bluuebunny/crossref_metadata_2025_split huggingface dataset:
Very High Baseline HIV viremia impairs efficacy of NNRTI-based ART: A long-term observation in treatment-naïve patients
Authors: Chen Shuai , Han Yang , Song Xiaojing , Li Yanling , Zhu Ting , Lu Hongzhou , Tang Xiaoping , Zhang Tong , Zhao Min , He Yun , He Shenghua , Wang Min , Li Yongzhen , Huang Shaobiao , Li Yong , Liu Jing , Cao Wei , Li Taisheng 
Published: April 2020

Abstract
Background: High baseline HIV-RNA level (≥100,000 copies/ml) has been proved to be related with weaker virological response to antiretroviral therapy (ART). However, it was not completely clear whether a very high pre-therapy viral load (≥500,000 copies/ml) can further impair the virological response, especially in the long run. Methods: A retrospective study based on data from multicenter cohorts in China was performed. We enlisted untreated HIV infected adults recruited between18 and 65 years old, who received China’s first-line non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimen. All patients had baseline HIV-RNA levels over 500 copies/ml, showed good adherence, and were followed for at least 24 weeks. Virological suppression (VS) was defined as the first HIV-RNA <50 copies/ml which lasted for six months. Virological failure was defined as any of incomplete viral suppression (HIV-RNA ≥200 copies/mL with no recorded VS within 24 weeks of treatment) and viral rebound (confirmed HIV-RNA level ≥50 copies/mL after VS). Chi-square analysis was used to compare rates of VS between different HIV-RNA strata. Kaplan–Meier analysis and Cox regression model were used to compare time to virological suppression. Logistic regression was used to evaluate odds to virological failure. Results: 758 treatment-naïve HIV patients in China were enlisted. Median follow-up time (IQR) was 144 (108-276) weeks. Most patients (68.2%) were given tenofovir disoproxil fumarate (TDF) + lamivudine (3TC) + efavirenz (EFV) regimen. By week 48, rates of VS in three groups (<100,000, 100,000-500,000 and ≥500,000 copies/ml) were 94.1%, 85.0%, and 63.8%, respectively ( p <0.001). Very high baseline HIV viremia over 500,000 copies/ml were found to be independently associated with delayed VS [≥500,000 vs. <100,000, adjusted relative hazard (95% CI), 0.455 (0.32-0.65); p <0.001] as well as incomplete viral suppression [≥500,000 vs. <100,000, adjusted odds ratio (aOR) (95% CI), 6.084 (2.761-13.407); p <0.001] and viral rebound [≥500,000 vs. <100,000, aOR (95% CI), 3.671 (1.009-13.355), p =0.048]. Conclusion: Very high levels of pre-treatment HIV-RNA were significantly related with delayed efficacy of NNRTI-based ART and increased risk of treatment failure. More potent initial regimens should be considered for those with very high baseline viremia.
Clinical significance of peripheral blood-derived inflammation markers in advanced gastric cancer after radical resection
Authors: Gu Lihu , Chen Bangsheng , Zheng Dingcheng , Mo Jiahang , Yuan Lingling , Mao Feiyan , Zhang Kang , Ng Derry Minyao , Chen Ping , Wang Dongjie 
Published: April 2020

Abstract
Background and objective: The prognostic significance of peripheral blood-derived inflammation markers in patients with gastric cancer (GC) has not been elucidated. This study aimed to investigate the relationship between systemic inflammatory markers and GC prognosis.Methods: A prospective observational cohort study involving 598 patients was conducted to analyze the prognosis of GC based on systemic inflammatory markers. The following peripheral blood-derived inflammation markers were evaluated: the neutrophil-lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), systemic immune-inflammation index (SII), C-reactive protein/albumin (CRP/Alb) ratio, Glasgow Prognostic Score (GPS), modified Glasgow Prognostic Score (mGPS), prognostic nutrition index (PNI), and prognostic index (PI). The receiver operating characteristics (ROC) curve and the Youden index were used to determine the optimal cutoff values. Univariate and multivariate analysis of prognostic factors was conducted accordingly.Results: The optimal cutoff values of the PNI, fibrinogen, NLR, PLR, SII, and CRP/Alb were 49.5, 397ng/dl, 2.5, 154, 556, and 0.05, respectively. Multivariate analysis showed that age, PLR, TNM stage, and chemotherapy were the independent prognostic factors for advanced gastric cancer (AGC). Adjuvant chemotherapy improved the long-term prognosis of patients with PLR ≥154, but chemotherapy had no significant effect on the survival of patients with PLR <154.Conclusions: Our findings show that higher PLR (≥154) is an independent risk factor for poor prognosis in GC patients. Besides, PLR can predict adjuvant chemotherapy (oxaliplatin/5-fluorouracil combination) response in patients with GC after surgery.
Molecular typing, phenotypic and genotypic assessment of antibiotic resistance and virulence factors amongst the Staphylococcus aureus bacteria isolated from raw chicken meat
Authors: Fazel Nazanin , Karimi Sepideh , Momtaz Hassan 
Published: April 2020

Abstract
Background: Staphylococcus aureus is an important cause of foodborne diseases due to the consumption of contaminated raw chicken meat. The present research was performed to evaluate the phenotypic and genotypic properties of antibiotic resistance, virulence factor profiles and molecular typing of S. aureus strains isolated from chicken meat. A total of 36 S. aureus strains were isolated from raw chicken meat samples. Phenotypic pattern of antibiotic resistance was assessed by disk diffusion. Distribution of antibiotic resistance and virulence genes was evaluated by PCR. Molecular typing of isolates was perform ed by the ERIC-PCR. Results: Considering the over than 80% similarity, 36 S. aureus isolates were classified in 9 different profiles with 43 to 100% similarities. S. aureus strains showed the highest incidence of resistance against penicillin (100%), tetracycline (91.66%), cephalothin (77.77%), ciprofloxacin (75%), erythromycin (75%), mupirocin (63.88%), clindamycin (61.11%) and trimethoprim/sulfamethoxazole (61.11%). The most commonly detected antibiotic resistance genes amid the S. aureus isolates were mecA (100%), tetK (80.55%), tetM (66.66%), aacA-D (61.11%), msrA (55.55%) and ermA (55.55%). Total distribution of etB, etA, tsst-1, clfA and coa virulence factors amongst the S. aureus strains was 61.11%, 58.33%, 13.88%, 75% and 100%, respectively. Conclusions: Genetic cluster of bacteria affected the antibiotic resistance and virulence characters of S. aureus strains. S. aureus strains with the same ERIC-genetic cluster had similar antibiotic resistance and virulence characters which may show their similar origins. Presence of one or more virulence factors and antibiotic resistance genes amongst the resistant-S. aureus strains signifies an important public health threat rendering the consumption of raw or undercooked chicken meat.
Cytokine profile and nitric oxide levels in peritoneal macrophages of BALB/c mice exposed to Fucose-Mannose Ligand of Leishmania infantum combined with Glycyrrhizin
Authors: Hasan Namdar Ahmadabad , shafiei reza , Reza Hatam Gholam , Reza Zolfaghari Emameh , Ashok Aspatwar 
Published: April 2020

Abstract
Background: The Fucose-Mannose Ligand (FML) of Leishmania infantum is a complex glycoprotein which does not elicit adequate immunogenicity in human. In recent years, adjuvant compounds derived from plants have been used for improving the immunogenicity of the vaccines. Glycyrrhizin (GL) is a natural triterpenoid saponin that has known immunomodulatory activities. In the present study, we investigated the effects of a co-treatment with FML and GL on the production of cytokines and nitric oxide (NO) by macrophages, in vitro. Methods: Lipopolysaccharide (LPS) stimulated murine peritoneal macrophages were treated with FML (5 μg/ml) of Leishmania infantum and various concentrations of GL (1 μg/ml, or 10 μg/ml or 20 μg/ml). After 48h of treatment, cell culture supernatants were recovered and the levels of TNF-α, IL-10, IL-12p70, and IP-10 were measured by sandwich ELISA and NO concentration by Griess reaction. Results: Our results indicated that the treatment of activated macrophages with FML plus GL leads to enhanced production of NO, TNF-α, IL-12p70, and reduction of IL-10 levels in comparison with FML treatment alone. Conclusions: We, therefore, concluded that GL can improve the immunostimulatory effect of FML on macrophages and leads to polarization of them toward an M1-like phenotype.
Apolipoprotein A1 and lipoprotein(a) are protective factors for male papillary thyroid cancer patients. A cross-sectional study of single academic center in China.
Authors: Ma Maoguang , Wang Mingdian , Zhang Zhanqiang , Lin Bo , Sun Zicheng , Guan Haoyan , Lv Weiming , Li Jie 
Published: April 2020

Abstract
Background: Papillary thyroid cancer (PTC) is the most common type of thyroid cancer and the incidence of PTC continued to increase over the past decades. Many studies showed that obesity is an independent risk factor for PTC and obese PTC patients tend to have a relative larger tumor size and higher grade of tumor stage. Obesity is closely related with lipid metabolism, while the correlation between serum lipid and PTC remains unclear. Therefore, this study aimed to investigate the association between serum lipid level and PTC. Methods: We retrospectively analyzed 1018 PTC patients diagnosed and treated in our hospital, all these cases were first diagnosed with PTC and had complete clinical information including ultrasound reports before surgery, serum lipid (CHOL, TG, HDL-c, LDL-c, Apo-A1, Apo-B, Apo-E, Lp (a)) results, surgical records and pathological reports. Results: All these serum lipid biomarkers did not associated with tumor size in the female group. In the male group, on crude analysis, Apo-A1 and Lp (a) showed a marginally significant association with tumor size OR and 95% CI 0.158 (0.021-1.777), p=0.072; 0.997 (0.993-1.000) p=0.082 respectively. After adjusting for age and multifocality, Apo-A1 and Lp (a) showed a significant association with tumor size OR and 95% CI 0.126 (0.016-0.974) p=0.047; 0.996 (0.992-1.000) p=0.046 respectively. This association become more apparent in a young male subgroup, OR and 95% CI 0.051 (0.005-0.497), p=0.009; 0.926 (0.978-1.012), p=0.037 respectively. CHOL, TG, HDL-c, LDL-c, Apo-B, Apo-E did not show significant association with tumor size. As for LNM, neither in the male group nor in the female group were found to be associated with any serum lipid biomarkers. Conclusion: As PTC incidences continues to increase, our study demonstrated that Apo-A1 and Lp (a) are two protective factors for male PTC patients and provided us new clues about PTC and lipid metabolism, which may contribute to further investigation concerning diagnosing and preventing this most common type of thyroid cancer.
World Delirium Awareness Day 2019, delirium and risk of falls in the hospital setting.
Authors: Shekhar Rozina , Chasle Briony , Stott Katrina , Vueti Vaulina , Deane Vicki , Edmonds Renee , Moseley Margaret , Shepherd Bernadette , Mayahi-Neysi Mandana , Wilson Carol , Sandhu Navjot , Smitha Juvilet , Phillips Jennifer , Marov Lynda , Perkins Margaret , Carr Sara , Richardson K'Sandra , McGuire Kathy , Gujraz Poumansing , Kumar Binita , Jankulovski Daniella , Dixon Kylie , Lata Yashwani , Zachariah Rinsy , Rolls Kaye , Warner Bradley , Chroinin Danielle Ni , Frost Steven Alfred 
Published: April 2020

Abstract
Background Delirium is an acute change in cognition, common among older hospitalized patients, however, patients of all ages are at risk of delirium during a hospital stay. The International Federation of Delirium Societies promotes, each year, a World Delirium Awareness Day , to raise the awareness of, not just recognizing delirium in the hospital setting, but ensuring interventions are in place to prevent the development of delirium. Hospitalized patients with delirium have increased risk of adverse events such as falls, pressure injury, malnutrition, increased length of stay, increased health care costs, and mortality. This clinical audit aimed to estimate the risk of a subsequent fall, following an acute episode of in-hospital delirium, across a broad cross-sectional of clinical settings.Methods Seventeen adult acute inpatient wards across the South Western Sydney, Local Health District, undertook an audit of the number of admitted patients who had had at least one episode of delirium since being admitted to hospital. Using the hospital-based incident management reporting system, the rates of subsequent falls was compared between delirium and non-delirium patients.Results Fifty of the 473 patients (11.4%) were identified by the nursing staff to have had at least one episode of delirium since admission. The proportion of fallers among the delirium and non-delirium patients were 10% and 2%, respectively (p = 0.004). The rate of falls per 1000 patient days was 6.45 (95% confidence interval (CI) 2.1 to 15.1) among delirium patients, compared to 2.12 (95% CI 1.0 to 4.0) among patients without delirium. The risk of falling among delirium patients was 4.25 higher compared to non-delirium patients (adjusted hazard ratio (HR) = 4.25, 95% CI 1.26 to 14.39).Conclusion This clinical audit has been able to show that an acute episode of delirium increases the risk of an in-hospital fall fourfold. Importantly, these results have highlighted the need for a hospital wide approach, to not just in identifying delirium, but the need to have interventions in place to reduce the risk of delirium. In other words, delirium prevention should be ‘core business’ of all nursing care, across the acute hospital setting.
Preoperative Geriatric Nutritional Risk Index is an independent prognostic factor for postoperative survival after Gallbladder carcinoma radical surgery
Authors: Zhang Die , Xu Jing 
Published: April 2020

Abstract
Background

Surgical results of gallbladder cancer (CBG) are currently inadequate. The Geriatric Nutritional Risk Index (GNRI) can effectively assess nutritional status. The present study attempted to delve into investigating whether preoperative GNRI can act as a predicting factor for CBG.

Methods

202 consecutive GBC patients treated from 2010 to 2017 were taken retrospectively. By conducting univariate and multivariate Cox regression analyses on overall survival (OS) and recurrence-free survival (RFS), their preoperative GNRI was studied.

Results

Of the 202 patients, 103 (51.0%) had GNRI<100. The patients with low GNRI before surgery had the median OS of 26 months, less than that of patients having received high GNRI before surgery (39 months, P<0.001). GNRI displayed associations with less survival times in univariate (HR, 3.656; 95%CI, 2.308-5.790; P<0.001). As indicated from the results of multivariate analysis, patients exhibiting low GNRI showed a lower OS (HR, 2.386; 95%CI, 1.170-4.868; P=0.017) and RFS (HR, 7.610; 95%CI, 3.181-18.207; P<0.001) than those exhibiting high GNRI.

Conclusions

GNRI is an independent indicator of poor prognosis in GBC patients after GBC radical surgery.
Ethnobotanical study on Sustainable use of Non-Timber Forest Products and their Source Plant Species contribute to balance Livelihood and Conservation: a case of Sera Forest, Amigna District, Southern Ethiopia
Authors: Kidane Leul , Balke Abu Balke 
Published: April 2020

Abstract
Background: Non-Timber Forest Products (NTFPs) do have significant role as local source for medicine, fiber, forage and sustenance and offer income opportunities for poverty mitigation mainly in rural families. Sustainable use of NTFPs is imperative so, this study was focused on the documentation of plant species used for NTFPs and their conservation status in Sera forest. Methods: The study applied a combination of plant ecological and ethnobotanical methods. Ethnobotanical data were gathered through semi-structured questionnaires and interviews which involved 230 (206 randomly sampled general and 24 purposively selected key informants); group discussion, guided field walk and market survey. Data were analyzed and presented using analytical methods of ethnobotany including descriptive statistics, informant consensus factor (ICF) and ranking. Results: A total of 137 plant species belonging to 49 families used as a source of NTFPs were documented from the study area. In addition, 11 major use categories of the NTFPs were identified. Out of these, medicine, fire wood and charcoal making and construction materials were the most dominant uses requiring large volume of NTFPs in the study area. The output of direct matrix ranking of plant species used for multipurpose revealed - Hagenia abyssinica ranked first followed by Olea europaea ssp cuspidata, Grewia mollis, Croton macrostachyus, Ximenia americana and Carissa spinarum. Hence, local communities of the study area possess rich potential indigenous knowledge that helped to use their natural resources for sustainable livelihood. Conclusions: Sera forest is rich in NTFPs bearing plants and associated indigenous conservation knowledge. However, nowadays illegal timber extractions, grazing, over harvesting NTFPs, farm expansion and fire hazards were found to be threatening of the plant resources in the study area. Therefore, awareness creation on complementary conservation (in-situ and ex-situ) and sustainable use of plant resources of the area for higher livelihood outcomes with lower environmental impacts is desirable.
Dexamethasone - loaded polymeric porous sponge as a hard tissue regeneration agent
Authors: Alagha Amjad 
Published: April 2020

Abstract
Background : The aim of this study is to achieve the principles of tissue engineering using biopolymers to be applied in the field of vital endodontic treatment with the aim of stimulating stem cells and engineering and regeneration of dentin tissue. the blend was loaded with the steroidal anti-inflammatory drug, dexamethasone, and the porous drug-loaded bio-sponge was produced by lyophilization. Bio-sponge, as a direct pulp capping agent, was histologically studied compared to calcium hydroxide Ca(OH)2 in an animal experiment. Results: The results indicated the effectiveness of the bio-sponge as a direct pulp agent, where the dentin bridge was formed faster than Ca(OH)2 treated samples,. There was no inflammatory response in the pulp tissue throughout the follow-up period. Conclusions : The porous bio-sponge loaded with dexamethasone with a neutral pH resulted in enhancement the odontoblast differentiation from stem cells, resulted in the formation of a renewed dentin bridge without the slightest inflammatory response in the pulp.
Acellular dermal matrix treats lower extremity full-thickness skin defect on one-stage without skin graft or flaps
Authors: Li Gongchi , Zhou Pan , Liu Hanlin , Peng Han , Li Binghui , Chen Jianghai 
Published: April 2020

Abstract
Background Self-repair of lower limb wounds has always been one of the research hotspots. Flaps and skin graft are the preferred treatment for lower extremity wound reconstruction. However, these treatments have many disadvantages, such as secondary damage, poor healing quality. In recent years, the use of acellular dermal matrix has emerged as an alternative treatment option for extremity ulcers. Methods This study aimed to explore whether acellular dermal matrix can be used as a single treatment to promote wound healing. 7 patients with lower extremities cutaneous deficiency exposing bone or tendon, was covered by Pelnac, which was an acellular dermal matrix product approved by China Food and Drug Administration. All the wound was treated by Pelnac without flaps and skin graft. The external dressing was changed every 10 days. Results After a maximum of 20 weeks, all the wounds were completely healed. During the 12 months follow-up period none of the patients developed skin wear on the treatment area. All patients maintained their postoperative ambulatory ability. All patients were satisfied with the appearance and feeling after wound healing. Conclusions These findings may mean acellular dermal matrix is a novel method oﬀering opportunity for treatment of lower extremities cutaneous deficiency exposing bone or tendon. It also has the potential to close wounds of all uninfected, non-ischemic, full-thickness cutaneous deficiency.
The surgical outcomes and perioperative complications of bowel resection as part of debulking surgery of advanced ovarian cancer patients.
Authors: Ye Shuang , Wang Yiyong , Chen Lei , Wu Xiaohua , Yang Huijuan , Xiang Libing 
Published: April 2020

Abstract
Background: To review the utilization and perioperative outcomes of bowel resection during cytoreduction of ovarian cancer patients in our institution. Methods: All the patients who received bowel resection including anastomosis and ostomy formation between 2006/01 and 2018/12 were identified. Clinicopathological information was abstracted from the medical records. Postoperative morbidities were assessed according to Clavien-Dindo classification (CDC).Results: There were 182 patients in the anastomosis group and 100 patients in the ostomy group, leading to a total of 282 patients. The median age was 57 years and most patients had high-grade serous histology (88.7%). 49 (17.3%) patients received neoadjuvant chemotherapy. During operation, 78.7% patients had ascites and the median volume was 800 mL. Extensive bowel resection (at least two-segment) and upper abdominal operation was performed in 29 (10.2%) and 69 (24.4%) patients, respectively. Rectosigmoid colon was the most commonly resected (83.8%), followed by right hemicolectomy (5.9%) and small bowel resection (2.8%). No macroscopic residual disease was observed in 42.9% of the patients, while 87.9% of had residual disease ≤1 cm. For the entire cohort, 19.9% (56/282) experienced different complications, not including anastomotic leak (AL). Severe complications (CDC 3-5) accounted for 7.8%, mostly pleural effusion requiring drainage (3.5%), and followed by wound dehiscence requiring delayed repair in operation room (1.8%). Nine patients experienced AL: one in the ostomy group with extensive bowel resection and eight in the anastomosis group. The overall AL rate was 4.2% (9/212) per anastomosis. The AL rate per anastomosis was quite comparable in different populations: 4.4% (patients in the anastomosis group), 4.3% (patients with one-segment bowel resection and anastomosis), 4.0% (patients with extensive bowel resection and anastomosis) and 5.0% (patients with isolated rectosigmoid resection and anastomosis).Conclusions: Execution of bowel resection as part of debulking surgery of patients with newly diagnosed ovarian cancer resulted in an acceptable morbidity rate.