bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Burden of Laboratory-confirmed Influenza Infection in Lebanon Between 2008 and 2016: A single tertiary care center experience
Authors: Assaf-Casals Aia , Saleh Zeina , Khafaja Sarah , Fayad Danielle , Ezzeddine Hady , Saleh Mohammad , Chamseddine Sarah , Sayegh Rouba , Sharara Sima , Chmaisse Ahmad , Kanj Souha , Kanafani Zeina , Hanna-Wakim Rima , Araj George , Mahfouz Rami , Saito Reiko , Suzuki Hiroshi , Zaraket Hassan , Dbaibo Ghassan 
Published: April 2020

Abstract
BACKGROUND: Influenza is a major cause of morbidity and mortality worldwide. Following the 2009 pandemic, there was widened interest in studying influenza burden in all regions. However, since data from the World Health Organization (WHO) Middle East and North Africa (MENA) region remain limited, we aimed to contribute to the understanding of influenza burden in Lebanon. METHODS: A retrospective chart review extending over a period of 8 seasons from Jan 1st, 2008 till June 30 th , 2016 at a tertiary care center in Beirut was performed. All cases confirmed to have influenza based on rapid antigen detection or/and polymerase chain reaction on a respiratory sample were included for analysis. Data on epidemiology, clinical presentation, complications, antiviral use and mortality were collected for analysis. RESULTS: A total of 1829 cases of laboratory-confirmed influenza were identified. Average annual positivity rate was 14% (positive tests over total requested). Both influenza A and B co-circulated in each season with predominance of influenza A. Influenza virus started circulating in December and peaked in January and February. The age group of 19-50 years accounted for the largest proportion of cases (22.5%) followed by the age group of 5-19 years (18%). Pneumonia was the most common complication reported in 33% of cases. Mortality reached 3.8%. The two extremes of age (<2 years and ≥ 65years) were associated with a more severe course of disease, hospitalization, intensive care unit (ICU) admission, complications, and mortality rate. Of all the identified cases, 26% were hospitalized. Moderate-to-severe disease was more likely in influenza B cases but no difference in mortality was reported between the two types. Antivirals were prescribed in 68.8% and antibiotics in 41% of cases. There seemed to be an increasing trend in the number of diagnosed and hospitalized cases over the years of the study. CONCLUSION: Patients with laboratory-confirmed influenza at our center had a high rate of hospitalization and mortality. A population based prospective surveillance study is needed to better estimate the burden of Influenza in Lebanon that would help formulate a policy on influenza control.
Prognostic Value of Sarcopenia in Patients Treated by Radiochemotherapy for Locally Advanced Oesophageal Cancer
Authors: Mallet Romain , Modzelewski Romain , Lequesne Justine , New Sorina Dana Mihailescu , Decazes Pierre , Auvray Hugues , Benyoucef Ahmed , Fiore Frederic Di , Vera Pierre , Dubray Bernard , THUREAU SEBASTIEN 
Published: April 2020

Abstract
Background: Sarcopenia is defined by a loss of skeletal muscle mass with or without loss of fat mass. Sarcopenia has been associated to reduced tolerance to treatment and worse prognosis in cancer patients, including patients undergoing surgery for limited oesophageal cancer. Concomitant chemo-radiotherapy is the standard treatment for locally-advanced tumour, not accessible to surgical resection. Using automated delineation of the skeletal muscle, we have investigated the prognostic value of sarcopenia in locally advanced oesophageal cancer (LAOC) patients treated by curative-intent chemo-radiotherapy.Methods: The clinical, nutritional, anthropometric, and functional-imaging (18FDG-PET/CT) data were collected in 97 patients treated between 2006 and 2012 in our institution. The skeletal muscle area was automatically delineated on cross-sectional CT images acquired at the 3rd. lumbar vertebra level and divided by the patient’s squared height (SML3/h²) to obtain the Skeletal Muscle Index (SMI). The primary endpoint was overall survival probability.Results: Seventy-six deaths were reported. The median survival time was 27 [95% Confidence Interval 23 – 40] months for the whole population. Univariate analyses (Cox Proportional Hazard Model) showed decreased survival probabilities in patients with reduced SMI, WHO >0, Body Mass Index ≤21, and Nutritional Risk Index ≤97.5. Multivariate analyses showed that sarcopenia was the only significant prognostic factor (HR 2.32 [1.24-4.34], p=0.008). Using Receiver Operating Characteristics curves, the Area Under the Curve (AUC) was 0.73 in males (p=0.0002], the optimal threshold being 51.5 cm²/m². In women, the AUC was 0.65 (p=0.19).Conclusion: Sarcopenia is a powerful independent prognostic factor, associated with a rise of the overall mortality in patients treated exclusively by radiochemotherapy for a locally advanced oesophageal cancer. L3 CT images are easily gathered from 18FDG-PET/CT acquisitions
Sex differences in the trajectories of and factors related to extracurricular exercise: A cohort study spanning 13 years
Authors: Wu Wen-chi , Chang Ling-Yin , Luh Dih-Ling , Wu Chi-Chen , Stanaway Fiona , Yen Lee-Lan , Chang Hsing-Yi 
Published: April 2020

Abstract
Background Extracurricular exercise (ECE) refers to regular exercise/sports participation in addition to the normal physical exercise education in school among a school-aged population. Rather than general physical activity, ECE is typically deliberately initiated and presents an efficient target for interventions. However, relatively few studies have investigated sex differences in the development of ECE from childhood to emerging adulthood. This study aimed to examine the latent trajectories of ECE from childhood to emerging adulthood across sexes and to identify the associated sex-specific individual (i.e., body mass index, body dissatisfaction, stress, and screen behavior) and parental factors (i.e., parental exercise and parental screen behavior). Methods This study used data from part of the Child and Adolescent Behavior in Long-term Evolution (CABLE) project, which comprised 2,072 fourth graders (aged 9 years) in Northern Taiwan followed from 2001 to 2013. Repeated-measures latent class analysis was used to identify the trajectories of ECE for males and females, respectively. Multinomial logistic regression was further used to identify sex-specific factors related to ECE after controlling for the parental education level, family monthly income, and parental marital status. Results Four trajectories of ECE were identified for males and females. For males, these trajectories were Rarely-to-Never, Often-to-Rarely, Always-to-Never, and Always. For females, these trajectories were Rarely-to-Never, Rarely, Always-to-Rarely, and Always. We observed that the developmental patterns of ECE varied by sex such that there was an earlier decline in the trajectories of ECE in females than in males and that, compared with males, fewer females maintained exercise habits in young adulthood. Furthermore, we found several sex-specific factors related to ECE, namely, stress, BMI, and parental exercise. Body dissatisfaction and individual screen behavior were associated with trajectories of ECE for both sexes. Conclusions We found distinct trajectories of ECE from childhood to emerging adulthood for both sexes. The trajectories of ECE for males and females, however, differ in terms of patterns and associated factors. Our findings suggest that efforts to increase ECE should be initiated early and may be made more effective by considering sex differences.
Antibiotic-impregnated bone graft decreases time to CRP normalization in pyogenic discitis with vertebral osteomyelitis
Authors: Chang Hsiao-Kang , Lu Meng-Ling , Wegner Adam , Wu Re-Wen , Chen Sung-Hsiung , Hsu Chieh-Cheng , Chen Hou-Tsung , Yin Tsung-Cheng 
Published: April 2020

Abstract
Introduction Surgical treatment of pyogenic discitis with vertebral osteomyelitis (PDVO) is indicated for neurologic deficit, spinal instability, unknown pathogen, poorly controlled infection, or intractable pain. Although the posterior-only approach has been proved a safe, effective procedure that minimizes the risks and complications of anterior or staged surgery, parenteral antibiotic treatment for 4-6 weeks postoperatively is still necessary. We hypothesized that antibiotic-impregnated bone graft used in an all posterior approach could result in infection control and shorten the postoperative course of pyogenic discitis and vertebral osteomyelitis. Patients and Methods 21 consecutive patients with pyogenic discitis and vertebral osteomyelitis of the lumbar or thoracic spine were treated with transforaminal interbody debridement and fusion (TIDF) with antibiotic-impregnated bone graft (AIBG) between March 2014 and January 2017. Minimum follow up was 2 years. Outcomes included visual analog scale (VAS) back pain, ASIA scale for neurological status, kyphotic angle correction, fusion status, and functional outcome using Kirkaldy-Willis criteria, and c-reactive protein (CRP) levels. CRP levels from pre-op, immediately post-op, and 1, 2, 4 & 6 wks post operatively and the duration of treatment with postoperative IV antibiotics in our patients was compared to our previous case series in which TIDF was performed without AIBG. Results Surgical treatment for PDVO resulted in clinical improvement and adequate infection control. There was no difference in pre-op CRP levels between the two groups. Despite shorter post-op IV antibiotic duration (Mean 21.0 d vs 39.8 d), the AIBG group had a stable decline in CRP levels and continued to decrease at 1, 2, 4 & 6 wks, with significantly lower CRP levels at 6 weeks compared to bone graft without antibiotics. VAS scores improved from a mean of 7.2 to 2.3 one month postoperatively. Patients who had increased kyphotic angles had an average angle correction of 7.9° at last follow-up. Eighty-one percent of patients (17/21) had good to excellent functional outcomes. Conclusion TIDF combined with AIBG can achieve local infection control with faster reduction in CRP, leading to shorter antibiotic duration for pyogenic discitis and vertebral osteomyelitis
Glioma patients in outpatient care - Optimization of psychosocial care in neuro-oncological patients (GLIOPT): Protocol for a cluster randomized controlled trial.
Authors: Renovanz Mirjam , Hippler Melina , Voss Martin , Wehinger Jens , Keßler Almuth F. , Gempt Jens , Nadji-Ohl Minou , Lucas Carolin Weiß , Rapp Marion , Misch Martin , Coburger Jan , Mehlitz Marcus , Meixensberger Jürgen , Keric Naureen , Tabatabai Ghazaleh , Blettner Maria , Schranz Melanie , Singer Susanne 
Published: April 2020

Abstract
Background: Patients with high-grade gliomas (HGG) often suffer from high distress and require psychosocial support. However, due to neurological and neurocognitive deficits, adequate assessment of distress and support needs remains a challenging unmet clinical need. The objective of the present study is to investigate whether a systematic implementation of signaling questions into the routine outpatient consultation will be helpful to bridge this gap.Methods and design:This is a multicenter cluster randomized study with two arms. Randomization is done on a cluster level with 13 hospitals providing regular neuro-oncological outpatient services conducted by neurologists and/or neurosurgeons. The intervention will include an assessment of psychosocial distress of patients in doctor-patient-conversation compared to assessment of psychosocial distress via questionnaire (control, standard of care). In total, 616 HGG patients will be enrolled. The outcome will be the number of HGG patients with increased psychosocial distress who receive professional support from psychosocial services. Secondary endpoints are inter alia number of patients reporting psychosocial distress and unmet needs detected correctly by the respective method; quality of life; psychological well-being and burden of the patients before and after doctor-patient consultation as well as the length of the doctor-patient-consultation. Discussion: Patients with HGG are confronted with an oncological diagnosis and at the same time with high symptom burden. This often leads to distress, which is not always adequately recognized and treated. So far, only a limited number of adequate instruments are available to assess HGG patient's distress. Yet, an adequate care and support network might facilitate the course of the disease and tumor therapies for patients. Our hypothesis is that an assessment conducted directly by attending doctors and in which the doctors talk to patients with HGG will be more effective than an assessment via a questionnaire, leading to better identifying patients in need for support. This may lead to an improvement of health care in these patients. Further, this method might be implemented also in other brain tumor patients (e.g. patients with brain metastases).Trial registration: Register: German Clinical Trials Register, registration number: DRKS00018079Registration date: 3rd September 2019, URL: http://www.drks.de/DRKS00018079
Seasonal ecophysiological responses and behavior of phillyrea latifoliaspecie to climate change in Tunisia
Authors: Nefzi Khaoula , Mokhtar Baraket , Herzi Maroua , Nasr Zouhair 
Published: April 2020

Abstract
Background

As part of global climate change, variation in precipitation in arid ecosystems is leading to plant adaptation in water-use strategies; significant interspecific differences in ecophysiological response will change the plant behavior. The mainaim of this study was to investigate the ecophysiological responses of Phillyrea latifolia species to seasonal drought stress. Measurements were conducted between March and December 2018. The parameters studied were the Leaf Water Potential (ψ leaf ), Net photosynthesis (Pn), stomatal conductance (gs) and leaf transpiration (Tr), maximum efficiency of PSII photochemistry (Fv/ Fm), and Hydraulic conductivity.

Main results

The results showed that all measured parameters varied significantly with the season(P <.0001). The results of ψ leaf showed the highest average in summer (−2.99±0.08 MPa). Likewise, the highest values of the maximal photochemical efficiency of PSII (Fv/Fm) were observed in summer (0.83±0.06). However, the highest values of Pn (3.62±0.41 µmol m -2 s -1 )and Tr (0.3±0.028 µmol m -2 s -1 ) were noted in autumn. The Initial Hydraulic Conductivity ( K in ) value was in spring (1.34 -04 ±110 -5 mmol s -1 m -2 MPa -1 ) and autumn (1.1810 -04 ±2.3010 -6 mmol s -1 m -2 MPa -1 ) and the Maximal Hydraulic Conductivity ( K max ) was the highest during the spring season (3.4510 -04 ±2.7010 -11 mmol s -1 m -2 MPa -1 ). The results of the Stomatal Conductance (gs)were showed that the lowest values were recorded in summer (0.19±0.04 MPa). The percentage of loss conductivity (PLC) reached 66%. During the spring season, the soil had a decreasing moisture profile as it moved to the depths and varied from 15.23±5.48% at 20cm to 6.26±2.46% at 80 cm.

Conclusions

The best physiological performances of Phillyrea latifolia reported in spring and autumn may be attributed to favorable environmental conditions. The answers depend not only on the specie but also on the climates in which they grow.
Analysing the performance of health systems in Asian countries: What Myanmar can learn from Bangladesh and Vietnam
Authors: Löfgren Curt , Win Zin Mar 
Published: April 2020

Abstract
Background Advancements in medicine leads, among other things, to increasing life expectancy. However, at the same time, health care costs are increasing, and this may not be sustainable in the future. Governments and health care organizations need to implement efficiency measures in order to maximize health outcomes within available resources. This study aims to compare the technical efficiency of health systems in Asian countries, and to identify “efficient peers” for each “inefficient country”: in particular, for Myanmar. Methods A DEA variable returns to scale output-oriented model was used to evaluate technical efficiency in thirteen Asian countries. The input variables were current health expenditure per capita, the density of doctors, and the density of nurses and midwifery personnel. Two output variables, health adjusted life expectancy (HALE) and the infant mortality rate were (IMR) analysed separately. Myanmar may learn how to improve efficiency of its health care system through studying its efficient peers from DEA results. A review of relevant English language literature was used as a basis for informing a comparative analysis of the health systems of Myanmar and its efficient peers, Bangladesh and Vietnam. Results Among the thirteen Asian countries studied, 38.5% and 53.8% of countries were technically efficient when HALE and IMR were used as the measured output respectively. More countries were efficient at reducing IMR than increasing HALE. Myanmar is one of the most inefficient countries, and it should look at the health systems of its efficient peers, Bangladesh and Vietnam, to make its health system technically more efficient. Conclusions The results of this study suggested that countries with inefficient health systems can improve their health outcomes without increasing their health care resources. As DEA measures efficiency only, future studies should take into account equity to assess comprehensive health system performance.
Impact of Ambient Temperature on Inflammation-induced Encephalopathy in Endotoxemic Mice—Role of Phosphoinositide 3-Kinase Gamma
Authors: Lang Guang-Ping , Ndongson-Dongmo Bernadin , Lajqi Trim , Brodhun Michael , Han Yingying , Wetzker Reinhard , Frasch Martin G. , Bauer Reinhard 
Published: April 2020

Abstract
Background: Sepsis-associated encephalopathy (SAE) is an early and frequent event of infection-induced systemic inflammatory response syndrome. Phosphoinositide 3-kinase γ (PI3Kγ) is linked to neuroinflammation and inflammation-related microglial activity. In homeotherms, variations in ambient temperature (Ta) outside the thermoneutral zone lead to thermoregulatory responses, mainly driven by a gradually increasing sympathetic activity, and may affect disease severity. We hypothesized that thermoregulatory response to hypothermia (reduced Ta) aggravates SAE in PI3Kγ-dependent manner.Methods: Experiments were performed in wild-type, PI3Kγ knockout, and PI3Kγ kinase-dead mice, which were kept at neutral (30±0.5°C) or moderately lowered (26±0.5°C) Ta. Mice were exposed to lipopolysaccharide (LPS, 10 μg/g, from Escherichia coli serotype 055:B5, single intraperitoneal injection) - evoked systemic inflammatory response (SIR) and monitored 24 hours for thermoregulatory response and blood–brain barrier integrity. Primary microglial cells and brain tissue derived from treated mice were analyzed for inflammatory responses and related cell functions. Comparisons between groups were made with one-way or two-way analysis of variance, as appropriate. Post hoc comparisons were made with the Holm–Sidak test or t-tests with Bonferroni’s correction for adjustments of multiple comparisons. Data not following normal distribution was tested with Kruskal-Wallis test followed by Dunn’s multiple comparisons test.Results: We show that a moderate reduction of ambient temperature triggers enhanced hypothermia of mice undergoing LPS-induced systemic inflammation by aggravated SAE. PI3Kγ deficiency enhances blood–brain barrier injury and upregulation of matrix metalloproteinases (MMPs) as well as an impaired microglial phagocytic activity.Conclusions: Thermoregulatory adaptation in response to ambient temperatures below the thermoneutral range exacerbates LPS-induced blood–brain barrier injury and neuroinflammation. PI3Kγ serves a protective role in suppressing release of MMPs, maintaining microglial motility and reinforcing phagocytosis leading to improved brain tissue integrity. Thus, preclinical research targeting severe brain inflammation responses is seriously biased when basic physiological prerequisites of mammal species such as preferred ambient temperature are ignored.
Analyzing the Effects of Temperature and Human Movement on Malaria Disease Transmission Dynamics
Authors: Phaijoo Ganga Ram 
Published: April 2020

Abstract
Background: Malaria disease is transmitted by the bite of Anopheles mosquitoes. Plasmodium parasites are responsible for the disease. Due to human movement from one place to the other, vector borne diseases like malaria are spreading rapidly throughout the world. They have become major causes of morbidity and mortality worldwide. Changing temperature levels has significant impact on the life cycle, biting behavior and death rates of the mosquitoes which can transmit the disease.Methods: A multi patch SEIRS - SEI deterministic compartmental model for malaria disease is developed to study the disease transmission dynamics. The impact of temperature and human movement in transmission dynamics is investigated. Both global and local basic reproduction numbers are computed for two patches in two patch setting.Results: Disease free equilibrium is locally stable when the basic reproduction number is less than unity and unstable when the number is greater than unity. Numerical results show that the prevalence of the disease changes with the change in human movement rates between the patches; temperature affects the transmission dynamics of malaria disease.Conclusion: The burden of malaria disease can be reduced by managing the host movement between low and high disease prevalent patches. The optimal temperature for malaria disease transmission is 25 °C.
Combination of green tea catechins, polysaccharides, and flavonols against urban fine dust particle-induced bronchial damage mediated by modulation of inflammation factors and airway cilia
Authors: Kim Juewon , Choi Hyunjung , Choi Dong-Hwa , Park Kyuhee , Kim Hyung-June , Park Miyoung 
Published: April 2020

Abstract
Background

Many studies have reported that environmental pollution has become a serious public health issue. Airborne fine dust particles (FDPs) have been identified as major toxins in air pollution that threaten human respiratory health. Developing strategies for defense against FDPs is one of the primary goals of air pollution research.

Results

While searching for an anti-FDP reagent, we found that green tea extract (GTE) and green tea fractions rich in flavonol glycosides (FLGs) and crude green tea polysaccharides (CTPs) had protective effects against FDP-stimulated cellular damage in the BEAS-2B airway epithelial cell line. The results demonstrated that GTE, FLGs, and CTPs significantly increased viability and lowered oxidative stress levels in FDP-treated cells. Major catechin and flavonol compounds increased cell survival, and (-)-epigallocatechin gallate (EGCG) and myricetin exerted synergistic effects on cell survival under FDP stimulation. Combined treatment with GTE, FLGs, and CTPs also exerted synergistic protective effects on cells, and the green tea components attenuated FDP-induced elevations in inflammatory gene expression. Moreover, the green tea components increased the proportion of ciliated cells and upregulated ciliogenesis in the airway in FDP-stimulated BEAS-2B cells.

Conclusions

Our findings provide insights into how natural phytochemicals protect the airway and suggest that green tea could be used to reduce FDP-induced airway damage as an individual therapeutic agent or as an ingredient in pharmaceutical and cosmeceutical products.