bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hypoxia in non-rapid eye movement sleep in children with otitis media with effusion
Authors: Zhang Qing-Qing , Guo Rui-Xin , Xie Meng , Qiang Yin , Shi Yao , Liu Xiao-Hong , Cheng Long , Liu Hai-Qin , Luo Hua-Nan 
Published: October 2022

Objective This study aimed to analyze the status of hypoxia in non-rapid eye movement (NREM) sleep in children with otitis media with effusion (OME). Methods A total of 232 children with OME and/or adenotonsillar hypertrophy were enrolled in this retrospective study between August 2020 and November 2021. Polysomnographic monitoring was carried out, and the differences in polysomnographic results between the experimental group (children with OME and adenotonsillar hypertrophy) and control group (children with adenotonsillar hypertrophy only) were compared. Results The lowest oxygen saturation level during sleep was significantly lower in the experimental group (n  =  36) than in the control group (n = 196). However, the apnea-hypopnea index, respiratory disorder index, apnea index, obstructive apnea index, obstructive apnea-hypopnea index, and mixed apnea-hypopnea index were significantly higher in the experimental group than in the control group. More importantly, the apnea-hypopnea index, the oxygen desaturation index, oxygen desaturation events, the average heart rate during NREM sleep, and the NREM stage in total sleep time were also significantly higher in the experimental group than in the control group. Conclusions Hypoxia during NREM sleep may affect the severity of OME in children.
Friction and wear characteristics of synthetic diamond and graphene-filled polyether ether ketone composites
Authors: Kumar Vishal , Kaliyamoorthy Rajkumar 
Published: October 2022

Modifying tribo films using filler particles is a significant area of research in developing polymer-based tribo components to minimize material loss during the sliding process. This study focused on altering the wear characteristics of a polyetheretherketone (PEEK)/graphene high-performance polymer composite to strengthen the tribo film by adding synthetic diamond particles. The hot-pressed PEEK composite reinforced by graphene and diamond particles increased the hardness and thermal stability of the composite. Compared with pure PEEK, composites containing 1% graphene and 1% diamond particles showed an increment of 25% and 23% in hardness and thermal stability, respectively. Fourier-transform infrared spectroscopy and X-ray diffraction analysis verified the compatibility and intactness of the fillers in the PEEK matrix. The tribo properties of PEEK composites were characterized by a pin-on-disc tribometer on a counter steel surface. A PEEK composite containing 0.75 wt% graphene and 0.5 wt% diamond particles exhibited the lowest friction of 0.17 at a pressure of 1.5 MPa. The specific wear rate was low (1.78 × 10−6 mm3/Nm) for the composite containing 1 wt% graphene and 1 wt% diamond particles at a pressure of 1.5 MPa. Varying synthetic diamond and graphene filler concentrations in the PEEK matrix change the wear process by modifying the tribo film characteristics, revealing the lowest friction and wear rate. X-ray photoelectron and Raman spectroscopy show that the polymer film was transferred to the steel countersurface, and the tribo-chemical products of the tribo film contribute to a stable tribo film. The ferric oxide film and the tribo film improve the composite’s self-lubricating properties and load-bearing ability. Hence, the composite containing 0.75% of graphene and 0.5% of a synthetic diamond can be employed in the sliding bearing application of continuous conveyors used in mass production systems.
Achyranthoside D (AD) improve intervertebral disc degeneration through affect the autophagy and the activation of PI3K/Akt/mTOR pathway
Authors: Zhang Chao , Li Zhaoyong , Li Linghui , Li Shuofu , Yang Lei , Chen Long , Zhang Xiao , Yang Shaofeng , Guo Yantao 
Published: October 2022

Purpose This study aims to explore the potential mechanism of Achyranthoside D (AD) in improving intervertebral disc (IVD) degeneration (IDD). Methods The IDD model of SD rats and nucleus pulposus cells (NPCs) was established by lumbar cone annulus puncture and tert-butyl peroxide, respectively. Cell proliferation was detected by CCK8 assay. Apoptosis was detected by flow cytometry and TUNEL staining. IVD tissue injury was observed by HE staining. Alcian blue staining observed the glycoprotein secretion in IVD. Monodansylcadaverin (MDC) staining was used to detect the formation of autophagosomes. The LC3 expression was tested by immunofluorescence. The type II collagen, aggrecan and MMP3 expression were detected by ELISA. RT-qPCR was used to detect the Casp 3, Bax, Bcl2, Acan, Col2a1 and Mmp3 expression. The LC3, P62, type II collagen, aggrecan, Beclin1, Akt, MMP3, p-mTOR, PI3K, mTOR, p-PI3K and p-Akt expression were analyzed by western blot. Results The IVD tissue damage and apoptosis occurred in the Model group, and the glycoprotein secretion decreased. Compared with Model group, AD-H group alleviated the injury of IVD tissue, inhibited the apoptosis of cells, and increased the secretion of glycoprotein. 40 μg/mL AD restored the proliferation activity of NPCs. Compared to the Normal group, the NPCs apoptosis increased, the Collagen II, aggrecan and Bcl2 expressions were significantly decreased, the MMP3, Bax and Casp 3 expression were significantly increased, and the LC-3 II/I expression in IVD tissues were increased significantly in Model group, all of which was reversed in AD group. AD promoted the p-Akt, p-PI3K, p-mTOR, LC-3 II/I and Beclin1 expression, inhibited the P62 expression to alleviate the damage of nucleus pulporeus cells and the degeneration of IVD. Conclusion AD improved IDD by affecting the PI3K/Akt/mTOR pathway and autophagy.
Baricitinib Versus Tocilizumab for the Treatment of Moderate to Severe COVID-19
Authors: Reid Nancy Kierstin , Joyner Kayla Rena , Lewis-Wolfson Temeka Dawn 
Published: October 2022

Background: To date, minimal data directly compare tocilizumab with baricitinib for treatment in moderate to severe COVID-19. Objective: To compare the rates of in-hospital mortality with progression to mechanical ventilation in patients with COVID-19 who received either tocilizumab or baricitinib. Methods: The authors conducted a single-centered, institutional review board–approved, retrospective cohort study. Patients who were 18 years or older who were hospitalized with COVID-19 and who received tocilizumab or baricitinib were included. The primary end point is a composite outcome of progression to mechanical ventilation or in-hospital mortality. Secondary end points include components of the composite outcome and progression to higher level of care, duration of mechanical ventilation, and hospital and intensive care length of stay. Safety end points include the incidence of infections and thrombosis. Results: A total of 176 patients were included, of whom 61 (34.7%) received tocilizumab and 115 (65.3%) received baricitinib. In the primary outcome, there was no difference between the groups (52.5% tocilizumab vs 44.3% baricitinib, P = 0.305). For safety outcomes, there was a higher instance of thrombosis (11.5% tocilizumab vs 3.5% baricitinib, P = 0.042) and rates of antibiotic use after initiation of therapy (55.7% tocilizumab vs 38.3% baricitinib, P = 0.026) in the tocilizumab group. Conclusion and Relevance: There was no significant difference in the composite outcome in patients who received tocilizumab or baricitinib for the treatment of COVID-19. However, there was an increase in rates of thrombosis in those receiving tocilizumab compared with baricitinib. These results need to be confirmed in larger prospective, randomized trials.
Effect of Antidiabetic Therapy on Clinical Outcomes of COVID-19 Patients With Type 2 Diabetes: A Systematic Review and Meta-Analysis
Authors: Zhan Kegang , Weng Liuqi , Qi Li , Wang Luhan , Lin Hao , Fang Xiaoyu , Jia Hong , Ma Xiangyu 
Published: October 2022

Background: No study has yet systematically evaluated the effect of antidiabetic therapy on clinical outcomes of COVID-19 patients with type 2 diabetes (T2D). Objective: We aimed to evaluate the effect of different antidiabetic therapy on clinical outcomes of COVID-19 patients with T2D. Methods: We comprehensively retrieved the published research which examined the effect of antidiabetic therapy on clinical outcomes of COVID-19 patients with T2D. The odds ratio (OR) and its 95% confidence interval (95% CI) for clinical outcomes were calculated using the random-effects model, and meta-regression was adopted to evaluate the potential sources of heterogeneity between studies. Results: A total of 54 studies were included in this study. We found that the use of metformin (OR = 0.66, 95% CI: 0.58-0.75), SGLT-2i (OR = 0.80, 95% CI: 0.73-0.88), and GLP-1ra (OR = 0.83, 95% CI: 0.70-0.98) were significantly associated with lower mortality risk in COVID-19 patients with T2D, while insulin use might unexpectedly increase the ICU admission rate (OR = 2.32, 95% CI: 1.34-4.01) and risk of death (OR = 1.52, 95% CI: 1.32-1.75). No statistically significant associations were identified for DPP-4i, SUs, AGIs, and TZDs. Conclusion and Relevance: We demonstrated that the usage of metformin, SGLT-2i, and GLP-1ra could significantly decrease mortality in COVID-19 patients with T2D. The heterogeneity across the studies, baseline characteristics of the included patients, shortage of dosage and the duration of antidiabetic drugs and autonomy of drug selection might limit the objectivity and accuracy of results. Further adequately powered and high-quality randomized controlled trials are warranted for conclusive findings.
Perceptions and Knowledge Around Substance Use Disorders and the Role of Occupational Therapy: A Survey of Clinicians
Authors: Mattila Amy M , Santacecilia Gabriella , LaCroix Rebecca 
Published: October 2022

Background: Today’s healthcare system requires practitioners to acquire a level of confidence, knowledge, and personal desire that enables them to treat a growing clientele with substance use disorders (SUDs). Although SUDs impact millions of Americans, there are many barriers to receiving treatment. It is important to understand how occupational therapy (OT) practitioners’ perceptions of working with clients who experience SUDs relate to the knowledge and skills required to identify and provide treatment. Method: Two surveys, the Medical Regard Scale and modified Drug Problems Perceptions Scale, were utilized to analyze participants attitudes, perceptions, and knowledge around working with individuals with SUDs. Data was collected from 116 practitioners with a variety of experience, practice settings, and backgrounds in understanding SUDs. Results: The majority of respondents reported no formal training in treating clients with SUDs (72.4%). In terms of attitudes around working with this population, a fraction reported a preference not to work with patients experiencing SUDs (16.0%) or finding them “irritating” to work with (12.9%), while 62.0% reported they felt especially compassionate toward this population. The majority of respondents felt that insurance plans should cover patients like this to the same degree that they cover patients with other conditions; however, only 48.3% had a clear idea of their responsibilities in helping individuals with SUDs. In regard to knowledge around working with SUDs, just over half of respondents reported a true working knowledge of SUDs and SUDs related problems (53.4%). Conclusion: Occupational therapy practitioners would benefit from additional training, resources, and support related to provision of services to individuals with SUD. In addition, training to continue to reduce stigma within the profession can potentially increase access to care.
Calcium Potentiated Carbapenem Effectiveness Against Resistant Enterobacter Species
Authors: Isawumi Abiola , Abban Molly Kukua , Ayerakwa Eunice Ampadubea , Mosi Lydia 
Published: October 2022

Background: Antimicrobial resistance (AMR) remains a global health challenge, as bacteria display increasing resistance to last-resort antibiotics such as carbapenems. Enterobacter cloacae are evolving and developing high level of resistance to carbapenems. With increasing AMR, availability of antibiotics for treatment dwindles, hence a need to complement antibiotics to enhance activity or reduce the level of resistance. This study explored the use of calcium ions in attenuating bacterial resistance to carbapenems. Method: E. cloacae strains isolated from hospital fomites and air were subjected to antimicrobial susceptibility testing with carbapenem antibiotics (imipenem, meropenem, doripenem and ertapenem) using the disc diffusion ( E. coli ATCC 25922 as control). Growth profile, Ca-Adjusted assay and time-kill curve of the strains was determined in the presence and absence of carbapenem antibiotics following a calcium stress assay. Results: Growth profile showed that all the E. cloacae strains grew markedly well at 37°C relative to ATCC 25922 and all strains displayed 80% to 100% level of resistance to tested antibiotics. The growth rate of the strains in the presence of the antibiotics was comparable to the growth rate in the absence of carbapenems. Conditional growth stress with calcium ions showed a 50% reduction in the level of resistance with doripenem displaying the lowest level of reduction and ertapenem, the highest. Discussion: The study showed that E. cloacae strains displayed high levels of resistance to carbapenems, increasing the possibility of treatment failure. Challenging strains with calcium prior to antibiotic treatment led to a significant reduction in level of resistance, indicating that calcium ions could affect bacterial strains during antibiotic activity leading to reduction in level of resistance. Conclusion: Calcium supplement could potentiate carbapenem effectiveness and reduce bacterial AMR.
Diagnosis and Comparison of Three Invasive Detection Methods for Helicobacter pylori Infection
Authors: Kismat Saifa , Tanni Nusrat Nur , Akhtar Rokshana , Roy Chandan Kumar , Rahman Mohammad Mosiur , Molla Md. Maruf Ahmed , Anwar Shaheda , Ahmed Sharmeen 
Published: October 2022

Background: The purpose of this study was to compare different invasive methods for Helicobacter pylori ( H. pylori) detection, namely PCR for H. pylori specific ureC gene, Rapid urease test (RUT), and histopathological examination by modified Giemsa staining. Methodology: Endoscopic gastroduodenal biopsy materials were collected from dyspeptic patients who underwent endoscopic examination upon fulfilling the inclusion criteria. Three to four samples were collected from each patient after taking informed consent and proper clinical history. A rapid urease test (RUT) was done on spot with in-house RUT media from 1 specimen. One to two specimens were preserved in 10% formaldehyde for histopathology and PCR for ureC gene was done from 1 specimen. Collected biopsy specimens from gastric and duodenal mucosa of 142 patients were categorized as H. pylori-positive cases and H. pylori-negative cases based on the case definition used in the study upon positivity of 3 diagnostic tests. Results: Among 142 biopsy specimens, 34.5% were categorized as H. pylori-positive cases, 35.2% as H. pylori-negative cases, and finally 30.2% as doubtful or indeterminate cases. Rapid urease test was the most sensitive method, closely followed by ureC gene PCR and histopathology, with a sensitivity of 94.2%, 83.0%, and 76.5%, respectively. Whereas histology was the most specific, having 98.0% specificity followed by 83.0% in PCR. RUT was the least specific, with 55.5% specificity. Conclusion: While histopathology could detect H. pylori infection with the highest specificity, for definitive diagnosis combination of any 2 methods should be used, if available.
Progression-free survival as surrogate endpoint of overall survival in esophageal squamous cell carcinoma: a real-world data and literature-based analysis
Authors: Han Weiming , Wang Lan , Li Chen , Chen Junqiang , Zhang Wencheng , Wang Xin , Pang Qingsong , Zhao Yidian , Sun Xinchen , Zhang Kaixian , Li Gaofeng , Li Ling , Qiao Xueying , Liu Miaoling , Wang Yadi , Deng Lei , Wang Wenqing , Bi Nan , Zhang Tao , Deng Wei , Ni Wenjie , Chang Xiao , Zhou Zongmei , Liang Jun , Feng Qinfu , Wang Lvhua , Chen Dongfu , Lv Jima , Zhu Shuchai , Han Chun , Xiao Zefen 
Published: October 2022

Background: The surrogacy of progression-free survival (PFS) for overall survival (OS) in esophageal squamous cell carcinoma (ESCC) remains unelucidated. This study aimed to determine the validity of PFS as a surrogate endpoint for OS in ESCC patients treated with definitive radiotherapy or definitive chemoradiotherapy (dRT/dCRT), as well as characterize the prognostic factors and survival of such patients. Methods: A total of 3662 patients from 10 cancer centers were enrolled. One-, 2-, and 3-year PFS (PFS12, PFS24, and PSF36, respectively) were used as time points for analysis. At each time point, ESCC-specific mortality and OS were characterized using competing risk and conditional survival models, while correlation between PFS and OS was evaluated by linear regression. Results: At PFS12, PFS24, and PFS36, a progressive decrease in 5-year ESCC-specific mortality (35.2%–13.4%) and increase in 5-year OS (46.6%–62.9%) were observed. Regardless, the OS of patients remained markedly lower than those of the age- and sex-matched Chinese general population. TNM stage remained a significant prognostic factor at PFS36. Strong correlation was found between 3-year PFS and 5-year OS, which was further externally validated. Conclusions: Three-year PFS may act as a potential surrogate endpoint for 5-year OS. TNM stage was considered a significant prognostic factor for OS, and may represent the optimal prognostic tool to guide clinical decision-making and post-treatment follow-up.
Comorbidity between lung cancer and COVID-19 pneumonia: role of immunoregulatory gene transcripts in high ACE2-expressing normal lung
Authors: Lazar Vladimir , Raynaud Jacques , Magidi Shai , Bresson Catherine , Martini Jean-François , Galbraith Susan , Wunder Fanny , Onn Amir , Batist Gerald , Girard Nicolas , Lassen Ulrik , Pramesh C. S. , Al-Omari Amal , Ikeda Sadakatsu , Berchem Guy , Blay Jean-Yves , Solomon Benjamin , Felip Enriqueta , Tabernero Josep , Rubin Eitan , Philip Thierry , Porgador Angel , Berindan-Neagoe Ioana , Schilsky Richard L. , Kurzrock Razelle 
Published: October 2022

Background: SARS-CoV-2 (COVID-19) elicits a T-cell antigen-mediated immune response of variable efficacy. To understand this variability, we explored transcriptomic expression of angiotensin-converting enzyme 2 ( ACE2, the SARS-CoV-2 receptor) and of immunoregulatory genes in normal lung tissues from patients with non-small cell lung cancer (NSCLC). Methods: This study used the transcriptomic and the clinical data for NSCLC patients generated during the CHEMORES study [ n = 123 primary resected (early-stage) NSCLC] and the WINTHER clinical trial ( n = 32 metastatic NSCLC). Results: We identified patient subgroups with high and low ACE2 expression ( p = 1.55 × 10−19) in normal lung tissue, presumed to be at higher and lower risk, respectively, of developing severe COVID-19 should they become infected. ACE2 transcript expression in normal lung tissues (but not in tumor tissue) of patients with NSCLC was higher in individuals with more advanced disease. High- ACE2 expressors had significantly higher levels of CD8+ cytotoxic T lymphocytes and natural killer cells but with presumably impaired function by high Thymocyte Selection-Associated High Mobility Group Box Protein TOX ( TOX) expression. In addition, immune checkpoint-related molecules – PD-L1, CTLA-4, PD-1, and TIGIT – are more highly expressed in normal (but not tumor) lung tissues; these molecules might dampen immune response to either viruses or cancer. Importantly, however, high inducible T-cell co-stimulator ( ICOS), which can amplify immune and cytokine reactivity, significantly correlated with high ACE2 expression in univariable analysis of normal lung (but not lung tumor tissue). Conclusions: We report a normal lung immune-tolerant state that may explain a potential comorbidity risk between two diseases – NSCLC and susceptibility to COVID-19 pneumonia. Further, a NSCLC patient subgroup has normal lung tissue expressing high ACE2 and high ICOS transcripts, the latter potentially promoting a hyperimmune response, and possibly leading to severe COVID-19 pulmonary compromise.
Thrombolysis after dabigatran reversal: A nation-wide Italian multicentre study, systematic review and meta-analysis
Authors: Romoli Michele , Matteo Eleonora , Migliaccio Ludovica , Gentile Mauro , Mosconi Maria Giulia , Scura Giuseppe Maria , Naccarato Marcello , Colangeli Enrico , Candelaresi Paolo , Andreone Vincenzo , Giammello Fabrizio , Fortunata Musolino Rosa , Dell’Aera Cristina , Sepe Federica Nicoletta , Pronello Edoardo , Barbarini Leonardo , Caggiula Marcella , Rizzo Federica , Petruzzellis Marco , Giorli Elisa , Zedde Maria Luisa , Anticoli Sabrina , Mangiardi Marilena , Muto Mario , Diana Francesco , De Angelis Maria Vittoria , Digiovanni Anna , Concari Letizia , La Gioia Sara , Sessa Maria , Biguzzi Sara , Cordici Francesco , Longoni Marco , Ruggiero Maria , Cenciarelli Silvia , Eusebi Paolo , Sacco Simona , Caso Valeria , Paciaroni Maurizio , Ricci Stefano , Zini Andrea , Toni Danilo , Giannandrea David 
Published: October 2022

Introduction: Recent anticoagulant intake represents a contraindication for thrombolysis in acute ischemic stroke. Idarucizumab reverses the anticoagulant effect of dabigatran, potentially allowing for thrombolysis. This nation-wide observational cohort study, systematic review, and meta-analysis evaluated the efficacy and safety of thrombolysis preceded by dabigatran-reversal in people with acute ischemic stroke. Patients and methods: We recruited people undergoing thrombolysis following dabigatran-reversal at 17 stroke centers in Italy (reversal-group), people on dabigatran treated with thrombolysis without reversal (no-reversal group), and age, sex, hypertension, stroke severity, and reperfusion treatment-matched controls in 1:7 ratio (control-group). We compared groups for symptomatic intracranial hemorrhage (sICH, main outcome), any brain hemorrhage, good functional outcome (mRS 0–2 at 3 months), and death. The systematic review followed a predefined protocol (CRD42017060274), and odds ratio (OR) meta-analysis was implemented to compare groups. Results: Thirty-nine patients in dabigatran-reversal group and 300 matched controls were included. Reversal was associated with a non-significant increase in sICH (10.3% vs 6%, aOR = 1.32, 95% CI = 0.39–4.52), death (17.9% vs 10%, aOR = 0.77, 95% CI = 0.12–4.93) and good functional outcome (64.1% vs 52.8%, aOR = 1.41, 95% CI = 0.63–3.19). No hemorrhagic events or deaths were registered in no-reversal group (n = 12). Pooling data from 3 studies after systematic review (n = 1879), reversal carried a non-significant trend for sICH (OR = 1.53, 95% CI = 0.67–3.50), death (OR = 1.53, 95% CI = 0.73–3.24) and good functional outcome (OR = 2.46, 95% CI = 0.85–7.16). Discussion and conclusion: People treated with reperfusion strategies after dabigatran reversal with idarucizumab seem to have a marginal increase in the risk of sICH but comparable functional recovery to matched patients with stroke. Further studies are needed to define treatment cost-effectiveness and potential thresholds in plasma dabigatran concentration for reversal.