bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sofosbuvir/ledipasvir safety and efficacy for HCV patients with haemodialysis and compensated cirrhosis
Authors: Boushi Ebtisam , Cheha Khaled , Kakaje Ameer , Heydar Noha , Almokdad Rasha , Alassi Mohammed Waleed 
Published: May 2020

Abstract
Objectives: To evaluate the efficacy of Sofosbuvir/ledipasvir (SOF/LDV) combination for hepatitis C virus (HCV) in patients on haemodialysis and compensated liver cirrhosis as it was until recently approved by the FDA.Design: Retrospective study on patients who were on haemodialysis and used SOF/LDV for HCV.Setting: In one secondary health care facility (a hospital).Interventions: Treatment consisted of 90g of SOF/ 400g of LDV once daily. Patients were assessed for HCV at end treatment after 12 weeks and after 24 weeks for patients who had compensated cirrhosis with other follow-up for symptoms assessment.Results: The sample contained 16 males and 5 females with mean age of 40.9 years. Nineteen patients had no cirrhosis of the liver and the other two had clinical and radiological cirrhosis and had Child–Turcotte–Pugh (CTP) type B. Full follow-up was for only 20 patients and they all had HCV resolved as one patient passed away. Other factors were assessed such as HCV genotypes, but they had the same results with no difference in symptoms development (P>0.05).Conclusion: SOF/LDV combination is suggested to be effective when the patient is on haemodialysis and had compensated cirrhosis and CTP type B without the need of dose adjustment or increase duration with no major complications in patients with HCV 1a, 1b, 4, and 5.
Implementation and adherence to the Bedside Paediatric Early Warning System (BedsidePEWS) in a pediatric tertiary care hospital
Authors: Gawronski Orsola , Ferro Federico , Cecchetti Corrado , Atti Marta Luisa Ciofi Degli , Dall'oglio Immacolata , Tiozzo Emanuela , Raponi Massimiliano 
Published: May 2020

Abstract
BackgroundClinical deterioration in children admitted to hospital wards often manifests through signs of increasing illness severity that may lead to unplanned Pediatric Intensive Care Unit admissions or cardiac arrest, if undetected. The Bedside Pediatric Early Warning System (BedsidePEWS) is a validated Canadian scoring system used at a large tertiary care children’ hospital to prevent critical illness and standardize the response to deteriorating children on the wards.MethodsA 6-month audit was performed to evaluate the use of the BedsidePEWS, escalation of patient observations, monitoring and medical reviews on the wards in 2018.Two research nurses performed weekly visits to the hospital wards to collect data on BedsidePEWS scores, medical reviews, type of monitoring and vital signs recorded. Data were described through means or medians according to the distribution. Inferences were calculated either with Chi-square, Student’s t test or Wilcoxon-Mann–Whitney test, as appropriate (P <0.05 considered as significant).ResultsA total of 522 Vital Signs (VS) and score calculations on 177 patient clinical records were observed from 13 hospital inpatient wards. Frequency of VS and score documentation occurred <3 times per day in 33% of the observations. Adherence to the VS documentation frequency according to the hospital protocol was observed in 54% for all patients; for children with chronic health conditions (CHC) it was significantly lower than children admitted for acute medical conditions (47%, P=0.006). The BedsidePEWS score was correctly calculated and documented in 84% of the observed VS documentation events. Systolic blood Pressure was recorded in 79% and Temperature in 91% of the VS recording events. Patients within a 0-2 BedsidePEWS score range were all reviewed at least once a day by a physician. Only 50% of the patients in the 5-6 score range were reviewed within 4 hours and 42% of the patients with a score ≥7 within 2 hours. Transcutaneous Oxygen Saturation continuous monitoring was applied to 60% of the children at higher risk (BedsidePEWS ≥5).ConclusionsEscalation of patient observations, monitoring and medical reviews matching the BedsidePEWS is still suboptimal. Children with CHC are at higher risk of lower compliance. Impact of adherence to predefined response algorithms on patient outcomes should be further explored.
Altered expression of exosomal miRNAs from primary human trabecular meshwork cells induced by transforming growth factor-β2
Authors: Wang Yong , Zhang Jinling , Luo Jiawei , Guan Huaijin 
Published: May 2020

Abstract
Background

Primary open-angle glaucoma (POAG) is tightly related with extracellular matrix (ECM) remodeling of human trabecular meshwork cells (HTMCs). Transforming growth factor-β2 (TGF-β2) can induce ECM remodeling. MicroRNAs (miRNAs) serve as a potential therapeutic target in influencing the development of glaucoma by regulating TGF-β2. Recent studies also have found that exosomes may be involved in the regulation of intraocular pressure in patients of glaucoma. Therefore, the aim of the current study was to investigate the exosomal miRNAs expression changes derived from HTMCs treated with TGF-β2.
Methods

Exosomes were isolated from HTMCs supernatant cultured for 24 h with TGF-β2. The morphology of exosome pellets was examined by transmission electron microscopy. Nanoparticle tracking analysis used to demonstrate the particle size distribution. Total exosomal RNAs were extracted for subsequent miRNA gene chip analysis to investigate differentially expressed miRNAs between the control cells and treatment cells. Gene Ontology (GO) annotation, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were used to predict potential target and validate possible functions of the exosomal miRNAs.
Results

There were 23 miRNAs up-regulated and 3 miRNAs down-regulated. Go annotation and KEGG pathway enrichment analysis revealed that 469,102 and 94 GO terms involved in biological processes, cellular components and molecular function for the possible functions of the 26 miRNAs.
Conclusions

These findings indicate that TGF-β2 may alter exosomal miRNAs expression to participate in the pathogenesis of POAG in which multiple molecular functions and pathways are involved. They may provide significant information for potential biomarkers for POAG diagnosis, clinical treatment and potential prognosis.
Clinical Significance of Hemodynamic Parameters Identified by Ultrasound in the Extracranial Internal Carotid Artery and Posterior Cerebral Artery of Patients with Moyamoya Disease
Authors: Zheng Shuai , Ge Peicong , Wang Jingzhe , Shi Zhiyong , Li Yi , Ning Bin , Zhang Jinghan , Cheng Linggang , Zhang Dong , He Wen 
Published: May 2020

Abstract
BackgroundDigital subtraction angiography (DSA), magnetic resonance angiography (MRA) and other imaging methods are limited in the long-term and dynamic examination of hemodynamic changes in moyamoya disease (MMD). The aim of this study was to investigate the hemodynamic changes using ultrasound according to DSA findings and explore the association between ultrasound parameters and clinical manifestations of MMD.MethodsHemodynamic parameters of the extracranial internal carotid artery (EICA) and posterior cerebral artery (PCA) identified by ultrasound were classified into 3 groups according to DSA findings, and differences in ultrasound parameters among DSA stages were compared. Then, according to clinical manifestations, 30 patients were divided into the stroke group and the transient ischemic attack (TIA) group. We compared the differences in the EICA and PCA ultrasound parameters between the two groups, and receiver operating characteristic (ROC) curves were used to evaluate the value of ultrasound parameters in diagnosing stroke and TIA in MMD patients.ResultsThe diameter (D), peak systolic velocity (PSV), end diastolic velocity (EDV) and flow volume (FV) of EICA decreased as the Suzuki stage advanced (D: p༜0 .001, PSV: p = 0.002, EDV: p = 0.001, FV: p༜0.001). The PSV and EDV of PCA increased as the scores of the leptomeningeal system from the PCA to the anterior cerebral artery (ACA) and middle cerebral artery (MCA) territory advanced (PSV: p = 0.002, EDV: p༜0.001). Comparing the ultrasound parameters between the stroke group and the TIA group, the D and FV of EICA, the PSV and EDV of PCA were significantly different. ROC analysis showed that the area under the curve (AUC) based on the FV of EICA, the PSV of PCA and the combination of the two parameters were 0.676, 0.737 and 0.787, respectively, to diagnose stroke and TIA in MMD patients.ConclusionsOur results suggest that ultrasound parameters are related to DSA results, and that ultrasound is useful in predicting the clinical severity of MMD.Trial registration:Clinical Trial Registration-URL: http://www.chictr.org. Unique identifier: ChiCTR1900026075
Celastrol ameliorates experimental autoimmune neuritis by shifting the polarization of M1/M2 macrophages via the hypoxic response pathway
Authors: Qian Yun , Tang Bo , Jiang Minhai , Lu Shan , Huang Huan , Wei Wan 
Published: May 2020

Abstract
BackgroundGBS is an autoimmune disease characterized by inflammatory infiltration and demyelination of peripheral nerves. Macrophage polarization is involved in different stages of GBS. Altering the polarization of macrophages may be an effective therapeutic strategy for GBS. Celastrol was previously shown to contribute to anti-neuroinflammation. However, the mechanism underlying the effect of celastrol in GBS animal model experimental autoimmune neuritis (EAN) is unclear. We hypothesized that celastrol may shift the polarization of macrophages through the NRF /HIF-1αpathway.MethodsClinical scores, weight and histological changes were assessed to investigate the effects of celastrol on EAN. To detect the polarization state of macrophages, flow cytometry and immunofluorescence staining were applied. Inflammation cytokines were evaluated by ELISA. The expression of NRF2 and HIF-1α were detected by western-blot and immunofluorescence staining.ResultsCelastrol treatment significantly ameliorates the severity and neuroinflammation of EAN. The polarization state of macrophages from M1 to M2 was observed upon celastrol application. Consistently, pro-inflammatory cytokines were decreased, whereas anti-inflammatory cytokines were increased upon celastrol treatment. Furthermore, we found that celastrol treatment may increase expression of Nrf2 and decrease the expression of HIF-1α. ConclusionTaken together, these data demonstrate that celastrol may ameliorate the severity and neuroinflammation of EAN via promoting the polarization state of macrophages into M2, likely by modulating the hypoxic response. Celastrol may therefore serve as a novel therapeutic agent for GBS.
Intracytoplasmic expression of IL-6 and IL-17A in circulating CD4+ T cells are strongly associated with and predict disease activity in rheumatoid arthritis: A case-control study in Ghana
Authors: Sakyi Samuel Asamoah , Buckman Tonnies Abeku , Antwi-Berko Daniel , Yeboah-Mensah Kwame , Dey Dzifa , Owiredu Eddie-Williams , Amoani Benjamin , Mantey Richard 
Published: May 2020

Abstract
Background

T cell cytokines play important roles in the development and progression of rheumatoid arthritis (RA). Loss of Th1/Th2 and Th17/Treg balance has been reported in several inflammatory autoimmune diseases. However, their role in RA within the Ghanaian context has not been explored. Here, we evaluated the intracytoplasmic CD4 + T cell cytokine patterns in rheumatoid arthritis patients in Ghana and determined their relationship with disease activity.
Methods

This case-control study included 48 newly-diagnosed RA patients and 30 healthy controls from two major hospitals in Ghana. Validated structured questionnaires were administered to obtain demographic data; blood samples were collected and processed for flow cytometric analysis.
Results

IFN-γ, TNF-α, IL-4, IL-6, IL-10, IL-17A, IL-6/IL-4 and IL-17/IL-10 expression were significantly higher in RA cases compared to the healthy controls. The expression of IL-6 (0.00 (0.00-0.98) vs 0.82 (0.34–1.10) vs 1.56 (1.39–1.68), p < 0.0001), IL-17A (0.00 (0.00-0.02) vs 0.19 (0.09–0.30) vs 0.99 (0.64–1.25), p < 0.0001) and IL-17A/IL-10 (0.00 (0.00-0.39) vs 0.15 (0.09–0.26) vs 0.88 (0.41–1.47), p < 0.0001) increased significantly from the healthy controls through RA patients with low DAS scores to RA patients with moderate DAS scores. IL-6 (β = 0.681, r2 = 0.527, p < 0.0001), IL-17A (β = 0.770, r2 = 0.593, p < 0.0001) and IL-17A/IL-10 (β = 0.677, r2 = 0.452, p < 0.0001) expression were significantly directly associated with DAS28 scores. IL-6 (Cutoff = 1.32, Sensitivity = 100.0%, Specificity = 100.0%, Accuracy = 100.0%, AUC = 1.000) and IL-17A (Cutoff = 0.58, Sensitivity = 100.0%, Specificity = 100.0%, Accuracy = 100.0%, AUC = 1.000) presented with the best discriminatory power in predicting moderate DAS scores from low DAS scores.
Conclusion

Th1 and Th17 related cytokines predominate in the pathophysiology of RA; with IL-6 and IL-17 being principally and differentially expressed based on the severity of the disease. IL-6 and IL-17A could serve as useful prognostic and disease-monitoring markers in RA in the African context.
Comparative study for Treatment of Domestic Wastewater Using Chlorella Vulgaris
Authors: Moondra Nandini , Jariwala Namrata , Christian Robin A 
Published: May 2020

Abstract
Tertiary treatment using chemicals frequently prompts secondary contamination of sludge, making other issues of safe disposal. Thus, vitality and cost required for tertiary treatment of wastewater stay an issue for industries and municipalities. In this study, different microalgal concentrations (20%, 25%, 30%, 35%, 40% and 45%) were studied to treat domestic wastewater at 11 hours HRT for both filtered and non- filtered effluent. During the study, removal was observed in Total Solids (TS), Total Dissolved Solids (TDS), Total Suspended Solids (TSS), Electrical Conductivity (EC), phosphate, ammonia and COD for all the microalgal concentrations mentioned. However, the maximum removal efficiency was observed at 30% microalgal concentration. Maximum removal efficiency found in ammonia, phosphate and COD for non-filtered effluent was 96.60%, 91.73% and 84.71% respectively, whereas, in the case of the filtered sample, removal efficiency reached up to 97.62%, 92.47% and 88.75% for ammonia, phosphate and COD respectively. In the case of solids (specifically TSS) and EC, removal efficiency reached up to 30.87% and 24.31% respectively for non-filtered effluent and was 48.00% and 25.88% in the filtered sample. The study showed that an algae-based system could accomplish more affordable and environment-friendly way to treat domestic wastewater without tertiary treatment to a desirable limit.
The additional iron cable fixation between proximal patella and tibial tuberosity to treat AO/OTA 34C3 patellar fracture
Authors: Zhang Dongzheng , Shen Yong 
Published: May 2020

Abstract
Background: It is very difficult to deal with AO/OTA 34C3 patellar fracture. Although the modified Kirschner wire tension band, the cerclage and plate has been proposed to treat it, the result is not very good. We found that if the fixation was not firm enough after the modified Kirschner wire tension band with or without the cerclage had been carried out, the additional iron cable fixation between proximal patella and tibial tuberosity could resolve it effectively.Methods: Retrospective analysis was completed. 21 patients with AO/OTA 34C3 patellar fracture were treated in our department from January 2014 to January 2018. They were divided into 2 groups according to the operation plan. Group 1 (normal group), with 12 patients, was treated with modified Kirschner wire tension band with or without cerclage cable. Group 2 (cable group), with 9 patients, was treated with the additional iron cable fixation between proximal patella and tibial tuberosity when the fixation was not firm enough after the modified Kirschner wire tension band with or without the cerclage had been completed.Results: The two groups of the age, sex ratio, trauma mechanism, operation time, free articular fragment, comorbidity and follow-up time had no significant statistical difference (P>0.05). There was no significant statistical difference between the two groups of the clinical results. (such as Bostman total score and its specific individual score, the excellent and good ratio, the complications, and the bone union time, etc.) (P>0.05).Conclusions: To deal with AO/OTA 34C3 patellar fracture, when the fixation of modified Kirschner wire tension band with or without the cerclage cable is not firm enough, the additional iron cable fixation between proximal patella and tibial tuberosity can resolve it effectively.
Increased percentage of Atrial Pace Ventricular Pace was associated with increased cardiovascular morality in patients with a DDD pacemaker
Authors: Lee Wen-Hsien , Lee Chee-Siong , Tsai Wei-Chung , Lin Feng-Hsien , Tsai Wan-Ling , Chen Ying-Chih , Chen Chang-Jen , Hsu Po-Chao , Chu Chun-Yuan , Lin Tsung-Hsien , Voon Wen-Chol , Su Ho-Ming 
Published: May 2020

Abstract
Background

Compared to single-chamber pacing system, dual chamber atrioventricular pacing system (DDD) was associated with reduced mortality and hospitalization for heart failure. High percentage of right ventricular pacing was reported to be associated with high cardiovascular events. However, another meta-analysis study showed ventricular pacing reduction modalities did not improve adverse clinical outcomes. Hence, the relationship between the pacing percentage and clinical outcomes is necessary to be further studied.
Methods

The present study was designed to evaluate the association of total and cardiovascular mortality with the percentages of atrial sense ventricular sense (ASVS), atrial sense ventricular pace (ASVP), atrial pace ventricular sense (APVS), and atrial pace ventricular pace (APVP) in patients with a DDD pacemaker. Study subjects were selected from patients arranged for permanent pacemaker follow-up at our special clinic. 177 patients with a DDD pacemaker were included. We collected their pacemaker follow-up data at their first visit for pacemaker follow-up after permanent pacemaker implantation.
Results

Among the 177 subjects, the mean follow-up to mortality was 2.44 ± 1.03 years. There were 22 and 10 patients documented as total and cardiovascular mortality. In the Cox proportional hazards regression analysis, old age (P = 0.030) and low hemoglobin (P = 0.007) were the predictors of increased total mortality and increased creatinine (P = 0.023) and high percentage of APVP (hazard ratio [HR], 1.030; 95% confidence interval [CI], 1.012–1.049; P = 0.001) were the predictors of increased cardiovascular mortality after multivariable analysis.
Conclusion

In patients with a DDD pacemaker, old age and low hemoglobin were associated with increased total mortality and high creatinene and high percentage of APVP were associated with increased cardiovascular mortality after multivariable analysis. Hence, reduction in unnecessary atrial and ventricular pacing in patients with a DDD pacemaker might be useful in improving cardiovascular prognosis.
Identification and validation of an immune-related prognostic signature for hepatocellular carcinoma
Authors: Xia Xinxin , Liu Hui , Li Yuejun 
Published: May 2020

Abstract
Background: Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related mortality. The immune system plays vital roles in HCC initiation and progression. The present study aimed to construct an immune-gene related prognostic signature (IRPS) for predicting the prognosis of HCC patients. Methods: Gene expression data were retrieved from The Cancer Genome Atlas database. Univariate Cox regression analysis was carried out to identify differentially expressed genes that associated with overall survival. The IRPS was established via Lasso and multivariate Cox regression analysis. Both Cox regression analyses were conducted to determine the independent prognostic factors for HCC. Next, the association between the IRPS and clinical-related factors were evaluated. The prognostic values of the IRPS were further validated using the International Cancer Genome Consortium (ICGC) dataset. Gene set enrichment analyses (GSEA) were conducted to understand the biological mechanisms of the IRPS. Results: A total of 62 genes were identified to be candidate immune-related prognostic genes. Transcription factors-immunogenes network was generated to explore the interactions among these candidate genes. According to the results of Lasso and multivariate Cox regression analysis, we established an IRPS and confirmed its stability and reliability in ICGC dataset. The IRPS was significantly associated with advanced clinicopathological characteristics. Both Cox regression analyses revealed that the IRPS could be an independent risk factor influencing the prognosis of HCC patients. The relationships between the IRPS and infiltration immune cells demonstrated that the IRPS was associated with immune cell infiltration. GSEA identified significantly enriched pathways, which might assist in elucidating the biological mechanisms of the IRPS. Furthermore, a nomogram was constructed to estimate the survival probability of HCC patients.Conclusions: The IRPS was effective for predicting prognosis of HCC patients, which might serve as novel prognostic and therapeutic biomarkers for HCC.
Dynamic Monitoring of Cross-Bred Dogs for Translational Research in Ulcerative Colitis
Authors: Zhao Hairong , Wang Yujia , Liu Shengshuai , Yu Zhengyong , Xu Yusheng , Lu Qian , Liu Heng , Xu Zaiping , Zhang Chenggui , Zhao Yu 
Published: May 2020

Abstract
Background: Ulcerative colitis (UC)is a complex, chronic, immu ne-mediated inflammatory disease. The preclinical studies and assessment of UC drugs remain a major challenge. Dogs share similar environmental, genomic, anatomical, and intestinal physiologic features with humans. However, the model of UC in dogs is not understood and lacks systematic assessment. Methods: We developed a model for UC in the cross-bred dogs by different dose of acetic acid retention enema. Simultaneously, physiological pathologic indicators, including blood routine examination, inflammatory factor and colonoscopy, were monitored continuously for 14 days. Furthermore, olsalazine was used to treatment UC to evaluate the feasibility of the model. Results: The percentage of lymphocytes increases after induction UC by 10% acetic acid; C-reactive protein (CRP) and Cyclooxygenase-2(COX-2) are mainly inflammatory markers after induction UC by 10% or 7.5% acetic acid; acetic acid aggravates mucosal damage in a dose-dependent manner, and OLZ prevents 10% acetic acid-induced UC. The acetic acid concentration is controlled between 7.5 % and 10%, and the continuous damage of this model is 10 days.Conclusions: We suggest that cross-bred dogs represent a useful clinical model of UC, and it is suitable for translational research. Finally, we provide a model and dynamic endoscope atlas for UC in dogs.