bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of COVID-19 Pandemic on Emergency Calls and Trauma Emergency Calls in Hangzhou
Authors: Zhang Guohu , Wang Mingwei , Lv Shijin , Cheng Yongran , Xia Jinming , Wang Muding , Lai Dengpan 
Published: November 2020

Abstract
Background: This study aimed to investigate the impact of the coronavirus disease 2019 (COVID-19) pandemic on emergency calls and trauma emergency calls in Hangzhou, Zhejiang, China. Method: This was a single-center retrospective study. Data on emergency calls and trauma emergency calls in Hangzhou during the COVID-19 epidemic (January 23, 2020, to March 15, 2020) were collected from the Hangzhou Emergency Center (HEC). All emergency data were compared with the data during the same period in 2019. Results: The number of emergency calls from HEC decreased by 17.1%, ambulance assignments by 29.1%, rescue personnel first-aid calls by 22.4%, and trauma emergency calls by 40.8% in 2020 compared with those during the same period in 2019. Conclusion: The numbers of emergency calls from HEC and trauma emergency calls significantly decreased during the COVID-19 epidemic in Hangzhou, highlighting serious social issues that required the attention of the medical community and the government.
Fabrication of Black In2O3 with Dense Oxygen Vacancy through Dual Functional Carbon Doping for Enhancing Photothermal CO2 Hydrogenation
Authors: Qi Yuhang , Jiang Jiawei , Liang Xichen , Ouyang Shuxin , Mi Wenbo , Ning Shangbo , Zhao Lei , Ye Jinhua 
Published: November 2020

Abstract
Photothermocatalytic CO2 reduction as the channel of the energy and environmental issues resolution has captured persistent attention in recent years. In2O3 has been prompted to be a potential photothermal catalyst in this sector on account of unique physicochemical properties. However, different from the metal-based photothermal catalyst with the nature of efficient light-to-thermal conversion and H2 dissociation, the wide-bandgap semiconductor needs to be modified to possess wide-wavelength-range absorption and the active surface. It remains a challenge to achieve the two aims simultaneously via single material modulation approach. In this study, one strategy of carbon doping can empower In2O3 with two advantageous modifications. The carbon doping can reduce the formation energy of oxygen vacancy, which induces the generation of oxygen-vacancy-riched material. The introduction of oxygen defect levels and carbon doping levels in band gap of In2O3 significantly reduces this band gap, which endows it full-spectral and intensive solar light absorption. Therefore, the carbon doped In2O3 achieves effective light-to-thermal conversion and delivers a 123.6 mmol g− 1 h− 1 of CO generation rate with near-unity selectivity, as well as prominent stability in photothermocatalytic CO2 reduction.
Impact of Implementation of Sequential Trauma Education Programs (STEPs) Course on Missed Injuries in Emergency Polytrauma Patients, Ismailia, Egypt
Authors: Elbaih Adel Hamed , El-Setouhy Maged , Hirshon Jon Mark , El-Hariri Hazem Mohamed , El-Shinawi Mohamed 
Published: November 2020

Abstract
Introduction: Trauma deaths account for 8% of all deaths in Egypt. Patients with multiple injuries are at high risk but may be saved with a good triage system and a well-trained trauma team in dedicated institutions. The incidence of missed injuries in the Emergency Department (ED) of Suez Canal University Hospital (SCUH) was found to be 9.0% after applying Advanced Trauma Life Support (ATLS) guidelines. However, this rate is still high compared with many trauma centers.Aim: Improve the quality of management of polytrauma patients by decreasing the incidence of missed injuries by implementing the Sequential Trauma Education Programs (STEPs) course in the ED at SCUH.Methods: This interventional training study was conducted in the SCUH ED. The study was conducted during the 1-month precourse and for 6 months after the implementation of the STEPs course for ED physicians. Overall, 458 polytrauma patients were randomly selected, of which 45 were found to have missed injuries after applying the inclusion and exclusion criteria. We assessed the clinical relevance of these cases for missed injuries before and after the STEPs course.Results: Overall, 45 patients were found to have missed injuries, of which 15 (12%) were pre-STEPs and 30 (9%) were post-STEPs course. The STEPs course significantly increased adherence to vital data recording, but the reduction of missed injuries (3.0%) was not statistically significant in relation to demographic and trauma findings. However, the decrease in missed injuries in the post-STEPs course group was an essential clinically significant finding.Conclusion: STEPs course implementation decreased the incidence of missed injuries in polytrauma patients. Thus, the STEPs course can be considered at the same level of other advanced trauma courses as a training skills program or possibly better in dealing with trauma patients. Repetition of this course by physicians should be mandatory to prevent more missed injuries. Therefore, the validation of STEPs course certification should be completed at least every 2 years to help decrease the number of missed injuries, especially in low-income countries and low-resource settings.
Atypical Hemolytic Uremic Syndrome After Traumatic Rectal Injury: A Case Report
Authors: Park Yunchul , Kang Ji-Hyoun 
Published: November 2020

Abstract
Background: Atypical hemolytic uremic syndrome (aHUS) is a rare, progressive, life-threatening condition of thrombotic microangiopathy (TMA) that is characterized by thrombocytopenia, microangiopathic hemolytic anemia, and renal impairment. The mechanisms of aHUS are still unknown. To our knowledge, there is currently no report establishing aHUS after traumatic injury. We herein present a case of aHUS after traumatic injury.Case presentation: A 55-year-old man with a medical history of percutaneous coronary intervention due to ST elevation myocardial infarction visited the emergency room after a traumatic injury caused by a tree limb. Abdominal computed tomography revealed a rectal wall defect with significant air density in the perirectal space and preperitoneum, implying rectal perforation and, therefore, an emergency operation was performed. As there was an absence of intraperitoneal intestinal perforation, we performed diverting sigmoid loop colostomy. An additional intermittent simple repair was performed due to perianal and anal injuries. One day after the operation, his urine output abruptly decreased and serum creatinine level increased. In addition, his platelet level decreased, and a spiking fever occurred after 2 days. The patient was diagnosed with acute renal failure secondary to aHUS and was treated with fresh frozen plasma replacement. Continuous renal replacement therapy (CRRT) was also started for oliguria and uremic symptoms. The patient received CRRT for 3 days and intermittent hemodialysis thereafter. He received four weekly sessions of hemodialysis for 2 weeks. After hemodialysis and subsequent supportive treatment, his urine output and renal function continuously improved. Similarly, his hemolytic anemia and thrombocytopenia also gradually improved. His dialysis was terminated on day 22 of admission and he was discharged after recovery. His improved state has since been maintained.Conclusions: This case suggests that a traumatic event can be a triggering factor for aHUS, and it should be considered in patients who have thrombocytopenia and acute renal failure with microangiopathic hemolytic anemia after trauma. Early diagnosis and appropriate management can be critical to achieve favorable outcomes in posttraumatic patients with aHUS.
Labor Induction And The Incidence of Intrapartum Maternal Fever In Epidural Labor Analgesia: A Retrospective Case-Control Study
Authors: Wang Min , Li Yiting , Gu Zhongya , Manlin Duan 
Published: November 2020

Abstract
Background: To assess the influence of labor induction on the intrapartum maternal fever in epidural labor analgesia and to determine its association with intrapartum fever.Methods: A retrospective case-control study was performed during 2016–2018 in a first-class tertiary hospital. All patients who received epidural labor analgesia were allocated into either case (parturients who received labor induction and had intrapartum fever) or control (parturients who did not receive labor induction but had intrapartum fever) groups. Maternal demographic and intrapartum data, epidural infusions records, and neonatal short-term outcome were studied.Results: A total of 710 epidural labor analgesia occurred during the study period and 119 (16.76%) women had intrapartum fever. Intrapartum fever occurred in 66 (25.68%) women who received labor induction and in 53 (11.70%) who did not. After correction for confounding factors, labor induction (OR 2.818, 95% CI, 1.778–4.467, P<0.001), number of vaginal examinations (OR 1.242, 95% CI, 1.048–1.471, P=0.012), baseline maternal temperature (OR 6.702, 95% CI, 2.065–21.755, P=0.002), admission white blood cell count (OR 1.171, 95% CI, 1.052–1.303, P=0.004), and neonatal birth weight (OR 3.015, 95% CI, 1.739–5.227, P<0.001) were risk factors for intrapartum maternal fever during epidural labor analgesia.Conclusion: Labor induction was significantly associated with an increased risk of intrapartum maternal fever during epidural labor analgesia.
The PD-L1 Metabolic Interactome Intersects with Choline Metabolism and Inflammation
Authors: Pacheco-Torres Jesús , Penet Marie-France , Mironchik Yelena , Krishnamachary Balaji , Bhujwalla Zaver M 
Published: November 2020

Abstract
Background: Harnessing the power of the immune system by using immune checkpoint inhibitors has resulted in some of the most exciting advances in cancer treatment. The full potential of this approach has, however, not been fully realized for treating many cancers such as pancreatic and breast cancer. Cancer metabolism influences many aspects of cancer progression including immune surveillance. An expanded understanding of how cancer metabolism can directly impact immune checkpoints may allow further optimization of immunotherapy. We therefore investigated, for the first time, the relationship between the overexpression of choline kinase-α (Chk-α), an enzyme observed in most cancers, and expression of the immune checkpoint PD-L1. Methods: We used small interfering RNA to downregulate Chk-a, PD-L1 or both in two triple negative human breast cancer cell lines (MDA-MB-231 and SUM-149) and two human pancreatic ductal adenocarcinoma cell lines (Pa09C and Pa20C). The effects of the downregulation were studied at the genomic, proteomic and metabolomic levels. The findings were compared with results obtained by analysis of public data from The Cancer Genome Atlas Program.Results: We identified an inverse dependence between Chk-α and PD-L1 at the genomic, proteomic and metabolomic levels. We also found that prostaglandin-endoperoxide synthase 2 (COX-2) and transforming growth factor beta (TGF-β) play an important role in this relationship. We independently confirmed this relationship in human cancers by analyzing data from The Cancer Genome Atlas Program. Conclusions: Our data identified previously unknown roles of PD-L1 in cancer cell metabolic reprogramming, and revealed the immunosuppressive increased PD-L1 effect of Chk-α downregulation. These data suggest that PD-L1 regulation of metabolism may be mediated through Chk-α, COX-2 and TGF-β. The observations provide new insights that can be applied to the rational design of combinatorial therapies targeting immune checkpoints and cancer metabolism.
Investigation on the Absorption Bands Around 3.3 μm in CRISM Data
Authors: Manzari Paola , Marzo Cosimo , Ammannito Eleonora 
Published: November 2020

Abstract
Recently, the methane seepage detected by Mars Sample Laboratory (MSL) in the Gale crater area during 2013 was confirmed by methane detection by the Planetary Fourier Spectrometer (PFS). While analyzing NIR-IR CRISM data on a site in Oxia Planum area, in the view of a future comparison with data that will be collected by the Rosalind Franklin rover onboard the ExoMars2022 mission, a 3.3 μm absorption was noted in some pixel spectra. Since methane, like other hydrocarbons, shows absorptions in the range 3.1-3.6 μm, we begun to study this band in CRISM data to explore the possibility to look for seepages on Mars surface. The datasets chosen for this study, aside the site in Oxia Planum area, include some sites of observations on Gale Crater and other sites in Nili Fossae area. We used the Planetary Spectrum Generator to simulate CRISM spectra of the different sites, with the diverse concentrations of CH4 spikes. These simulations served to establish the relation between concentration and methane band depths, as seen by CRISM spectrometer. Then, mapping the Modified Gaussian Model fit on CRISM data, we extracted the band parameters of the absorptions in the 3.3 μm spectral region. Aside rare, suspected absorptions, an artifact was highlighted. Therefore, we have set a threshold on the depth to consider as depth of potential true absorptions, on the basis of the standard deviation (s) of absorption depth map. Finally, we concluded to favor as potential absorptions: distribution of clusters of pixels in the band mapping not vertically stacked and a threshold value >μ (average)+5σ (standard deviation) of the depth map. These threshold values set the lower limit for each observation on the methane concentration potentially detectable by CRISM. The threshold value varies from one observation to another, in a range between 0.0136-0.0237, that would correspond in a range of lower limit concentrations of 180 and 600 ppbv. We found interesting cluster of pixels which spectra overcome the imposed threshold. We still consider that part of them could still be a kind of unknown artifact. Nevertheless, the aim of this paper is to show that CRISM data can show potential absorptions of methane in such quantities that in some observations are compatible with the order of the methane spikes effectively detected in literature. Even if this work does not confirm nor deny the occurrences of methane seepages in the investigated images it shows a possible method for assessing a confidence limit in the detection of this band in CRISM data.
Knowledge and Understanding of Obstetric Danger Signs Among Pregnant Women Attending the Antenatal Clinic at the National Referral Hospital in Thimphu, Bhutan: A Cross-Sectional Study
Authors: Tamang Saran Tenzin , Dorji Thinley , Yoezer Sonam , Phuntsho Thinley , Dorji Phurb 
Published: November 2020

Abstract
Background: The third Sustainable Development Goal aims to reduce maternal and newborn deaths. Pregnant women’s understanding of danger signs is an important factor in seeking timely care during emergencies. We assessed knowledge of obstetric danger signs using both recall and understanding of appropriate action required during obstetric emergencies.Methods: This was a cross-sectional study among pregnant women attending antenatal clinic at Bhutan’s largest hospital in Thimphu. Recall was assessed against seven obstetric danger signs outlined in the Mother and Child Health Handbook (7 points). Understanding of danger signs was tested using 13 multiple choice questions (13 points). Knowledge was scored out of 20 points and reported as “good” (≥80%), “satisfactory” (60 – 79%) and “poor” (<60%). Association between knowledge score and participant characteristics were tested using Chi-square, Fisher’s Exact and t-tests. Corresponding non-parametric tests were performed where appropriate. Correlation between participant characteristics and knowledge score as well as number of danger signs recalled was tested using Pearson’s correlation coefficient. Results with p<0.05 were considered significant.Results: Four hundred and twenty-two women responded to the survey (response rate = 96.0%). Mean (±SD) knowledge score was 12 (±2.5). Twenty women (4.7%) had “good knowledge”, 245 (58.1%) had “satisfactory knowledge” and 157 (37.2%) had “poor knowledge”. The median number of danger signs recalled was 2 (IQR 1, 3) while 68 (20.3%) women could not recall any danger signs. Women were most knowledgeable about pre-labour rupture of membranes (96.0%) and least knowledgeable about spotting during pregnancy (19.9%). Knowledge level was significantly associated with reading Mother and Child Health Handbook, mother’s education level, husband’s education level, number of antenatal care visits, gestational age and past surgery on reproductive tract. Both knowledge score and number of danger signs recalled significantly correlated with the period of gestation. Conclusions: Most pregnant women had satisfactory knowledge score but recognized the appropriate actions warranted during obstetric emergencies. The MCH Handbook has played a significant role in improving knowledge and understanding of danger signs.
Primary Undifferentiated Pleomorphic Sarcoma in Oral-maxillary Area: Retrospective Study and Molecular Analysis
Authors: Xiao Meng , You Yuanhe , Du Zhong , Tian Zhuowei , Xu Guisong , Shi Rongxin , Wang Lizhen , Wang Yanan 
Published: November 2020

Abstract
BackgroundUndifferentiated pleomorphic sarcoma (UPS) in oral-maxillary area is rarely reported. Herein, we aimed to investigate the clinical characteristics, treatment strategies, prognosis, and molecular features of the oral-maxillary UPS. MethodsRetrospectively, we reviewed the UPS patients who were diagnosed and treated in our department. The medical histories, imaging features, histopathological characteristics, treatment strategies, clinical outcomes were summarized and analyzed. Besides, the molecular features were demonstrated by whole exonic sequencing. ResultsTotally, 10 cases with primary oral-maxillary UPS were included. The rapidly progressive UPS can easily develop at advanced and life-threatening stage, especially concerning the complex anatomical structures and spaces in the oral-maxillary area. The finial diagnosis for UPS greatly depends on histological findings and immunohistochemistry under the exclusion of all the possible differential diagnosis. Retrospectively, the treatment strategies for the involved cases still referred to those of oral squamous cell carcinoma. Statistically, the median overall survival (OS) for all the included cases was 7.75 months (range: 5-17 months). Comparatively, 3 cases had improved OS (median survival: 17 months, range: 17-18 months) experienced PR/SD with neoadjuvant chemotherapy (anlotinib). Cancer driver genes detection revealed GBP4 as a candidate driver gene for the oral-maxillary UPS. Additionally, a missense mutation in gene PIK3CA (p.E545K) was also identified. ConclusionOur findings can greatly expand the knowledge about the oral-maxillary UPS, and provide molecular evidences to improve the therapeutic options for the oral-maxillary UPS. Further studies are warranted to validate our discoveries on the oral-maxillary UPS.
Evaluation of Xpert® MTB/RIF for the Detection of Mycobacterium Tuberculosis in Sputum-Smear Negative Patients Using Bronchoalveolar Lavage Fluid
Authors: Oyeh Ernest , Zhang Zhenghao , Wang Yanan , Xu Peng , Jin Faxiang , Xu Wenfang 
Published: November 2020

Abstract
BackgroundAn estimated three million cases of tuberculosis (TB) are missed annually and much time elapse for the diagnosis of suspected sputum-smear negative cases, hence, the need for rapid and accurate diagnostic test. This retrospective study was conducted to evaluate the use of the Xpert®MTB/RIF assay on BALF specimens in TB diagnosis in terms of time to treatment initiation and its effect on empirical treatment.MethodsBronchoscopy was offered to sputum smear-negative patients with suspected pulmonary tuberculosis (PTB). Collected BALF was tested by fluorescent microscopy, MGIT960, and Xpert®MTB/RIF assay. First-line drug sensitivity tests were performed on positive samples. Similar tests were done using sputum.ResultsBetween November 2017 and November 2019, a total of 395 suspected TB patients underwent bronchoscopy in our hospital. BALF samples were collected and analysed using different methods. Using BALF culture as the standard reference test, the sensitivity and specificity of Xpert®MTB/RIF for TB diagnosis using BALF specimens were 79.2% and 95.8%, respectively. The positive and negative predictive values were 87.5% and 93.0%, respectively. Rifampin resistance was highly predictive of multidrug resistant tuberculosis (MDR-TB) using Xpert®MTB/RIF, with a value of 72.7%.The median time to treatment initiation using BALF was 5 days (IQR=4-7 days) for fluorescent staining, 6 days (IQR=3-8 days) with Xpert®MTB/RIF and 31 days (IQR=29-35 days) for culture.Further, 179(45.3%) out of the 395 sputum smear-negative patients suspected of PTB were already started on empirical treatment before bronchoscopy. After bronchoscopy, 96(24.3%) tested positive for TB whilst 83(21%) tested negative with Xpert®MTB/RIF using BALF.ConclusionXpert®MTB/RIF done using BALF for sputum smear-negative patients suspected of PTB increases the diagnostic accuracy of TB and decreases the time to treatment initiation of PTB as well as the rate of empirical treatment use.
The Fundamental Role of Prophylactic Anticoagulation Therapy and the Complications of Hypercoagulability in Patients infected with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)
Authors: Alwaeli Haidar , Shabbir Mahvesh , Sobi Mali Khamissi , Demirjian Jack , Ahmad Arham , Musallam Serene 
Published: November 2020

Abstract
Coronavirus disease 2019 (COVID-19) is predominately an upper respiratory infectious disease caused by the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2). Although most patients infected with COVID-19 generally present with acute respiratory distress symptoms, we are now learning that the virus can cause a multitude of disruption in physiological and pathophysiological homeostasis. Moreover, there are increasingly reported cases of thromboembolic events occurring in infected patients, resulting in widespread use of anticoagulation therapy. This case series presents seven patients who have received anticoagulation therapy over the course of the disease. Additionally, the correlation between thromboembolic complications secondary to COVID-19, prophylactic use of anticoagulation therapy and the significant pathological findings that might arise will be assessed and discussed in great details.