bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Exogenous Nerve Growth Factor on The Expression of BMP-9 and VEGF in The Healing of Rabbit Mandible Fracture With Local Nerve Injury
Authors: Yang Sen , Cheng Jiao , Man Cheng , Jiang Lian , Long Guogeng , Zhao Wenjun , Zheng Dexin 
Published: December 2020

Abstract
Background: Mandibular fracture healing is a complex process involving nerves and growth factors. Nerve growth factor (NGF) not only facilitates the maintenance of sympathetic neurite growth but also stimulates other growth factors that can promote the essential osteogenesis and angiogenesis for fracture healing. Therefore, it is necessary to analyze the combined effects of NGF, bone morphogenic protein-9 (BMP-9), and vascular endothelial growth factor (VEGF) to accelerate the healing of mandible fractures.Methods: The models of mandible fracture with local nerve injury established in forty-eight rabbits were randomly divided into nerve growth factor group (NGF group), gelatin sponge group (GS group), blank group, and intact group. The recovery of nerve reflex was assessed by observing the number of rabbits with lower lip responses to acupuncture. The fracture healing was observed with visual and CBCT, and then callus tissues from the mandibular fracture area were collected for hematoxylin and eosin (HE) staining observation, and the expression of BMP-9 and VEGF in callus at different stages was detected by quantitative real-time PCR (qRT-PCR).Results: Needling reaction in the lower lip showed the number of animals with nerve reflex recovery was significantly higher in the NGF group than that in the GS and blank groups at the 2nd and 4th weeks after the operation. The combined results of macroscopic observation, CBCT examination, and histological analysis showed that a large number of osteoblasts and some vascular endothelial cells were found around the trabecular bone in the NGF group and the amount of callus formation and reconstruction was better than that in the GS group at the 2nd week after the operation. The qRT-PCR results indicated that the expression levels of BMP-9 and VEGF in the four groups reached the highest values at the 2nd week, while the expression levels of both in the NGF group were significantly higher than that in the GS group.Conclusion: The exogenous NGF could accelerate the healing of mandible fractures. This work will provide a new foundation and theoretical basis for clarifying the mechanism of fracture healing, thereby promoting fracture healing and reducing the disability rate of patients.
Wrapping the Stump of the Gastroduodenal Artery Using the Ligamentum Teres Hepatis During Laparoscopic Pancreaticoduodenectomy – A Center’s Preliminary Experience
Authors: Meng Lingwei , Cai He , Cai Yunqiang , Li Yongbin , Peng Bing 
Published: December 2020

Abstract
Background: The present study aims to assess the preliminary outcomes of the effectiveness of wrapping the ligamentum teres hepatis (LTH) around the gastroduodenal artery stump for the prevention of erosion hemorrhage after laparoscopic pancreaticoduodenectomy (LPD).Methods: We reviewed 247 patients who had undergone LPD between January 2016 and April 2019. The patients were divided into 2 groups according to whether LTH wrapped the stump of the gastroduodenal artery: group A (119 patients) who underwent the LTH wrapping procedure, and group B (128 patients) who did not undergo the procedure. The perioperative data from the two groups were reviewed to assess the effectiveness of the LTH procedure for the prevention of postpancreatectomy hemorrhage (PPH) and other complications.Results: No differences were observed in the clinical characteristics between the 2 groups. The data from 247 patients were acceptable for analysis: 119 patients underwent wrapping, and 128 patients did not. The incidence of clinically relevant pancreatic fistula (8.4% vs 3.9%), biliary fistula (2.5% vs 1.6%), intra-abdominal infection (10.1% vs 3.9%) and delayed gastric emptying (13.4% vs 16.4%) showed no significant difference between group A and group B. The 90-day mortality and 90-day reoperation rates (0.8% vs 0.8% and 5.0% vs 3.1%) were also similar between group A and group B. Furthermore, postpancreatectomy hemorrhage of Grade B and C occurred in 0 patients (0.0%) in the wrapping group, which was significantly less frequent than the occurrence in the nonwrapping group (7 patients; 5.5%, P=0.02).Conclusions: Wrapping the LTH around the gastroduodenal artery stump after LPD does not reduce the incidence of clinically relevant pancreatic fistula, biliary fistula or delayed gastric emptying. However, this procedure has a trend of reducing the rate of PPH of Grade B and C after LPD and is simple to perform.
Determinants of Developing Symptomatic Disease in Ethiopian COVID-19 Patients: A Case-Control Study
Authors: Leulseged Tigist Workneh , Alemahu Degu G. , Hassen Ishmael S. , Maru Endalkachew H. , Zewde Wuletaw C. , Chamesew Nigat W. , Yegele Kalkidan T. , Abebe Daniel S. , Abdi Firaol M. , Menyelshewa Etsegenet Y. , Gerbi Tegenu G. , Hagos Helen T. 
Published: December 2020

Abstract
Background: Studies show that having some symptoms seems to be associated with more severe disease and poor prognosis. Therefore, knowing who is more susceptible to symptomatic COVID-19 disease is important to provide targeted preventive and management practice. The aim of the study was to assess the determinants of having symptomatic disease among COVID-19 patients admitted to Millennium COVID-19 Care Center in Ethiopia.Methods: A case-control study was conducted from August to September 2020 among a randomly selected 765 COVID-19 patients (372 Asymptomatic and 393 Symptomatic patients). Chi-square test and independent t-test were used to detect the presence of a statistically significant difference in the characteristics of the cases (symptomatic) and controls (asymptomatic), where p-value of <0.05 considered as having a statistically significant difference. Multivariable binary logistic regression was used to assess a statistically significant association between the independent variables and developing symptomatic COVID-19 where Adjusted Odds ratio (AOR), 95% CIs for AOR, and P-values were used for testing significance and interpretation of results. Results: The result of the multivariable binary logistic regression shows that age group (AOR= 1.818, 95% CI= 1.210, 2.731, p-value=0.004 for 30-39 years; AOR= 1.611, 95% CI= 1.016, 2.554, p-value=0.043 for 40-49 years and AOR= 4.076, 95% CI= 2.582, 6.435, p-value=0.0001 for years and above), sex (AOR= 1.672, 95% CI= 1.216, 2.299, p-value=0.002) and history of diabetes mellitus (AOR= 2.406, 95% CI= 1.384, 4.181, p-value=0.002) were found to be significant factors that determine the development of symptomatic disease in COVID-19 patients.Conclusions: Developing a symptomatic COVID-19 disease was found to be determined by exposures of old age, male sex, and being diabetic. Therefore, patients with the above factors should be given enough attention in the prevention and management process, including inpatient management, to pick symptoms earlier and to manage accordingly so that these patients can have a favorable treatment outcome.
Prevalence and Risk Factors of Hemodynamic Instability Associated with Preload-Dependence During Continuous Renal Replacement Therapy in a Prospective Observational Cohort of Critically Ill Patients
Authors: CHAZOT Guillaume , BITKER Laurent , MEZIDI Mehdi , CHEBIB Nader , CHABERT Paul , CHAUVELOT Louis , FOLLIET Laure , DAVID Guillaume , PROVOOST Judith , YONIS Hodane , Richard Jean-christophe 
Published: December 2020

Abstract
BackgroundHemodynamic instability is a frequent complication of continuous renal replacement therapy (CRRT). Postural tests (i.e. passive leg raising in the supine position or Trendelenburg maneuver in the prone position) combined with measurement of cardiac output are highly reliable to identify preload-dependence and may provide new insights into the mechanisms involved in hemodynamic instability related to CRRT (HIRRT). We aimed to assess the prevalence and risk factors of HIRRT associated with preload-dependence in ICU patients.MethodsWe conducted a single-center prospective observational cohort study in ICU patients with acute kidney injury KDIGO 3, started on CRRT in the last 24 hours, and monitored with a PiCCO® device. The primary endpoint was the rate of HIRRT episodes associated with preload-dependence during the first 7 days after inclusion. HIRRT was defined as the occurrence of a mean arterial pressure below 65 mm Hg requiring therapeutic intervention. Preload-dependence was assessed by postural tests every 4 hours, and during each HIRRT episode. Data are expressed in median [1rst quartile-3rd quartile], unless stated otherwise.Results42 patients (62% male, age 69 [59–77] year, SAPS-2 65 [49–76]) were included 6 [1–16] hours after CRRT initiation and studied continuously for 121 [60–147] hours. A median of 5 [3–8] HIRRT episodes occurred per patient, for a pooled total of 243 episodes. 131 episodes (54% [CI95%: 48%-60%]) were associated with preload-dependence, 108 (44%, [CI95%: 38%-51%]) without preload-dependence, and 4 were unclassified. Multivariate analysis (using variables collected prior to HIRRT) identified the following variables as risk factors for the occurrence of HIRRT associated with preload-dependence: preload-dependence before HIRRT (odd ratio (OR) = 3.82, p < 0.001), delay since last HIRRT episode > 8 hours (OR = 0.56, p < 0.05), lactate (OR = 1.21 per 1-mmol.L− 1 increase, p < 0.05), cardiac index (OR = 0.47 per 1-L.min− 1.m− 2 increase, p < 0.001) and SOFA at ICU admission (OR = 0.91 per 1-point increase, p < 0.001). None of the CRRT settings was identified as risk factor for HIRRT.Conclusions:In this single center study, HIRRT associated with preload-dependence was slightly more frequent than HIRRT without preload-dependence in ICU patients undergoing CRRT. Testing for preload-dependence to adjust fluid removal by CRRT could help preventing HIRRT occurrence during CRRT.
Risk factors of poor prognosis and impairment of activities of daily living in patients with hemorrhagic gastroduodenal ulcers
Authors: Arai Junya , Kato Jun , Toda Nobuo , Kurokawa Ken , Shibata Chikako , Kurosaki Shigeyuki , Funato Kazuyoshi , Kondo Mayuko , Takagi Kaoru , Kojima Kentaro , Ohki Takamasa , Seki Michiharu , Tagawa Kazumi 
Published: December 2020

Abstract
Background: Impairment of activities of daily living (ADL) due to hemorrhagic gastroduodenal ulcers (HGU) has rarely been evaluated. We analyzed the risk factors of poor prognosis, including mortality and impairment of ADL, in patients with HGU.Methods: In total, 582 patients diagnosed with HGU were retrospectively analyzed. Admission to a care facility or the need for home adaptations during hospitalization were defined as ADL decline. The clinical factors were evaluated: endoscopic features, need for interventional endoscopic procedures, comorbidities, symptoms, and medications. The risk factors of outcomes were examined with multivariate analysis.Results: Advanced age (> 75 years) was a significant predictor of poor prognosis, including impairment of ADL. Additional significant risk factors were renal disease (odds ratio [OR], 3.43; 95% confidence interval [CI], 1.44–8.14) for overall mortality, proton pump inhibitor (PPIs) usage prior to hemorrhage (OR, 5.80; 95% CI, 2.08–16.2), and heart disease (OR, 3.05; 95% CI, 1.11–8.43) for the impairment of ADL. Analysis of elderly (> 75 years) subjects alone also revealed that use of PPIs prior to hemorrhage was a significant predictor for the impairment of ADL (OR, 8.24; 95% CI, 2.36–28.7).Conclusion: In addition to advanced age, the presence of comorbidities was a risk of poor outcomes in patients with HGU. PPI use prior to hemorrhage was a significant risk factor for the impairment of ADL, both in overall HGU patients and in elderly patients alone. These findings suggest that the current strategy for PPI use needs reconsideration.
Association between insulin resistance and left ventricular hypertrophy in asymptomatic Black sub-Saharan African hypertensive patients: A case-control study
Authors: PHANZU Bernard KIANU , Aliocha Nkodila Natuhoyila , Eleuthère Kintoki Vita , Jean-René M’Buyamba Kabangu , Benjamin Longo-Mbenza 
Published: December 2020

Abstract
Background: Conflicting information exists regarding the association between insulin resistance (IR) and left ventricular hypertrophy (LVH).We described the associations between obesity, fasting insulinemia, homeostasis model assessment of insulin resistance (HOMA-IR), and LVH in Black patients with essential hypertension.Methods: A case-control study was conducted at the Centre Médical de Kinshasa (CMK), the Democratic Republic of the Congo, between January and December 2019. Cases and controls were hypertensive patients with and without LVH, respectively. The relationships between obesity indices, physical inactivity, glucose metabolism and lipid disorder parameters, and LVH were assessed using linear and logistic regression analyses in simple and univariate exploratory analyses, respectively. When differences were observed between LVH and independent variables, the effects of potential confounders were studied through the use of multiple linear regression and in conditional logistic regression in multivariate analyses. The coefficients of determination (R2), adjusted odds ratios (aORs), and their 95% confidence intervals (95% CIs) were calculated to determine associations between LVH and the independent variables.Results: Eighty-eight LVH cases (52 men) were compared against 132 controls (81 men). Variation in left ventricular mass (LVM) could be predicted by the following variables: age (19%), duration of hypertension (31.3%), body mass index (BMI, 44.4%), waist circumference (WC, 42.5%), glycemia (20%), insulinemia (44.8%), and HOMA-IR (43.7%). Hypertension duration, BMI, insulinemia, and HOMA-IR explained 68.3% of LVM variability in the multiple linear regression analysis. In the logistic regression model, obesity increased the risk of LVH by 3-fold [aOR: 2.8; 95% CI (1.06–7.4); p = 0.038], and IR increased the risk of LVH by 8-fold [aOR: 8.4; 95: (3.7–15.7); p < 0.001].Conclusion: Obesity and IR appear to be the primary predictors of LVH in Black sub-Saharan African hypertensive patients. The comprehensive management of cardiovascular risk factors should be emphasized, with particular attention paid to obesity and IR. A prospective population-based study of Black sub-Saharan individuals that includes the use of serial imaging remains essential to better understand subclinical LV deterioration over time and to confirm the role played by IR in Black sub-Saharan individuals with hypertension.
Revisiting Methods For Modeling Longitudinal and Survival Data: The Framingham Heart Study
Authors: Ngwa Julius S , Cabral Howard J , Cheng Debbie M , Gagnon David R , LaValley Michael P , Cupples L. Adrienne 
Published: December 2020

Abstract
Background: Statistical methods for modeling longitudinal and time-to-event data has received much attention in medical research and is becoming increasingly useful. In clinical studies, such as cancer and AIDS, longitudinal biomarkers are used to monitor disease progression and to predict survival. These longitudinal measures are often missing at failure times and may be prone to measurement errors. More importantly, time-dependent survival models that include the raw longitudinal measurements may lead to biased results. In previous studies these two types of data are frequently analyzed separately where a mixed effects model is used for the longitudinal data and a survival model is applied to the event outcome. Methods: In this paper we compare joint maximum likelihood methods, a two-step approach and a time dependent covariate method that link longitudinal data to survival data with emphasis on using longitudinal measures to predict survival. We apply a Bayesian semi-parametric joint method and maximum likelihood joint method that maximizes the joint likelihood of the time-to-event and longitudinal measures. We also implement the Two-Step approach, which estimates random effects separately, and a classic Time Dependent Covariate Model. We use simulation studies to assess bias, accuracy and coverage probabilities for the estimates of the link parameter that connects the longitudinal measures to survival times. Results: Simulation results demonstrate that the Two-Step approach performed best at estimating the link parameter when variability in the longitudinal measure is low but is somewhat biased downwards when the variability is high. Bayesian semi-parametric and maximum likelihood joint methods yield higher link parameter estimates with low and high variability in the longitudinal measure. The Time Dependent Covariate method resulted in consistent underestimation of the link parameter. We illustrate these methods using data from the Framingham Heart Study in which lipid measurements and Myocardial Infarction data were collected over a period of 26 years.Conclusions: Traditional methods for modeling longitudinal and survival data, such as the time dependent covariate method, that use the observed longitudinal data, tend to provide downwardly biased estimates. The two-step approach and joint models provide better estimates, although a comparison of these methods may depend on the underlying residual variance.
Long-period ground motion simulation using centroid moment tensor inversion solutions based on the regional three-dimensional model in the Kanto region, Japan
Authors: Takemura Shunsuke , Yoshimoto Kazuo , Shiomi Katsuhiko 
Published: December 2020

Abstract
We conducted centroid moment tensor (CMT) inversions of moderate ( Mw 4.5–6.5) earthquakes in the Kanto region, Japan, using a local three-dimensional (3D) model. We then investigated the effects of our 3D CMT solutions on long-period ground motion simulations. Grid search CMT inversions were conducted using displacement seismograms for periods of 25–100 s. By comparing our 3D CMT solutions with those from the local one-dimensional (1D) catalog, we found that our 3D CMT inversion systematically provides magnitudes smaller than those in the 1D catalog. The Mw differences between 3D and 1D catalogs tend to be significant for earthquakes within the oceanic slab. By comparing ground motion simulations between 1D and 3D velocity models, we confirmed that observed Mw differences could be explained by differences in the rigidity structures around the source regions between 3D and 1D velocity models. The 3D velocity structures (especially oceanic crust and mantle) are important for estimating seismic moments in intraslab earthquakes, which are related to fault size estimation. A detailed discussion for intraslabe seismicity can be conducted by using the 3D CMT catalog. The seismic moments also directly affect the amplitudes of ground motions. The 3D CMT catalog allows us to directly conduct the precise forward and inverse modeling of long-period ground motion without adjusting source models, which have been typically applied in the cases using the 1D CMT catalog. We also conducted long-period ground motion simulations using our 3D CMT solutions to evaluate the reproducibility of long-period ground motions at stations within the Kanto Basin. The simulations of our 3D CMT solutions well-reproduced observed ground motions for periods longer than 10 s, even at stations within the Kanto Basin. The reproducibility of simulations was improved from those using solutions in the 1D catalog.
A randomized, multicenter, open-label, adaptive, proof of concept clinical trial of new antivirals working against Sars-CoV2: Direct Antivirals Working against the Novel coronavirus – Azithromycin (DAWn-AZITHRO) trial
Authors: Gyselinck Iwein , Liesenborghs Laurens , Landeloos Ewout , Belmans Ann , Verbeke Geert , Verhamme Peter , Vos Robin , Janssens Wim 
Published: December 2020

Abstract
Background: The rapid emergence and the high disease burden of the novel coronavirus Sars-CoV-2 has created a medical need for readily available drugs that can decrease viral replication or blunt the hyperinflammatory state leading to severe COVID-19 disease. Azithromycin is a macrolide antibiotic, known for its immunomodulatory properties. It has shown antiviral effect specifically against Sars-CoV-2 in vitro, and acts on cytokine signaling pathways that have been implicated in COVID-19.Methods: DAWn-Azithro is a randomized, open-label, phase 2 proof-of-concept, multicenter clinical trial, evaluating the safety and efficacy of azithromycin for treating hospitalized patients with COVID-19. It is part of a series of trials testing promising interventions for COVID-19, running in parallel and grouped under the name DAWn-studies. Patients hospitalized on dedicated COVID-wards are eligible for study-inclusion when they are symptomatic (i.e. clinical or radiological signs) and have been diagnosed with COVID-19 within the last 72 hours through PCR (nasopharyngeal swab or bronchoalveolar lavage), or chest CT scan showing typical features of COVID-19 and without alternate diagnosis. Patients are block-randomized (9 patients) with a 2:1 allocation to receive azithromycin plus standard of care versus standard of care alone. Standard of care is mostly supportive, but may comprise hydroxychloroquine, up to the treating physician’s discretion and depending on local policy and national health regulations. The treatment group receives azithromycin qd 500 mg during the first 5 consecutive days after inclusion. The trial will include 284 patients and recruits from 15 centers across Belgium. Primary outcome is time from admission (day 0) to life discharge or to sustained clinical improvement, defined as an improvement of two points on the WHO 7-category ordinal scale sustained for at least 3 days.Discussion: The trial investigates the urgent and still unmet global need for drugs that may impact on the disease course of COVID-19. It will either provide support or else justify the discouragement of the current widespread, uncontrolled use of azithromycin in patients with COVID-19. The analogous design of other parallel trials of the DAWN-consortium, will amplify the chance of identifying successful treatment strategies and allow comparison of treatment effects within an identical clinical context.Trial registration: EU Clinical trials register, EudraCT Nb 2020-001614-38. Start date 2020-04-22.
Post-status epilepticus treatment with the Fyn inhibitor, saracatinib, improves cognitive function in mice
Authors: Luo Xinming , Zhao Jing , Wu Wenyue , Fu Jie , Li Zhengyu , Zhang Ming , Lu Jie 
Published: December 2020

Abstract
BackgroundStatus epilepticus (SE) is a life-threatening neurological disorder. The hippocampus, as an important area of the brain that regulates cognitive function, is usually damaged after SE, and cognitive deficits often result from hippocampal neurons lost after SE. Fyn, a non-receptor Src family of tyrosine kinases, is potentially associated with the onset of seizure. Saracatinib, a Fyn inhibitor, suppresses epileptogenesis and reduces epileptiform spikes. However, whether saracatinib inhibits cognitive deficits after SE is still unknown. MethodsIn the present study, a pilocarpine-induced SE mouse model was used to answer this question by using the Morris water maze and normal object recognition behavioral tests. ResultsWe found that saracatinib inhibited the loss in cognitive function following SE. Furthermore, we found that the number of hippocampal neurons in the saracatinib treatment group was increased, when compared to the SE group. ConclusionsThese results showed that saracatinib can improve cognitive functions by reducing the loss of hippocampal neurons after SE, suggesting that Fyn dysfunction is involved in cognitive deficits after SE, and that the inhibition of Fyn is a possible treatment to improve cognitive function in SE patients.