bluuebunny/crossref_metadata_2025_split huggingface dataset:
Probable human origin of the SARS-CoV-2 polybasic furin cleavage site
Authors: Romeu Antonio R. 
Published: May 2022

Abstract
The origin of the SARS-CoV-2 is still unclear. Simply said, its emergence was due to the acquisition of the polybasic furin cleavage site at the S protein in one of its closest relatives. The discovery in Laos of bat Rhinolophus coronaviruses that contain receptor binding domains almost identical to that of SARS-CoV-2, and despite not having that polybasic furin cleavage site, they can therefore infect human cells (1), is the cornerstone to identify the SARS-CoV-2 progenitor. However, it is not yet known where the furin site inserted at the S1/S2 junction in the S protein of the pandemic virus come from, nor the how and when of such acquisition. The CGG-CGG encoded arginine dimer is rare in coronaviruses (2), however, an arginine dimer with this code is present at the SARS-CoV-2 acquired furin site: the PRRA four amino acid residue motif. Then, my question was if the SARS-CoV-2 S gene insert encoding the furin site would match to human transcripts. Here, I address this issue by using NCBI and GISAID databases, the NCBI Human Genome Resources, sequence analysis tools and in-house developed bioinformatic tools. I found that the possible 12-nucleotide fragments which properly inserted in the S gene encode the SARS-CoV-2 furin site 100% match to several NCBI RefSeq human transcripts. Taking this into consideration and the expression patterns of these genes, together with further evidences found here, such as the codon optimization of that SARS-CoV-2 furin site arginine dimer and other PRRA-like insertions in the S protein, results provide insight into the human-virus recombination link as origin of the SARS-CoV-2 furin site, during undetected human-to-human virus transmission.
Analgesic effect of ultrasound-guided erector spinae plane block(ESPB) in general anesthesia for cesarean section: A randomized controlled trial
Authors: hu Jia , Chen Qi , Xu Qian , Song Yun , Wei Ke , Lei Xiaofeng 
Published: May 2022

Abstract
Background: The analgesic effects of the erector spinae plane block in general anesthesia for cesarean section and the recovery from puerperae remain unclear.Methods: Sixty patients with contraindications for spinal anesthesia who required general anesthesia for cesarean section were enrolled and randomly divided into the erector spinal plane block (ESPB) combined with general anesthesia group (group E) and the general anesthesia group (group G). Group E received bilateral ESPB (20 ml of 0.25% ropivacaine on each side) under ultrasound guidance 30 min before general anesthesia. The heart rate (HR), mean arterial pressure (MAP) were recorded 10 min before the start of anesthesia (T0), at the induction of anesthesia (T1), at skin incision (T2), fetal delivery (T3), and immediately after surgery (T4). Intraoperative anesthesia dosage, fetal delivery time, and puerperae emergence time were also recorded. Visual analog scale (VAS) and Bruggrman comfort scale (BCS) scores at 2h, 6h, 12h, and 24h after operation were compared between the two groups. Number of patient-controlled intravenous analgesia (PCIA) boluses, and adverse reactions were also recorded.Results: The MAP and HR of T2 and T3 in group G were significantly increased compared with T1 (P<0.05), as well as with those in group E at the same time point (P<0.05); compared with group G, the doses of propofol and remifentanil were significantly reduced (P<0.0001), the emergence time of the puerpera was shortened (P=0.003), the VAS score at 2h and 6h after the operation was reduced, the BCS score was increased (P<0.05), the number of PCIA boluses was reduced (P<0.001), and the incidence of nausea and vomiting significant decreased (P=0.014).Conclusion: Ultrasound-guided ESPB applied to general anesthesia for cesarean section can significantly reduce the required dose of general anesthetic drugs, shorten the recovery time of puerperae, and improve postoperative analgesia.
The Clinicopathological and Prognostic Significance of Foxp3 Expression in Gastric Cancer: A Meta-Analysis and TCGA Analysis
Authors: Gao Jiacheng , Jia Zirui , Wang Yuhang , Zhou Tingting , Zhang Xiangwen , Zu Guo 
Published: May 2022

Abstract
Purpose：In gastric cancer (GC) patients, the relationship between Forkhead Box P3 (Foxp3) expression and clinicopathological parameters and prognosis is controversial. Our purpose was to study the association between Foxp3 expression and clinicopathological parameters and overall survival (OS) of GC patients.Method：The data for this article was analyzed by Stata 15.1 software. The association between Foxp3 expression and clinicopathological data and OS was explored by pooled odds ratio (OR) with a 95% confidence interval (CI). We used deek’s plots to evaluate publication bias. By The Cancer Genome Altlas (TCGA) data, we detected that the association between Foxp3 expression and OS in stomach adenocarcinoma (STAD) patients.Results：We obtained 12 articles including 1,583 GC patients. Our research observed that Foxp3 expression was not related to age (OR = 0.899, 95% CI = 0.549-1.472, p = 0.672), gender (OR = 0.836, 95% CI = 0.647-1.080, p = 0.171), differentiation (OR = 1.083, 95% CI = 0.616-1.904, p = 0.781), and TNM stage (OR = 0.967, 95% CI = 0.583-1.605, p = 0.898) in GC patients. We found that Foxp3 expression was related to tumor size (OR = 0.489, 95% CI = 0.2857-0.839, p = 0.009) and lymph node metastasis (OR = 0.514, 95% CI = 0.280-0.944, p = 0.032) in GC patients. Our studies showed that high Foxp3 expression of 1-year OS (OR = 0.606, 95% CI = 0.399-0.921, p = 0.019), 3-year OS (OR = 0.629, 95% CI = 0.436-0,908, p = 0.013), and 5-year OS (OR = 0.412, 95% CI = 0.231-0.734, p = 0.003) was better than low Foxp3 expression in GC patients. The OS of high Foxp3 expression group was better than low Foxp3 expression group by TCGA, but there was no different in statistic (p=0.34).Conclusion：Foxp3 expression was relate to tumor sizes, lymph node metastasis and better OS in GC patients. Foxp3 expression was not related to age, sex, differentiation, and TNM stage. Foxp3 might be a prognosis maker in GC patients.
Immunogenicity and safety of the BNT162b2 mRNA Covid-19 vaccine in patients with melanoma treated with immunotherapy
Authors: Diamantopoulos Panagiotis , Kontandreopoulou Christina-Nefeli , Gkoufa Aikaterini , Solomou Elena , Anastasopoulou Amalia , Palli Eleni , Kouzis Panagiotis , Bouros Spyros , Samarkos Mihalis , Magiorkinis Gkikas , Gogas Helen 
Published: May 2022

Abstract
Introduction. The BNT162b2 vaccine against SARS-CoV-2 has a proven efficacy and a favorable safety profile. In cancer patients under immunotherapy in the form of immune checkpoint inhibitors (ICIs), the efficacy of the vaccine has not been thoroughly studied, while a theoretical concern about the triggering of immune related adverse events (irAEs) by the vaccine has also been raised. Patients and methods. We conducted a prospective, non-interventional study on the immunogenicity and safety of the BNT162b2 vaccine in patients with advanced or metastatic melanoma treated with ICIs. Blood samples were obtained 0-4 days before the first and 12-21 days after the second dose of the vaccine for the quantification of the SARS-CoV-2 anti-spike antibody with an ELISA and immunophenotyping of the T and myeloid cell subpopulations. Active recording of the AEs for a two-month period was conducted. Results. Forty patients were included in the study. All but one (97.3%) achieved seroconversion after two doses of the vaccine and no correlations of the antibody titers with any of the studied parameters (age, gender, stage and duration of the disease, type of ICI, previous treatment, etc.) were found. Moreover, no differences in the subpopulations of the T cells (including the T-regulatory cells) or the myeloid cells were found pre- and post-vaccination. All AEs were low-grade, while one case or arthritis exacerbation was noted.Discussion. The seroconversion rate in the studied population was high, comparable to that of healthy subjects, while no major safety issues were raised during the safety follow-up. Finally, no derangements in the subpopulations of T cells or myeloid cells were noted. This is the first study focusing on the immunogenicity, safety, and effect on the blood cell immunophenotype status of anti-SARS-Cov-2 vaccines in patients with melanoma treated with ICIs.
Association of Pre-pregnancy low-carbohydrate diet with maternal oral glucose tolerance test levels in Gestational Diabetes
Authors: Hao Yanhui , Qu Lei , Guo Yuna , Ma Liying , Guo Muhe , Zhu Yiqing , Jin Yan , Gu Qin , Zhang Yue , Sun Wenguang 
Published: May 2022

Abstract
Background
Limited evidence exists on the correlation between the pre-pregnancy low-carbohydrate (LC) diet and maternal oral glucose tolerance test (OGTT) levels during pregnancy. Our aim was to compare the differences in maternal OGTT levels among women who had been diagnosed with gestational diabetes mellitus (GDM) during pregnancy and adopted different dietary patterns in the pre-pregnancy period.
Methods
This was a case-control study in 20 GDM women with LC diet during pre-conception (LC/GDM), using 80 GDM women with conventional diet (Con/GDM) and 80 women with conventional diet but without GDM as reference (Con/Healthy), respectively. Potential risk factors of GDM were controlled. We used unadjusted raw data to compare the dietary composition data and biomarkers of the three study groups.
Results
Compared with the Con/GDM group, the OGTT-1h and OGTT-2h values in LC/GDM group were significantly higher (10.36 ± 1.28 mmol/L vs. 9.75 ± 0.98 mmol/L; 9.12 ± 0.98 mmol/L vs. 8.29 ± 1.06 mmol/L). Furthermore, 40% of the LC/GDM group participants had abnormal values in both OGTT-1h and OGTT-2h, significantly higher than 16.3% of the Con/GDM group.
Conclusions
We observed a relationship between the pre-pregnancy LC diet and more detrimental OGTT values in patients with GDM. This finding warrants further studies to understand the effect of pre-pregnancy LC diet behavior on maternal glucose tolerance.
Did Medicaid expansion close African American-white health care disparities nationwide? A scoping review
Authors: Snowden Lonnie R. , Graaf Genevieve , Keyes Latocia , Kitchens Katherine , Ryan Amanda , Wallace Neal 
Published: May 2022

Abstract
Objectives
To investigate the impact of the Affordable Care Act’s (ACA) Medicaid expansion on African American-white disparities in health coverage, access to healthcare, receipt of treatment, and health outcomes.
Design:
A search of research reports, following the PRISMA-ScR guidelines, identified twenty-six national studies investigating changes in health care disparities between African American and white non-disabled, non-elderly adults before and after ACA Medicaid expansion, comparing states that did and did not expand Medicaid. Analysis examined research design and findings.
Results
Whether Medicaid eligibility expansion reduced African American-white health coverage disparities remains an open question: Absolute disparities in coverage appear to have declined in expansion states, although exceptions have been reported. African American disparities in health access, treatment, or health outcomes showed little evidence of change for the general population.
Conclusions
Future research addressing key weaknesses in existing research may help to uncover sources of continuing disparities and clarify the impact of future Medicaid expansion on African American health care disparities.
Predictive value of reactogenicity for anti-SARS-CoV-2 antibody response in mRNA-1273 recipients: a multicenter prospective cohort study
Authors: Choi Min Joo , Heo Jung Yeon , Seo Yu Bin , Yoon Young Kyung , Sohn Jang Wook , Noh Ji Yun , Cheong Hee Jin , Kim Woo Joo , Choi Ju-Yeon , Lee Young Jae , Lee Hye Won , Kim Sung Soon , Kim Byoungguk , Song Joon Young 
Published: May 2022

Abstract
Messenger RNA (mRNA) vaccination has been implemented to mitigate the coronavirus disease 2019 pandemic. However, data on antibody kinetics and factors influencing mRNA vaccines’ immunogenicity are limited. We conducted a prospective study on healthy young adults who received two doses of the mRNA-1273 vaccine at 28-day intervals. After each dose, adverse events were prospectively evaluated and blood samples were collected. The correlation between humoral immune response and reactogenicity after vaccination was determined. In 177 participants (19–55 years), the geometric mean titers of the anti-S IgG antibody were 178.07 and 4409.61 U/mL, whereas those of 50% neutralizing titers were 479.95 and 2851.67 U/mL 4 weeks after the first and second doses, respectively. The anti-S IgG antibody titers were not associated with local reactogenicity, but they were significantly higher in participants who experienced systemic adverse events (fever, headache, and muscle pain). Antipyretic use was an independent predictive factor of strong anti-SARS-CoV-2 antibody response after receiving both doses. Systemic reactogenicity after the first dose influenced antibody response after the second dose. mRNA-1273 induced a robust antibody response in healthy young adults. Post-vaccination immunogenicity might be related to systemic reactogenicity. Antipyretic use did not decrease the anti-SARS-CoV-2 antibody response after mRNA-1273 vaccination.Funding: This work was supported by the Korea National Institute of Health, Korea Disease Control and Prevention Agency [2021ER260300].
Chained Dual-GAN: A Generalized Defense against Adversarial Attacks
Authors: Singh Amitoj Bir , Awasthi Lalit Kumar , Bansal Urvashi 
Published: May 2022

Abstract
Neural networks play a significant role in the field of image classification. When an input image is modified by adversarial attacks, the changes are imperceptible to the human eye, but it still leads to misclassification of the images. In this paper, we create a new approach to defend against adversarial attacks, dubbed Chained Dual-GAN (CD-GAN) that tackles the defense against adversarial attacks by minimizing the perturbations of the adversarial image using iterative undersampling and oversampling.
Quantitative measurement and potential diagnosis of dental caries based on fusion modeling of IOS and CBCT images
Authors: Lian Xiaoli , Zhang Lanrui , Shen Lin , Wang Guanhua , Dai Xiaohua , Han Lei , Lin Xin , Dai Yanmei , Han Jianda , Wang Hongpeng , Zou Huiru 
Published: May 2022

Abstract
Objective: To evaluate the effects of a quantitative measurement and potential diagnosis of dental caries methodology based on fusion modeling of intraoral scanner (IOS) and cone-beam computerized tomography (CBCT).Materials and methods: Sixty extracted human permanent mandibular molar teeth were collected from Tianjin Stomatological Hospital. Two independent caries detection methods were used as index tests: assessment using fusion modeling of IOS and CBCT, visual-tactile examination with periapical radiographic assessment using international caries detection and assessment system (ICDAS) criteria. Histological assessment was used as the reference test. One-way ANOVA test was used for statistical analysis.Results: The teeth samples presented various caries stages among each groups. Fusion modeling of IOS and CBCT gave an accuracy of 96.7% while visual-tactile examination with periapical radiographic assessment reached 83.3% and 81.7%, respectively. Most index tests showed significant correlation with histological assessments. IOS-CBCT fusion group resulted in the highest reliability, and the highest sum of sensitivity (SE) and specificity (SP) (sum SE-SP: 1.60–1.84). Conclusions: The measurement and diagnosis of dental caries methodology based on fusion modeling of IOS and CBCT images was noninvasive and sensitive. The findings reported here shed new light on dental caries detection, classification, diagnosis, treatment and prevention. Clinical relevance: This dental caries measurement and diagnosis method offered a foundation for risk assessment and surveillance, disease prevention and health promotion of dental caries. It could be helpful in supporting the continuing development of caries lesion classification and disease management systems, and facilitating communication between practitioners, patients, researchers and policymakers.
Digital Financial Services for Health in Support of Universal Health Coverage: Qualitative Programmatic Case Studies from Kenya and Rwanda
Authors: Wilson David Randolph , Haas Sherri , Gelder Sicco van , Hitimana Regis 
Published: May 2022

Abstract
Background: This document describes two programmatic case studies documenting experiences implementing digital financial systems (DFS) for health with a focus on expanding access to universal health coverage (UHC). The CBHI 3MS system in Rwanda and the i-PUSH and Medical Credit Fund programs in Kenya were selected because they represent innovative use of digital financing technologies to support UHC programs at scale.Methods: These studies were conducted from April-August 2021 using a mixed methods process evaluation approach to answer three questions: 1) what was the experience implementing the program, 2) how was it perceived to influence health systems performance, and 3) what was the client/beneficiary experience? Qualitative interviews involved a range of engaged stakeholders, including implementers, developers, and clients/users from the examined programs in both countries. Secondary data were used to describe key program trends.Results: Respondents agreed that DFS contributed to health system performance by making systems more responsive, enabling programs to implement changes to digital services based on new laws or client-proposed features, and improving access to quality data for better management and improved quality of services. Key informants and secondary data confirmed that both implementations likely contributed to increasing health insurance coverage; however, other changes in market dynamics were also likely to influence these changes. Program managers and some beneficiaries praised the utility of digital functions, compared to paper-based systems, and noted their effect on individual savings behavior to contribute to household resilience. Discussion/Conclusions: Several implementation considerations emerged as facilitators or barriers to successful implementation of DFS for health, including the importance of multisectoral investments in general ICT infrastructure, the value of leveraging existing community resources (CHWs and mobile money agents) to boost enrollment and help overcome the digital divide, and the significance of developing trust across government and private sector organizations.The studies led to the development of four main recommendations for the design and implementation of health programs incorporating DFS.
COVID-19 Patients With Altered Steroid Hormone Levels Are More Likely To Have Higher Disease Severity
Authors: Sezer Sevilay , Bal Ceylan , Kalem Ayşe Kaya , Kayaaslan Bircan , Eser Fatma , Hasanoğlu İmran , Akıncı Esragül , Güner Rahmet , Erel Özcan , Yılmaz Gülsen 
Published: May 2022

Abstract
Purpose: This study aims to evaluate the correlations between the severity of the disease and serum steroid levels by analyzing the serum steroid levels in COVID-19 patients with different levels of disease progression and the control group.Methods: Morning plasma Aldosterone, 11-deoxycortisol, Androstenedione, 17- hydroxyprogesterone, Dihydrotestosterone (DHT), Dihydroepiandrostenedion (DHEA), Corticosterone, Dihydroepiandrostenedion sulfate (DHEAS), Estrone, 11- deoxycorticosterone, Cortisol, Corticosterone, Androsterone, Pregnenolone, 17- hydroxypregnenolone levels were measured in 153 consecutive patients were grouped as mild, moderate, and severe based on the WHO COVID-19 disease severity classification and the control group. Steroid hormone levels were analyzed at once with a liquid chromatography-tandem mass spectrometric method (LC-MS/MS). Results: In our study, all of the steroids except DHT and DHEAS were statistically significantly higher in the patients’ group than in the control group (p>0.001). Also, DHEA was an independent predictor of the disease severity with COVID-19Conclusions: Our study reveals that altered steroid hormone levels have a negative impact on COVID-19 prognosis by simultaneous measurement of steroid hormones levels with LC-MS/MS. Also, adrenal insufficiency due to COVID-19 is an endocrinological pathology that should be followed up.
Does maturity status explain training intensity and physical fitness variations of youth football players?
Authors: Silva Rui , Clemente Filipe Manuel , González-Fernández Francisco , Nobari Hadi , Haghighi Hamed , Carral José María Cancela 
Published: May 2022

Abstract
Background: Different predictive maturity status methods are available for coaches to apply during the training process. However, understanding the potential use of such methods to explain both physical fitness and training intensity (TI) measures, can give coaches new insights to better adjust training according to each individual needs. Objectives: The purpose of the present study was two-fold: (1) To analyse TI and physical fitness variations of youth football players after a full-season; and (2) to examine whether training intensity and physical fitness variations are explainable by estimated maturation status.Methods: Twenty-seven youth elite Under-15 football players were daily monitored for TI measures during 38 weeks. At the beginning and at the end of the season, all players were assessed for physical fitness. Also, different methods of maturity status estimation were collected at the beginning of the season.Results: Significant differences were found for all physical fitness and TI measures after the season. The 2-digit (2D) and 4-digit (4D) of left and right hands had negative moderate correlations with change of direction (COD) variations (r=-.39 to -.45 | p=.05 to .02). The right-fingers 2D:4D (RF2D:4D) had positive moderate-to-large correlations with all TI measures (r=-.40 to -.56 | p=.04 to .001). From the reported significant correlations, the RF2D:4D measure explained the greatest proportion of all TI variations (r=.40 to .62 | p=.04 to .001).Results: The use of the 2D:4D method of maturity status estimation may be a potential predictor of TI variations. Furthermore, the maturity offset and 2D:4D methods may not be useful to predict physical fitness variations after an Under-15 football season.