bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Prolonged Cholera Outbreak Caused by Drinking Contaminated Water from a Stream, Kyangwali Refugee Settlement, Hoima District, Western Uganda: February-May 2018
Authors: Monje Fred , Ario Alex Riolexus , Musewa Angella , Bainomugisha Kenneth , Mirembe Bernadette Basuta , Aliddeki Dativa Maria , Eurien Daniel , Nsereko Godfrey , Nanziri Carol , Kisaakye Esther , Ntono Vivian , Kweiga Benon , Kadobera Daniel , Bulage Lilian , Bwire Godfrey , Tusiime Patrick , Harris Julie , Zhu Bao-Ping 
Published: June 2020

Abstract
Background: On 23 February 2018, the Uganda Ministry of Health (MOH) declared a cholera outbreak affecting more than 60 persons in Kyangwali Refugee Settlement, Hoima District, bordering the Democratic Republic of Congo (DRC). We investigated to determine the outbreak scope and risk factors for transmission, and recommend evidence-based control measures.Methods: We defined a suspected case as sudden onset of watery diarrhoea in a person aged ≥2 years in Hoima District, 1 February-9 May 2018. A confirmed case was a suspected case with V. cholerae cultured from a stool sample. We found cases by active community search and record reviews at Cholera Treatment Centres. We calculated case-fatality rates (CFR) and attack rates (AR) by sub-county and nationality. In a case-control study, we compared exposure factors among case- and control-households. We conducted an environmental assessment in the refugee settlement, including testing of water samples from stream water, tank water, and spring water for presence of fecal coliforms. We tested suspected cholera cases using cholera Rapid Diagnostic Test (RDT) kits followed by culture for confirmation. Results: We identified 2,122 case-patients and 44 deaths (CFR=2.1%). Case-patients originating from DRC were the most affected (AR=15/1000). The overall attack rate in Hoima District was 3.2/1,000, with Kyangwali sub-county being the most affected (AR=13/1,000). The outbreak lasted 4 months, which was a multiple point-source. Environmental assessment showed that a stream separating two villages in Kyangwali Refugee Settlement was a site of open defecation for refugees. Among three water sources tested, only stream water was fecally-contaminated, yielding >100 CFU/100ml. Of 130 stool samples tested, 124 (95%) yielded V. cholerae by culture. Stream water was most strongly associated with illness (OR=14.2; CI=1.5-133), although tank water also appeared to be independently associated with illness (OR=11.6; CI=1.4-94). Persons who drank tank and stream water had a 17-fold higher odds of illness compared with persons who drank from other sources (OR=17.3, CI=2.2-137). Conclusions: Drinking contaminated stream water was associated with cholera outbreak. We recommended boiling drinking water, increasing latrine coverage, and provision of safe water by the District and United Nations High Commissioner for Refugees.
Sappanone A inhibits oxidative stress, inflammation and apoptosis in cigarette smoke-induced human bronchial epithelial cells through regulating Nrf2/HO-1 and TLR4/NF-κB signaling pathways
Authors: Zhang Yan , Wang Shanshan , Li Hongli , Xu Xia 
Published: June 2020

Abstract
Chronic obstructive pulmonary disease (COPD) is a common respiratory disease associated with inflammation and oxidative stress. Sappanone A (SA) is a homoisoflavanone that has been proven to have anti-inflammatory and anti-oxidant effects. However, the role of SA in COPD remains unclear. Thus, the present study was aimed to evaluate the beneficial effect of SA on COPD in vitro. The human bronchial epithelial cells were exposed to 5% cigarette smoke extracts (CSE) to induce an in vitro model of COPD. Our results showed that SA treatment significantly attenuated the CSE-caused induction of ROS and reduction of SOD and GPx activities in 16HBE cells. In addition, SA inhibited the production of inflammatory cytokines IL-6, IFN-γ, and TNF-α in CSE-stimulated 16HBE cells. Moreover, the CSE-stimulated cell apoptosis of 16HBE cells were abrogated by SA. Furthermore, we observed that SA treatment greatly promoted the activation of Nrf2/HO-1 signaling pathway, as well as inhibited the activation of TLR4/NF-κB signaling pathway in CSE-stimulated 16HBE cells. Subsequent rescue assay revealed that the protective effects of SA on CSE-stimulated 16HBE cells were reversed by Nrf2 knockdown or TLR4 overexpression. Taken together, these findings demonstrated that SA inhibits oxidative stress, inflammation and apoptosis in CSE-induced human bronchial epithelial cells through regulating Nrf2/HO-1 and TLR4/NF-κB signaling pathways.
COVID-19 Pandemic:&nbsp;management of patients affected by SARS-CoV-2 in Rome Covid Hospital 2 Trauma Center and safety of our surgical equipe&nbsp;
Authors: Mauro Domenico De , MD  , Smimmo Alessandro , Meschini Cesare , Mocini Fabrizio , MD  , Falez Francesco , Liuzza Francesco , MD  
Published: June 2020

Abstract
Background. SARS-CoV-2 Pandemic left a deep mark in the Health Systems around the globe, leading to an important change in the way we intend the access to the healthcare and its fruition. Hospitals faced something unexpected and they underwent a deep change and so did the orthopedic activity.Materials and Methods. In “A. Gemelli” University hospital new protocols were adopted for the safe management of patients affected by SARS-CoV-2. Among these patients, six had to be treated also for orthopedic problems. The management of these patients, from the admission in the Emergency Room (E.R). to the operating room (O.R.), followed the protocols we predisposed for the Coronavirus crisis.Results. Four among the six patients underwent surgical treatments. Two of them showed a change of their clinical status, due to a worsening of the COVID-19 symptoms, so the surgical option was postponed. All of them were admitted to the Infectious Diseases Unit, rather than the Orthopedic and Traumatology Unit, in order to provide the best measures to prevent the spread of the contagion and to ensure the best treatment for the COVID-19. No O.R. staff was infected by SARS-CoV-2.Conclusions. More studies are needed to provide a higher statistical significance to the safety measures taken in order to contrast the spread of SARS-CoV-2 in the Surgical Room. Orthopedic surgeons are more exposed to the contagion due to the particular tools set they use. A more sensible and specific quick test for novel Coronavirus is particularly needed, due to the lack of sensibility of the serological rapid test.
Development &amp; Evaluation of Virtual Reality (VR) based Novel Vision System for the da Vinci Surgical Robot
Authors: Mun Gyeongbin , Kim Young Gyun , Kim Myungjoon , Jeon Byoungjun , Kong Seong-Ho , Jeong Chang Wook , Lee Kyu Eun , Kim Sungwan 
Published: June 2020

Abstract
Background: Robot surgery has become prevalent because of its various advantages as a progressive method based on empirical researches of conventional open surgery and minimally invasive surgery. However, the da Vinci surgical robot system, the most widely used and researched surgical robot, still requires an ergonomic improvement because of the uncomfortable posture in which it has to be operated. The stereo viewer—the current vision system of the da Vinci surgical robot—requires a user to maintain a posture wherein the user is looking down, which causes discomfort and results in musculoskeletal disorders. To overcome this limitation, a virtual reality (VR) head-mounted display (HMD) is proposed by previous researchers as an appropriate option to replace the stereo viewer, as it enables surgeons to move freely during surgery instead of having to look down on the stereo viewer. Presently, there is no direct comparison between the stereo viewer and a VR HMD by surgeons. Comparative evaluations were performed using peg transfer tasks, a questionnaire, and a NASA-Task Load Index (TLX). These were planned and performed by surgeons and novices to determine if the stereo viewer can be replaced by the VR HMD and to investigate whether the VR HMD has ergonomic.Results: Based on the results of peg transfer tasks, completion times when using VR HMD were shorter than those when using the stereo viewer. In these tasks, the participants performed more executions using the VR HMD compared to the stereo viewer. Based on the questionnaire, the participants favored the VR HMD compared to the stereo viewer, with respect to its visual and ergonomic performance. The modified NASA-TLX showed positive perceptions for the VR HMD.Conclusions: This comparative evaluation confirmed that the VR HMD can be employed as a potential alternative for the stereo viewer in a surgical robot system to achieve ergonomic improvements. The VR HMD improved the task performance of the surgical robot system, and it provided an ergonomic operation environment.
A Novel Glycolysis-Related Gene Signature that can Predict the Prognosis of Glioblastoma Patients
Authors: Zhang Chaocai , Wang Minjie , Ji Fenghu , Peng Yizhong , Zhao Jiannong , Wu Jiandong 
Published: June 2020

Abstract
Background: Glioblastoma (GBM) is one of the most common primary intracranial malignancies, with limited treatment options and poor overall survival (OS). Metabolic changes in GBM have attracted wide attention in recent years, and one of the main metabolic features of cancer cells is the high level of glycolysis. Therefore, it is necessary to identify novel biomarkers associated with glycolysis in GBM. Methods: In this study, we performed gene set enrichment analysis and profiled four glycolysis-related gene sets, which revealed 327 genes associated with biological processes. Univariate and multivariate Cox regression analyses were performed to identify genes for constructing a risk signature, and we identified ten mRNAs (B4GALT7, CHST12, G6PC2, GALE, IL13RA1, LDHB, SPAG4, STC1, TGFBI and TPBG) in the Cox proportional hazards regression model for GBM. Results: Based on this gene signature, we divided patients into high-risk (with poor outcomes) and low-risk (with better outcomes) subgroups. Multivariate Cox regression analysis showed that the prognostic power of this ten-gene signature is independent of clinical variables. Furthermore, we validated this model in two other GBM databases (Chinese Glioma Genome Atlas (CGGA) and REMBRANDT). In the functional analysis, the risk signature was associated with almost every step of cancer progression, such as adhesion, proliferation, angiogenesis, drug resistance and even an immune-suppressed microenvironment. Conclusion: The 10 glycolysis-related gene risk signature could serve as an independent prognostic factor for GBM patients and might be valuable for the clinical management of GBM patients.
Preoperative AICS (lung) abnormalities predict postoperative recurrence in patients undergoing curative resection for non-small cell lung cancer
Authors: Higashiyama Masahiko , Miyazaki Ryohei , Yamamoto Hiroshi , Anayama Takashi , Kikuchi Shinya , Hirohashi Kentaro , Okami Jiro , Maniwa Tomohiro , Kimura Toru , Orihashi Kazumasa , Imamura Fumio 
Published: June 2020

Abstract
[Background] AminoIndexTM Cancer Screening (AICS (lung)) was developed as a screening test for lung cancer using a multivariate analysis of plasma-free amino acid (PFAA) profiles. According to the developed index composed of PFAA, the probability of lung cancer was categorized into AICS (lung) ranks A, B, and C in order of increasing risk. The aim of the present study was to investigate the relationship between the preoperative AICS (lung) rank and surgical outcomes in patients who underwent curative resection for non-small cell lung cancer (NSCLC).[Methods] Preoperative blood samples were collected from 297 patients who underwent curative resection for NSCLC between 2006 and 2015. PFAA concentrations were measured. The relationship between the preoperative AICS (lung) rank and clinicopathological factors was examined. The effects of the preoperative AICS (lung) rank on postoperative outcomes were also analyzed.[Results] The AICS (lung) rank was A in 93 patients (31.3%), B in 82 (27.6%), and C in 122 (41.1%). The AICS (lung) rank did not correlate with any clinicopathological factors, except for age. Based on follow-up data (median follow-up period of 6 years), postoperative recurrence was observed in 22 rank A patients (23.7%), 15 rank B (18.3%) and 49 rank C (40.2%). In the univariate analysis, preoperative AICS (lung) rank C was a worse factor of recurrence-free survival (p=0.0002). The multivariate analysis identified preoperative AICS (lung) rank C (HR: 2.17, p=0.0005) as a significant predictor of postoperative recurrence, particularly in patients with early-stage disease or adenocarcinoma. [Conclusion] Preoperative AICS (lung) abnormalities are a high-risk predictor of postoperative recurrence in NSCLC patients undergoing curative resection.
Development of Competency Model for Family Physicians Against the Background of 'Internet Plus Healthcare' in China: A Mixed Methods Study
Authors: Ni Ziling , Wang Xiaohe , Zhou Siyu , Zhang Tao 
Published: June 2020

Abstract
Background: Identification of the service competences of family physicians are central to ensuring high-quality primary care and improving patient outcomes. However, little is known about how to assess the family physicians’ service competences in primary care settings. It is necessary to develop and validate a general model of core competences of the family physician under the stage of construction of family doctor system and implementation of ‘Internet Plus Healthcare’ service model in China.Methods: The literature review, behavioral event interviews, expert consultation and questionnaire survey were performed. The scale’s 35 questions were measured by response rate, highest score, lowest score, and average score for each. Delphi method was used to assess content validity, Cronbach’s α to estimate reliability, and factor analysis to test structural validity. Respondents were randomly divided into two groups; data for one group were used for exploratory factor analysis (EFA) to explore possible model structure. Confirmatory factor analysis (CFA) was then performed.Results: Effective response rate was 93.56%. Cronbach’s α coefficient of the scale was 0.977. Factor analysis showed KMO of 0.988. Bartlett’s test showed χ2 of 22917.515 (df=630), p<.001. Overall authority grade of expert consultation was 0.80, and Kendall’s coefficient of concordance W was 0.194. By EFA, the five-factor model was retained after thorough consideration, and four items with factor loading less than 0.4 were proposed to obtain a five-dimension, 32-item scale. CFA was performed on the new structure, showing high goodness-of-fit test (NFI=0.98, TLI=0.91, SRMSR=0.05, RMSEA=0.04). Overall Cronbach’s α coefficients of the scale and each sub-item were greater than 0.9.Conclusions: The scale has good reliability, validity, and credibility, and can therefore serve as an effective tool for assessment of Chinese family physicians’ service competences.
Underwater-treadmill training attenuates blood-spinal cord barrier disruption by promoting angiogenesis and inhibiting MMP-2/9 expression following spinal cord injury
Authors: Ying Xinwang , Xie Qingfeng , Li Shengcun , Yu Xiaolan , Zhou Kecheng , Yue Jingjing , Chen Xiaolong , Tu Wenzhan , Yang Guanhu , Jiang Songhe 
Published: June 2020

Abstract
Background
The blood-spinal cord barrier (BSCB) can be seriously damaged after SCI and is considered to be a therapeutic target. Exercise training is a recognized method for the treatment of SCI. The destruction of the BSCB mediated by matrix metalloproteinase (MMP) leads to inflammation, neurotoxin production, and apoptosis of neurons. The failure of effective regeneration of new blood vessels is also an important reason for the difficulty of recovery after SCI. We introduced underwater-treadmill training (TT) for the first time, which can help SCI rats successfully exercise, and we explored the role of TT in promoting the ability to exercise after SCI and its possible mechanism.
Methods
SCI models were established and randomly divided into three groups. Rats underwent TT after SCI. The degree of neurological deficit, water content, BSCB permeability, protein expression and ultrastructure of vascular endothelial cells were assessed by the BBB motor rating scale, haematoxylin-eosin (HE) staining, Evans blue (EB) staining, Western blot (WB) experiments, and immunofluorescence and transmission electron microscopy (TEM).
Results
Our experiments show that TT reduces the permeability of BSCB and decreased tissue structure damage and improved functional recovery after SCI; TT prevent the loss of TJ and AJ protein; TT promotes angiogenesis and inhibits the expression of MMP-2 and MMP-9 after SCI.
Conclusions
In this study, the results indicate that TT promotes functional recovery partly for the following reasons: (1) TT protects residual BSCB structure from further damage; (2) it promotes vascular regeneration; and (3) it inhibits the expression of MMP-2/9 to mitigate BSCB damage.
Defining Malaria Risks Among Forest Workers in Aceh, Indonesia: A Formative Assessment
Authors: Ekawati Lenny Lia , Johnson Kelly C. , Jacobson Jerry O. , Cueto Carmen A. , Zarlinda Iska , Elyazar Iqbal RF , Fatah Abdul , Sumiwi Maria E. , Noviyanti Rintis , Cotter Chris , Smith Jennifer L. , Coutrier Farah N. , Bennett Adam 
Published: June 2020

Abstract
Background. Following a dramatic decline of malaria cases in Aceh province, geographically-based reactive case detection (RACD) was recently evaluated as a tool to improve surveillance with the goal of malaria elimination. While RACD detected few cases in households surrounding index cases, engaging in forest work was identified as a risk factor for malaria and infections from Plasmodium knowlesi—a primate malaria parasite—were more common than expected. This qualitative formative assessment was conducted to improve understanding of malaria risk from forest work and identify strategies for targeted surveillance among forest workers. Methods. Between June and August, 2016, five focus groups and 18 in-depth interviews with forest workers and key informants were conducted in each of four subdistricts in Aceh Besar and Aceh Jaya districts. Themes included: types of forest activities, mobility of workers, interactions with non-human primates, malaria prevention and treatment-seeking behaviors, and willingness to participate in malaria surveys at forest work sites and using peer-referral. Results. Reported forest activities included mining, logging, and agriculture in the deep forest and along the forest fringe. Forest workers, particularly miners and loggers, described often spending weeks to months at work sites in makeshift housing, rarely utilizing mosquito prevention and, upon fever, self-medicating and seeking care from traditional healers or pharmacies rather than health facilities. Non-human primates are frequently observed near work sites, and most forest work locations are within a day’s journey of health clinics. Employers and workers expressed interest in undertaking malaria testing and in participating in survey recruitment by peer-referral and at work sites. Conclusions. Diverse groups of forest workers in Aceh are potentially exposed to malaria through forest work. Passive surveillance and household-based screening may under-estimate malaria burden due to extended stays in the forest and health-seeking behaviors. Active surveillance specifically targeting forest workers through work-site screening and/or peer-referral appears promising for addressing undetected infections.
Stereotactic Body Radiation Therapy (SBRT) for Liver Oligometastases: outcomes and safety
Authors: Cazic Dejan , Marosevic Goran 
Published: June 2020

Abstract
Background: The aim of this study was to investigate adverse effects, progression free survival (PFS), one-year local control (LC) and one-year overall survival (OS) of patients with liver oligometastases treated with stereotactic body radiotherapy (SBRT), and whether there is a significant difference in these parameters in patients with primary colorectal cancer compared to other tumor localizations.Methods: Patients were simulated using four-dimensional computed tomography (4DCT). Using volumetric modulated arc therapy (VMAT) technique, SBRT was performed on 16 patients with <3 liver metastases. The prescribed dose was 60 Gy in 8 fractions (BED 105 Gy). Cone beam CT (CBCT) was used for image guidance before each fraction with online correction.Results: There were no adverse effects. Mean PFS for all patients, patients with primary colorectal cancer, and patients with primary non-colorectal cancer was 12.2 months (SD 8.3), 16.3 months (SD 7.9), 8.1 months (SD 6.8), respectively. There was a significant difference in the mean PFS for these two observed groups (p = 0.023). The one-year LC was 62.5%. Patients with primary colorectal cancer had the one-year LC of 87.5%, while the group of patients with primary non-colorectal cancer had the one-year LC of 37.5% (p = 0.014). The total one-year OS was 87.5%. In the group of patients with primary colorectal cancer, the one-year OS was 100%, while in the group of patients with primary non-colorectal cancer, the one-year OS was 75% (p = 0.147).Conclusion: SBRT is a safe and effective method of treating liver oligometastases.
Potential transmission risk of SARS-CoV-2 through medical wastewater in COVID-19 outbreak cities
Authors: Zhou Jun-Bo , Kong Wen-Hua , Wang Sheng , Long Yi-Bing , Dong Lian-Hua , He Zhen-Yu , Liu Man-Qing 
Published: June 2020

Abstract
COVID-19 outbreak first reported in Wuhan has been officially declared as a global pandemic. Considering the fecal shedding of SARS-CoV-2 has been proven by the viral strains isolated from COVID-19 patient’s stool specimens, it proposed the possibility that contaminated wastewater and fomites might involve in the disease transmission in outbreak cities. In this study, we collected the wastewater samples collected from COVID-19 designated hospitals, Fangcang shelter hospitals, quarantine spots and wastewater treatment plants in Wuhan, China, and performed RT-qPCR and droplet digital PCR (ddPCR) for the detection of SARS-CoV-2. Although high concentration of residual chlorine for disinfection of SARS-CoV-2 is persisted, low level SARS-CoV-2 RNA can be detected by qPCR and droplet digital PCR (ddPCR) in the wastewater samples during the COVID-19 outbreak. This preliminary data firstly described in China implies the potential transmission risk of SARS-CoV-2 through medical wastewater in the cities during the COVID-19 outbreak, which calls particular attention for the surveillance and efficient disinfection of wastewater from COVID-19 related facilities.