bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anastrozole and Levonorgrestrel-Releasing Intrauterine Device in the Treatment of Endometriosis: A Randomized Clinical Trial.
Authors: Acién Pedro , Velasco Irene , Acién Maribel 
Published: August 2020

Abstract
Background: To study the effectiveness of an aromatase inhibitor (Anastrozole) associated to levonorgestrel-releasing intrauterine device (LNG-IUD, Mirena®) in the treatment of endometriosis.Methods: Prospective, randomized clinical trial. Setting: University Hospital (single center). Elegibility criteria: Endometriomas >3×4 cm, CA-125>35 U/mL and endometriosis symptoms. Patients: Thirty-one women randomized to anastrozole+Mirena®+Conservative Surgery(CS) (n=8), anastrozole+Mirena®+transvaginal ultrasound-guided puncture-aspiration (TUGPA) (n=7), Mirena®+CS (n=9), or Mirena®+TUGPA (n=7). Interventions: Anastrozole 1 mg/day and/or only Mirena® for 6 months; CS (ovarian and fertility-sparing) or TUGPA of endometriomas one month after starting medical treatment. Main Outcome Measures: Visual analogic scale for symptoms, CA-125 levels, ultrasound findings of endometriomas and recurrences.Results: A significant improvement in symptoms during the treatment (difference of 43%, 95% CI 29.9-56.2) occurred, which was maintained at 1 and 2 years. It was more significant in patients treated with anastrozole (51%, 95% CI 33.3-68.7). For CA-125, the most significant decrease was observed without anastrozole (73.8%, 95% CI 64.2-83.4 vs. 53.8%, 95% CI 25.7-81.6 under Mirena®+anastrozole). After CS for endometriosis, a reduction of findings of endometriomas and long-term recurrences occurred, with or without anastrozole. At 4,2±1,7 years (95% CI 3,57-4,85), 88% of the patients who underwent CS were asymptomatic, without medication or reoperation, compared to only 21% if TUGPA was performed, with or without anastrozole (p=0.019).Conclusions: Dosing anastrozole for 6 months, starting one month before CS of endometriosis, reduces more significantly the painful symptoms and delays recurrences, but has no other significant advantages over the single insertion of LNG-IUD (Mirena®) during the same time.Details of trial registration: Eudra CT System of the European Medicines Agency (London, 29-Sept-2008) Nº EudraCT: 2008-005744-17 (07/11/2008). Date of enrolment of first patient: 15/01/2009.
Body mass index and cardiovascular outcomes in patients with acute coronary syndrome by diabetic status: Korean cohort study
Authors: Park Se-Jun , Ha Kyoung Hwa , Kim Dae Jung 
Published: August 2020

Abstract
Background: The “obesity paradox” has not been elucidated in the long-term outcomes of acute coronary syndrome (ACS). Therefore, we investigated the association between obesity and cardiovascular (CV) outcomes in ACS patients with and without diabetes.Methods: We identified 6,978 patients with ACS aged 40–79 years from the Korean National Health Insurance Service-Health Screening Cohort between 2003 and 2015. Baseline body mass index (BMI) was categorized as underweight (<18.5 kg/m2), normal weight (18.5–22.9 kg/m2), overweight (23.0–24.9 kg/m2), obese class I (25.0–29.9 kg/m2), and obese class II (≥30.0 kg/m2). The primary outcome was major adverse CV events (MACE)—CV death, myocardial infarction (MI), and stroke. The secondary outcomes were the individual components of MACE, hospitalization for heart failure (HHF), and all-cause death. Results: The study included 3,989 patients with and 2,989 without diabetes. Compared to normal-weight patients without diabetes (reference group), those with diabetes had a higher risk of MACE (hazard ratio [HR], 1.29; 95% confidence interval [CI], 1.07–1.56). Obese patients without diabetes had a lower risk of MACE (HR, 0.78; 95% CI, 0.62–0.97) than those with diabetes (HR, 0.95; 95% CI 0.78–1.14). In patients without diabetes, obese BMI decreased the risk of HHF (HR, 0.62; 95% CI, 0.42–0.92) and stroke (HR, 0.61; 95% CI, 0.42–0.88), but not in those with diabetes. Conclusion: Among patients with ACS, obesity had rather protective effect on CV outcomes compared to normal weight, while this was not evident in patients with diabetes.
Strength and Size of Phosphorus-Rich Patches Determine the Foraging Strategy of Neyraudia reynaudiana
Authors: Cai Liping , Wang Yuzhen , Tigabu Mulualem , Hou Xiaolong , Wu Pengfei , Zhou Chuifan , Ma Xiangqing , Cai Liping 
Published: August 2020

Abstract
Background: Under natural conditions, soil nutrients are heterogeneously distributed, and plants have developed adaptation strategies, such as root morphological plasticity and/or physiological plasticity, to efficiently forage patchily distributed nutrient. Most previous studies examined either patch strength or patch size separately and focused mainly on root morphological plasticity, thus the effects of both patch strength and size on morphological and physiological plasticity are not well understood. In this study, we examined the foraging strategy of Neyraudia reynaudiana (Kunth) Keng ex Hithc, a pioneer grass colonizing degraded sites, with respect to patch strength and size in heterogeneously distributed phosphorus (P), and how foraging patchily distributed P affects total plant biomass. Plants were grown in sand-culture pots divided into ½, ¼, 1/6 compartments and full size and supplied with 0 + 0/30, 0 + 7.5/30 and 7.5 + 0/30 mg P/kg dry soil as KH2PO4 or 0 + 15/15, 0 + 18.5/ 18.5, 7.5 + 15/15 mg kg−1 in the homogenous treatment. The first amount was the P concentration in the central region, and that the second amount was the P concentration in the outer parts of the pot. Results: After 3 months of growth under experimental conditions, significantly (p < 0.05) high root elongation, root surface area, root volume and average root diameter was observed in large patches with high patch strength. Roots absorbed significantly more P in P-replete than P-deficient patches. Whole plant biomass was significantly higher in larger patches with high patch strength than small patches and homogeneous P distribution. Conclusion: The result demonstrates that root morphological and physiological plasticity are important adaptive strategies for foraging patchily distributed P and the former is largely determined by patch strength and size. The results also establish that foraging patchily distributed P resulted in increased total plant biomass compared to homogeneous P distribution.
Current situation of medication errors in Saudi Arabia: a nationwide observational study
Authors: Alshammari Thamir M , Alenzi Khalidah A. , Alatawi Yasser M , Almordi Afnan S. , Altebainawi Ali F. 
Published: August 2020

Abstract
BackgroundMedication process complexity could cause confusion among healthcare professionals (HCPs) and patients and lead to medication errors. This nationwide study aimed to characterize the types of medication errors and determine the error occurs in different stages of the medication process.MethodsThis was a retrospective observational study of medication errors reported by 265 government hospitals and primary care centers during the period of March 2018 to June 2019. The reported information include several aspects of medication errors, including patient information, medication information, error information, and the level of staff reporting and causing the error. The medication use process was categorized into ordering/prescribing, transcribing, dispensing, administering, and monitoring. ResultsA total of 71,332 medication error reports were reported between March 2018 and June 2019. The reported errors involved patients aged <10 (12,1312; 17.3%) and >60 (8,857; 12.4%) years, and the medication error rate was estimated to be 0.15%. Errors were frequently made by physicians 63120 (88.5%) and frequently detected by pharmacists (75.9%). The majority of errors were detected at the prescribing stage (84.8%), followed by the transcribing (5.8%) and dispensing (5.7%) stages. A total of 4,182 (5.8%) errors reached the patient. Work overload of staff was associated with one-third of the reported errors (31.6%), and 22.7% of the errors were due to a lack of experience among HCPs.ConclusionsThe study highlights the concern regarding medication errors occurrence during different medication use process. Despite all efforts, prescribing stage is still a big concern as source of harm to the patients.
Nonalcoholic fatty liver disease as a risk factor for severity of acute cholangitis
Authors: Mahmud Mahamid , Fteiha Bashar , Adi Nubani , Goldin Eran , Nseir Wiliam 
Published: August 2020

Abstract
Background: Nonalcoholic fatty liver disease (NAFLD) is one of the most prevalent chronic liver disorders worldwide. Acute cholangitis (AC) is a serious and life-threatening illness. We aimed to determine whether NAFLD is a risk factor for severity of AC.Methods: We retrospectively studied hospitalized patients with diagnosis of AC over the span of 5 years. Subjects were divided into a NAFLD group and Non NAFLD group. We compared between the two groups in terms of demographic characteristics, comorbidities, laboratory data, and severity of AC (including Charlson Comorbidity index and Tokyo Consensus meeting criteria). Results: 298 of 419 patients who had AC and were hospitalized met the inclusion criteria and were included in the study. Of them, 73/298 (24.5%) were included in NAFLD group. NAFLD group patients were younger, diabetic and more obese than non NAFLD group. Subjects in the NAFLD presented with higher serum C-reactive protein and higher liver enzymes (p<0.05, for each parameter) and suffered more events of organ dysfunction(p<0.001) and bacteremia (p<0.005). Regarding the severity of AC according to Tokyo classification, among the NAFLD group more subjects presented with Grade II (39.7 Vs 33.3%, p <0.001) and Grade III (23.3 vs 18.3, p<0.001) cholangitis, as opposed more Grade I cholangitis among the non-NAFLD group (48.4 vs 37%, p<0.001). Multivariate logistic regression analysis showed that NAFLD is independently associated with severe AC, grade III (OR 3.25, 95% CI 1.65-6.45, p=0.038). Conclusions: NAFLD is as an independent risk factor for severity of AC.
High frequency jet ventilation through mask contribute to oxygen therapy in patients undergoing bronchoscopic intervention under deep sedation
Authors: Yang Mingyuan , Wang Bin , Hou Qingwu , Zhou Yunzhi , Li Na , Wang Hongwu , Li Lei , Cheng Qinghao 
Published: August 2020

Abstract
Background: High frequency jet ventilation (HFJV) is an open ventilating technique to maintain ventilation for emergency or difficult airway. However, it is unclear whether jet ventilation or conventional oxygen therapy (COT) is more effectively and safely to maintain adequate oxygenation in patients with airway stenosis during bronchoscopic intervention (BI) under deep sedation.Methods: A prospective randomized cohort study was conducted to compare HFJV with normal frequency jet ventilation (NFJV) and COT (high flow oxygen) in oxygen supplementation during BI under deep sedation from March 2020 to August 2020. Patients receiving BI under deep sedation were randomly divided into 3 parallel groups of 50 patients each: the COT group (FiO21.0, 12 L/min), the NFJV Group (FiO2 1.0, driving pressure 0.1MPa, respiratory rate (RR) 15bpm) and HFJV Group (FiO2 1.0, driving pressure 0.1MPa, RR 1200bpm). SpO2, MBP and HR were recorded during the whole procedure. Arterial blood gas was examined and recorded at 15 minutes after initiation of procedure. Procedure duration, dose of anesthetics and adverse events during BI in the three groups were also recorded.Results: A total of 161 patients were enrolled with 11 patients excluded. Clinical characteristics were similar among the three groups. PaO2 of HFJV group was significantly higher than that of COT and NFJV group (P<0.001). PaO2 was significantly correlated with ventilation mode (P<0.001), BMI (P=0.019) and procedure duration (P=0.001). Multiple linear regression showed that only BMI and procedure duration were independent influencing factors of arterial blood gas PaO2 (P=0.040, P=0.002). The location of airway lesions and severity of airway stenosis were no statistical correlation with PaCO2 and PaO2.Conclusions: HFJV can effectively and safely improve intra-operative PaO2 in patients with airway stenosis during BI in deep sedation, and doesn’t increase intra-operative PaCO2 and the risk of hypercapnia. The location of airway lesions and severity of airway stenosis may not affect oxygenation maintain during basic and some advanced BI.Trial registration: Chinese Clinical Trial Registry. Registration number, ChiCTR2000031110, registered on March 22, 2020.
Performance of NT-proBNP as a single biomarker in comparison to SCORE and the recommended ESC/EASD cardiovascular risk stratification model for risk prediction in type 2 diabetes mellitus
Authors: Prausmüller Suriya , Resl Michael , Arfsten Henrike , Spinka Georg , Wurm Raphael , Neuhold Stephanie , Bartko Philipp , Goliasch Georg , Strunk Guido , Pavo Noemi , Clodi Martin , Hülsmann Martin 
Published: August 2020

Abstract
Background. Recently, the European Society of Cardiology (ESC) and European Association for the Society of Diabetes (EASD) introduced a new cardiovascular (CV) risk stratification model to aid further treatment decisions in individuals with diabetes. Our study aimed to investigate the prognostic performance of NT-proBNP and the Systematic COronary Risk Evaluation (SCORE) compared to the ESC/EASD risk model in an unselected cohort of type 2 diabetes mellitus (T2DM).Methods & Results. A total of 1690 T2DM patients with a 10-year follow up for fatal CV and all-cause death and a 5-year follow up for CV and all-cause hospitalizations were analyzed. According to ESC/EASD risk criteria 25 (1.5%) patients were classified as moderate, 252 (14.9%) high, 1125 (66.6%) very high risk and 288 (17.0%) were not classifiable. NT-proBNP, the ESC/EASD and SCORE risk model were all associated with 10-year CV and all-cause death and 5-year CV and all-cause hospitalizations. NT-proBNP showed significantly higher C-indices than the ESC/EASD and SCORE risk model for CV death [0.80 vs 0.53 vs 0.64, p<0.001] and all-cause death [0.73 vs 0.52 vs 0.66, p<0.001]. The performance of SCORE improved in a subgroup without CV disease aged 40-64 years compared to the unselected cohort, whilst performance of NT-proBNP was robust across all groups. Conclusion. NT-proBNP is a high-performing biomarker for CV risk assessment in T2DM. Single NT-proBNP is superior compared to SCORE and the multiparameter ESC/EASD risk stratification model for predicting 10-year CV and all-cause fatal events.
Verification of Bio-Resonance Efficiency Method for Neutralization of Chosen Pathogens
Authors: Krzysztof Patrycja , Strus Magdalena , Nabagło Tomasz 
Published: August 2020

Abstract
Background: The purpose of this study was to verify the effectiveness of the selected bio-resonance method under in- vitro conditions. The question of alternative therapies efficiency is very important in situation when traditional therapies may be not enough effective. In such situations, patients reach for alternative solutions and sometimes even physicians suggest their application.Methods: In the article, the authors present results of a neutralization method efficiency of selected pathogens using selected bio-resonance method. The verification of the method was conducted with usage of a constructed generator. The generator strictly realized a signal described in the literature associated with the bio-resonance topic. The authors carried out tests in in- vitro laboratory conditions on material including both clinical and reference strains of both bacteria and fungi.Results: According analysis of 24 test series of the bacterial and the fungi strains, the samples treated with the generator did not show a significant decrease of the pathogen population in relation to the comparative samples. Generally accepted standards in microbiology, describes a significant reduction of the pathogen population appears when the population size decrease at least about one order of magnitude in relation to the comparative samples.Conclusions: As a result of the tests, the ineffectiveness of the tested method was demonstrated. This is an important result because this method is considered as effective in many environments, and patients based on this fact, often give up conventional treatment.
Do second-line oral antidiabetic drugs have different long-term effects on persons with young-onset type 2 diabetes? ---A nationwide population base cohort study
Authors: Yen Fu-Shun , Wei James Cheng-Chung , Liu Jia-Sin , Hsu Chih-Cheng , Hwu Chii-Min 
Published: August 2020

Abstract
Background: People with young-onset diabetes (YOD) exhibit a higher risk of morbidity and mortality than those with late-onset diabetes. Few studies have explored the preferred management of diabetes in such patients; therefore, we compared the risks of hospitalization and mortality among people with YOD to whom second-line oral antidiabetic drugs (OADs) were administered.Methods: We conducted a nationwide cohort study using the National Health Insurance Research Database (Taiwan). A total of 7257 people taking second-line OADs after initial metformin therapy were enrolled during 2009–2014. Using add-on sulfonylureas (SUs) as a reference, the multivariable Cox regression model was used to compare the risks of hospitalization and mortality among 5 categories of second-line OADs: alpha-glucosidase inhibitors, meglitinide, dipeptidyl peptidase-4 (DPP-4) inhibitors, SUs, and thiazolidinediones.Results: The mean age of patients, duration of diabetes, and follow-up period were 31.6, 3.3, and 1.9 years, respectively. After baseline characteristics, comorbidities, duration of diabetes, and cardiovascular drug use were controlled, the adjusted hazard ratios and 95% confidence interval for all-cause, cardiovascular, and non-infection hospitalization and all-cause mortality for metformin plus DPP-4 inhibitors were 0.62 (0.52–0.73), 0.49 (0.29–0.85), 0.64 (0.54–0.76), and 0.50 (0.27–0.92), respectively, when compared with the data for metformin plus SUs.Conclusions: We found that among people with YOD, taking add-on DPP-4 inhibitors was associated with lower risks of all-cause hospitalization and mortality than taking add-on SUs. DPP-4 inhibitors thus seem to be a suitable second-line OAD for such patients.Trial registration: retrospectively registered
STAU2 Protein Level is Controlled by Caspases and the CHK1 Pathway and Regulates Cell Cycle Progression in the Non-transformed hTERT-RPE1 Cells
Authors: Conde Lionel , Beaujois Remy , DesGroseillers Luc 
Published: August 2020

Abstract
Background: Staufen2 (STAU2) is an RNA binding protein involved in the posttranscriptional regulation of gene expression. In neurons, STAU2 is required to maintain the balance between differentiation and proliferation of neural stem cells through asymmetric cell division. However, the importance of controlling STAU2 expression for cell cycle progression is not clear in non-neuronal dividing cells. We recently showed that STAU2 transcription is inhibited in response to DNA-damage due to E2F1 displacement from the STAU2 gene promoter. We now study the regulation of STAU2 steady-state levels in unstressed cells and its consequence for cell proliferation. Results: CRISPR/Cas9-mediated and RNAi-dependent STAU2 depletion in the non-transformed hTERT-RPE1 cells both facilitate cell proliferation suggesting that STAU2 expression influences pathway(s) linked to cell cycle controls. Such effects are not observed in the CRISPR STAU2-KO cancer HCT116 cells nor in the STAU2-RNAi-depleted HeLa cells. Interestingly, a physiological decrease in the steady-state level of STAU2 is controlled by caspases. This effect of peptidases is counterbalanced by the activity of the CHK1 pathway suggesting that STAU2 partial degradation/stabilization fines tune cell cycle progression in unstressed cells. A large-scale proteomic analysis using STAU2/biotinylase fusion protein identifies known STAU2 interactors involved in RNA translation, localization, splicing, or decay confirming the role of STAU2 in the posttranscriptional regulation of gene expression. In addition, several proteins found in the nucleolus, including proteins of the ribosome biogenesis pathway and of the DNA damage response, are found in close proximity to STAU2. Strikingly, many of these proteins are linked to the kinase CHK1 pathway, reinforcing the link between STAU2 functions and the CHK1 pathway. Indeed, inhibition of the CHK1 pathway dissociates STAU1 from proteins involved in translation and RNA metabolism. Conclusions: These results indicate that STAU2 is involved in pathway(s) that control(s) cell proliferation, likely via mechanisms of posttranscriptional regulation, ribonucleoprotein complex assembly, genome integrity and/or checkpoint controls. This novel function of STAU2 is regulated by caspases and by the kinase CHK1 pathway.
Clinical Signs Associated With Earlier Diagnosis of Children With Autism Spectrum Disorder
Authors: Sicherman Nachum , Charite Jimmy , Eyal Gil , Janecka Magdalena , Loewenstein George , Law Kiely , Lipkin Paul H. , Marvin Alison R. , Buxbaum Joseph D. 
Published: August 2020

Abstract
Background: The objective of this study is to gain new insights into the relationship between clinical signs and age at diagnosis. Method: We utilize a new, large, online survey of parents of children diagnosed with ASD, and use multiple statistical approaches. Results: We find that clinical signs that most strongly predict early diagnosis are not necessarily specific to autism, but rather those that initiate the process that eventually leads to an ASD diagnosis. Given the high correlations between symptoms, only a few signs are found to be important in predicting early diagnosis. For several clinical signs we find that their presence and intensity are positively correlated with delayed diagnosis (e.g., tantrums and aggression). Even though our data are drawn from parents’ retrospective accounts, we provide evidence that parental recall bias and/or hindsight bias did not play a significant role in shaping our results. Conclusion: In the subset of children without early deficits in communication, diagnosis is delayed, and this might be improved if more attention will be given to clinical signs that are not necessarily considered as ASD symptoms. Our findings also suggest that careful attention should be paid to children showing excessive tantrums or aggression, as these behaviors may interfere with an early ASD diagnoses.
Development and structural characterization of a two-MAb cocktail for delayed treatment of enterovirus D68 infections
Authors: Huang Zhong , Zhang Chao , Xu Cong , Dai Wenlong , Wang Yifan , Liu Zhi , Zhang Xueyang , Wang Xuesong , Gong Sitang , Cong Yao 
Published: August 2020

Abstract
Enterovirus D68 (EV-D68) is an emerging pathogen associated with respiratory diseases and/or acute flaccid myelitis. Here, two MAbs, 2H12 and 8F12, raised against EV-D68 virus-like particle (VLP), showed distinct preference in binding VLP and virion and in neutralizing different strains. The 2H12/8F12 cocktail exhibited balanced and potent neutralization effects and conferred broader protection in mice than single MAbs when given at onset of symptoms. Cryo-EM structures of EV-D68 virion complexed with 2H12 or 8F12 showed that both antibodies bind to south rim of the canyon and obscure the canyon, blocking virus–cell binding. Additionally, 2H12 binding could partially impair virions and trigger uncoating, resulting in premature viral RNA release. We also captured an uncoating intermediate induced by 2H12 binding, not detected before in picornaviruses. Our study elucidates neutralizing mechanisms of the MAbs and supports further development of the 2H12/8F12 cocktail as a broad-spectrum therapeutic agent against EV-D68 infections in humans.