bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multidisciplinary Approach in COVID-19 Pneumonia: A Backward Path by an Expert Team
Authors: Calabrese Fiorella , Pezzuto Federica , Giraudo Chiara , Vedovelli Luca , Fortarezza Francesco , Vecchio Claudia del , Lunardi Francesca , Fraia Anna Sara , Cocconcelli Elisabetta , Vuljan Stefania Edith , Gregori Dario , Crisanti Andrea , Balestro Elisabetta , Spagnolo Paolo 
Published: December 2020

Abstract
Background: The novel coronavirus disease 2019 (COVID-19) represents a medical challenge worldwide. COVID-19 pneumonia is an extremely complex disease. The hypothesis of the study was that a multidisciplinary approach involving experienced specialists in diffuse parenchymal lung disease might improve the diagnosis of patients with COVID-19 pneumonia.Methods: Two pulmonologists, two radiologists, and two pathologists reviewed 27 patients who died of severe COVID-19 pneumonia as the main diagnosis made by non-pulmonologists. To evaluate whether the contribution of specialists, individually and/or in combination, might modify the original diagnosis, a three-step virtual process was planned. Pulmonologists, radiologists and pathologists were asked to classify every case into four distinct levels of diagnostic certainty, based on clinical, radiological, and morphological/virologic data obtained from an autoptic lung sample, respectively. The whole lung examination was considered the gold standard for the final diagnosis. The probability of a correct diagnosis was calculated, and the effectiveness of a multidisciplinary diagnosis was obtained by comparing diagnoses made by experienced pulmonologists with those made by non-pulmonologists. Results: COVID-19 pneumonia was excluded in 2 cases (8%) and was a marginal feature in 3 cases (11%). The probability of a correct diagnosis increased strikingly from an undedicated clinician to an expert specialist, becoming progressively more accurate at different steps. Every single specialist made significantly more correct diagnoses than any non-pulmonologist. The highest level of accuracy was achieved by the combination of 3 expert specialists.Conclusions: In summary, the dynamic interaction between expert specialists significantly improves the diagnostic confidence and management of patients with COVID-19 pneumonia.
Measuring Energy Availability and Energy Conservation in Endurance Athletes in the Pre-Race Period
Authors: Jurov Iva , Keay Nicola , Hadžić Vedran , Spudić Darjan , Rauter Samo 
Published: December 2020

Abstract
Background: Low energy availability in male athletes has gained a lot of attention in the last years, but direct evidence of its effects on health and performance is lacking. Aim of this research was to objectively measure energy availability (EA) in healthy male endurance athletes without pre-existing relative energy deficiency signs during pre-race season. Methods: 12 trained endurance athletes (performance level 3, 4 and 5) participated in the cross-sectional controlled laboratory study. Fat free mass, exercise energy expenditure and energy intake were measured to calculate EA. Resting energy expenditure was measured and estimated to assess energy conservation. Three specific performance tests were used to assess endurance, agility and explosive strength performance. For psychological evaluation, the Three Factor Eating Questionnaire and a short Well-being questionnaire were completed.Results: Mean EA was 29.5 kcal/kg FFM/day. The majority (66.6%) had EA under the threshold for low EA in females. Critical cognitive restriction (≥13) was reported by 75% of participants. There were no differences in performance, blood values or psychological evaluation when subjects were divided into two groups divided by EA=30kcal/kg FFM/day. Cognitive restriction was negatively associated with measured resting energy expenditure and energy conservation (r=-.578, p=.025 and r=-.549, p=.032, respectively).Conclusions: The mean EA measured in this study supports the theory that the threshold for low EA in endurance male athletes might be under the threshold for females. In addition, we confirmed cognitive restriction could be useful for early detection of energy conservation. The high cognitive restriction as measured in our sample stressed the need of eating behavior screening in endurance athletes in order to reduce risk of any disordered eating patterns.
Farmers’ Perceptions of Navy Bean (Phaseolus Vulgaris L.) Production Constraints, Preferred Traits, Farming Systems and Their Implications on Bean Breeding:&nbsp;A Case Study from South East Lowveld Region of Zimbabwe
Authors: Mutari Bruce , Sibiya Julia , Nchanji Eileen Bongweh , Simango Kennedy , Gasura Edmore 
Published: December 2020

Abstract
Background: Navy bean is an important legume crop in Zimbabwe. Its production is limited by multiple constraints including biotic, abiotic and socio-economic. However, there is no documented participatory research on production status, biotic stress management strategies, farmers’ perceived production, and marketing constraints, and cultivar trait preferences among the major navy bean growing regions. Thus, this study aimed at identifying farmers’ production constraints, preferred traits and cultivars of navy bean, and strategies used to mitigate some of these constraints.Methods: A Participatory Rural Appraisal approach involving transect walks, focus group discussions (FGDs), and formal surveys with semi-structured questionnaires was conducted in four villages of the Lowveld region of Zimbabwe. In each of the four villages, two FGDs (one for men and one for women) were conducted. A total of 176 (75 males and 101 females) navy bean growing households were interviewed. Data from household interviews and FGDs was analysed using the Statistical Package for Social Scientists computer package.Results: The most important constraints to navy bean production were drought stress (Females – 86 %, Males – 73 %), heat stress (Females – 58 %, Males – 55 %), load shedding (Females – 46 %, Males – 54 %), poor soil fertility (Females – 32 %; Males – 33 %) and susceptibility to pod shattering (Females – 32 %, Males – 43 %). Mitigation strategies included mulching (18 %), ridges (12 %), reduced acreage (11 %), and cultivating to retain more soil moisture (11 %) for drought stress, while irrigating at night (32 %), and adjusting planting dates (29 %) were used to manage heat stress. Farmer-preferred traits included tolerance to drought and heat, early maturing varieties and disease resistance. Marketing constraints included non-payment for produce in hard currency, lack of diversity in terms of off-takers, high inflation, low grain producer price, delayed payment and breach of contract by contractors. Conclusion: There will be increased adoption of improved navy bean cultivars if breeding programs address the aforementioned constraints and consider farmer-preferred traits when developing new cultivars. Breeders should work closely with extension officers to ensure that cultivars released are cultivated with appropriate agronomic packages for increased productivity and high adoption.
Clinical Impact of Abdominal Versus Mediastinal Metastases as a Prognostic Factor for Poor Outcomes Following Esophageal Cancer Surgery: A Retrospective Study
Authors: Miyawaki Yutaka , Sato Hiroshi , Oya Shuichiro , Sugita Hirofumi , Hirano Yasumitsu , Sakuramoto Shinichi , Okamoto Kojun , Yamaguchi Shigeki , Koyama Isamu 
Published: December 2020

Abstract
BackgroundSurgery is still the mainstay of radical treatment for resectable esophageal cancer (EC). It is apparent that the presence or spread of lymph node metastasis is a powerful prognostic factor in patients with EC who are eligible for curative treatment. Although the importance and efficacy of lymph node dissection in radical esophagectomy have been reported, the clinical or prognostic relevance of specific metastatic patterns within the mediastinal cavity and abdomen remains unclear. MethodsWe retrospectively analyzed the association between postoperative survival with clinical mediastinal lymph node metastases (cMLNMs) and abdominal lymph node metastases (cALNMs) in 143 patients who underwent radical EC surgery at our hospital between May 2012 and July 2017.ResultsA significant difference in cause-specific survival (CSS) was observed between patients with and without cALNM (log-rank p=0.000). A multivariate Cox regression analysis revealed that cALNM and thoracic surgery (mediastinal lymphadenectomy via conventional open right thoracotomy or video-assisted thoracoscopic surgery) independently predicted CSS (p=0.001 and 0.037, respectively). Moreover, a significant difference in systemic recurrence-free survival was observed between those with and without cALNM (log-rank p=0.000). Multivariate Cox regression analysis revealed that cALNM and sex independently predicted systemic recurrence-free survival (p=0.005 and 0.013, respectively). ConclusioncALNM was an independent poor prognostic factor for CSS after EC surgery. It may also be an independent prognostic factor for postoperative systemic recurrence, which can shorten CSS. For patients with cALNM-positive EC who have a high potential risk of systemic metastases, more extensive treatment besides the conventional perioperative systemic chemotherapy may be necessary.
Communication Link Model Using Trellis Coded Modulation for 5G Communication in the Tropical Regions
Authors: Patra Trilochan , Mitra Swarup Kumar 
Published: December 2020

Abstract
Signal fading is a major problem in the tropical regions. Here the signals get highly attenuated for torrential rain, hence the signal power diminishes and the bit error rate (BER) increases. To enhance the signal to noise ratio (SNR) or to minimize the BER a communication link model using trellis coded modulation (TCM) for 5G communication has been proposed in this paper for the tropical regions. Various diversity techniques have been applied to minimize BER in the tropical regions. STBC (Space-Time Block Coding) MIMO technique is a spatial diversity technique which has been used in the proposed model in this paper. Bit error rate values are obtained for MIMO multi path fading distributions viz. Rayleigh fading distribution and Rician fading distribution. BER values are also attained in respect of different MIMO techniques (2x2, 3x3 and 4x4). The 4x4 STBC MIMO System has been generated using hardware co-simulation block and the results are implemented in Xilinx kintex-7 FPGA board. From the analysis of the result it is observed that Rayleigh fading distribution reflects better performance than that of Rician fading distribution. 4x4 MIMO Technique renders better result in comparison with that of lower MIMO techniques.
Quality of Life after Total Parathyroidectomy in Patients with Secondary Hyperparathyroidism
Authors: XU JIA , Zhou DongS , Fu RongZ , Wang YuL 
Published: December 2020

Abstract
Background. Patients with end-stage renal disease (ESRD) have a decreased quality of life (QoL), which is attributable in part to secondary hyperparathyroidism (SHPT). Surgery is the definitive treatment for SHPT. The aim of this study is to assess the effect of total parathyroidectomy (PTX) with deltoid autotransplantation on QoL.Methods: A total of 201 ESRD patients with SHPT were enrolled. The operation efficacy was evaluated by analyzing preoperative and postoperative values, including the levels of intact parathyroid hormone (PTH), serum phosphorus, serum calcium, alkaline phosphatase (ALP) and calcium-phosphorus product. The QoL was evaluated by scores on the Medical Outcomes Study 36-item short-form (SF-36) health survey preoperatively and 6 months postoperatively.Results: Compared with preoperatively, postoperatively, the levels of iPTH (2033 pg/ml vs 62.5 pg/ml), serum phosphorus (2.30 mg/dl vs 1.60 mg/dl), serum calcium (3.62 mg/dl vs 1.84 mg/dl), and calcium-phosphorus product were all decreased. Variations in the number and anatomic location of thyroid glands were found in the patients. QoL improved significantly in all 8 individual and 2 component summary scales, with a more significant decrease in the physical health scales.Conclusion: PTX significantly improves QoL in patients with SHPT.
Effect of Combined G6PD Deficiency and Diabetes on Protein Oxidation and Lipid Peroxidation.
Authors: Karadsheh Naif S , Quttaineh Nisreen A. , Karadsheh Salem N. , El-Khateeb Mohammad 
Published: December 2020

Abstract
Oxidative Stress, an imbalance in the pro oxidant / antioxidant homeostasis occurs by a large number of physiological and nonphysiological processes and in several human diseases including diabetes.The use of protein carbony protein (PC) and malanodialdehyde (MDA) as biomarkers of oxidative stress are the most widely measured markers for protein and lipid oxidation. These are measured by spectrophotometric assay. the aim of the study is to measure the effect of G6PD – deficiency on the oxidative markers and the antioxidant GSH in diabetic and non diabetic individuals because of the high incidence of G6PD – deficiency in Jordan and many parts of the worldThe results show that diabetes and/or G6PD deficiency are positively connected to protein and lipid oxidation. The effect is additive in protein oxidation when both disorders are present. The antioxidant, GSH level, is not affected by diabetes but reduced to 50% by G6PD deficiency.
Long-term Outcomes of Adding Alpha-glucosidase Inhibitors in Insulin-treated Patients with type 2 Diabetes
Authors: Yen Fu-Shun , Wei James Cheng-Chung , Lin Mei-Chen , Hsu Chih-Cheng , Hwu Chii-Min 
Published: December 2020

Abstract
Background: In insulin-treated patients with type 2 diabetes mellitus (T2DM), glycemic control is usually suboptimal. Methods: This study compared the risks of mortality and cardiovascular events in insulin-treated patients adding or not adding alpha-glucosidase inhibitors (AGIs). Results: This cohort study included data from the Taiwan National Health Insurance Research Database. In total, 17,417 patients newly diagnosed as having T2DM and undergoing insulin therapy during 2000–2012 were enrolled. Overall incidence rates of all-cause mortality, hospitalized coronary artery disease (CAD), stroke, and heart failure were compared between 4165 AGI users and 4165 matched nonusers. The incidence rates of all-cause mortality were 17.10 and 19.61 per 1000 person-years in AGI nonusers and users, respectively. Compared with nonusers, AGI users had a higher mortality risk [adjusted hazard ratio (aHR) = 1.21, 95% confidence interval (CI) = 1.05–1.40; p = 0.01]. Regarding AGI use, aHRs (95% CI) for cardiovascular death, non-cardiovascular death, hospitalized CAD, stroke, and heart failure were 1.20 (0.83–1.74), 1.27 (1.07–1.50), 1.12 (0.95–1.31), 0.98 (0.85–1.14), and 1.03 (0.87–1.22) respectively. Conclusion: AGI use was associated with higher risks of all-cause mortality and non-cardiovascular death in insulin-treated patients with T2DM. Therefore, adding AGIs in insulin-treated patients may not be appropriate.
A Prognostic Model for the Overall Survival of Patients with Ewing's Sarcoma
Authors: Feng Xiaofei , Ma Yao , Lei Hai , Wang Wenji 
Published: December 2020

Abstract
Background: Ewing's sarcoma (ES) is the second most common primary malignant bone tumor. Although the disease has been studied on a molecular basis, its prognosis has not improved. Therefore, the goal of this study is to screen effective biomarkers for predicting the prognosis and progression of ES.Methods: In this study, the gene expression profile of Ewing's sarcoma was downloaded from public databases. Candidate genes were screened by two methods of weighted gene co-expression network analysis (WGCNA) and differential genes expression analysis, and the Hub gene were determined by the protein–protein interaction (PPI) network. The univariate cox regression and least absolute shrinkage and the selection operator (LASSO) Cox regression were performed on the Hub gene to construct a prognostic model. The receiver operating characteristic (ROC) curve tests the predictive power of the prognostic model. Use the clinical data in the International Cancer Genome Consortium (ICGC) database for verification. Finally, Gene Set Enrichment Analysis (GSEA) was performed to obtain the biological role of prognostic genes in ES.Results: A total of 542 differentially expressed genes（DEGs） were obtained. Through WGCNA, the obtained turquoise module is significantly related to ES. PPI network analysis of candidate genes identified 10 Hub genes. The univariate cox regression results showed that CACNB1, IDH2, ATP1B4, PRKAG3, STAC3 are risk factors affecting the prognosis of ES. A prognostic model was constructed using IDH2 and PRKAG3, and patients were divided into two risk groups. The survival time of patients in the high-risk group was significantly shorter than that in the low-risk group. The ROC curve confirms that this model has certain accuracy. IGCG cohort verification yielded consistent results. GSEA results showed that IDH2 in the development of ES may promote the progression of the disease through G2M CHECKPOINT, GLYCOLYSIS, MITOTIC SPINDLE, MTORC1 SIGNALING, PEROXISOME, PI3K-AKT-MTOR SIGNALING pathways, while PRKAG3 through MYOGENESIS pathway.Conclusions: This study shows that IDH2 and PRKAG3 may play important roles in the progression of ES, and can be used as therapeutic targets and prognostic evaluation biomarkers.
Investigation of Candidate Genes and Mechanism Associated with Immune Cell during the Progression of Glioblastoma based on Bioinformatics
Authors: Xie Hui , Ding Xiao-hui , Yuan Ce , Li Jin-jiang , Li Zhao-yang , Lu Wei-cheng 
Published: December 2020

Abstract
Background: This study aimed to investigate the molecular mechanism of immune cell infiltration during the development of glioblastoma multiforme (GBM), and explore the potential immune cell associated prognostic genes for GBM. Methods: Gene expression data and corresponding clinical data of GBM samples (tumor group) and normal samples (normal group) in TCGA-GBM and GTEx dataset were downloaded. The differentially expression analysis was performed on samples between two groups. Based on tumor immune microenvironment analysis, the immune-related RNAs (lncRNAs and mRNAs) were further explored. Then, functional enrichment analysis, ceRNA network, risk prediction model and prognosis investigation were performed. Finally, the results of survival prognosis of key genes were tested by additional datasets. Results: A total of 4989 up-regulated genes and 2349 down-regulated genes were revealed between tumor group and normal group. M2 macrophages accounted for the largest proportion of tumor infiltrates immune cells in GBM, and was related to the prognosis of GBM patients. Totally 168 mRNAs (KIF18B) and 5 lncRNAs were related to infiltration of M2 Macrophage, of which 25 mRNAs and 5 lncRNAs forms a ceRNA network through 37 miRNAs (eg., miR-6849-3p). These genes were mainly assembled in functions like signal release. A risk model based on 5 mRNAs (such as FOX4 and ELFN2) and lncRNA PR11-161H23.5 was constructed. Verification test showed that all 5 mRNAs were significantly associated with OS prognosis.Conclusions: M2 Macrophage infiltration might participate in tumorigenesis of GBM via RP11-161H23.5-miR6849-3p-KIF18B ceRNA interaction. Furthermore, mRNAs such as FOX4 and ELFN2 might be potential prognostic markers for GBM patients.
Sodium Tanshinone IIA Sulfonate Promotes Spinal Cord Injury Repair by Inhibiting BSCB Disruption In Vitro and In Vivo
Authors: Luo Dan , Li Xing , Zhan Jiheng , Hou Yonghui , Luan Jiyao , Lin Dingkun 
Published: December 2020

Abstract
Background:Spinal cord injury (SCI) leads to microvascular damage and the destruction of blood spinal cord barrier (BSCB), which progresses to secondary injuries like apoptosis and necrosis of neurons and glia, culminating in permanent neurological deficits. BSCB restoration is the primary goal of SCI therapy, although very few drugs can repair the damaged barrier structure and permeability. Sodium tanshinone IIA sulfonate (STS) is commonly used to treat cardiovascular disease. We found that STS restored BSCB integrity and promoted microvessel recovery 7 days after SCI in a mouse model. However, the therapeutic effects of STS on damaged BSCB in the early stage of SCI remained uncertain. Methods: we exposed spinal cord microvascular endothelial cells (SCMECs) to H2O2 and treated them with different doses of STS. The mice received intraperitoneal injection of STS after SCI in vivo model. Spinal cord tissue was taken 1 and 3d post-SCI. HE, Nissl staining, BSCB permeability, and the expression levels of tight junction (TJ) and adherens junction (AJ), MMP2, MMP9, NeuN, and C-caspase-3 were analyzed.Results: In addition to protecting the cells from H2O2-induced apoptosis, STS also reduced cellular permeability. In the in vivo model of SCI as well, STS reduced BSCB permeability, relieved tissue edema and hemorrhage, suppressed MMPs activation and prevented TJ and AJ the loss of proteins. Conclusions:Our findings indicate that STS treatment promotes SCI recovery, and should be investigated further as a drug candidate against traumatic SCI.
Establishment and Comparison of an Experimental Kidney Yang Deficiency Syndrome Rat Model Caused by Hydrocortisone, Adenine, and Dexamethasone Combined with Adriamycin in Rats
Authors: Zhang Yehui , Tong Junfeng , Zhu Yan , Luo Qihan , Yu Hongxia , Huang Shuo , Ji Liting , Li Changyu 
Published: December 2020

Abstract
Objective: The paper is aimed to establish a method for renal injury in rats with kidney yang deficiency syndrome (KYDS) of the stable by comparing different model establishment methods and optimize the final modeling method.Method: In order to mimic water metabolism disorder of KYDS- a diagnostic pattern in traditional Chinese medicine (TCM), we made a comparison of hydrocortisone-induced, adenine-induced, dexamethasone combined with adriamycin-induced KYDS rat model according to testing general behavior, detecting Hypothalamus-pituitary-adrenal (HPA) axis function and renal function also making use of drug action. Additionally, the effect of adenine at a dose of 100 mg/kg, 150 mg/kg, and 200 mg/kg, respectively, on establishment of KYDS model was investigated in rats. Finally, Shenqi Wan (SQW, 3 g/kg) was used to estimate the deterioration of adenine that is associated with KYDS. Result: Three KYDS model rats all exhibited weight loss, anal temperature drop, reduced food intake and dysfunction of the Hypothalamus-pituitary-adrenal (HPA) axis, which could be alleviated by SQW. However, different from other two methods, adenine-induced rats were prominently manifested as water and fluid metabolism disorders (sharply increased water intake and urine volume). Renal injury in adenine-induced rats was more obvious than it in hydrocortisone-induced rats and dexamethasone combined with adriamycin-induced rats. And renal toxicity caused by adenine was reversible by SQW treatment. Water metabolism disorder in adenine-induced rats was more closer to clinical symptoms of patients with KYDS. Subsequently, we found different dose of adenine gavage (100, 150, 200 mg/kg) for 14 days result in general behavior change, dysfunction of HPA axis and renal function damage. But only medium-dose of adenine induced toxicity could be reversed by SQW treatment for 21 days.Conclusion: The result of the comparison between the three modeling methods showed that adenine-induced was more effective to establish the KYDS model, and only a medium-dose of adenine for inducing renal poison could be recovered by SQW treatment. Therefore, a medium-dose of adenine was optimal for the establishment of the KYDS rat model.Trial registration : This is an animal experiment, trial registration is not necessary.