bluuebunny/crossref_metadata_2025_split huggingface dataset:
Establishing A Sorting Protocol for The Data Cleaning of Health Record Databases for Eco-Epidemiological Studies: The Case of Beirut
Authors: Ghabi Elie , Farah Wehbeh , Abboud Maher , Chalhoub Elias , Ziade Nelly , Annesi-Maesano Isabella , Habib Laurie Abi , Mrad Myriam 
Published: September 2019

Abstract
Background Health information records in many countries, especially developing countries, still rely on a paper-based system which, when compared to electronic systems, are disadvantageous in terms of storage and data extraction. Given the importance of health records as a data resource for epidemiological studies, guidelines for systematic data cleaning and sorting are essential, yet are largely absent in the literature. This paper discusses the process by which an electronic database was generated from emergency department registers in Lebanon and the data subsequently cleaned, sorted, and categorized.Methods Demographic and health complaint-related information was extracted from emergency department registers of a convenience sample of seven hospitals in Beirut. Appropriate categories were selected for data categorization. For health-complaint related information, disease categories and codes were selected according to the International Classification of Disease 10th Edition.Results A total of 16,537 entries were collected. Demographic information was categorized into appropriate categories and groups as required for future epidemiological studies. Analysis of the health information allowed for the creation of a sorting algorithm which then used to categorize and code the heath data. Several counts were then performed to represent and visualize the data numerically and graphically to aid in data interpretation.Conclusions The article describes the current state of health information records in Lebanon and the associated disadvantages of a paper-based system in terms of storage and data extraction and subsequent analysis. Furthermore, the article describes the algorithm by which health information was sorted and categorized to allow for future data analysis using paper records.
Independent Risk Factor Analysis for Major Cardiovascular Adverse Events in Patients with Mild Coronary Stenosis
Authors: Luo Wei , Zhao Ru , Song YanQiu , Zhao Hui , Ma WeiJun , Ma YanZhe , Cong Hongliang 
Published: September 2019

Abstract
Background: Independent risk factors for major adverse cardiovascular event (MACE) in patients with mild coronary stenosis are uncertain. This study aims to predict high-risk plaques detected by coronary computed tomographic angiography (CCTA) associated with indicative biomarkers.Methods: Totally 381 patients with mild coronary stenosis were included and MACE incidences were recorded through a 24-month follow-up. Totally 91 high-risk plaques are detected by CCTA, dividing into three plaque groups: high-risk group (HR), intermediate-risk group (IR) and low-risk group (LR). Specific blood biomarker measurements of hs-CRP, MMP-9, and MPO were taken simultaneously.Results: The mean age, levels of hs-CRP and MPO in HR and IR group were significantly higher than LR group. A considerably higher level of MMP-9 showed in HR group compared to LR group. The incidence rates of MACE were remarkably higher in HR group than LR group and IR group. Kaplan—Meier survival analysis demonstrated that the cumulative event—free survival rate of HR was significantly higher than that in LR and IR group and there were no significant difference between LR and IR group. The univariate COX regression analysis indicated that the age of patients, hs-CRP, MPO, and high-risk plaque scores≥2 were independent risk factors for MACE. Conclusion: Age, levels of hs-CRP and MPO, and high-risk plaque features informed by CCTA independently predicted MACE in patients with mild coronary stenosis. These results may improve the risk stratification in patients with mild coronary stenosis and suggest strategies for the individualized prevention programs.
Second drug-eluting stent implantation versus coronary artery bypass grafting in treatment of young patients with left main and/or multivessel coronary disease
Authors: Chen Xue , Zhang Xuehui , Yan Yunfeng , Zhao Xin , Nie Maoxiao , Feng Tingting , Liang Zhe , Zhao Quanming 
Published: September 2019

Abstract
Background Many studies have compared outcomes of coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) for complex coronary artery disease (CAD). However, no trials have focused on young patients (< 45 years) with complex CAD. We conducted a retrospective evaluation to compare the outcomes of a 2nd drug-eluting stent and CABG in young patients with LM or three-vessel disease. Methods and results In the young patients with complex CAD who underwent PCI or CABG, Kaplan-Meier analysis and Cox regression before and after propensity-score matching were used to compare major adverse cardiac and cerebrovascular events (MACCE), including myocardial infarction (MI), stoke, death and repeat revascularization. During the follow-up, MACCE occurred in 20.5% of patients in the PCI group and 8.6% in the CABG group (hazard ratio [HR]: 3.263, 95% confidence interval [CI]: 1.379 to 7.722, p=0.007). Repeat revascularization occurred more frequently in the PCI group (18.9% vs. 3.7% respectively, HR: 6.968, 95% CI: 2.036 to 23.842, p=0.002). There were no significant differences in other endpoints. After propensity-score matching, no conclusions were changed. Conclusions In young patients with LM or three-vessel disease, PCI showed a higher incidence of MACCE, which was mainly driven by repeat revascularization. However that did not translate into hard endpoints differences. Therefore, PCI is an alternative treatment to CABG in young patients with complex CAD.
Platelet P-selectin(CD62P) and soluble TREM-like transcript-1(sTLT-1) are associated with coronary artery disease-A case control study
Authors: Shen Li , Yang Tianlun , Xia Ke , Yan Zhiqiang , Tan Juanjuan , Li Lei , Qin Yingchun 
Published: September 2019

Abstract
Background/Aims: Platelet activation plays a crucial role in the pathogenesis of coronary artery disease(CAD) ， platelet P-selectin(CD62P )is a platelet classic activation indicator in platelet surface and soluble TREM-like transcript-1 (sTLT-1) is a new one,the relation between these two makers and acute coronary syndromes(ACS) has not been elucidated. This study aimed to investigate the expression of CD62P in platelet surface and sTLT-1 on serum and their relationship with CAD. Methods: We measured the levels of CD62P and sTLT-1 in 83 patients undergoing CAD compared to 49 controls.The associations with age, blood pressure,lipid profiles, body mass index and liver injury marker levels were also examined. Results: A stepwise increase in CD62P concentration was found based on the number of CAD patients (P <0.01), especially in AMI (P <0.01) . Serum sTLT-1 concentration of AMI and UAP were more higher than the NC group (P <0.01). Conclusions: The consistent of sTLT-1 and CD62P expression levels in CAD,indicating that sTLT-1 level may be a new maker of platelet activating and positively related with CAD.
Low Bone Mineral Density Could Predict Cognitive Impairment during the Acute and Recovery Phases of Ischemic Stroke
Authors: Lee Sang-Hwa , Jang Min Uk , Kim Yerim , Park So Young , Kim Chulho , Kim Yeo Jin , Sohn Jong-Hee 
Published: September 2019

Abstract
Background: Little is known about the effect of osteoporosis at the acute and recovery phase of stroke on cognitive function. We evaluated the effect of osteoporosis on cognitive function in patients with ischemic stroke aged >50 years.Methods: We retrospectively examined consecutive patients with acute stroke hospitalized between 2016 and 2018. Osteoporosis was defined as a T score of <-2.5 for the femoral neck or lumbar spine bone mineral density. The primary outcome was cognitive impairment measured by the Korean Mini-Mental State Examination in the acute phase and recovery phase of ischemic stroke. The association between osteoporosis and the severity of cognitive impairment was investigated using a multivariate analysis.Results: Of the 260 included subjects (107 men and 153 women), 70 (26.9%) had osteoporosis. Cognitive impairment was more severe in the osteoporosis group than in the non-osteoporosis group (30.5% versus 47.1%, p=0.001). After recovery phase of stroke, the proportion of patients with cognitive impairment remained higher in the osteoporosis group. The multivariate analysis revealed a correlation between a low femoral neck bone mineral density and severe cognitive impairment in the acute and recovery phases of stroke (adjusted odds ratio [OR] 3.66, 95% confidence interval [CI] 1.05-12.79 in the acute phase and adjusted OR 11.17, 95% CI 1.12-110.98 in the recovery phase), whereas lumbar spine osteoporosis was not associated with cognitive impairment.Conclusions: Low bone mineral density is associated with poor cognitive function in patients with acute stroke. Early bone mineral density assessments during acute stroke, particularly at the femoral neck, may be a useful marker of cognitive function.
Unintentional Exposure and Incidental Findings during Conventional Chest Radiography in the Pediatric Intensive Care Unit
Authors: Temsah Mohamad-Hani , Al-Eyadhy Ayman , Alsohime Fahad , Nassar Saeed Majed , AlHoshan Talal Nabil , Alebdi Hatim Abdullah , Almojel Faisal , AlBattah Muath Abdullah , Narayan Omendra , Hasan Gamal Mohamad , Abujamea Abdullah 
Published: September 2019

Abstract
Background: Anatomical overexposure is common in CXRs of pediatric patients. However, overexposure may reveal incidental findings that can help to guide patient management or warrant quality improvement. Objective: To assess the prevalence of overexposure in chest X-ray (CXRs) in pediatric intensive care unit (PICU); and identify the incidental findings within overexposed areas. Materials and methods: Retrospective cohort study of children admitted to PICU. Two independent evaluators reviewed patient’s charts and digital CXRs according to the American College of Radiology standards; to evaluate overexposure of the anatomical parameters and incidental findings. Results: A total of 400 CXRs of 85 patients were reviewed. The mean number of CXRs per patient was 4.7. Almost all (99.75%) CXRs met the criteria for overexposure, with the most common being upper abdomen (99.2%), upper limbs (97%) and neck (95.7%). In addition, 43% of these X-rays were cropped by the radiology technician to appear within the requested perimeter. There was a significant association between field cropping and overexposure (t-test: t=9.8, p<.001). Incidental findings were seen in 41.5% of the radiographs; with the most common being gaseous abdominal distension (73.1%), low-positioned nasogastric tube (24.6%), and constipation (10.3%). Conclusions: Anatomical overexposure in routine CXRs remains high and raises a concern in PICU practice. Appropriate collimation of the X-ray beam, rather than electronically cropping the image, is highly recommended to minimize hiding incidental findings in the cropped-out areas. Redefining the anatomic boundaries of CXR in critically ill infants and children may need further studies and consideration. Quality improvement initiatives to minimize radiation overexposure in PICU are recommended.
Utilization and economic burden of Percutaneous Vertebroplasty or Percutaneous Kyphoplasty for Treatment of Osteoporotic Vertebral Compression Fractures in China: A Retrospective Claim Database Study
Authors: Yang Dehong , Zhang Yanlei , Ma Xiao , Huo Li , Li Liran , Gao Yue , Xuan Jianwei 
Published: September 2019

Abstract
Background Osteoporotic vertebral compression fractures (OVCF) is a common and often debilitating complication of osteoporosis, leading to significant morbidity and increased mortality. Percutaneous vertebroplasty (PVP) and Percutaneous kyphoplasty (PKP) are recommendable surgical treatments for osteoporotic vertebral compression fractures.Objective To evaluate PVP/PKP utilization and their related costs for OVCF treatment in China.Methods A population-based medical claims database of a metropolitan city in China was analyzed, which included all inpatient claims from 01/01/2015 to 31/12/2017. Eligible patients were 50 years or older, diagnosed with vertebral fractures with/without osteoporosis, and received PVP/PKP. Survival analysis function was used to estimate time to re-surgery and non-parametric statistical tests were used for comparison of cost and re-surgery rate between PVP and PKP.Results Of the 50,686 patients with OVCF identified, 14,527 (28.66%) received a total number of 15,599 records of PVP/PKP surgeries from 2015 to 2017. Mean age was 75 at the first surgery captured in the database analysis period; and females accounted for 79.54% of all cases. Median length of surgery stay was 9 days. Cumulative re-surgery rates were 1.22% in 30 days, 2.58% in 90 days, 3.61% in 183 days, 5.42% in one year, and 7.95% in two years. There was no significant difference of re-surgery rate between PVP and PKP (p=0.3897). Median time to the re-surgery was 139 days. Mean cost per PVP/PKP-related hospitalization was 35,906 CNY (34,195 CNY for PVP, 44,414 CNY for PKP, p<0.01). The overall cost of hospitalization averaged 186.61 million CNY (26.97 million USD) per year in this metropolitan city.Conclusion From 2015 to 2017, nearly one third of OVCF inpatients received PVP/PKP and re-surgery rate was high. PKP/PVP procedures for OVCF place a high economic burden for both the healthcare system and patients. Early detection and treatment of patients with osteoporosis is critical in China.
Human papillomavirus type 18 oncoproteins exert their oncogenicity in esophageal and tongue squamous cell carcinoma cell lines distinctly
Authors: Boon Siaw Shi , Chen Zigui , Ching Karen Lee Yin , Cai Liuyang , Li Jintao , Zhong Rugang , Chan Paul Kay Sheung 
Published: September 2019

Abstract
Background: Increasing evidence indicates an etiological role of human papillomavirus (HPV) in head and neck cancers, particularly oropharyngeal squamous cell carcinoma (OPSCC). However, the association between HPV and other cancers, including esophageal and tongue remains unclear.
Methods: We compared the molecular characteristics of HPV18 E6 and E7 in esophageal (EC109 and EC9706) and tongue (Tca83) cancer cell lines with reference to cervical cancer (HeLa). We studied the expression of HPV transcripts using Next Generation RNA sequencing. We used small interference RNA (siRNA) against HPV18 oncoproteins to verify their oncogenic roles in molecular signaling, targeting metalloproteases and apoptotic pathways in these cancers.
Results: We observed that the HPV transcription profiles of esophageal and tongue cancer cells mimicked that of cervical cancer cells, with notable disruption of E2, and expression of E6, spliced E6 (E6 * ), E7, E1 and L1 transcripts. As with cervical cancer cells, p53 and its downstream transactivation target, p21, were found to be the major targets of E6 in esophageal and tongue cancer cell lines. Intriguingly, E7 preferentially targeted p130 in the two esophageal cancer cell lines, instead of pRb as in cervical cancer. Tca83 exhibited an E7 to E6 transcript ratio comparable to HeLa (cervix), targeted the ERK1/2 and MMP2 pathways, and was dependent on E6 and E7 to survive and proliferate. In contrast, both the esophageal cancer cell lines were distinct from HeLa in these aspects.
Conclusion: This is the first study to delineate the transcripts expression and role of HPV18 E6 and E7 in esophageal and tongue cancer cell lines. This findings suggest that HPV18 plays an oncogenic role in inducing these cancers, albeit via distinct pathways than those observed in cervical cancer.
Implementation of Gamification from blended learning based on the flex model and efficacy of this program on students: an experiences from Iran, An Quasi-experimentaL Study
Authors: abdian tahereh , abdollahifar saeed , Mosalanejad Leili 
Published: September 2019

Abstract
Background: New gamification technology with a detailed understanding of the goals and prospects, and with the help of game elements and techniques, leads to promotion of motivation and participation, and ultimately behavior change.
Methods: In this study, with the design of mental illness lessons for undergraduate and executive groups, using flex model, two parts of technical and educational design were used. In the technical section, three parts on dynamics, mechanisms and elements of gaming were considered. Intervention was studied on different groups of medical students including medical, health, and laboratory sciences and its impact on learning and performance was studied using quantitative and qualitative analyses.
Results: The results of the students’ prospective about the efficacy of the method showed that the mean scores of most of the items were higher than the average. This implies that students’ attitude towards using gamification was positive. In the other part, the qualitative results of the study were analyzed and the student's analysis of their advantages and disadvantages and their perceptions on the impact of the intervention were examined.
Conclusion: Based on the Flex model, mental gamification based on blended learning is effective in shaping the students' satisfaction.
Comparative study between intrathecal dexmedetomidine and intrathecal magnesium sulfate for the prevention of post-spinal anaesthesia shivering in uroscopic surgery. (RCT)
Authors: Omar Heba , adel Wessam , Hassan Mohamed Mahmoud , Hassan Amany , Hassan Passaint , Elshall Ahmed , Khalid Dalia , Mostafa Maha , Zarif pierre , hossameldin Mona , Wedad Mai , abdelhamid Bassant Mohamed 
Published: September 2019

Abstract
Background: Hypothermia and shivering are common complications after spinal anaesthesia, especially after uroscopic procedures in which large amounts of cold intraluminal irrigation fluids are used. Magnesium sulfate and dexmedetomidine are the most effective adjuvants with the least side effects. The aim of this study was to compare the effects of intrathecal dexmedetomidine versus intrathecal magnesium sulfate on the prevention of post-spinal anaesthesia shivering.
Methods: This prospective randomized, double-blinded controlled study included 105 patients who were scheduled for uroscopic surgery at the Kasr El-Aini Hospital. The patients were randomly allocated into three groups. Group C (n=35) received 2.5 ml of hyperbaric bupivacaine 0.5% (12.5 mg) + 0.5 ml of normal saline, Group M (n=35) received 2.5 ml of hyperbaric bupivacaine 0.5% (12.5 mg) + 25 mg of magnesium sulfate in 0.5 ml saline, and Group D (n=35) received 2.5 ml of hyperbaric bupivacaine 0.5% (12.5 mg) + 5 μg of dexmedetomidine in 0.5 ml saline. The primary outcomes were the incidence and intensity of shivering. The secondary outcomes were the incidence of hypothermia, sedation, the use of meperidine to control shivering and complications.
Results: Group C had significantly higher proportions of patients who developed shivering (21), developed grade IV shivering (20) and required meperidine (21) to treat shivering than group M (8,5,5) and group D (5,3,6) , which were comparable to each other.
The time between block administration and meperidine administration was similar among the three groups. Hypothermia did not occur in any of the patients.
The three groups were comparable regarding the occurrence of nausea, vomiting, bradycardia and hypotension. All the patients in group C, 32 patients in group M and 33 patients in group D had a sedation score of 2. Three patients in group M and 2 patients in group D had a sedation score of 3.
Conclusions: Intrathecal injections of both dexmedetomidine and magnesium sulfate were effective in reducing the incidence of post -spinal anaesthesia shivering. Therefore, we encourage the use of magnesium sulfate, as it is more physiologically available, more readily available in most operating theatres and much less expensive than dexmedetomidine.
Seedling Emergence and Seedling Growth of Mustard and Rapeseed Genotypes under Salt Stress
Authors: Hooks Triston , Niu Genhua , Ganjegunte Girisha 
Published: September 2019

Core Ideas
Varietal differences in salt tolerance were observed.
There were differences in salt tolerance between the seedling emergence and seedling growth stages.
Growth and photosynthesis decreased at high salinity, indicating osmotic stress.
Chlorophyll fluorescence did not decrease at high salinity, indicating no stress on photosystem II.
Leaf chloride concentrations varied among genotypes, suggesting different salt tolerance mechanisms.
Salt‐tolerant energy crops can be grown on marginal lands for sustainable biofuel production without competing with food crops for arable land. However, salt tolerance is a variable trait among plant species, varieties, and growth stages. In this study, the relative salt tolerance of seven mustard (Brassica juncea) genotypes and four rapeseed (Brassica napus) genotypes was evaluated at the seedling emergence and seedling growth stages. In the first experiment, seeds were sown in a growth chamber with reverse osmosis water or saline solution at an electrical conductivity (EC) of 10 mS cm−1 for 10 d, and emergence was determined daily. In the second experiment, seedlings were grown in a greenhouse and irrigated with nutrient solution (control) with an EC of 1.5 mS cm−1 or saline solutions (EC 5 and 10 mS cm−1, respectively) for 4 wk. For the seedling emergence stage, the relative emergence percent, and emergence index showed great variation among genotypes (range, 11–112% and 7–110%, respectively). For the seedling growth stage, the saline treatments caused reductions in leaf area and fresh and dry biomass that averaged 63, 65, and 65% relative to the control, respectively. Overall, hierarchal cluster analyses showed differences in salt tolerance between the seedling emergence and seedling growth stages. Net photosynthetic rate decreased with salinity, but soil‐plant analysis development readings increased by an average of 18% in the EC10 treatment. Chlorophyll fluorescence did not change, but performance index tended to increase in response to salinity. Chloride concentrations in the leaf tissue increased with salinity and ranged from 32 to 111 mg g−1, with significant varietal differences.