bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primarily Treated Patients versus Referred Patients in the Treatment of Native Septic Arthritis of Digits: A Retrospective Comparative Study
Authors: Kwak Sang Ho , Bae Jung Yun , Oh Youngkwang , Jang Hyo Seok , Ahn Tae Young , Lee Sang Hyun 
Published: May 2020

Abstract
Background Septic arthritis of digits needs urgent treatment. When treatments delayed or insufficient, patients may be referred to the upper-level hospital due to uncontrolled infection. We reviewed the treatment history of referred patients and compared the microorganisms and the clinical course of both primary and referred patients as relevant studies are rare. Methods In this retrospective review of consecutive case series, 45 patients (primary, n=11; referred, n=34) were treated with multiple irrigation and debridement. Cefazolin was used as empiric antibiotics, then changed according to microbiologic study. Previously used antibiotics, treatment delay, surgical history of the referred patients were reviewed. Identified microorganisms, required surgical intervention, hospital stay, radiologic outcome, functional outcomes were compared between both groups. Results In the referred patients, methicillin-resistant Staphylococcus aureus (MRSA) was commonly found and cefazolin was susceptible in only 15% of the cases. Longer hospital stay, prolonged antibiotic therapy, more surgical intervention including flap surgery was required to treat the referred patients. Postoperative pain was not severe in daily activities, but the final range of motion was significantly less in the referred patients compared to the primary patients.Conclusions This study suggests that in the treatment of uncontrolled septic arthritis of the digits, antibiotic agents covering MRSA may shorten the duration of antibiotic therapy in areas of high MRSA incidence. Besides, more number of I & D including flap surgery may be required for the referred patients compared with the primary patients. These findings can help the surgeon in setting up a treatment plan or in counseling of referred patients with uncontrolled septic arthritis of the digits.
Mental distress among frontline healthcare workers outside the central epidemic area during the novel coronavirus disease (COVID-19) outbreak in China: A cross-sectional study
Authors: LIU YAYUN , liu xinsheng , gao bai , li chengzhong , Liang XueSong 
Published: May 2020

Abstract
Background and aim:At the initial stage of the fight against COVID-19, a large number of medical staff and materials were dispatched to Wuhan City and Hubei Province to contain the outbreak quickly and effectively.The national infection prevention and control strategy posed a challenge to the physical and psychological resilience of frontline healthcare workers(HCWs) outside the central epidemic area.This study aims to survey frontline HCWs outside the central epidemic area in China to understand their levels of perceived stress, anxiety, and depression during the initial stage of the fight against the COVID-19 outbreak.Methods: From February 11 to February14, 2020, an online survey was conducted in Jinzhong, Shanxi Province using snowball sampling techniques. The survey consisted of two parts, namely, demographic data and psychological screening. Demographic information included gender, age, hospital classification, working department, profession type, and working experience. Perceived stress was assessed by Chinese simple Perceived Stress Scale 10, general anxiety was assessed by the General Anxiety Disorder Scale, and depression was evaluated by the Patient Health Questionnaire-9.Results: A total of 1,315 frontline HCWs were included,of which 646(49.1%) reported a moderate to severe stress(scores≥14), 141(10.7%) reported moderatetosevere anxiety (score≥10), and164(12.4%) reported a major depression (score≥10). Female gender was significantly associated with high levels of perceived stress, anxiety, and depression (P<0.05), and working time was negatively correlated with the level of perceived stress, anxiety, and depression (P<0.05). Statistical difference was observed in perceived stress score among different age groups, levels of hospital group,and working departments (P<0.05).Conclusion:During the initial stage of the fight against COVID-19in China, more than half of the frontline HCWs outside the central epidemic area rated perceived stress as moderatetosevere, and nearly 23% of them reported moderatetosevere anxiety or depression.Female gender, low hospital level, and emergency department were associated with a high level of perceived stress.
Incidence and risks for surgical site infection after closed tibial plateau fractures in adults treated by open reduction and internal fixation: a prospective study
Authors: Li Junyong , Zhu Yanbin , Zhao Kuo , Zhang Junzhe , Meng Hongyu , Jin Zhucheng , Ma Jiangtao , Zhang Yingze 
Published: May 2020

Abstract
Background
Surgical site infection (SSI) was the most common complication of tibial plateau fracture after open reduction and internal fixation (ORIF). Severe infections even required repeat surgeries, which would cause serious psychological harm to patients and increased the economic burden of treatment. In order to identify the characteristics of the SSI and to avoid the occurrence of SSI, we conducted a prospective study to investigate the incidence and independent risk factors of SSI after ORIF for closed tibial plateau fractures in adults.
Methods
This study was performed at a first-level trauma center. From October 2014 to December 2018, the study subjects were adult patients with closed fractures of the tibial plateau, all of whom underwent open reduction and internal fixation (ORIF) treatment. Finally, a total of 1108 patients were followed up. We collected patient demographics information, surgery-related variables and indexes from pre-operative laboratory examinations. Univariate and multivariate logistic analysis models were used to investigate the potential risk factors.
Results
Twenty-five patients (2.3%, 25/1108) developed SSI. A total of 15 of 25 infections (60.0%) were due to Staphylococcus aureus and 3 (12.0%) were due to MRSA. Independent risk factors of SSI identified by multivariate logistic analysis model were bone grafting: autograft (OR, 6.38; 95% CI, 2.155–18.886; p = 0.001) and allograft (OR, 3.215; 95% CI, 1.009–10.247; p = 0.048), fracture type (Schartzker Ⅴ-Ⅵ) (OR, 8.129; 95% CI, 2.961–22.319; p < 0.001), aspartate aminotransferase (> 40 U/L) (OR, 5.500; 95% CI, 2.191–13.807; p < 0.001), white blood cell (> 10*109/L) (OR, 2.498; 95% CI, 1.025–6.092; p = 0.044), and anion gap (> 16 mmol/L) (OR, 8.194; 95% CI, 1.101–60.980).
Conclusions
We should pay enough attention to patients who carried one or more of these factors at admission and adopt more reasonable treatment strategies to reduce or avoid the occurrence of SSI.
Electronic ordering and the management of treatment interdependencies: a qualitative study of paediatric chemotherapy
Authors: Lichtner Valentina , Franklin Bryony Dean , Dalla-Pozza Luciano , Westbrook Johanna I 
Published: May 2020

Abstract
Background
There are serious safety risks associated with chemotherapy, often associated with interdependencies in regimens administered over months or years. Various strategies are used to manage these risks. Computerized provider order entry (CPOE) systems are also implemented to improve medication safety. Little is known regarding the effect of CPOE on how clinicians manage chemotherapy interdependencies and their associated safety strategies.
Methods
We conducted a multi-method qualitative study in a paediatric hospital. We analysed 827 oncology incidents reported following CPOE implementation and carried out semi-structured interviews with doctors (n = 10), nurses (n = 6), a pharmacist, and oncology CPOE team members (n = 2). Results were interpreted according to safety models (ultra-safe, high-reliability organisations [HROs], or ultra-adaptive).
Results
Incident reports highlighted two interrelated types of interdependencies: those within organisation of clinical activities and those inherent in chemotherapy regimens. Clinicians reported strategies to address chemotherapy risks and interdependencies. These included rigid rules and ‘no go’ contexts for treatment to proceed, typical of the ultra-safe model; use of time (e.g. planning only so far ahead) and sensitivity to operations, typical of HROs. CPOE supported ultra-safe strategies through automation and access to rules/standardisation. However, sensitivity to operations was needed to anticipate and resolve uncertainties, hazards, CPOE limitations, and mismatches between CPOE processes and workflow in practice.
Conclusions
Within oncology, CPOE appears to move the ‘mix’ of risk strategies towards ultra-safe models of safety and protocol-mandated care. However, operating ultra-safe strategies embedded in CPOE and staying on protocol necessitate sensitivity to operations in CPOE use. CPOE design can be advanced by better consideration of mechanisms to support interdependencies.
Amorphous silica nanoparticles accelerated atherosclerotic lesion progression in ApoE-/- mice through endoplasmic reticulum stress-mediated CD36 up-regulation in macrophage
Authors: Ma Ru , Qi Yi , Zhao Xinying , Li Xueyan , Sun Xuejing , Niu Piye , Li Yanbo , Guo Caixia , Chen Rui , Sun Zhiwei 
Published: May 2020

Abstract
Background
Given the prominent cardiovascular effects of nanosized particulate matter in air pollution, our limited understanding of the potential cardiovascular effects of engineered nanoparticles, in particular, is a pressing concern. Silica nanoparticles (SiNPs) are among the most widely manufactured and used nanoparticles. However, the interaction between SiNPs exposure and atherosclerosis, and the underlying mechanisms still remain unknown.
Results
Ultrasound microscopy showed a significant increase of pulse wave velocity (PWV) in ApoE−/− mice fed by a Western diet after SiNPs exposure via intratracheal instillation compared to the control mice. Histopathological investigation reflected a greater plaque burden with higher lipid load in the aortic root of SiNPs-exposed ApoE−/− mice. When compared to the control, serum levels of total triglycerides (TG) and low-density lipoprotein cholesterol (LDL-C) were significantly elevated after SiNPs exposure. Moreover, intensified macrophage infiltration and endoplasmic reticulum (ER) stress were occurred in plaques after SiNPs exposure, as evidenced by the upregulated CD68 and Bip, CHOP levels. Further, in vitro, SiNPs was confirmed to activate ER stress and induce lipid accumulation in mouse macrophage, RAW264.7. Mechanistic analyses showed that 4-PBA (a classic ER stress inhibitor) pretreatment could greatly alleviate SiNPs-induced macrophage lipid accumulation, and reverse the elevated CD36 expression by SiNPs.
Conclusions
Our results firstly revealed the acceleratory effect of SiNPs on atherosclerosis in ApoE−/− mice. SiNPs aggravated the plaque load in the aorta of mice, promoted macrophage infiltration and ER stress inside the lesion, alongside with the exacerbated arterial stiffness and dyslipidemia. Further, ER stress-mediated CD36 upregulation contributed to the formation of macrophage-derived foam cell caused by SiNPs, ultimately contributing to the progression of atherosclerotic plaque.
LncRNA GAS5 suppresses the proliferation and invasion of osteosarcoma cells via the miR-23a-3p/PTEN/PI3K/AKT axis
Authors: Liu Jianmin , Chen Ming , Ma Longyang , Dang Xingbo , Du Gongliang 
Published: May 2020

Abstract
Background: Accumulating evidence has shown that lncRNA growth arrest special 5 (GAS5) is a well‑known tumor suppressor in the pathogenesis of a variety of human cancers. However, the detailed role of GAS5 in osteosarcoma is largely unclear. Here, we explore the role of GAS5 in progression of osteosarcoma. Methods: The expression level of GAS5 was detected in human osteosarcoma tissues and matched adjacent tissues, as well as osteosarcoma cell lines and nonmalignant osteoblast cells. Then, in vitro gain- and loss-of-function experiments, with the pcDNA-GAS5 expression vector and GAS5-siRNA, were performed in U2OS and HOS cells to determine the effect of GAS5 on osteosarcoma cell proliferation and invasion. Subsequently, we searched potential miRNA targets with bioinformatics analysis and confirmed their interaction by using luciferase reporter gene and RNA pull-down assays. The function and mechanism of miR-23a-3p in proliferation and invasion was also investigated in U2OS and HOS cells. Furthermore, rescue experiments were performed to verify the involvement of miR-23a-3p and its target gene in GAS5-mediated cell behaviors. Finally, a xenograft nude mouse model was established by subcutaneous injection with U2OS cells overexpressing GAS5 or not, and the effect of GAS5 on tumor growth in vivo was evaluated. Results: GAS5 was downregulated in human osteosarcoma tissues and cell lines. Overexpression of GAS5 could significantly suppress, and downregulation of GAS5 promoted, proliferation and invasion of osteosarcoma cells. GAS5 could directly bind with and upregulated miR-23a-3p, which post-transcriptionally downregulated the tumor suppressor PTEN and positively regulated proliferation and invasion of osteosarcoma cells. Rescue experiments confirmed the involvement of miR-23a-3p and PTEN in GAS5-mediated cell behaviors by modifying the phosphatidylinositol-3-kinases/protein-serine-threonine kinase (PI3K/AKT) pathway. GAS5 could inhibit tumor growth in vivo. Conclusion: GAS5 functions as a competing endogenous RNA, sponging miR-23a-3p, to promote PTEN expression and suppress cell growth and invasion in osteosarcoma by regulating the PI3K/AKT pathway.
Quality of life data for individuals affected by Spinal Muscular Atrophy: A baseline dataset from the Cure SMA Community Update Survey
Authors: Belter Lisa , Cruz Rosángel , Jarecki Jill 
Published: May 2020

Abstract
BACKGROUND Individuals and/or caregivers of individuals affected by Spinal Muscular Atrophy (SMA) completed the 2019 Cure SMA Community Update Survey, online, assessing health-related quality of life (HRQoL), loss of work productivity, and fatigue using the Health Utilities Index Questionnaire (HUI), the Work Productivity and Activity Impairment Questionnaire (WPAI), and the Patient Reported Outcomes Measurement Information System Fatigue Short Form (PROMIS Fatigue SF), respectively. The purpose was to collect baseline quality of life results among individuals affected by SMA using the above Patient Reported Outcome Measures (PROMs). RESULTS Of 666 surveys completed between March and May 2019, 478 were included in this analysis, accounting for duplicates, missing data, or deaths. The breakdown across SMA type I, II and III was 25%, 47% and 28%, respectively. Responses were characterized by current functional status/milestone, with subsets for “permanent ventilation,” “non-sitters,” “sitters,” “walk with support,” and “walk alone.” WPAI and HUI respondents included affected adults and caregivers. The PROMIS Fatigue SF was completed by the primary caregiver of affected children. Overall, those affected by a less severe form of SMA and with a higher functional status reported higher HRQoL and lower work productivity and activity impairment. All affected individuals reported higher fatigue levels than the general population. CONCLUSIONS This study offers useful insights into the burden of SMA among affected individuals and their caregivers. The results provide a baseline picture of the patient and caregiver experience with SMA in a post-treatment era from which to measure year-over-year changes in quality of life scores from new therapies and improved care. The WPAI demonstrates the significant impact of work productivity among SMA populations. Aspects of the HUI seem more appropriate to certain SMA sub-populations than others. Measures from the PROMIS Fatigue SF appear to under-represent the burden of fatigue often reported by SMA individuals and caregivers; this may, perhaps be due to a lack of sensitivity in the questions associated with fatigue in the SMA affected population, when compared with other studies on this topic. Overall, these results suggest the need for SMA-specific quality of life outcome measures to fully capture clinically meaningful change in the SMA population.
Ectopic bone formation and systemic bone loss in a transmembrane TNF-driven model of human spondyloarthritis
Authors: -Vafeiadou Eleni Christodoulou , Geka Christina , Ntari Lydia , Kranidioti Ksanthi , Argyropoulou Eleni , Meier Florian , Armaka Marietta , Mourouzis Iordanis , Pantos Constantinos , Rouchota Maritina , Loudos George , Denis Maria C , Karagianni Niki , Kollias George 
Published: May 2020

Abstract
Background The transmembrane-TNF transgenic mouse, TgA86, has been shown to develop spontaneously peripheral arthritis with signs of axial involvement. To assess similarity to human spondyloarthritis we performed detailed characterization of the axial, peripheral and comorbid pathologies of this model. Methods TgA86 bone pathologies were assessed at different ages using CT imaging of the spine, tail vertebrae and hind limbs and characterized in detail by histopathological and immunohistochemical analysis. Cardiac function was examined by echocardiography and electrocardiography and bone structural parameters by µCT analysis. The response of TgA86 mice to either early or late anti-TNF treatment was evaluated clinically, histopathologically and by µCT analysis. Results TgA86 mice developed with 100% penetrance spontaneous axial and peripheral pathology which progressed with time and manifested as reduced body weight and body length, kyphosis, tail bendings as well as swollen and distorted hind joints. Whole body CT analysis at advanced ages revealed bone erosions of sacral and caudal vertebrae as well as of sacroiliac joints and hind limps, and also, new ectopic bone formation and eventually vertebral fusion. The pathology of these mice highly resembled that of SpA patients, as it evolved through an early inflammatory phase, evident as enthesitis and synovitis in the affected joints, characterized by mesenchymal cell accumulation and neutrophilic infiltration. Subsequently, regression of inflammation was accompanied by ectopic bone formation, leading to ankylosis. In addition, both systemic bone loss and comorbid heart valve pathology were evident. Importantly, early anti-TNF treatment, similar to clinical treatment protocols, significantly reduced the inflammatory phase of both the axial and peripheral pathology of TgA86 mice. Conclusions The TgA86 mice develop a spontaneous peripheral and axial biphasic pathology accompanied by comorbid heart valvular dysfunction and osteoporosis, overall faithfully reproducing the progression of pathognomonic features of human spondyloarthritis. Therefore, the TgA86 mouse represents a valuable model for deciphering the pathogenic mechanisms of spondyloarthritis and for assessing the efficacy of human therapeutics targeting different phases of the disease.
EPHA5 mutation predicts the durable clinical benefit of immune checkpoint inhibitors in patients with lung adenocarcinoma
Authors: Huang Weimei , Lin Anqi , Luo Peng , Zhu Weiliang , Wei Ting , Guo Linlang , Zhang Jian 
Published: May 2020

Abstract
Background: Immune checkpoint inhibitor (ICI ) therapy has shown remarkable clinical benefit in lung adenocarcinoma (LUAD) patients. Genomic mutations may be applicable to predict the response to ICIs. Eph receptor A5 (EPHA5) is frequently mutated in breast cancer, lung cancer and other tumors; however, its association with outcome in patients who receive immunotherapy remains unknown. Methods: Somatic mutation data, gene expression data and clinicopathologic information were curated from patients with LUAD who were treated with ICI therapy (MSKCC ICI-treated cohort) and patients with LUAD who did not receive ICI therapy (TCGA-LUAD cohort). The CIBERSORT and gene set enrichment analysis (GSEA) algorithms were separately used to infer the relative abundance of leukocytes and significantly enriched pathways in the defined subgroups. Tumor mutation burden (TMB), tumor neoantigen load, the fraction of copy number variants (CNVs), the mutation frequency of DNA damage repair (DDR) genes, and the prognosis of patients were compared between the EPHA5-mutated subgroup and the EPHA5 wild - type subgroup. Whole-exome sequencing (WES) data and drug sensitivity data downloaded from the Genomics of Drug Sensitivity in Cancer (GDSC) database were used to evaluate the relationship of the 50% inhibitory concentration (IC50) of multiple drugs and the EPHA5 mutation status in LUAD cells. Results: EPHA5 mutations were associated with increased TMB, neoantigen load, levels of immune - related gene expression signatures, and enhanced tumor-infiltrating lymphocytes (TILs). Patients with EPHA5 mutations in the immunotherapy cohort achieved a longer progression - free survival (PFS) time than patients with wild-type EPHA5. Immune response pathways were among the top enriched pathways in samples with EPHA5 mutations. In addition , patients with EPHA5 mutations tended to be more sensitive to certain targeted molecular inhibitors , including serdemetan, lox2 and PF1-1. Conclusion: Our results suggest that identifying mutations in the EPHA5 gene may provide insight into the genome-wide mutational burden and may serve as a biomarker to predict the immune response of patients with LUAD.