bluuebunny/crossref_metadata_2025_split huggingface dataset:
Detection of choroidal neovascularisation in flat irregular pigment epithelial detachment in central serous chorioretinopathy using optical coherence tomography angiography: en-face image combined with cross-sectional image
Authors: Ryu So Jung , Lee Jong Sub , Lee Sang Hyup , Ahn Seong Joon , Lee Byung Ro 
Published: December 2020

Abstract
Background: This study investigated choroidal neovascularisation (CNV) in FIPED by two methods: en-face OCTA and cross-sectional OCTA. We intended to evaluate the incidence of CNV and compare the efficacy of each imaging modalities. Methods: We retrospectively studied OCT and OCTA images of 328 eyes with CSC. OCTA B-scans and macular cube scans were primarily reviewed for the detection of FIPED and CNV. En-face OCTA and cross-sectional OCTA with Angio-B view, which is an image that combines an OCT B-scan with a flow signal were analysed to evaluate the presence of CNV in FIPED. Results: Among 93 eyes of 88 patients with FIPED, CNV was observed in 23 eyes on en-face OCTA and 21 eyes on cross-sectional OCTA. There were eight discrepant cases, in which the findings were not consistent with that of cross sectional OCTA. Conclusions: The CNV and FIPED lesions were well detected on both cross-sectional and en-face OCTA. Integration of these two imaging modalities can further improve the efficacy of OCTA in differentiating CNV from FIPED lesion.
Association of Neuroimaging Markers of Cerebral Small Vessel Disease With Short-Term Outcomes in Patients With Minor Cerebrovascular Events
Authors: Chen Xuemei , Wang Lin , Jiang Junying , Gao Yuanyuan , Zhang Rui , Zhao Xiaoyuan , Shen Tingwen , Dai Qi , Li Junrong 
Published: December 2020

Abstract
Background: Increasing evidences have showed that neuroimaging markers of SVD can predict the short-term outcome of acute ischemic stroke (AIS).It is unclear that whether neuroimaging markers of SVD are also associated with short-term outcomes of minor cerebrovascular events. In the present study, we investigate neuroimaging markers of SVD in order to explore their roles in prediction of short-term outcome in patients with minor cerebrovascular events. Methods: Consecutive first-ever stroke patients (n=546) from the Affiliated Jiangning Hospital of Nanjing Medical University were enrolled. A total of 388 patients were enrolled according to minor cerebrovascular events definition（National Institutes of Health Stroke Scale Score≤3）and exclusion criteria. MRI scans were performed within seven days of stroke onset, and then neuroimaging markers of SVD including WMH, lacunes, cerebral microbleeds (CMB), and perivascular spaces (PVS) , SVD burden scores were assessed. We completed baseline characteristics and evaluated the relationships of short-term outcomes to SVD neuroimaging markers and SVD scores. The 90-day modified Rankin Scale (mRS) was thought as primary outcome and was dichotomized as good functional outcome (mRS 0-1) and poor outcome (mRS 2-6). Secondary outcomes were stroke progression and stroke recurrence. Results: Higher age, National Institutes of Health Stroke Scale (NIHSS) upon admission, lipoprotein-associated phospholipase A2 (LP-PLA2) and lacunes, Fazekas score were correlated with poor functional outcome (P<0.05), But after adjusting for confounding variables, among the neuroimaging markers of cerebral small vessel disease, only Fazekas score (OR, 1.343; 95% confidence interval, 1.020-1.770; P=0.036) was found to be associated with poor outcome at 90 days. Higher Fazekas and SVD scores were not associated with stroke progression or stroke recurrence. Conclusion: WMH can predict the poor functional outcome of minor cerebrovascular events. Adding other neuroimaging markers of SVD and total SVD burden score, however, does not improve the prediction, which indicated WMH can as neuroimaging markers for guiding the treatment of minor cerebrovascular events.
Anxiety and depression are risk factors for recurrent pregnancy loss: A nested case-control study
Authors: Wang Yanxia , Meng Zhaoyan , Pei Jianyin , Qian Liu , Mao Baohong , Li Yamei , Li Jing , Dai Zhirong , Cao Jianing , Zhang Chunhua , Chen Lina , Jin Yuxia , Yi Bin 
Published: December 2020

Abstract
Background: To evaluate the interaction of depression and anxiety with the development of recurrent pregnancy loss (RPL).Methods: A nested case–control study involving 2,558 participants was conducted with data from the prospective Miscarriage Woman Cohort study between 2017 and 2019 in the province of Gansu, China. The questionnaire data, self-rating anxiety scale and self-rating depression scale were collected after each participant’s first miscarriage. Information on RPL outcomes was obtained from the medical records within the subsequent two years. All patients diagosed RPL were recruited as cases whilst a randomly selected group of women with only one miscarriage in the past were recruited as controls. The logistic regression and the interaction effects between anxiety and depression and RPL were analysed.Results: The prevalence of anxiety (n=325, 28.7% vs. n=278, 19.5%) and depression symptoms (n=550, 48.6% vs. n=589, 41.3%) for the 1,132 RPL cases were higher than 1,426 non-RPL controls (P< 0.001). After adjusting for possible confounding variables, the odds ratio (OR) value, reflecting the multiplicative interaction, was 1.91 (95% CI: 1.50–2.44, P<0.001) for cases with both anxiety and depression symptoms compared with the non-RPL group. The relative excess risk of interaction value, reflecting the additive interaction between anxiety and depression to RPL was 1.15 (95% CI: 0.32–4.21). Moreover, the adjusted OR for RPL cases with mild anxiety and severe depression was 2.77 (95% CI:1.07-44.14, P<0.001) , for RPL cases with severe anxiety and mild depression was 4.23 (95% CI: 1.01–22.21, P<0.001), for RPL cases with severe anxiety and moderate depression was 4.34 (95% CI: 1.03–21.28, P<0.001) and for RPL cases with severe anxiety and severe depression was 5.95 (95% CI: 1.09–45.09, P<0.05).Conclusions: Either depression or anxiety alone could increase the risk of subsequent RPL. Anxiety and depression had a synergistic effect after the first miscarriage which increased the development of subsequent RPL disease.
Analysing the effectiveness of topical bleeding care following tooth extraction in patients receiving dual antiplatelet therapy-retrospective observational study
Authors: Lewandowski Bogumił , Myszka Aleksander , Migut Małgorzata , Czenczek-Lewandowska Ewelina , Brodowski Robert 
Published: December 2020

Abstract
Background Patients using antiplatelet drugs following infarctions, acute coronary syndrome (ACS) or stroke pose a significant clinical problem if it is necessary to perform surgery, including dental surgery, since they are at risk of prolonged or secondary post-extraction bleeding. Discontinuation of this therapy is associated with a high risk of serious thromboembolic complications. The purpose of this study was to assess the effectiveness of TachoSil fibrin-collagen patches in stopping and preventing of secondary post-extraction bleeding in patients undergoing chronic antiplatelet therapy.Methods The study was conducted through retrospective examination of the medical records of 153 patients using chronic antiplatelet therapy and those qualified for tooth extraction. The largest group comprised 74 patients using aspirin and clopidogrel as dual platelet antiaggregation therapy; in this group 75 tooth extractions were carried out. In all of the patients TachoSil fibrin-collagen patches and stiches were applied to the wounds resulting from tooth removal. Results Following tooth extraction, primary bleeding was stopped in all the patients and their wounds closed via coagulation within 20-30 minutes. In eight cases, accounting for 4.9% of the patients, secondary bleeding occurred and was successfully stopped only by applying a pressure dressing soaked in tranexamic acid. Secondary bleeding occurred in three patients on the second day and in five patients on the third day following tooth removal. Conclusion Topical application of TachoSil patches following tooth removal in patients using single or dual antiplatelet therapy effectively stopped bleeding and prevented secondary bleeding after tooth extraction.
Clinical profiles, Outcomes and Risk Factors among Type 2 Diabetic Inpatients with Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State: A Hospital-Based Analysis over a 6-Year Period
Authors: Wu Xiao-yan , She Dun-min , Wang Fang , Guo Gang , Li Ran , Fang Ping , Li Ling , Zhou Yun , Zhang Ke-qin , Xue Ying 
Published: December 2020

Abstract
Objective: Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are the two most common hyperglycemic emergencies (HEs) associated with diabetes mellitus. Individuals with HEs can present with combined features of DKA and HHS. The objective of this study is to assess the clinical characteristics, therapeutic outcomes, and associated predisposing factors of type 2 diabetic patients with isolated or combined HEs in China. Methods: We performed a retrospective analysis of 158 patients with type 2 diabetes (T2DM), complicated with DKA, HHS, or DKA combined with HHS (DKA-HHS) in Shanghai Tongji Hospital, China from 2010 to 2015. Admission clinical features, therapeutic approaches and treatment outcomes of those patients were extracted and analyzed.Results: Of the 158 patients with T2DM, 65 (41.1%) patients were DKA, 74 (46.8%) were HHS, and 19 (12.0%) were DKA-HHS. The most common precipitants were infections (111, 70.3%), newly diagnosed diabetes (28,17.7%) and non-compliance to medications (9, 5.7%). DKA patients were divided into mild, moderate and severe group, based on arterial blood gas. Spearman correlation analysis revealed that C-reaction protein (CRP) was positively correlated with severity of DKA, whereas age and fasting C peptide were inversely correlated with severity of DKA (P<0.05). The mortality was 10.8% (17/158) in total and 21.6% (16/74) in the HHS group, 5.9% (1/17) in DKA-HHS. Spearman correlation analysis indicated that death in patients with HHS was positively correlated to effective plasma osmolality (EPO), renal function indicators and hepatic enzymes, while inversely associated with the continuous subcutaneous insulin infusion (CSII) therapy. Logistic regression analysis suggested that elevated blood urea nitrogen (BUN) on admission was an independent predisposing factor of mortality in HHS, while CSII might be a protective factor for patients with HHS. Furthermore, the receiver-operating characteristic (ROC) curve analysis indicated that BUN had the largest area under the ROC curves for predicting death in patients with HHS.Conclusions: Our findings showed elevated CRP and decreased fasting C-peptide might serve as indicator for severe DKA. Elevated BUN might be an independent predictor of mortality in patients with HHS, whereas CSII might be a protective factor against death in HHS.
[18F]-Fluciclovine PET discrimination of recurrent intracranial metastatic disease from radiation necrosis
Authors: Parent Ephraim Edward , Patel Dhruv , Nye Jonathon A , Zhuo Li , Olson Jeffrey , Schuster David , Goodman Mark 
Published: December 2020

Abstract
Background Stereotactic radiosurgery (SRS) is often the primary treatment modality for patients with intracranial metastatic disease. Despite advances in magnetic resonance imaging, including use of perfusion and diffusion sequences and molecular imaging, distinguishing radiation necrosis from progressive tumor remains a diagnostic and clinical challenge. We investigated the sensitivity and specificity of 18F-fluciclovine PET to accurately distinguish radiation necrosis from recurrent intracranial metastatic disease in patients who had previously undergone SRS. Methods Fluciclovine PET imaging was performed in 8 patients with a total of 15 lesions that had previously undergone SRS and had subsequent MRI and clinical features suspicious for recurrent disease. The SUVmax of each lesion and the contralateral normal brain parenchyma were summated and evaluated at 4 different time points (5 minutes, 10 minutes, 30 minutes, and 55 minutes). Lesions were characterized as either recurrent disease (11 of 15 lesions) or radiation necrosis (4 of 15 lesions) and confirmed with histopathological correlation (7 lesions) or through serial MRI studies (8 lesions). Results Time activity curve analysis found statistically greater radiotracer accumulation for all lesions, including radiation necrosis, when compared to contralateral normal brain. While the mean and median SUVmax for recurrent disease was statistically greater than that of radiation necrosis at all time points, the difference was more significant at the earlier time points (p = 0.004 at 5 min – 0.025 at 55 min). Using a SUVmax threshold of ≥1.3, fluciclovine PET demonstrated a 100% accuracy in distinguishing recurrent disease from radiation necrosis up to 30 minutes after injection and an accuracy of 87% (sensitivity = 0.91, specificity = 0.75) at the last time point of 55 minutes. However, tumor to brain ratios (TBRmax) were not significantly different between recurrent disease and radiation necrosis at any time point due to variable levels of fluciclovine uptake in the background brain parenchyma. Conclusions Fluciclovine PET may play an important role in distinguishing active intracranial metastatic lesions from radiation necrosis in patients previously treated with SRS but needs to be validated in larger studies.
Clinical utility of procalcitonin in febrile infants younger than 3 months of age visiting a pediatric emergency room: A retrospective single-center study.
Authors: park Jun Sung , Byun Young-Hoon , Lee Jeong-Yong , Lee Jong Seung , Ryu Jeong-Min , Choi Seung Jun 
Published: December 2020

Abstract
BackgroundFever in infants under 90 days of age is highly likely to be caused by a severe bacterial infection (SBI) and it accounts for a large number of patients visiting the pediatric emergency room. In order to predict the presence of a bacterial infection and reduce unnecessary inpatient treatment, the classic classification system is based on crude white blood cell (WBC) count, urinalysis, and x-ray, and it is modified and applied at each center incorporating recently studied biomarkers such as c-reactive protein (CRP) or procalcitonin (PCT). This study analyzed the usefulness of PCT in predicting SBI when applied along with the existing classification system, including CRP, among infants less than 90 days old who visited the hospital with a fever at a single institution pediatric emergency center.MethodsWe retrospectively reviewed the medical records of patients younger than 3 months of age who presented with fever at the Seoul Asan Medical Center pediatric emergency room between July 2017 and October 2018.ResultsA total of 317 patients were analyzed, and 61 were diagnosed with SBI, of which urinary tract infection (UTI) accounted for the largest proportion (55/61, 90.2%). There were differences in WBC, neutrophil proportion, CRP, and PCT between the SBI group and the non-SBI group, and the AUC values of WBC, CRP, and PCT were 0.651, 0.804, and 0.746, respectively. When using the cutoff values of CRP and PCTs as 2.0 mg/dL and 0.3 ng/mL, respectively, the sensitivity and specificity for SBI were 49.2/89.5, and 54.1/87.5, respectively. WBC, CRP, and PCT were statistically significant for predicting SBI in multivariate analysis (odds ratios 1.066, 1.377, and 1.291, respectively). When the subjects were classified using the existing classification criteria, WBC and CRP, the positive predictive value (PPV) and negative predictive value (NPV) were 29.3% and 88.7%, respectively, and when PCT was added, the PPV and NPV were 30.7% and 92%, respectively, both increased.ConclusionPCT is useful for predicting SBI in children aged 3 months or less who visit the emergency room with a fever. Combining PCT with traditional biomarkers (WBC and CRP) may help increase the diagnostic accuracy.
Transcriptional expression of secondary resistance genes ccdB and repA2 is enhanced in presence of cephalosporin and carbapenem in Escherichia coli
Authors: Baishya Somorita , Deshamukhya Chandrayee , Wangkheimayum Jayalaxmi , Das Bhaskar Jyoti , Anbarasu Anand , Talukdar Anupam Das , Bhattacharjee Amitabha , Choudhury Manabendra Dutta 
Published: December 2020

Abstract
Background: The issue of carbapenem resistance in E.coli is very concerning and it is speculated that cumulative effect of both primary resistance genes and secondary resistance genes that act as helper to the primary resistance genes are the reason behind their aggravation. Therefore, here we attempted to find the role of two secondary resistance genes (SRG) ccdB and repA2 in carbapenem resistance in E. coli (CRE).Methods: Influential genes belonging to secondary resistome that act as helper to the primary resistance genes like blaNDM and blaCTX-M in aggravating β-lactam resistance were selected from an earlier reported in silico study. Transcriptional expression of the selected genes in clinical isolates of E.coli that were discretely harboring blaNDM-1, blaNDM-4, blaNDM-5, blaNDM-7 and blaCTX-M-15 with and without carbapenem and cephalosporin stress (2µg/ml) was determined by real time PCR. Cured mutants sets that were lacking (i) primary resistance genes, (ii) secondary resistance genes and (iii) both primary and secondary resistance genes were prepared by SDS treatment. These sets were then subjected to antibiotic susceptibility testing by Kirby Bauer disc diffusion method.Results: Out of the 21 genes reported in the in silico study, 2 genes viz. repA2 and ccdB were selected for transcriptional expression analysis. repA2, coding replication regulatory protein, was downregulated in response to carbapenems and cephalosporins. ccdB, coding for plasmid maintenance protein, was also downregulated in response to carbapenems except imipenem and cephalosporins. Following plasmid elimination assay increase in diameter of zone of inhibition under stress of both antibiotics was observed as compared to uncured control hinting at the reversion of antibiotic susceptibility by the-then resistant bacteria. Conclusion: SRGs repA2 and ccdB help sustenance of blaNDM and blaCTX-M under carbapenem and cephalosporin stress.
Histone methyltransferase SETD1A participates in lung cancer progression
Authors: Du Mei , Gong Piping , Zhang Yun , Liu Yanguo , Liu Xiaozhen , Zhang Feng , Wang Xiuwen 
Published: December 2020

Abstract
Lung cancer is the leading cause of cancer-related death worldwide, with an estimated 1.2 million deaths each year. Despite advances in lung cancer treatment, 5-year survival rates are lower than ~15%, which is attributes to diagnosis limitations and current clinical drug resistance. Recently, more evidence has suggested that epigenome dysregulation is associated with the initiation and progress of cancer, and targeting epigenome-related molecules improves cancer symptoms. Interestingly, some groups reported that the level of methylation of histone 3 lysine 4 (H3K4me3) was increased in lung tumors and participated in abnormal transcriptional regulation. However, a mechanistic analysis is not available. In this report, we found that the SET domain containing 1A (SETD1A), the enzyme for H3K4me3, was elevated in lung cancer tissue compared to normal lung tissue. Knockdown of SETD1A in A549 and H1299 cells led to defects in cell proliferation and epithelial-mesenchymal transition (EMT), as evidenced by inhibited WNT and TGFβ pathways, compared with the control group. Xenograft assays also revealed a decreased tumor growth and EMT in the SETD1A silenced group compared with the control group. Mechanistic analysis suggested that SETD1A might regulate tumor progression via several critical oncogenes, which exhibited enhanced H3K4me3 levels around transcriptional start sites in lung cancer. This study illustrates the important role of SETD1A in lung cancer and provides a potential drug target for treatment.
Improvement of urinary tract symptoms and quality of life in Benign Prostate Hyperplasia patients, associated with consumption of a newly developed whole tomato-based food supplement. A phase II prospective, randomized double-blinded, placebo-controlled study.
Authors: Cormio Luigi , Calò Beppe , Falagario Ugo , Iezzi Manuela , Lamolinara Alessia , Vitaglione Paola , Silecchia Giovanni , Carrieri Giuseppe , Fogliano Vincenzo , Iacobelli Stefano , Natali Pier Giorgio , Piantelli Mauro 
Published: December 2020

Abstract
Background: Benign prostatic hyperplasia (BPH) is the most common urologic disease among elderly men. The diagnosis of BPH is usually driven by lower urinary tract symptoms (LUTS) that can significantly affect patients’ quality of life. This phase II prospective, randomized double-blinded, placebo-controlled study aimed to determine the efficacy and safety of a novel whole tomato-based food supplement on LUTS of patients diagnosed with BPH.Methods: Forty consecutive patients with histologically proved BPH were randomized 1:1 to receive daily for two months a sachet (5 grams) of a newly developed whole tomato food supplement (WTFS) (treatment=Group A) or placebo (Group B). Patients were asked to fill the International Prostatic Symptom Score questionnaire before and after treatment.Results: All but 1 patient in Group B successfully completed the scheduled regimen. No side effects were recorded. Unlike placebo, treatment significantly reduced (p<0.0002) LUTS since mean IPSS decreased from 9.05+1.15 SE to 7.15+1.04 SD (paired t-test, two-tailed p-value <0.001), and improved life quality (P < 0.0001) A trend toward a reduction of total PSA levels was observed in WTFS treated patients (8.98 ng/ml+1.52 SE vs 6.95+0.76 SE, P = 0.065), with changes being statistical significant only in the subgroup of patients with baseline levels above 10 ng/ml (18.5ng/ml+2.7vs. 10.3+2.1p= 0.009)Conclusions: The new WTFS may represent a valid option for the treatment of symptomatic BPH patients. Unlike pharmacological treatments, the supplement is side effects free and highly accepted among patients
Emergency Department Use by Patients with End-stage Renal Disease in the United States
Authors: Wang Ningyuan , Pei Jiao , Fan Hui , Ali Yaseen , Prushinskaya Anna , Zhao Jian , Zhang Xingyu 
Published: December 2020

Abstract
Background: We sought to describe the national characteristics of ED visits by patients with end-stage renal disease (ESRD) in the United States in order to improve the emergency treatment and screening of ESRD patients. Methods: We analyzed data from 2014-2016 ED visits provided by the National Hospital Ambulatory Medical Care Survey. We sampled adult (age ≥ 18 years) ED patients with ESRD. By proportion or means of weighted sample variables, we quantified annual ED visits by patients with ESRD. We investigated demographics, ED resource utilization, clinical characteristics, and disposition of patients with ESRD and compared these to those of patients without ESRD. Logistic regression models were used to estimate the association between these characteristics and ESRD ED visits. Results: Approximately 722,692 (7.78%) out of 92,899,685 annual ED visits represented ESRD patients. Males were more likely to be ESRD patients than females (aOR: 1.34; 95% CI: 1.09–1.66). Compare to whites, non-Hispanic Blacks were 2.55 times more likely to have ESRD (aOR: 2.55; 95% CI: 1.97 – 3.30), and Hispanics were 2.68 times more likely to have ESRD (95% CI: 1.95–3.69). ED patients with ESRD were more likely to be admitted to the hospital (aOR: 2.70 ; 95% CI: 2.13-3.41) and intensive care unit (ICU) (aOR: 2.21; 95% CI: 1.45-3.38) than patients without ESRD. ED patients with ESRD were more likely to receive blood tests and get radiology tests.Conclusion: We described the unique demographic, socioeconomic, and clinical characteristics of ED patients with ESRD, using the most comprehensive, nationally representative study to date. These patients’ higher hospital and ICU admission rates indicate that patients with ESRD require a higher level of emergency care.