bluuebunny/crossref_metadata_2025_split huggingface dataset:
Calcium supplementation prolongs the time of hospitalization and has a double effect on mortality in septic patients: A retrospective study from MIMIC-III
Authors: He Wencheng , An Youzhong , Huang Lei , Luo Hua , Chen Jingying , Li Weijia , Zhang Yiming , Zhang Weixing 
Published: March 2020

Abstract
Background Hypocalcemia is a common electrolyte disturbance in sepsis, calcium administration in those patients remains a controversial issue. The aim of this study was to assess the association of calcium supplementation with the time of hospitalization and mortality in septic patients. Method 5761 eligible septic patients, including 2689 with calcium supplementation and 3072 without calcium supplementation, were extracted from the MIMIC-III database. A total of 1463 pair patients were included in the analysis after propensity score matching according to the age, sex, SOFA score and lactate on first ICU admission. We compared the length of stay (LOS) in the intensive care unit (ICU) and hospital, as well as the 28-day and hospital mortality, which stratified the analysis according to the Sequential Organ Failure Assessment (SOFA) score, and the iCa on the first ICU admission between the matched groups. Results The results showed that either a too-low or a too-high iCa increased the risk for septic patients, but the minimum of the mortality curve in the non-calcium supplement group was locally in the mild hypocalcemia range. Regardless of the SOFA score and iCa, the LOS in both the ICU and hospital were higher in the calcium supplement group than in the non-calcium supplement group. Overall, the 28-day and hospital mortality were greater but not statistically significant in the calcium supplement group than in the non-calcium supplement group (14.83% vs 13.39%, p=0.416; 16.20% vs 13.88%, p=0.079, respectively). However, the survival analysis stratified by SOFA score showed that calcium supplementation reduced mortality when the patient’s SOFA score was >8 (p=0.028), while it worsen the outcome when the SOFA score was ≤4 (p<0.001) and had no significant effect with SOFA scores from 5~8 (p=0.556). Conclusion Our findings suggest that mild hypocalcemia may be protective in septic patients and that calcium supplementation may prolong hospitalization and have a double effect on mortality. The SOFA score may be a valuable clinical index for calcium administration decision making.
Procalcitonin, a Biomarker for Diagnosing and Differentiating Infection among Liver Transplant Recipients: a systematic review and meta-analysis
Authors: Dong Wei , Wan Ding-yuan , Zhong Xi , Luo Xin-yao , Wu Yu-meng , Guo Jun , Fu Min , Zhang Zhong-wei 
Published: March 2020

Abstract
Background Infection has long been the major cause for death after liver transplantation. Diagnosing this deadly disease in time can be of great help to support the patients in intensive care units. However, tests like blood culture would take too much time to generate an outcome. Procalcitonin seems to be a promising biomarker in such clinical settings these days. To evaluate its diagnostic value as a biomarker in identifying and differentiating infectious complications in liver transplant recipients. Methods PUBMED, Scopus, Web of Science, Cochrane Library were searched for articles published from January 1990 to September 2019 without language limitation. Cohort or case-control study investigating the value of PCT in distinguishing postoperative infectious complications among liver transplant recipients were included, followed by measurement using QUADAS-2 tool to estimate the risk of bias of each study. Bivariate approach and random-effects model were performed to generate the pooled outcomes. Results 8 studies (studying 560 liver transplant recipients) from 6 populations were reviewed and included, one of which is later excluded due to huge heterogeneity it caused. No significant threshold effect was found, suggesting that heterogeneity returned by the I 2 was not due the various cutoff values. The pooled DOR was 18.65 (95%CI 9.85-35.31) and the area under HSROC was 0.857 ( θ =-0.024; β =-0.203). The positive likelihood ratio and negative likelihood ratio are 3.472 (95% 2.352-5.127) and 0.289 (95% 0.192-0.434). Conclusion Current articles suggest a reasonable diagnostic value for the procalcitonin test in identifying infectious complications among patients undergoing liver transplantation. However, the reason why no threshold effect was found remained explored.
Modified pedicle screw-rod versus anterior subcutaneous internal pelvic fixation for unstable pelvic anterior ring fracture: A retrospective study and finite element analysis
Authors: Ding Sheng-Long , Chen Fan-Cheng , Huang Jun-Ming , Zhang Guang-Ming , Wang Fu-Yong , Lei Jing-Hui , Wu Xiao-Tian , Ruan Zhi-yong 
Published: March 2020

Abstract
Objectives: This study compared the stability and clinical outcomes of modified pedicle screw-rod fixation (MPSRF) and anterior subcutaneous internal pelvic fixation (INFIX) for the treatment of anterior pelvic ring fractures. Methods: In a retrospective review of a consecutive patient series conducted in a level 1 trauma university hospital, 63 patients with Orthopaedic Trauma Association (OTA)/Arbeitsgemeinschaft für Osteosynthesefragen (AO) type B or C pelvic ring fractures were treated by MPRSF (n=30) or INFIX (n=33). The mean follow-up was 20 months. The main outcome measure was the incidence of complications and adverse outcomes, and fixation stability was evaluated by finite element analysis (FEA). Results: The 2 groups did not differ in terms of injury severity score, OTA classification, cause of injury, and time to pelvic surgery (P>0.05). However, the MPSRF group had a higher satisfactory rate according to the Tornetta and Matta grading system than the INFIX group (73.33% vs 63.63%) as well as a higher Majeed score (81.5±10.4 vs 76.3±11.2), which was statistically significant at 6 months’ post-surgery (P<0.001). FEA showed that MPRSF was stiffer and more stable than INFIX and had a lower risk of implant failure. Conclusions: Both MPSRF and INFIX have acceptable biomechanical stability for the treatment of unstable pelvic anterior ring fractures. However, MPRSF has better fixation stability and lower risk of implant failure, which can lead to better clinical outcomes.
Protocol for the development and validation of a risk prediction model for stillbirths from 35 weeks gestation in Australia
Authors: Sexton Jessica , Coory Michael , Kumar Sailesh , Smith Gordon , Gordon Adrienne , Chambers Georgina , Pereira Gavin , Raynes-Greenow Camille , Hilder Lisa , Middleton Philippa , Bowman Anneka , Lieske Scott , Warrilow Kara , Ellwood David , Flenady Vicki 
Published: March 2020

Abstract
Background Despite advances in the care of women and their babies in the past century, an estimated 1.7 million babies are born still each year throughout the world. A robust method to estimate a pregnant woman’s individualized risk of late-pregnancy stillbirth is needed to inform decision-making around timing of birth to reduce the risk of stillbirth from 35 weeks gestation. Methods This is a protocol for a retrospective cohort study of all late-pregnancy births in Australia (1998-2015) from 35 weeks gestation including 7,200 stillbirths among 4.9 million births at an estimated rate of 1.47 stillbirths per 1000 live births. A multivariable logistic regression model will be developed in line with current T ransparent R eporting of a multivariable prediction model for I ndividual P rognosis or D iagnosis (TRIPOD) guidelines to estimate the gestation-specific probability of stillbirth with prediction intervals. Candidate predictors were identified from systematic reviews and clinical consultation and will be assessed through univariate regression analysis. To generate a final model, elimination by backward stepwise logistic regression will be performed. The model will be internally validated using K-fold cross-validation and externally validated using a geographically unique dataset. Overall model performance will be assessed with R 2 in addition calibration and discrimination. Calibration will be visualized using a calibration plot. Discrimination will be measured by the C- statistic and visualized using area underneath the receiver-operator curves (AUROC). Clinical usefulness will be reported as positive and negative predictive values and a decision curve analysis will be considered. Discussion A robust method to predict a pregnant woman’s individualized risk of late-pregnancy stillbirth is needed to inform timely, appropriate care to reduce stillbirth. Among existing prediction models designed for obstetric use, few have been subject to internal and external validation and many fail to meet recommended reporting standards. In developing a risk prediction model for late-gestation stillbirth with both providers and pregnant women in mind, we endeavor to develop a validated model for clinical use in Australia that meets current reporting standards.
Occupational injuries, daily workload, and fitness levels among fitness and swimming instructors.
Authors: Bonato Matteo , Merati Giampiero , Agnello Luca , Grevers Dorothée , Maggioni Martina Anna 
Published: March 2020

Abstract
Introduction: Few data has been published on injury risk among fitness instructors, especially regarding those who are expected to continuously practice while teaching. As the number of fitness instructors is increasing, new specific information about their possible injuries, daily workload, and fitness levels is needed. Objectives: The aim of this study was to assess occupational injuries, cardiorespiratory fitness, and daily workload of fitness (FI) and swimming instructors (SI). Methods. An online survey addressing occupational injuries was conduct among 435 FI (n=256) and SI (n=179). In a subgroup, cardiorespiratory fitness level was evaluated using maximal oxygen consumption ( O 2max ) as in indicator. Daily workload was monitored by heart rate (HR) and perception of fatigue. Results. Of the two groups, FI exhibited a higher incidence of musculoskeletal injuries and SI experienced more upper respiratory tract infections. O 2max ranged from 47.0±4.0 to 51.9±3.7 ml·kg -1 ·min -1 , and was similar between FI and SI. Regarding the daily workload, female SI had significantly higher HR mean and HR mean /HR max compared to female FI, but no significant differences between male FI and SI were found. No significant differences were observed between the perceived fatigue of FI and SI. Conclusions. Preventive strategies for the reduction of occupational injuries in FI and SI are needed.
Spinal Cerebrospinal Fluid Leak in the context of Pars Interarticularis Fracture: A Case Series
Authors: Chan Tommy Lik Hang , Cowan Robert , Hindiyeh Nada , Hashmi Syed , Lanzman Bryan , Carroll Ian 
Published: March 2020

Abstract
Introduction: Spinal Cerebrospinal fluid (CSF) leak can lead to intracranial hypotension and is an important differential diagnosis to consider in patients with sudden-onset chronic daily headaches. Pars interarticularis (PI) fracture is a potential rare cause of suspected spinal CSF leak.

Methods: This is a retrospective case series of 6 patients with suspected spinal CSF leak evaluated between January 2016 and September 2019. All patients received a magnetic resonance imaging (MRI) of the brain with and without gadolinium, MRI whole spine and full spine computed tomography (CT) myelogram. Targeted epidural patches with fibrin sealant were performed. Treatment response at return visit (3 months post patch) was documented.

Results: Six patients (4 females, 2 males) were diagnosed with a suspected spinal CSF leak and PI fracture. Mean age at the time of headache onset was 39 years old, and a range from 32 to 50 years old. Mean time to targeted epidural patches with fibrin sealant was 4.5 years. All 6 patients had PI fractures identified on CT myelogram and received targeted epidural patches with fibrin sealant at the site of the PI fracture. All patients had significant improvement in their headache intensity.

Conclusion: Our study highlights: 1) the importance of PI fracture as a possible culprit of suspected spinal CSF leak in patients with intracranial hypotension; 2) the added benefit of CT imaging for detecting bony abnormalities such as fractures in patients with intracranial hypotension; and 3) the successful treatment of suspected spinal CSF leak when targeting the fracture site.
Efficacy and safety of cinepazide maleate injection in patients with acute ischemic stroke: A multicenter, randomized, double-blind, placebo-controlled trial
Authors: Ni Jun , Chen Huisheng , Chen Guofang , Ji Yong , Yi Fei , Zhang Zhuobo , Yang Yi , Wu Jin , Cai Xueli , Shao Bei , Wang Jianfeng , Liu Yafang , Geng Deqin , Qu Xinhui , Li Xiaohong , Wei Yan , Ding Jianping , Lu Hua , Huang Yining , Huang Yonghua , Xiao Bo , Gong Tao , Cui Liying 
Published: March 2020

Abstract
Background: Ischemic stroke is a leading cause of morbidity and mortality. Thrombolytic therapy improves disability and survival rates; however, to be effective, it must be given within 4.5 hours of onset. Moreover, thrombolytic therapy is frequently contraindicated. Therefore, alternative therapeutic options are required. In China, cinepazide maleate injection has been shown to improve the cerebral collateral circulation and further reduce disability in stroke patients; however, very few studies investigating this therapy have been conducted to date. Therefore, this study aimed to further confirm the efficacy and safety of cinepazide maleate injection in patients with acute ischemic stroke. Methods: Patients with acute ischemic stroke were administered an intravenous infusion of 320 mg cinepazide maleate or placebo once daily for 14 days. All patients were also administered basic therapy (citicoline sodium). The primary efficacy endpoint was the proportion of patients with a modified Rankin scale (mRS) ≤2 on day 90. Secondary efficacy endpoints included Barthel Index ≥95. Safety was evaluated by recording all adverse events (AEs), monitoring laboratory parameters and vital signs, and electrocardiogram. Results: In total, 937 patients with an acute ischemic stroke were included, with a mean (standard deviation, SD) National Institutes of Health Stroke Scale score of 8.8 (2.4) and a mean (SD) stroke onset of 30.9 (11.4) hours prior. Following treatment for 90 days, the proportion of patients with an mRS score ≤2 was significantly higher in the cinepazide maleate group than in the control group (60.9% vs. 50.1%; p=0.0004). Moreover, the proportion of patients with a Barthel Index of ≥95 on day 90 was also significantly higher in the cinepazide maleate group than in the control group (53.4% vs. 46.7%; p=0.0230). There were no statistically significant differences in safety parameters between the cinepazide maleate and control groups. Conclusions: The results of this study show that cinepazide maleate injection is superior to placebo in improving neurological function and activities of daily living, reducing disability, and promoting functional recovery in patients with acute ischemic stroke. Cinepazide maleate injection was safe and well tolerated with no unexpected AEs reported.
Cigarette smoking is associated with abnormal ferroptosis in human sperm
Authors: Ou Zhanhui , Wen Qirong , Deng Yu , Yu Yang , Chen Zhiheng , Sun Ling 
Published: March 2020

Abstract
Purpose The effects of cigarette smoking on male semen quality are controversial, and the molecular mechanisms underlying how cigarette smoking affects semen quality are not clear yet. Methods In this study, semen samples from 70 heavy smokers and 75 non-smokers receiving infertility treatment were included. Basic semen parameters in non-smokers and heavy smokers were evaluated. Levels of ferroptosis glutathione (GSH), lipid reactive oxygen species (ROS), iron and GSH-dependent peroxidase 4 (GPX4) protein level) were observed in human semen and in GC-2 Spd cells exposed to cigarette smoke condensate (CSC). Results Heavy smokers had significantly higher abnormalities (sperm viability and sperm progressive motility) than non-smoking counterparts. Comparing non-smokers group, GSH level was reduced in the group of heavy smokers (P<0.05). However, the level of lipid ROS and iron were significantly increased (P<0.05). Besides, GSH level was reduced following treatment with CSC for 24 h, while lipid ROS and iron levels were increased (P<0.05). However, the levels were reduced after being co-cultured with Ferrostatin-1 (Fer-1) (P<0.05). The level of GPX4 protein was reduced after being treated with CSC in 24 h, and increased after being co-cultured with Fer-1(P<0.05). Conclusion Cigarette smoking is associated with abnormalities of ferroptosis in human sperm.
Determinants of dehydration status and associated risk factors of cholera outbreak in Oromia, Ethiopia
Authors: Ali Endale Alemayehu , Tilahun Tsigereda , Mebrate Eshetu 
Published: March 2020

Abstract
Introductions: Cholera is a diarrheal disease caused by infection of the intestine with the gram-negative bacteria Vibrio cholera. According to updated global burden of cholera estimate 2018 in Ethiopia 68,805,272 populations are at risk of cholera with incidence rate of 4 per 1000 population and case fatality of 3.8% estimated annual number of cases 275,221.Methods: The main objective of this study is to identify the significant risk factors of dehydration status of cholera outbreak in Oromia regional state of Ethiopia. Ordinal logistic regression was used to model the data by incorporating the assumption behind this novel model. Results: The results of the study indicated that of the total 965 cholera patients, most of them 560(58%) were severely dehydrated by cholera. The overall goodness of model (p-valu=0.07) shows that the model fits the data well. Besides, the proportional odds assumption also revealed that the slop coefficients in the model are the same across dehydration status (p-value=0.094). For those have history of travel, the odds of severely dehydrated versus the combined some dehydrated and no dehydrated was exp(1.133804)=3.11 times higher than those have no history of travel (p-value<0.01). All the other factors like history of contact with other patients, other sick patients in the family, Intravenous and Antibiotics drugs are statistically significant with 5% level of significance to determine the status of dehydration. Conclusions: The ordinal logistic regression was fitted the data well and most of the included factors were significant for the dehydration status of cholera outbreak.
Effects Of Virtual Reality Associated With Serious Games For Upper Limb Rehabilitation In Patients With Multiple Sclerosis: A Randomized Controlled Trial
Authors: Cuesta-Gómez Alicia , Baeza Patricia Sanchez-Herrera , Oña-Simbaña Edwin Daniel , Martínez-Medina Alicia , Ortiz-Comino Carmen , de Quirós Carlos Balaguer-Bernaldo , Jardón-Huete Alberto , Cuerda Roberto Cano-de la 
Published: March 2020

Abstract
Background: Dexterity and activities of daily living limitations on the upper limb (UL) represent one of the most common problems in patients with multiple sclerosis (MS). The aim of this study was to evaluate the effectiveness of the specially developed Serious Games that make use of the Leap Motion Controller (LMC) as main user interface for improving UL grip muscle strength, dexterity, fatigue, quality of life, satisfaction and compliance.Methods: A single-blinded randomized controlled trial was conducted. The sample was randomized into two groups: an experimental group who received treatment based on serious games designed by the research team using the developed LMC based Serious Games for the UL plus conventional rehabilitation, and a control group who received the same conventional rehabilitation for the UL. Both groups received two 60 min sessions per week over a ten-week period. Grip muscle strength, coordination, speed of movements, fine and gross UL dexterity, fatigue, quality of life, satisfaction and compliance were assessed in both groups pre-treatment, post-treatment and in a follow-up period of one month without receiving any treatment.Results: In the experimental group compared to the control group, significant improvements were observed in the post-treatment assessment for coordination, speed of movements, fine and gross UL dexterity. Also, significant results were found in the follow-up in coordination, speed of movements, fine and gross for the more affected side. Conclusions: An experimental protocol using an LMC based Serious Games designed for UL rehabilitation showed improvements for unilateral gross manual dexterity, fine manual dexterity, and coordination in MS patients with high satisfaction and excellent compliance.
Relationship of para- and perirenal fat and high-density lipoprotein and its function in patients with type 2 diabetes mellitus
Authors: Ke Jing , Wang Yan , Liu Simo , Li Kun , Xu YueChao , Yang Longyan , Zhao Dong 
Published: March 2020

Abstract
Background Para- and perirenal fat is a fat pad surrounding the kidneys. Recent researches have showed the association between para- and perirenal fat and cardiovascular diseases including atherosclerosis, hypertension and so on. Limited studies have explored the relation between para- and perirenal fat and serum high density lipoprotein (HDL) level, but the results were inconsistent. We aimed to assess the relationship between para-perirenal ultrasonographic fat thickness and serum HDL level and cholesterol efflux capacity of HDL in patients with type 2 diabetes mellitus (T2DM). Methods We recruited 58 subjects with T2DM and collected anthropometric indices including height, weight, waist circumference and so on. Para-perirenal ultrasonographic fat thickness (PUFT) was measured via ultrasound. Serum lipid profile and other metabolic indices were determined as well. Then we analyzed the relationship between PUFT and HDL level and cholesterol efflux capacity in all patients and subgroups divided by gender and body mass index (BMI). Results Patients with higher PUFT have lower serum HDL level but increased cholesterol efflux capacity of HDL. Further analysis showed that PUFT negatively correlated with serum HDL level in all patients, with no difference in group divided by BMI. While subgroup analysis divided by gender indicated that the relationship only existed in males. In addition, PUFT was positively correlated with cholesterol efflux capacity in all patients. However, subgroup analysis showed that PUFT did not significantly correlated with cholesterol efflux capacity in males and BMI ≥28kg/m 2 . Multiple stepwise regression analysis showed an independent association of PUFT and serum HDL level and cholesterol efflux capacity. Conclusions PUFT is closely correlated with serum HDL level and cholesterol efflux capacity in patients with T2DM.