bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient Outcomes With Prevented vs Negative Clostridioides difficile Tests Using a Computerized Clinical Decision Support Tool
Authors: Madden Gregory R , Enfield Kyle B , Sifri Costi D 
Published: March 2020

Abstract

Background
Overtesting and overdiagnosis of Clostridioides difficile infection are suspected to be common. Reducing inappropriate testing through interventions designed to promote evidence-based diagnostic testing (ie, diagnostic stewardship) may improve C. difficile test utilization. However, the safety of these interventions is not well understood despite the potential risk for missed or delayed diagnoses.

Methods
This retrospective case–control study examined the outcomes of patients admitted to the University of Virginia Medical Center following introduction of a computerized clinical decision support tool without hard-stops designed to reduce inappropriate tests. Outcomes were compared between patients with a prevented C. difficile nucleic acid amplification test and those with a negative result. Chart reviews were performed for patients with a subsequent positive within 7 days, as well as those patients who received C. difficile–active antibiotics after implementation of the computerized clinical decision support tool.

Results
Multivariate analysis of 637 cases (490 negative, 147 prevented) showed that a prevented test was not significantly associated with the primary composite outcome (inpatient mortality or intensive care unit transfer) compared with a negative test (adjusted odds ratio, 0.912; P = .747). Fifty-four of 147 (37%) prevented tests were followed by a completed test within 7 days; 11 of these results were positive, resulting in a potential delay in diagnosis. Individual case reviews found that either clinical changes warranted the delay in testing or no adverse events occurred attributable to C. difficile infection. C. difficile treatment without a positive test was not identified.

Conclusions
Diagnostic stewardship of C. difficile testing using computerized clinical decision support may be both safe and effective for reducing inappropriate inpatient testing.
Evolutionary History and Activity of RNase H1-Like Proteins in Arabidopsis thaliana
Authors: Kuciński Jan , Chamera Sebastian , Kmera Aleksandra , Rowley M Jordan , Fujii Sho , Khurana Pragya , Nowotny Marcin , Wierzbicki Andrzej T 
Published: March 2020

Abstract
RNase H1 is an endonuclease specific toward the RNA strand of RNA:DNA hybrids. Members of this protein family are present in most living organisms and are essential for removing RNA that base pairs with DNA. It prevents detrimental effects of RNA:DNA hybrids and is involved in several biological processes. Arabidopsis thaliana has been previously shown to contain three genes encoding RNase H1 proteins that localize to three distinct cellular compartments. We show that these genes originate from two gene duplication events. One occurred in the common ancestor of dicots and produced nuclear and organellar RNase H1 paralogs. Second duplication occurred in the common ancestor of Brassicaceae and produced mitochondrial- and plastid-localized proteins. These proteins have the canonical RNase H1 activity, which requires at least four ribonucleotides for endonucleolytic digestion. Analysis of mutants in the RNase H1 genes revealed that the nuclear RNH1A and mitochondrial RNH1B are dispensable for development under normal growth conditions. However, the presence of at least one organellar RNase H1 (RNH1B or RNH1C) is required for embryonic development. The plastid-localized RNH1C affects plastid DNA copy number and sensitivity to replicative stress. Our results present the evolutionary history of RNH1 proteins in A. thaliana, demonstrate their canonical RNase H1 activity and indicate their role in early embryonic development.
Planktonic stages of the ecologically important sea urchin, Diadema africanum: larval performance under near future ocean conditions
Authors: Hernández José Carlos , Clemente Sabrina , García Eliseba , McAlister Justin S 
Published: March 2020

Abstract
Diadema africanum is a recently described sea urchin from the Eastern Atlantic archipelagos, and adults play a major ecological role mediating the transition between two alternative ecosystem states: macroalgal beds and urchin barrens. The aim of this study was to describe for the first time the egg characteristics, fertilization and larval development. To determine basic life-history characteristics for this species, we reared larvae through to metamorphic competence under an energy shortage experiment and temperature–pH experiments to characterize the morphological plasticity of larval responses to actual and future oceanic conditions. D. africanum produces eggs that are larger both in diameter (82.7 μm) and volume (0.30 nl) than the eggs of both Diadema antillarum (70.0 μm, 0.18 nl) and Diadema mexicanum (68.0 μm, 0.16 nl). Larval development is similar to other species within the Family Diadematidae, with a Echinopluteus transversus larval type morphology. The combined effects of the climate change-related environmental factors resulted in a reduction in fitness of D. africanum at the warmer limit of its thermal range when combined with low pH. Results suggest that the egg and larval life-history characteristics of D. africanum may have evolved to facilitate long-distance oceanic transport; however, near-future oceanic conditions may compromise larval survival.
The assessment of patients with the antiphospholipid antibody syndrome: where are we now?
Authors: Gaspar Pedro , Cohen Hannah , Isenberg David A 
Published: March 2020

Abstract
The antiphospholipid antibody syndrome (APS), a chronic autoimmune thrombophilia with an increased mortality and morbidity, has been recognized for more than three decades. Unlike other autoimmune rheumatic conditions such as systemic lupus erythematosus, myositis and Sjögren’s syndrome, relatively few attempts have been made to develop activity, damage or disease-specific quality of life indices for APS. In this review of the literature, we consider those attempts that have been made to develop assessment tools for patients with APS, but also reflect upon the nature of the condition, to discuss, in particular, whether an activity index is appropriate for this disease.
DOSE ASSESSMENT OF NATURAL TERRESTRIAL RADIONUCLIDES IN COMMONLY CONSUMED FOODS IN NORTH INDIA
Authors: Kaur Sarabjot , Maheshwari Poorvi , Mehra Rohit 
Published: March 2020

Abstract
The present study aimed to record natural radionuclide content in branded food samples representative of a typical North Indian diet. Forty samples of various food items falling into three categories namely, cereal grains, pulses and beverages were collected from the local markets of Punjab. The radiometric analysis was performed using NaI(Tl) scintillator detector. The activity concentrations ranged between 10 ± 1 and 20 ± 5 Bq kg−1 for 226Ra, Below Detectable Limit (BDL) and 10 ± 2 Bq kg−1 for 232Th and 440 ± 56 and 562 ± 70 Bq kg−1 for 40K. The radium equivalent (Raeq) varied from 55 Bq kg−1(corn) to 70 Bq kg−1 (tea) with an average of 62 Bq kg−1. Internal hazard index (HI) was also calculated (0.18–0.24), which was well below the prescribed threshold of one (24). Age-specific annual effective doses were estimated for infants, children and adults. Children were the most sensitive group of population to radionuclide doses from cereal grains. The annual effective doses were further used to calculate the lifetime cancer risk which exceeded the world average of 2.9$\times$10−4 (24). However, the overall results showed that the intake of these dietary products by the general public did not pose any serious health risk.
Factors Associated With Cannabis Use Among African American Nondaily Smokers
Authors: Rubenstein Dana , Aston Elizabeth R. , Nollen Nicole L. , Mayo Matthew S. , Brown Alexandra R. , Ahluwalia Jasjit S. 
Published: March 2020

Objectives:
Cannabis and tobacco dual use is a growing concern in the United States, especially among African Americans (AAs). Dual use increases nicotine dependence and poses negative health effects. Despite decreasing numbers of people who smoke daily, nondaily smokers (NDS) are increasing. Polytobacco use, including blunt use, is higher in AA NDS than AAs who smoke daily. This study examined factors associated with cannabis use among AA NDS.

Methods:
Adult AA NDS participated in a randomized controlled trial (n = 278) for smoking cessation. A subset of this sample (n = 262; mean age 48.2 years; 50% male) was analyzed to identify correlates of cannabis use. Logistic regression assessed the associations of demographic, smoking-related, and psychosocial variables with cannabis use.

Results:
Participants smoked cigarettes on an average of 18 days of the last 30 and used 4.5 cigarettes on smoking days. Of the participants analyzed, 38% used cannabis, including blunts (ie, cigars hollowed out filled with cannabis) at baseline. Cannabis use was associated with polytobacco product use not including blunts (odds ratio [OR] 2.11, 95% confidence interval [CI] 1.18–3.77, P = 0.012), depressive symptoms (OR 1.22, 95% CI 1.05–1.42, P = 0.011), and younger age (OR 0.97, 95% CI 0.94–0.99, P = 0.004).

Conclusions:
Rates of cannabis and tobacco dual use in our sample exceed national rates. Dual use poses harmful health effects that exceed the risk of either substance alone. Findings will inform future work in tailoring treatments to vulnerable groups of people who use both tobacco and cannabis.
Treatment of thrombotic antiphospholipid syndrome in adults and children
Authors: Madison Jacqueline A. , Duarte-García Alí , Zuo Yu , Knight Jason S. 
Published: March 2020

Purpose of review
Antiphospholipid syndrome (APS), more common than once believed, is an autoimmune disease best known for its high risk of incident and recurrent thrombotic events. The approach to treatment potentially differs from treatment of thrombosis in the general population, and this article endeavors to review the latest updates on this topic.

Recent findings
The epidemiology of APS is being increasingly elucidated by large population-based studies, with APS perhaps affecting as many as 1 in 2000 individuals. Vitamin K antagonists, aspirin, and heparinoids continue to have obvious roles in the management of patients with APS. There has recently been intensive study of direct oral anticoagulants in APS, with the most recent randomized studies raising concerns about their inferiority to vitamin K antagonists, at least in some subgroups. Other approaches to treating APS beyond anticoagulants and antiaggregants are also receiving increased attention in mechanistic and preclinical studies with an eye toward future roles in patients with refractory and/or microvascular disease. Pediatric APS is identified as an area in desperate need of additional prospective research.

Summary
Progress continues to be made in pursuit of improving the lives of individuals afflicted with APS. The most important future directions would seem to involve leveraging modern molecular technologies in order to improve subphenotyping of antiphospholipid antibody-positive individuals. This will help personalize risk profiles and ideally define the optimal approach to therapy based on future risk, rather than past morbid events.
Segmental Flexibility in Adolescent Idiopathic Scoliosis Assessed Using the Fulcrum-bending Radiography Method
Authors: Kawasaki Sachiko , Shigematsu Hideki , Tanaka Masato , Okuda Akinori , Masuda Keisuke , Yamamoto Yusuke , Tanaka Yasuhito 
Published: March 2020

Introduction:
Assessment of segmental flexibility at each disk level of the scoliotic curve in patients with adolescent idiopathic scoliosis (AIS) has rarely been performed, despite its importance for surgical planning of fusion levels. The fulcrum-bending radiography method could be used to assess flexibility at specific spinal segments of the scoliotic curve for preoperative planning. Therefore, our aim was to use the fulcrum-bending method to evaluate the pattern of segmental flexibility in patients with AIS.

Materials and Methods:
Our retrospective analysis was based on preoperative fulcrum-bending radiographs in 21 patients presenting with main thoracic curve scoliosis. The apex vertebra was defined as the “0” level, with the sequential cranial disk levels defined as “+1 to +5” and the sequential caudal levels as “−1 to −5.” The segmental Cobb angle was measured on both, standing and fulcrum-bending radiographs. The segmental flexibility index (FI) was calculated as: [(the segmental Cobb angle in standing position−the segmental Cobb angle in the fulcrum-bending position)/the segmental Cobb angle in standing position]×100. The FI was measured from the upper-most to the lower-most end vertebrae of the main curve.

Results:
There was a significant difference in the FI among segments, with the greatest flexibility detected at the level of the −5 disk (median FI, 50%) and least flexibility at the periapical segments (+1 and −1; FI, 50%–66.7%).

Conclusions:
The curve around the apex and upper thoracic segments in thoracic AIS is relatively rigid. Understanding differences in FI between each disk level is important for optimal corrective surgery.
Human Umbilical Cord-Derived Mesenchymal Stem Cells for Acute Respiratory Distress Syndrome
Authors: Yip Hon-Kan , Fang Wen-Feng , Li Yi-Chen , Lee Fan-Yen , Lee Chen-Hsiang , Pei Sung-Nan , Ma Ming-Chun , Chen Kuan-Hung , Sung Pei-Hsun , Lee Mel S. 
Published: March 2020

Objectives:
To investigate the safety, feasibility, and possible adverse events of single-dose human umbilical cord-derived mesenchymal stem cells in patients with moderate-to-severe acute respiratory distress syndrome.

Design:
Prospective phase I clinical trial.

Setting:
Medical center in Kaohsiung, Taiwan.

Patients:
Moderate-to-severe acute respiratory distress syndrome with a Pao
2/Fio
2 ratio less than 200.

Interventions:
Scaling for doses was required by Taiwan Food and Drug Administration as follows: the first three patients received low-dose human umbilical cord-derived mesenchymal stem cells (1.0 × 106 cells/kg), the next three patients with intermediate dose (5.0 × 106 cells/kg), and the final three patients with high dose (1.0 × 107 cells/kg) between December 2017 and August 2019.

Measurements and Main Results:
Nine consecutive patients were enrolled into the study. In-hospital mortality was 33.3% (3/9), including two with recurrent septic shock and one with ventilator-induced severe pneumomediastinum and subcutaneous emphysema. No serious prespecified cell infusion-associated or treatment-related adverse events was identified in any patient. Serial flow-cytometric analyses of circulating inflammatory biomarkers (CD14+CD33+/CD11b+CD16+/CD16+MPO+/CD11b+MPO+/CD14dimCD33+) and mesenchymal stem cell markers (CD26+CD45–/CD29+CD45–/CD34+CD45–/CD44+CD45–/CD73+CD45–/CD90+CD45–/CD105+CD45–/CD26+CD45–) were notably progressively reduced (p for trend < 0.001), whereas the immune cell markers (Helper-T-cellCD3+CD4+/Cytotoxity-T-cellCD3+CD8+/Regulatory-T-cellCD4+CD25+FOXp3+) were notably increased (p for trend < 0.001) after cell infusion.

Conclusions:
The result of this phase I clinical trial showed that a single-dose IV infusion of human umbilical cord-derived mesenchymal stem cells was safe with favorable outcome in nine acute respiratory distress syndrome patients.
Prediction of Symptomatic Venous Thromboembolism in Critically Ill Patients: The ICU-Venous Thromboembolism Score*
Authors: Viarasilpa Tanuwong , Panyavachiraporn Nicha , Marashi Seyed Mani , Van Harn Meredith , Kowalski Robert G. , Mayer Stephan A. 
Published: March 2020

Objectives:
To identify risk factors and develop a prediction score for in-hospital symptomatic venous thromboembolism in critically ill patients.

Design:
Retrospective cohort study.

Setting:
Henry Ford Health System, a five-hospital system including 18 ICUs.

Patients:
We obtained data from the electronic medical record of all adult patients admitted to any ICU (total 264 beds) between January 2015 and March 2018.

Interventions:
None.

Measurements and Main Results:
Symptomatic venous thromboembolism was defined as deep vein thrombosis, pulmonary embolism, or both, diagnosed greater than 24 hours after ICU admission and confirmed by ultrasound, CT, or nuclear medicine imaging. A prediction score (the ICU-Venous Thromboembolism score) was derived from independent risk factors identified using multivariable logistic regression. Of 37,050 patients who met the eligibility criteria, 529 patients (1.4%) developed symptomatic venous thromboembolism. The ICU-Venous Thromboembolism score consists of six independent predictors: central venous catheterization (5 points), immobilization greater than or equal to 4 days (4 points), prior history of venous thromboembolism (4 points), mechanical ventilation (2 points), lowest hemoglobin during hospitalization greater than or equal to 9 g/dL (2 points), and platelet count at admission greater than 250,000/μL (1 point). Patients with a score of 0–8 (76% of the sample) had a low (0.3%) risk of venous thromboembolism; those with a score of 9–14 (22%) had an intermediate (3.6%) risk of venous thromboembolism (hazard ratio, 6.7; 95% CI, 5.3–8.4); and those with a score of 15–18 (2%) had a high (17.7%) risk of venous thromboembolism (hazard ratio, 28.1; 95% CI, 21.7–36.5). The overall C-statistic of the model was 0.87 (95% CI, 0.85–0.88).

Conclusions:
Clinically diagnosed symptomatic venous thromboembolism occurred in 1.4% of this large population of ICU patients with high adherence to chemoprophylaxis. Central venous catheterization and immobilization are potentially modifiable risk factors for venous thromboembolism. The ICU-Venous Thromboembolism score can identify patients at increased risk for venous thromboembolism.
Advancements in medical and surgical treatments of Takayasu arteritis-induced renal arteritis: a systematic review
Authors: Dai Xiao-Min , Yin Meng-Meng , Liu Yun , Ma Li-Li , Ying Jun , Jiang Lin-Di 
Published: March 2020

AbstractBackgroundTakayasu arteritis-induced renal arteritis (TARA), commonly seen in Takayasu arteritis (TA), has become one of the main causes of poor prognosis and early mortality in patients with TA. TARA progressing into Takayasu arteritis-induced renal artery stenosis (TARAS), could lead to severe complications including malignant hypertension, cardiac-cerebral vascular disease, and ischemic nephropathy. Since there existed no guidelines on treatments, this study aimed to review the comprehensive treatments for TARA.MethodsWe searched systematically in databases including PubMed, Ovid-Medline, EMBASE, Web of Science, China National Knowledge Infrastructure, Wanfang, and SinoMed, from inception to May 2018. Literature selection, data extraction, and statistical analysis were performed.ResultsEighty-two literatures were recruited focusing on medical treatments (n = 34) and surgical treatments (n = 48). We found that combined medical treatments of glucocorticoids and conventional synthetic disease-modifying anti-rheumatic drugs could reach high rates of remission in patients with TARA, and biological disease-modifying anti-rheumatic drugs were preferred for refractory patients. After remission induction, surgical treatment could help reconstruct renal artery and recover renal function partly. Percutaneous transluminal angioplasty was the first choice for patients with TARAS, while open surgery showed a good long-term survival.ConclusionsPatients with TARA should benefit both from medical treatments and from surgical treatments comprehensively and sequentially. Multidisciplinary team coordination is recommended especially in patients with severe complications.
Effect of KIF22 on promoting proliferation and migration of gastric cancer cells via MAPK-ERK pathways
Authors: Yu Ze-Yuan , Jiang Xiang-Yan , Zhao Rong-Rong , Qin Jun-Jie , Luo Chang-Jiang , Ren Yan-Xian , Ren Wen , Ma Zhi-Jian , Jiao Zuo-Yi 
Published: March 2020

Abstract

Background
Gastric cancer (GC) is one of the most globally prevalent cancers in the world. The pathogenesis of GC has not been fully elucidated, and there still lacks effective targeted therapeutics. The influence of altered kinesin superfamily protein 22 (KIF22) expression in GC progression is still unclearly. The aim of this study was to investigate the KIF22 effects on GC and related mechanisms.

Methods
Gastric carcinoma tissues and matching non-cancerous tissues were collected from patients with GC who have accepted a radical gastrectomy in Lanzhou University Second Hospital from May 2013 to December 2014. The expression of KIF22 was examined in GC of 67 patients and 20 para-carcinoma tissues by immunochemical staining. The relationship between the expression of KIF22 and clinicopathologic characteristics was next investigated in the remaining 52 patients except for 15 patients who did not complete follow-up for 5 years. Cell viability was performed via 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) test and colony formation assay in the MGC-803 and BGC-823 GC cells. Cell scratch and trans-well invasion assay was performed to assess migration ability in the MGC-803 and BGC-823 GC cells. Gene set enrichment analysis (GSEA) pathway enrichment analysis was performed to explore the potential functions. Cell cycle was detected by flow cytometry. In addition, the two GC cell lines were used to elucidate the underlying mechanism of KIF22 in GC in vitro via assessing the effects on mitogen-activated protein kinase and extracellular regulated protein kinases (MAPK/ERK) signal transduction pathway-related expressions by Western blotting assays. The differences were compared by t tests, one-way analysis of variance, and Chi-squared tests.

Results
The study showed that KIF22 was up-regulated in GC, and KIF22 high expression was significantly related to differentiation degree (χ
2 = 12.842, P = 0.002) and poorly overall survivals. GSEA pathway enrichment analysis showed that KIF22 was correlated with the cell cycle. Silence of KIF22 decreased the ability of the proliferation and migration in gastric cells, induced G1/S phase cell cycle arrest via regulating the MAPK-ERK pathways.

Conclusions
KIF22 protein level was negatively correlated with prognosis. KIF22 knockdown might inhibit proliferation and metastasis of GC cells via the MAPK-ERK signaling pathway.
Chemokine-like factor-like MARVEL transmembrane domain-containing family in autoimmune diseases
Authors: Duan Hong-Ji , Li Xin-Yi , Liu Chang , Deng Xiao-Li 
Published: March 2020

AbstractThe chemokine-like factor (CKLF)-like MARVEL transmembrane domain-containing family (CMTM) is widely expressed in the immune system. Abnormal expression of CMTM is associated with the development of various diseases. This article summarizes the relevant research on the role of the CMTM family in immune disorders. This information will increase our understanding of pathogenesis and identify promising targets for the diagnosis and treatment of autoimmune diseases. The CMTM family is highly expressed in peripheral blood mononuclear cells. CKLF1 may be involved in the development of arthritis through its interaction with C-C chemokine receptor 4. CKLF1 is associated with the pathogenesis of lupus nephritis and psoriasis. Both CMTM4 and CMTM5 are associated with the pathogenesis of systemic lupus erythematosus. CMTM1, CMTM2, CMTM3, and CMTM6 play a role in rheumatoid arthritis, systemic sclerosis, Sjögren syndrome, and anti-phospholipid syndrome, respectively. The CMTM family has been implicated in various autoimmune diseases. Further research on the mechanism of the action of CMTM family members may lead to the development of new treatment strategies for autoimmune diseases.