bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diffusion Tensor Imaging and Electrophysiology as Robust Assays to Evaluate the Severity of Acute Spinal Cord Injury in Rats
Authors: Chen Beike , Tan Qiang , Zhao Weikang , Yang Qiming , Zhang Hongyan , Gao Fabao , Liu Xin , Feng Hua , Jiang Dianming 
Published: May 2020

Abstract
Background: Diffusion tensor imaging (DTI) is an effective method to identify subtle changes to normal‐appearing white matter (WM). Here we analyzed the DTI data with other examinations, including motor evoked potentials (MEPs), histopathological images, and behavioral results, to reflect the lesion development in different degrees of spinal cord injury (SCI) in acute and subacute stages.Method: Except for 2 Sprague -Dawley rats which died from the anesthesia accident, the rest 42 female rats were randomized into 3 groups: control group (n=6), moderate group (n=18), and severe group (n=18). Moderate (a 50-g aneurysm clip with 0.4-mm thickness spacer) or severe (a 50-g aneurysm clip with no spacer) contusion SCI at T8 vertebrae was induced. Then the electrophysiological assessments via MEPs, behavioral deterioration via the Basso, Beattie, and Bresnaha (BBB) scores, DTI data, and histopathology examination were analyzed. Results: In this study, we found that the damage of WM myelin, MEPs amplitude, BBB scores and the decreases in the values of fractional anisotropy (FA) and axial diffusivity (AD) were more obvious in the severe injury group than those of the moderate group. Additionally, the FA and AD values could identify the extent of SCI in subacute and early acute SCI respectively, which was reﬂected in a robust correlations with MEPs and BBB scores. While the values of radial diffusivity (RD) showed no significant changes. Conclusions: Our data confirmed that DTI was a valuable in ex vivo imaging tool to identify damaged white matter tracts after graded SCI in rat, which may provide useful information for the early identification of the severity of SCI.
Meta-analysis in periprosthetic joint infection: a global bibliometric analysis
Authors: Li Cheng , Thies Cristina Ojeda , Xu Chi , Trampuz Andrej 
Published: May 2020

Abstract
Background: Periprosthetic joint infection (PJI) is the most serious complication of joint replacement surgery. Further comorbidities include bedsore, deep vein thrombosis, reinfection, or even death. An increasing number of researchers are focusing on this challenging complication. The aim of the present study was to estimate global PJI research based on bibliometrics from meta-analysis studies. Methods: A database search was performed in PubMed, Scopus, and Web of Science. Relevant studies were assessed using the bibliometric analysis.Results: A total of 117 articles were included. The most relevant literature on PJI was found on Scopus. China made the highest contributions to global research, followed by the United States and the United Kingdom. The institution with the most contributions from the University of Bristol. The journal with the highest number of publications was The Journal of Arthroplasty, whereas the Journal of Clinical Medicine had the shortest acceptance time. Furthermore, the top three frequently used databases were Embase, MEDLINE, and Cochrane. The most frequent number of authors in meta-analysis studies was four. Most studies focused on the periprosthetic hip and knee. The alpha-defensin diagnostic test, preventive measures on antibiotics use, and risk factors of intra-articular steroid injections were the most popular topic in recent years. Conclusion: Based on the results of the present study, we found that there was no single database covered all relevant articles, the optimal method for bibliometric analysis is a combination of databases. The most popular research topics on PJI focused on alpha-defensin, antibiotic use, risk factors of intra-articular steroid injections, and the location of prosthetic hip and knee infection.
FASCE, the benefit of spironolactone for treating acne in adult females: study protocol for a randomized double-blind trial
Authors: Poinas Alexandra , Lemoigne Marie , Naour Sarah Le , Nguyen Jean-Michel , Schirr-Bonnans Solène , Riche Valery-Pierre , Vrignaud Florence , Machet Laurent , Claudel Jean-Paul , Leccia Marie-Thérèse , Hainaut Ewa , Beneton Nathalie , Dert Cécile , Boisrobert Aurélie , Flet Laurent , Chiffoleau Anne , Corvec Stéphane , Khammari Amir , Dréno Brigitte 
Published: May 2020

Abstract
Background: Acne vulgaris of adult females has increased over the past 10 years; it affects currently 20 to 30% of adult females. The physiopathology of adult female acne is distinguished from that of teenagers essentially by two factors: hormonal and inflammatory. On a therapeutic plan, in female acne, four types of systemic treatment approved in this indication include: cyclines (leading to bacterial resistance); zinc salts (less effective than cyclines); and antiandrogens (risks of phlebitis). The last alternative is represented by isotretinoin, but its use in women of childbearing potential is discouraged because of the teratogen risks.In this context, spironolactone could represent an interesting alternative. It blocks the 5-alpha-reductase receptors at the sebaceous gland and inhibits LH production at the pituitary level. It has no isotretinoin constraints and does not lead to bacterial resistance. Currently, a very few studies have been performed on a limited number of patients. They showed that at low doses (lower than 200 mg/day), spironolactone can be effective against acne.In that context, it seemed clearly interesting to perform the first double-blind randomized study of spironolactone vs cyclines, which remains the moderate acne reference treatment, and to demonstrate the superiority of spironolactone’s efficacy in order to establish it as an alternative to cyclines.Methods: Two hundred female patients will be included. They will have acne vulgaris with at least ten inflammatory lesions and no more than three nodules. After randomization, the patients will be treated by spironolactone or doxycycline for three months and after placebo. The study will be blind for the first six months and open for the last six months. Discussion: The treatment frequently used in female acne is systemic antibiotics with many courses as it is a chronic inflammatory disease. In the context of the recent WHO revelation about the serious, worldwide threat to public health of antibiotic resistance, this trial could give the physician another alternative for adult female acne before using isotretinoin, whose management is more complex. Trial registration: On ClinicalTrials.gov, registration number NCT03334682, first published on 7 November, 2017. Recruitment is still ongoing.
The circulating levels of CTRP5 and the ratio of CTRP1 to CTRP5 plasma levels are significant predictors for cIMT value in patients with type 2 diabetes: A case-control study
Authors: Majidi Ziba , Omidifar Abolfazl , Emamgholipour Solaleh , Fard Soheil Rahmani , Poustchi Hossein , Shanaki Mehrnoosh 
Published: May 2020

Abstract
Background: There is growing evidence that the C1qTNF-related protein (CTRP) family has a crucial role in the physiology and pathophysiology of metabolic disorders such as Type 2 Diabetes (T2D) and obesity. We sought to identify the association of CTRP1 and CTRP5 circulating levels with various obesity parameters such as visceral adipose tissue (VAT) thickness, visceral adiposity index (VAI), and with carotid intima-media thickness (cIMT) in patients with T2D and healthy subjects. Methods: This case-control study recruited subjects with T2D patients (n=42) as case group (all men) and without T2D (n=42) as controls (all men). cIMT and VAT thickness measurement was performed using an Accuvix XQ ultrasound. Circulating CTRP1 and CTRP5 concentrations were measured by enzyme-linked immunosorbent assay (ELISA). Results: CTRP-1 and CTRP1/CTRP5 ratio were markedly higher in patients with T2D compared to controls (p < 0001 and p = 0004 respectively). Interestingly, binominal logistic regression revealed that a higher circulating level of CTRP1 was associated with the presence of T2D (odds ratio [OR]: 13203.554 [95% CI: 65.186-2674407.708]; P=.000). When considering the study population as a whole, CTRP1 circulating levels were correlated with WHR, VAT, and HOMA-IR. Also, we observed that the ratio of CTRP1 to CTRP5 plasma levels (β = 0.648, P=0.005) and CTRP5 circulating levels (β = 0.444, P=0.049) are significant predictors for cIMT value. Conclusions: Our results indicated that CTRP1 and CTRP5 concentrations were correlated with atherosclerosis in human subjects and these adipokines might have a causal role for cardiometabolic risk in type 2 diabetes disease
The effects of changes in distance to nearest health facility on under-5 mortality and health care utilization in rural Malawi, 1980-2000
Authors: Quattrochi John Paul , Hill Kenneth , Salomon Joshua A , Castro Marcia C 
Published: May 2020

Abstract
Background: Despite important progress, the burden of under-5 mortality remains unacceptably high, with an estimated 5.3 million deaths in 2018. Lack of access to health care is a major risk factor for under-5 mortality, and distance to health care facilities has been shown to be associated with less access to care in multiple contexts, but few such studies have used a counterfactual approach to produce causal estimates. Methods: We combined retrospective reports on 22,088 births between 1980 and 2000 from the 2000 Malawi Demographic and Health Survey with a 1998 health facility census that includes the date of construction for each facility, including 335 maternity or maternity/dispensary facilities built in rural areas between 1980 and 1998. Using a difference-in-differences approach with Cox proportional hazards models, we estimated the effect of a reduction in distance to nearest facility, conditional on initial distance, on under-5 mortality. Using a difference-in-difference approach with linear probability models, we estimated the effect of a reduction in distance to nearest facility on number of antenatal visits prior to delivery, place of delivery, receiving skilled assistance during delivery, and receiving a check-up following delivery.Findings: We found no effects of a decrease in distance to the nearest health facility on the hazard of death before age five years. We also found no effect of reduced distance to nearest facility on utilization of maternal health services. The effects estimated here likely depend on the quality of health care, the availability of transportation, the demand for health services, and the underlying causes of mortality, among other factors.Conclusion: Reducing under-5 mortality and increasing utilization of care in rural Malawi and similar settings may require more than the construction of new health infrastructure.
Identification of Prognosis-Related Genes and Construction of Multi-regulatory Networks in Pancreatic Cancer Microenvironment by Bioinformatics Analysis
Authors: Li Tong , Liu Qiaofei , Zhang Ronghua , Liao Quan , Zhao Yupei 
Published: May 2020

Abstract
Background: As one of the most lethal cancers, pancreatic cancer has been characterized by abundant supportive tumor-stromal cell microenvironment. Although the advent of tumor-targeted immune checkpoint blockers has brought light to patients with other cancers, its clinical efficacy in pancreatic cancer has been greatly limited due to the protective stroma. Thus, it is urgent to find potential new targets and establish multi-regulatory networks to predict patient prognosis and improve treatment.Methods: We followed a strategy based on mining the Cancer Genome Atlas (TCGA) database and ESTIMATE algorithm to obtain the immune scores and stromal scores. Differentially expressed genes (DEGs) associated with poor overall survival of pancreatic cancer were screened from a TCGA cohort. By comparing global gene expression with high vs. low immune scores and subsequent Kaplan-Meier analysis, DEGs that significantly correlate with poor overall survival of pancreatic cancer in TCGA cohort were extracted. After constructing the protein-protein interaction network using STRING and limiting the genes within the above DEGs, we utilized RAID 2.0, TRRUST v2 database and degree and betweenness analysis to obtain non-coding RNA (ncRNA)-pivotal nodes and TF-pivotal nodes. Finally, multi-regulatory networks have been constructed and pivotal drugs with potential benefit for pancreatic cancer patients were obtained by screening in the DrugBank.Results: In this study, we obtained 246 DEGs that significantly correlate with poor overall survival of pancreatic cancer in the TCGA cohort. With the advent of 42 ncRNA-pivotal nodes and 7 TF-pivotal nodes, the multi-factor regulatory networks were constructed based on the above pivotal nodes. Prognosis-related genes and factors such as HCAR3, PPY, RFWD2, WSPAR and Amcinonide were screened and investigated.Conclusion: The multi-regulatory networks constructed in this study are not only beneficial to improve treatment and evaluate patient prognosis with pancreatic cancer, but also favorable for implementing early diagnosis and personalized treatment. It is suggested that these factors may play an essential role in the progression of pancreatic cancer.
Clinical Features of COVID‐19 in a Young Man with Massive Cerebral Hemorrhage: Case Report
Authors: Bao Yi , Lin Shu Yu , Cheng Zhao Hui , Xia Jun , Sun Yan Peng , Zhao Qi , Liu Guang Jian 
Published: May 2020

Abstract
COVID-19 is currently a pandemic in the world, can invade multiple systems, and has a high morbidity and mortality. So far, no cases of acute cerebrovascular disease have been reported. This article reports the clinical features of a COVID-19 patient whose first symptom was cerebral hemorrhage. More importantly, after the craniotomy, the patient had high fever and it was difficult to retreat. After cerebrospinal fluid testing, it was determined that an intracranial infection had occurred. After anti-infection and plasma infusion of the recovered person, the patient's symptoms gradually improved. This case suggests that COVID-19 may infringe on cerebral blood vessels and cause cerebral hemorrhage. Transfusion of plasma from rehabilitation patients is effective for critically ill patients.
Factors affecting independent participants of Indonesia’s National Health Insurance in paying premium compliance: a qualitative study
Authors: Sunjaya Deni Kurniadi , Herawati Dewi Marhaeni Diah , Siregar Adiatma YM 
Published: May 2020

Abstract
Background: There are currently 14% independent participants in Indonesia's National Health Insurance (INHI) from the overall (199 millions) participants. However, around 43.8% of them do not comply in paying the insurance premium. The purpose of the study is to explore factors that influence delinquent payment of contributions. Methods : The research design was qualitative study with phenomenology approach and constructivism paradigm. Data collected by in-depth interview and using theoretical sampling approach. We recruited 16 respondents of unpaid worker participants who arrear and who obey to pay the premiums from 4 difference cities/ districts. Triangulation was done trough 15 respondents from various stakeholders. We constructed substantive theory from data trough coding, cathegorizing and pattern matching. Results: Compliance of paying insurance premium is affected by the intention to pay for contribution. Meanwhile, the intention to pay is influenced by the understanding of INHI program, financial ability, self attitude, operational system and service quality. These constructs consist of 5 to 8 indicators. To improve payment contribution of independent participants, INHI program has to pay attention for factors originating internally from the participants themselves and also externally: social and institutional environment support and the quality of health care and financing system. Conclusions: INHI program need to improve a proper socialization, mechanisms for collecting beneficiary contributions, and strengthening the healthcare system, both for services and the implementation of the financing system.
A Urine-Based Exosomal Gene Expression Test Stratifies Risk of High-Grade Prostate Cancer in Men with Prior Negative Prostate Biopsy Undergoing Repeat Biopsy
Authors: McKiernan James , Noerholm Mikkel , Tadigotla Vasisht , Kumar Sonia , Torkler Phillipp , Sant Grannum , Alter Jason , Donovan Michael J , Skog Johan 
Published: May 2020

Abstract
Background : Initial prostate biopsy often fails to identify prostate cancer resulting in patient anxiety, especially when clinical features such as prostate specific antigen (PSA) remain elevated, leading to the need for repeat biopsies. Prostate biomarker tests, such as the ExoDx™ Prostate (IntelliScore) , or EPI test, have been shown to provide individualized risk assessment of clinically significant prostate cancer at initial biopsy; however, the performance in the repeat biopsy setting is not well established. Methods : As part of a previous prospective clinical validation study evaluating the performance of the EPI test, we collected first-catch, non-DRE urine samples across 22 sites from men with prior negative biopsy scheduled to undergo a repeat prostate biopsy to rule out prostate cancer. All men were 50 years or older with a PSA 2-10ng/mL. Exosomal mRNA was extracted and expression of three genomic markers, PCA3, ERG and SPDEF was measured. The resulting EPI score was correlated with biopsy results.Results : 229 men with a prior negative biopsy underwent repeat biopsies. ExoDx Prostate demonstrated good performance ruling out high-grade (Grade group 2, GG2, or higher) prostate cancer (HGPCa) using the previously validated 15.6 cut point in the initial biopsy setting. The EPI test yielded an NPV of 92% independent of other clinical features and would have avoided 26% of unnecessary biopsies while missing only five patients with HGPCa (2.1%). Furthermore, the EPI test provided additional information at a cut-point of 20 and 29.6 with an NPV of 94%, potentially delaying 35% and 61% of unnecessary biopsies, respectively. Conclusions : The EPI test provided good performance using the 15.6 cut-point for ruling out HGPCa / GG2 or higher in men undergoing a repeat prostate biopsy with a PSA of 2-10ng/ml. Furthermore, the test utilizes gene expression data independent of clinical features to predict the likelihood of HGPCa / GG2 on a subsequent needle biopsy.
APACHE IV system helps to determine cholecystostomy role in elderly patients with acute cholecystitis
Authors: Jiang Hua , Guo Guo , Yao Zhimin , Wang Yuehua 
Published: May 2020

Abstract
Background
Cholecystostomy offers an alternative method for patients unfit to undergo immediate cholecystectomy. Nevertheless, the role of cholecystostomy in the clinical management of high-risk surgical patients remains unclear. One of the main problems concerning the therapeutic effect in critically ill patients with acute cholecystitis is the lack of validated, well-established scoring systems to stratify the severity of patient disease states. APACHE IV scoring system was useful to estimate the hospital mortality for high-risk patients. We try to evaluate the performance of the APACHE IV scoring system in patients over 65 years of age with acute cholecystitis and the therapeutic effect of percutaneous cholecystostomy.
Methods
597 patients over 65 years of age with acute cholecystitis between January 2011 and December 2018 were retrospectively analyzed with the APACHE IV scores.
Results
Among the 597 patients, 52 successfully underwent cholecystectomy (2 died, 3.85%), 65 underwent percutaneous cholecystostomy (1 died, 1.54%), and 480 received conservative therapy (27 died, 5.63%). The fitness of the APACHE IV score prediction is good with the area under the ROC curve of 0.894. The APACHE IV models were well-calibrated (with the Hosmer-Lemeshow statistic). Using the method of binary regression analysis, for the patients whose estimated mortality rate was more than 10%, cholecystostomy was an important factor for prognosis (P = 0.048). The estimated mortality of PC patients before and after operation was compared, which indicated that the estimated mortality after puncture was significantly decreased, either in the whole patient group (P = 0.004) or in the group with an estimated mortality greater than 10% (P = 0.008).
Conclusion
The APACHE IV scoring system showed that cholecystostomy was a safe and effective treatment for elderly high-risk patients with acute cholecystitis.
Enhanced Functional Expression of the Polyhydroxyalkanoate Synthase Gene from Cupriavidus Necator A-04 Using a Cold-Shock Promoter for Efficient Poly(3-Hydroxybutyrate) Production in Escherichia Coli
Authors: Boontip Thanawat , Waditee-Sirisattha Rungaroon , Honda Kohsuke , Napathorn Suchada Chanprateep 
Published: May 2020

Abstract
Background: The present study attempted to increase PHB production by improving the functional expression of the PhaC gene using various types of promoters, and the effects on PhaC activity in terms of PHB productivity, yield coefficient (YP/S) and molecular weights were investigated.Results: Here, the PHB biosynthesis operon of Cupriavidus necator A-04, isolated in Thailand with a high degree of 16S rRNA sequence similarity with C. necator H16, was subcloned into pGEX-6P-1, pColdI, pColdTF, pBAD/Thio-TOPO and pUC19 (constitutive expression) and transformed into E. coli JM109. To alter the expression of phaCAB biosynthesis genes, we optimized parameters in flask experiments to obtain high expression of soluble PhaCA−04 protein with high YP/S and PHB productivity. pColdTF-phaCABA−04-expressing E. coli produced 2.5 ± 0.1 g/L (90.6±4.3%) PHB in 24 h, similar to pColdI-phaCABA−04-expressing E. coli. The amounts of phaC protein and PHB produced from pColdTF-phaCABA−04 and pColdI-phaCABA−04 were significantly higher than those from other promoters. Cultivation in a 5-L fermenter led to PHB production of 7.9±0.7 g/L with 90.0±2.3% PHB content in the cell dry mass (DCM), a YP/S value of 0.38 g PHB/g glucose and a productivity of 0.26 g PHB/(L⋅h) using pColdTF-phaCABA−04. The PHB from pColdTF-phaCABA−04 had MW 5.79 × 105 Da, MN 1.86 × 105 Da and PDI 3.11 and the film exhibited high transparency, Young’s modulus and tensile strength, possibly due to the TF chaperones. Interestingly, when pColdI-phaCABA−04-expressing E. coli was used to produce PHB from crude glycerol and compared with constitutive pUC19-nativeP-phaCABA−04-expressing E. coli, the amounts of PHB were similar, but MW 1.1 × 106 Da, MN 2.6 × 105 Da and PDI 4.1 were obtained from constitutive pUC19-nativeP-phaCABA−04-expressing E. coli, indicating that slow and low expression could prolong and maintain phaC polymerization activity.Conclusions: The cspA promoter in a cold-inducible vector can improve PhaCA−04 expression levels, and TF chaperones show obvious effects on enhancing PhaCA−04 solubility. The high level of phaCA−04 resulted in a high amount of PHB, but the chain termination reaction of PhaC polymerization occurred faster than that with the retarded and low expression of phaCA−04 by the constitutive promoter pUC19, which in turn resulted in a low amount of PHB with a high molecular weight.