bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality and Quantity–Cultured Human Mononuclear Cells Improve Human Fat Graft Vascularization and Survival in an In Vivo Murine Experimental Model
Authors: Geeroms Maxim , Fujimura Satoshi , Aiba Emiko , Orgun Doruk , Arita Kayo , Kitamura Rie , Senda Daiki , Mizuno Hiroshi , Hamdi Moustapha , Tanaka Rica 
Published: November 2020

Background:
Fat graft ischemia impedes us from having satisfying long-term results. The quality and quantity culture is a 1-week cell culture that increases the vasculogenic potential of peripheral blood mononuclear cells (PBMNC). This in vivo murine model investigates whether enrichment with quality and quantity–cultured human mononuclear cells (MNC-QQ) improves the vascularization in the human fat graft and whether this decreases the tissue loss.

Methods:
Human adipose tissue, PBMNC, MNC-QQ, and stromal vascular fraction were prepared. First, PBMNC, MNC-QQ, and stromal vascular fraction were compared in vitro for vasculogenic potential by endothelial progenitor cell colony-forming and culture assays. Second, 0.25-g fat grafts were created with 1 × 106 PBMNC (n = 16), 1 × 106 MNC-QQ (n = 16), 1 × 106 stromal vascular fraction (n = 16), or phosphate-buffered saline as control (n = 16) before grafting in BALB/c nude mice. Grafts were analyzed for weight persistence, vessel formation by CD31 immunohistochemistry, and angiogenic markers by quantitative polymerase chain reaction.

Results:
MNC-QQ develop more definitive endothelial progenitor cell colonies and more functional endothelial progenitor cells compared to PBMNC and stromal vascular fraction. Weight persistence after 7 weeks was significantly higher in grafts with MNC-QQ (89.8 ± 3.5 percent) or stromal vascular fraction (90.1 ± 4.2 percent) compared with control (70.4 ± 6.3 percent; p < 0.05). MNC-QQ–enriched grafts had the highest vessel density (96.6 ± 6.5 vessels/mm2; control, 70.4 ± 5.6 vessels/mm2; p < 0.05). MNC-QQ exerted a direct vasculogenic effect through vascular integration and a potential paracrine vascular endothelial growth factor–mediated effect.

Conclusion:
Quality and quantity–cultured human mononuclear cells containing endothelial progenitor cells stimulate fat graft vascularization and enhance graft survival in a rodent recipient.
Unusual presentation of metastatic malignant melanoma: a case report
Authors: Sah Mukesh Kumar , Barakoti Rimmy , Shrestha Nirajan , Gautam Neha , Sharma Upama , Kafle Monique 
Published: November 2020

Introduction:
The presentation of metastatic lesion of malignant melanoma (MM) may be unusual, as this case, in which the lesions were multicystic swelling over right arm and necrotized swelling at right chest wall. Identifying the unusual variants of MM is important to allow application of the most appropriate treatment strategies before something wrong happens.

Methods:
This case report has been prepared following the SCARE guideline 2018, a surgical case report guidelines.

Presentation of the case:
A 60-year-old man presented with a 14-month history of swelling on right arm and anterior chest wall with the chief complain of blackish discharge from the latter. Six months ago, he amputated his right thumb for melanoma after a histopathology evaluation. It was an unusual presentation of a metastatic lesion of MM. On the basis of the histopathology report, the final diagnosis of our patient was subcuticular metastatic MM which has a very poor prognosis. According to TNM classification, the final diagnosis of the case was T4bN0M1a. Although he has been under regular follow-up, the lesions are still present and his health condition is deteriorating.

Discussion:
Metastatic melanomas are often rare; their misdiagnosis potentially jeopardizes patients’ health and survival, and have medico-legal implications. Melanoma often has a protracted disease course, in which patients have a disease-free period following surgical excision of the primary tumor, only to discover visceral metastases—months, years, or even decades later. Melanoma metastasis is an ominous sign as it generally predicts a poor prognosis. This case is an unusual presentation of metastatic melanoma where, with the elaboration of history and proper examination of lesion, the diagnosis of metastatic melanoma was made.

Conclusion:
Metastatic MM has a very poor prognosis and an early diagnosis with clinical presentation is very essential in a country where health facilities are not well developed. Knowing the unusual variants of MM is important to allow application of the most appropriate treatment strategies before something wrong happens.
Personality impairment in the DSM-5 and ICD-11: Current standing and limitations
Authors: Sleep Chelsea , Lynam Donald R. , Miller Joshua D. 
Published: November 2020

Purpose of review
The current review provides an examination of the levels of personality functioning outlined by the International Classification of Diseases-11 and the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders.

Recent findings
Across self-report measures, high convergence is observed, and they evince relatively robust relations with general and pathological traits as well as other clinical symptoms. At the same time, current measures of impairment also demonstrate unstable factor structures, poor discriminant validity (when measures offer subscales aligned with different forms of personality impairment), and tend to account for relatively little unique variance beyond traits. As a result, some have questioned the utility of personality impairment, as currently measured.

Summary
The dimensional models of personality psychopathology included in the International Classification of Diseases-11 and 5th edition of the Diagnostic and Statistical Manual of Mental Disorders signify important steps toward an empirically supported and clinically useful diagnostic model; however, self-report measures of impairment are problematic. The authors conclude by calling for the refinement of these measures to more directly assess deficits in various domains of functioning as well as the dimensional models, by assessing traits first, and then examining the nature of the associated personality impairment.
Barriers to Health Behavior Change in People with Type 2 Diabetes: Survey Study
Authors: Mohamdy Oumoukelthoum 
Published: November 2020

Structured AbstractBACKGROUNDDiabetes mellitus DM (type 2) is one of the major chronic disease that creates burden at the population level. A prevalence of 422 million patients with diabetes worldwide is detected 1. UAE population has an increased prevalence of DM; According to International Diabetes Federation (IDF) 17.3% of the UAE population between the ages of 20 and 79 have type 2 diabetes in 2017 2. UAE has been suffering with the health problems that result from obesity and sedentary lifestyle. The purpose of this study is to understand barriers to health behavior among community patients with diabetes mellitus type 2. METHODS: This is a qualitative survey study of 123 adult individuals with type 2 diabetes who are above 18 years old, who participated in a survey that explore their perception about barriers to health behavior change. The survey was distributed online and in 6 health care centers under ministry of health and prevention in the United Arab Emirates. RESULTS: This study finds that the top barrier for behavior change is difficulty to follow healthy schedule (19.4%), workplace condition and timing (14.3%), and laziness (13%). The least barrier was lack of knowledge about healthier behaviors (5.3%). The best way to motivate behavior change was doctor’s advice during regular visit (26.3%), joining support group (18.4%), and receiving electronic tips and reminders on smartphones (15%) CONCLUSION: The outcomes of this study can aid directly in community programs design and implementation, health education campaigns, and health policies. The findings of this study help in understanding real barriers to initiating and sustaining positive health behavior.
GenomeDiver: A platform for phenotype-guided medical genomic diagnosis
Authors: Pearson Nathaniel , Stolte Christian , Shi Kevin , Beren Faygel , Abul-Husn Noura S. , Bertier Gabrielle , Brown Kaitlyn , Odgis Jacqueline A. , Suckiel Sabrina A. , Horowitz Carol R. , Wasserstein Melissa , Gelb Bruce D. , Kenny Eimear E. , Gagnon Charles , Jobanputra Vaidehi , Bloom Toby , Greally John M. 
Published: November 2020

ABSTRACTPurposeMaking a diagnosis from clinical genomic sequencing requires well-structured phenotypic data to guide genotype interpretation. A patient’s phenotypic features can be documented using the Human Phenotype Ontology (HPO), generating terms used to prioritize genes potentially causing the patient’s disease. We have developed GenomeDiver to provide a user interface for clinicians that allows more effective collaboration with the clinical diagnostic laboratory, with the goal of improving the success of the diagnostic process.MethodsGenomeDiver is designed to prompt reverse phenotyping of patients undergoing genetic testing, enriching the amount and quality of structured phenotype data for the diagnostic laboratory, and helping clinicians to explore and flag diseases potentially causing their patient’s presentation.ResultsWe show how GenomeDiver communicates the clinician’s informed insights to the diagnostic lab in the form of HPO terms for interpretation of genomic sequencing data. We describe our user-driven design process, the engineering of the software for efficiency, security and portability, and an example of the performance of GenomeDiver using simulated genomic testing data.ConclusionsGenomeDiver is a first step in a new approach to genomic diagnostics that enhances laboratory-clinician interactions, with the goal of directly engaging clinicians to improve the outcome of genomic diagnostic testing.
Seven day continuous ambulatory electrocardiographic telemetric study with pocket electrocardiographic recording device for detecting hydroxychloroquin induced arrhythmias
Authors: Walia Rohit , Prabhakaran Nanda , Kodliwadmath Ashwin , Singh O Budha Charan , Sabbarwal Vikas , Nigam Abhimanyu , Vijay B Kartik , Pai Venkatesh Srinivasa 
Published: November 2020

AbstractBACKGROUND & AIMSThe use of hydroxycholoroquin for COVID 19 treatment and prophylaxis raised issues concerning its cardiac safety owing to possibility of QT prolongation and arrhythmias.1 There was no study on long term electrocardiographic telemetry monitoring of patients taking hydroxychloroquin and we planned a continuous electrocardiographic holter telemetry of these patients for a period of seven days.MethodsHealthcare workers taking hydroxycholoroquin as pre exposure prophylaxis, patients taking hydroxychloroquin were monitored by holter electrocardiographic telemetry with continuous beat to beat analysis for seven days with capacity to report any arrhythmic event or significant QT prolongation instantly to medical faculty.Results25 participants with mean age 42.4 ± 14.1 years, 40% females. 20% patients needed to stop HCQ. Four patients developed QT prolongation > 500 ms and needed to stop HCQ, one patient had accelerated idioventricular rhythm and stopped treatment. one had short episodes of atrial fibrillation. No malignant arrhythmia or ventricular arrhythmia or torsades were noted. No episode of significant conduction disturbance and arrhythmic death noted. Baseline mean QTc was 423.96 ± 32.18 ms, mean QTc corrected at 24 hours 438.93 ± 37.95, mean QTc 451.879 ± 37.99 at 48 hours, change in baseline mean QTc to max QTc was 30.74 ± 21.75 ms at 48 hours. All those develop QTc prolongation > 500 ms were greater than 50 years of age.ConclusionAmbulatory telemetry ECG monitoring seems to detect early QT prolongation and stopping drug timely prevented malignant arrhythmias. HCQ seems to have less risk of QT prolongation in young healthy individuals.
Biobank scale pharmacogenomics informs the genetic underpinnings of simvastatin use
Authors: Wendt Frank R , Koller Dora , Pathak Gita A , Jacoby Daniel , Miller Edward J , Polimanti Renato 
Published: November 2020

AbstractBackground and PurposeStudying drug metabolizing enzymes, encoded by pharmacogenes (PGx), may inform biological mechanisms underlying the diseases for which a medication is prescribed. Until recently, PGx loci could not be studied at biobank scale. Here we analyze PGx haplotype variation to detect associations with medication use in the UK Biobank.MethodsIn 7,649 unrelated African-ancestry (AFR) and 326,214 unrelated European-ancestry (EUR) participants from the UK Biobank, aged 37-73 at time of recruitment, we associated clinically-relevant PGx haplotypes with 265 (EUR) and 17 (AFR) medication use phenotypes using generalized linear models covaried with sex, age, age2, sex×age, sex×age2, and ten principal components of ancestry. Haplotypes across 50 genes were assigned with Stargazer. Our analyses focused on the association of PGx haplotype dose (quantitative predictor), diplotype (categorical predictor), and rare haplotype burden on medication use.ResultsIn EUR,NAT2metabolizer phenotype (OR=1.05, 95% CI: 1.03-1.08, p=7.03×10−6) and activity score (OR=1.09, 95% CI: 1.05-1.14, p=2.46×10−6) were associated with simvastatin use. The dose of N-acetyltransferase 2 (NAT2)*1 was associated with simvastatin use relative toNAT2*5 (NAT2*1 OR=1.04, 95% CI=1.03-1.07, p=1.37×10−5) and was robust to effects of low-density lipoprotein cholesterol (LDL-C) concentration (NAT2*1 given LDL-C concentration: OR=1.07, 95% CI=1.05-1.09, p=1.14×10−8) and polygenic risk for LDL-C concentration (NAT2*1 given LDL-C PRS: OR=1.09, 95% CI=1.04-1.14, p=2.26×10−4). Interactive effects betweenNAT2*1, simvastatin use, and LDL-C concentration (OR: 0.957, 95% CI=0.916-0.998, p=0.045) were replicated in eMERGE PGx cohort (OR: 0.987, 95% CI: 0.976-0.998, p=0.029).Conclusions and relevanceWe used biobank-scale data to uncover and replicate a novel association betweenNAT2locus variation (and suggestive evidence with several other genes) and better response to simvastatin (and other statins) therapy. The presence ofNAT2*1 versusNAT2*5 may therefore be useful for making clinically informative decisions regarding the potential benefit (e.g., absolute risk reduction) in LDL-C concentration prior to statin treatment.Subject termsgenetics, genetic association studies, cardiovascular disease
Undetectable=untransmittable (U=U) messaging increases uptake of HIV testing among men: Results from a pilot cluster randomized trial
Authors: Smith Philip , Buttenheim Alison , Schmucker Laura , Bekker Linda-Gail , Thirumurthy Harsha , Davey Dvora L. Joseph 
Published: November 2020

AbstractHIV testing coverage in sub-Saharan Africa is lower among men than women. We investigated the impact of a peer-delivered U=U (undetectable equals untransmittable) message on men’s HIV testing uptake through a cluster randomized trial with individual mobile clinic days as unit of randomization.On standard of care (SOC) days, peer promoters’ informed men about the availability of HIV testing at the mobile clinic. On intervention days, peer promoters’ delivered U=U messages. We used logistic regression adjusting for mobile clinic location, clustering by study day, to determine the percentage of invited men who tested for HIV at the mobile clinic.Peer promoters delivered 1048 invitations over 12 days. In the SOC group, 68 (13%) of 544 men invited tested for HIV (3, 4.4% HIV-positive). In the U=U group, 112 (22%) of 504 men invited tested for HIV (7, 6.3% HIV-positive). Men in the U=U group had greater odds of testing for HIV (adjusted odds ratio=1.59, 95% CI=0.98-2.57).Tailored, peer-delivered messages that explain the benefits of HIV treatment in reducing HIV transmission can increase men’s HIV testing uptake.
Assessment of effectiveness of a COVID-adapted diagnostic pathway for colorectal cancer to mitigate the adverse impact on investigation and referrals
Authors: Miller Janice , Maeda Yasuko , Au Stephanie , Gunn Frances , Porteous Lorna , Pattenden Rebecca , MacLean Peter , Noble Colin L , Glancy Stephen , Dunlop Malcolm G , Din Farhat V N 
Published: November 2020

AbstractObjectivesThe Coronavirus-19 (COVID-19) pandemic continues to impose formidable challenges on healthcare services. The dramatic curtailment of endoscopy and CT colonography capacity has adversely impacted on timely diagnosis of colorectal cancer (CRC). We describe a COVID-adapted pathway rapidly implemented to mitigate risk and maximise cancer diagnosis in patients referred with symptoms of suspected CRC during the pandemic.DesignThe “COVID-adapted pathway” integrated multiple quantitative faecal immunochemical tests (qFIT), to enrich for significant colorectal disease. CT with oral contrast was used to detect gross pathology. Patients reporting ‘high-risk’ symptoms were triaged to qFIT+CT and the remainder underwent initial qFIT. Prospective data collection comprised referral category, symptoms, blood results, medical history, time to first test, qFIT and CT results.SettingTertiary colorectal unit which manages over 500 cancer patients annually.ParticipantsAll patients referred as ‘urgent suspicious of cancer’ (USOC) were included. Overall 422 patients (median age 64 years, 220 females) were triaged using this pathway.Main outcome measuresOutcomes comprised cancer detection frequency.ResultsCompared to the same time period (1stApril – 31stMay) in 2017-2019, we observed a 43% reduction in primary care referrals with suspected CRC (1071 referrals expected reducing to 609). Overall 422 patients (median age 64 years, 220 females) were triaged using this pathway. Most (84·6%) were referred as USOC. Of the 422 patients, 202 (47·9%) were triaged to CT and qFIT, 211 (50·0%) to qFIT only, eight (1·9%) to outpatient clinic, and one to colonoscopy. Fifteen (3·6%) declined investigation and seven (1·7%) were deemed unfit. We detected 13 cancers (3·1%); similar to the mean cancer detection rate from all referrals in 2017-2019 (3·3%).ConclusionsThe response to the COVID-19 pandemic resulted in a marked reduction in referrals and cessation of key diagnostic services. Although this COVID-adapted pathway mitigated the adverse effects on diagnostic capacity, the overall reduction in expected diagnoses is very substantial. It is clear that the adverse impact of measures taken to constrain the pandemic will lead to many undetected cancers due to the decrease in referrals.Trial registrationNot applicable
Validating the RISE UP score for predicting prognosis in patients with COVID-19 in the emergency department, a retrospective study
Authors: van Dam Paul M.E.L. , Zelis Noortje , Stassen Patricia M. , van Twist Daan J.L. , de Leeuw Peter W. , van Kuijk Sander M.J. , Buijs Jacqueline 
Published: November 2020

AbstractObjectiveTo mitigate the burden of COVID-19 on the healthcare system, information on the prognosis of the disease is needed. The recently developed RISE UP score has very good discriminatory value with respect to short-term mortality in older patients in the emergency department (ED). It consists of six items: age, abnormal vital signs, albumin, blood urea nitrogen (BUN), lactate dehydrogenase (LDH), and bilirubin. We hypothesized that the RISE UP score could have discriminatory value with regard to 30-day mortality in ED patients with COVID-19.SettingTwo EDs of the Zuyderland Medical Centre (MC), secondary care hospital in the Netherlands.ParticipantsThe study sample consisted of 642 adult ED patients diagnosed with COVID-19 between March 3rd until May 25th 2020. Inclusion criteria were: 1) admission to the hospital with symptoms suggestive of COVID-19, and 2) positive result of the polymerase chain reaction (PCR), or (very) high suspicion of COVID-19 according to the chest computed tomography (CT) scan.OutcomePrimary outcome was 30-day mortality, secondary outcome was a composite of 30-day mortality and admission to intensive care unit (ICU).ResultsWithin 30 days after presentation, 167 patients (26.0%) died and 102 patients (15.9%) were admitted to ICU. The RISE UP score showed good discriminatory value with respect to 30-day mortality (AUC 0.77, 95% CI 0.73-0.81), and to the composite outcome (AUC 0.72, 95% CI 0.68-0.76). Patients with RISE UP scores below 10% (121 patients) had favourable outcome (0% mortality and 5% ICU admissions). Patients with a RISE UP score above 30% (221 patients) were at high risk of adverse outcome (46.6% mortality and 19% ICU admissions).ConclusionThe RISE UP score is an accurate prognostic model for adverse outcome in ED patients with COVID-19. It can be used to identify patients at risk of short-term adverse outcome, and may help guiding decision-making and allocating healthcare resources.
Healthcare workers hospitalized due to COVID-19 have no higher risk of death than general population. Data from the Spanish SEMI-COVID-19 Registry
Authors: Díez-Manglano Jesús , Marquínez Marta Nataya Solís , García Andrea Álvarez , Alcalá-Rivera Nicolás , Riesco Irene Maderuelo , Aseguinolaza Martín Gericó , Pérez José Luis Beato , Bailon Manuel Mendez , Ruiz Ane Elbire Labirua-Iturburu , Gómez Miriam García , Cilleros Carmen Martinez , Fontan Paula Maria Pesqueira , Vázquez Lucy Abella , Encinar Julio César Blázquez , Boixeda Ramon , Sánchez Ricardo Gil , de la Peña Fernández Andrés , Amigo Jose Loureiro , Sevilla Joaquin Escobar , Garcia Marcos Guzmán , Escalante María Dolores Martín , Gamboa Jeffrey Oskar Magallanes , Gonzalez Angel Luís Martínez , Bermejo Carlos Lumbreras , Santos Juan Miguel Antón ,   for the SEMI-COVID-19 Network
Published: November 2020

ABSTRACTAimTo determine whether healthcare workers (HCW) hospitalized in Spain due to COVID-19 have a worse prognosis than non-healthcare workers (NHCW).MethodsObservational cohort study based on the SEMI-COVID-19 Registry, a nationwide registry that collects sociodemographic, clinical, laboratory, and treatment data on patients hospitalised with COVID-19 in Spain. Patients aged 20-65 years were selected. A multivariate logistic regression model was performed to identify factors associated with mortality.ResultsAs of 22 May 2020, 4393 patients were included, of whom 419 (9.5%) were HCW. Median (interquartile range) age of HCW was 52 (15) years and 62.4% were women. Prevalence of comorbidities and severe radiological findings upon admission were less frequent in HCW. There were no difference in need of respiratory support and admission to intensive care unit, but occurrence of sepsis and in-hospital mortality was lower in HCW (1.7% vs. 3.9%; p=0.024 and 0.7% vs. 4.8%; p<0.001 respectively). Age, male sex and comorbidity, were independently associated with higher in-hospital mortality and healthcare working with lower mortality (OR 0.219, 95%CI 0.069-0.693, p=0.01). 30-days survival was higher in HCW (0.968 vs. 0.851 p<0.001).ConclusionsHospitalized COVID-19 HCW had fewer comorbidities and a better prognosis than NHCW. Our results suggest that professional exposure to COVID-19 in HCW does not carry more clinical severity nor mortality.
Blowin’ In The Wind: Long-Term Downwind Exposure to Air Pollution from Power Plants and Adult Mortality
Authors: Tanaka Shinsuke 
Published: November 2020

AbstractWe estimate the causal effects of long-term exposure to air pollution emitted from fossil fuel power plants on adult mortality. We leverage quasi-experimental variation in daily wind patterns, which is further instrumented by the county orientation from the nearest power plant. We find that the county’s fraction of days spent downwind of plants within 20 miles in the last 10 years is associated with increased mortality from COVID-19 through the third peak in mortality in January 2021. This effect is more pronounced in fenceline communities with high poverty rates, low health insurance coverage, and low educational attainment.