bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of Chronic Active Antibody-mediated Rejection in Renal Transplant Recipients – A single center retrospective study
Authors: Chiu Hsien-Fu , Wen Mei-Chin , Wu Ming-Ju , Chen Cheng-Hsu , Yu Tung-Min , Chuang Ya-Wen , Huang Shih-Ting , Tsai Shang-Feng , Lo Ying-Chih , Ho Hao-Chung , Shu Kuo-Hsiung 
Published: December 2019

Abstract
Background: Chronic active antibody-mediated rejection is a major etiology of graft loss in renal transplant recipients. However, there are no approved treatments. Methods: Computerized records from Taichung Veterans General Hospital were collected to identify the renal transplant biopsies performed in the past 7 years with the diagnosis of chronic active antibody-mediated rejection. The patients were divided into two groups according to treatment strategy: Group 1: aggressive treatment (double filtration plasmapheresis and one of the followings: rituximab, intravenous immunoglobulin, antithymogycte globulin, bortezomib, or methylprednisolone pulse therapy); and group 2: supportive treatment. Results: From February 2009 to December 2017, a total of 82 patients with biopsy-proven chronic antibody mediated rejection were identified. Kaplan-Meier analysis of death-censored graft survival showed a worse survival in group 2 ( P = 0.015 by log-rank test). Adverse event-free survival was lower in group 1, whereas patient survival was no significant different. Proteinuria and supportive treatment were independent risk factors for graft loss in multivariate analysis. Conclusions : Aggressive treatment was associated with better graft outcome. However, higher incidence of adverse events merit personalized treatment, especially for those with higher risk of infection. Appropriate prophylactic antibiotics are recommended for aggressive treatment patients.
The different dietary sugars modulate the composition of the gut microbiota in honeybee during overwintering
Authors: Author) Hongfang Wang(Former Corresponding , Liu Chunlei , Liu Zhenguo , Wang Ying , Ma Lanting , Author) Baohua Xu(New Corresponding 
Published: December 2019

Abstract
Background : The health of honeybee colonies is critical for bee products and agricultural production, and colony health is closely associated with the bacteria in the guts of honeybees. Although colony loss in winter is now the primary restriction in beekeeping, the effects of different sugars as winter food on the health of honeybee colonies are not well understood. Therefore, in this study, the influence of different sugar diets on honeybee gut bacteria during overwintering was examined. Methods: The bacterial communities in honeybee midguts and hindguts before winter and after bees were fed honey, sucrose, and high-fructose syrup as winter-food were determined by targeting the V4 region of 16S rDNA using the Illumina MiSeq platform. Results: The dominant microbiota in honeybee guts were the phyla Proteobacteria (63.17%), Firmicutes (17.61%; Lactobacillus , 15.91%), Actinobacteria (4.06%; Bifidobacterium , 3.34%), and Bacteroidetes (1.72%). The dominant taxa were conserved and not affected by season, type of overwintering sugar, or spatial position in the gut. However, the relative abundance of the dominant taxa was affected by those factors. In the midgut, microbial diversity of the sucrose group was higher than that of the honey and high-fructose syrup groups, but in the hindgut, microbial diversity of the honey and high-fructose groups was higher than that in the sucrose group. Sucrose increased the relative abundance of Actinobacteria (Bifidobacteriales Bifidobacteriaceae ) and Alphaproteobacteria (Rhizobiales and Mitochondria ) of honeybee midgut, and honey enriched the Bacteroidetes and Gammaproteobacteria (Pasteurellales) in honeybee hindgut. High-fructose syrup increased the relative abundance of Betaproteobacteria (Neisseriales: Neisseriaceae ) of the midgut. Conclusion: The type of sugar used as winter food affected the relative abundance of the dominant bacterial communities in honeybee guts, not the taxa, which could affect the health and safety of honeybee colonies during overwintering. The presence of the supernal Alphaproteobacteria, Bifidobacteriales, and Lactobacillaceae in the gut of honeybees fed sucrose and cheaper than honey both indicate that sucrose is very suitable as the overwintering food for honeybees.
Ultrasonography in assessing suspected bone fractures: a cross-sectional survey amongst German general practitioners
Authors: Schmid Gordian Lukas , Kühnast Beatrice , Heise Marcus , Deutsch Tobias , Frese Thomas 
Published: December 2019

Abstract
Background: Over the last two decades, ultrasonography (US) has been shown to be an accurate tool for the diagnosis of suspected bone fractures; however, the integration of this application of US into routine care and outpatient settings needs to be explored. In this study, we surveyed German general practitioners (GPs) to assess their knowledge, attitudes, and utilization of US for the diagnosis of suspected fractures. Methods: Notification of the study, a self-designed questionnaire, and a reminder were mailed to 600 randomly selected GPs in Saxony and Saxony-Anhalt. Results: The response rate was 47.7% ( n = 286), and respondents did not differ from the population of all GPs in respect to sex and practice type. Among GPs surveyed, 48.6% used an US device in their practice. On average, GPs diagnosed six patients with suspected fractures per month, yet only 39.3% knew about the possibility of ultrasonographic fracture diagnosis, and only 4.3% of GPs using US applied it for this purpose. Among participants, 71.9% believed that US is inferior to conventional X-rays for the diagnosis of bony injuries. Users of US were better informed of and more commonly used US for fracture diagnosis compared to non-users. Conclusion: The need to rule out possible fractures frequently arises in general practice, and US devices are broadly available. Further efforts are needed to improve the knowledge and attitudes of GPs regarding the accuracy of US for fracture diagnosis. Multicenter controlled trials could explore the safety, usefulness, and effectiveness of this still seldom used diagnostic approach for suspected fractures.
Sarcopenia and intramuscular fat deposition are associated with poor survival in Indonesian patients with hepatocellular carcinoma: a retrospective study
Authors: Mardian Yan , Yano Yoshihiko , Ratnasari Neneng , Choridah Lina , Wasityastuti Widya , Setyawan Nurhuda Hendra , Hayashi Yoshitake 
Published: December 2019

Abstract
Background: A large-scale Japanese study showed that low skeletal muscle index (SMI) and intramuscular fat (IMF) deposition are associated with hepatocellular carcinoma (HCC) survival. Here, we evaluated the effects of SMI and IMF on the survival of Indonesian HCC patients, whose characteristics differ from those of Japanese patients. Methods: SMI and mean muscle attenuation (MA) were evaluated using computed tomography images of the third lumbar vertebra (L3) in a prospective cohort of 100 Indonesian HCC patients. Clinical, laboratory and body composition data were analysed using the Kaplan–Meier method and Cox regression model to investigate which factors are associated with prognosis. Results: Of 100 patients, 31 were diagnosed with sarcopenia (L3 SMI value ≤36.2 cm 2 /m 2 for men and ≤29.6 cm 2 /m 2 for women), and 65 had IMF deposition (MA value ≤44.4 HU for men and ≤39.3 HU for women). These groups had shorter median survival than the reference groups (both P <0.0001). In multivariable analysis, sarcopenia (hazard ratio [HR], 1.921; P = 0.016), IMF deposition (HR, 3.580; P <0.001), Barcelona Clinic Liver Cancer (BCLC) stages C and D (HR: 2.396, P <0.01 and HR: 6.131, P <0.01, respectively), Japan Integrated Staging (JIS) score 4 (HR: 2.067, P = 0.020), and male gender (HR: 3.211, P <0.001) were independently associated with mortality. Conclusion: Sarcopenia and IMF deposition showed superior value in combination with BCLC stage and JIS score for predicting the survival of Indonesian HCC patients. Increased awareness and strategies to prevent or reverse these factors might improve patient outcomes.
Effect of proton pump inhibitor on the movement of Helicobacter pylori across the mucus layer to the gastric lumen
Authors: Author) shanshan Su(Former Corresponding , Author) Guo-qi Zheng(New Corresponding , Liu Ying-ying , Liang Yu-fei , Song Hui , Yin Wen-jie , Zhang Guo-zun 
Published: December 2019

Abstract
Background: Helicobacter pylori ( H. pylori ) cannot usually be detected in the gastric juice and it is thought that H. pylori may reside under the mucus layer for long term. The mechanisms of action of proton pump inhibitor (PPI)for H. pylori eradication are not entirely clear. Our study aimed to determine the role of PPI on the movement of H. pylori across the mucus layer to the gastric lumen and the mechanism of PPI on H. pylori eradication. Methods: Patients with H. pylori infection were intravenous injected with PPI (intervention group, n=31) or without PPI (control group, n=37). The presence of H. pylori in the gastric juice was evaluated by the rapid urease test (RUT), polymerase chain reaction (PCR), and culture methods. Results: The H. pylori positive detection rates were all significantly higher among patients in the intervention group than among patients in the control group by the RUT ( P < 0.0001), PCR ( P < 0.0001), and culturing ( P = 0.0386). Conclusion: H. pylori can penetrate across the mucus layer to the gastric lumen following PPI intervention, and thus it might represent a novel target in the eradication of H. pylori .
Genetic diversity of C4 photosynthesis pathway genes in Sorghum bicolor (L.)
Authors: Tao Yongfu , George-Jaeggli Barbara , Bouteille-Pallas Marie , Tai Shuaishuai , Cruickshank Alan , Jordan David , Mace Emma 
Published: December 2019

Abstract
Background C 4 photosynthesis has evolved in over 60 different plant taxa and is an excellent example of convergent evolution. Plants using the C 4 photosynthetic pathway have an efficiency advantage, particularly in hot and dry environments. They account for 23% of global primary production and include some of our most productive cereals. While previous genetic studies comparing phylogenetically related C 3 and C 4 species have elucidated the genetic diversity underpinning the C 4 photosynthetic pathway, no previous studies have described the genetic diversity of the genes involved in this pathway within a C 4 crop species. Enhanced understanding of the allelic diversity and selection signatures of genes in this pathway may present opportunities to improve photosynthetic efficiency, and ultimately yield, by exploiting natural variation. Results Here, we present the first genetic diversity survey of 8 known C 4 gene families in an important C 4 crop, Sorghum bicolor (L.) Moench using sequence data of 48 genotypes covering wild and domesticated sorghum accessions. Average nucleotide diversity of C 4 gene families varied more than 20-fold from the NADP-MDH gene family (θπ =0.2×10 -3 ) to the PPDK gene family (θπ = 5.21×10 -3 ). Genetic diversity of C 4 genes was reduced by 22.43% in cultivated sorghum compared to wild and weedy sorghum, indicating that the group of wild and weedy sorghum may constitute an untapped reservoir for alleles related to the C 4 photosynthetic pathway. A SNP-level analysis identified purifying selection signals on C 4 PPDK and CA genes, and balancing selection signals on C 4 PPDK-RP and PEPC genes. Allelic distribution of these C 4 genes was consistent with selection signals detected. Conclusions Domestication of sorghum has reshaped diversity of C 4 pathway. A better understanding of the genetic diversity of this pathway in sorghum paves the way for mining the natural allelic variation for the improvement of photosynthesis.
Prediction of patients with a tumor proportion score &gt;50% who do not respond to first-line monotherapy with pembrolizumab
Authors: Morita Mitsunori , Tamiya Motohiro , Fujimoto Daichi , Tamiya Akihiro , Suzuki Hidekazu , Hirano Katsuya , Fukuda Yasushi , Yokoyama Toshihide , Kominami Ryota , Kanazu Masaki , Uchida Junji , Hara Satoshi , Yamashita Shuji , Tomioka Hiromi 
Published: December 2019

Abstract
Background: Pembrolizumab is effective as first-line therapy against advanced non-small cell lung cancer (NSCLC) in patients with programmed death ligand-1 (PD-L1) expression levels ≥50%. However, it is not effective in all patients, and the factors predicting responses among this population remain unknown. Methods: We retrospectively analyzed patients with NSCLC and a PD-L1 tumor proportion score (TPS) >50%, who received first-line monotherapy with pembrolizumab from February 1, 2017 to April 30, 2018. The study included 11 hospitals, which participated in the Hanshin Oncology clinical Problem Evaluation group (HOPE). We analyzed the differences between responders and non-responders in terms of age, sex, performance status score, degree of progression, histological type, smoking history, expression of PD-L1, use of steroids prior to treatment, metastasis site, and laboratory data. Results: A total of 205 patients were included in this study. Of those, 108 patients exhibiting complete or partial response were defined as responders. Those exhibiting progressive disease (N=52) were defined as non-responders. In the univariate analysis, Eastern Cooperative Oncology Group performance status score ≥2 (p=0.0832), stage IV disease or recurrence (p=0.0487), PD-L1 TPS 50–89% (p=0.0657), use of steroids prior to the administration of pembrolizumab (p=0.0243), malignant pleural effusion (p=0.0032), and baseline C-reactive protein (CRP) levels >1.0 mg/dL (p=0.0390) were significantly associated with non-response to treatment. In the multivariate analysis, use of steroids prior to the administration of pembrolizumab (odds ratio [OR]: 5.86; 95% confidence interval [CI]: 1.32–31.8; p=0.0200), malignant pleural effusion (OR: 2.68; 95% CI: 1.15–6.35; p=0.0228), and baseline CRP >1.0 mg/dL (OR: 2.17; 95% CI: 1.03–4.68; p=0.0402) were significantly associated with non-response to treatment. Conclusion: In real-world patients with NSCLC and a PD-L1 TPS ≥50%, use of steroids prior to treatment, malignant pleural effusion, and baseline CRP levels >1.0mg/dL reduced the effectiveness of first-line monotherapy with pembrolizumab.
Predictive Value of Admission D-dimer for Contrast-induced Acute Kidney Injury and Poor Outcomes after Primary Percutaneous Coronary Intervention
Authors: Lin Kai-Yang , Chen Han-Chuan , Jiang Hui , Wang Sun-Ying , Chen Hong-mei , Wu Zhi-Yong , Jiang Feng , Guo Yan-Song , ZHU PENG-LI 
Published: December 2019

Abstract
Background DD was found to be associated with acute myocardial infarction (AMI) and renal insufficiency. However, it is uncertain whether DD is an independent risk factor of CI-AKI in patients undergoing pPCI.Methods We prospectively enrolled 550 consecutive patients with STEMI undergoing pPCI between January 2012 and December 2016. The predictive value of admission DD for CI-AKI was assessed by receiver operating characteristic(ROC) and multivariable logistic regression analysis. CI-AKI was defined as an absolute serum creatinine increase ≥0.3 mg/dl or a relative increase in serum creatinine ≥50% within 48 h of contrast medium exposure.Results Overall, the incidence of CI-AKI was 13.1%. The ROC analysis showed that the cutoff point of DD was 0.69 ug/ml for predicting CI-AKI with a sensitivity of 77.8% and a specificity of 57.3%. The predictive value of DD was similar to the Mehran score for CI-AKI (AUC DD =0.729 vs AUC Mehran =0.722; p =0.8298). Multivariate logistic regression analysis indicated that DD >0.69 ug/ml was an independent predictor of CI-AKI (odds ratio[OR]=3.37,95%CI:1.80-6.33, p <0.0001). Furthermore, DD >0.69 ug/ml was associated with an increased risk of long-term mortality during during a mean follow-up period of 16 months(hazard ratio=3.41, 95%CI:1.4-8.03, p =0.005).Conclusion admission DD >0.69 ug/ml is a significant and independent predictor of CI-AKI and long-term mortality in patients undergoing pPCI.
Prevalence and patterns of birth defects among newborns in Southwestern Ethiopia: Retrospective study
Authors: Geneti Soressa Abebe , Gebru Girmai , Amenu Demisew , Dube Lemessa 
Published: December 2019

Abstract
Background : Intrauterine development can be considered as normal development as well as abnormal development. Abnormal development commonly called birth defects occur because of interference of normal development from genetic disorders, environmental factors and the combination of both genetic and environment factors during the critical period of embryogenesis. The present study aimed to evaluate the prevalence and patterns of birth defects at birth in Southwestern Ethiopia. Methods : Institutions based cross-sectional study design was used. Six hospitals were selected from the existing hospitals in southwestern Ethiopia purposively based on case load. The study was conducted from September 2011 to December 2015 during which 45,951 deliveries were attained. All records of births that were occurred in the selected hospitals during the study period were identified from medical records, to locate the birth defect records. Results : Twenty-one different birth defects were recorded. Of these, 49.6 % of the birth defects recorded were Anencephaly and Hydrocephalus. Five types of birth defects namely: Anencephaly (25.0%), Hydrocephalus (24.6%), Spinal bifida (13.1%), Meningomyelocele (7.1%), and Umbilical hernia (4.8 %) accounted about three-fourth (75%) of all recorded birth defects. The present study revealed that the prevalence of the birth defects at birth was found to be 5.5 per 1000 births. Among twenty one birth defects identified in this study, the neural tube defects were the most frequent with prevalence rate of 4.1 per 1000 birth followed by gastrointestinal defects (0.7 per 1000 births) Conclusions: As compared to other study, the prevalence of birth defect identified in the present study was found to be higher. The neural tube defects were the most prevalent with the frequency of 4.05 cases per 1000.The present study also identified that nearly equal proportions of birth defect occurred among males and females newborns. The majority of the mother who gave birth to birth defects was younger than 35 years old. As the birth defect was found to be a main cases of infant mortality and morbidity, there need to an urgent interventions to control the cases.
Midwives' Perspectives of Respectful Maternity Care during Childbirth: A Qualitative Study
Authors: Moridi Maryam , Pazandeh Farzaneh , Hajian Sepideh , Ebadi Abbas , Potrata Barbara 
Published: December 2019

Abstract
Background: The adoption of respectful maternity care during labour and birth is complex process which needs both scientific and interpersonal skills of providers. In this regard, identifying the potential barriers and applying effective strategies for implementing respectful maternity care are essential. This study aimed to explore the perceptions of Iranian midwives regarding respectful maternity care during labour and childbirth. Methods: This was a qualitative study which was conducted from September-December 2018 in two non-teaching public hospitals in Tehran, Iran. Twenty four semi-structured interviews were conducted with midwives, who had more than one year work experience in labor and childbirth units, through a purposive sampling method. The data was analyzed using conventional content analysis approach and managed by MAX QDA 10 software. Results: Three themes were extracted including showing empathy, women-centered care and protecting rights. Showing empathy reflects that establishing a friendly relationship and being with women. Women-centered care indicated keeping women safe and participating in decision making. Protecting rights reflected a need for safeguarding dignity as well as giving equal care and preparing appropriate environment. Conclusions: Iranian midwives considered respectful maternity care a broader concept rather than preventing mistreatment. Providing supportive care through friendly interaction with women was the first step for providing respectful maternity care. Promoting respectful care also should be through performing safe care by implementing evidence-based care and women’s involvement in their care as well as appropriate environment for women, families and caregivers.
Association of major cardiovascular risk factors, risk factor clustering with cardiovascular diseases from eastern China A population-based cross-sectional study
Authors: Yang Hua-Feng , Hong Xin , Wang Wei-Wei , Ye Qing , Wang Zhi-Yong , Qi Sheng-Xiang , Wang Chen-Chen , Zhou Hai-Rong , Li Chao , Qin Zhen-Zhen 
Published: December 2019

Abstract
Background: Cardiovascular diseases (CVDs) are serious public health issues and the burden of CVDs is at alarmingly high level in China. The aim of the current study was to estimate the prevalence of CVDs and modifiable risk factors, and explore the association of risk factors, risk factor clustering with CVDs among Nanjing adults from eastern China. Methods: A population-based cross-sectional survey was conducted by a stratified clustered sampling between June and November 2011. A representative sample of 40,896 residents aged over 18 years was interviewed by face-to-face questionnaire survey, anthropometric measurements and laboratory examinations. The prevalence of CVDs including coronary heart disease (CHD) and stroke was determined according to a participant’s self-report. Multivariable logistic regression models were used to estimate the relationship between relevant risk factors, their clustering and CVDs. Results: The weighted prevalence of self-reported in the entire population was 1.1% for CHD; and 1.4% for stroke. The weighted prevalence of hypertension, diabetes, dyslipidemia, overweight or obesity, and current smoking was 25.0%, 6.7%, 29.6%, 35.9% and 24.5%, respectively. In multivariable-adjusted models, higher levels of body mass index, systolic blood pressure and fasting plasma glucose could be associated with increased risks of CHD and stroke, whereas higher level of high-density lipoprotein cholesterol could be related to lower risks of CHD. Hypertension, diabetes and dyslipidemia were likely to be positively associated with self-reported CVDs regardless of genders in multivariable logistic regression models. Participants with CVDs had significant higher proportion of at least two of CVD risk factors than their counterparts without CVDs. Compared to those having no risk factor; adults with one, two, three or more CVD risk factors had possibly gradually increased risks of CHD and stroke in both genders. Conclusion: Higher regional prevalence of CVDs was likely to be synergistic effects of risk factors aggregation. Therefore, multifactorial intervention strategies based on associated risk factors may be available for prevention and control of CVDs in Chinese population. Keywords: Cardiovascular diseases, Risk Factors, Prevalence, Coronary heart disease, Stroke, China