bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early combination therapy with etanercept and methotrexate in JIA patients shortens the time to reach an inactive disease state and remission: Results of a double-blind placebo-controlled trial
Authors: Alexeeva Ekaterina , Horneff Gerd , Dvoryakovskaya Tatyana , Denisova Rina , Nikishina Irina , Zholobova Elena , Malievskiy Viktor , Santalova Galina , Stadler Elena , Balykova Larisa , Spivakovskiy Yuriy , Kriulin Ivan , Alshevskaya Alina , Moskalev Andrey 
Published: September 2020

Abstract
Background Remission is the primary objective of treating juvenile idiopathic arthritis (JIA). It is still debatable whether early intensive treatment is superior in terms of earlier achievement of remission. The aim of this study was to evaluate the effectiveness of early etanercept+methotrexate (ETA+MTX) combination therapy versus step-up MTX monotherapy with ETA added in refractory disease. Methods A multi-centre, double-blind, randomized study in active polyarticular JIA patients treated with either ETA+MTX (n=35) or placebo+MTX (n=33) for up to 24 weeks, followed by a 24-week open-label phase. The efficacy endpoints included pedACR30 criteria improvement at week 12, inactive disease at week 24, and remission at week 48. Patients who failed to achieve the endpoints at week 12 or at week 24 escaped to open-label ETA+MTX. Safety was assessed at each visit. Results By intention-to-treat analysis, more patients in the ETA+MTX group reached the pedACR30 response at week 12 (33 (94.3%)) than in the placebo+MTX group (20 (60.6%); p=0.001). At week 24, comparable percentages of patients reached inactive disease (11 (31.4%) vs 11 (33.3%)). At week 48, 11 (31.4%) and eight (24.2%) patients achieved remission. The median (+/-IQR) times to achieve an inactive disease state in the ETA+MTX and placebo+MTX groups were 24 (14–32) and 32 (24–40) weeks, respectively. Forty-four (74/100 patient-years) adverse events (AEs) were reported, leading to treatment discontinuation in 6 patients.Conclusions Early combination therapy with ETA+MTX proved to be highly effective compared to the standard step-up regimen. Compared to those treated with the standard regimen, more patients treated with a combination of ETA+MTX reached the pedACR30 response and achieved inactive disease and remission more rapidly.Trial registrationThe study was registered by the European Clinical Trials Database (EudraCT) as 2015-003384-11 on 07-21-2014.
Mesenchymal stem cells modified by FGF21 and GLP1 ameliorate lipid metabolism while reducing blood glucose in type 2 diabetic mice
Authors: Xue Binghua , Xiao Xiuxiao , Yu Tingting , Xiao Xinhua , Xie Jie , Ji Qiuhe , Wang Li , Na Tao , Meng Shufang , Qian Lingjia , Duan Haifeng 
Published: September 2020

Abstract
Objective: The purpose of the study was to investigate the therapeutic effects of genetically modified mesenchymal stem cells (MSCs) in the treatment of type 2 diabetes mellitues (T2DM), in order to find a new method of diabetes treatment different from traditional medicine, and provide a new way to fundamentally improve or treat diabetes.Methods: MSCs derived from adipose tissue were modified with over-expression of FGF21 and GLP1, which was achieved through lentiviral particles transduction. The cells were transplanted to the BKS.Cg-Dock7m+/+Leprdb/Nju mice (T2DM mice model). The injections of physiological saline (0.1 mL), Liraglutide (0.5mg/kg) were employed as negative and positive controls respectively. The protein analyses were performed using ELISA or western blot analysis, while quantitative real-time PCR was adopted for gene expression.Results: The genetic modification had no effects on morphology, differentiation ability, or immunophenotype of MSCs. Moreover, MSC-FGF21+GLP1 cells exhibited significantly increased secretion of FGF21 and GLP1. In T2DM model mice, the transplantation of MSC-FGF21+GLP1 cells ameliorated blood glucose and weight, promoted the secretion of insulin, enhanced the recovery of liver structures, and improved lipid profiles. Moreover, FGF21 and GLP1 exhibited synergistic effects in regulation of glucolipid metabolism through controlling the expression of insulin, srebp1 and srebp2.Conclusion: The stem cell treatment based on MSCs modified by FGF21 and GLP1 genes is an effective approach for treatment of T2DM.
Pulse oximetry curves in healthy children living at moderate altitude: a cross-sectional study from the Ecuadorian Andes
Authors: Mayorga Vinicio Andrade , Andrade Felipe , Riofrío Pablo , Nedel Fulvio , Martin Miguel , Romero Natalia 
Published: September 2020

Abstract
Background
In populations above 3,000 meters above sea level (m.a.s.l.) normal values of oxygen saturation (SpO2) above 90% have been reported. Few studies have been conducted in cities of moderate altitude (between 2,500 and 3,000 m a.s.l). We set out to describe the range of SpO2 values measured with a pulse oximeter in healthy children between 1 month and 12 years of age living in an Ecuadorian Andean city.
Methods
A cross-sectional study was carried out in Quito, Ecuador, located at 2,810 m a.s.l. SpO2 measurement in healthy children of ages ranging from 1 month to 12 years of age residents in the city were recorded by pulse oximetry. Age and gender were recorded, and median and 2.5 th and 5 th percentile were drawn. Non parametric tests were used to compare differences in SpO2 values by age and gender.
Results
1,378 healthy children were included for the study, 719 (52.2%) males. The median SpO2 for the entire population was 94.5%. No differences were observed between SpO2 median values by age and gender. The 2.5 th percentile for global SpO2 measurements was 90%, in children under 5 years of age was 91% and it was 90% in children older than 7.
Conclusions
Our results provide SpO2 values for healthy children from 1 to 12 years old residents in Quito, a city of moderate altitude. The SpO2 percentile curve could contribute as a healthy range for the clinical evaluation of children residing at this altitude.
Response of Groundnut (Arachis hypogaea L.) Genotypes to Combined Application of Phosphorus and Foliar Zinc Fertilizers in Central Tigray, Ethiopia&nbsp;
Authors: Berhe Hintsa Meresa , Abera Dereje Assefa , Yemane Yemane Tsehaye 
Published: September 2020

Abstract
Background:Objective of the study was to investigate the response of groundnut genotypes to combined application of phosphorus and zinc on yield and nutritional contents. A field experiment was conducted at Sheka-Tekli in 2017/18 cropping season. Methods:The treatments were consisted of three groundnut genotypes (ICGV00308, ICGV91114 and Sedi) as main plot and four combined PZn fertilizer levels (00), 10 kg P/ha +0.50 g Zn/L, 20 kg P/ha +1 g Zn/L and 30 kg P/ha+1.5 g Zn/L as sub plot were assigned in split plot design with tree replications.Result: The result indicated that yield and yield components respond significantly to the main and interaction effects. The highest significant seed yield (2,529 kg/ha) and protein content (37.79%) were obtained in response to the application of P30Zn1.5 fertilizer on sedi variety in the loamy sand soil The percentage of crude protein and fat content had significantly affected by interaction components. Most of the yield component traits showed strong positive correlation with seed yield. While the lowest seed yield was recorded from ICGV00308 without fertilizer. The highest fat content (43.95%) was gained from genotype ICGV00308 at P30Zn1.5 fertilizer. From the interaction of sedi with P30Zn1.5 fertilizer was recorded highest protein content. Based on economic analysis the highest MRR (380.58%) was obtained from ICGV00308 genotype at P10Zn0.5 fertilizer. Conclusion: From the result of the study, application of PZn fertilizer increases seed yield of groundnut. Therefore, based on the MRR result ICGV00308 genotype at P10Zn0.5 fertilizer was optimum for groundnut production in the study area and similar agro-ecologies.
Three redescriptions in Tintinnopsis (Protista: Ciliophora: Tintinnina) from coastal waters of China, with cytology and phylogenetic analyses based on ribosomal RNA genes
Authors: Bai Yang , Wang Rui , Song Wen , Li Lifang , Santoferrara Luciana F. , Hu Xiaozhong 
Published: September 2020

Abstract
Background: The taxonomy of tintinnine ciliates is vastly unresolved because it has traditionally been based on the lorica (a secreted shell) and it has only recently incorporated cytological and molecular information. Tintinnopsis, the most speciose tintinnine genus, is also the most problematic: it is known to be non-monophyletic, but it cannot be revised until more of its species are studied with modern methods. Results: Here, T. hemispiralis Yin, 1956, T. kiaochowensis Yin, 1956, and T. uruguayensis Balech, 1948, from coastal waters of China, were studied. Lorica and cell features were morphometrically investigated in living and protargol-stained specimens, and sequences of three ribosomal RNA (rRNA) loci were phylogenetically analyzed. The three species show a complex ciliary pattern (with ventral, dorsal, and posterior kineties and right, left, and lateral ciliary fields), but differ in lorica morphology, details of the somatic ciliature and rRNA gene sequences. Tintinnopsis hemispiralis is further distinguished by a ciliary tuft (a ribbon of very long cilia originating from the middle portion of the ventral kinety and extending out of the lorica) and multiple macronuclear nodules. Both T. kiaochowensis and T. uruguayensis have two macronuclear nodules, but differ in the number of somatic kineties and the position of the posterior kinety. Two neotypes are fixed for T. hemispiralis and T. kiaochowensis to stabilize the species names objectively, mainly because of the previous unavailability of type materials. By phylogenetic analysis and comparison with closely-related species, we infer that the ciliary tuft and details such as the commencement of the rightmost kinety in the lateral ciliary field are synapomorphies that may help clarify the systematics of Tintinnopsis-like taxa. Conclusion: The redescriptions of three poorly known Tintinnopsis species, namely T. hemispiralis, T. kiaochowensis, and T. uruguayensis firstly revealed their ciliary pattern and rRNA sequences. This study expands knowledge and database of tintinnines and helps in identifying potential synapomorphies for future taxonomic rearrangements.
Precursors and outcomes of work engagement among nursing professionals—a cross-sectional study
Authors: Slåtten Terje , Lien Gudbrand 
Published: September 2020

Abstract
Background: Health services organizations must understand how best to lower nursing professionals’ turnover intentions, increase their job satisfaction and quality of care provided to patients. This study aims to examine whether work engagement, which refers to a positive fulfilling, work-related state of mind, is a significant predictor of the achievement of these preferred organizational goals. The study also aims to examine whether organizational culture and climate can manage the work engagement of nursing professionals and indirectly contribute to the accomplishment of the preferred organizational goals.Methods: The proposed conceptual model was tested in a quantitative study in which nursing professionals participated. The data were analyzed using confirmatory factor analysis and structural equation modeling in Stata.Results: The three key findings from this study were: i) work engagement of nursing professionals was found to be positively related to service quality of care (b = 0.551) and job satisfaction (b = 0.883). Job satisfaction fully mediates the relationship between work engagement and turnover intention and in itself explains almost 60% (R2 = 0.59) of turnover intention (which refers to the intention to leave a job on a personal/workers level), ii) nursing professionals’ perception of organizational culture (b = 0.278) and collaboration climate (b = 0.331) were both directly related to their work engagement, iii) work engagement fully mediates the relationship between organizational culture, organizational climate and service quality of care and job satisfaction. Moreover, work engagement particularly mediates the relationship between collaborative climate and job satisfaction.Conclusions: The work engagement of nursing professionals is highly correlated, especially to their job satisfaction. Work engagement and intention to leave a job is (fully) mediated by job satisfaction. Employers should therefore focus on improving job satisfaction of nursing professionals. The work engagement of nursing professionals is a common key factor for improvements. Consequently, leaders and managers should continuously manage nursing professionals’ work engagement, focusing on such areas as organizational culture and climate because work engagement is a substantial driver to enable multiple desirable outcomes for hospital organizations.
Retrospective cohort study on radial head arthroplasty comparing long-term outcomes between valgus type injury and fracture dislocation
Authors: Chen Alvin Chao-Yu , Weng Chun-Jui , Chiu Chih-Hao , Chang Shih-Sheng , Cheng Chun-Ying , Chan Yi-Sheng 
Published: September 2020

Abstract
Background: Radial head arthroplasty (RHA) has been commonly adopted for irreparable radial head fractures while little information is addressed on valgus type injury. The purpose of this study is to report long-term outcomes and radiographic analysis in RHA for valgus type injury with comparison to fracture dislocation injury.Methods: A retrospective cohort study was conducted in patients receiving unilateral RHA with loose-fit, modular metal prosthesis for irreparable radial head fractures between 2004 and 2012. Totally, 33 patients with a mean follow up of nine years (range, 7 to 15 years) were enrolled and divided into two groups including 14 valgus injuries and 19 fracture-dislocations. Demographics of the patients, injury details, clinical and radiographic outcomes, and correlation analysis were investigated and compared between two groups.Results: In patient demographics, significant difference was noted in sex distribution, lateral collateral ligament involvement and time from injury to RHA between two groups. No patient underwent subsequent removal or revision of prosthesis. Good to excellent results according to Mayo Elbow Performance Score (MEPS) was achieved in 13 and 14 patients in group A and B respectively. Final motion range and Disabilities of the Arm, Shoulder, and Hand score was significantly better in valgus injury group. Radiographic analysis demonstrated fewer patients in valgus injury group presented periprosthetic osteolysis with weak to moderate negative correlation between radiolucency score and MEPS.Conclusions: With an average of nine years follow-up, RHA using loose-fit, modular metal prosthesis achieves encouraging outcomes for both valgus injury and fracture dislocation. In valgus type injury, better motion range, lower disability score and lower incidence of periprosthetic osteolysis is noted while correlation analysis of radiolucency score suggests extended, long-term investigation.
Somatic development in children with Shwachman-Diamond Syndrome
Authors: Bogusz-Wójcik Agnieszka , Kołodziejczyk Honorata , Klaudel-Dreszler Maja , Oracz Grzegorz , Pawłowska Joanna , Szalecki Mieczysław 
Published: September 2020

Abstract
Background: Shwachman-Diamond syndrome (SDS) is a rare genetic, multi-systemic disease characterized by exocrine pancreatic insufficiency, immune deficiency, bone marrow failure and skeletal abnormalities. Most patients present with failure in somatic development and short stature, but systematic data concerning those features are limited. The aim of the study was to assess the prevalence of failure in somatic development in the children with SDS.Methods: An analysis of anthropometric measurements of 21 patients (14 girls and 7 boys),aged 2 to 17 years (mean age 6.3 years) with SDS diagnosed in The Children’s Memorial Health Institute in Warsaw, Poland was performed. The patients were measured using a Holtain Limited stadiometer, an electronic scale, a Harpenden anthropometer, a metric tape and a spreading caliper. The assessed anthropometric parameters were expressed as standard deviation scores in relation to the reference values in Poland, suitable for sex as well as calendar and growth age.Results: A total of 66 measurements was collected and analyzed with a median number of 3 observations per patient. The group of boys presented with a significantly lower height (-3.0 SD, p<0.0001) and BMI (-1.4 SD, p<0.00001), and in the relation to the growth age a lower weight ( -1.0 SD, p<0.001) as well as a smaller chest width (-0.9 SD, p<0.05), hip width (-0,5 SD, p<0,05) and lower limb length (-0,5 SD, p<0,05). The group of girls also showed significantly lower height (-2.6 SD, p<0.00001) and BMI (-0.8 SD, p<0.00001), and in relation to the growth age, lower weight (-0.5 SD, p<0.001) as well as decreased width of the chest (-1.7 SD, p<0.0001) and shoulder (‑1.0 SD, p<0.001) were observed. Boys and girls were also characterized by significantly decreased circumference and width of head, additionally, girls had also smaller head length.Conclusions: Patients with SDS have abnormal somatic development. Both boys and girls are characterized by short stature, decreased weight, BMI, leg length, chest width as well as circumference and width of head. Anthropometric measurements provide important data on the process of growth and body proportions in children with SDS.
An Assessment of Heatwave Impact in Enugu Metropolis of Enugu State
Authors: Agu Christian Chijioke , Amarachi Ikwuka , Tukur Kamila , Omede Hassan , Nwadike Blessing Kakushia 
Published: September 2020

Abstract
BackgroundThe context of this research the impact of heatwave within Enugu city center, with the aim to analyze the impact in the city metropolis of Enugu state which comprises of three local government areas namely Enugu East Enugu North and Enugu South.ResultFrom the result, our findings showed the increase in lst over the period of years and over 50% inhabitants feel discomfort, while the vegetation index reduced in year 2020.ConclusionThe summary of the research looked at the change detection, NDVI, LST, and thermal comfortablity index, the potential implication of the result shows that heatwave impact is more felt in the study area and, the city will become more hotter in the near future thereby making it unfavourable and un comfortable for people to live or habit.
A Model for Marginal Relative Survival
Authors: Lambert Paul Christopher , Syriopoulou Elisavet , Rutherford Mark J 
Published: September 2020

Abstract
Background: When quantifying the probability of survival in cancer patients using cancer registry data, it is common to estimate marginal relative survival, which under assumptions can be interpreted as marginal net survival. Net survival is a hypothetical construct giving the probability of being alive if it was only possible to die of the cancer under study and enables comparisons between populations with diﬀerential mortality rates due to other causes. Marginal relative survival can be estimated non-parametrically (Pohar Perme estimator) or in a modeling framework. In the modeling framework, even when just interested in the marginal survival in a population it is necessary to model covariates that aﬀect the expected mortality rates (e.g. age, sex and calendar year). The marginal relative survival function is then obtained through regression standardization. Given that these covariates will generally have non-proportional eﬀects, the model can become complex even before other exposure variables are considered.Methods: This paper proposes a ﬂexible parametric model incorporating restricted cubic splines that directly estimates marginal relative survival and thus removes the need to model covariates that aﬀect the expected mortality rates. In order to do this the likelihood needs to incorporate the marginal expected mortality rates at each event time taking account of informative censoring. In addition time-dependent weights need to be incorporated into the likelihood. An approximation is proposed using data expansion which enables the marginal model to be ﬁtted using standard software. Additional weights can be incorporated when needing to standardize to an external reference population.Results: The methods are illustrated using English cancer registration data. In addition a simulation study has been performed comparing estimation using a non-parametric approach, regression-standardization and the new marginal model showing that the method has good statistical properties.Conclusion: The approach enables estimation of standardized marginal relative survival without the need to model covariates that aﬀect the expected mortality rates and thus avoids potential model misspeciﬁcation problems.
Management of a giant aortic root aneurysm in a young patient with Marfan syndrome: a case report
Authors: SHEN JIAYU , Gan Changping , Rajaguru R.D.T. , Yuan Dou , XIAO ZHENGHUA 
Published: September 2020

Abstract
IntroductionMarfan syndrome (MFS) is a common heritable connective tissue disease involving multiple organs. Even though the clinical manifestations of MFS can be various, aortic root aneurysm is estimated as one of the most serious complications. We herein describe an individualized treatment decision-making process for a 23-year-old male with MFS, suffering from a giant but stable aortic root aneurysm which is extremely rare at his age.CaseThe patient, a 23-year-old male with a family history of MFS, presented to our cardiovascular department because of progressive exertional chest distress, fatigue and occasional precordial pain. Physical examinations revealed 190.5cm of height, high myopia, and a diastolic murmur at the aortic valve area. Laboratory examinations for systemic vasculitis and infectious diseases were negative. Transthoracic echocardiography and enhanced thoracic computed tomography (CT) scan revealed the existence of a giant aortic root aneurysm (125.1 mm in short-axis), severe aortic valve regurgitation, cardiac dilatation (LV; 99 mm in diastolic diameter) and a poor ejection fraction (EF; 18%). Considering the risk of rupture or dissection of the dilated aortic root, we performed Bentall procedure based on the results of multidisciplinary team discussion and intraoperative exploration. Postoperative thoracic CT scan revealed a normal sized reconstructed aortic root, and the patient was discharged uneventfully 7 days later.ConclusionIt is extremely rare to report such a giant aortic root aneurysm in a young patient. In the treatment decision-making process, the patient’s specific situation should be taken into consideration. A mechanical Bentall procedure seems to be an acceptable option for some selected cases.