bluuebunny/crossref_metadata_2025_split huggingface dataset:
Infectious Complications and Mortality after Noncardiac Surgery Associated with CHA2DS2-VASc Score: A Retrospective Cohort Study Based on a Real-world Database
Authors: Sung Li-Chin , Liu Chih-Chung , Lin Chao-Shun , Yeh Chun-Chieh , Cherng Yih-Giun , Chen Ta-Liang , Liao Chien-Chang 
Published: October 2020

Abstract
Background: Little was know about the association between the CHA2DS2-VASc score and postoperative outcomes. Our purpose is to evaluate the effects of CHA2DS2-VASc score on the perioperative outcomes in patients with atrial fibrillation (AF).Methods: We identified 47,402 patients with AF over the age of 20 years who underwent noncardiac surgeries between 2008 and 2013 from claims data of the National Health Insurance in Taiwan. The CHA2DS2-VASc score was used to evaluate postoperative complications, mortality and the consumption of medical resources by calculating adjusted odds ratios (ORs) and 95% confidence intervals (CIs).Results: Compared with patients with a CHA2DS2-VASc score of 0, patients with scores ≥ 5 had an increased risk of postoperative pneumonia (OR 1.81, 95% CI 1.30-2.51), septicemia (OR3.24, 95% CI 2.36-4.43), urinary tract infection (OR 1.64, 95% CI 1.20-2.25), intensive care (OR 2.94, 95% CI 2.46-3.51), and mortality (OR 2.07, 95% CI 1.17-3.64). There was a significant positive correlation between risk of postoperative complication and the CHA2DS2-VASc score (P<0.0001).Conclusion: The CHA2DS2-VASc score was highly associated with postoperative infection and 30-day mortality among AF patients. Cardiologists and surgical care teams may consider using the CHA2DS2-VASc score to evaluate perioperative outcome risks in patients with AF.
Vitamin D, Chronic Migraine and Extracranial Pain: Is there a Link? Data from an Observational Study.
Authors: Rebecchi Valentina , Gallo Daniela , Cariddi Lucia Princiotta , Piantanida Eliana , Damavandi Payam Tabaee , Carimati Federico , Gallazzi Marco , Clemenzi Alessandro , Banfi Paola , Candeloro Elisa , Tanda Maria Laura , Mauri Marco , Versino Maurizio 
Published: October 2020

Abstract
Background: Several studies focused on the possible role of vitamin D (vitD) in pain chronicization.. The aim of this study was to assess the potential implications of VitD deficit on headache characteristics and extracranial pain extension.Methods: Eighty consecutive patients with primary headache underwent neurological examination, laboratory exams including serum calcifediol 25(OH)D and headache features assessment along with three questionnaires investigating depression, anxiety and allodynia. Results: The 82.6% of the population had migraine (48% episodic and 52% chronic form). The 45% of patients had extracranial pain and 47% suffered from allodynia. In the 45% of patients had a VitD deficit since the serum 25(OH)D levels fell below the cut-off level of 20 ng/ml. The occurrence of VitD deficit was significantly higher (p=0.009) in patients suffering from chronic migraine (CM)- medication overuse migraine (MOH) (64.7%) than in episodic migraine (EM) or tension type headache (TTH). The occurrence of subjects with extracranial pain and allodynia was higher, as expected, in the CM-MOH than in the EM and in the TTH groups but was not related to the co-occurrence of vit-D deficiency (Fischer’s exact test p=0.11 and p=0.32 respectively).Conclusions: Our findings show that 25(OH)D deficit is related to chronic pain suggesting that vitD probably has anti-inflammatory and tolerogenic properties, rather than a direct antinociceptive effect, and reinforce the idea of a neuroinflammatory mechanisms underpinning migraine chronicization.
Delirium Screening in the Emergency Department: A Systematic Review and Meta-analysis
Authors: Zhang Qian , Chen Meixi , Hou Liangying , Guo Ziqi , Zhang Qing , Di Baoshan , Ge Long 
Published: October 2020

Abstract
Background: Delirium is a complex syndrome characterized by a disturbance in attention and awareness, with a prevalence of 10-20% in patients admitted to the Emergency Department (ED). Screening tools have been developed to identify delirium in the ED, but their accuracy of screening remains unclear. To address this challenge, we conducted a comprehensive meta-analysis to systematically review the accuracy of delirium screening tools currently being used to assess ED patients.Methods: PubMed, PsycINFO, EMBASE, and the Cochrane Library were searched. Studies involving ED inpatients which compared diagnostic tools with the Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria as a reference standard were included. Two reviewers independently screened the studies, extracted data, and assessed the quality of studies using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 scale. We conducted a conventional meta-analysis for each screening tool. Then we used network meta-analysis method to calculate the relative sensitivity and specificity among the diagnostic tests. The diagnostic accuracies were then ranked through the superiority index.Results: Thirteen studies included six screening tools. The pooled sensitivity and specificity for the Confusion Assessment Method (CAM) were 0.71 and 0.98, and for 4AT (Arousal, Attention, Abbreviated Mental Test 4, Acute change) were 0.83 and 0.93, respectively. The other four tools used were only reported in one or two studies. Their sensitivity ranged from 0.70 to 1.00, and their specificity ranged from 0.64 to 0.99. Moreover, network meta-analysis indicated that the CAM and 4AT had a greater superiority index and a higher diagnostic accuracy.Conclusions: The available data suggested that both the CAM and 4AT can be used as efficient screening tools for the ED patients.
Modelling Bluetongue Risk in Kazakhstan
Authors: Abdrakhmanov Sarsenbay , Kanatzhan Beisembayev , Sultanov Akmetzhan , Mukhanbetkaliyev Yersyn , Kadyrov Ablaikhan , Ussenbayev Altay , Zhakenova Аigerim , Torgerson Paul 
Published: October 2020

Abstract
Background: Bluetongue is a serious disease of ruminants transmitted by biting midges (Culicoides spp). Serological evidence from livestock and the presence of at least one vector competent spp of Culicoides suggests that transmission of bluetongue is possible and may have occurred in Kazakhstan. Methods: We estimated the relative risk of transmission using a mathematical model of the reproduction number R0 for bluetongue. This model depends on livestock density and climatic factors which affect vector density. Data on climate and livestock numbers from the 2466 local communities were used. This together with previously published model parameters was used to estimate R0 for each month of the year, which was rescaled to give a relative risk of transmission. These relative risks were mapped using kernal density estimates using R statistical software and mapping tools.Results: The results suggest that transmission of bluetongue in Kazakhstan is not possible in the winter from November to March. Assuming there are vector competent species of Culicoides endemic in Kazakhstan, then low levels of risk first appear in the south of Kazakhstan in April before spreading north and intensifying reaching maximum levels in northern Kazakhstan in August. The risk decline in September with only a low risk of transmission in October.Conclusion: These results should aid in surveillance efforts for the detection and control of bluetongue in Kazakhstan by indicating where and when outbreaks of bluetongue are most likely to occur.
P2X7R-mediated autophagic impairment contributes to central sensitization in a chronic migraine model with recurrent nitroglycerin stimulation in mice
Authors: Jiang Li , Zhang Yixin , Jing Feng , Long Ting , Qin Guangcheng , Zhang Dunke , chen Lixue , Zhou Jiying 
Published: October 2020

Abstract
Background: Central sensitization is an important pathophysiological mechanism of chronic migraine (CM). According to our previous studies, microglial activation and subsequent inflammation in the trigeminal nucleus caudalis (TNC) contribute to the central sensitization. The P2X7 receptor (P2X7R) is a purinergic receptor expressed in microglia and participates in central sensitization in chronic pain, but its role in CM is unclear. Numerous studies have shown that P2X7R regulates the level of autophagy and that autophagy affects the microglial activation and inflammation. Recently, autophagy has been shown to be involved in neuropathic pain, but there is no information about autophagy in CM. Therefore, the current study investigated the role of P2X7R in CM and its underlying mechanism, focusing on autophagy regulation.Methods: The CM model was established by repeated intraperitoneal injection of nitroglycerin (NTG) in mice. A Von Frey filament and radiant heat were used to assess the mechanical and thermal hypersensitivity. Western blotting and immunofluorescence assays were performed to detect the expression of P2X7R, autophagy-related proteins, and the cellular localization of P2X7R. To determine the role of P2X7R and autophagy in CM, we detected the effects of the autophagy inducer, rapamycin (RAPA) and P2X7R antagonist, Brilliant Blue G (BBG), on pain behavior and the expression of calcitonin gene-related peptide (CGRP) and c-fos. In addition, the effect of RAPA and BBG on microglial activation and subsequent inflammation were investigated.Results: The expression of P2X7R was increased and was mainly colocalized with microglia in the TNC following recurrent NTG administration. The autophagic flux was blocked in CM, which was characterized by up-regulated LC3-II, and accumulated autophagy substrate protein, p62. RAPA significantly improved the basal rather than acute hyperalgesia. BBG alleviated both basal and acute hyperalgesia. BBG activated the level of autophagic flux. RAPA and BBG inhibited the activation of microglia, limited the inflammatory response, and reduced the expression of CGRP and c-fos. Conclusions: Our results demonstrate the dysfunction of the autophagic process in CM. Activated autophagy may have a preventive effect on migraine chronification. P2X7R contributes to central sensitization through mediating autophagy regulation and might become a potential target for CM.
Rapid Evidence Review of Harm Reduction Interventions and Messaging for People Who Inject Drugs During Pandemic Events: Implications for the On-Going COVID-19 Response
Authors: Wilkinson Rebecca , Hines Lindsey , Holland Adam , Mandal Sema , Phipps Emily 
Published: October 2020

Abstract
Background People who inject drugs (PWID) are at increased health risk in a pandemic due to their greater susceptibility to severe disease and as a consequence of the restrictions put in place to halt the spread of infection. Harm reduction (HR) services, which aim to reduce the negative effects of drug use on health, are likely to be diminished in a pandemic. However, innovative HR interventions and messaging may also develop in response to such a crisis. It is vital to understand the most effective ways to deliver HR in pandemic situations so that guidance can be provided for current and future disruptions to service provision. Methods A rapid evidence review was conducted with the aim of exploring what HR interventions and messaging are most effective during a pandemic type situation. Ten health databases were systematically searched using terms relevant to the research aim. A search was also made of grey literature, including a targeted search of HR messaging from key national and service provider websites. Results In the initial search, 121 pieces of evidence were identified which, after screening and de-duplication, resulted in 60 for inclusion. The included evidence consists mainly of non-peer reviewed, pre-publication or expert opinion pieces. The rapid findings suggest that HR services should be deemed essential during a pandemic, with staff supported to work safely and social distancing adaptations implemented. Services should be encouraged to operate more flexibly; for instance, in deciding the amounts of take-home supplies of injecting equipment and medications. The evidence on HR communication was very limited but key messages on infection control, uncertain drug supply and accessing services were identified.Conclusions This rapid evidence review identifies implications for national policy makers, commissioners and HR service providers. A person-centred rather than disease-centred approach to HR delivered by collaborating partners, as well as prioritizing tailored HR messaging, is recommended. Further research evaluating the delivery of HR services and messaging, particularly focusing on health inequalities, is urgently needed.
Drug Use, Homelessness and Health: Responding to The Opioid Overdose Crisis with Housing First Models
Authors: Milaney Katrina , Passi Jenna , Zaretsky Lisa , Liu Tong , O'Gorman Claire M , Hill Leslie , Dutton Daniel 
Published: October 2020

Abstract
Background: Canada is in the midst of an opioid overdose crisis and Alberta has one of the highest opioid use rates across the country. Populations made vulnerable through structural inequities who also use opioids, such as those who are unstably housed, are at an increased risk of experiencing harms associated with opioid use. The main purpose of this study was to explore if there was an association between unstable housing and hospital use for people who use opioids. Methods: Analysis utilized self-reported data from the Alberta Health and Drug Use Survey which surveyed 813 Albertans in three cities. Hospital use was modeled using a logistic regression with our primary variable of interest being housing unstable status. Chi square tests were conducted between hospital use and variables associated with demographics, characteristics of drug use, health characteristics, and experiences of receiving services to establish model inclusion. Results: Results revealed a significant association between housing instability and hospital use, with unstably housed individuals twice as likely to become hospital users. Conclusions: Results highlight the importance of concurrently addressing housing instability alongside the provision of harm reduction services such as Housing First programs and supervised consumption sites. These findings have significant implications for policy and policymakers during the opioid overdose epidemic, and provide a foundation for future areas of research.
Prevalence of Genital Chlamydia Trachomatis among Pregnant Women in a Northwestern Teaching Hospital, Nigeria
Authors: Muhammad Rabi'at Aliyu , Adesiyun Adebiyi Gbadebo , Sada Shafaatu Ismail , Aliyu Shamsudin , Olorukooba Abdulhakeem Abayomi 
Published: October 2020

Abstract
Background: Chlamydia trachomatis (Ct) is now being considered as an “obstetric pathogen” due to its potential in causing adverse pregnancy and perinatal outcomes. Consequent to being the commonest bacterial sexually transmitted infection, screening is recommended at the initial visit of antenatal care, but few countries have routine pregnancy screening and treatment programs. Prevalence assessment is a core component of the World Health Organisation sexually transmitted infection -surveillance programming which enables a country to monitor trends of this infection, for appropriate implementation of preventive measures. Aim: To determine the prevalence of Ct infection among pregnant women, and to describe sociodemographic characteristics and reproductive profile of seropositive pregnant women attending the antenatal clinic of Ahmadu Bello University Teaching Hospital, Zaria. Methods: Socio-demographic characteristics and risk factors were sought from 90 pregnant women using a proforma. Their sera were assayed for the presence of Ct immunoglobulin G (IgG) using ELISA. Data were analysed using SPSS version 21. Categorical variables were represented using frequency and percentages while associations between categorical variables were determined using Fisher’s exact test with p < 0.05 considered significant. Results: Prevalence of Ct infection was found to be 3.3% (3/90). The mean age of infected women was 34.3 ± 4.6 years. All seropositive women were gainfully employed and had tertiary education. Mean parity was 3, the majority (2/3,66.7%) had no previous miscarriage and none had a history of prior stillbirth.Conclusion: The prevalence of Ct in this study is low compared to the pooled prevalence for the West African sub-region. A broader community-based study using a nucleic acid amplification technique is suggested.
PCDHB17P/miR-145-3p/MELK/NF-κB Feedback Loop Promotes Metastasis and Angiogenesis of Breast Cancer
Authors: Zhu Li , Zhang Yan-Jun , Wang Bin , Yang Li , Zheng Yi-Qiong , Sun Lin-De , Tian Lin , Wang Jian-Dong , Chen Tao 
Published: October 2020

Abstract
Breast cancer is one of the most common life-threatening cancers, mainly due to its aggressiveness and metastasis. Accumulating evidence indicates that long non-coding RNAs (lncRNAs) participate in the development and progression of breast cancer. Nevertheless, the function and expression level of lncRNAs in breast cancer are still not fully understood. Here, we demonstrated that lncRNA PCDHB17P was up-expressed in human breast cancer tissues and cell lines. Knockdown of PCDHB17P remarkably suppressed migration and invasion as well as tube formation ability of breast cancer cells. MiR-145-3p was significantly decreased in breast cancer samples, which was negatively correlated to the expression of PCDHB17P. In addition, we identified MELK was a direct target gene of miR-145-3p, which was higher expressed in breast cancer tissues than that in adjacent normal tissues. Mechanistic investigation indicated that PCDHB17P acted as a cancer-promoting competing endogenous RNA (ceRNA) by binding miR-145-3p and upregulating MELK. Interestingly, MELK could in turn increase the promoter activity and expression of PCDHB17P via NF-κB, thus forming a positive feedback loop that drives the metastasis and angiogenesis of breast cancer. Overall, the results demonstrated that the constitutive activation of PCDHB17P/miR-145-3p/MELK /NF-κB feedback loop promotes the metastasis and angiogenesis of breast cancer, suggested that this lncRNA might be a promising prognostic biomarker and therapeutic target for breast cancer.
Anlotinib Inhibits the Growth of Breast Cancer Cells by Promoting Autophagy and Apoptosis via the Akt/GSK-3α Signalling Pathway
Authors: chen shuyi , Zhu Ping , Wang Xue , Jin Youping , Zhi Xiuling , Yang Huanjun , Zhou Ping 
Published: October 2020

Abstract
Background: Anlotinib, a multi-target tyrosine kinase inhibitor, has already been indicated to have significant anticancer effects on lung cancer, colon cancer and ovarian cancer in a phase II clinical trial, but its effect on breast cancer (BC) has not been adequately investigated. Methods: The proliferation activity of BC cell lines MCF-7 and MDA-MB-231 with the treatment of anlotinib was tested by Cell Counting Kit-8 (CCK-8) assay and immunocytochemistry (ICC) staining. We investigated the alteration of cell cycle and apoptosis and autophagy level and the underlying mechanism in the cell lines by quantitative real-time reverse-transcription polymerase chain reaction (qRT-PCR), Western blots, ICC and TUNEL staining and flow cytometry. Further, AT-3 cells were subcutaneously injected into C57BL/6 mice, followed by anlotinib intragastrically. The extracted tumours were assessed by qRT-PCR, Western blots and immunohistochemistry.Results: We found that anlotinib suppressed the cell viability and proliferation of MCF-7 and MDA-MB-231 cell lines and tumour growth in BC xenografts in mice, likely due to abnormal cell cycle arrest and induction of autophagy and apoptosis. Then, we further examined the underlying mechanism of anlotinib, and the results indicated that anlotinib induced apoptosis by promoting autophagy in MCF-7 and MDA-MB-231 cells by regulating the Akt/GSK-3α pathway. The analysis of data from patients with BC collected in TCGA revealed that increased VEGFA expression was related to BC.Conclusions: Our study demonstrated that anlotinib inhibited the growth of BC cells via promoting apoptosis through autophagy mediated by Akt/GSK-3α signalling and may be an effective new drug for BC treatment.
Quarantine Due to the COVID-19 Pandemic From the Perspective of Adolescents: The Crucial Role of Technology
Authors: Salzano Giuseppina , Passanisi Stefano , Pira Francesco , Sorrenti Lacrima , Monica Giuseppa La , Pajno Giovanni B , Pecoraro Maria , Lombardo Fortunato 
Published: October 2020

Abstract
Background. The year 2020 will be remembered as the “year of the COVID-19 pandemic”. The world population had to familiarize themselves with words as swabs, personal protective equipment, pandemic. To curb the wave of the pandemic, almost all the countries imposed self-isolation and social distancing. We conducted a web-based survey to investigate the behavioural responses during the quarantine due to the COVID-19 pandemic. Methods. Participants were 1860 youth aged 12-18 years attending lower secondary schools and upper secondary schools. Data were collected on demographic characteristics, lifestyle changes during the quarantine period, and the psychological impact of the lock-down on adolescents’ life.Results. Most adolescents experienced feelings of fear, discouragement, and anxiety which strongly affected the approach to their daily lifestyles. Most of the surveyed subjects reported having used this period to acquire new skills and to practice physical activities at home. The use of technology was predominant both for recreational activities and educational purposes.Conclusions. Despite the strong psychological impact of the quarantine, adolescents showed good levels of resilience. Technology played a crucial role during the quarantine for young subjects who have increased the daily use of technological devices to stay connected with the rest of the world.
The Use of Neck Circumference as Marker of Overweight and Obesity Among Adolescents Aged 12-19 Years. A Case of Southwestern Uganda Secondary School Adolescents
Authors: Katamba Godfrey , Agaba David Collins , Muzaale Francis , Namaganda Agnes , Namayanja Rosemary , Musasizi Abdul , Kinene Mivule Abdul , Migisha Richard 
Published: October 2020

Abstract
Background: Overweight and obesity have become more common among adolescents. Various indicators have been used to assess this burden across populations. Recent findings elsewhere have found neck circumference to be useful in defining overweight and obesity. However, the use of neck circumference as marker of overweight and obesity needs to be further explored among adolescents in Uganda. Objective: To assess the usefulness of neck circumference as a marker of overweight and obesity. Methods: A cross sectional study was conducted among secondary adolescents aged 12-19 years from May to August in 2018, Height was measured using a wall mount height board and weight using a standard weighing scale. Neck circumference was measured using an inelastic measuring tape. Pearson correlation coefficient was used to determine the correlation between neck circumference, height, weight and body mass index. Receiver operating characteristic (ROC) curve analysis was used to determine the suitable cutoff of neck circumference for overweight and obesity. Results: We enrolled 616 adolescents aged 12-19 years, with mean age of 15.6±2.0 years. Most (65.6%) were female. Neck circumference was significantly correlated with height (p<0.01), weight (p<0.01) and body mass index (p<0.01). The best cutoff of neck circumference to identify participants with obesity were ≥31.0 cm with AUC of 0.83[0.73-0.94] and ≥32.0cm with an AUC of 0.59[0.11-1.00] among the females and males respectively. Conclusion: Neck circumference was useful in defining and hence classifying for overweight or obesity among the female adolescents in our study population. It could useful for screening for overweight and obesity among the female adolescents.