bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting COVID-19 Disease Progression and Patient Outcomes based on Temporal Deep Learning
Authors: Sun Chenxi , Hong Shenda , Song Moxian , Wang Zhenjie , Li Hongyan 
Published: August 2020

Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic has caused health concerns worldwide since December 2019. From the beginning of infection, patients will progress through different symptom stages, such as fever, dyspnea or even death. Identifying disease progression and predicting patient outcome at an early stage helps target treatment and resource allocation. However, there is no clear COVID-19 stage definition, and few studies have addressed characterizing COVID-19 progression, making the need for this study evident.Methods: We proposed a temporal deep learning method, based on a time-aware long short-term memory (T-LSTM) neural network and used an online open dataset, including blood samples of 485 patients from Wuhan, China, to train the model. Specifically, our method predicted the outcome of COVID-19 patients by T-LSTM, considering both the biomarkers and the irregular time intervals. Then, we used the patient representations, extracted from T-LSTM units, to subtype the patient stages and describe the disease progression of COVID-19.Results: Using our method, the accuracy of the outcome of prediction results was more than 90% at 12 days and 98%, 95% and 93% at 3, 6, and 9 days, respectively. Most importantly, we found 4 stages of COVID-19 progression, with different patient statuses and risks, such as mortality and length of illness. Predicting which of the 4 stages the patient is currently in can help doctors better assess and cure the patient. Conclusions: To combat the COVID-19 epidemic, this paper aims to help clinicians better assess and treat infected patients, provide relevant researchers with potential disease progression patterns, and enable more effective use of medical resources. Our method predicted patient outcomes with high accuracy and identified a four-stage disease progression. We hope that the obtained results and patterns will aid in fighting the disease.
Differences of tensile strength in knot tying technique between orthopaedic surgical instructors and trainees
Authors: Harato Kengo , Yagi Mitsuru , Kaneda Kazuya , Iwama Yu , Masuda Akihiko , Kaneko Yosuke , Oya Akihito , Matsumura Noboru , Suzuki Taku , Nakayama Robert , Kobayashi Shu 
Published: August 2020

Abstract
Background: Knot tying technique is an extremely important basic skill for all surgeons. Clinically, knot slippage or suture breakage will lead to wound complications. Although some previous studies described the knot-tying technique of medical students or trainees, little information had been reported on the knot-tying technique of instructors. The objective of the preset study was to assess surgeons’ manual knot tying techniques and to investigate the differences of tensile strength in knot tying technique between surgical instructors and trainees. Methods: A total of 48 orthopaedic surgeons (postgraduate year: PGY 2-18) participated. Surgeons were requested to tie surgical knots manually using same suture material. They were divided into two groups based on each career; instructors and trainees.　Although 4 open conventional knots with 4 throws were chosen and done with self-selected methods, knot tying practice to have the appropriate square knots was done as education only for trainees before the actual trial. The knots were placed over a 30 cm long custom made smooth polished surface with 2 cylindrical rods. All knots were tested for tensile strength using a tensiometer. The surgical loops were loaded until the knot slipped or the suture broke. The tensile strength of each individual knot was defined as the force (N) required to result in knot failure. Simultaneously, knot failure was evaluated based on knot slippage or suture rupture. In terms of tensile strength or knot failure, statistical comparison was performed between groups using two-tailed Mann-Whitney U test or Fisher exact probability test, respectively. Results: Twenty-four instructors (PGY6- PGY18) and 24 trainees (PGY2-PGY5) were enrolled. Tensile strength was significantly greater in trainees (83.0 ± 27.7N) than in instructors (49.9 ± 34.4N, P=0.0246). The ratio of slippage was significantly larger in instructors than in trainees (P<0.001). Knot slippage (31.8 ± 17.7N) was significantly worse than suture rupture (89.9 ± 22.2N, P<0.001) in tensile strength. Conclusions: Mean tensile strength of knots done by trainees after practice was judged to be greater than that done by instructors in the present study. Clinically, knot slippage can lead to wound dehiscence, compared to suture rupture.
Visual outcomes and complications following One-way Air-fluid exchange technique for vitreous hemorrhage post vitrectomy in proliferative diabetic retinopathy patients
Authors: Wang Qun , Zhao Jie , Xu Qing , Han Cui , Hou Baojie , Huang Yifei 
Published: August 2020

Abstract
Background
To evaluate the efficacy and outcomes following one-way surgical technique for the treatment of vitreous hemorrhage post vitrectomy in proliferative diabetic retinopathy (PDR) patients.
Methods
Those PDR patients who had vitrectomy with balance saline tamponade and then developed vitreous hemorrhage post vitrectomy were included in this study. 47 patients underwent the one-way air-fluid exchange surgical procedure with a 10 ml syringe used to exchange between 4.5–5.5 ml of fluid in the treatment room. After the air-fluid surgical exchange procedure, additional treatments were administered when needed. Best corrected visual acuity (BCVA) and occurrence of intra-procedural and post-procedural complications were collected and analyzed.
Results
A total of 47 eyes of 47 PDR patients with a mean age of 50.8 ± 12.0 years were reviewed. All 47 eyes had undergone vitrectomy with balance saline tamponade because of PDR. 4 of them were diagnosed with type 1 diabetes mellitus (T1DM), and 43 of them were diagnosed with type 2 diabetes mellitus (T2DM). All the 47 eyes were given the one-way air-fluid exchange procedure in the treatment room. In 4 cases the procedure was administered twice, and in 1 case the procedure was administered three times, followed by additional retinal photocoagulation and one intravitreal injection of Conbercept. The BCVA at the final follow-up was significantly improved from the initial acuity baseline in all cases. No complications were observed during the follow-ups.
Conclusion
This one-way air-fluid exchange procedure could effectively exchange the vitreous hemorrhage and improve visual acuity without obvious complications in treating vitreous hemorrhage post vitrectomy.
Morphological Characterization and Genetic Diversity Analysis of a Tunisian Durum Wheat (Triticum Turgidum Var. Durum) Collection
Authors: Ouaja Maroua , Bahri Bochra Amina , Aouini Lamia , Ferjaoui Sahbi , Medini Maher , Marcel Thierry , Hamza Sonia Mihed 
Published: August 2020

Abstract
Background: Tunisia is a center of genetic diversity of durum wheat and has a large number of abandoned old local landraces. An accurate investigation and characterization of the morphological and genetic features of these landraces would allow their rehabilitation and use for practical and beneficial purposes. In this context, a collection of 304 local accessions of durum wheat, collected from five regions and three climatic zones of central and southern Tunisia, was studied. Results: Morphological characterization was carried out using 12 spike-related traits and rendered a mean Shannon-Weaver Index (H') of 0.80 indicating the presence of a high level of polymorphism among accessions. Based on these traits 11 local landraces, namely Mahmoudi, Azizi, Jneh Khotifa, Mekki, Biskri, Taganrog, Biada, Badri, Richi, Roussia and Souri were identified. Spike length (H’=0.98) and shape (H’=0.86) with grains size (H’=0.94), form (H’=0.87) and color (H’=0.86) were the most polymorphic morphological traits. The genetic diversity was assessed using 10 SSR markers, with a polymorphic information content (PIC) of 0.69. Levels of genetic diversity were generally high, with a Shannon's Information Index (I) of 0.62 and a gene diversity (He) of 0.35. In addition, population structure analysis distinguished 11 genetic groups resulted from STRUCTURE and Mantel test showed a significant correlation between genetic and morphological distances. Analysis of molecular variance (AMOVA) showed high genetic variations within regions (81%) and wheat subpopulations (41%) showing a considerable amount of admixture between landraces realized by farmers; as well as a moderate (19%) and high (59%) genetic variations among regions and wheat subpopulations, indicating practices of selection pressure conducted by farmers. The Mahmoudi landrace showed spike densities significantly different between the center to the south of Tunisia; notably loose spikes with open glumes in the south and compact ones in the center, which may represent an adaptation form for tolerance to high temperature. Conclusion: Overall, this study highlights the genetic richness of local resources for better in situ or ex situ conservation and for their subsequent use in plant breeding programs.
The first biological choice in patients with rheumatoid arthritis: data from the Moroccan register of biotherapies
Authors: Eddaoudi Meryem , Rostom Samira , Hmamouchi Ihsane , Binoune Imane El , Amine Bouchra , Abouqal Redouane , Achemlal Lahcen , Allali Fadoua , Bouchti Imane El , Maghraoui Abdellah El , Ghozlani Imad , Hassikou Hasna , Harzy Taoufik , Ichchou Linda , Mkinsi Ouafa , Niamane Redouane , Bahiri Rachid 
Published: August 2020

Abstract
Background: The aim of our study is to determine, from data of the Moroccan register of biotherapies, the factors influencing the choice of the first prescribed biological treatment.Methods: Cross-sectional multicenter study including rheumatoid arthritis patients who were initiated the first biological treatment either: Rituximab, an anti-TNF, or Tocilizumab. The determinants related to the patient and disease have been gathered. A univariate and then multivariate analysis to determine the factors associated with the choice of the first bDMARDs was realized.Results: A total of 225 rheumatoid arthritis patients were included in the Moroccan registry. The mean age was 52 ± 11 years, with female predominance 88% (n = 197). The first prescribed biological treatment was Rituximab 74% (n = 166), the second one was Tocilizumab, 13.6% (n = 31) then comes the anti-TNF in 3rd position with 12.4% (n = 28). The factors associated with the choice of Rituximab as the first line bDMARDs prescribed in univariate analysis were: the insurance type, the positivity of the rheumatoid factor. In multivariate analysis, only the insurance type that remains associated with the choice of Rituximab as the first biological drugs. The Tocilizumab was associated with shorter disease duration and was more prescribed as mono-therapy compared to non Tocilizumab group. TNFi was associated with the insurance type.Conclusion: Our study suggests that Rituximab and TNFi are associated with the type of insurance and Tocilizumab is the most prescribed biologic mono-therapy in RA patients. Further studies are needed to confirm these results.
Correlation of pain with Substance P and neurokinin-1 receptor in the L5-S2 spinal cord in rats with chronic nonbacterial prostatitis
Authors: Hao Liya , Zhang Junfeng , Bai Xianguang , Liu Li , Qi Jinxu , Wang Zhonglin , Zhang Wanjie , Zuo Yubin , Zheng Xinhua 
Published: August 2020

Abstract
BackgroundTo investigate the correlation of the pain with the expression of SP and NK-1R in the posterior horn of the L5-S2 spinal cord in a rat model of chronic nonbacterial prostatitis (CNP) at different time points of modeling. MethodsForty adult male SD rats were randomly divided into four equal groups: control group, 45 day (d) group, 60 d group, and 90 d group, and proteins were obtained from the prostatic tissue of another 30 rats. The CNP model was established by intraperitoneal injection of 0.5 mL diazepam vaccine and intradermal injection of a mixed solution of 1 mL prostatein extract and complete adjuvant at a 1:1 ratio. The control group rats were injected with the same volume of normal saline. At 45, 60, and 90 days after modeling, we measured the paw withdrawal threshold (PWT) of the rats, detected the level of TNF-α, IL-1ß, IL-2, and IL-10 in the prostate tissues by ELISA, observed the histomorphological changes in the prostate by transmission electron and light microscopy, and detected the expression of SP and NK1-R in the L5-S2 spinal cord by immunohistochemistry. ResultsThe levels of TNF-α, IL-1ß, IL-2, and IL-10 in the prostate tissue were markedly higher in the CNP models than those in the control group(all P<0.05); this difference was Most significant at 90 days (all P<0.05). Immunohistochemistry showed that the expressions of SP and NK-1R were remarkably higher in the CNP model groups than in the control (all P<0.05), with the highest expression found at 90 days. Light microscopy revealed no inflammatory cell infiltration in the prostate tissue of the control rats, and obvious edema and increased lymphocyte count were observed as the duration of modeling increased. Transmission electron microscopy showed inflammatory changes in the prostate tissue of the model rats; peritubular interstitial edema was most obvious at 90 days, with widened gaps between the peritubular cells and epithelial base and increased numbers of fibroblasts and collagen fibrils. ConclusionThere was a correlation between the pain and the expressions of SP and the NK-1R in the L5-S2 spinal cord of the rats.
Effects of Sevoflurane and Propofol on the Optic Nerve Sheath Diameter in Patients Undergoing Laparoscopic Gynecological Surgery: A Randomized Controlled Clinical Studies&nbsp;
Authors: Geng Weilian , Chen Changxing , Sun Xingfeng , Huang Shaoqiang 
Published: August 2020

Abstract
Background The results of studies on changes in intracranial pressure in patients undergoing laparoscopic surgery are inconsistent. Meanwhile, previous neurosurgery studies have suggested that propofol and sevoflurane have inconsistent effects on cerebral blood flow and cerebrovascular self-regulation. The purpose of this study is to compare changes in the optic nerve sheath diameter in patients undergoing laparoscopic gynecological surgery under anesthetic maintenance with propofol versus sevoflurane. Methods This study included 110 patients undergoing laparoscopic gynecological surgery with an estimated operative time of more than 2 hours under general anesthesia. The study was a randomized controlled study. The ONSD at various time points was measured by ultrasound, including when the patients entered the operating room (Tawake), after successful anesthesia induction and endotracheal intubation (Tinduction), when the body position was adjusted to the Trendelenburg position and the CO2 pneumoperitoneum pressure reached 14 mmHg, which was recorded as T0. Then, measurements were conducted every 15 minutes for first 1 hour and then once every hour until the end of the surgery（T15,T30,T45 ,T1h ,T2h…）, after end of surgery and the tracheal tube was removed (Tend), and before the patients were transferred to the ward (Tpacu).Results A significant difference in optic nerve sheath diameter was found between two groups at T15, T30, T45 (4.64±0.48mm and 4.50±0.29mm, respectively, p =0.031; 4.77±0.45mm and 4.62±0.28mm, respectively, p =0.036; 4.84±0.46mm and 4.65±0.30mm, respectively, p =0.012), while no significant difference at Tawake and other time points. Conclusion During laparoscopic gynecological surgery lasting more than 2 hours, the optic nerve sheath diameter gradually increased with establishment of the CO2 pneumoperitoneum and patient placement in the Trendelenburg position in both sevoflurane group and propofol group and returned to baseline 1 hour after surgery. No significant difference was observed between the two groups 1 hour after surgery. Trial registration clinicaltrials.gov，NCT03498235. Retrospectively registered 1 March2018,https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0007UMM&selectaction=Edit&uid=U00040C5&ts=39&cx=c7i8icThe manuscript adheres to CONSORT guidelines.
Testing Attitudes, Social Desirability and Behavioral Regulations as Moderators of Implicit-Explicit Exercise Cognition Discrepancies in Iranian Students
Authors: Berry Tanya , Taymoori Parvaneh , Shirzadi Kohestan , Pashaei Tahereh , Bahamani Afshin 
Published: August 2020

Abstract
The authors have withdrawn this preprint due to author disagreement.
Supporting Women With Mild to Moderate Anxiety in Pregnancy: a Feasibility Study of a Midwife Facilitated Intervention
Authors: Evans Kerry , Morrell Jane , Spiby Helen 
Published: August 2020

Abstract
Aim: The aim of the study was to determine the acceptability and feasibility of an intervention to support women with mild to moderate anxiety in pregnancy.Design: The intervention development and feasibility testing followed the MRC guidelines for complex interventions. A feasibility study was conducted between April - May 2016.Methods: Qualitative and quantitative data were collected to assess the acceptability and feasibility of the intervention. The intervention was delivered in three components: pre-group individual meeting with the midwife; group sessions; guided self-help resources. The intervention was facilitated by midwives and co-facilitated by midwifery support workersResults: Eight women with self-reported symptoms of mild to moderate anxiety participated in the study. Women reported an improvement in anxiety symptoms and felt they had benefitted from participation. Accessing social support from other women in similar circumstances had helped women to feel less isolated and facilitated open and honest discussions. Women valued the involvement of the midwife facilitator to support their wellbeing and provide specific advice about their pregnancies.Conclusions: The intervention design appeared to be acceptable and beneficial for this group of women. This study highlights the potential for midwives to facilitate supportive interventions to enhance the current provision of emotional support for women with anxiety symptoms in pregnancy and address the current gap in services. The intervention is potentially feasible for introduction into current clinical practice with minimal additional resources.
Systemic Lupus Erythematosus Activity and Hydroxychloroquine Use Before and After End Stage Renal Disease
Authors: Guerrero Maria Salgado , Jimenez Alejandra Londono , Dobrowolski Chrisanna , Mowrey Wenzhu B. , Goilav Beatrice , Wang Shudan , Broder Anna 
Published: August 2020

Abstract
Background: SLE manifestations after ESRD may be underdiagnosed and undertreated, contributing to increased morbidity and mortality. Whether specific symptoms persist after ESRD or a shift towards new manifestations occurs has not been studied. In addition, hydroxychloroquine (HCQ) prescribing patterns post-ESRD have not been described. The objective of this study was to assess lupus activity and HCQ prescribing before and after ESRD development. Knowledge gained from this study may aid in the identification of SLE manifestations and improve medication management post-ESRD. Methods: We performed a retrospective cohort study of SLE patients with incident ESRD between 2010 and 2017. SLE-related symptoms, serologic markers of disease activity, and medication use were collected from medical records before and after ESRD development. Results: Fifty-nine patients were included in the study. Twenty-five (43%) patients had at least one clinical (non-renal) SLE manifestation documented within 12 months before ESRD. Of them, 11/25 (44%) continued to experience lupus symptoms post-ESRD; 9 patients without clinical or serological activity pre-ESRD developed new symptoms of active SLE. At the last documented visit post-ESRD, 42/59 (71%) patients had one or more clinical or serological markers of lupus activity; only 17/59 (29%) patients achieved clinical and serological remission.Thirty-three of 59 (56%) patients had an active HCQ prescription at the time of ESRD. Twenty-six of the 42 (62%) patients with active SLE manifestations post-ESRD and 10/17(59%) patients with no manifestations of active disease post-ESRD were on HCQ. Patients who continued HCQ post-ESRD were more likely to be followed by a rheumatologist (26 [87%] vs 17 [61%], p=0.024), had a higher frequency of documented arthritis (10 [32%] vs 1 [4%], p=0.005), CNS manifestations (6 [20%] vs 1 [4%], p=0.055), and concurrent immunosuppressive medication use (22 [71%] vs 12 [43%], p=0.029).Conclusions: Lupus activity may persist after the development of ESRD. New onset arthritis, lupus-related rash, CNS manifestations, low complement and elevated anti-dsDNA may develop. HCQ may be underutilized post-ESRD. Careful clinical and serological monitoring for signs of active disease and frequent rheumatology follow up is advised in SLE patients both, pre and post-ESRD.
Improved Oncologic Outcomes Following Laparoscopic Surgery for Small T4 Colon Cancer : A Multi-center Comparative Study
Authors: Park Sung Sil , Lee Joon Sang , Park Hyoung-Chul , Park Sung Chan , Sohn Dae Kyung , Oh Jae Hwan , Han Kyung Su , Lee Dong-Won , Kang Sung-Bum , Park Kyu Joo , Jeong Seung‑Yong 
Published: August 2020

Abstract
Background: Laparoscopic surgery for T4 colon cancer may be safe in selected patients. Based on the theory that small tumor size might preoperatively predict a good laparoscopic surgery outcome, we herein compare the clinicopathologic and oncologic outcomes of open and laparoscopic surgery in small T4 colon cancer.Methods: In a retrospective multicenter study, we reviewed the data of 449 patients, including 117 patients with tumors ≤4 cm, who underwent T4 colon cancer surgery between January 2014 and December 2017. We compared the clinicopathologic and 3-year oncologic outcomes between the laparoscopic and open surgery groups.Results: Blood loss, length of hospital stay, and postoperative morbidity were lower in the laparoscopic group than in the open group (86 mL vs. 278 mL, p < 0.001; 10.0 days vs. 12.5 days, p = 0.003; and 18.0% vs. 29.5%, p = 0.005, respectively). There were no intergroup differences in overall survival (OS) and 3-year disease-free survival (DFS; 87.8% vs. 83.2%, p = 0.117; 69.5% vs. 68.1%, p = 0.408, respectively). Among patients with tumors of size ≤4 cm, blood loss was lower in the laparoscopic surgery group than in the open group (80 mL vs. 208 mL, p = 0.001); despite no statistical difference observed in the 3-year OS (84.4% vs 78.7%, p = 0.442), the laparoscopic group had a better 3-year DFS (73.8% vs. 46.0%, p = 0.004).Conclusions: Laparoscopic surgery showed similar outcomes to open surgery in T4 colon cancer patients, and may have favorable short-term oncologic outcomes in patients with small T4 tumors.