bluuebunny/crossref_metadata_2025_split huggingface dataset:
Procedural sedation for direct current cardioversion: a feasibility study between two management strategies in the emergency department.
Authors: Stronati Giulia , Capucci Alessandro , Russo Antonio Dello , Adrario Erica , Carsetti Andrea , Casella Michela , Donati Abele , Guerra Federico 
Published: June 2020

Abstract
BackgroundA cardiologist-only approach to procedural sedation with midazolam in the setting of elective cardioversion (DCC) for AF has already been proven as safe as sedation with propofol and anaesthesiologist assistance. No data exist regarding the safety of such a strategy during emergency procedures. The aim of this study is to compare the feasibility of sedation with midazolam, administered by a cardiologist, to an anaesthesiologist-assisted protocol with propofol in emergency DCC.MethodsSingle centre, prospective, open blinded, randomized study including all consecutive patients admitted to the Emergency Department requiring urgent or emergency DCC. Patients were randomized in a 1:1 fashion to either propofol or midazolam treatment arm. Patients in the midazolam group were managed by the cardiologist only, while patients treated with propofol group underwent DCC with anaesthesiologist assistance.ResultsSixty-nine patients were enrolled and split into two groups. Eighteen patients (26.1%) experienced peri-procedural adverse events (bradycardia, severe hypotension and severe hypoxia), which were similar between the two groups and all successfully managed by the cardiologist. No deaths, stroke or need for invasive ventilation were registered. Patients treated with propofol experienced a greater decrease in systolic and diastolic blood pressure when compared with those treated with midazolam.ConclusionsProcedural sedation with midazolam given by the cardiologist alone was safe, well-tolerated and cost-effective in emergency DCC.
COVID-19 Infection Manifesting as a Severe Gastroparesis Flare: A Case Report
Authors: Song Jun , Bhuta Rajiv , Baig Kamal , Parkman Henry P. , Malik Zubair 
Published: June 2020

Abstract
Background: Coronavirus Disease 2019 (COVID-19) is a disease caused by infection with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which commonly presents with symptoms including fever, cough, and dyspnea. More recently, however, some patients have tested positive for COVID-19 after developing gastrointestinal (GI) symptoms either solely or in conjunction with respiratory symptoms. This may be due to SARS-CoV-2 infection of the GI tract. In patients with chronic GI illnesses, COVID-19 may initially present as a flare of their underlying GI conditions as viruses have historically been implicated in exacerbations of GI disorders, including gastroparesis. Case presentation: We report a case of a 37 year-old female with a history of diabetic gastroparesis who presented to the Emergency Department (ED) in a gastroparesis flare. Her symptoms in the ED failed to improve with fluids and anti-emetic medications. After developing a fever, she was tested and found to be positive for COVID-19.Conclusion: To our knowledge, at the present time, this is the first report of a patient with COVID-19 presenting with signs and symptoms of a gastroparesis flare. This case illustrates that patients with underlying GI disorders, such as gastroparesis, may have SARS-CoV-2 infections that present as an exacerbation of their underlying disorder. Initial presentation of these patients manifesting as a flare of their chronic GI disease, more severe than usual, should prompt an index of suspicion for COVID-19.
Perioperative change in neutrophil count predicts worse survival in esophageal squamous cell carcinoma
Authors: Song Qian , Wu Jun-zhou , Wang Sheng , Xu Song-xiao 
Published: June 2020

Abstract
Background
Numerous studies reported the prognostic significance of neutrophil count (or preferably NLR) in patients with esophageal squamous cell carcinoma (ESCC), while the relationship between perioperative change in neutrophil count and survival of patients with ESCC after surgery has not been assessed.
Methods
A total of 603 patients with newly diagnosed ESCC after the operation were enrolled in the study. Neutrophil change (Nc) (Nc = Post-Neutrophil–Pre-Neutrophil) was counted according to data within one week before surgery and two week after surgery. The median of Nc was selected to be the cut off value to evaluate the relationship between Nc and Overall survival (OS).
Results
105 (17.4%) patients had pathological stage 1a-1b, 205 (34.0%) patients had pathological stage 2a-2b, and 293 (48.6%) patients had pathological stage 3a-3c.There were 180 (29.9%) patients who had vessel invasive, and 423 (70.1%) patients without vessel invasive. There were 215(35.7%) patients who had nerve infiltration, and 388 (64.3%) without nerve infiltration. In univariate analysis, six parameters including neutrophil change(Nc)(≥ 2.60 vs.<2.60) (P = 0.010, HR = 0.694, 95% CI 0.526–0.915) significantly correlated to worse OS. Multivariate analysis revealed that neutrophil change(Nc)(≥ 2.60 vs.<2.60) was an independent prognostic marker for OS (P = 0.022, HR = 0.720, 95% CI 0.544–0.954). Kaplan-Meier curves shown that Nc < 2.60 was significantly associated with worse OS (P = 0.016).
Conclusions
Perioperative change in neutrophil count predicts worse survival in patients with ESCC after the operation.
rhCygb reverses bleomycin-induced established pulmonary fibrosis in rats
Authors: Zhen Li , Zhongshun Lin , Ping Wang , Dong Wenqi 
Published: June 2020

Abstract
PurposeRecombinant human cytoglobin (rhCygb) has been demonstrated to anti-inflammation, anti-oxidation, anti-fibrosis in liver and kidney in animal disease models. However, the effect of rhCygb on the progression of pulmonary fibrosis is still unclear. The aim of this study was to investigate the therapeutic effect of rhCygb in the bleomycin (BLM)-induced pulmonary fibrosis rats.MethodsWe tested whether rhCygb would reverse lung fibrosis (at day 28 and 56) in Sprague-Dawley rats treated with bleomycin. Bleomycin (5mg/kg) resulted in fibrosis by CT and serum measurement at day 7. Effects of rhCygb treatment on morphological and CT imaging of the lung, as well as serial serum levels of biomarkers with progressive lung fibrosis were tested at day 28 and 56.ResultsIn BLM-treated rats (7 days), the well-established lung fibrosis was evidence by changes in rat lungs with CT images and serum levels of hyaluronic acid (HA), laminin (LN), procollagen III N-terminal peptide (PIIINP) and type IV collagen (IVC).After treatment with rhCygb for 49 days, we found significantly decreasing in HA, LN, PIIINP and IVC levels almost to controls. Hydroxyproline (HYP) , CT mean lung density（MLD）and Masson collage volume fraction (CVF) were also significantly reduced. Furthermore, CT MLD positively correlated with serum levels of HA, LN, PIIINP, IVC, and HYP, and especially with CVF.ConclusionrhCygb may be a new potential medicine for reversing lung fibrosis in the future.
LncRNA LINC00240 suppresses invasion and migration in non-small cell lung cancer by sponging miR-7-5p
Authors: Ku gwan woo , Kang Yujin , Yu Seong-Lan , Park Joonghoon , Park Sejin , Jeong In Beom , Kang Min Woong , Son Ji Woong , Kang Jaeku 
Published: June 2020

Abstract
Background
lncRNAs have important roles in regulating cancer biology. Accumulating evidence has established a link between the dysregulation of lncRNAs and microRNA in cancer progression. In previous studies, miR-7-5p has been found to be significantly down-regulated in mesenchymal-like lung cancer cell lines and directly regulated EGFR. In this work, we investigated the lncRNA partner of miR-7-5p in the progression of lung cancer.
Methods
We investigated the expression of miR-7-5p and the lncRNA after transfection with an miR-7-5p mimics using a microarray. The microarray results were validated using quantitative real time-polymerase Chain Reaction (qRT-PCR). The regulatory effects of lncRNA on miR-7-5p and its target were evaluated by changes in the expression of miR-7-5p after transfection with siRNAs for lncRNA and the synthesis of full-length lncRNA. The effect of miR-7-5p on lncRNA and the miRNA target was evaluated after transfection with miRNA mimic and inhibitor. The role of lncRNA in cancer progression was determined using invasion and migration assays. The level of lncRNA in lung cancer and normal lung tissue was analyzed using TCGA data.
Results
We found that LINC00240 was downregulated in lung cancer cell line after miR-7-5p trandfection with an miR-7-5p mimic. Further investigations reveal ed that the knockdown of LINC00240 induced the overexpression of miR-7-5p. The overexpression of miR-7-5p diminished cancer invasion and migration. The EGFR expression was down regulated after siRNA treatment for LINC00240. Silencing LINC00240 suppressed the invasion and migration of lung cancer cells, whereas LINC00240 overexpression exerted the opposite effect. The lower expression of LINC00240 in squamous lung cancer was analyzed using TCGA data.
Conclusions
Taken together, LINC00240 acted as a sponge for miR-7-5p and induced the overexpression of EGFR. LINC00240 may represent a potential target for the treatment of lung cancer.
Feasibility of circulating tumor cells (CTCs) combined with medical imaging examinations to screen for cancer and improve diagnosis in non-metastatic invasive breast cancer patients: a cohort study
Authors: Shao Xuan , Jin Xiao Yan , Chen Zhi Gang , Zhang Zhi Gang , Wang Ke , Yu Xiu Yan , Chen Wu Zhen , Jiang Jing Xin , Wang Zhen , Cui Ying , Fan Wan Hung , Huang Jian 
Published: June 2020

Abstract
Background

Previous study has reported that circulating tumor cells (CTCs) could serve as a diagnostic biomarker in breast cancer (BC) screening. However, the differential efficacy of routine examination including ultrasound (US), mammogram (MG), magnetic resonance imaging (MR), and breast-specific gamma imaging (BSGI) and CTCs is unknown. This study aimed to combine CTCs with other BC screening imaging modalities to screen for cancer and enhance diagnostic potency in non-metastatic BC patients.
Methods

102 treatment-naive non-metastatic BC patients were enrolled in this study between December 2017 and November 2018. All these patients received CTC detection and at least one medical imaging examination. Correlations of CTC enumeration with patients’ clinicopathological characteristics and medical imaging examinations were evaluated.
Results

CTC detection rates (average CTC counts) in stage I-III BC patients were 92.9% (2.1), 87.2% (2.4) and 100% (4.2), respectively. CTCs counts were positively associated with cancer stage (p = 0.0084) and tumor size (p = 0.0301). CTCs counts were more correlated with US than MR, and showed least correlation with MG. CTCs counts were not associated with molecular subtypes of BC nor breast-specific gamma imaging (BSGI) results, indicating that CTC enumeration cannot be used to reflect molecular signatures of BC. When both cut-off values for CTCs and Breast Imaging-Reporting and Data System (BI-RADS) were used, false negative rates (FNR) of CTCs, US, MG and MR in BC detection in this study were 22.5%, 15.8%, 30.6% and 12.8%, respectively. Combination of CTC with US, MG or MR decreased FNR of BC detection to 7.9%, 8.3% and 5.8%, respectively. False negatives are more common in early stage patients, and in patients with smaller tumors.
Conclusion

CTCs counts can be used as a diagnostic aid in BC screening and early diagnosis. CTCs counts were more relevant to US than MR or MG. Conjugation of CTCs counts would improve the diagnostic potency of medical imaging examinations for BC detection, especially for MG in Chinese women.
Distribution of Medical Institutions in Cold Regions of China Based on Public Health Emergencies
Authors: Wu Yue , He Jun , Zhang Shanshan 
Published: June 2020

Abstract
Background: Recently, investments in the construction of medical resources have been increasing annually China, and consequently, the allocation of these resources has improved. However, the outbreak of covid-19 in 2020 highlights the problems in the distribution of medical institutions. After the occurrence of public health emergencies, the joint action of different levels of medical and health institutions can bring the role of urban medical and health system into full play. Therefore, after a global public health emergency, the study of medical institution distribution needs to be reconsidered.Methods: With the continuous application and development of GIS, the application of GIS in civil planning is relatively mature, and research investigating distribution has been conducted in depth. Based on this foundation, this paper analyzes the factors impacting distribution, such as the transportation system, land use characteristics and personal factors, by a weighted spatial separation model of a representative city in a cold region in China.Results: A weighted spatial separation model was built and applied to comprehensively consider several factors affecting accessibility, including the spatial coverage separation, the service areas separation, the road network separation, the population separation and the weather separation. To calculate the accessibility of medical institutions using a weighted spatial separation model, Harbin was chosen as a case study. The accessibility of medical institutions was analyzed.Conclusions: The accessibility of medical institutions in this representative cold city in China was comparatively analyzed in this paper through theoretical research, software computations/simulations and model analysis based on the GIS paradigm. This study will help optimize the layout of medical institutions and improve medical equality.Trial registration: An ethics review and approval for this study was not required according to the local legislation and institutional requirements.
The Impacts of Family Physician Plan and Health Transformation Plan on Hospitalization Rates in Iran: An Interrupted Time Series
Authors: Rouhani Samad , Esmaeili Reza , YazdaniCharati Jamshid , Khandehroo Masoud 
Published: June 2020

Abstract
Background : Low and middle income countries has recently implemented various reforms toward Universal Health Coverage (UHC). This study aims to assess the impact of Family Physician Plan (FPP) and Health Transformation Plan (HTP) on hospitalization rate in Iran.Methods: We conducted an Interrupted Time Series (ITS) design. The data was monthly hospitalization of Mazandaran province over a period of 7 years. Segmented regression analysis was applied in R version 3.6.1.Results: A decreasing trend by -0.056 for every month was found after implementation of Family Physician Plan, but this was not significant. Significant level change was appeared at the beginning of Health Transformation Plan and average of hospitalization rate increased by 1.04 (P<0.001). Also hospitalization trend increased significantly nearly 0.09 every month in period after Health Transformation Plan (P<0.001).Conclusions: Family physician created a decreasing trend for hospitalization. Development of FPP to urban area of Iran will lead to health system efficiency. HTP with lower user fee in public hospitals and clinics as well as fee-for-service mechanisms, stimulated both level and trend changes in hospital admissions. Some integrated health policy is required to optimize the implementation of diverse simultaneous reforms in low and middle-income countries.
Epidemic Trend of Corona Virus Disease 2019 (COVID-19) and Public Health Response in Senegal
Authors: Diop Boly , Faye Adama , Ndiaye El Hadj Mamadou , Ndiaye Mamadou , Diallo Jean Pierre , Diongue Fatou Bintou 
Published: June 2020

Abstract
Background: The first case of Covid-19 was notified in Senegal on March 2, 2020. One month after, this study aims to analyze the trend and the main measures that have been taken.Methods: Data sources are from the Department of Disease Prevention in Senegal and some administrative documents. The epidemic trend has been described through epidemic curves according to the characteristics of infected people.Results: Of the 195 patients tested positive for COVID-19, a proportion of 53.8% is female. Six out of 14 regions were affected by the epidemic on April 1, 2020. The mean age is 37.9 years with a standard deviation of 18.6 years. The proportion of imported cases is 39.5%. The major strategy in Senegal is based on the isolation of cases for treatment and tracking of contacts. Decisions have been made to limit spread of the virus through social distancing. Airlines have been closed and border control strengthened.Conclusions: The preparation and the measures taken made it possible to contain the pandemic during the first month. However, there is a need to strengthen the surveillance following the appearance of community-based cases and readjust strategies to hope to contain the pandemic during the second month.
Willingness to Pay for a for a Potential Vaccine Against SARS-CoV-2 / COVID-19 Among Adult Persons
Authors: Berghea Florian , Berghea Camelia Elena , Abobului Mihai , Vlad Violeta Maria 
Published: June 2020

Abstract
Background: This study aims to investigate willingness to pay for a potential vaccine against SARS-CoV-2 / COVID-19 among adult persons in Romania. The study was conducted during the peak period of the pandemic curve in Europe and Romania, too.Methods: An online survey was developed and delivered to Romanian general population by using two of the largest social networking web services (Facebook and LinkedIn). The questionnaire included demographic data, description of the responder’s financial situation and their willingness to pay for a hypothetical anti COVID-19 vaccine. The study was based on the Van Westendorp Price Sensitivity Meter method.Results: A total of 203 adult subjects participated in the survey; 42.4% male and 55,2% members of a family with at least one child. Mean participants’ age was 44.12 ± 8.9 (mean ± SD). The acceptable price range for a vaccine against SARS-CoV-2 / COVID-19 was situated between 20 and 200 EUR. Subgroup analyses revealed similar price range in all groups with the notable exception of those with excellent financial situation who selected a 50 to 400 EUR interval. These results match the existing optional various vaccination schemes offered in the private health care sector: 43.2 ± 32.1 EUR. Conclusions: Despite substantial social impact of SARS-CoV-2, potential patients would pay for a perfect vaccination scheme against COVID-19 a price in the same range with the prices of existing vaccination schemes. Our findings could impact the way a vaccination policy will be developed in this context both in terms of general acceptance of vaccine and personal and social costs.
Wearable Sensors Technology as a Tool for Discriminating Frailty Levels During Instrumented Gait Analysis
Authors: Apsega Andrius , Petrauskas Liudvikas , Alekna Vidmantas , Daunoraviciene Kristina , Sevcenko Viktorija , Mastaviciute Asta , Vitkus Dovydas , Tamulaitiene Marija , Griskevicius Julius 
Published: June 2020

Abstract
Background: One of the greatest challenges facing the healthcare of the aging population is frailty. There is growing scientific evidence that gait assessment using wearable sensors could be used for prefrailty and frailty screening. The purpose of this study was to examine the ability of a wearable sensor-based assessment of gait to discriminate between frailty levels (robust, prefrail, and frail).Methods: 133 participants (≥ 60 years) were recruited and frailty was assessed using the Fried criteria. Gait was assessed using wireless inertial sensors attached by straps on the thighs, shins, and feet. Between-group differences in frailty were assessed using analysis of variance. Associations between frailty and gait parameters was assessed using multinomial logistic models with frailty as the dependent variable. We used receiver operating characteristic (ROC) curves to calculate the area under the curve (AUC) to estimate the predictive validity of each parameter. The cut-off values were calculated based on the Youden index.Results: Frailty was identified in 37 (28%) participants, prefrailty in 66 (50%), and no Fried criteria were found in 30 (23%) participants. Gait speed, stance phase time, swing phase time, stride time, double support time, and cadence were able to discriminate frailty from robust, and prefrail from robust. Stride time (AUC = 0.915), stance phase (AUC = 0.923), and cadence (AUC = 0.930) were the most sensitive parameters to separate frail or prefrail from robust. Other gait parameters, such as double support, had poor sensitivity. We determined the value of stride time (1.19s), stance phase time (0.68s), and cadence (101 steps/min) to identify individuals with prefrailty or frailty with sufficient sensitivity and specificity.Conclusions: The results of our study show that gait analysis using wearable sensors could discriminate between frailty levels. We were able to identify several gait indicators apart from gait speed that distinguish frail or prefrail from robust with sufficient sensitivity and specificity. If improved and adapted for everyday use, gait assessment technologies could contribute to frailty screening and monitoring.
Meta-analysis of Genome-wide Association Study Identifies FBN2 as a Novel Locus Associated With Systemic Lupus Erythematosus in Thai Population
Authors: Tangtanatakul Pattarin , Thumarat Chisanu , Satproedprai Nusara , Kunhapan Punna , Chaiyasung Tassamonwan , Klinchanhom Siriwan , Wang Yong-Fei , Wei Wei , Wongshinsri Jeerapat , Chiewchengchol Direkrit , Rodsaward Pongsawat , Ngamjanyaporn Pintip , Suangtamai Thanitta , Mahasirimongkol Surakameth , Pisitkun Prapaporn , Hirankarn Nattiya 
Published: June 2020

Abstract
Background: Differences in the expression of variants across ethnic groups in the Systemic Lupus Erythematosus (SLE) patients have been well documented. However, the genetic architecture in the Thai population has not been thoroughly examined. In this study, we carried out genome-wide association study (GWAS) in Thai population.Methods: Two GWAS cohorts were independently collected and genotyped: discovery dataset (487 SLE cases and 1,606 healthy controls) and replication dataset (405 SLE cases and 1,590 unrelated-disease controls). Data were imputed to the density of the 1,000 Genomes Project Phase 3. Association studies were performed based on different genetic models, and pathway enrichment analysis was further examined. In addition, the performance of disease risk estimation for individuals in Thai GWAS was assessed based on the polygenic risk score (PRS) model trained by other Asian populations.Results: Previous findings on SLE susceptible alleles were well replicated in the two GWAS. The SNPs on HLA-class II (rs9270970, A>G, OR=1.82, p-value = 3.61E-26), STAT4 (rs7582694, C>G, OR=1.57, p-value = 8.21E-16), GTF2I (rs73366469, A>G, OR=1.73, p-value = 2.42E-11) and FAM167A-BLK allele (rs13277113, A>G, OR=0.68, p-value = 1.58E-09) were also significantly associated with SLE in Thai population. Meta-analysis of the two GWAS identified a novel locus at the FBN2 that was specifically associated with SLE in the Thai population (rs74989671, A>G, OR=1.54, p-value = 1.61E-08). Functional analysis showed that rs74989671 resided in a peak of H3K36me3 derived from CD14+ monocytes and H3K4me1 from T-lymphocytes. In addition, we showed that the PRS model trained from the Chinese population could be applied in individuals of Thai ancestry, with the area under the receiver-operator curve (AUC) achieving 0.76 for this predictor.Conclusions: We demonstrated the genetic architecture of SLE in the Thai population and identified a novel locus associated with SLE. Also, our study suggested a potential use of the PRS model from Chinese population to estimate the disease risk for individuals of Thai ancestry.