bluuebunny/crossref_metadata_2025_split huggingface dataset:
A clinical scoring system for the diagnosis of pediatric hand-foot-mouth
Authors: Huang Hui , Deng Li , Jia Liping , Zhu Runan 
Published: June 2019

Abstract
Background

The aim of the present study was to develop a clinical scoring system for the diagnosis of hand-foot-mouth disease (HFMD) with improved accuracy.

Methods

A retrospective analysis was performed on standardized patient-history and clinical-examination data obtained from 1435 pediatric patients under the age of three years who presented with acute rash illness and underwent enterovirus nucleic-acid-detection testing. Patients were then divided into the HFMD (1094 patients) group or non-HFMD (341 patients) group based on a positive or a negative result from the assay, respectively. Multivariate logistic regression was performed on 15 clinical variables (e.g. age, exposure history, number of rash spots in a single body region) to identify variables highly predictive of a positive diagnosis. Using the variables with high impact on the diagnostic accuracy, we generated a scoring system for predicting HFMD.

Results

Using the logistic model, we identified seven clinical variables (age, exposure history, and rash density at specific regions of the body) to be included into the scoring system. While the final scores ranged from −4 to 23 (higher score positively predicted a HFMD diagnosis), a cutoff score of 7 resulted in a sensitivity of 0.74 and specificity of 0.69.

Conclusions

This study establishes an objective scoring system for the diagnosis of typical and atypical HFMD using measures accessible through routine clinical encounters. Due to the accuracy and sensitivity achieved by this scoring system, it can be employed as a rapid, low-cost method for establishing diagnoses in children with acute rash illness.
A foodborne outbreak of gastroenteritis caused by Norovirus and Bacillus cereus at a university in the Shunyi District of Beijing, China 2018
Authors: Chen Dongwan , Li Yongjin , Lv Jinchang , Liu Xiufeng , Gao Peng , Zhen Guoxin , Zhang Wenzeng , Wu Dan , Jing Hongbo , Li Ying , Zhao Yao , Ma Xiaochen , Ma Huilai , Zhang Lijie 
Published: June 2019

Abstract
Background

On 4 September 2018, a boarding school in the Shunyi District of Beijing, China reported an outbreak of acute gastroenteritis. At least 209 affected students developed the symptoms of diarrhea and vomiting. Investigations were conducted to identify the agent and source of this outbreak, and to implement controls to prevent further transmission.

Methods

A retrospective cohort study was conducted among the school students and staff in order to test hypothesis that food served at the school canteen. We collected information on demographics, refectory records at the canteen and contact to ill persons or vomit, using a uniform epidemiological questionnaire. Risk ratios (RR) and 95% conﬁdence intervals (CI) were calculated. Stool specimens of cases and canteen employees, food served, water, and environmental swabs were investigated by laboratory analysis.

Results

We identiﬁed 209 cases(including 28 laboratory-confirmed cases) that occurred from August 29 to September 10. All cases were students, and the median age was 20 years, 52% were male. The outbreak lasted for 13 days, and peaked on September 5. Consumption of Drinks window and Rice flour window on 1 September(RR: 3.4, 95% CI: 1.5-7.8, and RR: 7.6, 95% CI: 2.8-20.2), Rice flour window and Fish meal window on 2 September(RR: 4.0, 95% CI: 1.2-13.6, and RR: 4.6, 95% CI: 1.7-12.5), Moslem meal window on 4 September(RR: 2.7, 95%CI: 1.3-5.4), Barbeque window on 5 September(RR: 3.0, 95%CI: 1.2-7.0) were independently associated with increased risk of disease within the following 2 days. Rectal swabs or stool samples from twenty-five cases and ten canteen employees were positive for norovirus GI.6. Five cases were positive for Bacillus cereus, among them, two stool samples were detected by a mixed infection of Norovirus and Bacillus cereus. Four retained food specimens were positive for Bacillus cereus, and environmental samples were negative for any viruses or bacteria.

Conclusion

Our investigation indicated that consumption of high-risk windows was the source of this outbreak. The high rate of infection of both pathogens was exacerbated by unhygienic manipulation and Inappropriate hygiene practices in canteen employees.
Intestinal schistosomiasis of Ijinga Island, north-western Tanzania: Prevalence, intensity of infection, hepatosplenic morbidities and their associated factors
Authors: Mueller Andreas , Fuss Antje , Ziegler Uwe , Kaatano Godfrey M. , Mazigo Humphrey D. 
Published: June 2019

Abstract
Background: Intestinal schistosomiasis is highly endemic in Tanzania and mass drug administration (MDA) using praziquantel is the mainstay of the control program. However, the MDA program covers only school aged children and does not include neither adult individuals nor other public health measures. The Ijinga schistosomiasis project aims to introduce an intensified treatment protocol using a MDA approach combined with other public health interventions to demonstrate the feasibility of eliminating intestinal schistosomiasis in a highly endemic African setting. In preparation of this project, we report about baseline data on S.mansoni prevalence, intensity of infection, related hepatosplenic morbidities and their associated factors.
Methods: A cross sectional study was conducted among 930 individuals aged 3-95 years living at Ijinga Island, north-western Tanzania. Single stool and urine samples were collected from each study participant and processed using Kato Katz (KK) technique and point-of-care Circulating Cathodic (POC-CCA) antigen test for detection of S.mansoni eggs and antigen. Ultrasonographical examination for S.mansoni hepatosplenic morbidities was done to all participants.
Results: Overall based on KK technique and POC-CCA test, 68.9% (95%CI: 65.8-71.8) and 94.5% (95%CI: 92.8-95.8) were infected with S.mansoni. The overall geometrical mean eggs per gram (GMepg) of faeces was 85.7epg (95%CI: 77.5-94.8). A total of 27.1%, 31.2% and 51.9% of the study participants had periportal fibrosis (PPF-grade C-F), splenomegaly and hepatomegaly. Risk factors for PPF were being male (aRR=1.08, 95%CI: 1.02-1.16, P<0.01), belong to the age group 16-25 years (aRR=1.23, 95%CI: 105-1.44, P<0.01), 26-35 years (aRR=1.42, 95%CI: 1.21-1.67, P<0.001), 36-45 years (aRR=1.56, 95%CI:1.31-1.84, P<0.001) and ≥ 46 years (aRR=1.64, 95%CI:1.41-1.92, P<0.001). The length of the left liver lobe was associated with being female (P<0.03), belong to the age group 1-5 years (P<0.013), 6-15 years (P<0.04) and S.mansoni intensity of infection (P<0.034). Similarly, being male (aRR=1.15, 95%CI:1.06-1.24, P<0.001), belonging to the age group 16-25 years (aRR=1.27, 95%CI:1.05-1.54, P<0.02), 26-35 years (aRR=1.32, 95%CI:108-1.61, P<0.01) were associated with splenomegaly.
Conclusion: Schistosoma mansoni infection and its related morbidities are common in the study area. The prevalence of S.mansoni was above 50% in each age group and based on the observed prevalence, we recommend MDA to the entire community.
Cerebral salt wasting in a patient with myeloproliferative neoplasm
Authors: Orlik Lea , Venzin Reto , Fehr Thomas , Hohloch Karin 
Published: June 2019

Abstract
Background

Cerebral salt wasting (CSW) is a rare metabolic disorder with severe hyponatremia and volume depletion usually caused by brain injury like trauma, cerebral lesion, tumor or a cerebral hematoma. The renal function is normal with excretion of very high amounts of sodium in the urine. Diagnosis is made by excluding other reasons for hyponatremia, mainly the syndrome of inappropriate antidiuretic hormone secretion (SIADH).
MR Imaging Features of Orbital Langerhans Cell Histiocytosis
Authors: wu chunnan , Mu xuetao , Hei yan , lan pengyu , li kuncheng 
Published: June 2019

Abstract
Background: To investigate the magnetic resonance imaging (MRI) features of orbital Langerhans cell histiocytosis (LCH) to improve diagnostic accuracy.
Methods: We retrospectively reviewed clinical manifestations and MRI findings of 23 patients with histology-confirmed LCH of the orbit. The findings were evaluated for the following: (a) symptoms, (b) disease duration，(c) location, (d) configuration, (e) margin, (f) MR imaging signal intensity and enhanced performance.
Results: Eighteen patients (78%) in our series were male, only five (22%) patients were female, and the mean age at presentation was 6.3 years. The common symptoms include swollen eyelids, exophthalmos, and a palpable mass. Fourteen patients presented with swollen eyelids and/or exophthalmos. Twenty-two cases involved unilateral orbits, and one case involved bilateral orbits. In our study, there was one patient with cough and expectoration, and one patient with polydipsia and polyuria. Lesions were located in the superior or superlateral orbital roof of seventeen patients (74%). Lesions formed masses or irregular shapes. The majority of lesions appeared heterogeneous isointense and iso-hypointense on T1-weighted imaging and hyper-hypointense mixed signals on T2-weighted imaging. The appearance of hemorrhage and cystic change were usually seen in lesions. After enhancement, majority lesions presented marked enhancement at the edges and the surrounding tissues, and with heterogeneous obvious enhancement of the lesion center. Besides, several lesions were surrounded by a low circular signal.
Conclusion: There were several characteristics MRI features that can provide crucial information for clinicians and improve our understanding and the diagnostic accuracy of the orbital LCH
Self-administered acupressure for allergic rhinitis: Study protocol for a randomized, single blind, non-specific controlled, parallel trial
Authors: Liang Yaqun , Lenon George Binh , Yang Angela Wei Hong 
Published: June 2019

Abstract
Background

Allergic rhinitis (AR) is an IgE-mediated inflammatory disease. Current conventional therapies for AR are unsatisfactory. Acupuncture has been recommended as an optional treatment for AR patients who are interested in non-pharmacotherapy in the new clinical practice guidelines for AR. Acupressure is a sub-type of acupuncture which is non-invasive with a low risk and can be self-administered. However, the current limited evidence is compromised by the high risk of bias and heterogeneity of methodology. Therefore, rigorously designed randomized controlled trials (RCTs) are needed. This proposed RCT aims to evaluate the efficacy and safety of self-administered acupressure for the management of AR.

Methods/design

We have designed a randomized, single blind, non-specific controlled, two-arm, parallel clinical trial involving a 2-week run-in period, a 4-week intervention period and an 8-week follow-up period. The eligible participants will be randomized into either specific or non-specific acupressure group. They will be required to perform self-administered acupressure on either 5 specific acupressure points or 5 non-specific acupressure points, one minute for each point, twice a day for 4 weeks. Participants will be asked to complete self-administered questionnaires for outcome measures including 7-point scale of symptom severity, Rhinoconjunctivitis Quality of Life Questionnaire with Standardized Activities (RQLQs), relief medication scores, adverse events and participants’ opinion of this study at the different assessment points throughout the trial period. Data will be analyzed by chi-square or t-test using Statistical Package for Social Science (SPSS) software.

Discussion

The findings from this study will provide scientific evidence for the efficacy and safety of self-administered acupressure for the management of AR. This study may assist to develop a non-cost, non-invasive self-management method for AR sufferers.
Establishment of a large-diameter pipeline failure risk matrix in water distribution systems in Taiwan
Authors: Huang Kochin , Chuo Paul , Lin Kim-loong , Yu Mengsyu , Huang Chihpin 
Published: June 2019

Abstract
The bursting of large-diameter water pipelines in distribution systems will lead to industrial, economic, and public safety impacts. Therefore, multi-criteria analysis (MCA) was applied in this study, which utilizes a series of quantifiable parameters to establish the mathematical method of a risk model. The risk matrix of a pipeline was defined as the multiple of the probability of pipeline failure and potential consequences of pipeline failure. By combining the GIS (geographic information system), each evaluation unit was assigned to different risk levels. The large-diameter (above 800 mm) pipeline length statistic for various risk evaluation units of Taiwan Water Corporation reveals the length of high risk is 171 km (7.7%), secondary high risk 574.6 km (25.8%), middle risk 714.3 km (32%), low risk 701.5 km (31.5%), and the unranked length is 67.8 km (3.0%). Finally, the detection frequencies were classified as high risk with a term check of every five years, sub-high risk with planned check every five to ten years, medium risk with checking/monitoring if needed, and low risk with quick repair and no need to take measurements and monitoring. Therefore, we can significantly lower the probability of bursting for large-diameter pipelines in the water distribution system.
ANTI-TUMOUR ACTIVITY OF BROMOPYRROLE ALKALOIDS AGAINST HUMAN BREAST TUMOUR (MCF-7) THROUGH APOPTOSIS INDUCTION
Authors: MANIKANDAN S. , GANESAPANDIAN S. , SINGH MANOJ , KUMARAGURU A. K. 
Published: June 2019

Objective: The present study was conducted to screen the cytotoxicity and initiation of apoptosis in MCF-7 human breast tumour cells using the Indian sponge Acanthostylotela cornuta of the Gulf of Mannar.
Methods: The crude methanol extract of A. cornuta was fractionated using a reversed phase silica gel column chromatography. The purity of the active fraction of bromopyrrole alkaloids was confirmed with Gas Chromatography-Mass Spectrometry (GCMS). The bromopyrrole alkaloids induce apoptotic changes in MCF-7 cells were studied with electrophoresis, caspase assay, and different staining analysis. The MCF-7 cells were analyzed by Flow cytometry to determine their DNA content.
Results: Bromopyrrole alkaloids of A. cornuta showed cytotoxicity against MCF-7 human breast tumour cells with the IC50 value of 8.0μg/ml. The bromopyrrole compounds induced cells exhibited scatted red fluorescence, showing the presence of several residual bodies and condensation of chromatin. Caspase-3, pro-caspase-9, caspase-9 and Poly-ADP-Ribose-Polymerase (PARP) activity were occurred in bromopyrrole alkaloids treated tumour cell. The cell cycle arrest is conceivable that the compound prevented the progression of cell cycle through the G phase resulting from inhibition of survival, leading them to undergo apoptosis.
Conclusion: Bromopyrrole alkaloids of A. cornuta possess antitumor activity which was arrested the G phase in cell cycle that clearly indicated its nature as that of antitumour drugs.
IN VITRO EVALUATION OF ANTI-CANCER POTENTIAL OF A3 ADENOSINE RECEPTOR AGONIST ON A549 HUMAN LUNG CANCER CELL LINE
Authors: Solanki Nilay D , Patel Alkesh , Patel Leena 
Published: June 2019

Objective: The objective of this study was to evaluate the cytotoxic potential of A3AR agonist (ABMECA) against human lung cancer cell line A549 by using 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) assay.
Methods: Adenocarcinoma cell line A549 was used to assess MTT based cells viability. In vitro cytotoxic activity was evaluated for 3 different concentration of doxorubicin and A3AR by MTT cytotoxicity assay. Cytotoxicity assay carried out for 3 consecutive days that involves culturing cells into Dulbecco’s MEM medium modified with 10% FBS for 24 h then treatment with different dose of standard and test drug with incubation period of 24 h followed by treatment with MTT for estimation of cytotoxicity and finally, optical density (OD) was measured at 570-630 nm.
Results: Different concentration of doxorubicin (1, 5, 10 µM) and ABMECA (10-6M, 10-5M and 10-4M) shown dose-dependent cytotoxicity. There was a significant decrease (p<0.05) in cell viability in both doxorubicin and ABMECA concentration in a dose-dependent manner. This study may guide further for in vivo evaluation of test drug in the lung cancer model.
Conclusion: A3 Adenosine Receptor agonist could be potential moiety for the treatment of lung cancer and it would require in vivo study for further research.
ANTI HYPERGLYCAEMIC AND ANTIOXIDANT ACTIVITY OF CATUNAREGAM SPINOSA (THUNB) AGAINST DEXAMETHASONE INDUCED DIABETES IN RATS
Authors: Basini Jyothi , SWETHA D. , MALLIKARJUNA G. 
Published: June 2019

Objective: The study was aimed at evaluating the folkloric use of the Catunaregam spinosa (Thunb) bark for its hypoglycaemic and antioxidant activity against dexamethasone-induced diabetes in wistar rats.
Methods: Diabetes was induced in wistar rats by dexamethasone administration 10 mg/kg, b. wt., s. c for 11 consecutive days to all group animals (except Group I). After confirmation of diabetes, the animals were divided into 5 groups (n=6). Group I: Vehicle control treated with normal saline only, Group II: Diabetic control treated with dexamethasone only, Group III: Standard control treated with dexamethasone plus glibenclamide (5 mg/kg, b. wt., p. o), Group IV and V: Test control received dexamethasone plus ethanolic extract of Catunaregam spinosa (EECS) at graded doses of 200 mg/kg, b. wt. and 400 mg/kg, b. wt., p. o for 21days respectively. On the last day of the experiment, the effect of Catunaregam spinosa bark was measured by estimating the biochemical and antioxidant parameters.
Results: There was a significant alteration in the serum glucose, HbA1c, total proteins, serum lipid profile and tissue antioxidant parameters in dexamethasone-treated animals when compared to the normal control rats.
In test groups treated with glibenclamide and EECS, it was significantly ameliorated the altered parameters such as serum glucose, HbA1c, total proteins, serum lipid profile and the antioxidant parameters like SOD, CAT, GSH and MDA when compared to dexamethasone-treated animals with evidence of histopathological studies of the pancreas.
Conclusion: The results indicated that the ethanolic extract of Catunaregam Spinosa (Thunb) bark has shown the hypoglycemic and antioxidant property.
1003-P: Clinical Response (HbA1c ≥1% and/or Body Weight ≥5% Reduction) to Semaglutide by Baseline HbA1c and Body Weight in the SUSTAIN Program
Authors: ARODA VANITA R. , LARSEN JULIE F. , ØSTOFT SIGNE HARRING , REA ROSANGELA R. , SUGIMOTO DANNY , ZIEGLER UWE , VILSBØLL TINA 
Published: June 2019

The SUSTAIN clinical development program assessed semaglutide once weekly, a glucagon-like peptide-1 (GLP-1) analog, across the continuum of type 2 diabetes (T2D) care, including in drug-naïve subjects and those on a background of oral antidiabetic drugs and/or insulin. Semaglutide demonstrated superior reductions in HbA1c and body weight (BW) vs. placebo and comparators (sitagliptin, exenatide extended release, insulin glargine, dulaglutide). This post hoc analysis assessed the proportion of semaglutide-treated subjects achieving clinically relevant responses (composite endpoint: ≥1% HbA1c reduction and ≥5% BW loss; individual components: ≥1% HbA1c or ≥5% BW loss) by baseline HbA1c and BW across SUSTAIN 1-5 and 7. A consistently high proportion of semaglutide-treated subjects achieved clinically relevant responses (composite, 42.0%; ≥1% HbA1c reduction, 76.6%; ≥5% BW loss, 49.9%), regardless of baseline HbA1c and BW (Figure). Baseline HbA1c and BW did not affect the likelihood of achieving the composite and ≥5% BW endpoints. A ≥1% HbA1c reduction was significantly more likely to be achieved with higher baseline HbA1c (143% increased odds per 1% unit higher baseline HbA1c;p&lt;0.0001). Semaglutide provides meaningful reductions in HbA1c and BW across a range of HbA1c and BW. Individuals with poorly controlled HbA1c were more likely to achieve a ≥1% HbA1c reduction.

Disclosure
V.R. Aroda: Consultant; Self; ADOCIA, AstraZeneca, Becton, Dickinson and Company, Novo Nordisk Inc., Sanofi, Zafgen, Inc. Employee; Spouse/Partner; Merck & Co., Inc. Research Support; Self; AstraZeneca, Calibra Medical, Eisai Inc., Janssen Research & Development, Novo Nordisk Inc., Sanofi, Theracos, Inc. J.F. Larsen: Employee; Self; Novo Nordisk A/S. S.H. Østoft: Employee; Self; Novo Nordisk A/S. R.R. Rea: Other Relationship; Self; Amgen Inc., AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Novo Nordisk A/S, Sanofi. D. Sugimoto: Research Support; Self; Gan & Lee Pharmaceuticals, Novo Nordisk A/S, Sanofi. U. Ziegler: Employee; Self; KOEHLER eClinical GmbH, Freiburg im Breisgau, Germany. T. Vilsbøll: None.

Funding
Novo Nordisk A/S
101-OR: Identification of Warm Sensitive Neurons in the Hypothalamic Preoptic Area as Powerful Regulators of Glucose Homeostasis
Authors: DEEM JENNIFER D. , OGIMOTO KAYOKO , NELSON JARRELL , PHAN BAO ANH N. , VELASCO KEVIN R. , DAMIAN VINCENT , KNIGHT ZACHARY , SCHWARTZ MICHAEL W. , MORTON GREGORY J. 
Published: June 2019

Inhibition of warm sensitive neurons (WSNs) in the hypothalamic preoptic area (POA) has been suggested to play a key role in the thermogenic response to cold exposure. As this response is enabled by a marked increase of insulin sensitivity in thermogenic tissues, we hypothesized that 1) WSN inhibition mediates metabolic as well as thermogenic responses to cold, and therefore, 2) WSN activation has the opposite effects. To test this hypothesis, we utilized DREADD technology to activate or inhibit a recently identified subpopulation of POA WSNs defined by their expression of the neuropeptide, Pacap, using the drug clozapine-N-oxide (CNO). We report that, pharmacogenetic activation of this POA WSN population found significant reductions in energy expenditure (Sal vs. CNO: 0.32±0.10 vs. 0.21±0.02 kcal/hr; p&lt;0.05) and, as previously reported, core temperature (Tc) (Sal vs. CNO: 35.4±0.1 vs. 30.4±0.1C; p=0.0001). Further, the response to pharmacogenetic activation was quite long-lived (∼2-3 days) and was accompanied by severe glucose intolerance both 1h and 24h following a single injection of CNO relative to vehicle (glucose AUC: 3610±1216 for Sal vs. 23985±2742 for 1h CNO; 28459±2411 for 24h CNO au; p&lt;0.05 vs. saline), an effect that occurred despite a compensatory increase of glucose-induced insulin secretion at the 24h (but not the 1h) time point (p&lt;0.05 vs. Sal). Thus, activation of POA Pacap+ WSNs is sufficient to reduce thermogenesis and impair glucose tolerance. Conversely, we found that inhibition of POA Pacap+ neurons in chow-fed mice led to a modest but significant increase in Tc (Sal vs. CNO: 35.4±0.1 vs. 35.9±0.1C; p=0.01) and whereas glucose tolerance was not improved in these animals, it was improved by POA Pacap+ neuron inhibition in mice with diet-induced obesity (glucose AUC: 9630±571 for Sal vs. 7517±628 for CNO au; p&lt;0.05). We conclude that POA Pacap+ neurons constitute a subset of WSNs with profound and previously unrecognized effects on glucose homeostasis.

Disclosure
J.D. Deem: None. K. Ogimoto: None. J. Nelson: None. B.N. Phan: None. K.R. Velasco: None. V. Damian: None. Z. Knight: None. M.W. Schwartz: Consultant; Self; Novo Nordisk A/S. Research Support; Self; Novo Nordisk A/S. G.J. Morton: None.

Funding
University of Washington Diabetes Research Center