bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of COVID-19 outbreak in an Italian cohort of patients with systemic sclerosis
Authors: Del Papa Nicoletta , Sambataro Gianluca , Minniti Antonina , Maglione Wanda , Pignataro Francesca , Caminati Antonella , Harari Sergio , Sambataro Domenico , Vitali Claudio , Caporali Roberto Felice 
Published: September 2020

Background: Mortality rate in patients infected by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) can be related to the presence of comorbidities like diabetes, cardiovascular and pulmonary diseases. On the contrary, few data exist on the impact of CoronaVirus Disease 2019 (COVID-19) on patients with rheumatic disorders, namely in those having pulmonary involvement and treated with immunosuppressive agents. The present survey is aimed at knowing the impact of COVID-19 in a cohort of patients with systemic sclerosis (SSc). Methods: Telephone interviews were carried out during the COVID-19 outbreak in patients with SSc followed in a Rheumatic Disease Unit in Italy. Patients were asked for confirmed SARS-CoV-2 infection, symptoms suggestive of COVID-19, and modification of their therapy. Results: A total number of 526 patients with SSc were contacted and interviewed. Of them, 270 and 256 had limited cutaneous and diffuse cutaneous SSc, respectively. Interstitial lung disease (ILD) was present in 45% of patients and most of them (68.2%) were treated with immunosuppressive therapy. Only two patients were hospitalized for COVID-19-related pneumonia, and one of them died despite invasive ventilator support. An additional 11 patients reported flu-like symptoms compatible with a mild form of COVID-19. Nobody modified the therapy during the COVID-19 outbreak. Conclusion: Despite the large prevalence of ILD and immunosuppressive therapies, which can be considered risk factors for the occurrence and severity of incidental viral infections, the impact of COVID-19, in terms of mortality rate and morbidity, does not appear particularly severe in this large cohort of patients with SSc. Possible mechanisms influencing this figure are discussed.
Effect of hydroxyurea exposure before puberty on sperm parameters in males with sickle cell disease
Authors: Joseph L. , Jean C. , Manceau S. , Chalas C. , Arnaud C. , Kamdem A. , Pondarré C. , Habibi A. , Bernaudin F. , Allali S. , de Montalembert M. , Boutonnat-Faucher B. , Arlet J.-B. , Koehl B. , Cavazzana M. , Ribeil J.-A. , Lionnet F. , Berthaut I. , Brousse V. 
Published: September 2020

Abstract
Sperm parameters are known to be impaired in men with sickle cell disease (SCD). Although treatment with hydroxyurea (HU) has an impact on sperm quality, sperm preservation is impossible before puberty. This study’s primary objective was to analyze and compare sperm parameters in male patients with SCD exposed (or not) to HU before puberty. Twenty-six sperm samples from 15 patients (median age, 17 years; range, 16-23) treated with HU during childhood were compared with 46 samples from 23 HU-naïve patients (20 years; 16-24). The median age at HU initiation was 6 years (1-14 years), the median duration of HU treatment was 4 years (0.5-10), and the mean dose of HU was 22.4 ± 3.7 mg/kg per day. Although we observed substantial quantitative and qualitative semen abnormalities in all patients, there were no significant differences in semen volume, sperm concentration, total sperm count, or spermatozoa motility, morphology, and vitality between the HU-exposed and HU-naïve groups. At the time of the semen analysis, 100% of the patients in the HU-exposed group and 52% of the patients in the HU-naïve group received transfusion therapy. The specific effect of HU on spermatogenesis in very young infants and the putative value of transfusion for reversing the toxicity of HU warrant further investigation.
Systematic evaluation and external validation of 22 prognostic models among hospitalised adults with COVID-19: an observational cohort study
Authors: Gupta Rishi K. , Marks Michael , Samuels Thomas H.A. , Luintel Akish , Rampling Tommy , Chowdhury Humayra , Quartagno Matteo , Nair Arjun , Lipman Marc , Abubakar Ibrahim , van Smeden Maarten , Wong Wai Keong , Williams Bryan , Noursadeghi Mahdad 
Published: September 2020

The number of proposed prognostic models for coronavirus disease 2019 (COVID-19) is growing rapidly, but it is unknown whether any are suitable for widespread clinical implementation.We independently externally validated the performance of candidate prognostic models, identified through a living systematic review, among consecutive adults admitted to hospital with a final diagnosis of COVID-19. We reconstructed candidate models as per original descriptions and evaluated performance for their original intended outcomes using predictors measured at the time of admission. We assessed discrimination, calibration and net benefit, compared to the default strategies of treating all and no patients, and against the most discriminating predictors in univariable analyses.We tested 22 candidate prognostic models among 411 participants with COVID-19, of whom 180 (43.8%) and 115 (28.0%) met the endpoints of clinical deterioration and mortality, respectively. Highest areas under receiver operating characteristic (AUROC) curves were achieved by the NEWS2 score for prediction of deterioration over 24 h (0.78, 95% CI 0.73–0.83), and a novel model for prediction of deterioration <14 days from admission (0.78, 95% CI 0.74–0.82). The most discriminating univariable predictors were admission oxygen saturation on room air for in-hospital deterioration (AUROC 0.76, 95% CI 0.71–0.81), and age for in-hospital mortality (AUROC 0.76, 95% CI 0.71–0.81). No prognostic model demonstrated consistently higher net benefit than these univariable predictors, across a range of threshold probabilities.Admission oxygen saturation on room air and patient age are strong predictors of deterioration and mortality among hospitalised adults with COVID-19, respectively. None of the prognostic models evaluated here offered incremental value for patient stratification to these univariable predictors.
Primary ciliary dyskinesia: a major player in a bigger game
Authors: Bhatt Reena , Hogg Claire 
Published: September 2020

Primary ciliary dyskinesia (PCD) is an inherited disorder of clinical and genetic heterogeneity resulting from mutations in genes involved in the transport, assembly and function of motile cilia. The resulting impairment in mucociliary clearance means patients suffer from chronic progressive lung disease, bronchiectasis, rhinosinusitis and middle ear disease. Subfertility is common to both male and female patients. Situs abnormalities occur in around half of patients, with a subgroup suffering more complex situs arrangements where congenital heart defects or other organ abnormalities frequently coexist. Variations from the classical PCD phenotype are increasingly recognised where overlapping features across a range of motile and nonmotile ciliopathies are redefining our approach to both diagnosis and management of these complex conditions. PCD offers an ideal opportunity for direct visualisation of ciliary function and structure, following nasal brush biopsy, allowing opportunities for researchers to directly interrogate the downstream impact of loss of function mutations. In turn, this has led to rapid advances in the development of new diagnostic tests. These advances mean that PCD is an excellent disease model for understanding the genetic and mechanistic causes of the clinical phenotype for all respiratory ciliopathies. Furthermore, the overlapping role of motile ciliary defects in a wider set of complex and syndromic disorders related to loss of function mutations in primary, nonmotile cilia has been recognised. As we better understand the role of ciliary defects in a broad spectrum of diseases, we should aim to map out a framework through which we can identify, diagnose and treat all respiratory ciliopathies.Key pointsPrimary ciliary dyskinesia is just one of a group of conditions where a heterogeneous array of genetic mutations affect the assembly or structure of motile cilia.Overlapping phenotypes between motile and nonmotile ciliopathies are redefining the diagnostic and therapeutic approach to encompass all ciliopathy patients with a respiratory phenotype.An extended diagnostic algorithm may be required to capture the majority of cases with a respiratory ciliopathy, including patients with syndromic ciliopathies.The terminology around disorders of motile cilia is becoming more descriptive to better reflect the heterogeneity and underlying disease mechanisms across the spectrum of respiratory ciliopathies.Educational aimsTo summarise the existing knowledge base around the disease mechanisms for respiratory ciliopathies, including primary ciliary dyskinesia (PCD).To explore and understand the reasons for changing terminology around respiratory ciliopathies.To emphasise key messages around the diagnosis and treatment of all ciliopathies.Diagnosing PCD is complex and time consuming, and there is no single stand-alone test that can confirm or exclude a diagnosis in all cases.
European Headache Federation recommendations for placebo and nocebo terminology
Authors: Mitsikostas Dimos D. , Blease Charlotte , Carlino Elisa , Colloca Luana , Geers Andrew L. , Howick Jeremy , Evers Andrea W. M. , Flaten Magne A. , Kelley John M. , Kirsch Irving , Klinger Regine , MaassenVanDenBrink Antoinette , Moerman Daniel E. , Sfikakis Petros P. , Vase Lene , Wager Tor D. , Benedetti Fabrizio ,   on behalf of the European Headache Federation
Published: September 2020

Abstract
Background and aim
Despite recent publications, practitioners remain unfamiliar with the current terminology related to the placebo and nocebo phenomena observed in clinical trials and practice, nor with the factors that modulate them. To cover the gap, the European Headache Federation appointed a panel of experts to clarify the terms associated with the use of placebo in clinical trials.

Methods
The working group identified relevant questions and agreed upon recommendations. Because no data were required to answer the questions, the GRADE approach was not applicable, and thus only expert opinion was provided according to an amended Delphi method. The initial 12 topics for discussion were revised in the opinion of the majority of the panelists, and after a total of 6 rounds of negotiations, the final agreement is presented.

Results/recommendations
Two primary and mechanism-based recommendations are provided for the results of clinical trials: [1] to distinguish the placebo or nocebo response from the placebo or nocebo effect; and [2] for any favorable outcome observed after placebo administration, the term “placebo response” should be used, and for any unfavorable outcome recorded after placebo administration, the term “nocebo response” should be used (12 out of 17 panelists agreed, 70.6% agreement). The placebo or nocebo responses are attributed to a set of factors including those that are related to the medical condition (e.g. natural history, random comorbidities, etc.), along with idiosyncratic ones, in which the placebo or nocebo effects are attributed to idiosyncratic, or nonspecific mechanisms, exclusively (e.g. expectation, conditioning, observational learning etc.). To help investigators and practitioners, the panel summarized a list of environmental factors and idiosyncratic dynamics modulating placebo and nocebo effects. Some of them are modifiable, and investigators or physicians need to know about them in order to modify these factors appropriately to improve treatment. One secondary recommendation addresses the use of the terms “placebo” and “nocebo” (“placebos” and “nocebos” in plural), which refer to the triggers of the placebo/nocebo effects or responses, respectively, and which are inert agents or interventions that should not be confused with the placebo/nocebo responses or effects themselves (all panelists agreed, 100% agreement).

Conclusion
The working group recommends distinguishing the term response from effect to describe health changes from before to after placebo application and to distinguish the terms placebo(s) or nocebo(s) from the health consequences that they cause (placebo/nocebo responses or effects).
A novel approach to minimally invasive hysterectomy without the use of a uterine manipulator: Kamran’s TLH technique
Authors: Gendia Ahmed M. , Donlon Noel E. , Kamran Waseem M. 
Published: September 2020

Abstract
Background
There are a number of techniques documented in the literature to perform laparoscopic hysterectomy, and here, we propose a safe and novel technique that obviates the need for a pelvic assistant, removes the need for a uterine manipulator and can potentially reduce operative duration.

Results
Total laparoscopic hysterectomy can be approached without the use of uterine manipulator or vaginal tubes using the steps demonstrated.

Conclusions
This novel technique is safe, efficient and conducive to standardising minimally invasive hysterectomy practices obviating the need for a uterine manipulator and pelvic assistant.
Adsorption of SF6 Decomposed Products on ZnO-Modified C3N: A Theoretical Study
Authors: Wu Peng , Zhang Xiaoxing , Chen Dachang , Tang Ju 
Published: September 2020

AbstractSF6, as an outstanding insulation medium, is widely used in the high-voltage insulation devices, guaranteeing the safe operation of the power system. Nevertheless, the inevitable partial discharge in a long-running device causes the decomposition of SF6 and deteriorates its insulation performance. In this work, DFT calculations were performed to study the adsorbing and sensing properties of ZnO-modified C3N (ZnO-C3N) nanosheet towards SF6 decomposed products, in order to propose a novel nano-candidate for evaluating the operation status of SF6 insulation devises. We first investigated the structure of ZnO-C3N monolayer and then simulated its adsorption behaviour upon four typical SF6 decomposed species, namely H2S, SO2, SOF2, and SO2F2. It is found that the ZnO-C3N monolayer can exhibit desirable reactivity and sensitivity on SO2, SOF2, and SO2F2, leading to the intense deformation of gas molecules and large adsorption energies. These consequences allow the potential application of gas adsorbent based on ZnO-C3N monolayer for removing impurity gases from SF6 insulation equipment. According to the analysis, it is supposed that ZnO-C3N monolayer is qualified to be used in maintaining insulation strength and ensuring the safe operation of power system.
Mitochondrial-nuclear coadaptation revealed through mtDNA replacements in Saccharomyces cerevisiae
Authors: Nguyen Tuc H. M. , Sondhi Sargunvir , Ziesel Andrew , Paliwal Swati , Fiumera Heather L. 
Published: September 2020

AbstractBackgroundMitochondrial function requires numerous genetic interactions between mitochondrial- and nuclear- encoded genes. While selection for optimal mitonuclear interactions should result in coevolution between both genomes, evidence for mitonuclear coadaptation is challenging to document. Genetic models where mitonuclear interactions can be explored are needed.ResultsWe systematically exchanged mtDNAs between 15 Saccharomyces cerevisiaeisolates from a variety of ecological niches to create 225 unique mitochondrial-nuclear genotypes. Analysis of phenotypic profiles confirmed that environmentally-sensitive interactions between mitochondrial and nuclear genotype contributed to growth differences. Exchanges of mtDNAs between strains of the same or different clades were just as likely to demonstrate mitonuclear epistasis although epistatic effect sizes increased with genetic distances. Strains with their original mtDNAs were more fit than strains with synthetic mitonuclear combinations when grown in media that resembled isolation habitats.ConclusionsThis study shows that natural variation in mitonuclear interactions contributes to fitness landscapes. Multiple examples of coadapted mitochondrial-nuclear genotypes suggest that selection for mitonuclear interactions may play a role in helping yeasts adapt to novel environments and promote coevolution.
Genome-wide analysis of the WRKY gene family in the cucumber genome and transcriptome-wide identification of WRKY transcription factors that respond to biotic and abiotic stresses
Authors: Chen Chunhua , Chen Xueqian , Han Jing , Lu Wenli , Ren Zhonghai 
Published: September 2020

Abstract
Background
Cucumber (Cucumis sativus L.) is an economically important vegetable crop species. However, it is susceptible to various abiotic and biotic stresses. WRKY transcription factors play important roles in plant growth and development, particularly in the plant response to biotic and abiotic stresses. However, little is known about the expression pattern of WRKY genes under different stresses in cucumber.

Results
In the present study, an analysis of the new assembly of the cucumber genome (v3.0) allowed the identification of 61 cucumber WRKY genes. Phylogenetic and synteny analyses were performed using related species to investigate the evolution of the cucumber WRKY genes. The 61 CsWRKYs were classified into three main groups, within which the gene structure and motif compositions were conserved. Tissue expression profiles of the WRKY genes demonstrated that 24 CsWRKY genes showed constitutive expression (FPKM > 1 in all samples), and some WRKY genes showed organ-specific expression, suggesting that these WRKYs might be important for plant growth and organ development in cucumber. Importantly, analysis of the CsWRKY gene expression patterns revealed that five CsWRKY genes strongly responded to both salt and heat stresses, 12 genes were observed to be expressed in response to infection from downy mildew and powdery mildew, and three CsWRKY genes simultaneously responded to all treatments analysed. Some CsWRKY genes were observed to be induced/repressed at different times after abiotic or biotic stress treatment, demonstrating that cucumber WRKY genes might play different roles during different stress responses and that their expression patterns vary in response to stresses.

Conclusions
Sixty-one WRKY genes were identified in cucumber, and insight into their classification, evolution, and expression patterns was gained in this study. Responses to different abiotic and biotic stresses in cucumber were also investigated. Our results provide a better understanding of the function of CsWRKY genes in improving abiotic and biotic stress resistance in cucumber.
An investigation and analysis of the activities of daily living of older adults living at home in Ningxia Hui Autonomous Region of China: a cross-sectional study
Authors: Xu Xiaofeng , Yang Lina , Miao Xiaohui , Hu Xiuying 
Published: September 2020

Abstract
Background
To investigate the current situation regarding the activities of daily living (ADL) of older adults living at home in Ningxia Hui Autonomous Region of China and to analyze the associated factors of ADL performance so that we can provide references for the implementation of pension policies and long-term care insurance of older adults living at home.

Methods
We surveyed a total of 1040 older adults who live at home and receive home-based care in Ningxia Hui Autonomous Region by a face-to-face evaluation. A logistic regression model was used to analyze the factors associated with ADL performance.

Results
In the study, 82.79% of the older adults living at home can live independently. A total of 11.92% of the older adults have mild dysfunction, 4.33% have moderate dysfunction, and 0.96% have severe dysfunction. Multiple logistic analyses indicated that older adults with very difficult economic conditions (OR 3.212; 95% CI(1.209–8.534)) and without a spouse (OR 1.616; 95% CI(1.098–2.377)) were significantly associated with ADL limitations. In addition, the risks of ADL limitations in older adults aged 60–69 years and 70–79 years were 0.187 and 0.4307 times, respectively, that of older adults over 80 years old. The risk of ADL limitations in older adults of the Han nationality was 0.605 times that of the minority population. More highly educated and older adults without diseases have a lower risk of ADL limitations.

Conclusions
Compared with the national average in China, the number of ADL limitations of older adults in Ningxia is greater and is associated with advanced age, ethnic minority status, low education level, low income, lacking a spouse and having diseases. As the number of older adults increases, maintaining and improving their ability to perform ADL and providing comfortable pension services and health services urgently need to be solved.
Patient and provider perspectives on the development and resolution of prescribing cascades: a qualitative study
Authors: Farrell Barbara J. , Jeffs Lianne , Irving Hannah , McCarthy Lisa M. 
Published: September 2020

Abstract
Background
Prescribing cascades occur when the side effect of a medication is treated with a second medication. The aim of the study was to understand how prescribing cascades develop and persist and to identify strategies for their identification, prevention and management.

Method
This qualitative study employed semi-structured interviews to explore the existence of prescribing cascades and to gather patients', caregivers' and clinicians’ perspectives about how prescribing cascades start, persist and how they might be resolved. Participants were older adults (over age 65) at an outpatient Geriatric Day Hospital (GDH) with possible prescribing cascades (identified by a GDH team member), their caregivers, and healthcare providers. Data were analyzed using an inductive content analysis approach.

Results
Fourteen participants were interviewed (eight patients, one family caregiver, one GDH pharmacist, three GDH physicians and one family physician) providing a total of 22 interviews about patient-specific cases. The complexity and contextually situated nature of prescribing cascades created challenges for all of those involved with their identification. Three themes impacted how prescribing cascades developed and persisted: varying awareness of medications and cascades; varying feelings of accountability for making decisions about medication-related care; and accessibility to an ideal environment and relevant information. Actions to prevent, identify or resolve cascades were suggested.

Conclusion
Patients and healthcare providers struggled to recognize prescribing cascades and identify when they had occurred; knowledge gaps contributed to this challenge and led to inaction. Strategies that equip patients and clinicians with resources to recognize prescribing cascades and environmental and social supports that would help with their identification are needed. Current conceptualizations of cascades warrant additional refinement by considering the nuances our work raises regarding their appropriateness and directionality.
Different clinical presentations of two renal transplant recipients with coronavirus disease 2019: a case report
Authors: Li Jing , Chen Gang , Zhang Mingmin , Tu Shenghao , Chen Chao 
Published: September 2020

Abstract
Background
The Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome Coronavirus-2 has spread rapidly worldwide and disease spread is currently increasing. Data on the clinical picture of transplant recipients and management of the anti-rejection immunosuppressive therapy on COVID-19 infection are lacking.

Case presentation
We report two cases of COVID-19 infection in renal transplant recipients with variable clinical presentations. The first patient presented with mild respiratory symptoms and a stable clinical course. The second patient had more severe clinical characteristics and presented with severe pneumonia and multi-organ failure. Both patients received a combination therapy including antiviral treatment and reduced immunosuppression therapy and finally recovered.

Conclusions
We report COVID-19 infection in two renal transplant recipients with a favorable outcome but different clinical courses, which may provide a reference value for treating such patients.