bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Germline/somatic DNA Damage Repair Gene Mutations Modulate the Therapeutic Response in Chinese Patients With Advanced Pancreatic Ductal Adenocarcinoma
Authors: Shui Lin , Li Xiaofen , Peng Yang , Tian Jiangfang , Li Shuangshuang , He Du , Li Ang , Tian Bole , Li Mao , Yi Cheng , Cao Dan 
Published: August 2020

Abstract
Background: PDAC is a fatal disease with molecular heterogeneity, inducing differences in biological behavior and therapeutic strategy. NGS profiles of pathogenic alterations in Chinese PDAC population are limited. We conducted a retrospective study to investigate the predictive role of DNA damage repair (DDR) mutations in precise medicine. Methods: NGS were performed on resected tissues or peripheral blood from 195 Chinese PDAC patients. Baseline clinical or genetic characteristics, and survival status were collected. The Kaplan–Meier survival analyses were performed by the R version 3.6.1.Results: The main driver genes were KRAS, TP53, CDKN2A, and SMAD4. Advanced patients with KRAS mutation showed worse OS than those without (p=0.048). DDR deficiency was identified in 30 (15.38%) of overall patients, mainly involving BRCA2 (n=9, 4.62%), ATM (n=8, 4.10%) and RAD50 genes (n=3, 1.54%). There was no significant improvement of OS between patients with or without DDR mutations (p=0.88). Treatment with platinum-based chemotherapy (p=0.0096) or olaparib (p=0.018) respectively improved the overall survival of patients with DDR mutation. No statistical correlation between tumor mutation burden (TMB) and DDR mutations was identified. Treatment of PD-1 blockades did not bring significiantly improved OS to DDR-mutated patients than intact DDR group (p=0.14). Conclusions: In this multi-center retrospective study, we showed the role of germline and somatic DDR mutation in predicting the efficacy of olaparib and platinum-based chemotherapy. However, DDR alteration has shown limited value in prediction of hypermutational status and the sensitivity to PD-1 blockade.
Gender-based Inequalities in Health literacy among an Iranian Kurd Population: Results of a Community Survey
Authors: Mahmoodi Hassan , Moradzadeh Rahmatollah , Iranpour Abedin , Shahi Fatemeh , Azimi Somayeh , Saqqezi Pershang Sharifi , Keshavarzian Khadijeh , Shirzadi Shayesteh , Kousha Ahmad , Hosking Sarah , Nadrian Haidar 
Published: August 2020

Abstract
Background

Health literacy, as a social determinant of health, has a decisive role in providing different populations with healthcare services in an equal manner. Our aim in this study was to investigate the contribution of socio-demographic factors to functional health literacy (FHL) in a population of Iranian adults and identify differences in the contribution of these factors across genders.
Methods

This community-based cross-sectional study was conducted in 2015 to 2016 in Sanandaj, Iran. Multistage cluster sampling was employed to recruit 1000 people older than 18 (response rate = 89.2%) from 35 urban and 10 rural health care centers. Test of functional health literacy in adults (TOFHLA) was used to assess FHL. In order to measure inequality in FHL, concentration index decomposition was used.
Results

In total, 869 respondents (response rate: 86.9%) with a mean age (standard deviation; SD) of 33.68 (13.0) completed TOFHLA questionnaire. More than half of participants were women (57.5%). Participants demonstrated an average TOFHLA score of 51.9. Women demonstrated slightly higher TOFHLA scores (52.2 [SD: 0.46]) compared to men (50.7 [SD: 0.4]). However, the concentration index for gender was 10.9% suggesting gender contributed only moderately to TOFHLA scores. Comparatively, 54.3% of TOFHLA differences were attributed to geographic location. Among women, place of residence, monthly income, age, education level and being head of household contributed to 43%, 32%, 13%, 11.5% and 11% of FHL inequality, respectively. Among men, however, place of residence (45.2%), size of household (15.1%) and monthly income (13.5%) contributed most to inequality in FHL.
Conclusions

Although gender was not the strongest contributing factor for FHL inequalities, poor FHL was mostly concentrated among men. Different factors were attributed to FHL inequality by gender, as discussed inside. Understanding these differences may assist in identifying and targeting interventions towards men and women with low levels of FHL. Our findings shed light the critical role of social determinants of health (SDH) in promoting the health literacy of populations, particularly in developing countries like Iran.
Circulating insulin-like growth factor I is involved in the effect of diet on peripheral amyloid β clearance
Authors: Herrero-Labrador Raquel , Trueba-Saiz Angel , Martinez-Rachadell Laura , Sevilla Maria Estrella Fernandez de , Zegarra-Valdivia Jonathan A , Diaz-Pacheco Sonia , Fernandez Ana M , Aleman Ignacio Torres 
Published: August 2020

Abstract
BackgroundObesity is a risk factor for Alzheimer´s disease (AD), but underlying mechanisms are not clear.MethodsWe analyzed peripheral clearance of amyloid β (Aβ) in overweight mice because its systemic elimination may impact on brain Aβ load, a major landmark of AD pathology. We also analyzed whether circulating insulin-like growth factor I (IGF-I) intervenes in the effects of overweight as this growth factor modulates brain Aβ clearance, and is increased in serum of overweight mice. Results Overweight mice showed increased peripheral Aβ clearance by the liver, the major site of elimination of systemic Aβ, but unaltered brain Aβ levels. We also found that Aβ clearance by hepatocytes is stimulated by IGF-I, and that mice with low serum IGF-I levels show reduced peripheral Aβ clearance and unchanged brain Aβ levels. In the brain, IGF-I favored association of its receptor (IGF-IR) with Aβ precursor protein (APP), and at the same time stimulated non-amyloidogenic processing of APP in astrocytes, as indicated by an increased sAPPα/sAPPβ ratio after IGF-I treatment. Since serum IGF-I enters into the brain in an activity-dependent manner, we analyzed in overweight mice the effect of brain activation by environmental enrichment (EE) on brain IGF-IR phosphorylation and its association to APP, as a readout of IGF-I activity. After EE, significantly reduced brain IGF-IR phosphorylation and APP/IGF-IR association was found in overweight mice as compared to lean controls. Conclusions Collectively, these results indicate that diet influences peripheral clearance of Aβ without affecting brain Aβ load. Increased serum IGF-I likely contributes to enhanced peripheral Aβ clearance in overweight mice, without affecting brain Aβ clearance probably because its brain entrance is reduced.
Experimental Optimization of Effective Parameters of Sandwich Panels With Aluminum Foam Core Under Low Velocity Impact
Authors: Torabizadeh Mohammad Amin 
Published: August 2020

Abstract
This paper introduces the application of Taguchi optimization methodology in optimizing the production parameters of aluminum foam sandwich panels (AFSP) with different skin layer under low velocity impact loading. The core material of AFSP is A356 aluminum foam reinforced with SiC particles produced using the CaCO3 foaming agent with 20, 30 and 40 mm thickness. The skin layer of plates are made of glass / epoxy with quasi-isotropic and cross-ply layout as well as pure aluminum layer. For the impact test, drop weight impact device used. Three types of spherical, parabolic and cone impactor used. The impact parameters that are chosen to be evaluated in this study are skin layer layout, impactor shape and core thickness of AFSP. While, the response factors to be measured are specific absorbed energy (SAE), maximum displacement (MD) and maximum impact force (MIF). Taguchi method used to check the effect of the production parameters on the response factors by creating orthogonal array (OA). The result from this study shows that the application of the Taguchi method can determine the best combination of production parameters. These results can provide the optimal impact response that are the largest SAE, smallest MD and smallest value of MIF. For the best SAE and MIF, A1–B1–C1 (cross-ply/conical/40 mm core) found. Meanwhile, the optimized combination of levels for all the three production factors from the analysis that provides the lowest MD found to be A3–B2–C1 (pure Aluminum/spherical/40 mm core).
Construction of a telomerase-immortalized porcine tracheal epithelial cell model for swine-origin mycoplasma infection
Authors: Xie Xing , Hao Fei , Wang Haiyan , Pang Maoda , Gan Yuan , Liu Beibei , Zhang Lei , Wei Yanna , Chen Rong , Zhang Zhenzhen , Bao Wenbin , Bai Yun , Shao Guoqing , Xiong Qiyan , Feng Zhixin 
Published: August 2020

Abstract
Background: Primary porcine tracheal epithelial cells (PTECs) are an appropriate model for studying the molecular mechanism of various porcine respiratory diseases, including swine-origin mycoplasmas, which were isolated from pig respiratory tract and were mainly found on the mucosal surface surrounding swine trachea. However, the short proliferation ability of primary PTECs greatly limits their lifespan.Results: In this study, we carefully isolated and cultured primary PTECs. Besides, we constructed immortalized PTECs by transfecting primary PTECs with the recombinant constructed plasmid pEGFP-hTERT containing human telomerase reverse transcriptase (hTERT). Immortal PTECs (hTERT-PTECs) maintained both the morphological and functional characteristics of primary PTECs, as indicated by the expression of cytokeratin 18, cell-cycle analysis, proliferation assay, western blotting, telomerase activity assay, karyotype analysis and quantitative RT-PCR. hTERT-PTECs had an extended replicative lifespan, higher telomerase activity, and enhanced proliferative activity. In addition, using this cell line, the lack of transformed and grown tumors in nude mice indicated that it could be safely applied in further studies. Moreover, hTERT-PTECs were vulnerable to all swine-origin mycoplasmas and were suitable as a cell adhesion model.Conclusions: In summary, hTERT-PTECs could be widely used as an adhesion cell model for swine-origin mycoplasmas and in the infection study of various porcine respiratory pathogens.
Ultrasound Versus Arthrography in Diagnosing the Stability of Minimally Displaced Lateral Humeral Condyle Fractures in Children
Authors: Wu Xing , Li Xiongtao , Yang Shaowei , Wang Si , Xia Jingdong , Chen Xiaoliang , Shen Xiantao 
Published: August 2020

Abstract
Background: The evaluation of the articular cartilage status of the distal humeral epiphysis is difficult. Ultrasound of the elbow is increasingly used to confirm the integrity of the articular cartilage of minimally displaced lateral humeral condyle fractures in children in minimally displaced fractures. The aim of this study was to assess the correlation between ultrasound with arthrography for predicting the integrity of the cartilage hinge and describe the utility of ultrasound in directing the need for pre-treatment. Methods: 39 patients with minimally displaced lateral humeral condyle fractures and underwent ultrasound and arthrography examinations before operation from May 2018 to December 2019 were included in this study. The ultrasound and arthrography predictors of the cartilage hinge status were independently measured. Result of ultrasound and arthrography were compared.Results: The mean displacement of fractures was 3.1 mm (range, 2.0～5.0 cm). The arthrography showed an incomplete fracture in 24 patients (61.5%) and complete in 15 patients (38.5%). The ultrasound showed an incomplete fracture in 25 patients (64.1%) and complete in 14 patients (35.9%). The ultrasound and arthrography evaluations of the integrity of the articular surface were consistent in 92.3% of the cases, including 23 were predicted to have an intact articular surface, and 13 were predicted to have incongruity articular surface. There was no correlation between displacement and the fracture being complete on ultrasound. The Pearson coefficient value of ultrasound and arthrography for assessing the integrity of the articular surface was 0.837. Conclusions: Ultrasound and arthrography assessments of the integrity of the cartilage hinge status appear to be highly consistent. Ultrasound can be used as a complementary tool with arthrography to predict the integrity of the cartilage hinge status of patients with minimally displaced lateral humeral condyle fractures in children.Level of evidence: Retrospective study; level Ⅳ.
Circadian Rhythms in Septic Shock Patients
Authors: Lachmann Gunnar , Ananthasubramaniam Bharath , Wünsch Viktor A. , Scherfig Lara-Marie , Haefen Clarissa von , Knaak Cornelia , Edel Andreas , Ehlen Lukas , Koller Barbara , Goldmann Anton , Herzel Hanspeter , Kramer Achim , Spies Claudia 
Published: August 2020

Abstract
Background: Although intensive efforts to improve diagnosis and therapy of sepsis over the last decade, the mortality of septic shock remains high and causes substantial socioeconomical burden of disease. The function of immune cells is time-of-day-dependent and is regulated by several circadian clock genes. This study aims to investigate whether the rhythmicity of clock gene expression is altered in patients with septic shock.Methods: This prospective pilot study was performed at the university hospital Charité – Universitätsmedizin Berlin, Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK). We included 20 patients with septic shock between May 2014 and January 2018, from whom blood was drawn every 4 hours over a 24-hour period to isolate CD14-positive monocytes and to measure expression of 17 clock and clock-associated genes. Of these patients, 3 whose samples expressed fewer than 8 clock genes were excluded from the final analysis. Expression data were compared to data of a healthy study population and a rhythmicity score SP was calculated, which comprises values between -1 (arrhythmic) and 1 (rhythmic). Results: Overall, the rhythmicity scores for septic shock patients were significantly (p < 0.0001) lower (0.23 ± 0.26) compared to the control group (12 healthy young men, 0.70 ± 0.18). 77% of the measured clock genes were classified as having inconclusive rhythms, i.e. neither rhythmic nor arrhythmic. The clock genes NR1D1, NR1D2 and CRY2 were the most rhythmic, while CLOCK and ARNTL were the least rhythmic. In addition, the expression of clock genes CRY1, NR1D1, NR1D2, DBP, and PER2 was suppressed in septic shock patients and CRY2 was significantly upregulated compared to controls.Conclusion: Compared to young healthy men, molecular rhythms in immune cells of septic shock patients were substantially decreased. The decrease in rhythmicity was clock gene-dependent. The loss of rhythmicity and downregulation of clock gene expression might be caused by sepsis and might further deteriorate immune responses and organ injury, but further studies are necessary to understand underlying pathophysiological mechanisms.Clinical trial registered with www.ClinicalTrials.gov (NCT02044575) on 24 January 2014.
Preparedness, Response and Assessment of First Phase Lockdown Impact Amid COVID-19 Pandemic – India Scenario
Authors: Andra Sai Kumar , Adibhatla Shravani , Praneeth Sai , Kanda Aditya Srinivas , Susmitha Rani , Sukumar Hariharan Thangatur , Cheela VR Sankar , Dubey Brajesh 
Published: August 2020

Abstract
The Corona Virus Disease (COVID-19) pandemic has been created due to the infection by novel coronavirus. Globally, countries have taken measures to reduce social contact to slow down the spread of the virus. Social (physical) distancing via lockdown and awareness on personal hygiene are mitigating measures to prevent transmission of disease. Indian government has implemented the first phase of national lockdown for 21 days (March 24 to April 14, 2020) to reduce the transmission of COVID-19. This study is performed in two stages. First, review of Indian scenario till the end of the first phase of national lockdown and second the impact assessment of the first phase of social lockdown on doubling rate of COVID-19 cases in different Indian states and overall India. The timeline of activities, health care facilities, schemes and services by government and private organizations in combating COVID-19 in India are presented. Analysis is performed using the 3-day moving average daily growth statistical technique. The states are categorized based on the improved doubling rate during third week (Category 1) and second week (Category 2). The overall Indian scenario is analysed to assess the consequences of social lockdown on the transmission rate of the virus. Kerala and Orissa handled the pandemic effectively by drawing lessons from earlier epidemics and disasters. Telangana, Andhra Pradesh, Uttara Pradesh, West Bengal and Maharashtra has improved doubling rate during second week of lockdown. The average doubling rate of coronavirus cases in India improved after lockdown, account for 7.5 days compared to 3.4 days before lockdown. Lockdown played a key role in reduction of increasing rate of confirmed cases. The stringent lockdown combined with rapid testing led the nation in yielding positive outcomes. The discussions presented in this article will equip the council’s authorities and regulatory bodies globally in designing the mechanisms for handling present and future epidemics or pandemics.
High prevalence of under-five child mortality in the pastoralist communities of Ethiopia: Evidence from the 2016 Ethiopian demographic and health survey data
Authors: Kassaw Mesfin Wudu , Mamo Aele , Abate Biruk , Kassie Ayelign , Masresha Seteamlak 
Published: August 2020

Abstract
Objective: The aim of this study was to assess the prevalence and association of child mortality in the pastoralist regions of Ethiopia. The study is a further analysis from 2016 Ethiopian Demographic and Health Survey data. Results: The prevalence of under-five child mortality in the pastoralist’s regions was 23.2%, 95%CI (21.4%, 24.6%). The prevalence of mortality among daughters was 15.4%, 95%CI (14.2, 16.6%), and sons 16.8%, 95%CI (15.6, 18.1%).In logistic regression, wealth index, head of household, Khat chewing, type of child birth, husband education, and child age in months were associated with under-five mortality irrespective of the deceased children’s gender. The prevalence of under-five child mortality in the pastoralist regions of Ethiopia was high, which was far highest in relative to the national under-five mortality prevalence. In assessing the effect of variables on under-five child mortality by gender, almost all the variables that have an effect on female or male child are similar. The government should emphasize on the pastoralists’ regions to decrease the high prevalence of under-five child mortality.
Preterm Morbidity and Mortality by Gestational Age. A Birth Population-Based Study
Authors: Sun Bo , Guo Xiaojing , Li Xiaoqiong , Qi Tingting , Pan Zhaojun , Zhu Xiaoqin , Wang Hui , Dong Ying , Yue Hongni 
Published: August 2020

Abstract
Background: Despite 15-17 million of annual births in China, there is a paucity of information on preterm morbidity and mortality. We characterized the outcome of preterm births and hospitalized preterm infants by gestational age (GA) in Huai’an in 2015, an emerging prefectural region of China.Methods: Of 59,245 regional total births, clinical data on 2,651 preterm births and 1,941 hospitalized preterm neonates were extracted from Huai’an Women and Children’s Hospital (HWCH) and non-HWCH hospitals in 2018-2020. Preterm morbidity and mortality rates were characterized and compared by hospital categories and GA spectra. Death risks of preterm births and hospitalized preterm infants in the whole region were analyzed with multivariable logistic regression.Results: The incidences of extreme, very, moderate, late and total preterm of the regional total births were 1.4, 5.3, 7.2, 30.8 and 44.7‰, with all-death rates being 1.0, 1.6, 0.6, 1.1 and 4.3‰, respectively, of the regional total births. There were 1,025 (52.8% of whole region) preterm admissions in HWCH, with significantly lower in-hospital death rate of inborn (33/802) than out-born (23/223) infants. Compared to non-HWCH, four-fold more neonates in HWCH were under critical care with higher death rate, including most extremely preterm infants. Significant all-death risks were found for the total preterm births in BW < 1,000g, II-III degree of amniotic fluid contamination, Apgar-5 min < 7, and birth defects (BD). For the hospitalized preterm infants, significant in-hospital death risks were found in out-born of HWCH, GA < 32 weeks, Apgar-5 min < 7, BD, necrotizing enterocolitis and ventilation, whereas born in HWCH, antenatal glucocorticoids, cesarean delivery and surfactant use were protective factors against death.Conclusions: The integrated data revealed GA-specific morbidity and mortality on the basis of total preterm births and their hospitalization, demonstrating the efficacy of leading referral center and whole regional perinatal-neonatal network in China. The concept and protocol of our current study should be extended to gain comprehensive understanding in the world-wide campaign for prevention of preterm birth.
Influence of antepartum hemorrhage on placenta previa: A multi-center, retrospective cohort study
Authors: Qing Wenjie , Li Linda , Venna Alyssia , Zhou Jie 
Published: August 2020

Abstract
BACKGROUND
Placenta previa can be a serious, life-threatening obstetric complication that causes painless but potentially catastrophic bleeding. It is unclear as to whether the frequency of antepartum hemorrhage (APH) relative to the specific gestational week in placenta previa will lead to negative perinatal outcomes. The purpose of the present study was to determine the relationship between APH and gestational week number, and to ascertain the different perinatal outcomes in women with placenta previa.
METHODS
This was a multi-center, retrospective study in which we enrolled all women with placenta previa between October of 2015 and September of 2018. Patients with placenta previa were divided into two groups: women with APH and women without APH.
RESULTS
A total of 247 patients were included in this study: 121 women with APH and 126 women without. The incidence of APH was 49.0% (121/247). The mean bleeding frequency was 2.2 ± 1.3 (mean ± SD), with the majority having experienced a one-time bleeding episode (36.4%, 44/121), followed by 26.4% with 2 episodes (32/121), and 23.1% with 3 (28/121). The APH was distinct in every gestational-week category, with bleeding occurring at 31.4 ± 3.3 weeks, ranging from 24 to 37 gestational weeks. The incidence of bleeding varied from 2.6–14.6%, with the highest incidence at 32 gestational weeks. Patients categorized as having complete placental coverage included a greater number of women experiencing bleeding than women who did not bleed (72.9% vs 47.4%, P < 0.001), indicating that a complete placenta was an independent risk factor for APH (odds rations [OR], 4.17; 95% confidence interval [CI], 1.805–9.634). In addition, although APH did not augment the rates of hysterectomy (6.6% vs 7.1%, P = 0.869), it was associated with critical neonatal outcomes that included lower weight, lower Apgar score at 1 minute, preterm age, and more frequent neonatal intensive care unit admissions (P < 0.05).
CONCLUSIONS
The gestational week and frequency of each APH varied in patients with placenta previa and might result in an increase in adverse maternal and neonatal outcomes. The 32nd gestational week appeared to be the most precarious time—exhibiting the highest incidence of bleeding—and we consider complete placenta previa to be an independent risk factor for APH.