bluuebunny/crossref_metadata_2025_split huggingface dataset:
Circulating levels of soluble tumor necrosis factor receptor 2 are associated with progressive diabetic kidney disease in patients with type 2 diabetes mellitus
Authors: Wu Tsung-Hui , Chang Li-Hsin , Chu Chia-Huei , Hwu Chii-Min , Chen Harn-Shen , Lin Liang-Yu 
Published: December 2020

Abstract
Background

Chronic low-grade inflammation is considered one of the major mechanisms for the progression of diabetic kidney disease. We investigated the prognostic value of circulating soluble tumor necrosis factor receptor 2 (sTNFR2) for early nephropathy in patients with type 2 diabetes.
Materials and methods

A total of 346 patients with type 2 diabetes and an estimated glomerular filtration rate (eGFR) ≥ 30 mL/min/1.73 m2 were followed up for a median of 4 years. Renal outcomes were defined as a composite of either or both a > 30% decline in the eGFR and/or albuminuria stage progression determined with consecutive tests.
Results

Sixty-nine patients developed renal composite events. Serum concentrations of sTNFR2 were strongly associated with the risk of renal function decline and progressive changes in albuminuria. Through a receiver operating characteristic curve analysis, a serum sTNFR2 level of 1.608 ng/mL was adopted as the discriminator value for predicting renal outcomes (area under the curve 0.61, 95% confidence interval 0.54–0.68, p = 0.005), yielding a sensitivity of 73.9% and a specificity of 48.7%. The association of sTNFR2 levels ≥ 1.608 ng/mL to renal outcomes was significant after adjusting for relevant variables (hazard ratio 1.95, 95% confidence interval 1.01–3.74, p = 0.046) and remained consistent across subgroups stratified by age, sex, systolic blood pressure, eGFR, albuminuria, and the use of renin-angiotensin system blockers.
Conclusions

Higher circulating levels of sTNFR2 are independently associated with an eGFR decline and progressive albuminuria in patients with type 2 diabetes.
A Robust 4-channel Micro-power Low-noise Neural Recording Amplifier for Hippocampal Cognitive Prosthesis
Authors: Ni Ming , Han Yan , Lei Jian , Kim Hakbong 
Published: December 2020

Abstract
Background: Recording of electrical activity of neurons is indispensable for decoding the information in the brain. The amplitude of signals recorded by electrodes is small, and it must be amplified to the level that can be digitalized by the analog-to-digital convert (ADC). A micro-power low-noise neural recording amplifier is indispensable for implant hippocampal cognitive prosthesis. When the process turns into deep submicron, the gate leakage current of the metal oxide semiconductor (MOS) transistor becomes larger and mismatch between devices becomes worsen. It is necessary to keep the neural amplifier robust in all process corners. Methods: The proposed circuit is a two-stage amplifier which can achieve a good trade-off between power consumption and noise. Four second-stage amplifiers share a common reference amplifier to reduce area and power consumption. A pseudo-resistor with high resistance is utilized to realize a very-low frequency high pass corner without external components. In order to minimize process variation, a bulk-compensated (BC) technique is adopted to maintain adequate tolerance in all corner case. Results: The 4-channel neural amplifier is designed and fabricated in a 40 nm standard complementary metal oxide semiconductor (CMOS) process. It achieves a mid-band gain of 54 dB, a bandwidth of 70 Hz to 7.7 kHz, a total input-referred noise of 3.2 μVrms , and a Noise Efficiency Factor (NEF) of 3.3 while consuming 4.68 µW from the 1.1 V supply. The core area of one channel is only 0.032 mm 2 . Conclusion: A 4-channel integrated neural recording amplifier chip with bias-compensated circuits is presented in this paper. Extensive simulations insure that the design is “center”. The chip layout is verified using design rules check (DRC) and layout versus schematic (LVS) design check with the help of verification tools. Test results shows that it is less sensitive to process variation and consumes less power compared with amplifier without bulk-compensated circuit. This makes the design robust and uniquely appropriate for low-power implant application.
Nurses’ Viewpoints on the Quality of Care: A Qualitative Study in Timor-Leste
Authors: Luan Bernadethe Marheni , Lopes Paulo , Soares Domingos 
Published: December 2020

Abstract
BackgroundResearch on quality of care revealed nurse-to-patient ratio and skill mix as key elements in quality of care. However, those studies were done in countries where the nursing workforce had a higher proportion of professional nurses with bachelor degrees. The findings of the research studies may have overlooked health system challenges such as the auxiliary nursing services found in lesser developed small island countries with higher proportions of auxiliary nurses. Working in under-resourced places, nurses in Timor-Leste might have differing viewpoints on the aspects that contribute to quality of care perspectives.MethodsFocus group discussions (FGDs) were conducted in 2017, in three districts that included staff and senior nurses from three levels of health care facilities: primary, secondary, and tertiary. Data were analyzed using content analysis method.ResultsTwo themes emerged from the FGDs data: “patients as the center focus of the service” and “gaps in providing quality of care”. Aside from attributes of quality care such as equality, efficiency, and patient-centeredness in the delivery of care, the first theme also identified the importance of identifying nurses’ value system in order to support a specific level of quality of care. The second theme included quality care milieu amplifying distinctive factors facing a health system in under-resourced places. Problems related with structural dimension of quality of care such as facility infrastructure and staffing were described. Nurses were unable to improve the quality of care in healthcare facilities when faced with inadequate and deficient infrastructure, equipment, supplies, financing, management, and staffing support. Conclusions Compared to nurses in countries with a better workforce skill mix, nurses in lesser developed small island countries and nurses working in under-resourced places, face additional challenges that uniquely influence the quality of care. Findings from this study provide evidence that it is important to develop human resources for health (HRH) policies that contribute to professional management of the nursing workforce as the largest health workforce cadre, thus strengthening their ability to improve patient care service.
Analysis of the Situation of Unmet Health Care Need Among Extremely Rare Disease of Gaucher
Authors: Qi Xinye , Xu Jiao , Shan Linghan , Li Ye , Cui Yu , Liu Huan , Wang Kexin , Gao Lijun , Kang Zheng , Wu Qunhong 
Published: December 2020

Abstract
BackgroundThe diagnosis and health care of patients with rare diseases present a tremendous challenge worldwide. This study estimated the health service utilization, cost of illness, and patients with Gaucher disease (GD)’s/caregivers’ health-related quality of life in China.MethodAn online retrospective survey of patients with GD and their caregivers was conducted during May-June 2018. Socio-demographic, health service utilization, disease-related expenses, social support, sleep quality (Pittsburgh Sleep Quality Index [PSQI]), and the Short Form Health Survey (SF-36) were investigated. Using self-reported information, we estimated the annual cost of illness, including direct medical, direct non-medical, and indirect medical costs. ResultsForty patients and their 49 caregivers were surveyed. The patients’ onset age of GD was 9.3±10.9; their disease course was 3.5±3.1 years. 21 (42.9%) patients had ≥2 caregivers, but 35 (71.4%) caregivers reported have no experience as a caregiver. 79.6% caregivers have stopped working, and 87.8% changed weekly working schedule. Before final diagnosis, patients visited 3.9±3.1 (max=20) hospitals and took 1.2±1.7 (max=6.6) years for confirmed diagnosis. On average, 5.0±9.6 misdiagnoses occurred, and the per-patient diagnoses cost was USD ($) 7,576. After GD confirmation, 8 (16.3%) patients received no treatment, 40 (81.6%) received pharmacotherapy, 10 (20.4%) received surgery, 38 (77.6%) received outpatient service (8.8±9.1 times/annually), and 37 (77.5%) received inpatient service (4.0±3.5 times/annually). Annual per-patient cost was USD ($) 49,925 (95% confidence interval: 29,178, 70,672). Average direct medical cost was $41,816, including pharmaceutical ($29,908), inpatient ($7,451), and outpatient ($1,838). Productivity loss per-caregiver was $1,980, and their Zarit Burden Inventory score was moderate-severe (48.6±19.6). Both patients/caregivers reported lower social support (32.4±7.4, 34.9±7.6), two times higher PSQI (7.9±2.9, 8.7±3.6), and half lower SF-36 (41.3±18.6, 46.5±19.3) than those reported for healthy Chinese individuals.Conclusion﻿This study finds out that fill the unmet need for extremely rare diseases is very challenging. The high misdiagnosis rate, together with delayed diagnosis, substantial costs, and deteriorated health-related quality of life of GD patients as well as their heavy care burden, calls for extreme attention from policymakers in China. Further efforts of government and society are urgently demanded, including pharmaceutical reimbursement, screening newborns, developing precise diagnostic tools, and training doctors.
Small Extracellular Vesicles From Human Adipose-derived Stem Cells: A Potential Promoter of Keeping Fat Graft Survival
Authors: Chen Aizhen , Tang Shijie , He Jiawei , Li Xiangyu , Peng Guohao , Zhang Haoruo , Chen Jinghua , Chen Liangwan , Chen Xiaosong 
Published: December 2020

Abstract
Background: Small extracellular vesicles (sEVs) with genetic information secreted by cells play a crucial role in the cellular microenvironment. In this study, our purpose is to explore the characteristics of the small extracellular vesicles of human adipose-derived stem cells (hADSC-sEVs) and studied the role of hADSC-sEVs in improving the survival rate of grafted fat.Methods: In the present study, we used the transmission electron microscopy, nano-tracking analysis, nanoflow surface protein analysis, zeta potential value to identify sEVs. SEVs' trajectory was traced dynamically to verify whether hADSC-sEVs can be internalized into human umbilical vein endothelial cells (HUVECs) in vitro. The angiogenic property of hADSC-sEVs was observed by measuring the volume, weight and histological analysis of the grafted fats in nude mice modles. Results: Our research showed that the extracellular vesicles were sEVs with double-layer membrane structure and the diameter of which is within 30-150nm. hADSC-sEVs exert biological influence mainly through internalization into cells. Compared with the control group, the hADSC-sEVs group had a significantly higher survival rate of grafted fat, morphological integrity and a lower degree of inflammation and fibrosis. And immunohistochemistry showed that hADSC-sEVs significantly increased the neovascularisation and the expression of CD34, VEGFR2 and KI-67 in the graft tissue. Conclusions: As a potential nanomaterial, hADSC-sEVs has been explored in the field of cell-free application of stem cell technology. hADSC-sEVs promoted the survival of grafted fats by promoting the formation of new blood vessels, which is another promising progress in the field of regenerative medicine. We believe that hADSC-sEVs will have a broad application prospect in the field of regenerative medicine in the future.
The Influence of Male and Female Overweight/obesity on IVF&nbsp;Outcome: A Cohort Study Based on Registration in Western China
Authors: liu xiang , Sun Jianhua , Xue Xia , Zhang Zhou , Shi Juanzi , Xing Junping 
Published: December 2020

Abstract
Background: Overweight/obese couples are more likely to present with a lower fertility, but it is still unclear whether the Overweight/obese can reduce the successful rate of in vitro fertilization-embryo transform (IVF-ET).This systematic review uses strict Chinese BMI criterias to evaluate whether male and female overweight/obesity will affect embryo quality and IVF outcomes, and whether there are gender differences.Methods: We reviewed the IVF-ET data of Northwest Women and Children's Hospital from 2015.01 to 2019.06, and divided the included population into four groups: Group 1 (n = 3413, male and female BMI: 18.5≤BMI＜24kg/m2, the control group);Group 2 (n = 1437, female BMI≥24 kg/m2 and male BMI18.5≤BMI＜24 kg/m2, the experimental group 1); Group 3 (n=4283, female BMI18.5≤BMI＜24 kg /m2 and male BMI≥24 kg/m2, the experimental group 2) and Group 4 (n=2176, female BMI≥24 kg/m2 and male BMI≥24 kg/m2, the experimental group 3). .Primary outcomes were clinical pregnancy rate,（CPR), live birth rate(LBR)，available embryo rate and normal fertilization rate.Results: The study found that the overweight/obesity of the independent female group or the combined male and female group manifested with a much less number of available embryos and a much less number of high-quality embryos (p <0.05). Meanwhile, the independent male group displayed a significant reduction of IVF-ET cleavage rate (p=0.019) and the independent female group displayed a significant reduction of the fertilization rate (p=0.029) and the normal fertilization rate (p=0.004). The combined male and female group manifested with a significant reduction of the available embryo rate (p=0.026), the fertilization rate (p=0.010) and the normal fertilization rate (p=0.003)，but overweight/obesity has no significant effect on CPR、LBRand abortion rates. Conclusion: overweight/obesity affects the embryo quality, the fertilization rate, and the cleavage rate, and there exists gender differences. Therefore, in order to improve the embryo quality, the fertilization rate and the cleavage rate of IVF of overweight/obese couples, it is still recommended that one partner or both couples should manage to reduce their weight to a normal value before IVF treatment.
An ex Situ Underground Coal Gasification Experiment with a Siderite Interlayer. Course of the Process, Production Gas, Temperatures and Energy Efficiency
Authors: Wiatowski Marian , Kapusta Krzysztof , Nowak Jacek , Szyja Marcin , Basa Wioleta 
Published: December 2020

Abstract
A 72-hour ex situ hard coal gasification test in one large block of coal was carried out. The gasifying agent was oxygen with a constant flow rate of 4.5 Nm3/h. The surroundings of coal were simulated with wet sand with 11% moisture content. A 2-cm interlayer of siderite was placed in the horizontal cut of the coal block. As a result of this process, gas with an average flow rate of 12.46 Nm3/h was produced. No direct influence of siderite on the gasification process was observed; however, measurements of CO2 content in the siderite interlayer before and after the process allowed to determine the location of high-temperature zones in the reactor. The greatest influence on the efficiency of the gasification process was exerted by water contained in wet sand. At the high temperature that prevailed in the reactor, this water evaporated and reacted with the incandescent coal, producing hydrogen and carbon monoxide. This reaction contributed to the relatively high calorific value of the resulting process gas, averaging 9.41 MJ/kmol, and to the high energy efficiency of the whole gasification process, which amounted to approximately 70%.
Mechanism of Abnormal Surface Subsidence Induced by Fault Instability
Authors: Zhang Gangyan 
Published: December 2020

Abstract
Surface movement and deformation with faults differ significantly from that without faults, which the surface movement and deformation at the fault outcrop generally abnormally increase when a fault occurs in the overlying strata and loses stability as a result of mining. To explore the mechanism of abnormal surface subsidence induced by fault instability due to mining in the hanging wall and footwall, mechanical models for the fault slip and soil cantilevers were separately established. Moreover, based on numerical and similarity simulation experiment, the difficulty degrees of fault instability were compared and analysed during mining in hanging wall and footwall. The research results show that: (1) the abnormal surface subsidence at fault outcrop is caused by fracture of soil mass at the fault outcrop due to the cantilever effect. (2) The fault zone that can be stabilised during mining in the hanging wall is broader than that during mining in the footwall, and a fault remains stable when mining in hanging wall and the surface at fault outcrop is more likely to experience stepped subsidence when mining in the footwall. (3) Fault stability worsens with the growth of the fault dip angle when mining in hanging wall, the fault is certainly subjected to slip and instability when fault dip angle is lower than the internal friction angle of the rock mass within the fault zone and fault stability strengthens with increasing fault dip angle during mining in the footwall. (4) When mining in the footwall, the ratio of shear stress to normal stress at the fault outcrop is about five times that when mining in the hanging wall and the fault is more likely to undergo slip and instability during mining in the footwall. (5) As a natural weak plane in the rock mass, a fault exerts a blocking effect on the transfer of mining-induced stress and overburden movements.
Bacterial Profile of Nurses’ Uniforms: A Descriptive Cross-sectional Study
Authors: Bayuo Jonathan , Obour Emmanuel , Bonsu Felix , Agyei Frank , Asante Akua , Abeasi Doreen , Akyem Samuel , Nabaale Stephen 
Published: December 2020

Abstract
Background: The bacterial profile associated with nurses’ uniforms have not been empirically ascertained within the Ghanaian setting. Objective: To evaluate the bacterial profile of scrubs worn by nurses over a 24-hour period. Methods: A descriptive cross-sectional approach was used with 20 conveniently recruited Registered Nurses spread across a 24-hour shift period. Sterile scrubs were provided and at the end each shift, four zones were swabbed (axilla, anterior trunk, posterior trunk, and posterior aspects of the trousers). The laboratory isolation processes proceeded through colony identification, gram staining, catalase test (Gram-positive), lactose fermenter (Gram-negative), Triple Sugar Iron and Motility Indole Ornithine (Enterobacteria). Results: Both Gram-negative and Gram-positive bacteria were identified which may suggest that irrespective of the unit in which nurses worked, their uniforms served as surfaces of bacterial habitation. At least, one organism was isolated at all the areas swabbed suggesting that nurses’ uniforms are contaminated at the end of their shift.Conclusion: The findings suggest a need for collective efforts to ensure that uniforms are not worn beyond the confines of the healthcare setting as well as strict adherence to infection prevention and control policies within the hospital.
Diversity of 3’ Variable Region of cagA Gene in Helicobacter Pylori Strains Isolated from Chinese Population
Authors: Xue zhijing , You Yuanhai , He Lihua , Gong Yanan , Sun Lu , Han Xiurui , Fan Ruyue , Zhai Kangle , Yang Yaming , Zhang Maojun , Yan Xiaomei , Zhang Jianzhong 
Published: December 2020

Abstract
Background: CagA is one of the most important virulence factors of Helicobacter pylori (H. pylori). There is a highly polymorphic Glu-Pro-Ile-Tyr-Ala (EPIYA) repeat region in the CagA 3’ variable region. This repeat region is thought to play an important role in the pathogenesis of gastrointestinal diseases. The aim of this study was to investigate the diversity of CagA 3’ variable region and the amino acid polymorphisms in the EPIYA segments, and their association with gastroduodenal diseases.Methods: A total of 515 H. pylori isolates from patients in 14 different geographical regions of China were collected and the genomic DNA was extracted. The 3’ variable region of the cagA was amplified by polymerase chain reaction (PCR) and then followed by DNA sequencing, and the amino acid sequences were analyzed with MEGA 7.0 software.Results: A total of 503 (97.7%) H. pylori isolates were cagA-positive and 1,587 EPIYA motifs were obtained, including 12 types of EPIYA or EPIYA-like sequences. In addition to the four reported major segments, several rare segments (e.g., B’, B’’ and D’) were defined and 20 different sequence types (e.g., ABD, ABC) were found in our study. A total of 481 (95.6%) strains were East Asian type, most of them were ABD subtype (82.1%). Only 22 strains were Western type, including types AC, ABC, ABCC and ABCCCC. The CagA-ABD subtype had statistical difference in different geographic regions (P=0.006). There are seven amino acid polymorphisms in the sequences surrounding the EPIYA motifs, among which amino acid residue 893 and 894 had a statistical difference with gastric cancer (P=0.004).Conclusions: In this study, 503 CagA sequences was studied and analyzed in depth. In Chinese population, most H. pylori isolates are of the CagA-ABD subtype and its presence was associated with gastroduodenal disease. Amino acid polymorphisms at residue 893 and 894 flanking the EPIYA motif had a statistically significant association with gastric cancer.
Prospective Observational Study of an Eye-measuring Device Aiming at Application to Periodic Health Checkups for Under 12 Months of age Infants; The Feasibility of Gazefinder
Authors: Fukushima Shuntaro , Takahashi Tomoo , Tsukamoto Kazuki , Matsumura Misaki , Takigawa Ryo , Sakai Yasuo , Maniwa Sokichi , Murphy Lynne , Taketani Takeshi 
Published: December 2020

Abstract
Background Eye-tracking to evaluate gaze patterns is effective screening and assessment tool for children with Autism Spectrum Disorder (ASD). Gazefinder, one of eye-tracking devices is can be easily and quickly used. Few studies have investigated whether Gazefinder can be applied to infants under 12 months of age, and then we examined the feasibility of this device in this age group aiming at applications to periodic health checkups for early identification of ASD in the future. Methods We conducted a prospective observational study from April 2019 to March 2020 that included infants between 4 and 11 months of age who underwent a periodic health checkup in Ohchi County, Shimane, Japan. Data on participants’ sex, age, gestational age, birth weight, and Japanese Developmental Quotient (DQ; the Enjoji Scale) were collected. We presented nine patterns of short movies, and measuring the gaze data, fixation time percentages, and patterns. Results Infants who fulfilled the inclusion criteria were recruited, and 93 gaze datapoints were analyzed. The mean age was 6.5 months and mean DQ was 88%. Subjects were divided into four groups by age: 4-5, 6-7, 8-9, and 10-11 months. The mean fixation time percentage of all sequences was 81.0% (standard deviation; 4.4), and there was no significant difference in each group. Infants in all groups showed a significantly higher predilection for eyes than for mouths. There was a positive association of age with human gaze and a negative association with geometric gaze. Moreover, we confirmed that joint attention skills were enhanced in accordance with their growth process. Conclusions The eye-tracking data were almost corresponding to previous studies and Gazefinder could be applied to infants starting at 4 months of age. For ASD screening in early infancy, more researches are needed.