bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of COVID-19 pandemic on Obstetrics and Gynecology Residency Programs and perspectives on adaptive ways of training in Ethiopia
Authors: Gudu Wondimu , Wondafrash Mekitie , Bekele Delayehu , Nigatu Balkachew , Birrara Malede , Feyessa Mekdes Daba 
Published: June 2020

Abstract
Background: The impact of Covid-19 on healthcare system and trainings has been tremendous and unpredictable. In addition to service re-organization, teaching institutions will have to devise adaptive mechanisms to cope up with the disruption in medical education and residency training. Objectives: to assess the effect of Covid-19 pandemic on obstetrics and gynecology residency program and explore residents’ & program directors’ perspectives on alternative academic approaches in Ethiopia.Methods: This is a cross sectional mixed method study which was conducted at 12 institutions engaged in obstetrics and gynecology residency training in Ethiopia from May to June 2020. Quantitative data were collected from 240 residents employing an online platform (Google Forms) and focus group discussion was conducted using the ZOOM video-conferencing platform with eleven chief residents and eight program directors. Quantitative data analysis was performed using Stata 15 statistical software while thematic synthesis approach was used for the qualitative data analysis assisted by ATLAS.ti 7 for windows. Ethical clearance was obtained from IRB of Saint Paul’s Hospital Millennium Medical College. Results: All levels of residents from all residency sites were represented. The level of residents’ engagement in various routine clinical services vary depending on the type of service during COVID-19 pandemic period. Residents’ involvement in routine ANC, high risk clinics are “slightly” reduced while in Gynecology OPDs, the reduction was “severe”. There was no effort made to address the psychological impact of the pandemic on residents. The level of reduction in didactic and clinical teaching (rounds, case presentations, seminars, management sessions ranged from “some” to “complete interruption” for most of the residents at different years of training. Although the reduction in obstetric practical exposure (normal delivery, cesarean delivery) was “slight”, there was “sever” reduction to “complete suppression” (>80%) in major gynecologic surgeries primarily affecting final year residents. Research activities are completely halted in most of the institutions. Generally, adaptive methods to sustain the residency training were implemented in very few of the institutions. Conclusions: There was significant disruption in all domains of the residency training following the report of the first case of COVID-19 in Ethiopia. The preparedness and response of the programs was very poor and there was limited effort in implementing adaptive teaching methods in almost all of the institutions.
Early combination treatment with existing HIV antivirals: an effective treatment for COVID-19?&nbsp;
Authors: Dallocchio Roberto Nico , Dessì Alessandro , Vito Andrea De , Delogu Giovanna , Andrea Pier , Madeddu Giordano 
Published: June 2020

Abstract
Since no effective therapy exists, we aimed to test existing HIV antivirals for combination treatment of Coronavirus disease 19 (COVID-19). Our molecular docking findings suggest that lopinavir, ritonavir, darunavir, and atazanavir activated interactions with the key binding sites of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) protease with a better Ki for lopinavir, ritonavir, and darunavir. Furthermore, we evidenced the ability of remdesivir, tenofovir, emtricitabine, and lamivudine to be incorporated in SARS-CoV-2 RNA-dependent RNA polymerase in the same protein pocket where poses the corresponding natural nucleoside substrates with comparable Ki and activating similar interactions. In principle, the four antiviral nucleotides might be used effectively against SARS-CoV-2. The combination of a protease inhibitor and two nucleoside analogues should be evaluated in clinical trials for the treatment of COVID-19.
Endothelial Shear Stress Enhancements: A Potential Solution for Critically Ill Covid-19 Patients
Authors: Nour Sayed 
Published: June 2020

Abstract
Rationale: Most critically ill Covid-19 patients succumb to multiple organ failure and / or cardiac arrest as a result of comorbid endothelial dysfunction disorders which had probably aggravated by conventional mechanical assist devices. Even worse, mechanical ventilators prevent the respiratory pump from performing its crucial function as a potential generator of endothelial shear stress (ESS) which controls microcirculation and hemodynamics since birth. The purpose of this work is to bring our experience with ESS enhancement and pulmonary vascular resistance (PVR) management as a potential therapeutic solution in acute respiratory distress syndrome (ARDS). We propose a noninvasive device composed of thoracic and infradiaphragmatic compartments that will be pulsated in an alternating frequency (20/40 bpm) with low-pressure pneumatic generator (0.1-0.5 bar). Oxygen supply, nasogastric ± endotracheal tubes are considered. Proof-of-concept: prototypes were tested in pediatric models of refractory cardiac arrest (≥20min), showed restoration of hemodynamics (BP≥100 mm Hg) and urine output, regardless of heartbeats, pharmacological supports and mechanical ventilation. Conclusions ESS enhancement represents a more effective treatment to increase tissue oxygenation and improve hemodynamic in ARDS. A cost-effective method which could be induced with a non-invasive pulsatile device adaptable to cardiopulmonary-circulatory biophysics to maintain a fully functional respiratory pump and avoid confrontation of the opposite hydraulic circuits.
Linking the Effect of Psoriatic Arthritis-Related Foot Involvement to the Leeds Foot Impact Scale using the International Classification for Functioning, Disability and Health.
Authors: Carter Kate , Tannous Caterina , Walmsley Steven , Rome Keith , Turner Deborah E 
Published: June 2020

Abstract
Background Previous research to describe the impact of foot involvement in psoriatic arthritis has used the Leeds Foot Impact Scale in Rheumatoid Arthritis (LFIS-RA) in the current absence of any psoriatic arthritis foot-specific tools. However, the LFIS-RA is a rheumatoid arthritis disease-specific outcome measure and its content validity for evaluating the experiences of people with psoriatic arthritis-related foot involvement is unknown. The study objective was to determine the content validity of the LFIS-RA for assessing people with psoriatic arthritis, using the International Classification of Functioning, Disability and Health (ICF) as the frame of reference. Method Concepts within each item of the LFIS-RA were linked to the best-matched ICF categories using established linking rules, which enable a systematic and standardised linking process. All concepts were independently linked to the ICF by 2 investigators with different professional backgrounds, which included occupational therapy and podiatry. The list of ICF categories derived from previous research that pertained to the foot with psoriatic arthritis was then compared with the ICF categories linked to the LFIS-RA. The comparison was undertaken in order to determine the extent to which concepts important and relevant to people with psoriatic arthritis-related foot involvement were addressed. Results Thirty-five distinct ICF categories were linked to LFIS-RA, which related to body functions (44%), activities and participation (35%), environmental factors (16%) and body structure (5%). In comparison with the ICF categories derived from concepts of the foot in psoriatic arthritis previously defined, the LFIS-RA provided coverage of key constructs including pain, functioning, daily activities, footwear restrictions and psychological impact. Other concepts of importance in psoriatic arthritis such as skin and toenail involvement, self-management and paid employment were not addressed in the LFIS-RA. Conclusion Content validity of the LFIS-RA to determine the impact of foot functional impairments and disability in people with psoriatic arthritis was not supported by the results of this study. Future work should consider the development of a psoriatic arthritis foot-specific patient reported outcome measure, using the LFIS-RA as an important foundation.
Diabetic Retinopathy Screening in Urban Primary Care Setting with a Handheld Smartphone-based Retinal Camera.
Authors: Queiroz Márcia S , de Carvalho Jacira Xavier , Bortoto Silvia Ferreira , de Matos Mozania Reis , Cavalcante Cristiane das Graças Dias , Andrade Elenilda Almeida Silva , Correa-Giannella Maria Lúcia , Malerbi Fernando K 
Published: June 2020

Abstract
Aims: To evaluate diabetic retinopathy (DR) screening with a portable handheld smartphone-based retinal camera and telemedicine in an urban primary health care setting; to evaluate the learning curve for image acquisition, performed by healthcare personnel without previous experience on retinal imaging. Methods: Prospective study that enrolled patients with type 2 diabetes mellitus (T2DM) followed at a primary healthcare unit in São Paulo, Brazil. After a brief training in image acquisition, there was further continuous feedback during the remote image reading process. Each patient underwent two fundus and one anterior ocular segment images per eye, after mydriasis. Patients were classified according need of referral. Results: A total of 627 adult individuals with T2DM underwent retinal evaluation. The population was composed by 63.2% female individuals, age median of 66 years-old, diabetes duration 10.7 ± 8.2 years and A1c 7.7 ± 1.9% (61 + 20.8 mmol/mol). The most prevalent associated comorbidities were arterial hypertension (80.3%) and dyslipidemia (50.2%). Referral decision was possible in 81.2% patients. Most patients had absent or non-referable DR; the main ocular media opacity detected was cataract. After the 7th day of image acquisition, the daily rate of patients whose images allowed clinical decision was maintained above 80%. A higher A1c was associated with referable DR. Conclusion: A low-cost DR screening strategy with a handheld device and telemedicine is feasible and has the potential to increase coverage of DR screening in underserved areas; the possibility of mobile units is relevant for DR screening in the context of Covid-19 pandemic.
The number of circulating endothelial progenitor cells from septic patients are associated with different infectious organisms
Authors: Zhu Yingying , Yang Nana , Zhu Jing , Fu Chao , Tian Xinghan , Zhang Fusen , Zhao Lei , Zhu Jingwei , Lv Kaixuan , Wang Chunting 
Published: June 2020

Abstract
Background

Endothelial progenitor cells (EPCs) can affect the repairment of endothelial injury by improving the process of re-endothelialization and angiogenesis in sepsis patients. However, the markers of EPCs have not been standardized nowadays, and the changes of EPCs are still unclear in patients with different infectious organisms. This study explored the relationship between the number of EPCs and different infectious organisms in patients with sepsis.

Materials and Methods

39 septic patients and 20 healthy controls were enrolled in this study. The number of CD34+/KDR+, CD133+/KDR+, CD34+/CD133+/KDR+, CD34+, CD133+, and KDR+ cells were all analyzed through flow cytometry. Analysis of adhesion function of EPCs were also performed by counting the number of adherent cells in different cultured time points (4 days, 14 days, and 21 days).

Results

The number of EPCs in peripheral blood of septic patients were higher than that of healthy controls, but there were no significant differences between sepsis group and septic shock group, also between the survival group and the non-survival group. Additionally, the percentages of CD34+/CD133+/KDR+ cells in Gram-positive bacteremia group was significantly higher than the Gram-negative bacteremia group and negative blood culture group; the percentage of KDR+ cells in both Gram-positive bacteremia group and Gram-negative bacteremia group were significantly higher than the negative blood culture group. Furthermore, the adhesion function of EPCs in healthy controls was significantly higher than in septic patients.

Conclusions

The number of circulating EPCs and the adhesion function of EPCs in patients with sepsis are associated with different infectious organisms.
Retrospective Analysis of Pediatric Patients with Multiple Rare-Earth Magnet Ingestion: A Single-Center Experience from China.
Authors: Zheng Yucan , Zhang Zhihua , Yan Kunlong , Guo Hongmei , Li Mei , Lian Min , Liu Zhifeng 
Published: June 2020

Abstract
Background The aim of this study was to characterize patients with multiple rare-earth magnet ingestion in a single-pediatric medical center, reveal the harm of rare-earth magnets foreign bodies in digestive tract, and develop a clinical management algorithm. Methods This was a retrospective review of patients with rare-earth magnets foreign bodies in digestive tract admitted to a university-affiliated pediatric medical center in China, between January 2016 to December 2019, with a subset of medical data including clinical symptoms, signs, treatments and outcomes. Results A total of 51 cases were included in this study, including 36(70.6%) males and 15(29.4%) females. The magnets were passed naturally in 24(47.1%) patients and removed by intervention in 27(52.9%) patients, including five(9.8%) cases by endoscopy and 22(43.1%) cases by surgery. 22(43.1%) cases had gastrointestinal obstruction, perforation, and fistula. Compared with the non-surgical group, the proportion of males in the surgical group was higher (21/23 vs 15/28, p=0.004), and the visiting time to hospital was longer (80(72) vs 26(5), hours, p=0.008). Conclusions The rate of surgical intervention is high in multiple rare-earth digestion cases and the consequences are serious, and a more efficient management algorithm for these cases should be needed. A policy for strictly restricted or prohibited the sale of the toys with multiple rare-earth magnets needed to put into the agenda. Trial registration The study will be retrospectively registered.
Interobserver variability in target volume delineation in definitive radiotherapy for thoracic esophageal cancer: A multi-center study from China
Authors: Chang Xiao , Deng Wei , Wang Xin , Zhou Zongmei , Yang Jun , Guo Wenling , Liu Miaoling , Qi Xiaolu , Li Ling , Zhang Kaixian , Zhang Min , Shi Yonggang , Liu Ke , Zhao Yidian , Wang Huitao , Yu Zhilong , Zhang Jihong , Wang Lihua , Qiao Xueying , Han Chun , Zhu Shuchai , Zhang Ruohui , Chen Junqiang , Hu Cairong , Zhang Fuquan , Hou Xiaorong , Pang Qingsong , Zhang Wencheng , Li Gaofeng , Lin Hailei , Sun Xinchen , Ge Xiaoling , Li Caihong , Ge Hong , Li Dingjie , Wang Yadi , Lu Na , Gao Xianshu , Qin Shangbin , Tian Yuan , Xiao Zefen 
Published: June 2020

Abstract
Purpose: To investigate the interobserver variability (IOV) in target volume delineation of definitive radiotherapy for thoracic esophageal cancer (TEC) among cancer centers in China, and ultimately improve contouring consistency as much as possible to lay the foundation for multi-center prospective studies.Methods: Sixteen cancer centers throughout China participated in this study. In Phase 1, three suitable cases with upper, middle, and lower TEC were chosen, and participants were asked to contour a group of gross tumor volume (GTV-T), nodal gross tumor volume (GTV-N) and clinical target volume (CTV) for each case based on their routine experience. In Phase 2, the same clinicians were instructed to follow a contouring protocol to re-contour another group of target volume. The variation of the target volume was analyzed and quantified using dice similarity coefficient (DSC).Results: Sixteen clinicians provided routine volumes, whereas ten provided both routine and protocol volumes for each case. The IOV of routine GTV-N was the most striking in all cases, with the smallest DSC of 0.37 (95% CI: 0.32-0.42), followed by CTV, whereas GTV-T showed high consistency. After following the protocol, the smallest DSC of GTV-N was improved to 0.64 (95% CI: 0.45-0.83, P=0.005) but the DSC of GTV-T and CTV remained constant in most cases.Conclusion: Variability in target volume delineation was observed, but it could be significantly reduced and controlled using mandatory interventions.
Application of sample balance-based multi-perspective feature ensemble learning for prediction of user purchasing behaviors on mobile wireless network platforms
Authors: Zhang Huibing , Dong Junchao 
Published: June 2020

Abstract
In recent years, with the rapid development of wireless communication network, M-Commerce has achieved great success. Relying on mobile phones, tablets and other wireless communication devices for online shopping has become a mainstream way for users to consume. Users leave a lot of historical behavior data when shopping on the M-Commerce platform. Using these data to predict future purchasing behaviors of the users will be of great significance for improving user experience and realizing mutual benefit and win-win result between merchant and user. Therefore, a sample balance-based multi-perspective feature ensemble learning was proposed in this study as the solution to predicting user purchasing behaviors, specifically including: 1) “Sliding window”-centroid under-sampling was combined with sample balance method was used, while the positive sample size was enlarged using “sliding window”, centroid under-sampling was used to reduce the negative sample size within “sliding window”, so as to acquire user’s historical purchasing behavioral data with sample balance. 2) Influence feature of user purchasing behaviors were extracted from three perspectives—user, commodity and interaction, in order to further enrich the feature dimensions. Meanwhile, feature selection was carried out using XGBSFS algorithm. 3) An ensemble learning model—five-fold cross validation stacking—which could be used to predict user purchasing behaviors was raised. Three prediction models—XGBoost-Logistics, LightGBM-L2 and cascaded deep forest models—so that they could realize mutual collaboration and the overall prediction ability of the ensemble learning model could be improved. 4) Large-scale real datasets were experimented on Alibaba M-Commerce platform. The experimental results show that the proposed method has achieved better prediction effect in various evaluation indexes such as precision and recall rate.
GSG2 knockdown suppresses cholangiocarcinoma progression by regulating cell proliferation, apoptosis and migration
Authors: Zhou Jun , Huang Ranglang , Nie Wanpin , Yuan Jiajia , Zhang Zeyu , Mi Liangliang , Wang Changfa 
Published: June 2020

Abstract
Background: Cholangiocarcinoma (CCA) is the second most common type of hepatocellular carcinoma with high aggressiveness and extremely poor prognosis. Homo sapiens germ cell associated 2 (GSG2) is a histone H3 threonine-3 kinase required for normal mitosis. Nevertheless, the role and mechanism of GSG2 in progression and development of CCA remain elusive.
Methods: In the present study, correlation between GSG2 and CCA was elaborated by IHC, Mann-Whitney U and Spearman grading correlation. GSG2 knockdown cell lines were successfully constructed and further used to construct mouse xenotransplantation models. Subsequently, cell proliferation, cell apoptosis, cell cycle and cell migration were detected by MTT assay, Flow Cytometry and wound-healing assay, respectively.
Results: It was demonstrated that GSG2 was overexpressed in CCA specimens and relevant cell lines. The statistical analysis determined that high GSG2 expression was positively associated with more advanced tumor grade. Importantly, GSG2 knockdown inhibited cell proliferation, migration, promoted cell apoptosis and arrested cell cycle in G2 phase. Meanwhile, in vivo results also supported that GSG2 knockdown inhibit tumor growth. Additionally, GSG2 was involved in CCA progression via suppressing EMT.
Conclusions: In summary, our findings suggested that GSG2 may be a potential therapeutic target for CCA patients.
Short-term renoprotective effect of SGLT-2 inhibitor for renal function and albuminuria in type 2 diabetes: a retrospective study
Authors: Kubota Mitsunobu , Shiroyama Eri , Tanaka Kanako , Yoshii Yoko 
Published: June 2020

Abstract
Background Progression of diabetic nephropathy in type 2 diabetic patients is a factor that determines the prognosis of life. Empagliflozin and canagliflozin, two oral diabetic SGLT-2 inhibitors, have shown improved renal outcomes in type 2 diabetic patients with chronic kidney disease in a large clinical study. These results suggest that SGLT-2 inhibitors could be used not only for hypoglycemic effects, but also for renal protective effects in patients with type 2 diabetes. It is not fully understood in which contexts the use of SGLT-2 inhibitors is likely to exert its renal protective effects. The purpose of this study was to clarify the profiles of patients in whom SGLT-2 inhibitors are more likely to exert a renal protective effect in clinical practice. We examined renal function and urinary albumin changes in short-term use of SGLT-2 inhibitors by patient background. Methods We retrospectively analyzed the medical record information of sixty-three type 2 diabetic patients (33 males, 30 females, average age 53.0 ± 13.0 years) who were given usual doses of a SGLT-2 inhibitor. We investigated changes in body weight, blood pressure, glucose metabolism index, lipid metabolism index, estimated glomerular filtration rate (eGFR) and albuminuria (urinary albumin-to-creatinine ratio, UACR) three months before and after administration of a SGLT-2 inhibitor. Results Three months after administration of an SGLT-2 inhibitor, there were improvements in glucose tolerance, weight loss, blood pressure, and lipid indices. In all cases, there was no significant change in eGFR, but UACR decreased significantly. UACR decreased regardless of Angiotensin II Receptor Blocker medication and significantly decreased in nephropathy patients with microalbuminuria or overt albuminuria. UACR decreased only in the group in which blood pressure, body weight, and hemoglobin A1c decreased before and after administration of the SGLT-2 inhibitor. Conclusions Our study shows that the renoprotective effects of SGLT-2 inhibitors are more likely to be exerted in diabetic nephropathy patients who have advanced to at least microalbuminuria stage, and in addition to direct renal protection, the comprehensive effects of SGLT-2 inhibitors, which lower body weight, blood pressure, and blood glucose, are also important for their renal protection effects.
Microcrack propagation induced by dynamic infiltration of calcium-magnesium-alumino-silicate in columnar structures for thermal barrier coatings
Authors: Tseng Shaochen , Chao Chingkong , Zhang Weixu , Fan X.L. 
Published: June 2020

Abstract
Columnar-structured thermal barrier coating systems (TBCs) possess a strain tolerant columnar microstructure wherein the gaps between the columns are filled with high-porosity oxides. At high temperatures, columnar-structured TBCs may be eroded via contact with a significant amount of calcium-magnesium-alumina-silicate (CMAS). A numerical model is proposed to estimate the temperature and stress fields of the microcracks induced by the CMAS infiltration. The energy release rate is evaluated to understand the influence of CMAS on the microcracks in the columnar microstructure. The effects of CMAS on the microcrack propagation are discussed in detail by using the extended finite element method. The results demonstrate that both the stress and energy release rate near the microcrack were found to dramatically increase when the CMAS reached the microcrack. Moreover, increasing the time of CMAS infiltration could destroy the thermal insulation provided by the top coat and considerably increase the energy release rate. The present analysis reveals that the vertical cracks are easily to initiate from the microstructure column and coalesce with adjacent horizontal and vertical pores, thereby resulting in premature failure of TBCs via delamination.