bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and Validation of Risk Prediction Model for In-hospital Mortality Among Patients Hospitalized With Acute Exacerbation Chronic Obstructive Pulmonary Disease Between 2015 and 2019
Authors: Dong Fen , Ren Xiaoxia , Huang Ke , Wang Yanyan , Jiao Jianjun , Yang Ting 
Published: April 2021

Background: In patients with chronic obstructive pulmonary disease (COPD), acute exacerbations affect patients' health and can lead to death. This study was aimed to develop a prediction model for in-hospital mortality in patients with acute exacerbations of COPD (AECOPD).Method: A retrospective study was performed in patients hospitalized for AECOPD between 2015 and 2019. Patients admitted between 2015 and 2017 were included to develop model and individuals admitted in the following 2 years were included for external validation. We analyzed variables that were readily available in clinical practice. Given that death was a rare outcome in this study, we fitted Firth penalized logistic regression. C statistic and calibration plot quantified the model performance. Optimism-corrected C statistic and slope were estimated by bootstrapping. Accordingly, the prediction model was adjusted and then transformed into risk score.Result: Between 2015 and 2017, 1,096 eligible patients were analyzed, with a mean age of 73 years and 67.8% male. The in-hospital mortality was 2.6%. Compared to survivors, non-survivors were older, more admitted from emergency, more frequently concomitant with respiratory failure, pneumothorax, hypoxic-hypercarbic encephalopathy, and had longer length of stay (LOS). Four variables were included into the final model: age, respiratory failure, pneumothorax, and LOS. In internal validation, C statistic was 0.9147, and the calibration slope was 1.0254. Their optimism-corrected values were 0.90887 and 0.9282, respectively, indicating satisfactory discrimination and calibration. When externally validated in 700 AECOPD patients during 2018 and 2019, the model demonstrated good discrimination with a C statistic of 0.8176. Calibration plot illustrated a varying discordance between predicted and observed mortality. It demonstrated good calibration in low-risk patients with predicted mortality rate ≤10% (P = 0.3253) but overestimated mortality in patients with predicted rate &gt;10% (P &lt; 0.0001). The risk score of 20 was regarded as a threshold with an optimal Youden index of 0.7154.Conclusion: A simple prediction model for AECOPD in-hospital mortality has been developed and externally validated. Based on available data in clinical setting, the model could serve as an easily used instrument for clinical decision-making. Complications emerged as strong predictors, underscoring an important role of disease management in improving patients' prognoses during exacerbation episodes.
Lipid Extract From a Vegetable (Sonchus Oleraceus) Attenuates Adipogenesis and High Fat Diet-Induced Obesity Associated With AMPK Activation
Authors: Chen Chih-Yu , Su Chien-Wen , Li Xiangyong , Liu Yinghua , Pan Qian , Cao Tinglan , Kang Jing X. 
Published: April 2021

Scope:Sonchus Oleraceus, named bitter vegetable (BV), has been known to have multiple health benefits such as anti-aging and anti-inflammation. However, the role of BV in the prevention of obesity is unclear. The aim of this study was to examine the effect of BV lipid extracts (BVL) on obesity development.Methods and Results: Following treatments of high fat diet-induced obese mice (C57BL/6J) with BVL (0.3 mg/g of BW per mouse) for a month, mice exhibited a significant reduction in weight gain, blood triglyceride, and fasting blood glucose compared to control mice. Intriguingly, phosphorylated AMPK, a key regulator of nutrient metabolism, was markedly increased in inguinal fat of BVL group. In 3T3-L1 cells, BVL-7 (100 μg/ml), an omega-3 fatty acid-rich fraction from BVL, lowered lipid accumulation, and down-regulated the gene expression of adipocyte markers. The inhibitory effect of BVL occurred at the early stage of adipocyte differentiation, leading to the delay of mitotic clonal expansion. AMPK knockdown by siRNA abolished the inhibitory effect of BVL-7 on adipogenesis, suggesting that AMPK is essential for BVL-regulated adipocyte differentiation.Conclusion: BVL can effectively inhibit adipogenesis through, at least in part, stimulating AMPK pathway and attenuate HFD-induced obesity. Our findings suggest that BVL can be a promising dietary supplement for protection against obesity, and the effective component of BVL can be potentially developed as anti-obesity drugs.
Identification of Novel Prognostic Risk Signatures of Soft Tissue Sarcoma Based on Ferroptosis-Related Genes
Authors: Huang Wenjing , Duan Yuhe , Yang Xiuwei , Shang Cong , Chen Xin , Zhang Huanyu , Li Fujiang 
Published: April 2021

BackgroundThe role of ferroptosis in tumorigenesis has been confirmed in previous studies. However, the comprehensive analysis of ferroptosis-related gene (FRG) to study the role of FRG in soft tissue sarcoma (STS) is lacking.MethodsRNA sequencing profile of TCGA-SARC cohort and GTEx were used to select differentially expressed FRGs (DEFRGs). Univariate, LASSO, and multivariate Cox analyses were selected to determine overall survival (OS)- and disease-free survival (PFS)-related FRGs. Two prognostic signatures were established and validated in two independent sets from Gene Expression Omnibus (GEO). Finally, the expression of key FRGs were validated with RT-qPCR.ResultsIn total, 198 FRGs (90.4%) were abnormally expressed in STS. Twelve DEFRGs were incorporated in the final signatures and showed favorable discrimination in both training and validation cohorts. Patients in the different risk groups not only showed different prognosis, but also showed different infiltration of immune cells. Two nomograms combining signature and clinical variables were established and the C-indexes were 0.852 and 0.752 for the OS and DFS nomograms, respectively. Finally, the expression of NOX5, HELLS, and RPL8 were validated with RT-qPCR.ConclusionThis comprehensive analysis of the FRG landscape in STS revealed novel FRGs related to carcinogenesis and prognosis. These findings have implications for prognosis and therapeutic responses, which revealed potential prognostic biomarkers and promote precision medicine.
Apigenin Inhibits the Growth of Hepatocellular Carcinoma Cells by Affecting the Expression of microRNA Transcriptome
Authors: Wang Shou-Mei , Yang Pei-Wei , Feng Xiao-Jun , Zhu Yi-Wei , Qiu Feng-Jun , Hu Xu-Dong , Zhang Shu-Hui 
Published: April 2021

BackgroundApigenin, as a natural flavonoid, has low intrinsic toxicity and has potential pharmacological effects against hepatocellular carcinoma (HCC). However, the molecular mechanisms involving microRNAs (miRNAs) and their target genes regulated by apigenin in the treatment of HCC have not been addressed.ObjectiveIn this study, the molecular mechanisms of apigenin involved in the prevention and treatment of HCC were explored in vivo and in vitro using miRNA transcriptomic sequencing to determine the basis for the clinical applications of apigenin in the treatment of HCC.MethodsThe effects of apigenin on the proliferation, cell cycle progression, apoptosis, and invasion of human hepatoma cell line Huh7 and Hep3B were studied in vitro, and the effects on the tumorigenicity of Huh7 cells were assessed in vivo. Then, a differential expression analysis of miRNAs regulated by apigenin in Huh7 cells was performed using next-generation RNA sequencing and further validated by qRT-PCR. The potential genes targeted by the differentially expressed miRNAs were identified using a curated miRTarBase miRNA database and their molecular functions were predicted using Gene Ontology and KEGG signaling pathway analysis.ResultsCompared with the control treatment group, apigenin significantly inhibited Huh7 cell proliferation, cell cycle, colony formation, and cell invasion in a concentration-dependent manner. Moreover, apigenin reduced tumor growth, promoted tumor cell necrosis, reduced the expression of Ki67, and increased the expression of Bax and Bcl-2 in the xenograft tumors of Huh7 cells. Bioinformatics analysis of the miRNA transcriptome showed that hsa-miR-24, hsa-miR-6769b-3p, hsa-miR-6836-3p, hsa-miR-199a-3p, hsa-miR-663a, hsa-miR-4739, hsa-miR-6892-3p, hsa-miR-7107-5p, hsa-miR-1273g-3p, hsa-miR-1343, and hsa-miR-6089 were the most significantly up-regulated miRNAs, and their key gene targets were MAPK1, PIK3CD, HRAS, CCND1, CDKN1A, E2F2, etc. The core regulatory pathways of the up-regulated miRNAs were associated with the hepatocellular carcinoma pathway. The down-regulated miRNAs were hsa-miR-181a-5p and hsa-miR-148a-3p, and the key target genes were MAPK1, HRAS, STAT3, FOS, BCL2, SMAD2, PPP3CA, IFNG, MET, and VAV2, with the core regulatory pathways identified as proteoglycans in cancer pathway.ConclusionApigenin can inhibit the growth of HCC cells, which may be mediated by up-regulation or down-regulation of miRNA molecules and their related target genes.
School-Based Participatory Response for Reopening During the COVID-19 Pandemic: A Case Study of a Metropolitan High School Implementing the Health Promoting School
Authors: Kwon Insook , Kang Sunjoo , Kim Jin Sun 
Published: April 2021

Purpose: This study aimed to analyze how a private high school in Seoul developed and executed a “school disinfection strategy” to ensure the students' right to study in a safe environment, and also to analyze the lessons learned from this process.Methods: This was a case study of school health in a community-based school reopening during the COVID-19 pandemic. The study target was a 64-year-old private high school with 12 classes for each grade with a total of 1,100 students.Results: A “school disinfection strategy” was set up at individual and class environment levels to protect students from the risk of infection. In addition, school health activities were carried out with a “personal protection safety belt” and “community protection safety belt” for effective implementation. To ensure a safe educational environment for high school students and to ensure smooth execution of face-to-face classes (in-person teaching), the “prevention safety belt strategy” was introduced in accordance with governmental guidelines to sequentially implement various preventive measures necessary to guarantee environmental safety of schools. Activating personal prevention safety belts by checking the symptoms of students when entering the school and during each class, and providing self-made disinfectants by spraying alcohol on wet-wipes were cost-effective and sustainable methods used in this school to prevent the spread of infection.Conclusions: The experience of developing a prevention safety belt strategy to adapt the guidelines of the local education office to the school situation was presented. Focusing on the school community, as well as individual students and teachers, the concept of prevention safety belts helped to unite and stimulate voluntary participation of students in health promotion activities.
Three-dimensional acoustic impedance mapping of human skin by improved time–frequency domain analysis
Authors: Prastika Edo Bagus , Imori Atsushi , Kawashima Tomohiro , Murakami Yoshinobu , Hozumi Naohiro , Yoshida Sachiko , Nagaoka Ryo , Kobayashi Kazuto 
Published: April 2021

Abstract
Three-dimensional acoustic impedance microscopy was proposed for human cheek skin observation. A focused ultrasound wave was transmitted through a polymer substrate in contact with the skin, and the reflection was acquired by a time-domain measurement. The reflection was compared with that from a reference material representing the impulse response of the system. Time–frequency (dual-domain) deconvolution was performed to calculate the time-dependent reflection coefficient, which can subsequently be interpreted as the local acoustic impedance along the depth. The optimal conditions for deconvolution were discussed in order to perform quick and stable signal processing. Moreover, it was found that the stability of the dual-domain deconvolution was improved by adding the DC component to the transfer matrix, leading to a more stable calculation of the acoustic impedance distribution. The stability was statistically evaluated by means of the intensity distribution of the deconvolved signal. Finally, a 3D human cheek skin image was successfully reconstructed.
Análisis del consentimiento informado en pacientes con cáncer: una propuesta de algoritmo decisional
Authors: Gómez Álvarez José Enrique , Chávez Hernández Nora Hilda 
Published: April 2021

Una de las dificultades para la atención de los pacientes oncológicos es la posibilidad de que no colaboren con su tratamiento. A partir del análisis conceptual y del estudio de dos casos, se propone mejorar la calidad del procedimiento en el consultorio de oncología de atención ambulatoria en la Clínica 180 del IMSS.1 La literatura clínica revela diversas limitaciones de los pacientes al momento de consentir tratamientos; una muy frecuente es la mención del estrés. En los casos analizados aparecen, además, informaciones previas equivocadas sobre el tratamiento y la gravedad de la enfermedad. A partir de los datos encontrados, se diseñó un algoritmo decisional para señalar los momentos que pueden facilitar y permitir el consentimiento informado. Se concluye que el consentimiento debe darse a lo largo de todo el proceso, y que el algoritmo decisional es una propuesta de mejora en este sentido.
Voriconazole in Treatment of Resistant Fungal Keratitis
Authors: Riaz Sidrah , Khan Muhammad Tariq , Mehmood Khalid , Hussain Mahfooz , Riaz Sara 
Published: April 2021

Purpose: To study the effect of intrastromal Voriconazole for treatment of resistant fungal keratitis in a tertiary care eye hospital in Lahore, Pakistan.
Study Design: Experimental interventional study.
Place and Duration of Study: Avicenna Medical College Hospital, Lahore, from July 2017 to July 2019.
Methods: Sixty four patients were selected. All patients with fugal keratitis were included. The patients with previous corneal scar, mature cataract, endophthalmitis, Panophthalmitis, scleral involvement, impending or frank corneal perforation and uncontrolled diabetic patientswere excluded.Corneal scrapings of all patients were sent for 10% KOH staining. All patients were given intrastromal Voriconazole at 3 to 4 sites in divided doses in one ml syringe with 27-guage needle. Injection was repeated on 4th and 8th day. It was combined by topical antifungal and antibiotic eye drops six hourly. Patients were followed at day two, five, nine, three weeks and at 3 months.
Results: There were 55 males and 9 females. Average size of ulcer was 6.4mm ranging from 5.5mm ± 1.8mm. Fifty six (88%) patient showed improvement while eight (12%) patients ended up in melting of cornea which was managed with tectonic corneal graft. In three (5%) patients penetrating Keratoplasty was done. Conjunctival congestion and ocular pain improved significantly one week after third dose but final visual acuity was not significantly improved due to scarring.
Conclusion: The intrastromal corneal voriconazole is an effective treatment for fungal keratitis in term of healing corneal ulcer, control of infection and saving of eye from corneal perforation and permanent blindness.
Key Words: Voriconazole, Fungal keratitis, Penetrating Keratoplasty.
Treatment of Medial Canthal Tumor by Rotation Flap
Authors: Qurban Qirat , Kamil Zeeshan , Mahmood Khalid 
Published: April 2021

Purpose: To describe the cosmetic outcome after repairing medial canthal defects via glabellar rotation flaps in patients undergoing wide clear margin excision of medial canthal tumour.
Study Design: Interventional case series.
Place and Duration of Study: This study was conducted at Khalid Eye Clinic, Nazimabad, Karachi, from March 2019 to August 2019.
Methods: Study approval was obtained from the Ethical Review Committee. Eleven patients of both genders with clinically suspected medial canthal tumor were included in the study. Patients who underwent previous treatment such as radiation, cryotherapy or surgery were excluded. All surgeries were done to remove the tumor along with surrounding wide clear margins followed by reconstruction of the defect of the medial canthusareawith the help of arotation flap. Patients were followed for a period of up to six months post operatively for any wound related problems or recurrence. All patients were informed about the study and consent was obtained from each of them.
Results: All eleven patients of this study were satisfied at the end of the follow-up period with the final cosmetic outcome. Seven out of elevenpatients were males and the remaining four were females, which also highlighted a greater incidence of medial canthal tumors in the male gender.
Conclusion: Glabellar rotation flap is a suitable procedurefor themedial canthal area restoration after the tumor excision and can be customizedas per the characteristics of the surrounding skin as well as thesite, dimensions, and profundity of the defect.
Key Words: Medial canthal tumor, Glabellar rotation flap, Medial canthus.
Vogt – Koyanagi Harada Syndrome in a Pakistani Female
Authors: Rebecca Dr , Junejo Murtaza Sameen , Shaikh Fahad Feroz , Laghari Nazir Ashraf 
Published: April 2021

Vogt-Koyanagi-Harada syndrome is a rare multiorgan inflammatory disorder characterized by bilateral uveitis with serous retinal detachment and is often associated headache, hearing loss, vitiligo, and poliosis. Here we present a case of 37 years old female who presented with chronic photophobia, redness and progressive decreased vision in both eyes for 5 years along with cutaneous and hearing symptoms. On Ocular examination her best-corrected visual acuity was 6/60 OD and perception of light OS, while the intraocular pressure was 16 mm Hg OD and 18 mm Hg OS, measured with Goldmann applanation tonometer. The slit-lamp examination of right anterior segment showed diffuse Keratic precipitates along with diffuse iris atrophy and seclusion pupillae (360 degree). On detailed examination she found to be a case of VKH syndrome. This case is presentedto familiarize ophthalmologists and health care professionals about its findings and complications that are usually found in such patients.
Key Words: Uveitis, Poliosis, Vogt Koyanagi Harada, vitiligo.
Awareness Regarding Primary Eye Care Among Primary Healthcare Workers of Pakistan: a Way to Revitalize Health for All!
Authors: Rehman Noor ur , Sharif Hina 
Published: April 2021

Purpose: To assess awareness regarding Primary Eye Care among (primary healthcare workers) PHCWs and also intended to identify its determinants.
Study Design: Descriptive cross-sectional study.
Place and Duration of Study: All primary healthcare facilities of Tehsil Kallar Syedan, from October 2019 to December 2019.
Methods: The calculated sample size was 115. Data was collected from primary health care workers (PHCWs). Data was collected through a structured questionnaire with both open-ended and close-ended questions. Questions were made using simple language and were also translated in Urdu. Questionnaire was adapted from two articles and some questions were made after reading the components of National Programme for Prevention and Control of Blindness (Punjab, Pakistan).Chi-square test of independence was used for finding associations.
Results: Fifty-four percent PHCWs had poor awareness regarding primary eye care. Majority of the PHCWs, N = 64 (55.7%) identified just the names of common eye diseases. Cataract was identified with correct treatment by 88% primary healthcare workers. Age, education, designation were significantly associated with awareness of PHCWs.
Conclusion: The study concluded that more than half of PHCWs had low awareness regarding PEC. All of them mentioned that there was a need of improving and refreshing their knowledge related to primary eye care. This will definitely help to reduce pressure on secondary and tertiary healthcare workers.
Key Words: Primary eye care, Primary healthcare workers, Primary healthcare facilities, Pakistan.
Comparison of Intravitreal Bevacizumab versus Intravitreal Ranibizumab in Treatment Naive Macular Edema Patients (Real World Evidence in Pakistan)
Authors: Malik Hajra Arshad , Sabih Rayyan , Khan Hina , Asrar Aamir , Asif Muhammad 
Published: April 2021

Purpose: To compare the short-term efficacy and safety of intraocular Ranibizumab and Bevacizumab in patients with treatment Naïve macular edema.
Study Design: Quasi experimental study.
Place and Duration of Study: Amanat Eye Hospital, from August 2018 to November 2019.
Methods: Patients with macular edema confirmed with optical coherence tomography (OCT) or leakage on fluorescein angiography were included. Patients with NVE, PDR without macular edema and patients who switched to alternative anti-VEGF compounds prior to the completion of three consecutive monthly injections of their respective anti-VEGF or switched to other treatment options were excluded from the study. A thorough clinical examination was conducted including best corrected visual acuity (BCVA, intraocular pressure (IOP), anterior and posterior segment examination and OCT macula. The patients were then allocated to one of the two study arms (either Bevacizumab or Ranibizumab) based on the doctor’s input and patient affordability. All patients underwent three consecutive injections of the selected molecule at one month intervals. BCVA, CRT and macular volume were then recorded 04 weeks after the third injection.
Results: A statistically significant mean vision gain was observed from baseline in both groups (p < 0.05). However, the change in BCVA was not significantly different between intravitreal Bevacizumab group and intravitreal Ranibizumab group (p > 0.05). Similarly, although there was improvement in CRT and macular volume in both groups but there was no statistically significant difference between the two.
Conclusions: Treatment with intravitreal Bevacizumab and Ranibizumab injections cause statistically similar anatomical and functional results in cases of treatment naïve macular edema.
Key Words: Bevacizumab, Ranibizumab, Macular Edema, Diabetic Retinopathy, Macular Degeneration, Retinal Vein Occlusion.
LAKE SETTLEMENTS OF THE UPPER VOLGA REGION IN THE 7—6th mil. CAL BC: ARCHAEOLOGICAL AND PALAEOECOLOGICAL CONTEXT OF THE FIRST POTTERY’ «INVASION» (ZAMOSTJE 2)
Authors: Lozovskaya O. V. 
Published: April 2021

In the Middle Holocene, favorable living conditions were formed environmental on the territory of the modern Upper Volga River, which, after the retreat of the latest glacier, abounded with a branched system of feeders. They contributed to the economic stability driven by hunting for elk and beaver, waterfowl and marsh birds, as well as intensive fishing. In the recent decades, it was considered proven that ceramics were perceived by the native population, and the Early Neolithic, thus, was developed on a local basis. The new data accumulated in recent years makes it possible to bring up this topic again.
Natural, economic and cultural changes during the period from the end of the 7th to the beginning of the 6th millennium cal BC are considered on the example of the well-known multi-layer wetland site Zamostje 2, with preserved wooden fishing structures and a large number of bone and antler artefacts. The period of sharp climatic changes, known as the 8200 Cold Event, synchronous with the upper Mesolithic layer, influenced the site landscape, but, as it seems, did not affect the lifestyle of the local population.
The comparison between the two main archaeological layers of the lake settlement — the Late Mesolithic Upper layer (LM UL) and the Early Neolithic (EN), represented by the Upper Volga culture (UVc), shows both clear traces of continuity, primarily in the structure of the economy and production toolkits as well as new cultural influences reflected in the types of projectile hunting weapons and fishing gear. The function of the Early Neolithic pots, reconstructed on the basis of lipid analysis, also indicates the preservation of the comprehensive Mesolithic diet.