bluuebunny/crossref_metadata_2025_split huggingface dataset:
Xpert MTB/RIF assay for diagnosis of extrapulmonary tuberculosis in children: A systematic review and meta-analysis
Authors: Seo Young Seok , Kang Ji-Man , Kim Dong Soo , Ahn Jong Gyun 
Published: December 2019

Abstract
Background: The Xpert® MTB/RIF assay (Xpert; Cepheid, Sunnyvale, CA, USA) is a cartridge-based nucleic acid amplification assay for rapidly diagnosing tuberculosis and assessing antibiotic sensitivity. Although previous evidence supports the use of Xpert for diagnosing extrapulmonary tuberculosis (EPTB) in adults, information regarding the accuracy of Xpert for EPTB only in children is lacking. This meta-analysis was performed to assess the accuracy of Xpert for detecting EPTB in children. Methods: We searched the MEDLINE, EMBASE, and Cochrane Infectious Diseases Group Specialized Register from January 1, 2010 to July 16, 2019 for studies of the diagnostic performance wherein Xpert was analyzed against cultures or composite reference standards for <18-year-old children with EPTB. Results: In only pediatric studies, 8 studies including 652 samples were selected. The pooled sensitivity and specificity of Xpert for all samples were 71% (95% CI 0.63–0.79) and 97% (95% CI 0.95–0.99), respectively. The area under the summary receiver operating characteristic (sROC) curve was 0.89. For lymph node tissues or aspirates, the pooled sensitivity and specificity of Xpert were 80% (95% CI 0.70–0.88) and 94% (95% CI 0.89–0.97), respectively; for cerebrospinal fluid (CSF), these values were 42% (95% CI 0.22–0.63) and 99% (95% CI 0.95–1.00), respectively. Conclusion: Overall, Xpert displayed high specificity but modest sensitivity across various samples for diagnosing pediatric EPTB compared to the composite reference standard. Xpert sensitivity varied with the sampling site and was especially lower in CSF samples. Positive Xpert results may be considered to indicate a presumptive case of pediatric EPTB, whereas negative test results indicate that the possibility of pediatric EPTB should not be excluded.
Comparison of Fully-Covered vs Partially Covered Self-Expanding Metallic Stents for Palliative Treatment of Inoperable Esophageal Malignancy: A Systematic Review and Meta-Analysis
Authors: Wang Chunmei , Wei Hua , Li Yuxia 
Published: December 2019

Abstract
Background: This study aimed to compare clinical outcomes following placement of fully covered self-expanding metallic stents (FCSEMS) vs partially covered self-expanding metallic stents (PCSEMS) for palliative treatment of inoperable esophageal cancer.
Methods: We searched PubMed, ScienceDirect, Embase, and CENTRAL (Cochrane Central Register of Controlled Trials) databases from inception up to 10th July 2019. Studies comparing clinical outcomes with FCSEMS vs PCSEMS in patients with inoperable esophageal cancer requiring palliative treatment for dysphagia were included.
Results: Five studies were included in the review. 229 patients received FCSEMS while 313 patients received PCSEMS in the five studies. Improvement in dysphagia was reported with both FCSEMS and PCSEMS in the included studies. There was no difference in the rates of stent migration between FCSEMS and PCSEMS (Odds ratio [OR] 0.63, 95%CI 0.37-1.08, P= 0.09; I2=0%). Meta-analysis indicated no significant difference in technical success between the two groups (OR 1.32, 95%CI 0.30-5.03, P= 0.78; I2=12%). Similarly, there was no difference between the two stents for obstruction due to tissue growth (OR 0.81, 95%CI 0.47-1.39, P= 0.44; I2=2%) or by food (OR 0.41, 95%CI 0.10-1.62, P= 0.20; I2=29%). Incidence of bleeding (OR 0.57, 95%CI 0.21-1.58, P= 0.28; I2=0%) and chest pain (OR 1.06, 95%CI 0.44-2.57, P= 0.89; I2=0%) was similar in the two groups. Sensitivity analysis and subgroup analysis of RCTs and non-RCTs produced similar results. The overall quality of studies was not high.
Conclusion: Our results indicate that there is no difference in stent migration, and stent obstruction, with FCSEMS or PCSEMS when used for palliative treatment of esophageal malignancy.
Examining Trust as a Key Determinant of eHealth Adoption in Malawi
Authors: Gadabu Annabelle , Sunguh Kenneth , Arkorful Vincent Ekow , Uddin Mohammed Mahin , Lukman Sadia 
Published: December 2019

Abstract
Background There is value in having the general public take initiative in taking care of personal health. With the heavy burden of finances and shortage of healthcare personnel, patient-centered healthcare is increasingly becoming important especially through eHealth. The way technology is accepted and utilized may have significant hypothetical and concrete inferences. Thus, eHealth, like any other technology, has little value unless it is used. Nevertheless, there are many factors that potentially promote or hinder uptake and use of eHealth services. This study particularly focused on the role that trust plays in determining an individual’s decision to use eHealth services. Methods Using the Unified Theory of Acceptance and Use of Technology (UTAUT) model as the primary model of inference, two new constructs were introduced to determine whether trust is a significant contributor in consumers’ decision to use eHealth. Through convenience sampling, participant responses were collected over a period of 6 weeks and evaluated using Structural Equation Modeling (SEM) technique. Results A total of 400 responses were collected and outcomes of the analysis showed that Performance Expectancy (PE), Effort Expectancy (EE), Social Influence (SI), and Facilitating Conditions (FC), had an affirmative effect on Behavioral Intentions to use eHealth. Performance Expectancy indirectly had a positive effect on Behavioral Intentions to use eHealth services via Trust in Internet (ToI) and Trust in Online Healthcare Providers (ToH). However, ToI had an insignificant effect while ToH had a positive effect. Conclusion Trust is indeed an important element in a user’s determination to use eHealth services. However, it depends on what exactly it is that users place trust in. Consumers are less trusting in the internet to facilitate accessing health related services but are more trusting in online healthcare service providers to ably assist with relevant services. The study also shows that it is essential for key stakeholders such as public policy actors and web designers to take into consideration specific target groups and user preferences which will enhance greater engagement of eHealth services.
Non-rigid image registration of 4D-MRI data for improved target delineation of moving tumors in radiotherapy
Authors: Weick Stefan , Breuer Kathrin , Richter Anne , Exner Florian , Ströhle Serge-Peer , Lutyj Paul , Tamihardja Jörg , Veldhoen Simon , Flentje Michael , Polat Bülent 
Published: December 2019

Abstract
Background: To increase the image quality of end-expiratory and end-inspiratory phases of retrospective respiratory self-gated 4D MRI data sets using non-rigid image registration for improved target delineation of moving tumors. Methods: End-expiratory and end-inspiratory phases of volunteer and patient 4D MRI data sets are used as targets for non-rigid image registration of all other phases using two different registration schemes: In the first, all phases are registered directly (dir-Reg) while next neighbors are successively registered until the target is reached in the second (nn-Reg). Resulting data sets are quantitatively compared using diaphragm and tumor sharpness and the coefficient of variation of regions of interest in the lung, liver, and heart. Qualitative assessment of the patient data regarding noise level, tumor delineation, and overall image quality was performed by blinded reading based on a 4 point Likert scale. Results: The median coefficient of variation was lower for both registration schemes compared to the target. Median dir-Reg coefficient of variation of all ROIs was 5.6 % lower for expiration and 7.0 % lower for inspiration compared with nn-Reg. Statistical significant differences between the two schemes were found in all comparisons. Median sharpness in inspiration is lower compared to expiration sharpness in all cases. Registered data sets were rated better compared to the targets in all categories. Over all categories, mean expiration scores were 2.92 ± 0.18 for the target, 3.19 ± 0.22 for nn-Reg and 3.56 ± 0.14 for dir-Reg and mean inspiration scores 2.25 ± 0.12 for the target, 2.72 ± 215 0.04 for nn-Reg and 3.78 ± 0.04 for dir-Reg. Conclusions: In this work, end-expiratory and inspiratory phases of a 4D MRI data sets are used as targets for non-rigid image registration of all other phases. It is qualitatively and quantitatively shown that image quality of the targets can be significantly enhanced leading to improved target delineation of moving tumors.
Identification of Nucleus Sterility Candidate Genes using a Resequencing Technique in Sweet Pepper Sterile Line AB91
Authors: Meng Yaning , Fan Yanqin , Yan libin , zhang hongxiao 
Published: December 2019

Abstract
Background: Breeding hybrids with nuclear male sterile lines is an important method for the cross breeding of sweet peppers. To date, few reports have been published on the nuclear male sterility gene of sweet pepper. Yet, there are approximately 20 pepper nuclear male sterility lines in the world. Results: Using the self-developed testing material, sweet pepper nuclear male sterile dual-purpose line AB91, the genome-wide resequencing technique was applied to firstly find that the mutation site causing the abortion of sweet pepper nuclear male sterility AB91 is on chromosome #5. The mutation gene Capana05g000747 was filtered out and validated by the flight mass spectrometry genotyping method and determined to be the gene causing the abortion of sweet pepper nuclear male sterility AB91. The gene Capana05g000747 contains eight exons and seven introns, and its mutation site is a non-synonymous mutation site located at the 6th exon; the base C mutated into A, and the amino acid changed from alanine to serine. Sequence alignment analysis showed that the gene Capana05g000747 has a similar function to gene At2g02148. Conclusion: The gene At2g02148 contains a pentatricopeptide repeat protein which has important physiological functions in the gene expression process of organelles and is closely related to the performance of male sterility genes. Therefore, Capana05g000747 was selected as an important candidate gene for sweet pepper nuclear male sterile testing material AB91.
Treatment Of Glioblastoma Multiforme With “classic” 4:1 Ketogenic Diet Total Meal Replacement
Authors: Klein Pavel , Tyrlikova Ivana , Zuccoli Giulio , Tyrlik Adam , Maroon Joseph C. 
Published: December 2019

Abstract
Background: Glioblastoma (GBM) has poor survival with standard treatment.Experimental data suggest potential for metabolic treatment with low carbohydrate ketogenic diet (KD).Few human studies of KD in GBM have been done,handicapped by difficulty and variability of the diet,compliance and feasibility issues.We have developed a novel KD approach of total meal replacement (TMR) program using standardized recipes with ready-made meals.This pilot study evaluated feasibility,safety,tolerability and efficacy of GBM treatment using TMR program with “classic” 4:1 KD. Methods: GBM patients were treated in an open-label study for 6 months with 4:1 [fat]:[protein + carbohydrate] ratio by weight,10 g CH/day,1600 kcal/day TMR.Patients were either newly diagnosed (group 1) and treated adjunctively to radiation and temozolomide,or had recurrent GBM (group 2).Patients checked blood glucose and blood and urine ketone levels twice daily and had regular MRIs.Primary outcome measures included retention,treatment-emergent adverse events (TEAEs) and TEAE-related discontinuation.Secondary outcome measures were survival time from treatment initiation and time to MRI progression. Results: Recruitment was slow,resulting in early termination of the study. Eight patients participated,4 in group 1 and 4 in group 2.Five (62.5%) subjects completed the 6 months of treatment,4/4 subjects in group 1 and 1/4 in group 2.Three subjects stopped KD early:2 (25%) because of GBM progression and one (12.5%) because of diet restrictiveness.Four subjects,all group 1,continued KD on their own, three until shortly before death,for total of 26, 19.3 and 7 months, one ongoing. The diet was well tolerated.TEAEs,all mild and transient,included weight loss and hunger (n=6) which resolved with caloric increase,nausea (n=2),dizziness (n=2),fatigue and constipation (n=1 each).No-one discontinued KD because of TEAEs. Seven patients died.For these, mean (range) survival time from diet initiation was 20 months for group 1 (range 9.5-27) and 12.8 months for group 2 (6.3-19.9). Mean survival time from diagnosis was 21.8 months for Group 1 (11-29.2) and 25.4 for group 2 (range 13.9-38.7). One patient with recurrent GBM and progression on bevacizumab experienced a remarkable symptom reversal,tumor shrinkage and edema resolution 6-8 weeks after KD initiation and survival for 20 months after starting KD. Conclusions: Treatment of GBM patients with 4:1 KD using total meal replacement program with standardized recipes is feasible and well tolerated.
The diagnostic yield of intellectual disability: Combined whole genome low-coverage sequencing and medical exome sequencing
Authors: Wang Jun , Wang Yan , Wang Liwen , Chen Wangyang 
Published: December 2019

Abstract
Background: Intellectual disability (ID) is a heterogeneous neurodevelopmental disorder with a complex genetic underpinning in its etiology. Chromosome microarray (CMA) is recommended as the first-tier diagnostic test for ID due to high detection rate of copy number variation (CNV). Methods: To identify an appropriate clinical detection scheme for ID in Han Chinese patients, a whole genome low-coverage sequencing was performed as the first-tier diagnostic test, followed by medical exome sequencing as the second-tier diagnostic test for those patients with negative results of CNVs. Results: A total of 19 pathogenic CNVs in 16/95(16.84%) ID patients and 11 pathogenic single-nucleotide variations, including 7 novel mutations in 9/79(11.39%) ID patients were identified on whom no pathogenic CNVs were discovered. The detection rate of ID CNVs in multiple congenital anomalies (MCA) subgroup was significantly higher than ID with autism spectrum disorder and the other IDs subgroup. Also single-nucleotide variations showed a higher occurrence rate in the other IDs subgroup. Conclusions: There were differences in the diagnostic yields of different variation types among the three ID subgroups. Our findings provided a new perspective on appropriate clinical detection scheme for different ID subgroups based on the statistical results of different ID subgroups. The application of whole genome low-coverage sequencing as the first-tier diagnostic test for ID with MCA subgroup and medical exome sequencing as the first-tier diagnostic test for other IDs subgroup were considered as an efficient clinical detection schemes.
PTH Derivative Promotes Chronic Wound Healing via Synergistic Multicellular Stimulating and Exosomal Activities
Authors: Shen Yi-Fan , Huang Jing-Huan , Wang Kai-Yang , Zheng Jin , Cai Lin , Gao Hong , Li Xiao-Lin , Li Jing-Feng 
Published: December 2019

Abstract
Background: Chronic diabetic wounds are a disturbing and rapidly growing clinical problem. Parathyroid hormone related peptide (PTHrP-2) was assumed as multifunctional factor in angiogenesis, fibrogenesis and re-epithelization. This study aims to test PTHrP-2 efficiency and mechanism in chronic wound healing. Methods: Through repair phenomenon in vivo some problems were detected, and further research on their mechanisms was made. In vivo therapeutic effects of PTHrP-2 was determined by HE, Masson, microfil and immunohistochemical staining. In vitro direct effects of PTHrP-2 was determined by proliferation, migration, Vascular Endothelial Grown Factor and collagen I secretion of cells and Akt/ Erk1/2 pathway change. In vitro indirect effects of PTHrP-2 was study via exosomes. Exosomes from PTHrP-2 untreated and treated HUVECs and HFF-1 cells were insolated and identified. Exosomes were co-cultured with original cells, HUVECs or HFF-1 cells, and epithelial cells. Proliferation and migration and pathway change were observed. PTHrP-2-HUVEC-Exos was added into in vivo wound to testify its hub role in PTHrP-2 indirect effects in wound healing. Results: In vivo, PTHrP-2 exerted multifunctional pro-angiogenesis, pro-firbogenesis and re-epithelization effects. In vitro, PTHrP-2 promoted proliferation and migration of endothelial and fibroblast cells, but had no effect on epithelial cells. Therefore, we tested PTHrP-2 indirect effects via exosomes. PTHrP-2 intensified intercellular communication between endothelial cells and fibroblasts and initiated endothelial-epithelial intercellular communication. PTHrP-2-HUVEC-Exos played hub role in PTHrP-2 indirect effects in wound healing. Conclusion: The findings of this study indicate that PTHrP-2, a multifunctional factor, can promote chronic wound healing via synergistic multicellular stimulating and exosomal activities.
Emergence of human avian influenza A(H7N9) virus infections in Wenshan City in Southwest China, 2017
Authors: Jiang Li , Zhao Xiaonan , Xu Wen , Zhou Xuehua , Luo Chunrui , Zhou Jiunan , Fu Xiaoqing , Chen Yaoyao , Li Duo 
Published: December 2019

Abstract
Background: The emergence of human infection with avian influenza A(H7N9) virus was reported in Wenshan City, southwestern China in 2017. The study describes the epidemiological and virological features of the outbreak and discusses the origin of the infection. Methods: Poultry exposure and timelines of key events for each patient were collected. Samples derived from the patients, their close contacts, and environments were tested for influenza A(H7N9) virus by real-time reverse transcription polymerase chain reaction. Genetic sequencing and phylogenetic analysis were also conducted. Results: Five patients were reported in the outbreak. An epidemiological investigation showed that all patients had been exposed at live poultry markets. Virus isolates from these patients had low pathogenicity in avian species. Both epidemiological investigations of chicken sources and phylogenetic analysis of viral gene sequences indicated that the source of infection was from Guangxi Province. Conclusions: The transmission route spanned a long geographical region, with virus spreading from east to west. Chickens were an important carrier in the H7N9 virus spreading from Guangxi to Wenshan. Hygienic management of live poultry markets and virological screening of chickens transported across regions should be reinforced to limit the spread of H7N9 virus.
Carriage of high-risk human papillomavirus infection in male subjects in Ouagadougou, Burkina Faso
Authors: Tamini Sya Forazoun Bienvenue , Zohoncon Theodora Mahoukèdè , Soubeiga Serge Theophile , Djigma Florencia Wendkuuni , Traore Ina Marie Angele , Ouedraogo Rogomenoma Alice , Ouattara Abdoul Karim , Obiri-Yeboah Dorcas , Ouedraogo Charlemagne , Simpore Jacques 
Published: December 2019

Abstract
Background Human papillomavirus (HPV) infection is a public health problem in Africa because of its frequency and its various consequences in both men and women. In Burkina Faso, there is little data on the carriage of HPV infection in male subjects. This study aimed to determine the carriage of HPV infection in male subjects in Ouagadougou, Burkina Faso.Methods This was a cross-sectional study conducted from December 2015 to September 2016. During this study period, a total of 124 male subjects who gave informed consent were recruited as part of a fertility assessment. Semen samples were analyzed by Real- Time PCR using Real TM Quant High Risk Screen HPV kit to detect 14 high-risk HPV genotypes. The Chi square test was used for comparisons.Results Of the 124 male subjects, 22 were positive for at least one high-risk HPV, with a prevalence of 17.7%. HPV 56 was the most represented genotype with a frequency of 20%, followed by HPV 39 (11%) and HPV 68 (11%), HPV 16 (8%). The genotypes HPV 18, HPV33, HPV35, HPV51 and HPV52 also had the same frequency of 6% each and the HPV 31, 45, 59 and 66 had the same frequency of 3% each. Of the 22 positive cases, 10 were multiple infections. Spermocytogram of patients showed at least one abnormality in 87.9% of cases. Necrozoospermia and oligozoospermia were the most abnormalities observed with 42% and 40% respectively followed by asthenospermia (18%); teratozoospermia (16%) and azoospermia (14%).Conclusion This study showed that like women, men are infected by HPV with a relatively high prevalence. In addition, the predominant genotypes in the male subjects of this study are not those targeted by the HPV vaccines available in our countries. Hence the need to reinforce the strategies for controlling HPV infection and HPV prophylactic vaccination for young boys.
Longitudinal assessment of antibiotic resistance gene profiles from the infant gut microbiome
Authors: Loo Evelyn , Zain Amanda , Yap Gaik Chin , Purbojati Rikky W , Drautz-Moses Daniela I , koh Yan Qing , Chong Yap Seng , Tan Kok Hian , Gluckman Peter D , Yap Fabian , Eriksson Johan Gunnar , Tham Elizabeth , shek lynette , kjelleberg Staffan , Schuster Stephan C , Banerjee Ritu , Lee Bee Wah 
Published: December 2019

Abstract
Background: The rapid spread of multidrug- resistant pathogenic bacteria is a worldwide public health concern. Given the high carriage rate of extended spectrum beta-lactamase (ESBL)- producing Enterobacteriaceae in Asia, we aimed to evaluate community prevalence and dynamics by studying the longitudinal changes in antibiotic resistance gene (ARG) profiles and prevalence of ESBL-producing E coli and K. pneumoniae in the intestinal microbiome of infants participating in the Growing Up in Singapore Towards Healthy Outcomes (GUSTO) study, a longitudinal cohort study of pregnant women and their infants. Methods: We analysed the antibiotic resistance genes profile in the first year of life among 75 infants who had stool samples collected at multiple timepoints using metagenomics. Results: The mean number of ARGs per infant increased with age. The most common ARGs identified confer resistance to aminoglycoside, beta-lactam, macrolide and tetracycline antibiotics; all infants harboured these antibiotic resistance genes at some point in the first year of life. Few ARGs persisted throughout the first year of life. Beta-lactam resistant Escherichia coli and Klebsiella pneumoniae were detected in 4 (5.3%) and 32 (42.7%) of subjects respectively. Conclusion: In this longitudinal cohort study of healthy infants living in a region with high endemic antibacterial resistance, we demonstrate that majority of the infants harboured a number of antibiotic resistance genes in their gut and showed that the infant gut resistome is diverse and dynamic over the first year of life.