bluuebunny/crossref_metadata_2025_split huggingface dataset:
Natural Course of Metabolically Healthy Phenotype and Risk of Developing Cardiometabolic Diseases: a three years follow-up study
Authors: Elías-López Daniel , Vargas-Vázquez Arsenio , Mehta Roopa , Bautista Ivette Cruz , Olvera Fabiola Del Razo , Valdes Paloma Almeda , Aguilar-Salinas Carlos A. , Gómez-Velasco Donaji V. 
Published: November 2020

Abstract
Background:

Whether the metabolically healthy obese (MHO) phenotype is a single, stable or a transitional, fluctuating state is currently unknown. The Mexican-Mestizo population has a genetic predisposition for the development of type 2 diabetes and other cardiometabolic complications. Little is known about the natural history of metabolic health in this population. The aim of this study was to analyze the transitions over time among individuals with different degrees of metabolic health and body mass index, and evaluate the incidence of cardiometabolic outcomes according to phenotype.
Methods:

The study population consisted of a metabolic syndrome cohort with at least three years of follow up. Participants were apparently-healthy urban Mexican adults ≥ 20 years with a BMI ≥ 20 kg/m2. Metabolically healthy phenotype was defined using the criteria of the NECP ATP III metabolic syndrome criteria and the subjects were stratified into 4 groups according to their BMI and metabolic health. For cardiometabolic outcomes we estimated the incidence of cardiometabolic outcomes and standardized them per 1, 000 person-years of follow-up. Finally, to evaluate the risk for transition and development of cardiometabolic outcomes, we fitted Cox Proportional Hazard regression models.
Results:

Amongst the 5,541 subjects, 54.2% were classified as metabolically healthy and 45.8% as unhealthy. The MHO prevalence was 39.3%. Up to a third of the population changed from their initial category to another and the higher transition rate was observed in MHO (42.9%). We also found several novel factors associated to transition to metabolically unhealthy phenotype; socioeconomic status, number of pregnancies, a high carbohydrate intake, history of obesity and consumption of sweetened beverages. Similarly, visceral adipose tissue (VAT) was a main predictor of transition; loss of VAT ≥5% was associated with reversion from metabolically unhealthy to metabolically healthy phenotype (HR 1.545, 95%CI 1.266–1.886). Finally, we observed higher incidence rates and risk of incident T2D and hypertension in the MUHO and MUHL phenotypes compared to MHO.
Conclusions

Metabolic health is a dynamic and continuous process, at high risk of transition to metabolically unhealthy phenotypes over time. It is imperative to establish effective processes in primary care to prevent such transitions.
Pregnancy and Parenting Experiences of Women With Twin-to-twin Transfusion Syndrome: A Qualitative Study
Authors: Ren Lijie , Song Cancan , Xia Chunling , Wang Nan , Yang Yan , Yin Shaowei 
Published: November 2020

Abstract
BackgroundQualitative research can reflect the actual thoughts and experience of research subjects and can be used to explore the experiences of women presenting with twin-to-twin transfusion syndrome (TTTS) to facilitate the provision of targeted psychological support.MethodsA semi-structured interview method was used to assess the pregnancy and parenting experiences of women who presented with TTTS.ResultsWomen who presented with TTTS during pregnancy experienced persistent worry about their children’s health from the disease diagnosis to the subsequent parenting processes, when slight changes in their children’s health elicited concern. The lack of an efficient referral process and health information increased their uncertainty about their children’s health.ConclusionIn addition to the children’s health, other difficulties encountered during pregnancy and parenting may aggravate the pressure. Regardless of whether with successful delivery, women who experiencing TTTS may be more susceptible to psychological problems. Clinicians should improve the referral process and establish a follow-up system to provide women with health information and psychological support.
Value of Amniotic Fluid Homocysteine Assay in Prenatal Diagnosis of Combined Methylmalonic Acidemia and Homocystinuria, Cobalamin C Type
Authors: Chen Ting , Liang Lili , Zhang Huiwen , Ye Jun , Qiu Wenjuan , Xiao Bing , Zhu Hong , Wang Lei , Xu Feng , Gong Zhuwen , Gu Xuefan , Han Lianshu 
Published: November 2020

Abstract
Background: Combined methylmalonic acidemia and homocystinuria, cobalamin C type (cblC defect) is the most common inborn error of cobalamin metabolism. Even with rapid diagnosis and treatment, the long-term outcome remains poor. A reliable method for the prenatal diagnosis of cblC defect is needed for parental decisions regarding continuation of pregnancies of cblC defect fetuses.Results: The between-day and within-day imprecision of Hcy assay were 1.60%∼5.87% and 1.11%∼4.31%, respectively. For the 248 at-risk fetuses, there were 63 affected fetuses with cblC defect and 185 unaffected fetuses. The levels of Hcy in 63 affected fetuses were significantly higher than those in 185 unaffected fetuses, without overlap between the affected and unaffected groups. Sixteen fetuses displayed inconclusive genetic results of MMACHC variants, in which seven fetuses were determined to be affected with elevated amniotic fluid levels of Hcy, C3, C3/C2 and MMA. The remaining nine fetuses were considered unaffected based on a normal amniotic fluid metabolite profile. The diagnostic sensitivities of Hcy and other characteristic metabolites including propionylcarnitine (C3), ratio of C3 to acetylcarnitine (C2; C3/C2), methylmalonic acid (MMA), and methylcitrate acid (MCA) in amniotic fluid were 100%, 87.50%, 100%, 85.71%, and 28.57%, respectively. The respective specificities were 92.05%, 100%, 100%, 97.73%, and 99.43%. Conclusions: Hcy appears to be another sensitive characteristic metabolite biomarker for the prenatal diagnosis of cblC defect. The combination of Hcy assay with acylcarnitine and organic acid analysis is a fast, sensitive, and reliable prenatal diagnostic biochemical approach. This approach could overcome the challenge of the lack of genetic analysis for families with at-risk cblC defect fetuses.
Genes Induced by Fusarium Crown Rot in Wheat and Barley Significantly Overlap with those Induced by Drought Stress
Authors: Liu Chunji , Su Z.Y. , Powell Jonanthan , Gao Shawn , Zhou M. 
Published: November 2020

Abstract
Background: Fusarium crown rot is a chronic disease in cereal production worldwide. The impact of this disease is highly environmentally dependant and significant yield losses occur mainly in drought-affected crops. Results: In the study reported here, we evaluated possible relationships between genes conferring FCR resistance and drought tolerance using two approaches. The first approach studied FCR induced DEGs (differentially expressed genes) targeting two barley and one wheat loci against a panel of selected genes with known functions in drought tolerance. Of the 149 selected genes, 61% were responsive to FCR infection across the three loci. The second approach was an comparison of the global DEGs induced by FCR infection with the global transcriptomic responses under drought in wheat. This analysis found that approximately 48.0% percent of the DEGs detected one week following drought treatment and 74.4% of the DEGs detected three weeks following drought treatment were also differentially expressed between the susceptible and resistant isolines under FCR infection at one or more timepoints. As for the results from the first approach, the vast majority of common DEGs were downregulated under drought and expressed more highly in the resistant isoline than the sensitive isoline under FCR infection. Conclusions: Results from this study suggest that the resistant isoline in wheat was experiencing less drought stress, which could contribute to the stronger defence response than the sensitive isoline. However, most of the genes induced by drought stress in barley were more highly expressed in the susceptible isolines than the resistant isolines under infection, indicating that genes conferring drought tolerance and FCR resistance may interact differently between these two crop species. Nevertheless, the strong relationship between FCR resistance and drought responsiveness provide further evidence indicating the possibility to enhance FCR resistance by manipulating genes conferring drought tolerance.
Reliability and validity of the Patient Benefit Assessment Scale for Hospitalised Older Patients (P-BAS HOP)
Authors: Kluit Maria van der , Dijkstra Geke , de Rooij Sophia 
Published: November 2020

Abstract
Background: The Patient Benefit Assessment Scale for Hospitalised Older Patients (P-BAS HOP) is a tool which is capable of both identifying the priorities of the individual patient and measuring the outcomes relevant to him, resulting in a Patient Benefit Index (PBI) with range 0-3, indicating how much benefit the patient had experienced from the admission. The aim of this study was to evaluate the reliability, validity, responsiveness and interpretability of the P-BAS HOP.Methods: A longitudinal study among hospitalised older patients with a baseline interview during hospitalisation and a follow-up by telephone three months after discharge. Test-retest reliability of the baseline and follow-up questionnaire were tested. Percentage of agreement, Cohen’s kappa with quadratic weighting and maximum attainable kappa were calculated per item. The PBI was calculated for both test and retest of baseline and follow-up and compared with Intraclass Correlation Coefficient (ICC). Construct validity was tested by evaluating pre-defined hypotheses comparing the priority of goals with experienced symptoms or limitations at admission and the achievement of goals with progression or deterioration of other constructs. Responsiveness was evaluated by correlating the PBI with the anchor question ‘How much did you benefit from the admission?’. This question was also used to evaluate the interpretability of the PBI with the visual anchor-based minimal important change distribution method.Results: Reliability was tested with 53 participants at baseline and 72 at follow-up. Mean weighted kappa of the baseline items was 0.38. ICC between PBI of the test and retest was 0.77.Mean weighted kappa of the follow-up items was 0.51. ICC between PBI of the test and retest was 0.62.For the construct validity, tested in 451 participants, all baseline hypotheses were confirmed. From the follow-up hypotheses, tested in 344 participants, five of seven were confirmed. The Spearman’s correlation coefficient between the PBI and the anchor question was .51.The optimal cut-off point was 0.7 for ‘no important benefit’ and 1.4 points for ‘important benefit’ on the PBI. Conclusions: Although the concept seems promising, the reliability and validity of the P-BAS HOP appeared to be not yet satisfactory. We therefore recommend adapting the P-BAS HOP.
Assessment of embolization effect with temperature-sensitive p(N-isopropylacrylamide-co-butyl methylacrylate) nanogels in rabbit renal artery by CT perfusion and pathology
Authors: Zhang Zhen , Cen Chunyuan , Qian Kun , Li Han , Zhang Xin , Zhang Hongsen , Ma Guina , Chen Yan , Jiang Nanchuan , Zheng Chuansheng , Zhao Yanbing , Han Ping 
Published: November 2020

Abstract
The temperature-sensitive p(N-isopropylacrylamide-co-butyl methylacrylate) (PIB) nanogel is a novel embolic agent, but methods to assess its performance are limited. The study aimed to assess the effect of embolization with PIB nanogels in rabbit renal artery by non-invasive computed tomography (CT) perfusion and pathology to evaluate the feasibility of the nanogel as a blood vessel embolization agent. Ten healthy adult Japanese rabbits underwent right renal arterial embolization with PIB nanogels. CT perfusion scans were performed pre- and post-treatment at different time points (1, 4, 8, and 12 weeks). Two rabbits were euthanized and histologically examined each time, and the remaining rabbits were sacrificed at 12 weeks after the embolization. The efficacy of the nanogels was further confirmed by pathological examination. The renal volume and renal blood flow of the right kidney significantly decreased post-treatment during the 12-week CT re-examination (both P <��������������������������������������������������������������������������������������������������������������������������������
Radiologist’s Perspectives on the Use of Imaging for Diagnosis and Monitoring of Chronic Nonbacterial Osteomyelitis&nbsp;
Authors: Nuruzzaman Farzana , Huang Mingqian , Hedrich Christian M. , Girschick Hermann J. , Cherian Julie , Sato T. Shawn , Ferguson Polly J. , Onel Karen B. , Wang Xing , Zhao Yongdong 
Published: November 2020

Abstract
Background. Radiological imaging is integral to the diagnosis of chronic nonbacterial osteomyelitis (CNO). Objectives of this study were: 1) to determine imaging modalities and features deemed important by radiologists in the diagnostic workup of suspected CNO cases; 2) to generate input from radiologists regarding monitoring of patients with CNO.Methods. The population targeted were actively practicing radiologist physician members of the Society of Skeletal Radiology. The survey was administered online through RedCap. Fisher's exact test was used to examine associations between any two categorical variables. FDR adjusted p-values were used for the pairwise comparisons of proportions for more than 2 groups. A mixed effects logistic regression model was used to assess the association between variables.Results. Half of the survey respondents were pediatric radiologists, subspecializing in musculoskeletal radiology and 54% had >10 years of experience. Radiologists considered CNO in the radiological imaging interpretation differential diagnosis an average of 10 cases per year. 79% and 45% of respondents reported high confidence in identifying imaging features of CNO on whole body MRI (WBMRI) and localized MRI, respectively. The level of confidence dropped to 25% and 19% when interpreting X-rays or bone scintigraphy. Among all imaging modalities interpreted “always” in the initial diagnostic workup of potential cases of CNO, X-rays (52%) were most commonly interpreted, followed by localized MRI (46%) and WBMRI (35%). In established cases of CNO, wherein WBMRI was the most frequently requested (48%), followed by localized MRI (26%) and X-rays (25%). Conclusions. By radiologists, WBMRI is currently considered the most useful imaging modality for initial diagnosis and monitoring of CNO by radiologists. Findings from this survey will promote discussion within a focused group to develop imaging recommendations for the diagnostic workup and disease monitoring in CNO.
An Immunohistochemical Panel of Three SUMO&nbsp;Genes Predicts Outcomes of Patients With Triple-negative Breast Cancer
Authors: Lin Yuxiang , Wang Qingshui , Xiao Han , Chen Zhiwei , Jiang Meichen , Zhang Jie , Guo Rongrong , Kang Shaohong , Lin Yao , Song Chuangui 
Published: November 2020

Abstract
Background: Triple negative breast cancer (TNBC) is a highly heterogeneous and aggressive disease. Developing new candidate biomarkers for chemotherapy response and possible therapeutic targets has become an urgent clinical need. Small ubiquitin-like modifier (SUMOs) mediate post-translational modifications (SUMOylation) that target multiple proteins was involved in many biological processes. The role of SUMOylation in TNBC remains to be elucidated.Method: The expression of SUMO1/2/3 were analyzed using TCGA and GEO databases (N=412). We also evaluated the SUMO1/2/3 protein expression in 212 local TNBC patients using immunohistochemical (IHC) staining. We then built a classifier with the LASSO Cox regression model based on associations between the expression of SUMO1/2/3 proteins and the disease-free survival (DFS) of TNBC patients. Results: Elevated SUMO1/2/3 levels were indicated to be associated with a poorer overall survival (OS) and DFS for TNBC patients. Using the LASSO model, we built a classifier based on the IHC scores of SUMO1/2/3 proteins and named it ‘SB classifier’. Patients with the SB classifier defined high score were found to have an unfavorable response to chemotherapy (HR 4.04, 2.14-7.63; p<0.0001). We then developed a nomogram to predict which patients might benefit from chemotherapy. Finally, our analysis provides insights on possible mechanisms that MYC activation causes the activation of SUMOylation. Conclusion: We constructed a reliable prognostic and predictive tool for TNBC patients treated with chemotherapy. It may facilitate patient counseling and individualize management of TNBC patients. Meanwhile, our results suggested that the activation of SUMOylation pathway in TNBC may be induced by MYC signaling.
Path Analysis of Hospitalization Expenses of 2,164 Appendicitis Patients at County-Level Public Hospitals in Anhui Province, China
Authors: Xue Junjun , Wang Heng , Li Niannian , Ling Yuhuan , Qian Chen , Shen Chunhan , Gu Xinlong , Zhang Xue , Jiang Ping 
Published: November 2020

Abstract
Background and objective Appendicitis resection is one of the most common surgical procedures. Hospitalization expenses are a major determinant of appendicitis treatment. This study explored the factors influencing hospitalization expenses of appendicitis patients in Anhui province and provided a scientific basis for reasonably controlling medical expenses. Methods A multi-stage random cluster sampling method was used to collect case information on 2,164 patients who underwent appendicitis surgery at 6 county-level public hospitals in Anhui province, China. Path analysis was used to study the factors influencing hospitalization expenses of appendicitis patients. Results The average length of stay was 5.62 ± 2.64 days, with a median of 5 days; the average hospitalization expenses were 6,109.60 ± 2,109.44 CNY, with a median of 5,511.93 CNY. The direct effect of length of stay was 0.535. Surgical grades, surgical methods, and chronic appendicitis directly affected hospitalization expenses, with direct effects of 0.149, 0.081, and -0.037; surgical costs, anesthesia costs, disease outcomes, age, acute simple appendicitis, and operative duration not only directly affected hospitalization expenses, but also indirectly affected hospitalization expenses, the total effects were 0.283, 0.045, 0.200, 0.202, -0.162, and 0.062, respectively. The total number of surgeons and assistants only indirectly affected hospitalization expenses, with indirect effect of 0.020. Conclusions The length of stay is the most important factor affecting hospitalization expenses. Based on controlling the average length of stay, combined with shortening operative duration, conducting health education, strengthening controllable factors, and other comprehensive measures can effectively reduce the economic burden of patients and hospitals.
Monitoring Positive Mental Health in Swedish Adolescents: Psychometric Evaluation of the Mental Health Continuum – Short Form
Authors: Söderqvist Fredrik , Larm Peter 
Published: November 2020

Abstract
BackgroundThe Mental Health Continuum – Short form (MHC-SF) is a self-report measure that has been increasingly used to monitor mental well-being at the population level. The aim of this study was to evaluate, for the first time, the psychometric properties of the MHC-SF in a Swedish population, more specifically adolescents. MethodsFirst, the evaluation was performed by examining face validity and test–retest reliability obtained in a pre-study (n = 93). Then using data from the Survey of Adolescent Life in Vestmanland 2020 (n = 3880; participation rate = 71%; females = 51%; mean age = 16.23 years), we performed confirmatory factor analysis on different factor structures based on theory and previous research. Model-based estimates were calculated for assessing the internal reliability of the factor structure with the best fit. Convergent validity was assessed by bivariate as well as model-based correlations, and test–retest reliability was evaluated by intra-class correlation coefficients. ResultsThis study on Swedish adolescents found that the MHC-SF is essentially unidimensional and best described with a bifactor model consisting of a dominant general well-being factor and three specific group factors of emotional, social and psychological well-being. Its overall reliability and the reliability of the general well-being factor were good to excellent, while the reliability of its subscales (specific group factor) was poor, and thus should not be used alone. Test–retest reliability of the total scale was good, and convergent validity was supported by strong to very strong correlations with the Short Warwick–Edinburg Mental Well-being Scale. ConclusionsIn conclusion, we consider the Swedish MHC-SF to be a psychometrically sound instrument for monitoring overall mental well-being in Swedish adolescents.
Health-related Quality of Life Among Cervical Cancer Survivors at a Tertiary Hospital in Kumasi, Ghana
Authors: Antwi Kwabena Amo , Agambire Ramatu , Konney Thomas Opkoti , Nartey Yvonne , Kubi Adu-Appiah , Nguah Samuel Blay , Dassah Edward T. , Akakpo Patrick K. , Opoku Baafour K. , Ankobea Frank , Tawia Augustine , Nti Maxwell K. , Djokoto Rex Mawuli , Peprah Amponsah , Ansah Mavis Bobie , Johnston Carolyn 
Published: November 2020

Abstract
BackgroundCervical cancer survivors often experience significant diminution in health-related quality of life (HRQoL). We aimed to investigate the overall HRQoL, determine the role of the stage of disease and type of treatment received on HRQoL, and evaluate predictors of HROoL among cervical cancer survivors in Ghana.MethodsA hospital-based cross-sectional study was conducted in 153 cervical cancer patients who completed curative treatment between January 2004 and December 2018 at Komfo Anokye Teaching Hospital. The European Organization for Research and Treatment of Cancer core questionnaire (EORTC QLQ C-30) supplemented with the cervical cancer-specific (EORTC QLQ-CX24) module was used. The Kruskal-Wallis test was used to determine the effect of the stage of cervical cancer and the type of treatment received on mean scores of the different domains of HRQoL. Multivariate logistic regression was performed to identify predictors of HRQoL.ResultsThe mean global health status (GHS) was 79.7 (+/-16.2), and it differed significantly with FIGO stage, with 84.1 76.2, and 79.9, for stages I, II and III respectively (p=0.012). Financial burden was higher in participants with FIGO stage II compared to stage I disease (45.4 vs 20.8, p=0.012.). The mean GHS scores for surgery, chemoradiation and radiation only were 85.2, 75.9, and 82.1 respectively (p=0.027). Compared to participants who were treated with Chemoradiation, those treated with surgery had lower financial difficulties (12.1 vs 41.6 , p=0.019), better body image (95.7vs 79.5, p =0.039) and better symptom experience (5.9 vs 12.0, p =0.043).The likelihood that survivors’ HQROL is affected is decreased with illiteracy (AOR = 0.30, 95% CI=0.09–1.00), and increased with complaints of pain (AOR=5.50, 95%CI=1.68-18.29), loss of appetite (AOR=13.24, 95% CI=2.71– 64.67) and diminution in body image perception (AOR = 6.04, 95% CI=1.67–21.83). Conclusion﻿Cervical cancer survivors in Ghana have overall satisfactory HRQoL. Surgical treatment is associated with improved HRQoL and less financial burden. Efforts to enhance HRQoL should also be focused on maximizing survivors’ body image and managing pain and loss of appetite. Educating women about expected impacts on their quality of life, and strategies to manage and mitigate these impacts, is essential.