L. , Nagtegaal Iris D. , Hilling Denise E. 
Published: June 2020

Abstract
Background

Neoadjuvant therapy is indicated for patients with locally advanced rectal cancer, even though a significant number of patients show minimal or no response. Adequate response prediction before the start of neoadjuvant treatment might reduce unnecessary waiting periods and therapy related toxicity in non-responders. Genomic mutational status might provide a means to predict response to neoadjuvant therapy. However, it is unclear whether predictions based on genomic mutational status in single preoperative biopsies are reliable due to intra-tumoral heterogeneity.
In this study we aim to investigate the reliability of genomic mutations found in single pre-operative biopsies by comparing these genomic mutations to 4 other locations within the same tumor using next generation sequencing.

Methods

Rectal cancer patients undergoing primary resection, without neoadjuvant therapy, were included. Of all patients, one biopsy, two deep and two superficial samples were obtained and sequenced using a targeted next generation sequencing gene panel. Concordance between these 5 samples was assessed.

Results

In this feasibility study we included 11 patients. In 7 out of 11 (64%) patients, all 5 samples showed concordant mutations. In 4 out of 11 patients (36%) disconcordant mutations were observed.

Conclusions

Evaluation of genomic mutational status on a single pre-operative biopsy shows disconcordance in a substantial amount of patients.
Disease burden and prognostic factors for clinical failure in elderly community acquired pneumonia patients
Authors: Han Xiudi , Liu Xuedong , Chen Liang , Wang Yimin , Li Hui , Zhou Fei , Xing Xiqian , Zhang Chunxiao , Suo Lijun , Wang Jinxiang , Yu Guohua , Wang Guangqiang , Yao Xuexin , Yu Hongxia , Wang Lei , Liu Meng , Xue Chunxue , Liu Bo , Zhu Xiaoli , Li Yanli , Xiao Ying , Li Lijuan , Cui Xiaojing , Cao Bin 
Published: June 2020

Abstract
Background: The study was to evaluate initial antimicrobial regimen and clinical outcomes and to explore risk factors for clinical failure (CF) in elderly patients with community-acquired pneumonia (CAP).Methods: 3,011 hospitalized elderly patients were enrolled from 13 national teaching hospitals between January 1, 2014 and December 31, 2014 initiated by the CAP-China network. Risk factors for CF were screened by multivariable logistic regression analysis.Results: The incidence of CF in elderly CAP patients was 13.1%. CF patients were older, longer hospital stays and higher treatment costs than clinical success (CS) patients. The CF patients were more prone to present hyperglycemia, hyponatremia, hypoproteinemia, pleural effusion, respiratory failure and cardiovascular events. Inappropriate initial antimicrobial regimens in CF group were significantly higher than CS group. Undertreatment, CURB-65, PH<7.3, PaO2/FiO2 < 200 mmHg, sodium <130 mmol/L, healthcare-associated pneumonia, white blood cells >10000/mm3, pleural effusion and congestive heart failure were independent risk factors for CF in multivariable logistic regression analysis. Male and bronchiectasis were protective factors.Conclusions: Discordant therapy was a cause of CF. Early accurate detection and management of prevention to potential causes is likely to improve clinical outcomes in elderly patients CAP.Trial registration: A Retrospective Study on Hospitalized Patients With Community-acquired Pneumonia in China (CAP-China) (RSCAP-China), NCT02489578. Registered 16 March 2015, https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0005E5S&selectaction=Edit&uid=U0000GWC&ts=2&cx=1bnotb
Extreme Risk Protection Orders in King County, Washington: The Epidemiology of Dangerous Behaviors and an Intervention Response
Authors: Frattaroli Shannon , Omaki Elise , Molocznik Amy , Allchin Adelyn , Hopkins Renee , Shanahan Sandra , Levinson Anne 
Published: June 2020

Abstract
Background. Extreme Risk Protection Order (ERPO) laws are a promising gun violence prevention strategy. ERPO laws allow specific categories of people (law enforcement in all states, family in most) to petition a court to request that an individual be temporarily prohibited from purchasing and possessing firearms because that individual is behaving dangerously and at risk of violence, either to themselves or others. In 2017, Washington State’s ERPO law took effect. King County developed a comprehensive approach to implementing the ERPO law. The early experience of King County offers important insight into how early adopters of these laws are incorporating EPROs into their approach to gun violence prevention.Methods. We systematically reviewed, abstracted, and coded data from every ERPO petition filed in King County in 2017 and 2018, and all ERPO court records associated with those petitions. We conducted descriptive analyses of the coded data.Results: Seventy-five ERPO petitions were filed in King County during the study period. Judges granted a temporary ERPO in all 75 cases; 65 (87%) of these cases resulted in a one-year ERPO. Law enforcement initiated 73 (97%) of these petitions, and family members filed the remaining two. The 75 petitions filed described respondents’ risk as to “themselves only” in 30 cases (40%), to “others only” in 20 cases (27%) and “to themselves and others” in 25 cases (33%). Five cases where the threat was to “others only” met a definition of mass shooting threat. For 95% of the temporary ERPOs issued, the courts’ reasoning for issuing ERPOs included either current violence or brandishing a firearm. Court records for the 75 cases detail firearms removed and/or include receipts for removed firearms in 61 cases (81%) either as part of ERPO precipitating events (n=13, 17%) or in conjunction with ERPO service (n=48, 64%).Conclusions. These findings suggest that Washington’s ERPO law is being applied when someone is threatening violence to self or others, or brandishing a gun and at least one other risk factor is present. The early experience of King County provides insight into how this law is being implemented in one jurisdiction and how courts are evaluating such cases.
Factors Associated with Protection of Last Live Birth against Neonatal Tetanus among Mother Age 15-49 in Ethiopia: A Multilevel Analysis Using EDHS 2016
Authors: Kalayu Gebrezgiher , Fisseha Girmatsion , Shamie Reda , Berhe Awtachew , Embaye Kebede 
Published: June 2020

Abstract
BackgroundEthiopia has the highest neonatal tetanus mortality and morbidity rates in the world due to low TT immunization coverage coupled with the high amount of deliveries taking place at home. This study aimed to identify individual and community-level factors associated with protections of last live birth against neonatal tetanus among mothers age 15–49 in Ethiopia.MethodsThe P-value of less than 0.05 in the final model was considered as statistically significant. The interclass correlation coefficient and proportional change in variance were used to quantify the magnitude of the general contextual effect. The relative goodness-of-fit test was conducted using Akaike's information criterion.ResultHome delivery (AOR = 0.83; 95% CI: 0.72, 0.96), at least one ANC visits (AOR = 12.35; 95% CI: 10.42, 14.62) and wealth index (poorer (AOR = 1.27, 95% CI: 1.04, 1.54) and richer (AOR = 1.53, 95% CI: 1.21, 1.93). were the individual factors that had an association with the utilization of protection of last live birth against neonatal tetanus.ConclusionsUtilization of protection of last live birth against neonatal tetanus is affected both by the individual and community level factors with high state variation.
Evaluation of Resulting Disability from Back Pain After Childbirth: A Comparison Between Vaginal Delivery and Cesarean Section.
Authors: khansari mahda , shakeri hassan , Arab Amir Masoud 
Published: June 2020

Abstract
Objective:The purpose of this study was to assess the prevalence of postpartum LBP and resulting functional disability in a follow-up program (48 hours later and 3manths after delivery) between 2 methods of delivery.Background:Pregnancy-related low back pain(PLBP) and pelvic girdle pain(PGP) are considered common complications of pregnancy. The long term consequences for women with persistent LBP postpartum are under-investigated. [1-2] the main objective was comparing chronicity ratio and functional disability questionnaires score (Oswestry(OSW), Roland-Morris(RM) and TSK), in after birth and 3manths later stages, between 2 methods of delivery.Method:This is a follow-up study of the cohort including a sample of women who delivered from September 2016 to March 2017 in Sarem women hospital and west Tehran public healthcare centers. A total of 406 new moms received a questionnaire on LBP persistence and in case of a positive answer, the functional disability questionnaires were handed over and also were fallow up by a second questionnaire at approximately 3 months later.RESULTS:The final study sample consists of 406 women that N=208(51.5%) were in the Cs group and N=198(49.2%) were in the NVD group.In first stage N=164(40.4%) of total participants reported pain( Cs=81,NVD=83) while this figures decreased to N=150(36.9%) in second stage ( CS=74,NVD=76).The functional disability questionnaire average score in the first phase for the CS group was: OSW=14.45, RM=5.67 And TSK=10.76 and for NVD group was: OSW=20.37, RM=7.67 and TSK=11.73.In the second stage (3months after delivery) average scores for the CS group were: OSW=20.47, RM=6.48 and TSK=9.71 and for NVD group was OSW=21.56, RM= 6.46 and TSK=11.26.CONCLUSION:In this study, no relation between delivery type and LBP prevalence was found. OSW and RM average scores had significant difference in first stage, in a way that these scores were higher in NVD ( OSW p-value=0.02,RM p-value=0.03) but in second phase no significant difference was found,( OSW p-value=0.71,RM p-value=0.97). TSK scores didn’t show any significant difference in any stage ( first stage p-value=0.63 and second stage p-value=0.61).
Biased Technical Change in Hospital Care and the Demand for Physicians
Authors: Blank Jos L.T. , Niaounakis Thomas K. , Valdmanis Vivian G. 
Published: June 2020

Abstract
Background The development of labour productivity is relevant for accurately planning future staffing requirements, especially in sectors where technological developments may drive labour substitution. The present study investigates how labour productivity has developed across Dutch medical specialists (2007-2017) and discusses its implications for workforce planning, also in relation to the existing literature.Methods A regression model is developed in which the number of full-time equivalents is related to production (admissions), hospital characteristics and a trend parameter. The trend parameter captures the average annual change in the number of full-time equivalents per production output and is a measure for labour productivity. The model is applied to a micro-data set of Dutch hospitals in the period 2007-2017 across 24 different specialties using regression methods. Results The results indicate an increase in the number of full-time equivalents per admission has increased for most specialisms and that labour productivity has thus decreased. However, there is considerable heterogeneity and uncertainty across different specialisms.Conclusions The results amplify the issue of medical personnel shortages driven by the growing demand for health care. The research outcomes are linked to the existing literature regarding physicians’ productivity. Changes in accountability such as using relative value units, incentive payments, use of staff and mid-level providers, and technology have been discussed and some consensus has been reached.
Cost-effectiveness analysis of repeated self-sampling for HPV testing in primary cervical screening: a randomized study
Authors: Aarnio Riina , Östensson Ellinor , Olovsson Matts , Gustavsson Inger , Gyllensten Ulf 
Published: June 2020

Abstract
Background Human papillomavirus (HPV) testing is recommended in primary cervical screening to improve cancer prevention. An advantage of HPV testing is that it can be performed on self-samples, which could increase population coverage and result in a more efficient strategy to identify women at risk of developing cervical cancer. Our objective was to assess whether repeated self-sampling for HPV testing is cost-effective in comparison with Pap smear cytology for detection of cervical intraepithelial neoplasia grade 2 or more (CIN2+) in increasing participation rate in primary cervical screening.Methods A cost-effectiveness analysis (CEA) was performed on data from a previously published randomized clinical study including 36 390 women aged 30–49 years. Participants were randomized either to perform repeated self-sampling of vaginal fluid for HPV testing (n = 17 997, HPV self-sampling arm) or to midwife-collected Pap smears for cytological analysis (n = 18 393, Pap smear arm). Results Self-sampling for HPV testing led to 1633 more screened women and 107 more histologically diagnosed CIN2+ at a lower cost vs. midwife-collected Pap smears (€ 229 446 vs. € 782 772). Conclusions This study resulted in that repeated self-sampling for HPV testing increased participation and detection of CIN2+ at a lower cost than midwife-collected Pap smears in primary cervical screening. Offering women a home-based self-sampling may therefore be a more cost-effective alternative than clinic-based screening.Trial registration Not registered since this trial is a secondary analysis of an earlier published study (1).
Evaluation of the Relationship between Malaria Infection and Significant Spread of Electrolyte Variation in Patients: Within and Outside Limit Analytic Model.
Authors: Ndako James A. , Okolie Charles E. , Dojumo Victor T. , Fajobi Victor O. , Akinwumi Jeremiah A. 
Published: June 2020

Abstract
Background: Malaria is one of the most common diseased conditions across most developing countries caused by one of four species of Plasmodium. Electrolyte imbalance and mineral disturbances are majorly identified clinical symptoms in various infectious diseases including malaria. Malaria infection has also been shown to be associated with abnormalities in fluids, electrolytes and acid base balances which are capable of enhancing disease severity. The aim of this study was to investigate the effects of malaria infection on electrolytes parameters. Methods: Finger prick blood samples were collected from Two-Hundred (200) malaria-suspected subjects representing all age groups and gender. The Giemsa-stained blood smears were carefully examined according to standard procedure. Demographic information was obtained using structured questionnaires. Results: Pearson's Correlation Coefficient technique was used to investigate the relationship, and the strength of association between the variables. The mean bound of patients’ sodium level was observed to fall within the specified normal limits of 125mmol/L – 145mmol/L; except for positive malaria patients belonging to the MP-(++) which will fall below the 125mmol/L (i.e. 126.25mmol/L – 1.77mmol/L = 124.48mmol/L). Conclusion: In our study we found that Plasmodium falciparum showed more alteration in electrolytes parameters than Plasmodium vivax. This study discovered a significant linear relationship based on the Pearson product-moment correlation between creatinine and urea, potassium and chloride, potassium and creatinine, potassium and urea. The mean sodium and chloride level of positive malaria [MP-(++)] patients were observed to fall outside the normal limit.
Rapamycin alleviates experimental autoimmune hepatitis by immunoregulation of Th1 and Th17 cells
Authors: Tian Yan , Liu Qingqing , Tian Haixia , Zhang Shuting , Zhou Jianjun , Fan Weiping 
Published: June 2020

Abstract
Background

Increasing evidence in recent years has suggested that Th1, Th17 cells act as a crucial regulatorin autoimmune hepatitis (AIH). Rapamycin, as a inhibitor of mammalian target of rapamycin (mTOR), which modulates T cell activation, differentiation and migration, is known to be able to selectively inhibit the activation of T helper cells including Th1 and Th17 subsets. However, little is known about the underlying regulatory mechanisms.
Results

In this study, we demonstrated that rapamycin ameliorated AIH in mice model by inhibiting Th1 and Th17 cells. Further analysis revealed that the suppressive function of rapamycin was associated with the downregulation of p70s6k-STAT3 signaling, which is downstream of mTOR, in AIH mice.
Conclusions

These findings suggest a previously unrecognized role for rapamycin immunoregulatory function and its protective effect on AIH, providing additional insight for the selection of alternative clinical protocols for autoimmune diseases.