bluuebunny/crossref_metadata_2025_split huggingface dataset:
Derivation and validation of a novel and parsimonious prognosis prediction score for ischemic stroke patients: The S2AFI Score
Authors: Liu Xiaochuan , Luo Yunhe , Liu Yang , Li Xiaofan , Yan Zhimin , Zhao Jing 
Published: April 2020

Abstract
Background To develop and validate a novel and integer-based score to predict the unfavorable outcome at 3-month after ischemic stroke using a dataset from the Chinese population. Methods We retrospectively included 394 patients presented to our stroke center within 24 hours after symptom onset. 70% of them were randomly selected as the model derivation dataset and the remaining 30% as the model validation dataset. Step-wise logistic regression were applied to identify the strong predictors of the unfavorable outcome, which was defined as modified Rankin Scale (mRS) >2. Results We identified 4 strong predictors in the final prediction model: stroke severity, age, serum fibrinogen level and intravenous thrombolytic therapy. 2 points were assigned when patients with NIH stroke scale higher than 6 at admission. 1 point was assigned to patients older than 71 years old and serum fibrinogen level higher than 2.98g/L respectively. For patients miss the opportunity of intravenous thrombolysis therapy, 1 point was assigned. We called our score system as S2AFI score and it ranges from 0 to 5. The Youden index of the S2AFI score was 2 which means patients with 3 points or higher tend to have unfavorable outcome in the future. The discriminative ability of the S2AFI score as dichotomized predictor achieved an area under the curve of 0.72 (95% Confidence Internal 0.66-0.79) in the derivation dataset, 0.72 (95% Confidence Internal 0.61-0.83) in the validation dataset and 0.68 (95% Confidence Internal 0.63-0.74) in all patients. While for the S2AFI score as continuous predictor, the score achieved an area under the curve of 0.76 (95% Confidence Internal 0.69-0.83) in the derivation dataset, 0.74 (95% Confidence Internal 0.62-0.87) in the validation dataset and 0.74 (95% Confidence Internal 0.68-0.80) in all patients. There was a strong correlation between the S2AFI score and the risk of unfavorable outcome at 3-month (P for trend <0.001). Conclusions Our novel and parsimonious S2AFI score had good performance in the prediction of unfavorable outcome at 3-month after ischemic stroke.
Antibiotics prescreption pattern and resistance profile of common isolates at Soba university hospital in Khartoum, Sudan, a retrospective cross sectional study
Authors: Ahmed Fatima , Koko Abubaker , Mohamed Ola , Elhag Reem , Khalifa Sufian , Mohamed Mohamed , Abdelaziz Hind , Ahmed Almegadad , Abdelrahman Ihab 
Published: April 2020

Abstract
Introduction: Antimicrobial resistance (AMR) is an incrrasingly global public health threat. An average of 45% of all patients are prescribed antibiotics. Nearly 50% of these prescribed antibiotics are unnecessary and they may promote the emergence of resistant strains. Antimicrobial stewardship programs have been introduced to tackle this problem. In this study we aim to determine the pattern of antibiotics prescription and resistance profile of common bacterial isolates at Soba university hospital , Sudan. Methods: A retrospective cross sectional study that was conducted at the medicine and surgery wards in a tertiary care hospital . Records of all patients who were admitted during the study period were included. A presented data collection form was used to collect information. Results: Records of 269 inpatients were reviewed. The mean age of patients was 49.5±18.7 years. The most frequently reported diagnoses on admission included cerebrovascular accidents and chronic liver disease, with 10.6% and 7.1% respectively. Je mean duration of stay at the hospital was 6.6 ± 6 days. Almost 81.8% of admitted patients recieved antibiotics. The majority (38.7% and 34.2%) were given one, and two antibiotics, respectively. Most of the antibiotics were administered intravenously (82.1%). Third generation cephalosporin antibiotcs (38%) and metronidazole (21.7%) were the most frequently prescribed. No documented indication for antibiotic prescriptio was found in 40.5% of cases. The main reason for stopping antibitics was the patients discharge (63.6%). Of patients recieving antibiotics, only 5 (1.9%) had undergone culture. Complete blood count (CBC) was requesed in nearly all patients (99.2%). A total of 100 cultures were performed during the study time. Most of them were urine cultures (64%). Escherichia Coli was isolated from 14 (29.2%) cultures. Resistance percentage was highest for erythromycin, and oxacillin (100% for both). Conclusion: The study shows a trend of antibiotic misuse. Most patients recieved antibiotics without documented indication. Antibiotics sensitivity results showed high levels of resistance among isolated organisms. We recommended a wider study and formulation and impementation of clear guidlines to regulate antibiotics use.
External validation of the European risk assessment tool for cardio metabolic disease in a Middle Eastern population
Authors: Asgari Samaneh , Moosaie Fatemeh , Khalili Davood , Azizi Fereidoun , Hadaegh Farzad 
Published: April 2020

Abstract
Background: High burden of chronic cardio-metabolic disease (CCD) including type 2 diabetes mellitus (T2DM), chronic kidney disease (CKD), and cardiovascular disease (CVD) have been reported in the Middle East and North Africa region. We aimed to externally validate a Europoid risk assessment tool designed by Alssema et al, including non-laboratory measures, for the prediction of the CCD in the Iranian population. Methods: The predictors included age, body mass index, waist circumference, use of antihypertensive, current smoking, and family history of cardiovascular disease and or diabetes. For external validation of the model in the Tehran lipids and glucose study (TLGS), the Area under the curve (AUC) and the Hosmer-Lemeshow (HL) goodness of fit test were performed for discrimination and calibration, respectively. Results: Among 1310 men and 1960 women aged 28-85 years, 29.5% and 47.4% experienced CCD during the 6 and 9-year follow-up, respectively. The model showed acceptable discrimination, with an AUC of 0.72(95% CI: 0.69-0.75) for men and 0.73(95% CI: 0.71-0.76) for women. The calibration of the model was good for both genders (min HL P=0.5). Considering separate outcomes, AUC was highest for CKD (0.76(95% CI: 0.72-0.79)) and lowest for T2DM (0.65(95% CI: 0.61-0.69)), in men. As for women, AUC was highest for CVD (0.82(95% CI: 0.78-0.86)) and lowest for T2DM (0.69(95% CI: 0.66-0.73)). The 9-year follow-up demonstrated almost similar performances compared to the 6-year follow-up. Conclusion: This model showed acceptable discrimination and good calibration for risk prediction of CCD in short and long-term follow-up in the Iranian population.
Re-thinking treatment strategies for febrile neutropenia in paediatric oncology population: A perspective from a developing country.
Authors: James Vinson , Prakash Anand , Mehta Kayur , Durugappa Tarangini 
Published: April 2020

Abstract
Background: This study was conducted to evaluate the microbiological profile of bacterial isolates in febrile neutropenia in a pediatric oncology unit, thereby, reviewing the use of restricted antibiotics and need for aggressive medical treatment accordingly.Methods: A prospective observational study was conducted in a paediatric haemat-oncology division of a tertiary care teaching hospital in southern India from September 2014 to August 2016. Children with febrile neutropenia were enrolled in the study. Blood cultures were performed using automated system. Cultures from other sites were obtained if needed, based on the clinical profile. Standard antibiotic susceptibility testing was done. Statistical analysis was done using SPSS.Results: One hundred and thirty children were enrolled for the study. Two hundred and fifty episodes of febrile neutropenia were studied. Three hundred and eighty four cultures were sent and 92 (24%) cultures were positive. There were 52.2% gram negative isolates followed 35.8% gram positive isolates, 6.5% fungal isolates and 5.5% poly-microbial cultures. Lactose fermenting gram negative bacteria (29 isolates, 31.5%) were the most frequently isolated in the gram negative group, with Escherichia coli being the most common organism (19 isolates, 20.6%). Amongst gram positive coagulase negative staphylococcus (CONS) was the most common (29%). Escherichia coli and NFGNB had only 36%, 25% sensitivity to ceftazidime respectively. Most gram negative bacteria were found to have better sensitivity to amikacin (mean: 57). There was a higher prevalence of extended spectrum beta lactamase producing organisms. 36 out of 48 GNB were found to be either multi/extremely/pan drug resistant. Escherichia coli and Klebsiella were often drug resistant. Significantly higher mortality was associated with gram negative isolates (61.5%)Conclusions: In view of higher prevalence of gram negative isolates and emergence of multi drug resistance, frequent audits of resistance patterns should guide the choice of antimicrobials in febrile neutropenia management. Our results show the importance of surveillance, monitoring resistance frequencies and identifying risk factors specific to each region. Given that significant mortality is attributed to drug resistant gram negative bacteria, early initiation of appropriate antibiotics to cover for drug resistance is required while formulating empirical antibiotic policies for febrile neutropenia in the oncology units in the developing world.
Elevated cord blood oxidative stress biomarkers negatively affect neonatal outcomes of mothers with severe preeclampsia: A case-control study
Authors: liu linli , Zheng Beihong , Jiang ZhongQing , Wu SanShan , Jin Qiong , Lin PeiHong , Lin Zhou 
Published: April 2020

Abstract
Background

To determine the relationship between the levels of stress biomarkers in cord blood and preeclampsia in a hospital-based population of pregnant patients, and to evaluate the resulting effects on pregnancy outcomes.
Measures:

This prospective case-control study included a total of 282 severe preeclamptic and 534 normal pregnant women. Fetal blood was collected from the umbilical cord at delivery and was utilized for Malonaldehyde (MDA), reactive oxygen species (ROS, superoxide dismutase (SOD) and homocysteine (Hcy) analysis. For a better assessment, we performed a univariate general linear regression model to control for potential confounders and determined the underlying influencing factors for high MDA and ROS. Moreover, a receiver operating characteristic curve analysis was conducted to determine the cutoff values for identifying severe preeclampsia. Further, the severe PE group was divided into the low or high MDA and low or high ROS subgroups according to their cut-off values. Finally, we created logistic regression models to estimate the adjusted odds ratio for each perinatal outcome in high-MDA and -ROS subgroup.
Results

MDA and ROS levels are higher in women with severe preeclampsia than in normotensive pregnant patients. However, when adjusted for cord blood Hcy levels, the difference is insignificant. Additionally, both MDA (r = 0.359, p < 0.001) and ROS (r = 0.473, p < 0.001) are positively correlated with cord blood Hcy level. The AUCs of MDA and ROS levels were 0.65 (95% CI: 0.60–0.69) and 0.88 (95% CI: 0.86–0.90), respectively, for predicting severe PE. Higher MDA and ROS levels are associated with increased risks of low Apgar score, admission to the NICU, and assisted ventilation for the newborn.
Conclusion

Increased levels of cord blood oxidative stress markers are significantly associated with negative effects on newborns. High cord blood Hcy levels might be involved in the observed elevated MDA and ROS concentrations in women with severe PE.
Estimating the potential reduction in future sickness absence from optimizing group-level psychosocial work characteristics: a prospective, multicenter cohort study in German industrial settings
Authors: Fischer Joachim E , Genser Bernd , Nauroth Peter , Litaker David , Mauss Daniel 
Published: April 2020

Abstract
Background Absence from work due to sickness impairs organizational productivity and performance. Even in organizations with perfect work conditions, some inevitable baseline sickness absence exists amongst working populations. The excess sickness absence observed above this baseline rate has become the focus of traditional health promotion efforts, addressing preventable physical illness, health behavior and mental health at the personal level. However, a health and safety approach following the TOP-rule would consider work-group psychosocial work characteristics as a potential risk factor amenable to organizational measures. To date, there is a scarcity of studies relating psychosocial work characteristics to possible reduction of excess sickness-absence rates. MethodsWe aimed to estimate the potentially avoidable excess fraction of absence attributable to work-group psychosocial characteristics. We considered work-group averaged perception of psychosocial work conditions as the best proxy to an “objective” assessment of organizational characteristics. Participants were recruited from multiple sites of a German automotive manufacturer with individuals nested within work groups. We predicted 12-month follow-up work-group sickness absence rates using data from a baseline comprehensive health examination assessing work characteristics, health behavior, and biomedical risk factors. We considered the quartile of work-groups yielding favorable psychosocial work characteristics as a realistic existing benchmark. Using the population attributable fraction method we estimated the potentially amenable sickness absence from improving work-group psychosocial characteristics. Results Data from 3992 eligible participants from 29 work groups were analyzed (39 percent participation rate, average age 41.4 years (SD = 10.3 years), 89.9% males and 49% manual workers.). Work-group absence rates at follow up varied from 2.1% to 8.9% (mean 5.1%, 11.7 missed days). A prediction model of seven psychosocial work characteristics at the work group level explained 70 percent of the variance of future absence rates. The estimated reduction from improving psychosocial work characteristics to the benchmark level amounted to 32% of all sickness absence, compared to a 31% reduction from eliminating health behavioral and medical risk factors to the benchmark target. Conclusions Psychosocial characteristics at the work-group level account for a relevant proportion of all sickness absence. Health promotion interventions should therefore address psychosocial characteristics at the work group level.
Predictive factors for pleural drainage volume after uniportal video-assisted thoracic surgery lobectomy for non-small cell lung cancer: a single-institution retrospective study
Authors: Tang Ming-bo , Li Jia-lin , Tian Su-yan , Gao Xin-liang , Liu Wei 
Published: April 2020

Abstract
Objective: To identify predictive factors associated with pleural drainage volume (PDV) after uniportal video-assisted thoracic surgery (VATS) lobectomy for non-small cell lung cancer (NSCLC).Methods: A total of 440 consecutive NSCLC patients who underwent uniportal VATS lobectomy were enrolled in this study between November 2016 and July 2019. Twenty-eight parameters, including patients’ clinicopathological characteristics and other potential predictors were collected. Daily drainage volume was summed up as PDV. Univariate analysis and multivariate regression models were fitted to identify independent predictive factors for PDV.Results: The median PDV was 840 ml during the median drainage duration of 4 days. A strong correlation was observed between PDV and drainage duration (correlation coefficient = 0.936). On univariate analysis, age, forced expiratory volume in 1 second % predicted (FEV1%), left ventricular ejection fraction (LVEF), operation time, serum total protein (TP), and body mass index (BMI) showed a significant correlation with PDV (P value, ＜ 0.001, ＜ 0.001, 0.003, 0.008, 0.028 and 0.045, respectively). Patients with smoking history (P = 0.030) or who underwent lower lobectomy (P = 0.015) showed significantly increased PDV than never smokers or those who underwent upper or middle lobectomy, respectively. On multivariate regression analysis, older age (P ＜ 0.001), lower FEV1% (P ＜ 0.001), lower LVEF (P = 0.011), lower TP (P = 0.013), and lower lobectomy (P = 0.016) were independent predictors of increased PDV.Conclusions: Predictive factors of PDV can be identified. Based on these predictors, patients can be treated with tailored individualized safe chest tube management.
Interferon Regulatory Factor 5 Mediates Lipopolysaccharide Induced Neuroinflammation
Authors: Fan Ziqi , Zhao Shuai , Zhu Yueli , Li Zheyu , Liu Zhirong , Yan Yaping , Chen Yanxing , Zhang Baorong 
Published: April 2020

Abstract
Background

Activated microglia plays a vital role in neuroinflammation in central nervous system (CNS), which is associated with the pathogenesis and the progression of neurological diseases. Interferon regulatory factor 5 (IRF5) has been well established participating in inflammatory responses and is highly expressed in M1 macrophage in periphery, the role of which in the CNS remains elusive.
Methods

Lipopolysaccharide (LPS) was employed to induce neuroinflammation. Down-regulation of IRF5 in C57/BL6 mice and BV2 microglial cells were achieved by IRF5 siRNA transfection. The levels of pro-inflammatory cytokines were evaluated by ELISA and quantitative real-time PCR. The expression levels of IRF5 were examined by immnunofluorescence and Western blot.
Results

LPS induced significantly elevated expression of IRF5 in mouse brain, which co-localized with CD11b positive microglia. Down-regulation of IRF5 quenched the pro-inflammatory responses. The levels of pro-inflammatory cytokines TNF-α, IL-1β and IL-6 were up-regulated at 4 h after LPS treatment, which were significantly down-regulated with the knockdown of IRF5. LPS-induced pro-inflammatory responses were transient, which returned to basal level at 24 h after LPS treatment. However, LPS did not up-regulate the expression of IRF5 in BV2 microglial cells, indicating that LPS-induced inflammation in BV2 cells does not involve IRF5 signaling.
Conclusions

IRF5 mediates the inflammatory responses in the CNS, which might serve as a therapeutic target for CNS inflammatory diseases. LPS-induced inflammation does not involve IRF5 signaling in BV2 microglia.
Investigating host and parasite factors surrounding seasonal malaria chemoprevention in Bama, Burkina Faso
Authors: Somé Anyirékun , Bazié Thomas , Y. Ehrlich Hanna , Goodwin Justin , Lehane Aine , Neya Cathérine , Kabre Zakary , Wade Martina , OUATTARA Jean-Marie , Foy Brian , Dabiré K. Roch , Parikh Sunil , Ouédraogo Jean-Bosco 
Published: April 2020

Abstract
Background: Since 2014, seasonal malaria chemoprevention (SMC) with amodiaquine-sulfadoxine-pyrimethamine (AQ-SP) has been implemented on a large scale during the high malaria transmission season in Burkina Faso. We report in this paper the prevalence of microscopic and submicroscopic malaria infection at the outset and after the first round of SMC in children under five years old in Bama, Burkina Faso, as well as host and parasite factors involved in mediating the efficacy and tolerability of SMC. Methods: Two sequential cross-sectional surveys were carried out in the first month of SMC in a rural area in southwest Burkina Faso. Blood smears and dried blood spots were collected from 106 and 93 children under five, respectively, at the start of SMC and again three weeks later. Malaria infection was detected by microscopy and by PCR from dried blood spots. For all children, day 7 plasma concentrations of desethyl-amodiaquine (DEAQ) were measured and CYP2C8 genetic variants influencing AQ metabolism were genotyped. Samples were additionally genotyped for pfcrt K76T and pfmdr1 N86Y, molecular markers associated with reduced amodiaquine susceptibility. Results: 2.8% (3/106) of children were positive for Plasmodium falciparum infection by microscopy and 13.2% (14/106) by nested PCR within 2 days of SMC administration. Three weeks after SMC administration, in the same households, 4.3% (4/93) of samples were positive by microscopy and 14.0% (13/93) by PCR (p=0.0007). CYP2C8*2, associated with impaired amodiaquine metabolism, was common with an allelic frequency of 17.1% (95%CI=10.0-24.2). Day 7 concentration of DEAQ ranged from 0.48 to 362.80 ng/mL with a median concentration of 56.34 ng/mL. Pfmdr1 N86 predominated at both time points, whilst a non-significant trend towards a higher prevalence of pfcrt 76T was seen at week 3. Conclusion: This study showed a moderate prevalence of low-level malaria parasitemia in children 3 weeks following SMC during the first month of administration. Day 7 concentrations of the active DEAQ metabolite varied widely, likely reflecting variability in adherence and possibly metabolism. Our findings highlight factors that may contribute to the effectiveness of SMC in children in a high transmission setting.
Microstructure and fracture behaviour of composite structured Ti( C , N ) based cermets
Authors: Liu Aijun , Chen kebei , Liu Ning , Zhang Xialing , Chen Jigui 
Published: April 2020

Abstract
Microstructure and fracture behavior of composite structured Ti(C,N) based cermets were investigated, and compared to that of conventional Ti(C,N)-based cermets. Composite structure of the Ti(C,N) based cermets consists of cobalt enriched area,cobalt poor area and coarse granule. The fracture toughness of composite structured Ti(C,N) based cermets have higher than that of conventional Ti(C,N)-based cermets. The fracture morphology of the cermets were clearly observed, suggesting the effective load transfer between cobalt enriched area and cobalt poor area. Load transfer toughening mechanisms of composite structured Ti(C,N) based cermets can be deduced in this paper.
Seismic Scatter Associated with Earthquakes that Ended a Quiescent Period in Southeastern Korea
Authors: Iqbal Muhammad Zafar , Chung Tae-Woong , Nam Myung Jin 
Published: April 2020

Abstract
Two recent hazardous earthquakes ( M 5.8 and 5.5) in southeastern Korea were the largest instrumentally recorded inland events after an abnormally long, seismically quiet, period. In this study, we used coda envelope tomography to observe the heterogeneities related to active faults, which can, in turn, help mitigate seismic hazard in the area. However, this tomography was not able to detect faults in the intraplate region. By separating the periods before and after the M 5.8 earthquake, we analyzed 225 and 204 seismograms obtained from 127 and 86 events, respectively. Both periods showed time-varying heterogeneity correlated with fault activity. Adding 446 seismograms from 235 aftershocks of the two events to the analysis showed us a heterogenous structure that closely correlated to the active faults where the recent earthquakes originated.