bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of early renal angina index for prediction of subsequent severe acute kidney injury during septic shock in children
Authors: Huang Linlin , Shi Ting , Quan Wei , Li Weiming , Zhang Lili , Liu Xueping , Huang Saihu , Li Ying , Li Xiaozhong 
Published: August 2020

AbstractBackgroundAcute kidney injury (AKI) is independently related to the adverse outcome of septic shock, but it lacks effective early predictors. Renal anginal index (RAI) was used to predict subsequent severe AKI (AKIs) in critically ill patients. The application of RAI in children with septic shock has not been reported. This study aims to evaluate the efficacy of early RAI in predicting subsequent AKIs within 3 days after PICU admission in children with septic shock by comparing with early fluid overload (FO) and early creatinine elevation.MethodsSixty-six children admitted to PICU aged 1 month to 16 years old, with septic shock from January 2016 to December 2019 were analyzed retrospectively. According to the 2012 Kidney Disease Improving Global outcomes (KDIGO) criteria, AKIs was defined by the KDIGO stage ≥2 within 3 days after PICU admission. Early RAI positive (RAI+) was defined as RAI ≥ 8 within 12 h of PICU admission. Any elevation of serum creatinine (SCr) over baseline within 12 h after PICU admission was denoted as “Early SCr > base”. Early FO positive (FO+) was defined as FO > 10% within 24 h of PICU admission.ResultsOf 66 eligible cases, the ratio of early RAI+, early SCr > base, early FO+ was 57.57, 59.09 and 16.67% respectively. The incidence of AKIs in early RAI+ group (78.94%) was higher than that in early RAI- group (21.42%) (p = 0.04), and there was no significant difference compared with the early FO+ group (71.79%) and early SCr > base group (81.82%) (P > 0.05). After adjustment for confounders, early RAI+ was independently associated with the occurrence of AKIs within 3 days (OR 10.04, 95%CI 2.39–42.21,p < 0.01). The value of early RAI+ (AUC = 0.78) to identify patients at high risk of AKIs was superior to that of early SCr > base (AUC = 0.70) and early FO+ (AUC = 0.58). A combination of serum lactate with early RAI+ improved the predictive performance for assessing AKIs (AUC = 0.83).ConclusionsEarly RAI could be used as a more convenient and effective index to predict the risk of AKIs in children with septic shock within 3 days. Early RAI+ combined with serum lactate improved the predictive performance for assessing AKIs.
PRediction of acute coronary syndrome in acute ischemic StrokE (PRAISE) – protocol of a prospective, multicenter trial with central reading and predefined endpoints
Authors: Nolte Christian H. , von Rennenberg Regina , Litmeier Simon , Scheitz Jan F. , Leistner David M. , Blankenberg Stephan , Dichgans Martin , Katus Hugo , Petzold Gabor C. , Pieske Burkert , Regitz-Zagrosek Vera , Wegscheider Karl , Zeiher Andreas M. , Landmesser Ulf , Endres Matthias 
Published: August 2020

AbstractBackgroundCurrent guidelines recommend measurement of troponin in acute ischemic stroke (AIS) patients. In AIS patients, troponin elevation is associated with increased mortality and worse outcome. However, uncertainty remains regarding the underlying pathophysiology of troponin elevation after stroke, particularly regarding diagnostic and therapeutic consequences. Troponin elevation may be caused by coronary artery disease (CAD) and more precisely acute coronary syndrome (ACS). Both have a high prevalence in stroke patients and contribute to poor outcome. Therefore, better diagnostic algorithms are needed to identify those AIS patients likely to have ACS or other manifestations of CAD.Methods/designThe primary goal of the “PRediction of Acute coronary syndrome in acute Ischemic StrokE” (PRAISE) study is to develop a diagnostic algorithm for prediction of ACS in AIS patients. The primary hypothesis will test whether dynamic high-sensitivity troponin levels determined by repeat measurements (i.e., “rise or fall-pattern”) indicate presence of ACS when compared to stable (chronic) troponin elevation.PRAISE is a prospective, multicenter, observational trial with central reading and predefined endpoints guided by a steering committee. Clinical symptoms, troponin levels as well as findings on electrocardiogram, echocardiogram, and coronary angiogram will be recorded and assessed by central academic core laboratories. Diagnosis of ACS will be made by an endpoint adjudication committee. Severe adverse events will be evaluated by a critical event committee. Safety will be judged by a data and safety monitoring board. Follow-up will be conducted at three and twelve months and will record new vascular events (i.e., stroke and myocardial infarction) as well as death, functional and cognitive status.According to sample size calculation, 251 patients have to be included.DiscussionPRAISE will prospectively determine the frequency of ACS and characterize cardiac and coronary pathologies in a large, multicenter cohort of AIS patients with troponin elevation. The findings will elucidate the origin of troponin elevation, shed light on its impact on necessary diagnostic procedures and provide data on the safety and diagnostic yield of coronary angiography early after stroke. Thereby, PRAISE will help to refine algorithms and develop guidelines for the cardiac workup in AIS.Trial registrationNCT03609385registered 1st August 2018.
Comprehensive analysis of prognostic tumor microenvironment-related genes in osteosarcoma patients
Authors: Hu Chuan , Liu Chuan , Tian Shaoqi , Wang Yuanhe , Shen Rui , Rao Huili , Li Jianyi , Yang Xu , Chen Bo , Ye Lin 
Published: August 2020

AbstractBackgroundTumor microenvironment (TME) plays an important role in malignant tumors. Our study aimed to investigate the effect of the TME and related genes in osteosarcoma patients.MethodsGene expression profiles and clinical data of osteosarcoma patients were downloaded from the TARGET dataset. ESTIMATE algorithm was used to quantify the immune score. Then, the association between immune score and prognosis was studied. Afterward, a differential analysis was performed based on the high- and low-immune scores to determine TME-related genes. Additionally, Cox analyses were performed to construct two prognostic signatures for overall survival (OS) and disease-free survival (DFS), respectively. Two datasets obtained from the GEO database were used to validate signatures.ResultsEighty-five patients were included in our research. The survival analysis indicated that patients with higher immune score have a favorable OS and DFS. Moreover, 769 genes were determined as TME-related genes. The unsupervised clustering analysis revealed two clusters were significantly related to immune score and T cells CD4 memory fraction. In addition, two signatures were generated based on three and two TME-related genes, respectively. Both two signatures can significantly divide patients into low- and high-risk groups and were validated in two GEO datasets. Afterward, the risk score and metastatic status were identified as independent prognostic factors for both OS and DFS and two nomograms were generated. The C-indexes of OS nomogram and DFS nomogram were 0.791 and 0.711, respectively.ConclusionTME was associated with the prognosis of osteosarcoma patients. Prognostic models based on TME-related genes can effectively predict OS and DFS of osteosarcoma patients.
Tissue mechanics and expression of TROP2 in oral squamous cell carcinoma with varying differentiation
Authors: Zhang Baoping , Gao Shuting , Li Ruiping , Li Yiting , Cao Rui , Cheng Jingyang , Guo Yumeng , Wang Errui , Huang Ying , Zhang Kailiang 
Published: August 2020

Abstract
Background
Trophoblast cell surface antigen 2 (TROP2) is overexpressed in many squamous cell carcinomas and promotes tumor development and invasion. The association between TROP2 expression and occurrence and development of oral squamous cell carcinoma (OSCC) remains to be understood.

Methods
We investigated the role of TROP2 in OSCC patients using a combination of biophysical approaches. A total of 108 OSCC patient specimens with varying degrees of differentiation were subjected to hematoxylin and eosin staining, immunohistochemistry, Kaplan-Meier survival curve analysis, and atomic force microscopy to analyze TROP2 expression, morphology, and mechanical properties of OSCC tissues.

Results
TROP2 was overexpressed in 34% of poorly differentiated OSCC samples. High levels of TROP2 were associated with 10.2% survival rate lower than 45.4% and patient age (odds ratio [OR] = 0.437, P = 0.039, 95% confidence interval [CI, 0.198–0.966]), tumor size (OR = 13.148, P = 0.000, 95% CI [5.060–34.168]), and TNM stage (OR = 0.141, P = 0.000, 95% CI [0.082–0.244]). Average surface roughness of low, medium, and highly differentiated OSCC tissues were 448.9 ± 54.8, 792.7 ± 83.6, and 993.0 ± 104.3 nm, respectively. The Pearson coefficient revealed a negative association between tumor stiffness and TROP2 expression (r = − 0.84, P < 0.01).

Conclusion
Overexpression of TROP2 negatively associated with patient survival, degree of tumor differentiation, and tissue mechanics. Taken together, our findings demonstrated that TROP2 may be an indicator of OSCC differentiation leading to the altered mechanical properties of OSCC tissues.
DLBCL with amplification of JAK2/PD-L2 exhibits PMBCL-like CNA pattern and worse clinical outcome resembling those with MYD88 L265P mutation
Authors: Xue Xuemin , Huang Wenting , Qiu Tian , Guo Lei , Ying Jianming , Lv Ning 
Published: August 2020

Abstract
Background
Recently, copy number alteration (CNA) of 9p24.1 were demonstrated in 10% of diffuse large b-cell lymphoma (DLBCL), with gene expression and mutation profiles that were similar to those of primary mediastinal large B-cell lymphoma (PMBCL). However, their CNA-based profile and clinical impact still remain unclear.

Methods
Multiplex ligation-dependent probe amplification were employed to investigate the prevalence of JAK2/PD-L2 amplification in DLBCL and their CNA-based pattern of driver genes. The clinical outcome and characteristics were also analyzed.

Results
Using unsupervised hierarchical clustering, a small group of DLBCL (10.5%, 8/76) was clustered together with PMBCL as Cluster_2, demonstrating amplification of JAK2 (100%,8/8) and PD-L2 (75.0%,6/8). This subgroups of DLBCL demonstrated significant higher expression of PD-L1 than those with MYD88 L265P mutation(p = 0.024). And they exhibited dismal OS and PFS as compared with DLBCL_others(p = 0.003 and 0.001, respectively), which is similar to DLBCL with MYD88 L265P mutation.

Conclusions
DLBCL with amplification of JAK2/PD-L2 exhibits CNA pattern that is similar to PMBCL, and demonstrates unfavorable clinical outcome that resembles those with MYD88 L265P mutation. It is essential to identify this subgroup of DLBCL who may acquire more benefits from the JAK2 and PD-L1 signaling inhibition.
Bone impaction grafting with trabecular metal augments in large defects in young patients: unravelling a new perspective in surgical technique
Authors: De la Torre-Escuredo Basilio , Gómez-García Eva , Álvarez-Villar Salvador , Bujan Julia , Ortega Miguel A. 
Published: August 2020

Abstract
Background
Acetabular reconstruction with bone impaction grafting in large defects has yielded conflicting results.

Methods
This was a retrospective study of a case series of five patients with a young age (≤50 years) at the time of surgery who had large acetabular defects reconstructed by bone impaction grafting and trabecular metal augments. The mean follow-up was 79 months. We describe the surgical technique in detail.

Results
Improvement was significant on the WOMAC and SF-36 scales (p < 0.05). The radiographs taken at the last follow-up examination showed no migration of the polyethylene cup (p = 0.31) or differences in the abduction angle (p = 0.27) compared to the radiographs from the immediate postoperative period. One patient presented two dislocation episodes as a complication.

Conclusion
The combination of trabecular metal augments with the bone impaction grafting technique in young patients with large acetabular defects provides satisfactory results in the long term and restores the bone stock.
Role of norms in variation in cancer centers’ end-of-life quality: qualitative case study protocol
Authors: Knutzen Kristin E. , Schifferdecker Karen E. , Murray Genevra F. , Alam Shama S. , Brooks Gabriel A. , Kapadia Nirav S. , Butcher Rebecca , Barnato Amber E. 
Published: August 2020

AbstractBackgroundA critical barrier to improving the quality of end-of-life (EOL) cancer care is our lack of understanding of the mechanisms underlying variation in EOL treatment intensity. This study aims to fill this gap by identifying 1) organizational and provider practice norms at major US cancer centers, and 2) how these norms influence provider decision making heuristics and patient expectations for EOL care, particularly for minority patients with advanced cancer.MethodsThis is a multi-center, qualitative case study at six National Comprehensive Cancer Network (NCCN) and National Cancer Institute (NCI) Comprehensive Cancer Centers. We will theoretically sample centers based upon National Quality Forum (NQF) endorsed EOL quality metrics and demographics to ensure heterogeneity in EOL intensity and region. A multidisciplinary team of clinician and non-clinician researchers will conduct direct observations, semi-structured interviews, and artifact collection. Participants will include: 1) cancer center and clinical service line administrators; 2) providers from medical, surgical, and radiation oncology; palliative or supportive care; intensive care; hospital medicine; and emergency medicine who see patients with cancer and have high clinical practice volume or high local influence (provider interviews and observations); and 3) adult patients with metastatic solid tumors and whom the provider would not be surprised if they died in the next 12 months and their caregivers (patient and caregiver interviews). Leadership interviews will probe about EOL institutional norms and organization. We will observe inpatient and outpatient care for two weeks. Provider interviews will use vignettes to probe explicit and implicit motivations for treatment choices. Semi-structured interviews with patients near EOL, or their family members and caregivers will explore past, current, and future decisions related to their cancer care. We will import transcribed field notes and interviews into Dedoose software for qualitative data management and analysis, and we will develop and apply a deductive and inductive codebook to the data.DiscussionThis study aims to improve our understanding of organizational and provider practice norms pertinent to EOL care in U.S. cancer centers. This research will ultimately be used to inform a provider-oriented intervention to improve EOL care for racial and ethnic minority patients with advanced cancer.Trial registrationClinicaltrials.gov;NCT03780816; December 19, 2018.
Nutritional status impacts dengue virus infection in mice
Authors: Chuong Christina , Bates Tyler A. , Akter Shamima , Werre Stephen R. , LeRoith Tanya , Weger-Lucarelli James 
Published: August 2020

Abstract
Background
Dengue virus (DENV) is estimated to infect 390 million people annually. However, few host factors that alter disease severity are known. Malnutrition, defined as both over- and undernutrition, is a growing problem worldwide and has long been linked to dengue disease severity by epidemiological and anecdotal observations. Accordingly, we sought to establish a mouse model to assess the impact of nutritional status on DENV disease severity.

Results
Using transiently immunocompromised mice, we established a model of mild dengue disease with measurable viremia. We then applied it to study the effects of healthy weight, obese, and low-protein diets representing normal, over-, and undernutrition, respectively. Upon infection with DENV serotype 2, obese mice experienced more severe morbidity in the form of weight loss and thrombocytopenia compared to healthy weight groups. Additionally, obesity altered cytokine expression following DENV infection. Although low protein-fed mice did not lose significant weight after DENV2 infection, they also experienced a reduction in platelets as well as increased spleen pathology and viral titers.

Conclusions
Our results indicate that obese or undernourished mice incur greater disease severity after DENV infection. These studies establish a role for nutritional status in DENV disease severity.
Comparing stroke prevention therapy of direct oral anticoagulants and vitamin K antagonists in patients with atrial fibrillation: a nationwide retrospective observational study
Authors: Paschke Lena M. , Klimke Kerstin , Altiner Attila , von Stillfried Dominik , Schulz Maike 
Published: August 2020

AbstractBackgroundDirect oral anticoagulants (DOACs) are not only increasingly being used for the initial stroke prevention therapy but progressively also substitute vitamin K antagonist (VKA) treatment in patients with non-valvular atrial fibrillation (AF). DOACs have been compared regarding therapeutic efficacy and adverse outcomes to warfarin in several pivotal studies and showed non-inferiority in terms of stroke prevention and superiority in terms of bleeding complications. However, comprehensive comparative studies are lacking for phenprocoumon, a VKA prescribed frequently outside the USA and the UK and accounting for 99% of all VKA prescriptions in Germany. Patients treated with phenprocoumon seem to meet more often international normalized ratio values in the therapeutic range, which may have implications concerning their efficacy and safety. This study aims at comparing the risk of stroke and bleeding in phenprocoumon- and DOAC-treated patients with AF in an adequately powered observational study population.MethodsRetrospective analysis of stroke and bleeding incidence of 837,430 patients (1.27 million patient years) treated with DOAC or phenprocoumon for stroke prevention in German ambulatory care between 2010 and 2017. Relative risks of stroke and bleeding were estimated by calculating cox regression-derived hazard ratios (HR) and 95% confidence intervals (CI) of propensity score-matched cohorts.ResultsPatients treated with DOAC had an overall higher risk for stroke (HR 1.32; CI 1.29–1.35) and a lower risk for bleeding (0.89; 0.88–0.90) compared to phenprocoumon. When analyzed separately, the risk for stroke was higher for dabigatran (1.93; 1.82–2.03), apixaban (1.52; 1.46–1.58), and rivaroxaban (1.13; 1.10–1.17) but not for edoxaban (0.88; 0.74–1.05). The risk for bleeding was lower for dabigatran (0.85; 0.83–0.88), apixaban (0.71; 0.70–0.73), and edoxaban (0.74; 0.68–0.81) but not for rivaroxaban (1.03; 1.01–1.04).ConclusionsThis study provides a comprehensive view of the stroke and bleeding risks associated with phenprocoumon and DOAC use in Germany. Phenprocoumon may be preferable to DOAC treatment for the prevention of strokes in AF in a real-world population cared for in ambulatory care.
Clinical leishmaniosis in a captive Eurasian otter (Lutra lutra) in Spain: a case report
Authors: Cantos-Barreda Ana , Navarro Ricardo , Pardo-Marín Luis , Martínez-Subiela Silvia , Ortega Elena , Cerón José J. , Tecles Fernando , Escribano Damián 
Published: August 2020

Abstract
Background
Captive and free-ranging wild mammals have been recognized as potential reservoirs of Leishmania infantum infection. The aim of this study was to describe the first clinical case of leishmaniosis in the Eurasian otter.

Case presentation
A case of clinical leishmaniosis is reported in a 4-year-old male Eurasian otter housed at a wildlife park (Murcia, South Eastern Spain). The Eurasian otter showed bilateral epistaxis, anorexia, apathy, and weight loss. A complete blood cell count and biochemical analyses revealed hyperproteinemia, hyperglobulinemia, decreases of paraoxonase-1, increases of haptoglobin and ferritin, and proteinuria. Bilateral nephropathy with hydronephrosis, mesenteric lymphadenomegaly, and ascites were also observed. L. infantum infection was confirmed by microscopy (amastigotes were detected in macrophages from spleen aspirate), molecular diagnosis (L. infantum DNA was detected by real-time polymerase chain reaction), and serology (anti-Leishmania IgG2 antibodies were detected by time-resolved immunofluorometry). The animal was treated with allopurinol for 3 months and gained weight, the epistaxis disappeared, and the ferritin concentration decreased.

Conclusions
This is the first report of clinical leishmaniosis in the Eurasian otter. Our results suggest that Eurasian otters are susceptible to infection with L. infantum and can develop clinical leishmaniosis in endemic areas.
Crossed renal ectopia with fusion in a pelvic inlet area, atypical portal vein and coccygeal deformation in a young female cat
Authors: Hebel Mateusz , Ruszkowski Jakub Jędrzej , Giza Elżbieta , Pomorska-Mól Małgorzata 
Published: August 2020

Abstract
Background
The case report describes a rare congenital anomaly, crossed fused renal ectopia (CFRE), with coexistence of two other abnormalities – atypical portal vein and coccygeal vertebrae malformation in a domestic cat. The concomitance of those 3 congenital defects has not been described previously.

Case presentation
An 8-month-old female, domestic cat suffering from chronic diarrhea was referred to the diagnostic imaging unit. The patient showed no other clinical symptoms. An abdominal ultrasonographic examination was performed in order to evaluate the condition of abdominal organs, particularly the gastrointestinal tract. The ultrasound examination showed an ectopic duplex kidney at instead of kidneys in their typical location. Computed tomography (CT) with angiographic phase and excretory urography was requested to evaluate the condition of the kidneys and ureters. The final diagnosis was CFRE, atypical portal vein and coccygeal deformation in an asymptomatic cat with no changes in renal function and normal blood parameters.

Conclusions
Crossed fused renal ectopia is a rare congenital anomaly and is easily detectable by an abdominal ultrasonographic examination and CT, which allows more complete assessment of both anatomical relations and secretory function of the kidney. The occurrence of CFRE, abnormal portal vein and spinal malformation in a clinically healthy patient is the evidence that congenital malformations may simultaneously involve various, not directly related structures and systems, without significant influence on blood and urine parameters. Thus the most useful tool in the evaluation of the morphological and functional changes is the diagnostic imaging, especially contrast enhanced CT. Our results show that renal fusions should be considered in the differential diagnosis of caudal abdominal masses.