bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mental health impacts among health workers during COVID-19 in a low resource setting: a cross-sectional survey from Nepal
Authors: Khanal Pratik , Devkota Navin , Dahal Minakshi , Paudel Kiran , Joshi Devavrat 
Published: August 2020

Abstract
Background: Health care workers exposed to COVID-19 might be at increased risk of developing mental health problems. The study aimed to identify factors associated with anxiety, depression and insomnia among health workers involved in COVID-19 response in Nepal. Methods: This was a cross-sectional web-based survey conducted between April 26 and May 12, 2020. A total of 475 health workers participated in the study. Anxiety and depression were measured using a 14-item Hospital Anxiety and Depression Scale (HADS: 0- 21) and insomnia was measured by using a 7-item Insomnia Severity Index (ISI: 0-28). Multivariable logistic regression analysis was done to determine the risk factors of mental health outcomes. Results: Overall, 41.9% of health workers had symptoms of anxiety, 37.5% had depression symptoms and 33.9% had symptoms of insomnia. Stigma faced by health workers was significantly associated with higher odds of experiencing symptoms of anxiety (AOR: 2.47; 95% CI: 1.62-3.76), depression (AOR: 2.05; 95% CI: 1.34-3.11) and insomnia (AOR: 2.37; 95% CI: 1.46-3.84). History of medication for mental health problems was significantly associated with a higher likelihood of experiencing symptoms of anxiety (AOR: 3.40; 95% CI:1.31-8.81), depression (AOR: 3.83; 95% CI: 1.45-10.14) and insomnia (AOR: 3.82; 95% CI: 1.52-9.62) while inadequate precautionary measures in the workplace was significantly associated with higher odds of exhibiting symptoms of anxiety (AOR: 1.89; 95% CI: 1.12-3.19) and depression (AOR: 1.97; 95% CI: 1.16-3.37). Nurses (AOR: 2.33; 95% CI: 1.21-4.47) were significantly more likely to experience anxiety symptoms than other health workers. Conclusion: The study findings revealed a considerate proportion of anxiety, depression and insomnia symptoms among health workers during the early phase of the pandemic in Nepal. Health workers facing stigma, those with history of medication for mental health problems, and those reporting inadequate precautionary measures in their workplace were more at risk of developing mental health outcomes. A focus on improving mental wellbeing of health workers should be immediately initiated with attention to reduction of stigma, ensuring an adequate support system such as personal protective equipments, and family support for those with history of mental health problems.
Long Term Clinical Outcomes of Patients with Ischemic Stroke in Primary care – A 9-year Retrospective Study
Authors: Han Jinghao , Choi Yue Kwan , Leung Wing Kit , Hui Eric Ming Tung , Leung Maria Kwan Wa 
Published: August 2020

Abstract
Background: We aim to document the long-term outcomes of ischemic stroke patients and explore the potential risk factors for recurrent cardiovascular events and all-cause mortality in primary care.Methods: A retrospective cohort study performed at two general out-patient clinics (GOPCs) under Hospital Authority (HA) in Hong Kong (HK). Ischemic stroke patients with at least two consecutive follow-up visits during the recruitment period (1/1-30/6/2010) were enrolled. Patients were followed up regularly till the date of recurrent stroke, cardiovascular event, death or 31/12/2018. Risks of recurrent cardiovascular events and death were estimated by Cox proportional hazards model. The primary outcome was the occurrence of recurrent cerebrovascular event including transient ischemic stroke (TIA), ischemic stroke or hemorrhagic stroke. The secondary outcomes were all-cause mortality and coronary heart disease (CHD).Results: A total of 466 patients (mean age, 71.5 years) were enrolled. During a median follow-up period of 8.7 years, 158 patients (33.9%) died. Eighty patients (17.2%) had recurrent stroke and 57 (12.2%) patients developed CHD. Age was an independent risk factor for recurrent stroke, CHD and death. Statin therapy at baseline had a protective effect for recurrent stroke (hazard ratio [HR] =0.454, 95% confidence interval [CI] 0.269-0.766, P=0.003) and all-cause mortality (HR= 0.693, 95% CI 0.486-0.968, P=0.043). In addition, female sex, antiplatelet and a higher diastolic blood pressure (DBP) at baseline were also independent predictors for survival.Conclusions: Long term prognosis of ischemic stroke patients in primary care is favorable. Use of statin was associated with a significant decrease in stroke recurrence and mortality. Patients who died had a significant lower DBP at baseline, highlighted the need to consider both systolic and diastolic blood pressure in our daily practice.
Subcutaneous injection of IFN alpha-2b for COVID-19: an observational study
Authors: Wang Bo , Li Diandian , Liu Tao , Wang Haohua , Luo Fengming , Liu Yanbin 
Published: August 2020

Abstract
Background The global pandemic of coronavirus disease 2019 (COVID-19) infection is ongoing and associated with high mortality. Objective The aim of this study was to investigate the efficacy and safety of subcutaneous injection of interferon alpha-2b (IFN alpha-2b) combined with lopinavir/ritonavir (LPV/r) in the treatment of COVID-19 infection, compared with that of using LPV/r alone. Methods Patients diagnosed with laboratory-confirmed COVID-19 infection in Wuhan Red Cross hospital during the period from January 23, 2020 to March 19, 2020 were included. The length of stay, the time to viral clearance and adverse reactions during hospitalization were compared between patients using oral LPV/r and combined therapy of LPV/r and subcutaneous injection of IFN alpha-2b. Results A total of 22 patients were treated with LPV/r alone and 19 with combined therapy with subcutaneous injection of IFN alpha-2b. The average length of hospitalization in the combination group was shorter than that of LPV/r group (16±9.7 vs 23±10.5 days; P =0.028). Moreover, the days of hospitalization in early intervention group decreased from 25±8.5 days to 10±2.9 days compared with delayed intervention group (P =0.001). Combined therapy with IFN alpha-2b also significantly reduced the duration of detectable virus in the upper respiratory tract. No patient in each group was transferred to intensive care unit (ICU) or died during the treatment. There was no significant difference in the adverse effect composition between two groups. Conclusion Subcutaneous injection of IFN alpha-2b combined with LPV/r shortened the length of hospitalization and accelerated viral clearance in COVID-19 patients, which deserves further investigation in clinical practice.
Ultrapulsed CO2 Laser Combined with Long-pulsed Nd: YAG Laser for the Treatment of Oral and Maxillofacial Pyogenic Granuloma
Authors: Jiang Licheng , Zhang Di , Li Keyi , Zhang Bin , Zhang Anqi , Liu Jianlin 
Published: August 2020

Abstract
Background: Pyogenic granuloma is a common, benign, acquired vascular lesion involving the skin and mucous membrane. It occurs in exposed areas, such as oral and maxillofacial regions, hands and feet, which usually have aesthetic affections on the patients’ appearance. Although pyogenic granuloma is treatable by a variety of treatments, they bear defects such as high recurrence rate, multiple therapies, leaving obvious scars, hyperpigmentation, or skin atrophy. In this study, we treat pyogenic granuloma patients with both ultrapulsed CO2 laser and long-pulsed Nd: YAG laser, in order to achieve ideal effects. Methods: 20 participants with pyogenic granuloma of the oral and maxillofacial region were treated with ultrapulsed CO2 laser and long-pulsed Nd: YAG laser, reexamined one month later, and followed up for one year. Clinical characteristics and treatment effects were recorded and examined.Results: The 20 participants were all cured by one treatment with a cure rate of 100%. None of the patients had scar or recurrence during12 months of follow-up. Conclusions: Ultrapulsed CO2 laser combined with long-pulsed Nd: YAG laser is a safe and cosmetically effective solution for pyogenic granuloma of the oral and maxillofacial region.Trial registration: This research is a retrospective study.
Agnostic Evaluation of Ipilimumab and Nivolumab Association: A Metanalysis.
Authors: Marchetti Paolo , Botticelli Andrea , Ascierto Antonio Paolo , Curigliano Giuseppe , Giannarelli Diana 
Published: August 2020

Abstract
Background. Ipilimumab and Nivolumab, targeting the molecules CTLA-4, PD-1, respectively, have shown efficacy against several types of cancer. Despite these results, only a small percentage of patients maintain a long-lasting effect. Even Ipilimumab, in combination with nivolumab, has demonstrated a significant clinical benefit in multiple tumor types. However, no trial has been designed with the primary endpoint to compare the efficacy of nivolumab plus ipilimumab combined, compared to nivolumab alone. Hence, the added value of ipilimumab in the combination has not clearly been established yet. The aim of this study was to demonstrate the superiority of the combination strategy compared to single agent therapy.Materials and methods. We performed a meta-analysis of Phase I-II-III Clinical Trials, published from 2010 up to 2020, in which the combination of ipilimumab plus nivolumab was compared to nivolumab alone. We extracted ORR, OS and PFS HR on the basis of treatment from the subgroup analysis of each trial. Results. A total of 8 trials were included in the present meta-analysis. Overall, 1313 patients were treated with the nivolumab plus ipilimumab combination compared to 1110 patients treated with nivolumab alone. All trials reported the Objective response rate (ORR) (Table 2), no heterogeneity was found and the pooled Odds Ratio (Figure 1) was highly in favor of the nivolumab plus ipilimumab combination with respect to nivolumab alone (1.683; 95% CI: 1.407-2.012; P<0.0001). Three studies were considered for Progression free survival (PFS) analysis (Table 3), no heterogeneity was found and the pooled Hazard Ratio (Figure 2) favored the combination of nivolumab plus ipilimumab with respect to nivolumab alone (0.807; 95% CI: 0.719-0.907; P<0.0001). The Overall survival (OS) endpoint was considered only in 2 trials (Table 4), no heterogeneity was found and the pooled HR (Figure 3) favored, also in this case, the combination of nivolumab plus ipilimumab with respect to nivolumab alone (0.87; 95% CI: 0.763-0.997; P=0.045).Conclusions. The combination of ipilimumab plus nivolumab seems to be superior to nivolumab alone in cancer patients, regardless of histology.
Challenges in the management of ENT foreign bodies during COVID-19 Pandemic&nbsp;- Experience at a tertiary care centre.
Authors: Bellad Shama A , Hajare Priti S , Havaldar Rajesh Radhakrishna , Narasimman Dhivya Bharathi 
Published: August 2020

Abstract
The novel coronavirus disease 2019 (COVID-19) pandemic has put unprecedented challenges on the medical community. ENT surgical procedures are associated with very high risk of transmission of the virus due to aerosol generation. Management of ENT emergencies due to foreign bodies during ongoing COVID-19 was challenging. This is a prospective study done in our tertiary care centre from March 2020 to June 2020, during COVID-19 pandemic, where patients were referred from primary health facility after unsuccessful attempt. The challenges encountered in the management of these cases, precautions taken and protocols followed are being discussed. The foreign bodies should be removed by trained personnel using Personal Protective Equipment taking all precautions to minimize aerosol generating procedures and limit the length of these procedures whenever possible. Additionally, the use of povidone-iodine in varying concentrations is emphasized in reducing the viral load in the aerodigestive tract, thus proving to be safe to both the patients and the treating doctors.
Circ_0000005 Facilitates&nbsp;Proliferation,&nbsp;Apoptosis, Migration and&nbsp;Invasion of&nbsp;Acute&nbsp;Myeloid&nbsp;Leukemia&nbsp;Cells via&nbsp;Modulating&nbsp;miR-139-5p/Tspan3&nbsp;Axis
Authors: Tong Juan , Liu Huilan , Zheng Changcheng , Zhu Xiaoyu , Wan Xiang , Tang Baolin , Yao Wen , Zhang Lei , Song Kaidi , Sun Guangyu , Sun Zimin 
Published: August 2020

Abstract
Background: Accumulating circular RNAs (circRNAs) are reported to be abnormally expressed in diverse cancers, hematologic malignancies included. This study aimed to investigate the biological function and underlying mechanisms of circ_0000005 in acute myeloid leukemia (AML).Materials and methods: Bone marrow samples were enrolled from AML patients with normal samples as controls. Circ_0000005, miR-139-5p and tetraspanin 3 (Tspan3) were detected by qRT-PCR and Western blot, respectively. AML cell lines (KG1 and HL60) were used as cell models. CCK-8, Transwell and flow cytometry assays were adopted to study the biological functions of circ_0000005 on AML cells in vitro. The interrelation between circ_0000005 and miR-139-5p was detected by bioinformatics, qRT-PCR, luciferase reporter gene assay, RNA pull-down assay, and RNA-binding protein immunoprecipitation (RIP) assays. Ultimately, Western blot, qRT-PCR, luciferase reporter gene assay were adopted to corroborate the interrelation between miR-139-5p and its target Tspan3. Results: Circ_0000005 was demonstrably elevated in both AML clinical samples and cell lines. Circ_0000005 overexpression promoted the viability, migration and invasion of AML cells, and repressed the apoptosis of AML cells, while silencing circ_0000005 showed opposite biological effects. Circ_0000005 interacted with miR-139-5p and repressed its expression, and Tspan3 was proved to be negatively regulated by miR-139-5p. Circ_0000005 could promote the expression of Tspan3 via repressing miR-139-5p, and the oncogenic functions of circ_0000005 were dependent on its regulatory function on miR-139-5p/Tspan3 axis.Conclusion: Circ_0000005 facilitates the malignant phenotypes of AML cells via miR-139-5p/Tspan3 axis. Circ_0000005 may serve as a potential therapeutic target in AML.
Quantification of antibiotic resistance genes and mobile genetic elements in manure from dairy farms in California
Authors: Wang Yi , Pandey Pramod , Chiu Colleen , Jeannotte Richard , Kuppu Sundaram , Zhang Ruihong , Pereira Richard , Weimer Bart , Nitin Nitin , Aly Sharif 
Published: August 2020

Abstract
Antibiotic resistance genes (ARGs) are emerging environmental contaminants of concern to both human and animal health. Dairy manure is considered reservoir of ARGs. This study is focused on investigating prevalence of ARGs in California dairy farm manure under current common manure management. A total of 33 manure samples were collected from multiple manure treatment conditions: 1) flushed manure (FM), 2) fresh pile (FP), 3) compost pile (CP), 4) primary lagoon (PL), and 5) secondary lagoon (SL). After DNA extraction, all fecal samples were screened by PCR for the presence of 8 ARGs: four sulfonamide ARGs (sulI, sulII, sulIII, sulA), two tetracycline ARGs (tetW, tetO), two macrolide-lincosamide-streptogramin B (MLSB) ARGs (ermB, ermF). Samples were also screened for two mobile genetic elements (MGEs) (intI1, tnpA), which are responsible for dissemination of ARGs. Quantitative PCR was then used to screen all samples for five ARGs (sulII, tetW, ermF, tnpA and intI1). Prevalence of genes varied among sample types, but all genes were detectable in different manure types. Results showed that liquid-solid separation, piling, and lagoon conditions had limited effects on reducing ARGs and MGEs, and the effect was only found significant on tetW (p = 0.01). Besides, network analysis indicated that sulII was associated with tnpA (p < 0.05), and Psychrobacter and Pseudomonas as opportunistic human pathogens, were potential ARG/MGE hosts (p < 0.05). This research indicated current manure management practices in California dairy farms has limited effects on reducing ARGs and MGEs. Improvement of manure management in dairy farms is thus important to mitigate dissemination of ARGs into the environment.
Clinical data mining on network of symptom and index and correlation of tongue-pulse data in fatigue population
Authors: Shi yulin , Hu Xiaojuan , Ji Cui , Cui Longtao , Huang Jingbin , Ma Xuxiang , Tao Jiang , Yao Xinghua , Jun Li , Bi Zijuan , Li Jiacai , Yu Wang , Fu Hongyuan , Jue Wang , Lin Yanting , Bai Jingxuan , Guo Xiaojing , Tu Liping , Xu Jiatuo 
Published: August 2020

Abstract
BackgroundFatigue is a kind of non-specific symptom, which is widely found in sub-health and various diseases. It is closely related to people's physical and mental health.Due to lack of objective evidence, it is often neglected in clinical diagnosis,especially in the early stage of disease.A large number of clinical practices and studies have shown that tongue and pulse image are reflection of overall state of the body.Establishing an objective evaluation method for diagnosis of disease fatigue and non-disease fatigue by combining clinical symptom and index and tongue and pulse data is of great significance for timely and effective clinical treatment.MethodsIn this study, 2362 physical examination subjects were divided into healthy control, the group of sub-health fatigue and disease fatigue ,used complex network technology to screen out the core symptoms and western medicine indexes of fatigue,respectively. Constructed the core symptom network and the core symptom-index network. At the same time, used canonical correlation analysis to get the associated relationship of tongue and pulse, and analyzed the characteristic of the tongue and pulse data.ResultsThere were some similarities between the core symptoms of sub-health fatigue and disease fatigue,as well as differences. Symptom-index associated analysis of disease fatigue showed that the core indexes in the group of disease fatigue group had a significant canonical correlation, with the canonical correlation coefficient was 0.42 (P < 0.05). There was no statistically significant correlation between the tongue and pulse data in sub-health fatigue group.ConclusionsThe complex network technology was suitable for the correlation analysis of symptoms and indexes in the fatigue population, and the tongue and pulse objective data had certain diagnostic contribution to the classification of fatigue population.Name of the registry: Chinese Clinical Trial RegistryTrial registration number: ChiCTR-IOR-15006502; ChiCTR1900026008Date of registration: Jun. 04th, 2015URL of trial registry record:http://www.chictr.org.cn/showprojen.aspx?proj=11119;http://www.chictr.org.cn/edit.aspx?pid=38828&htm=4 (This is a retrospective registration)
Socioeconomic inequality in intermittent preventive treatment using Sulphadoxine pyrimethamine among pregnant women in Nigeria: A Decomposition analysis
Authors: Mahmud Fatima Muhammad , Majdzadeh Reza , Nedjat Saharnaz , Sajadi Haniye Sadat , Parsaeian Mahboubeh 
Published: August 2020

Abstract
Background: Sulphadoxine pyrimethamine using intermittent preventive treatment (IPTp-SP) for malaria prevention is recommended for all pregnant women at malaria endemic areas. However, there is limited evidence on the level of socioeconomic inequality in IPTp-SP use to prevent malaria in pregnant women in Nigeria. Thus, this study aimed to determine the level of socioeconomic inequality in IPTp-SP use among pregnant women and to decompose it into its contributing factors.Methods: A secondary data analysis of Nigerian demographic and health survey of 2018 was conducted. A sample of 2,162 pregnant women aged between 15-49 years and had live birth in the past 2 years before the survey were included to this analysis. Participants were recruited based on two-stage cluster sampling method. Socioeconomic inequality was decomposed into its contributing factors by concentration index.Result: The pregnant women who took at least one or more IPTp was 63.4%, while those who took two or more doses were 40.0 % and those who took three or more doses were 17%. Based on concentration index of 0.180 (p-value= <0.001, 95% CI: 0.176 to 0.183) and the Erreyger’s normalization concentration index 0.280 (p-value=<0.001, 95% CI: 0.251 to 0.309 IPTp utilization was pro-rich. The largest contributors to the inequality in IPTp uptake were wealth index (47.81%) and educational status (28.66%).Conclusion: Our findings showed that IPTp use was pro-rich in Nigeria. Wealth index and educational status were the factors that significantly contributed to the inequality. The disparities could be reduced through IPTp service expansion by targeting pregnant women from low socioeconomic status.
Explosion disaster distribution characteristics and outlet open-close effect of turning roadway
Authors: Lv Pengfei , Ju Minghua , Zhang Jiaxu , Pang Lei , Yang Kai 
Published: August 2020

Abstract
In this study, under the open-close conditions of a roadway outlet, the nonlinear dynamic analysis finite element program ANSYS/LS-DYNA was used to build models of explosions on roadways with 0˚ and 90˚ bending angles, to compare and analyse the shock wave propagation characteristics and variation laws. Moreover, the destructive effect of the explosion on the partition was analysed based on the level of damage caused to the human body by shock wave overpressure. The results show that the bending angle has an impact on the space-time distribution law of the explosion shock waves on the roadway. As the bending angle increases, the peak overpressure attenuation of the shock waves becomes prominent, and the arrival time for the same distance increases. The closure of the roadway outlet has a distance effect on the peak overpressure of the shock waves. The explosion shock waves cause the peak overpressure to rise sharply owing to the reflection and stacking effects near the closure. In the far zone of the outlet, the attenuation of the shock waves is too fast and has minimal impact on the peak overpressure. Additionally, overall, the closure of the roadway outlet increases the damage range of the explosion shock waves and the severity of their effect on the human body. With an increase in the bending angle, the damage range and severity decrease. These results can provide a reference for explosion disaster evaluation and prevention.
The Effect of Depression Status Change on Daily Cigarette Smoking Amount: a eleven-year follow up study of the Korea Welfare Panel Study
Authors: Kang Soo Hyun , Jeong Wonjeong , Jang Sung-In , Park Eun-Cheol 
Published: August 2020

Abstract
Background: In the past decade, the Korean smoking rate has only decreased by 3%, despite several smoking control policies. There is a need for such policies to take smokers’ psychological characteristics into account. Depression is a well-known contributor to failed smoking cessation. This study aimed to examine the effect of smokers’ depression status changes on their daily cigarette smoking amount (DCA).Methods: This study used a sample drawn from the Korea Welfare Panel Study (KoWePS) waves 3 (2008) to 13 (2018). The DCA refers to the number of the cigarettes smoked per day at the time of the survey. Depression was measured using an 11-item version of the Center for Epidemiologic Studies Depression Scale (CESD-11). A generalized estimating equation (GEE) model was employed to analyse the effect of change of depression status on DCA.Results: The Yes→No male depression status group had lower DCA (β=-0.631, p-value=0.0248) than the No→No group. The Yes→No male depression status group that began smoking before age 19 had lower DCA (β=-0.881, p-value: 0.0089) than the No→No group that started smoking before 19.Conclusions: We found that a change from depressed to non-depressed and non-depressed to depressed status is associated with decreasing and increasing DCA, respectively. Also, for smokers who began smoking before 19 years of age, the subgroup that went from depressed to non-depressed had much a lower DCA than general smokers. Thus, when treating people participating in smoking cessation programs, counsellors should check for depression symptoms and encourage individuals to pursue depression treatment simultaneously.