bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence and outcomes of acute respiratory distress syndrome in intensive care units of mainland China: a multicentre prospective longitudinal study
Authors: Huang Xu , Zhang Ruoyang , Fan Guohui , Wu Dawei , Lu Haining , Wang Daoxin , Deng Wang , Sun Tongwen , Xing Lihua , Liu Shaohua , Wang Shilei , Cai Ying , Tian Ye , Zhang Yi , Xia Jingen , Zhan Qingyuan ,   the CHARDSnet group, Xie Lixin , Wang Ying , Weng Li , Zhu Guangfa , Liu Yan , Song Man , Zhao Yanming , Chen Jing , Zhao Hongwen , Hou Haijia , Yang Jingping , Wu Rina , Xu Xiyuan , Yan Xixin , Xu Haibo , Wu Dawei , Lu Haining , Sun Gengyun , Zhang Dan , Zhao Beilei , Pan Binhai , Liu Jialin , Tan Ruoming , Pan Pinhua , Lu Rongli , Luo Hong , Zhang Han , Wang Daoxin , Deng Wang , Chen Yusheng , Lu Fengfeng , Xu Sicheng , Luo Xia , Teng Hong , Chen Lijuan , Xing Lihua , Wang Shilei , Sun Tongwen , Liu Shaohua , Han Bing , Li Yunlu 
Published: August 2020

Abstract
Objectives
To evaluate the incidence and mortality of acute respiratory distress syndrome (ARDS) in medical/respiratory intensive care units (MICUs/RICUs) to assess ventilation management and the use of adjunct therapy in routine clinical practice for patients fulfilling the Berlin definition of ARDS in mainland China.

Methods
This was a multicentre prospective longitudinal study. Patients who met the Berlin definition of ARDS were included. Baseline data and data on ventilator management and the use of adjunct therapy were collected.

Results
Of the 18,793 patients admitted to participating ICUs during the study timeframe, 672 patients fulfilled the Berlin ARDS criteria and 527 patients were included in the analysis. The most common predisposing factor for ARDS in 402 (77.0) patients was pneumonia. The prevalence rates were 9.7% (51/527) for mild ARDS, 47.4% (250/527) for moderate ARDS, and 42.9% (226/527) for severe ARDS. In total, 400 (75.9%) patients were managed with invasive mechanical ventilation during their ICU stays. All ARDS patients received a tidal volume of 6.8 (5.8–7.9) mL/kg of their predicted body weight and a positive end-expository pressure (PEEP) of 8 (6–12) cmH2O. Recruitment manoeuvres (RMs) and prone positioning were used in 61 (15.3%) and 85 (16.1%) ventilated patients, respectively. Life-sustaining care was withdrawn from 92 (17.5%) patients. When these patients were included in the mortality analysis, 244 (46.3%) ARDS patients (16 (31.4%) with mild ARDS, 101 (40.4%) with moderate ARDS, and 127 (56.2%) with severe ARDS) died in the hospital.

Conclusions
Among the 18 ICUs in mainland China, the incidence of ARDS was low. The rates of mortality and withdrawal of life-sustaining care were high. The recommended lung protective strategy was followed with a high degree of compliance, but the implementation of adjunct treatment was lacking. These findings indicate the potential for improvement in the management of patients with ARDS in China.

Trial registration
Clinicaltrials.gov NCT02975908. Registered on 29 November 2016—retrospectively registered.
Effect of albumin administration on outcomes in hypoalbuminemic patients hospitalized with community-acquired pneumonia (ALBUCAP): a prospective, randomized, phase III clinical controlled trial—a trial protocol
Authors: Rombauts Alexander , Abelenda-Alonso Gabriela , Simonetti Antonella Francesca , Verdejo Guillermo , Meije Yolanda , Ortega Lucia , Clemente Mercedes , Niubó Jordi , Ruiz Yolanda , Gudiol Carlota , Tebé Cristian , Videla Sebastian , Carratalà Jordi 
Published: August 2020

Abstract
Background
Community-acquired pneumonia (CAP) remains a leading cause of death worldwide, and hypoalbuminemia is associated with worse outcomes. However, it remains uncertain whether albumin administration could have any beneficial effects. We aim to assess whether the administration of albumin in hypoalbuminemic patients with CAP increases the proportion of clinically stable patients at day 5 compared with the standard of care alone.

Methods
This is a trial protocol for a superiority, non-blinded, multicenter, randomized, phase 3, interventional controlled clinical trial. The primary endpoint will be the proportion of clinical stable patients at day 5 (intention to treat), defined as those with stable vital signs for at least 24 h. The secondary endpoints will be time to clinical stability, duration of intravenous and total antibiotic treatment, length of hospital stay, intensive care unit admission, duration of mechanical ventilation and vasopressor treatment, adverse events, readmission within 30 days, and all-cause mortality. The trial has been approved by the Spanish Medicines and Healthcare Products Regulatory Agency. The investigators commit to publish the data in peer-reviewed journals within a year of the study completion date. Subjects will be recruited from three Spanish hospitals over a planned enrolment period of 2 years. A follow-up visit will be performed 1 month after discharge. We have estimated the need for a sample size of 360 patients at a two-sided 5% alpha-level with a power of 80% based on intention to treat. Eligible participants must be hospitalized, hypoalbuminemic (≤ 30 g/L), non-immunosuppressed, adults, and diagnosed with CAP. They will be randomly assigned (1:1) to receive standard care plus albumin (20 g in 100 mL) every 12 h for 4 days or standard care alone.

Discussion
If this randomized trial confirms the hypothesis, it should lead to a change in current clinical practice for the management of hypoalbuminemic patients with CAP.

Trial registration
European Clinical Trials Database (EudraCT) 2018-003117-18. Registered on 12 April 2019. ClinicalTrials.gov NCT04071041. Registered on 27 August 2019
The effect of ear acupressure (auriculotherapy) on sexual function of lactating women: protocol of a randomized sham controlled trial
Authors: Barghamadi Sanaz , Alimoardi Zainab , Oleson Terry , Bahrami Nasim 
Published: August 2020

Abstract
Background
Lactation has a negative effect on female sexual function. Hormonal changes during lactation cause changes which might lead to dyspareunia, lack of libido, and anorgasmia. There are various pharmacological and non-pharmacological approaches to treat sexual dysfunction. While pharmacological treatment has multiple unwanted side effects, non-pharmacological therapies such as complementary medicine are a potential safer alternative. The aim of this study is to evaluate the effect of ear acupressure on sexual function of lactating women.

Methods/design
This is a randomized clinical trial with a parallel sham control group. In this study, 76 lactating women between 6 months and 1 year after childbirth were referred to health care centers in Qazvin City and would be invited to participate. Participants will be divided into intervention (n = 38) and control (n = 38) groups using simple block randomization. Both intervention and sham control groups will be visited over 10 sessions within a 4-day interval. At each visit, the adhesives containing Vaccaria seed will be adhered for the intervention group, while non-latex-based adhesives with no Vaccaria seeds will be placed on the same ear acupoints for the sham control group. Selected ear acupoints include genitalia (two ear points), pelvic point, master shoulder, and posterior pituitary gland. The women will be asked to hold the seeds on their ears for 3 days and press each ear point three times a day for 20 s. After 3 days, they will be asked to remove the seeds from their ears and rest for 1 day. Sexual function as primary outcome in both groups will be assessed using the Female Sexual Function Index before and immediately after 1 and 2 months after the intervention. Also, Sexual Quality of Life as secondary outcome will be assessed using Sexual Quality of Life-Female (SQOL-F) before and 2 months after intervention. Data will be analyzed using repeated measure ANOVA at the significant level of 0.05.

Discussion
This study is expected to support the impact of ear channel ear acupressure on sexual function in lactating women.

Trial registration
Iranian Clinical Trial Registration Center IRCT20190626044028N1. Registered on 16 August 2019
Circulating histone signature of human lean metabolic-associated fatty liver disease (MAFLD)
Authors: Buzova Diana , Maugeri Andrea , Liguori Antonio , Napodano Cecilia , Lo Re Oriana , Oben Jude , Alisi Anna , Gasbarrini Antonio , Grieco Antonio , Cerveny Jan , Miele Luca , Vinciguerra Manlio 
Published: August 2020

Abstract
Background
Although metabolic associate fatty liver disease (MAFLD) is associated with obesity, it can also occur in lean patients. MAFLD is more aggressive in lean patients compared to obese patients, with a higher risk of mortality. Specific biomarkers to diagnose differentially lean or overweight MAFLD are missing. Histones and nucleosomes are released in the bloodstream upon cell death. Here, we propose a new, fast, imaging and epigenetics based approach to investigate the severity of steatosis in lean MAFLD patients.

Results
A total of 53 non-obese patients with histologically confirmed diagnosis of MAFLD were recruited. Twenty patients displayed steatosis grade 1 (0–33%), 24 patients with steatosis grade 2 (34–66%) and 9 patients with steatosis grade 3 (67–100%). The levels of circulating nucleosomes were assayed using enzyme-linked immunosorbent assay, while individual histones or histone dimers were assayed in serum samples by means of a new advanced flow cytometry ImageStream(X)-adapted method. Circulating nucleosome levels associated poorly with MAFLD in the absence of obesity. We implemented successfully a multi-channel flow methodology on ImageStream(X), to image single histone staining (H2A, H2B, H3, H4, macroH2A1.1 and macroH2A1.2). We report here a significant depletion of the levels of histone variants macroH2A1.1 and macroH2A1.2 in the serum of lean MAFLD patients, either individually or in complex with H2B.

Conclusions
In summary, we identified a new circulating histone signature able to discriminate the severity of steatosis in individuals with lean MAFLD, using a rapid and non-invasive ImageStream(X)-based imaging technology.
The diagnostic quandary of magnetic resonance imaging-negative Hirayama disease: a case report
Authors: Ojha Rajeev , Shahi Sumit , Nepal Gaurav , Shakya Arjana , Gajurel Bikram Prasad , Karn Ragesh , Rajbhandari Reema , Gautam Niraj 
Published: August 2020

Abstract
Background
Magnetic resonance imaging (MRI) features are typical findings in Hirayama disease (HD) and are useful diagnostic entities but may not be present in all patients.

Case presentation
We present the case of a 22-year-old Nepalese man who presented with insidious onset of weakness of his right upper limb of more than 5 years duration. His weakness was progressive for the first 3 years, and then remained static. On examination, weakness of the interossei, thenar, hypothenar, flexor, and extensor muscles were present in his right upper limb, power was normal in his left upper and bilateral lower limbs. Minipolymyoclonus was present in both upper limbs, less prominent on the left side. Electrophysiological findings showed motor axonal neuropathy in his right upper limb, neurogenic discharges and fibrillations, and fasciculations in both upper limbs. Contrast magnetic resonance imaging (MRI) of his cervical spine in flexion was normal. Our patient was diagnosed with HD based on clinical and electrophysiological findings. Our patient was advised to use a cervical collar and regular physiotherapy and was found to have subjective benefit.

Conclusion
A normal cervical MRI does not rule out HD and the diagnosis can also be made based on clinical and electrophysiological studies. Progressive distal upper limb weakness or tremor in young patients should be evaluated for HD, because early diagnosis and intervention might halt the progression.
Generation of a recombinant chickenized monoclonal antibody against the neuraminidase of H9N2 avian influenza virus
Authors: Wang Fei , Wang Yajuan , Wan Zhimin , Shao Hongxia , Qian Kun , Ye Jianqiang , Qin Aijian 
Published: August 2020

AbstractWe previously reported a monoclonal antibody (mAb), 1G8, against the neuraminidase (NA) of H9N2 avian influenza virus (AIV) with significant NA inhibitory activity. To generate a recombinant chickenized mAb (RCmAb) against the NA of H9N2 AIV for passive immunization in poultry, the gene of the fragment of antigen binding (Fab) of mAb 1G8 was cloned and fused with the fragment crystallizable (Fc) gene of chicken IgY. The RCmAb 1G8 was expressed in COS-1 cells and could be detected in cell culture supernatant. The results of NA inhibitory activity tests of the RCmAb 1G8 in an enzyme-linked lectin assay (ELLA) and a microneutralization (MN) assay showed that the RCmAb 1G8 maintained significant NA inhibitory activity and neutralizing ability. This is the first chickenized antibody against AIV, which would be a good candidate for passive immunization in poultry.
The inhibitory effects of metabolites from Bacillus pumilus on potato virus Y and the induction of early response genes in Nicotiana tabacum
Authors: Shen Shuo , Li Wei 
Published: August 2020

AbstractTo develop a new antiviral preparation from a microbial source, the halophilic bacterium Bacillus pumilus E303035 was isolated from a soil sample collected at Qarhan Salt Lake in Qinghai, China. The inhibitory activity of an ethyl acetate extract of its fermentation broth was higher than that of an n-butanol extract. After isolation and purification, 9 compounds were obtained: cyclo(L-Leu-L-Pro) (1), cyclo(L-Pro-L-Tyr) (2), Brevianamide F (3), 2-(3-Indolyl) ethanol (4), N-[2-(1H-indol-3-yl) ethyl] acetamide (5), 3, 3-di(1H-indol-3-yl)propane-1,2-diol (6), Lincomycin B (7), dibutylphthalate (8), and p-hydroxyphenethyl alcohol (9). Compounds 1, 5, and 9 showed inhibitory activities against potato virus Y (PVY). Compounds 1, 4, and 9 had significant inhibitory activity against genes HC-pro, P3, and Nib, compound 5 against gene P3, and compounds 1 and 4 against NIa. Compounds 1, 4, 5, and 9 had significant inhibitory activity against genes VPg and 6K1. Active compounds 1, 5, and 9 had various effects on the expression of viral genes related to pathogenesis. Expression of genes cullin and XTH was up-regulated and CP was down-regulated, compared to the positive control. In conclusion, compounds 1, 5, and 9 might be considered as potential antiviral agents for future development.
Existence of solutions of non-autonomous fractional differential equations with integral impulse condition
Authors: Kumar Ashish , Chauhan Harsh Vardhan Singh , Ravichandran Chokkalingam , Nisar Kottakkaran Sooppy , Baleanu Dumitru 
Published: August 2020

AbstractIn this paper, we investigate the existence of solution of non-autonomous fractional differential equations with integral impulse condition by the measure of non-compactness (MNC), fixed point theorems, and k-set contraction. The obtained results are verified via a supporting example.
Strong convergence of an inertial algorithm for maximal monotone inclusions with applications
Authors: Chidume C. E. , Adamu A. , Nnakwe M. O. 
Published: August 2020

AbstractAn inertial iterative algorithm is proposed for approximating a solution of a maximal monotone inclusion in a uniformly convex and uniformly smooth real Banach space. The sequence generated by the algorithm is proved to converge strongly to a solution of the inclusion. Moreover, the theorem proved is applied to approximate a solution of a convex optimization problem and a solution of a Hammerstein equation. Furthermore, numerical experiments are given to compare, in terms of CPU time and number of iterations, the performance of the sequence generated by our algorithm with the performance of the sequences generated by three recent inertial type algorithms for approximating zeros of maximal monotone operators. In addition, the performance of the sequence generated by our algorithm is compared with the performance of a sequence generated by another recent algorithm for approximating a solution of a Hammerstein equation. Finally, a numerical example is given to illustrate the implementability of our algorithm for approximating a solution of a convex optimization problem.
The rhythms of life in the Himalaya: seasonality and sociality among the Gurung people of the Nhāson Valley
Authors: Poudel Jiban Mani 
Published: August 2020

AbstractThe paper explores the linkage between ecological and social systems of the Gurung people in the Nhāson Valley of Nepal, accounting for the interconnectedness of social life and seasons. The main themes of the paper are the local people’s understanding and experience of seasons, and the ways in which their social life moves according to those seasons. The paper is based on 9 months of ethnographic fieldwork undertaken from 2012 to 2018 in Nhāson, a small mountain valley located in the central Himalayan region of Nepal. Informal interaction and conversation with the local people were the key sources of understanding the seasonality and sociality. The findings reveal that a single cultural group has multiple frameworks for marking and counting the year which are contextual and culturally specific. Likewise, seasons and social life in the mountain region are closely interlinked to each other. Local people see that the transformation of seasons from one to the next is related to socio-cultural changes that reflect the rhythm of life. The social and ecological systems in this Himalayan region of Nepal are gradually being affected by climate change.
Individual Patient Data Meta-Analysis of FOLFOXIRI Plus Bevacizumab Versus Doublets Plus Bevacizumab as Initial Therapy of Unresectable Metastatic Colorectal Cancer
Authors: Cremolini Chiara , Antoniotti Carlotta , Stein Alexander , Bendell Johanna , Gruenberger Thomas , Rossini Daniele , Masi Gianluca , Ongaro Elena , Hurwitz Herbert , Falcone Alfredo , Schmoll Hans-Joachim , Di Maio Massimo 
Published: August 2020

PURPOSE A proper estimation of the magnitude of the overall survival (OS) benefit from infusional fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI) plus bevacizumab versus doublets + bevacizumab is lacking because all trials that have investigated this regimen had primary end points other than OS. To test OS with higher power and to explore the interaction of treatment effect with main patient and disease characteristics, we performed an individual patient data (IPD) meta-analysis. PATIENTS AND METHODS IPD from 5 eligible trials were collected: CHARTA (ClinicalTrials.gov identifier: NCT01321957 ), OLIVIA (ClinicalTrials.gov identifier: NCT00778102 ), STEAM (ClinicalTrials.gov identifier: NCT01765582 ), TRIBE (ClinicalTrials.gov identifier: NCT00719797 ), and TRIBE2 (ClinicalTrials.gov identifier: NCT02339116 ). The primary end point was OS. Secondary end points were progression-free survival (PFS), objective response rate (ORR), R0 resection rate, grade 3/4 adverse events, and subgroup analyses according to clinical and molecular characteristics. RESULTS A total of 1,697 patients were randomly assigned to FOLFOXIRI + bevacizumab (n = 846) or doublets + bevacizumab (n = 851). Most (78%) had an Eastern Cooperative Oncology Group performance status of 0, and the median age was 61 years. After a median follow-up of 39.9 months, patients assigned to FOLFOXIRI + bevacizumab had significantly longer OS than those assigned to doublets + bevacizumab (median, 28.9 v 24.5 months; hazard ratio [HR], 0.81; 95% CI, 0.72 to 0.91; P < .001), with no significant heterogeneity among trials ( P = .39; I2 = 2%). No significant interaction effect between treatment arm and investigated characteristics was demonstrated. Patients assigned to FOLFOXIRI + bevacizumab had longer PFS (median, 12.2 v 9.9 months; HR, 0.74; 95% CI, 0.67 to 0.82; P < .001), higher ORR (64.5% v 53.6%; P < .001), higher R0 resection rate (16.4% v 11.8%; P = .007), and higher rates of grade 3/4 neutropenia (45.8% v 21.5%; P < .001), febrile neutropenia (6.3% v 3.7%; P = .019), and diarrhea (17.8% v 8.4%; P < .001). CONCLUSION FOLFOXIRI + bevacizumab significantly and meaningfully improves survival of patients with metastatic colorectal cancer compared with doublets + bevacizumab and provides advantage in PFS, ORR, and R0 resection rate at the price of a moderate increase in toxicity. No increased benefit is observed among patients with BRAF-mutant tumors.
Human Corticotropin-Releasing Hormone Tests: 10 Years of Real-Life Experience in Pituitary and Adrenal Disease
Authors: Ceccato Filippo , Tizianel Irene , Vedolin Carlotta Keiko , Boscaro Marco , Barbot Mattia , Scaroni Carla 
Published: August 2020

Abstract

Context
The human corticotropin-releasing hormone (CRH) test (hCRHtest) is used to differentiate Cushing disease (CD) from ectopic adrenocorticotropin (ACTH) secretion (EAS), to assess autonomous cortisol secretion by the adrenal glands, and to characterize pseudo-Cushing syndrome (CS) or adrenal insufficiency (AI).

Main Outcome Measure
The main outcome measure of this study was to assess the diagnostic accuracy of the hCRHtest.

Methods
We measured ACTH and cortisol levels; collected the peak values (peakACTH and peakcortisol), and calculated the percentage increases (∆%ACTH and ∆%cortisol) after an intravenous bolus of 100 μg hCRH.

Design and Setting
This cross-sectional study of hCRH tests from 2010 to 2019 took place in a referral university hospital center.

Patients
We enrolled 200 patients: 86 CD, 15 EAS, 18 adrenal CS, 25 mild adrenal autonomous cortisol secretion, 31 pseudo-CS, and 25 suspected AI.

Results
The hCRHtest was performed mainly for the differential diagnosis of ACTH-dependent CS or adrenal lesions (P = .048). PeakACTH and peakcortisol were higher in CD, and ∆%ACTH and ∆%cortisol were able to differentiate CD from EAS with a sensitivity and specificity greater than 80%. In patients with low (&lt; 10 pg/mL) or indeterminate (10-20 pg/mL) basalACTH levels, an absent or reduced peakACTH response was able to differentiate adrenal from ACTH-dependent forms. PeakACTH and peakcortisol after hCRHtest were lower in pseudo-CS than in CD, but ∆%ACTH and ∆%cortisol were similar. The role of hCRHtest in patients with AI was limited.

Conclusions
The hCRHtest test is the mainstay of the differential diagnosis of ACTH-dependent CS. It is also useful for pointing to a diagnosis of CD in the event of bilateral adrenal masses, and in patients with low basalACTH.