bluuebunny/crossref_metadata_2025_split huggingface dataset:
Associations of Socioeconomic Factors with Cause-specific Mortality and Burden of Cardiovascular Diseases: Findings from the Vital Registration in Urban Shanghai, China, during 1974-2015
Authors: Zhang Lijuan , Li Qi , Han Xue , Wang Shuo , Li Peng , Ding Yibo , Zhang Tao , Zhao Jia , Chen Yifan , Liu Jiluo , Li Jue , Tan Xiaojie , Liu Wenbin , Zhang Rong , Cao Guangwen 
Published: July 2020

Abstract
Background: Cardiovascular disease (CVD) is the leading cause of mortality worldwide. The effect of socioeconomic factors on cause-specific mortality and burden of CVD is rarely evaluated in low- and middle-income countries, especially in a rapidly changing society.Methods: Original data were derived from the vital registration system in Yangpu, a representative, population-stable district of urban Shanghai, China, during 1974-2015. Temporal trends for the mortality rates and burden of CVD during 1974-2015 were evaluated using Joinpoint Regression Software. The burden was evaluated using age-standardized person years of life loss per 100,000 persons (SPYLLs). Age-sex-specific CVD mortality rates were predicted by using age-period-cohort Poisson regression model. Results: A total of 101,822 CVD death occurred during 1974-2015, accounting for 36.95% of total death. Hemorrhagic stroke, ischemic heart disease, and ischemic stroke were the 3 leading causes of CVD death. The age-standardized CVD mortality decreased from 144.5/100,000 to 100.7/100,000 in the residents (average annual percentage change [AAPC] -1.0, 95% confidence interval [CI] -1.7 to -0.2), which was mainly contributed by women (AAPC -1.3, 95% CI -2.0 to -0.7), not by men. Hemorrhagic stroke, the major CVD death in the mid-aged population, decreased dramatically after 1991. The crude mortality of ischemic heart disease kept increasing but its age-adjusted mortality decreased continually after 1997. SPYLLs of CVD death increased from 1974 to 1986 (AAPC 2.1, 95% CI 0.4 to 3.8) and decreased after 1986 (AAPC 1.8, 95% CI -2.3 to -1.3). These changes were in concert with the implementation of policies including extended medical insurance coverage, pollution control, active prophylaxis of CVD including lifestyle promotion, and national health programs. The mortality of CVD increased in those born during 1937-1945, a period of the Japanese military occupation, and during 1958-1965, a period including the Chinese Famine. Sequelae of CVD and ischemic heart disease are predicted to be the leading causes of CVD death in 2029.Conclusions: Exposure to serious malnutrition in early life might increase CVD mortality in later life. Improvements in medical services, pollution control, and lifestyle could decrease CVD death. New strategy is needed to prevent the aging-related CVD death and burden in the future.
Promoting the use of evidence in health policymaking in the ECOWAS region: the development and contextualization of an evidence-based policymaking guidance
Authors: Uneke Chigozie Jesse , Sombie Issiaka , Johnson Ermel , Uneke Bilikis Iyabo , Okolo Stanley 
Published: July 2020

Abstract
Background

The Economic Commission of the West African States (ECOWAS), through her specialised health Institution, the West African Health Organization (WAHO) is supporting Members States to improve health outcomes in West Africa. There is a global recognition that evidence-based health policies are vital towards achieving continued improvement in health outcomes. The need to have a tool that will provide systematic guide on the use of evidence in policymaking necessitated the production of the evidence-based policy-making (EBPM) Guidance.

Methods

Google search was performed to identify existing guidance on EBPM. Lessons were drawn from the review of identified guidance documents. Consultation, interaction and interviews were held with policymakers from the 15 West African countries during WAHO organized regional meetings in Senegal, Nigeria, and Burkina Faso. The purpose was to elicit their views on the strategies to promote the use of evidence in policymaking to be included in the EBPM Guidance. A regional Guidance Validation Meeting for West African policymakers was thereafter convened by WAHO to review findings from review of existing guidance documents and validate the EBPM Guidance.

Results

Out of the 250 publications screened, six publications fulfilled the study inclusion criteria and were reviewed. Among the important issues highlighted include: what evidence informed decision-making is; different types of research methods, designs and approaches, and how to judge the quality of research. The identified main target end users of the EBPM Guidance are policy/decision makers in the West African sub-region, at local, sub-national, national and regional levels. Among the key recommendations included in the EBPM Guidance include: properly defining/refining policy problem; reviewing contextual issues; initiating policy priority setting; considering political acceptability of policy; commissioning research; use of rapid response services, use of policy advisory/technical/steering committees; and use of policy briefs and policy dialogue.

Conclusion

The EBPM Guidance is one of the emerging tools that can enhance the understanding of evidence to policy process. The strategies to facilitate the use of evidence in policymaking outlined in the Guidance, can be adapted to local context, and incorporated validated approaches that can be used to promote evidence-to-policy-to-practice process in West Africa.
Clinical characteristics and prognostic factors in elderly patients with COVID-19
Authors: Cheng Qin , Liao Yixuan , Lin Yujing , Tao Liyuan , Wang He , Li Mohan , Ge Qinggang , Li Yanming , Shen Ning 
Published: July 2020

Abstract
Background: The COVID-19 pandemic poses tremendous threats to the world. Elderly patients are among the high-risk population, and apt to experience worse outcomes.Methods: Elderly patients (age ≥60 years old) were enrolled from January 28 to February 29, 2020, in Tongji Hospital, one of designated COVID-19 medical centers in Wuhan, China. A retrospective study was performed to describe clinical characteristics, laboratory findings, chest imaging, treatment, and outcomes of elderly COVID-19 patients. COX regression was used to analyze predictors for 28-day mortality. Linear regression models were constructed to analyze factors associated with length of hospital stay (LOS).RESULT: A total of 186 elderly patients (aged 70.4 ± 7.1 years, 95 males (51.6%)) were enrolled, 120 patients (64.5%) were severe or critical type, and mortality rate was 16.1% (30/186). Of 156 survived patients, 150 were discharged. Fever (83.3%), cough (80.6%) and dyspnea (68.3%) were the most frequent symptoms. Common comorbidities included hypertension (48.9%) and diabetes (32.8%). Ground-glass opacities (97.3%) and peripheral distribution (59.1%) were the most predominant patterns on chest imaging. Patients in non-survival group had a higher smoking rate, more symptoms of dyspnea, lab results indicative of poorer health, and needed more medications or supportive treatment. Age (HR 1.128, 95% CI 1.066-1.194), lymphocyte count (HR 0.261, 95% CI 0.073-0.930), LDH (HR 1.003, 95% CI 1.002-1.005), procalcitonin (HR 1.061, 95% CI 1.002-1.125), and qSOFA (HR 3.162, 95% CI 1.646-6.072) were predictors of independently associated with 28-day mortalitydeath. CURB-65 plus LDH on admission were strong predictors of death by ROC analysis (AUROC=0.891). Among surviving patients, consolidation on CTs (β=8.611), elevated ferritin level (β=0.004) and neutrophil count (β=0.806) were associated with increased LOS.Conclusion: High incidence of comorbidities and mortality were observed in elderly patients. Decreased lymphocyte, older age, higher qSOFA score, procalcitonin and LDH levels were associated with 28-day mortalityindependent factors associated with death, and CURB-65 plus LDH could bewere a strong predictive model of deathfatal outcome. Consolidation on CTs, elevated ferritin and neutrophil level correlated with increased LOS. Further prospective studies should be performed to test our findings and for explore potential treatments.
Feasibility study of using simultaneous multi-slice RESOLVE diffusion weighted imaging to assess parotid gland tumors: comparison with conventional RESOLVE diffusion weighted imaging
Authors: Jiang Jia-Suo , Zhu Liu-Ning , Wu Qian , Sun Yi , Liu Wei , Xu Xiao-Quan , Wu Fei-Yun 
Published: July 2020

Abstract
Background To evaluate the feasibility of using simultaneous multi-slice (SMS) readout segmentation of long variable echo-trains (RESOLVE) diffusion-weighted imaging (DWI) to assess parotid gland tumors, compared with conventional RESOLVE DWIMethods From September 2018 to December 2018, 20 consecutive patients with parotid tumors who underwent MRI scan for pre-surgery evaluation were enrolled. SMS-RESOLVE DWI and conventional RESOLVE DWI were scanned with matched imaging parameters, respectively. The scan time of two DWI sequences was recorded. Qualitative (anatomical structure differentiation, lesion display, artifact, and overall image quality) and quantitative (apparent diffusion coefficient, ADC; ratio of signal-to-noise ratio, SNR ratio; ratio of contrast-to-noise ratio, CNR ratio) assessments of image quality were performed, and compared between SMS-RESOLVE DWI and conventional RESOLVE DWI by using Paired t-test. Two-sided P value less than 0.05 indicated significant difference.[l1] Results The scan time was 3 minutes and 41 seconds for SMS-RESOLVE DWI, and 5 minutes and 46 seconds for conventional RESOLVE DWI. SMS-RESOLVE DWI produced similar qualitative image quality with RESOLVE DWI (anatomical structure differentiation, P=0.164; lesion display, P=0.193; artifact, P=0.330; overall image quality, P=0.083). Meanwhile, there were no significant difference on ADCLesion (P=0.298), ADCMasseter (P=0.122), SNR ratio (P=0.584) and CNR ratio (P=0.217) between two DWI sequences. Conclusion Compared with conventional RESOLVE DWI, SMS-RESOLVE DWI could provide comparable image quality using markedly reduced scan time. SMS could increase the clinical usability of RESOLVE technique for DWI of parotid gland.
Deficits in Skilled Motor and Auditory Learning in a Rat Model of Rett Syndrome
Authors: Adcock Katherine S. , Blount Abigail E. , Morrison Robert A. , Alvarez-Dieppa Amanda , Kilgard Michael P. , Engineer Crystal T. , Hays Seth A. 
Published: July 2020

Abstract
Background

Rett Syndrome is an X-linked neurodevelopmental disorder caused by a mutation in the gene MECP2 . Individuals with Rett Syndrome display developmental regression at an early age, and develop a range of motor, auditory, cognitive and social impairments. Several studies have successfully modeled some aspects of dysfunction and Rett Syndrome-like phenotypes in transgenic mouse and rat models bearing mutations in the MECP2 gene. Here, we sought to extend these findings and characterize skilled learning, a more complex behavior known to be altered in Rett syndrome.

Methods

We evaluated the acquisition and performance of auditory and motor function on two complex tasks in heterozygous female Mecp2 rats. Animals were trained to perform a speech discrimination task or a skilled forelimb reaching task.

Results

Our results reveal that Mecp2 rats display slower acquisition and reduced performance on an auditory discrimination task than wild-type (WT) littermates. Similarly, Mecp2 rats exhibit impaired learning rates and worse performance on a skilled forelimb motor task compared to WT.

Conclusions

Together, these findings illustrate novel deficits in skilled learning consistent with clinical manifestation of Rett syndrome and provide a framework for development of therapeutic strategies to improve these complex behaviors.
Estimation of Breeding Values Using Different Densities of Snp to Inform Kinship in Broiler Chickens
Authors: Salvian Mayara , Moreira Gabriel Costa Monteiro , Reis Ândrea Plotzki , Dauria Brayan Dias , Pilonetto Fabrício , Gervásio Izally Carvalho , Ledur Mônica Corrêa , Coutinho Luiz Lehmann , Spangler Matthew Lee , Mourão Gerson Barreto 
Published: July 2020

Abstract

Background: Traditionally, breeding values are estimated based on phenotypic and pedigree information using the numerator relationship (A) matrix. With the availability of genomic information, genome-wide markers can be included in the estimation of breeding values through genomic kinship. However, the density of genomic information used can impact the cost of implementation. The aim of this study was to compare the rank, accuracy, and bias of estimated breeding values (EBV) for organs [heart (HRT), liver (LIV), gizzard (GIZ), lungs (LUN)] and carcass [breast (BRST), drumstick (DRM) and thigh (THG)] weight traits in a broiler population using pedigree-based BLUP (PBLUP) and single-step genomic BLUP (ssGBLUP) methods using various densities of SNP and variants imputed from whole-genome sequence (WGS). Results: For both PBLUP and ssGBLUP, heritability estimates varied from low (LUN) to high (HRT, LIV, GIZ, BRST, DRM and THG). Regression coefficients values of EBV on genomic estimated breeding values (GEBV) were similar for both the high density (HD) and WGS sets of SNPs, ranging from 0.87 to 0.99 across scenarios. Conclusion: Results show no benefit of using WGS data compared to HD array data using an unweighted ssGBLUP. Our results suggest that 10% of the content of the HD array can yield unbiased and accurate EBV.
Has the Non-Resection Rate Decreased During the Last Two Decades among Patients Undergoing Surgical Exploration for Pancreatic Adenocarcinoma?
Authors: Mattevi Catherine , Garnier Jonathan , Marchese Ugo , Ewald Jacques , Gilabert Marine , Poizat Flora , Piana Gilles , Delpero Jean-Robert , Turrini Olivier 
Published: July 2020

Abstract
Purpose

To determine if improvement in imaging reduces the non-resection rate (NRR) among patients with pancreatic ductal adenocarcinoma (PDAC).

Methods

From 2000 to 2019, 751 consecutive patients with PDAC were considered eligible for a intention-to-treat pancreatectomy and entered the operating room. In April 2011, our institution acquired a dual energy spectral computed tomography (CT) scanner and liver diffusion weighted magnetic resonance imaging (DW-MRI) was included in the imaging workup. We consequently considered 2 periods of inclusion: period #1 (February 2000–March 2011) and period #2 (April 2011–August 2019).

Results

All patients underwent a preoperative CT scan with a median delay to surgery of 18 days. Liver DW-MRI was performed among 407 patients (54%). Median delay between CT and surgery decreased (21 days to 16 days, P <.01), and liver DW-MRI was significantly most prescribed during period #2 (14% vs 75%, P <.01). According to the intraoperative findings, the overall NRR was 24.5%, and remained stable over the two periods (24% vs 25%, respectively). While vascular invasion, liver metastasis, and carcinomatosis rates remained stable, para-aortic lymph nodes invasion rate (0.4% vs 4.6%; P <0.001) significantly increased over the 2 periods. The mean size of the bigger extra pancreatic tumor significantly decrease (7.9mm vs 6.4mm ( P <.01), respectively) when the resection was not done. In multivariate analysis, CA 19-9<500U/mL ( P <.01), and liver DW-MRI prescription ( P <.01) favoured the resection.

Conclusions

Due to changes in our therapeutic strategies, the NRR did not decrease during two decades despite imaging improvement.
A DROP-IN beta probe for robot-assisted 68Ga-PSMA radioguided surgery: first ex vivo technology evaluation using prostate cancer specimens
Authors: Collamati Francesco , OOsterom Matthias van , De Simoni Micol , Faccini Riccardo , Fischetti Marta , Mancini-Terracciano Carlo , Mirabelli Riccardo , Moretti Roberto , Heuvel Judith olde , Solfaroli-Camillocci Elena , Beurden Florian van , Poel Henk van der , Valdes-Olmos Renato , Leeuwen Pim van , Leeuwen Fijs van , Morganti Silvio 
Published: July 2020

Abstract
Background: Recently, a flexible DROP-IN gamma-probe was introduced for robot-assisted radioguided surgery, using traditional low-energy SPECT-isotopes. In parallel, a novel approach to achieve sensitive radioguidance using beta-emitting PET-isotopes has been proposed. Integration of these two concepts would allow to exploit the use of PET-tracers during robot-assisted tumor-receptor-targeted. In this study, we’ve engineered and validated the performance of a novel DROP-IN beta-particle (DROP-INb) detector.Methods: Seven prostate cancer patients with PSMA-PET positive tumors received an additional intraoperative injection of ~70 MBq 68Ga-PSMA-11, followed by robot-assisted prostatectomy and extended pelvic lymph node dissection. The surgical specimens from these procedures were used to validate the performance of our DROP-INb probe prototype, which merged a scintillating detector with a housing optimized for a 12 mm trocar and prograsp instruments. Results: After optimization of the detector and probe housing via Monte Carlo simulations, the resulting DROP-INb probe prototype was tested in a robotic setting. In the ex vivo setting, the probe – positioned by the robot- was able to identify 68Ga-PSMA-11 containing hot-spots in the surgical specimens: signal-to-background (S/B) was > 5 when pathology confirmed that the tumor was located <1 mm below the specimen surface. 68Ga-PSMA-11 containing (and PET positive) lymph nodes, as found in two patients, were also confirmed with the DROP-INb probe (S/B>3). The rotational freedom of the DROP-IN design and the ability to manipulate the probe with the prograsp tool allowed the surgeon to perform autonomous beta tracing. Conclusions: This study demonstrates the feasibility of beta-radioguided surgery in a robotic context by means of a DROP-INb detector. When translated to an in vivo setting in the future, this technique could provide a valuable tool in detecting tumor remnants on the prostate surface and in confirmation of PSMA-PET positive lymph nodes.
Prognostic Impact of Estimated Remnant-like Particle Cholesterol in Patients with Differing Glycometabolic Status: an Observational Cohort Study from China
Authors: Zhao Qi , Zhang Ting-yu , Cheng Yu-jing , Ma Yue , Xu Ying-kai , Yang Jia-qi , Zhou Yu-jie 
Published: July 2020

Abstract
Background: It is uncertain whether estimated remnant-like particle cholesterol (RLP-C) could predict residual risk in patients with different glycometabolic status. This study aimed to evaluate the relationship between estimated RLP-C and adverse prognosis in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) treated with percutaneous coronary intervention (PCI) and to identify the potential impact of glycometabolism on the predictive value of estimated RLP-C.Methods: The study assessed 2419 participants with NSTE-ACS undergoing PCI at Beijing Anzhen Hospital from January to December 2015. Estimated RLP-C was calculated as follows: total cholesterol (TC) minus low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). The adverse events included all-cause death, non-fatal myocardial infarction (MI), and ischemia-driven revascularization.Results: Estimated RLP-C was prominently associated with adverse prognosis in the total population [hazard ratio (HR) 1.291 per 1-SD increase, 95% confidence interval (CI) 1.119-1.490, P < 0.001], independent of confounding risk factors. However, subgroup analysis showed that increasing estimated RLP-C was related to a higher risk of adverse events in the diabetic population only [HR 1.385 per 1-SD increase, 95% CI 1.183-1.620, P < 0.001]. Estimated RLP-C failed to be a significant determinant of adverse prognosis in non-diabetic and pre-diabetic subgroups. The addition of estimated RLP-C to a baseline model including traditional risk factors enhanced the predictive performance both in total and diabetic populations.Conclusions: High estimated RLP-C levels are a significant predictor for recurrent adverse events in patients with diabetes and NSTE-ACS treated with PCI.
Clinical analysis of pain after transvaginal mesh surgery in patients with pelvic organ prolapse
Authors: Shi Chang , Zhao Ying , Hu Qing , Gong Runqi , Yin Yitong , Xia Zhijun 
Published: July 2020

Abstract
Background
The purpose of this study was to investigate the relevant factors of pain after transvaginal mesh (TVM) surgery for the treatment of pelvic organ prolapse, and to analyze the management and relief of the pain.
Methods
A retrospective study of a clinical database of patients who underwent TVM surgery was conducted, and pain related aspects were analyzed.
Results
The incidence of pain after TVM surgery was 2.70% (50/1855), with a median occurrence time of 7.5 months. Pain symptoms mainly involved vagina, perineum, buttocks, groin, inner thighs, and lower abdomen. Greater intraoperative blood loss (OR = 1.284, 95%CI 0.868–2.401) and postoperative anatomic failure (OR = 1.577, 95%CI 0.952–3.104) were analyzed as risk factors with statistical significance. Mesh exposure rate in pain group was 38%, showing a significant difference between groups (P < 0.01). Forty patients underwent non-surgical treatments, with a relief rate of 40.0%; 33 patients were performed surgical treatments, 15 of which underwent partial mesh removal and 18 underwent complete mesh removal, with a relief rate of 84.8%. The total relief rate was 88% within all 50 patients suffering from pain.
Conclusions
Excessive intraoperative bleeding and postoperative anatomic failure can increase the risk of postoperative pain; mesh exposure, mesh contracture, and mesh position abnormality are also associated. Most patients can get pain relief with proper management, more than half of which may need mesh removal with differing amounts.