bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute Q Fever Diagnosed by Metagenomic Next-generation Sequencing and Clinically Compared With Scrub Typhus
Authors: Liu Xi , Lin Ziliang , Zhu Hongqiong , Chen Gongqi , He Pengyuan , Huang Mingxing , Xia Jinyu 
Published: July 2020

Abstract
Background: C. burnetti, the causative agent of Q fever, is considered a potential threat as a biological weapon because of highly infectious and pathogenic. There was an outbreak of Q fever in Zhuhai, P.R. China between December, 2018 and March 2019, although Zhuhai was not the endemic area of Q fever. 46 patients can be detected C. burnetti by metagenomic next-generation sequencing (mNGS). There are many similarities between acute Q fever and scrub typhus in clinical manifestations. Methods: We analyze the differences of clinical manifestations and serological between 46 patients with acute Q fever and 100 patients with scrub typhus. The general information of patients including gender, age, basic disease, days from disease onset and clinical manifestations were evaluated. Results: Their mean age of acute Q fever was 43.6±11.8 (ranging from 32 to 55 years old), younger than scrub typhus patients (53.9±12.7, ranging from 41 to 67 years old) (P<0.001). Males are more susceptible to C. burnetti. There were 45 males (97.8%) in acute Q fever patients and 59 males (59.0%) in scrub typhus patients (P<0.001). Compared with scrub typhus, patients with acute Q fever are more prone to present sore throat (P=0.003), abnormal liver function (P<0.001) and elevated levels of procalcitonin (P<0.001). Meanwhile, skin rash (P<0.001), eschar (P<0.001), lymphadenopathy (P<0.001), leukocytosis (P<0.001), thrombocytopenia (P=0.003), eosinophils reducing or disappearing (P=0.002) and pulmonary involvement on chest imaging (P=0.003) were more common in scrub typhus. There was significant difference between the two groups (P<0.001). Days from minocycline treatment to defervescence in acute Q fever (1.82±1.357, ranging from 0.5 to 3.2 days) were shorter than scrub typhus (2.85±2.801, ranging from 0.0 to 5.7 days) (P=0.008). Conclusions: mNGS is helpful to early diagnosis of acute Q fever. Sex, age, serologic test and physical examination are important in the differentiation of acute Q fever from scrub typhus in Zhuhai, China.
Instrumented gait analysis of stroke patients after FES-cycling therapy.
Authors: BARRIA PATRICIO , AGUILAR ROLANDO , DELGADO DAYA SERRANO , MORIS ANDRE , ANDRADE ASTERIO , AZORIN JOSE M 
Published: July 2020

Abstract
Background: Functional electrical stimulation (FES) is a modality of motor rehabilitation that consists of the programmed application of bursts of electrical current to the a ected neuromuscular region that aims to improve muscle strength, increase the range of motion, facilitate movement control and decrease spasticity. The present study aimed to measure the changes in gait biomechanics of people with Stroke after a FES-cycling rehabilitation program for the lower extremities. Methods: 39 subjects with chronic stroke received 24 sessions of multi-channel FES synchronized with a cycle-ergometer for the lower extremities. The gait of all subjects was evaluated before and after the intervention by an instrumented gait analysis. Results: Signifcant changes were found in the spatio-temporal parameters of gait, mainly in the speed and stride length when considering the general sample. Additionally, in people under 60 years of age, there are signi cant changes in joint kinematics after FES. Conclusions: The rehabilitation using a multi-channel FES-cycling system for lower extremities improve gait biomechanics in people with Stroke. Trial registration: This study was registered as Instrumental Gait Analysis on People With Stroke After Rehabilitation With a Synchronized FES and Cycle-Ergometer System on July 16, 2020 in Clinical Trials with the identier No NCT04473391 (available at https://clinicaltrials.gov/ct2/show/NCT04473391).
Older adults hospitalized with Covid-19: Clinical characteristics and early outcomes from a single center in Istanbul, Turkey
Authors: Medetalibeyoğlu Alpay , Senkal Naci , Kose Murat , Catma Yunus , Caparali Emine Bilge , Erelel Mustafa , Oncul Mustafa Oral , Bahat Gulistan , Tukek Tufan 
Published: July 2020

Abstract
Objective: Older adults have been continuously reported to be at higher risk for adverse outcomes of Covid-19. We aimed to describe clinical characteristics and early outcomes of the older Covid-19 patients hospitalized in our center comparatively with the younger patients, and also to analyze the triage factors that were related to the in-hospital mortality of older adults.Design: Retrospective; observational studySetting: Istanbul Faculty of Medicine hospital, TurkeyParticipants: 362 hospitalized patients with laboratory-confirmed Covid-19 from March 11 to May 11, 2020.Measurements: The demographic information; associated comorbidities; presenting clinical, laboratory, radiological characteristics on admission and outcomes from the electronic medical records were analyzed comparatively between the younger (<65 years) and older (≥65 years) adults. Factors associated with in-hospital mortality of the older adults were analyzed by multivariate regression analyses.Results: The median age was 56 years (interquartile range [IQR], 46-67), and 224 (61.9%) were male. There were 104 (28.7%) patients ≥65 years of age. More than half of the patients (58%) had one or more chronic comorbidity. The three most common presenting symptoms in the older patients were fatigue/myalgia (89.4%), dry cough (72.1%), and fever (63.5%). Cough and fever were significantly less prevalent in older adults compared to younger patients (p=0.001 and 0.008, respectively). Clinically severe pneumonia was present in 31.5% of the study population being more common in older adults (49% vs. 24.4%) (p<0.001). The laboratory parameters that were significantly different between the older and younger adults were as follows: the older patients had significantly higher CRP, D-dimer, TnT, pro-BNP, procalcitonin levels, higher prevalence of lymphopenia, neutrophilia, increased creatinine, and lower hemoglobin, ALT, albumin level (p<0.05). In the radiological evaluation, more than half of the patients (54.6%) had moderate-severe pneumonia, which was more prevalent in older patients (66% vs. 50%) (p=0.006). The adverse outcomes were significantly more prevalent in older adults compared to the younger patients (ICU admission, 28.8% vs. 8.9%; mortality, 23.1% vs. 4.3%, p<0.001). Among the triage evaluation parameters, the only factor associated with higher mortality was the presence of clinically severe pneumonia on admission (Odds Ratio=12.3, 95% confidence interval=2.7-55.5, p=0.001).Conclusion: Older patients presented with more prevalent chronic comorbidities, less prevalent symptomatology but more severe respiratory signs and laboratory abnormalities than the younger patients. Among the triage assessment factors, the clinical evaluation of pulmonary involvement came in front to help clinicians to stratify the patients for mortality risk.
Determinants of increased health care spending: Colombia in the international context
Authors: Piedrahita Juan José Espinal , Zea Jairo Humberto Restrepo , Gaviria Daniel Alberto Grajales 
Published: July 2020

Abstract
Financial sustainability in health refers to the balance over time between income and expenditure, so expenditure is a major fiscal challenge and its determinants require monitoring. The objective of this study is to define and measure the most important determinants that influence increases in health expenditure in 80 countries at different income levels, and to determine how the average level of increase compares with Colombia. A literature review was conducted to define the determinants. Then, a fixed-effects panel regression model was estimated to reveal the contribution of these determinants to the increase in spending. The results indicate that demographic variables and technological innovation have the greatest impact on the increase in health spending (45% and 43%, respectively). In conclusion, the study validates what is reported in the international literature with regard to upper-middle-income countries, where the evidence identifies that demographic and technological factors have the greatest impact on the increase in spending. There is also a need to include institutional and outcome variables to ensure that a fuller array of health spending determinants are considered, quantified, and explored.
Bacterial but no SARS-CoV-2 contamination after terminal disinfection of tertiary care intensive care units treating COVID-19 patients
Authors: Hofmänner Daniel A , Garcia Pedro D Wendel , Duvnjak Branko , Chakrakodi Bhavya , Maier Julian D , Huber Michael , Huder Jon , Wolfensberger Aline , Schreiber Peter W , Schüpbach Reto A. , Zinkernagel Annelies S , Bühler Philipp K , Brugger Silvio D 
Published: July 2020

Abstract
Background: In intensive care units (ICUs) treating patients with Coronavirus disease 2019 (COVID-19) invasive ventilation poses a high risk for aerosol and droplet formation. Surface contamination of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) or bacteria can result in nosocomial transmission.Methods: Two tertiary care COVID-19 intensive care units treating 53 patients for 870 patient days were sampled after terminal cleaning and preparation for regular use to treat non-COVID-19 patients.Results: A total of 176 swabs were sampled of defined locations covering both ICUs. No SARS-CoV-2 ribonucleic acid (RNA) was detected. Gram-negative bacterial contamination was mainly linked to sinks and siphons. Skin flora was isolated from most swabbed areas and Enterococcus faecium was detected on two keyboards.Conclusions: After basic cleaning with standard disinfection measures no remaining SARS-CoV-2 RNA was detected. Bacterial contamination was low and mainly localised in sinks and siphons.
Sub-Lethal Hyperthermia Enhances Anticancer Activity of Doxorubicin in Chronically Hypoxic HepG2 Cells Through ROS-Dependent Mechanism
Authors: Wang Qi , Zhang Hui , Ren Qianqian , Ye Tianhe , Liu Yiming , Zheng Chuansheng , Zhou Guofeng , Xia Xiangwen 
Published: July 2020

Abstract
Background and aims:
Thermal ablation in combination with transarterial chemoembolization (TACE) has been reported to exert a more powerful anti-tumor effect than thermal ablation alone in hepatocellular carcinoma (HCC) patients. However, the underlying mechanisms remain unclear. The purpose of this study was to evaluate whether sub-lethal hyperthermia encountered in the peri-ablation zone during thermal ablation enhances the anticancer activity of doxorubicin in chronically hypoxic (encountered in the tumor area after TACE) liver cancer cells and to explore the underlying mechanisms.
Methods
HepG2 cells pre-cultured under chronic hypoxic conditions (1% oxygen) were treated in a 42 °C water bath for 15 min or 30 min, followed by incubation with doxorubicin. Assays were then performed to determine intracellular uptake of doxorubicin, cell viability, apoptosis, cell cycle, mitochondrial membrane potential (MMP), reactive oxygen species (ROS), and total antioxidant capacity.
Results
The results confirmed that sub-lethal hyperthermia enhanced intracellular uptake of doxorubicin into hypoxic HepG2 cells. Hyperthermia combined with doxorubicin led to a greater inhibition of cell viability and increased apoptosis in hypoxic HepG2 cells compared to hyperthermia or doxorubicin alone. In addition, the combination induced apoptosis by increasing ROS and causing disruption of mitochondrial membrane potential. Pretreatment with the ROS scavenger N-acetyl cysteine (NAC) significantly inhibited the apoptotic response suggesting that cell death is ROS-dependent.
Conclusions
These findings suggest that sub-lethal hyperthermia enhanced the anti-cancer activity of doxorubicin in hypoxic HepG2 cells through ROS-dependent mechanism.
Progression Risk Assessment of Post-Surgical Papillary Thyroid Carcinoma Based on Circular RNA-Associated Competing Endogenous RNA Mechanisms
Authors: Wu Mengwei , Liu Rui , Yuan Hongwei , Xu Xiequn , Li Xiaobin , Liu Ziwen 
Published: July 2020

Abstract
BackgroundAccurate risk assessment of post-surgical progression in papillary thyroid carcinoma (PTC) patients is critical. Exploring key differentially expressed mRNAs (DE-mRNAs) regulated by differentially expressed circRNAs (DE-circRNAs) via the ceRNA mechanism could help establish a novel assessment tool. MethodsceRNA network was established based on differentially expressed RNAs and correlation analysis. DE-mRNAs within the ceRNA network associated with progression-free interval (PFI) of PTC were identified to construct a prognostic ceRNA regulatory subnetwork. LASSO-Cox regression was applied to identify hub DE-mRNAs and establish a novel DE-mRNA signature in predicting PFI of PTC.ResultsSix hub DE-mRNAs, namely CLCNKB, FXBO27, FXYD6, RIMS2, SPC24, and CDKN2A, were identified to be most significantly related to the PFI of PTC and a prognostic DE-mRNA signature was proposed. A nomogram incorporating the DE-mRNA signature and clinical parameters was established to improve the progression risk assessment in post-surgical PTC, which was superior to the ATA risk stratification system and MACIS score AJCC staging system.ConclusionsBased on the circRNA-associated ceRNA RNA mechanism, a DE-mRNA signature and prognostic nomogram was established, which may improve the progression risk assessment in post-surgical PTC.
Dynamic Biomarkers Indicate Immunological Benefits Provided by Ganoderma Spore Powder in Post-Operative Breast and Lung Cancer Patients: A Prospective Clinical Trial
Authors: deng yuwei , Ma jianli , Tang dabei , zhang qingyuan 
Published: July 2020

Abstract
Background: T lymphocyte subsets with correlative cytokines, albumin to globulin ratio (AGR) and neutrophil to lymphocyte ratio (NLR), have been linked to inflammatory indicators of immune response and prognosis in various cancer types. The aim of this study was to determine the utility of these biomarkers in predicting the immunological benefits of Ganoderma spore powder in post-operative patients with breast and lung cancer. Methods: We prospectively evaluated 120 consecutive breast and lung cancer patients with or without Ganoderma spore powder. T lymphocyte subsets, as well as relative cytokines were detected and assessed by Pearson correlation analysis. The relationships between AGR and NLR with ganoderma spore powder treatment and prognosis were analyzed using Kaplan–Meier and Cox regression methods.Results: The prevalence of CD3+, CD4+ and CD4+/CD8+, CD3+HLADR-, CD4+HLADR- and CD8+HLADR- cell types was higher in the ganderma spore treated group compared to untreated controls. In addition, the percentage of CD4+CD25+Treg, CD3+HLADR+, CD4+HLADR+ and CD8+HLADR+ cell types was lower in the treated group. IL-2 and IL-12 frequencies were significantly higher during the treatment period which negatively impacted levels of IL-10. Other immunosuppressive factors such as COX2, TGF- 1 and HIF-1A had higher prevalence in non-treated patients. Correlation analysis showed several correlations between the biomarkers, specifically between IL-6 and TGF- 1, CD28 and IL-12R, TGF- 1 and Foxp3, IL-10 and IL-12R with COX2, Foxp3 and CD8, IL-10 and CD28 with IL-12R, COX2 and CD8, IL-12R with COX2, CD3 with CD4 and CD8. A positive relationship was also observed between IL-2 and TGF- 1. Conversely, IL-2 was negatively related to CD3, and HIF-1 negatively related with CD4, CD28 and CD3. Kaplan–Meier analysis suggested that low AGR/high NLR was related to poor progression free survival (PFS, HR=1.572, P=0.038/HR=2.064, P=0.042). A combination of high AGR and low NLR that predicted treatment benefits was also associated with PFS (HR=0.661, P=0.033/HR=1.044, P=0.048).Conclusions: Our findings show that T lymphocyte subsets predominately combined with relevant cytokines and AGR/NLR inflammatory predictors may help to identify patients most likely to benefit from the immunological enhancements from Ganoderma spore powder treatment.
The Glutaminase Inhibitor Compound 968 Exhibits Potent in vitro and in vivo anti-tumor Effects in Endometrial Cancer
Authors: Yuan Lingqin , Guo Hui , Pan Guoyou , Wang Cong , Li Dapeng , Liu Naifu , Wei Ling , Li Peipei , Sheng Xiugui 
Published: July 2020

Abstract
Background: Glutamine is one of the primary nutrients utilized by cancer cells for energy production and biosynthesis. Interfering with glutamine metabolism may impose anti-tumor effects. In this study, we aimed to investigated the anti-tumorigenic effects of GLS1 inhibition in endometrial cancer cells in vitro and in vivo. Methods: In this study, we assessed the relationship between glutaminase-1 enzyme (GLS1) expression and prognosis in endometrial cancer by bioinformatics analyses. Overall survival (OS) and progression-free survival (PFS) analyses were performed using the Kaplan-Meier method. The effects of compound 968 on cell proliferation, cell cycle, apoptosis, cellular stress, invasion, and AKT/mTOR/S6 pathway inhibition in human endometrial cancer cell lines were assessed. The in vivo therapeutic potential of compound 968 in endometrial cancer was evaluated using tumor xenografts.Results: We found that GLS1 expression is elevated during endometrial cancer progression and is associated with poor prognosis. The GLS1-targeting compound 968 was able to reduce cancer cell proliferation, induce cell cycle arrest at the G1 phase, inhibit cell invasion, as well as promote cellular stress and cancer cell apoptosis. Compound 968 treatment significantly increased the sensitivity of cells to paclitaxel. Moreover, the treatment of endometrial cancer cells with compound 968 resulted in AKT/mTOR/S6 signaling pathway inhibition. In xenograft mouse models of endometrial cancer, compound 968 significantly suppressed tumor growth. Conclusion: We conclude that compound 968 is a promising anti-tumorigenic agent and that combination with paclitaxel may be a valuable strategy for the treatment of endometrial cancer.
Development of a prognostic model for esophageal cancer based on nine immune related genes
Authors: Zhang Zhi , Chen Cheng , Fang Ying , Li Sheng , Wang Xiaohua , Sun Lei , Zhou Guoren , Ye Jinjun 
Published: July 2020

Abstract
Background: Function of the immune system is correlated with the prognosis of the tumor. The effect of immune microenvironment on esophageal cancer (EC) development has not been fully investigated. Methods: This study aimed to explore a prognostic model based on immune-related genes (IRGs) for EC. We obtained the RNA-seq dataset and clinical information of EC from the Cancer Genome Atlas (TCGA). Results: We identified 247 upregulated IRGs and 56 downregulated IRGs. Pathway analysis revealed that the most differentially expressed IRGs were enriched in Cytokine-cytokine receptor interaction. We further screened 13 survival-related IRGs and constructed regulatory networks involving related transcription factors (TFs). Finally, a prognostic model was constructed with 9 IRGs (HSPA6, S100A12, CACYBP, NOS2, DKK1, OSM ,STC2 ,NGPTL3 and NR2F2) by multivariate Cox regression analysis. The patients were classified into two subgroups with different outcomes. When adjusted with clinical factors, this model was verified as an independent predictor, which performed accurately in prognostic prediction. Next, M0 and M2 macrophages and activated mast cells were significantly enriched in high-risk group, while CD8 T cells and regulatory T cells (Tregs) were significantly enriched in low-risk group. Conclusions: These molecules may serve as potential therapeutic targets and biomarkers for the new-immunotherapy of EC.
NKX6.1 Expression is Associated With The Prognosis in Breast Cancer.
Authors: Zhang Jie , Zhang Sujie , Li Xiaoyan , Zhang Fan , Zhao Lei 
Published: July 2020

Abstract
Background: Breast cancer is the most common cancer among women in the world. NKX6.1 is proved to be involved in several human cancers, but fewer researches have reported the functional roles of NKX6.1 in breast cancer. In this study, we investigated the clinical significance of NKX6.1 expression in breast cancer prognosis.Methods: The expression level of NKX6.1 in breast cancer tissues and paired non-cancerous tissues were detected by quantitative real-time polymerase chain reaction (qRT-PCR). Chi-square test was applied to evaluate the relationship between NKX6.1 expression and clinicopathologic parameters. The overall survival of breast cancer patients were analyzed by Kaplan-Meier method with log rank test. Additionally, cox regression analysis was used for prognosis analysis.Results: NKX6.1 expression level is increased in breast cancer tissues (P<0.001). Moreover, the elevated levels were significantly correlated with tumor size (P=0.002), TNM stage (P=0.018) and lymph node metastasis (P=0.007). In addition, breast cancer patients with high NKX6.1 level had a poorer overall survival than those with low level (log rank test, P=0.001). NKX6.1 was an independent prognostic factor for breast cancer (HR=2.961, 95%CI=1.368-6.411, P=0.006).Conclusions: NKX6.1 is up-regulated in breast cancer, which may be a potential prognostic biomarker for the cancer.
Characterization of the skin and gill microbiomes in farmed seabass and seabream across different age groups
Authors: Rosado Daniela , Pérez-Losada Marcos , Pereira Ana , Severino Ricardo , Xavier Raquel 
Published: July 2020

Abstract
Background Important changes in microbiome composition related to sexual maturation have been already reported in the gut of several vertebrates including mammals, amphibians and fish. Such changes in fish are linked to reproduction and growth during developmental stages, diet transitions and critical life events. We used amplicon (16S rRNA) high-throughput sequencing to characterize the skin and gill bacterial microbiomes of farmed seabass and seabream belonging to three different developmental age groups: early and late juveniles and mature adults. We also assessed the impact of the surrounding estuarine water microbiome in shaping the fish skin and gill microbiomes.Results Microbiome diversity, composition and potential metabolic functions varied across fish maturity stages. Alpha-diversity in the seabass microbiome varied significantly between age groups and was higher in older fish. Conversely, in the seabream, no significant differences were found in alpha diversity between age groups, although it was higher in the skin of juveniles. Microbiome structure varied significantly across age groups. Different bacterial metabolic pathways were predicted to be enriched in the microbiomes of both species. Finally, we found that the water microbiome is significantly distinct from all the fish microbiomes across the studied age groups, although a high percentage of ASVs is shared with the skin and gill microbiomes.Conclusions We report important microbial differences in composition and potential functionality across the different ages of farmed seabass and seabream. These differences may be related to somatic growth and the onset of sexual maturation. Importantly, some of the inferred metabolic pathways could enhance the host coping mechanisms during stressful conditions. Our results provide new evidence suggesting that growth and sexual maturation have an important role in shaping the external mucosa microbiomes of fish and highlight the importance of considering different life stages in microbiome studies.