bluuebunny/crossref_metadata_2025_split huggingface dataset:
Benefit of Canagliflozin In Patients With Type 2 Diabetes After Hospitalization For Acute Heart Failure
Authors: Dorado Ernesto Martin , López-Aguilera José , González Rafael , Anguita Manuel , Gutiérrez Guillermo , Luque Aurora , Paredes Nick , Oneto Jesús , Perea Jorge , Castillo Juan Carlos 
Published: October 2020

Abstract
BACKGROUND: Heart failure (HF) is one of the mayor contributors to cardiovascular morbidity and mortality in patients with diabetes. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have demonstrated to reduce the risk of hospitalization for HF in patients with type 2 diabetes mellitus. We aimed to compare the incidence of readmission in patients who received canagliflozin at discharge after hospitalization of acute HF and changes in N-terminal pro–B-type natriuretic peptide (NT-ProBNP) concentration during follow-up. METHODS: We retrospectively included 102 consecutive patients with diabetes discharged for acute heart failure and without contraindications for SGLT2 inhibitors. We divided them in two groups: 45 patients with canagliflozin at discharge therapy and 57 without any SGLT2 inhibitors.RESULTS: Over a median follow-up of 22 months, 45 (44.1%) were hospitalized for HF. Most of the patients who were readmitted due to heart failure occurred during the first year (37.3%). HF readmission at first year occurred in 10 patients (22.2%) in canagliflozin group and 29 patients (49.1%) in control group (HR: 0.45; 95% CI: 0.21–0.96; p < 0.039) after multivariate adjustment. A composite outcome of hospitalization for HF or death for cardiovascular causes was lower in canagliflozin group (37.8%) than in the control group (70.2%) (HR: 0.51; 95% CI: 0.27–0.95; p < 0.035). Analysis of NT-ProBNP concentration showed an interaction between canagliflozin therapy and follow-up time (p=0.002).CONCLUSIONS: Canagliflozin therapy at discharge was associated with lower risk of readmission for HF and a reduction of NT-ProBNP concentration in patients with diabetes after hospitalization for HF.
Multi-View 3D Skin Feature Recognition and Localization for Patient Tracking in Spinal Surgery Applications
Authors: Manni Francesca , Mamprin Marco , Holthuizen Ronald , Shan Caifeng , Burstöm Gustav , Elmi-Terander Adrian , Edström Erik , Zinger Svitlana , de With Peter H.N. 
Published: October 2020

Abstract
Background: Minimally invasive spine surgery is dependent on accurate navigation. Computer-assisted navigation is increasingly used in minimally invasive surgery (MIS), but current solutions require the use of reference markers in the surgical field for both patient and instruments tracking. Purpose: To improve reliability and facilitate clinical workflow, this study proposes a new marker-free tracking framework based on skin feature recognition. Methods: Maximally Stable Extremal Regions (MSER) and Speeded Up Robust Feature (SURF) algorithms are applied for skin feature detection. The proposed tracking framework is based on a multi-camera setup for obtaining multi-view acquisitions of the surgical area. Features can then be accurately detected using MSER and SURF and afterwards localized by triangulation. The triangulation error is used for assessing the localization quality in 3D. Results: The framework was tested on a cadaver dataset and in eight clinical cases. The detected features for the entire patient datasets were found to have an overall triangulation error of 0.207 mm for MSER and 0.204 mm for SURF. The localization accuracy was compared to a system with conventional markers, serving as a ground truth. An average accuracy of 0.627 and 0.622 mm was achieved for MSER and SURF, respectively. Conclusions: This study demonstrates that skin feature localization for patient tracking in a surgical setting is feasible. The technology shows promising results in terms of detected features and localization accuracy. In the future, the framework may be further improved by exploiting extended feature processing using modern optical imaging techniques for clinical applications where patient tracking is crucial.
An Acute Viral Hepatitis Epidemic: Does Ultrasound Help the Pediatrician?
Authors: Arooj Sadaf , Mukhtar Muhammad Umer , Abbas Farnaz 
Published: October 2020

Abstract
Objective: Acute viral hepatitis (AVH) caused by hepatitis virus A and hepatitis virus E is one of the many epidemics that plague third world countries like Pakistan. The serological tests required for the diagnosis of acute viral hepatitis may be unavailable or unaffordable to the denizens of a developing country like Pakistan. In such a scenario, the clinical manifestations and the ultrasonographic findings are the only diagnostic criteria usually present and these can be used to support a clinical diagnosis. This study aims to judge the utility of ultrasound in the diagnosis of AVH. Results:Among the forty-seven subjects of this study, gall bladder wall thickening (GWT) was the most common radiological finding seen in 39(82.9%) patients. Pericholecystic edema was the second most common finding, seen in 31(65.9%) patients. Starry sky appearance of the liver was observed in 30(63.8) patients. Hepatomegaly and ascites were seen in 28(59.5%) and 25(53.2%) of the patients, respectively. The ultrasonographic findings of GWT, pericholecystic edema, and starry sky appearance of the liver were the most common ultrasonographic findings associated with AVH.
Effect of Emergency Contraceptive Pill Use on Condom Utilization Among University Students in Nekemte Town, Western Ethiopia: A Cross-Sectional Study
Authors: Genemo Edao Sado , Korsa Ayana Tadesse , Bayisa Habte Gebeyehu 
Published: October 2020

Abstract
Background: Emergency contraceptive pill (ECP) is a type of hormonal contraceptives which prevents unplanned pregnancy, but not sexually transmitted infections (STIs). Besides, its impact on condom utilization is not known among female university students in Nekemte town. Thus, this study was aimed to assess the awareness and attitude of university students on the use of ECP and its impact on condom utilization. Methods: An institution-based cross-sectional study was conducted on 400 female students in three private universities in Nekemte town from February 1 to 29, 2016. A simple random sampling, after proportional size allocation to respective study settings, was used to select student participants. Among the 400 randomly selected participants, 381 have completed and returned the questionnaire with 95.25% response rate. Data were collected by using self-administered questionnaire and entered into EpiData 3.1, and analyzed by using SPSS version 20. Bivariate and multivariate analysis were performed to determine the effects of ECP use on condom utilization with statistical significance set at P-value < 0.05. Results: Nearly half (48.8%) of the students indicated that they had sexual intercourse before and heard of ECP. Moreover, 30% of the respondents reported that they used ECP. Majority (61.7%) showed willingness to use ECP. Furthermore, students who used ECP were 3 times less likely to use condoms when compared to those who never used ECP (AOR = 0.322, 95% CI 0.164, 0.632). Alternatively, students who believed ECP does not prevent STIs were 2 times more likely to use condoms when compared to those who believed ECP does prevent STIs (AOR= 2.217 95% CI 1.070, 4.593). Conclusions: our findings identified that most students lack knowledge of ECP while having positive attitude on its use. On the other hand, ECP use imposes negative impact on condom utilization so that female students could be exposed to risky STIs.
CRISPR/Cas9-Mediated Whole Genomic Wide Knockout Screening Identifies Specific Genes Related to Mineral Absorption Involving in PM2.5 Liver Toxicity
Authors: Peng Jinfu , Yi Bin , Wang Mengyao , Tan Jieqiong , Huang Zhijun 
Published: October 2020

Abstract
Background: PM2.5 , also known as fine particles, refers to particulate matter with a dynamic diameter of ≦ 2.5 µm in air pollutants, carrying toxic substances (e.g. heavy metals or minerals), which can pass through the alveolar epithelium and enter the bloodstream and tissues, can have more serious health problems, such as non-alcoholic fatty liver and hepatocellular carcinoma. However, the underlying mechanisms for toxic effect of PM2.5 are poorly understood. Results: Here, we subjected L02 cells to expose of PM2.5 and performed a pooled genome‐wide CRISPR (clustered regularly interspaced short palindromic repeats)/Cas9 (CRISPR-associated protein 9) loss of function screen to discover new potential targets for PM2.5. Enrichr and KEGG were employed to identify candidate genes which might involve in PM2.5 toxicity. We found that ATP1A2(ATPase Na+/K+ transporting subunit alpha 2), MT1M(metallothionein 1M), SLC6A19(solute carrier family 6 member 19) and TRPV6(transient receptor potential cation channel subfamily V member 6) genes contributed to PM2.5 toxicity involving in mineral absorption pathway. Moreover, we demonstrated that these candidate genes deficiency increased the cell viability and attenuated apoptosis in cells explored to PM2.5. Conclusions: ATP1A2, MT1M, SLC6A19 and TRPV6 contribute to PM2.5 toxicity and may be potential therapeutic targets for PM2.5 related diseases.
Breastfeeding Counseling Based on Formative Research at Primary Healthcare Services in Mexico.
Authors: Bueno-Gutiérrez Diana , Castillo Edgar Uriel Romero , Mondragón Angélica Emili Hernández 
Published: October 2020

Abstract
Breastfeeding rates in Mexico are among the lowest in Latin America with 14.4% for Exclusive Breastfeeding (EBF) under six months of age. It has been reported that rates has been decreasing among low-income and vulnerable population, where there is lack of healthcare assistance. Culturally appropriate counseling based on formative research has shown to be effective in improving breastfeeding. Our objective was to evaluate the effect of interpersonal counseling on EBF in a primary healthcare center in Tijuana, México. MethodsThis was a randomized controlled trial pilot with a sample of mothers with infants under 4 months of age from a Primary Care Center. Participants were randomized to a 1) Control Group, receiving counseling about immunizations as well as routine infant feeding information, and 2) Intervention Group, receiving breastfeeding counseling based on previous formative research using a socio-ecological framework. Changes in breastfeeding attitudes, self-efficacy and EBF at 2 months post-intervention were evaluated.ResultsEighty mothers were included in the study (40 in each group). The mean age was 26.4 years for mothers and 1.4 months for infants. Breastfeeding obstacles reported were breastfeeding in public discomfort (23%), infant unsatisfied (23%), pain (19%), insufficient milk (15%) and returning to work (8%). We observed a significant improvement in breastfeeding attitudes (P=0.0001), self-efficacy (P=0.018) and EBF (P=0.001). There was a 30% increase in EBF in the intervention group and 15% decrease in the control group post-intervention.ConclusionsBreastfeeding counseling based on formative research improved breastfeeding attitudes, self-efficacy and practices in this population. Breastfeeding should be promoted by well-trained health professionals with knowledge and skills to clearly communicate breastfeeding messages, and sensitivity to address women’s needs according to their sociocultural context. Since breastfeeding responds to health systems and socio-economic and cultural environments in which the mother lives; development and evaluation of programs to increase breastfeeding rates in low- and middle-income countries are necessary. Trial Registration ANZCTR ID: 380462 (Under review). Retrospectively registered.
Thirty-Day Readmission Rates After Takotsubo Syndrome With or Without Malignancy: A Nationwide Readmissions Database Analysis
Authors: Jang Sun-Joo , Yeo Ilhwan , Jonas Chanel , Goyal Parag , Cheung Jim W. , Feldman Dmitriy N. , McCullough S. Andrew , Krishnan Udhay , Narotsky David L. , Singh Harsimran S. , Minutello Robert M. , Bergman Geoffrey , Wong S. Chiu , Kim Luke K. 
Published: October 2020

Abstract
Background: Association of malignancy with readmission after TTS hospitalization has not been fully described. We sought to examine the rates, cause and cost of 30-day readmissions and 30-day all-cause mortality of Takotsubo syndrome (TTS) patients with or without malignancy. Methods: The Nationwide Readmissions Databases from 2010 to 2014 were queried to identify and compare baseline characteristics and outcomes of patients hospitalized for TTS with and without malignancy. Results: We identified 61,588 index hospitalizations for TTS. TTS patients with malignancy were older (70.6 ± 0.2 vs. 66.1 ± 0.1, p < 0.001), and the overall burden of comorbidities was higher than in those without malignancy. TTS patients with malignancy had significantly higher 30-day readmission rates than those without malignancy (15.9% vs. 11.0%; odds ratio [OR], 1.35; 95% confidence interval [CI], 1.18 - 1.56). Majority (75.5%) of the etiologies for readmissions were non-cardiac, with infection being most common (20.1%). The 30-day readmission rate due to the recurrent TTS was similar in both groups (0.4% and 0.5%, respectively; p = 0.47). Importantly, 30-day all-cause mortality was higher in TTS with vs. without malignancy (4.8% vs 2.5%; OR, 1.62; 95% CI, 1.25 - 2.10). The total costs (index admission + readmission) were higher by 25% (p < 0.001) in TTS patients with malignancy vs. without malignancy. Conclusions: In patients hospitalized with TTS, the presence of malignancy was associated with increased risk of 30-day readmission, mostly attributable to non-cardiac etiologies. Importantly, the 30-day all-cause mortality and cost were also significantly higher. These findings highlight the importance of optimization of treatment and follow up in patients with malignancy after hospitalizations for TTS.
Divide and Conquer: Clustering Patients With Autism by Gene Expression Profiles Using Machine Learning Algorithms
Authors: Lin Ping-I , Moni Mohammad Ali , Eapen Valsamma , Gau Susan Shur-Fen 
Published: October 2020

Abstract
BackgroundClinical heterogeneity in autism spectrum disorder (ASD) can complicate diagnostics and treatments. The identification of biomarkers may hold the key to the classification of ASD subgroups. Accumulating evidence suggests that genetic or genomic markers may facilitate the clustering of patients with ASD. The goal of the current study is to use machine learning algorithms to analyze microarray data to identify clusters with relatively homogeneous clinical features, such as language function.MethodsThe whole-genome gene expression microarray data were used to predict communication quotient (SCQ) scores against all probes to select differential expression regions (DERs). Gene set enrichment analysis was performed to identify hub pathways that play a role in the severity of social communication deficits inherent to ASD. We then used two machine learning methods, random forest classification (RF) combined with partition around medoids (PAM) and support vector machine (SVM), to identify two clusters using DERs. Finally, we evaluated how accurately the clusters predicted language impairment.ResultsA total of 191 DERs were identified. Cholesterol biosynthesis and metabolisms pathways appear to act as hubs that connect other trait-associated pathways to influence the severity of social communication deficits inherent to ASD. Both RF and SVM algorithms can yield a classification accuracy level greater than 90% when all 191 DERs were analyzed. LimitationsThe primary limitation of the current study is the small sample size. Nevertheless, some machine learning algorithm, such as SVM, can handle a small sample with a large number of features. Additionally, model overfitting may arise due to a lack of another independent sample for validation. Furthermore, unknown confounders may cause spurious associations between the phenotype and genomic markers. ConclusionsThe ASD subtypes defined by the presence of language impairment, a strong indicator for prognosis, can be predicted by transcriptomic profiles associated with social communication deficits and cholesterol biosynthesis and metabolism. Our proof-of-concept study suggests that both RF and SVM are acceptable options for machine learning algorithms to identify AD subgroups characterized by clinical homogeneity related to prognosis.
An In Vitro Intestinal Model Captures Immunomodulatory Properties of the Microbiota in Inflammation
Authors: Lock Jaclyn Y. , Caboni Mariaelena , Strandwitz Philip , Morrissette Madeleine , DiBona Kevin , Joughin Brian A. , Lewis Kim , Carrier Rebecca L. 
Published: October 2020

Abstract
BackgroundThere is a growing appreciation for the significance of the gut microbiome in health and disease. Specifically, considerable effort has been put forth to understand mechanisms by which the microbiota modulates and responds to inflammation. Here, we explored whether oxidation metabolites produced by the host during inflammation, sodium nitrate and trimethylamine oxide, impact the composition of a human stool bacterial population in a gut simulator. We then assessed whether an immune-competent in vitro intestinal model responded differently to spent medium from bacteria exposed to these cues compared to spent medium from a control bacterial population. ResultsThe host-derived oxidation products were found to decrease levels of Bacteroidaceae and overall microbiota metabolic potential, while increasing levels of pro-inflammatory Enterobacteriaceae and lipopolysaccharide in bacterial cultures, reflecting shifts that occur in vivo in inflammation. Spent medium, with or without sodium nitrate and trimethylamine oxide, induced elevated intracellular mucin levels and reduced intestinal monolayer integrity as reflected in trans-epithelial electrical resistance relative to fresh medium controls. However, multiplexed cytokine analysis revealed markedly different cytokine signatures from intestinal cultures exposed to spent medium with added oxidation products relative to spent control medium, while cytokine signatures of cultures exposed to fresh media were similar regardless of addition of host-derived cues. Further, the presence of immune cells in the intestinal model was required for this differentiation of cytokine signatures. ConclusionsThis study indicates that simple in vitro immune-competent intestinal models can capture bacterial-mammalian cross-talk in response to host-derived oxidation products and supports utility of these systems for mechanistic studies of interactions between the gut microbiome and host in inflammation.
Responses of Cyanobacterial Aggregate Microbial Communities to Algal Blooms
Authors: Zhu Congmin , Zhang Junyi , Wang Xin , Yang Yuqing , Chen Ning , Lu Zuhong , Ge Qinyu , Jiang Rui , Zhang Xuegong , Yang Yunfeng , Chen Ting 
Published: October 2020

Abstract
BackgroundFreshwater lakes are threatened by harmful cyanobacterial blooms; whose basic unit is Cyanobacterial Aggregate (CA). Community variations of CA-attached bacteria are substantial during different blooming stages. However, little is known about their transcriptional and metabolic variations. Most bacterial genomes in CA were not constructed in existing database, which limits our understanding of the bacterial variations as responses to cyanobacterial blooms. ResultsIn this longitudinal study, 16 CA samples were collected from Lake Taihu, one of the largest freshwater lakes in China, from April of 2015 to February of 2016. By sequencing the V4 region of 16S rRNA genes, full metagenomes (MG) and metatranscriptomes (MT), we generated 424 Mb of 16S rRNA gene data, 122 Gb of high-quality MG data and 160 Gb of high-quality MT data. We analyzed the taxonomic, functional and transcriptional variations of microbes in CAs along three blooming stages, and constructed metagenome-assembled genomes (MAGs) by binning analysis. First, 55 OTUs, 456 genes and 37 transcripts mainly associated with pathways of transporters, photosystem and energy metabolism showed significantly different abundance among the three stages. Second, 161 high-quality MAGs in CAs were achieved, with 19 of which significantly shifted in relative abundance among three stages. The most abundant MAGs have gene capacities to synthesize flagella and divers of transporters, and participate in metabolic pathways of nitrogen, phosphorus and sulfur. Finally, 22 high-quality cyanobacterial MAGs were constructed and can be divided into four functional clusters, which showed significant differences on the energy pathways, transporters and prokaryotic defense system.ConclusionOverall, these results demonstrated the taxonomic, functional and transcriptional variations of microbes in CAs among three different blooming stages. Genome construction and metabolic analysis of cyanobacteria and their attached bacteria suggested that the material exchange and signal transmission do, indeed, exist among them. Our understanding of the underlying molecular pathways for cyanobacterial blooms could potentially lead to the control of blooms by interventional strategies to disrupt the expression of critical microbes.
Evaluation of algorithms using administrative health and structured electronic medical record data to determine breast and colorectal cancer recurrence in a Canadian province
Authors: Decker Kathleen , Lambert Pascal , Pitz Marshall , Singh Harminder 
Published: October 2020

Abstract
Background: Algorithms that use administrative health and electronic medical record (EMR) data to determine cancer recurrence have the potential to replace chart reviews. This study evaluated algorithms to determine breast and colorectal cancer recurrence in a Canadian province with a universal health care system.Methods: Individuals diagnosed with stage I-III breast or colorectal cancer diagnosed from 2004 to 2012 in Manitoba, Canada were included. Pre-specified and conditional inference tree algorithms using administrative health and structured EMR data were developed. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) correct classification, and scaled Brier scores were measured.Results: The weighted pre-specified variable algorithm for the breast cancer validation cohort (N=1181, 167 recurrences) demonstrated 81.1% sensitivity, 93.2% specificity, 61.4% PPV, 97.4% NPV, 91.8% correct classification, and scaled Brier score of 0.21. The weighted conditional inference tree algorithm demonstrated 68.5% sensitivity, 97.0% specificity, 75.4% PPV, 95.8% NPV, 93.6% correct classification, and scaled Brier score of 0.39. The weighted pre-specified variable algorithm for the colorectal validation cohort (N=693, 136 recurrences) demonstrated 77.7% sensitivity, 92.8% specificity, 70.7% PPV, 94.9% NPV, 90.1% correct classification, and scaled Brier score of 0.33. The conditional inference tree algorithm demonstrated 62.6% sensitivity, 97.8% specificity, 86.4% PPV, 92.2% NPV, 91.4% correct classification, and scaled Brier score of 0.42. Conclusions: Algorithms using administrative health and structured EMR data to determine breast and colorectal cancer recurrence had moderate sensitivity and PPV, high specificity, NPV, and correct classification, but low accuracy. Algorithms for determining cancer recurrence must improve before replacing chart reviews.