bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Clinical and Sociodemographic Factors on Fatigue Among Patients With Substance Use Disorder: A Cohort Study From Norway for The Period 2016-2020
Authors: Vold Jørn Henrik , Gjestad Rolf , Aas Christer F. , Chalabianloo Fatemeh , Skurtveit Svetlana , Løberg Else-Marie , Johansson Kjell Arne , Fadnes Lars Thore 
Published: September 2020

Abstract
Background The impact of clinical and sociodemographic factors on fatigue remains unknown among patients with substance use disorders (SUD). This study aims to evaluate fatigue among patients with SUD using a nine-item fatigue severity scale (FSS-9) and identify the impact that clinical and sociodemographic factors – such as injecting substance use, chronic infectious diseases, liver fibrosis, opioid agonist therapy (OAT), debt difficulties, and housing situation – have on fatigue.Methods We used data from a cohort of patients with SUD in Norway with annual health assessments surveying FSS-9 and some clinical and sociodemographic factors. A total of 915 FSS-9 measurements were collected from 654 patients during the period 2016-2020. We defined baseline as the first annual health assessment when the health assessments were listed chronologically. Time was defined as months from baseline. We used a linear mixed model to analyse whether the clinical and sociodemographic factors affected the FSS-9 sum score, presented with beta coefficients (β) with 95% confidence intervals (CI). Results The mean sum score of the FSS-9 was 43 (standard deviation: 16) at baseline. Being female (change in FSS-9 sum score: 4.1, 95 % CI: 1.3-7.0), having debt difficulties (2.9;0.4-5.3), and using benzodiazepines (5.7;3.0-8.4), amphetamine or cocaine (-5.0;-8.0--2.0) affected the FSS-9 sum score. The other clinical and sociodemographic factors did not predict any clinically relevant change in the FSS-9 sum score from baseline to the following health assessments.Conclusion Patients with SUD suffer from high levels of fatigue. Focusing on closer follow-up of females and reducing debt difficulties and the use of benzodiazepines may mitigate fatigue in the SUD population.
Diastolic Dysfunction and Impaired Cardiac Output Reserve in Dysmetabolic Nonhuman Primate With Proteinuria
Authors: Wikstrom Johannes , Liu Yongqiang , Whatling Carl , Gan Li-ming , Konings Peter , Mao Binchen , Zhang Chao , Ji Yanqin , Xiao Yong-Fu , Wang Yixin 
Published: September 2020

Abstract
Background Cardiorenal complications are common in patients with dysmetabolism and diabetes. The present study aimed to examine if a nonhuman primate (NHP) model with spontaneously developed metabolic disorder and diabetes develops similar complications to humans, such as proteinuria and cardiac dysfunction at resting condition or diminished cardiac functional reserve following dobutamine stress echocardiography (DSE).Methods and Results A total of 66 dysmetabolic and diabetic cynomolgus (Macaca fascicularis) NHPs were enrolled to select 19 NHPs (MetS) with marked metabolic disorders and diabetes (fasting blood glucose: 178+18 vs. 61+3 mg/dL) accompanied by proteinuria (ACR: 134+34 vs. 1.5+0.4 mg/mmol) compared to 8 normal NHPs (CTRL). Under resting condition, MetS NHPs showed mild left ventricular (LV) diastolic dysfunction (E/A: 1+0.06 vs. 1.5+0.13), but with preserved ejection fraction (EF: 65+2 vs. 71+3%) compared to CTRL. DSE with an intravenous infusion of dobutamine at ascending doses (5, 10, 20, 30 and 40 μg/kg/min, 7 min for each dose) resulted in a dose-dependent increase in cardiac function, however, with a significantly diminished magnitude at the highest dose of dobutamine infusion (40 μg/kg/min) in both diastole (E/A: -12+3 vs. -38+5%) and systole (EF: 25+3 vs. 33+5%) as well as ~42% reduced cardiac output reserve (COR: 63+8 vs. 105+18%, p<0.02) in the MetS compared to CTRL NHPs.Conclusion These data demonstrate that MetS NHPs with cardiorenal complications: proteinuria, LV diastolic dysfunction and preserved LV systolic function under resting conditions displayed compromised cardiac functional reserve under dobutamine stress. Based on these phenotypes, this NHP model of diabetes with cardiorenal complications can be used as a highly translational model mimic human disease for pharmaceutical research.
Nomogram Based on Preoperative CT Imaging Predicts The EGFR Mutation Status in Lung Adenocarcinoma
Authors: Zhang Guojin , zhang Jing , Cao Yuntai , Zhao Zhiyong , Li Shenglin , Deng Liangna , Zhou Junlin 
Published: September 2020

Abstract
Background: Tyrosine kinase inhibitors (TKIs) provide clinical benefits to the lung cancer patients with epidermal growth factor receptor (EGFR) mutations. However, non-invasively determine EGFR mutation status in patients before targeted therapy remains a challenge. This study aimed to develop and validate a nomogram for preoperative prediction of EGFR mutation status in patients with lung adenocarcinoma.Methods: This study retrospectively collected medical records of 403 patients with histologically confirmed lung adenocarcinoma from January 2016 and June 2020. The patients were divided into development and validation cohorts. The preoperative information on all patients was obtained, including clinical characteristics and computed tomography (CT) features. Multivariate logistic regression analysis was used to develop the predictive model. We combined CT features and clinical risk factors and used them to build a prediction nomogram. The performance of the nomogram was evaluated in terms of calibration, discrimination, and clinical usefulness. The nomogram was further validated in an independent external cohort.Results: The predictive factors incorporated in the personalized prediction nomogram included smoking history (OR, 0.2; 95% CI: 0.1, 0.4; P < 0.001), bubble-like lucency (OR, 2.2; 95% CI: 1.3, 3.8; P = 0.003), pleural attachment (OR, 0.4; 95% CI: 0.2, 0.7, P = 0.001) and thickened adjacent bronchovascular bundles (OR, 3.1; 95% CI: 1.8, 5.3; P < 0.001). Based on these parameters, the prediction model has good discrimination and calibration ability. The area under the curve in the development and validation cohorts were 0.784 (95% CI: 0.733, 0.835) and 0.740 (95% CI: 0.643, 0.838), respectively. Decision curve analysis showed that the model was clinically useful.Conclusions: This study presented a nomogram that contained CT features and clinical risk factors, which could conveniently and non-invasively predict EGFR mutation status in patients with lung adenocarcinoma before surgery.
A Global Genome-Wide Scan with Optimal Cutoff Mining for Emerging Biomarkers in Head and Neck Squamous Cell Carcinoma
Authors: Chi Li-Hsing , Wu Alexander TH , Hsiao Michael , Li Yu-Chuan (Jack) 
Published: September 2020

Abstract
Background: The survival analysis of the Cancer Genome Atlas (TCGA) dataset is a well-known method to discover the gene expression-based prognostic biomarkers of head and neck squamous cell carcinoma (HNSCC). In order to utilize a continuous gene expression for survival analysis, it is necessary to determine a cutoff point by the dichotomization of the patients. There is some optimization software for cutoff determination. However, those predetermined cutoffs by software usually set at the median, 1/4 quantile, or 3/4 quantile of RNA sequencing (RNA-Seq) value to find a significant P-value of the Kaplan-Meier curve. There are few clinicopathological features available on their pre-processed data sets. Methods: We developed a comprehensive workflow by R script, running on the Rstudio platform. It includes data retrieving and pre-processing, feature selection, cutoff mining engine, Kaplan-Meier survival analysis, Cox proportional hazard modeling, and biomarker discovery. Results: Using this workflow on the TCGA HNSCC cohort, we scanned human protein-coding genes (20,500) programmatically. After adjustment with other confounders, we found that the clinical tumor stage and the surgical margin involvement are independent risk factors in patient survival. According to the resulting tables with Bonferroni adjusted P-value under optimal cutoff as well as hazard ratio (>=1.5), there were ten candidate biomarkers, named as DKK1, CAMK2N1, STC2, PGK1, SURF4, USP10, NDFIP1, FOXA2, STIP1, and DKC1, which are significantly associated with the poor prognosis of overall survival (OS). At the same time, the other ten genes were over-expressed in the better survival patients (with hazard ratio <=0.5), named as ZNF557, ZNF266, IL19, MYO1H, FCGBP, LOC148709, EVPLL, PNMA5, IQCN (previous name as KIAA1683), and NPB. Further validations are warranted.Conclusions: We suggested this analysis tool equipped with an optimal cutoff finder will help with biomarker discovery of protein-coding genes, in terms of tumor-agnostic therapy.
Implementation Support for Contingency Management: Preferences of Opioid Treatment Program Leaders and Staff&nbsp;
Authors: Scott Kelli , Jarman Shelly , Moul Samantha , Murphy Cara M , Yap Kimberly , Garner Bryan , Becker Sara J 
Published: September 2020

Abstract
Background: Contingency management (CM), a behavioral intervention that provides incentives for achieving treatment goals, has strong evidence for its effectiveness when combined with medication to treat opioid use disorder. Unfortunately, many front-line treatment providers do not utilize CM, likely due to contextual barriers that limit effective training and ongoing support for evidence-based practices. User-informed approaches offer a unique opportunity to adapt implementation strategies to support CM implementation. Methods: Leaders and treatment providers working in community-based opioid treatment programs (OTPs; N = 43) completed qualitative interviews inquiring about their preferences for implementation support (didactic training, performance feedback, and ongoing facilitation). Interviews were coded using a reflexive team approach to identify common a priori and emergent themes. Results: Leaders and providers expressed a preference for brief training that included case examples and research data, along with experiential learning strategies. They reported a desire for performance feedback from internal supervisors, patients, and clinical experts. Providers and leaders had mixed feelings about audio recording sessions but were open to the use of rating sheets to evaluate CM performance. Finally, participants desired both on-call and regularly scheduled ongoing facilitation to support their continued use of CM. Conclusions: This study provides an exemplar of a user-informed approach to adapt implementation support strategies for CM scale-up in community OTPs. Study findings highlight the need for user-informed approaches to training, performance feedback, and facilitation to support sustained CM use in this setting.
Analysis of the Clinical and Genetic Characteristics of 3 Cases of A20 Haploinsufficiency
Authors: Zhang Dan , Zhou Zhixuan , Lai Jianming , Su Gaixiu 
Published: September 2020

Abstract
Background To evaluate the clinical and genetic characteristics of 3 children with HA20. Methods The clinical and genetic testing data of 3 children with HA20 treated at CIP between August 2016 and October 2019 were retrospectively analysed. Results Patient 1 presented with arthritis and inflammatory bowel disease, patient 2 presented with axial spinal arthritis and lupus-like syndrome, and patient 3 presented with recurrent oral ulcers, gastrointestinal ulcers, and perianal abscesses. For laboratory examination, In patient 1, the WBC,CRP and AESR showed high. In patient 2, the WBC was normal, but CRP and AESR showed high. In patient 3, the WBC, CRP, and AESR showed high. Patient 2 was positive for antinuclear antibodies, anti-Sjögren’s syndrome antigen A, dsDNA, rheumatoid factor and Coombs test. Genetic testing showed that the 3 patients were heterozygous for mutations in the TNFAIP3 gene. For treatment, patient 1 used TNFα antagonist and thalidomide, patient 2 used TNFαantagonist and sulfasalazine, and patient 3 used hormones and thalidomide. Patients 1 and 2 were followed up for 4 and 3 months, respectively. There was improvement in joint and gastrointestinal symptoms, inflammatory indices and RF were normal, dsDNA and Coombs test became negative. Patient 3 was treated at an outside hospital and showed gradual improvement in oral ulcers and perianal abscesses. Conclusion HA20 is a single-gene auto-inflammatory disease caused by mutation in the TNFAIP3 gene. It presents clinically as a Behçet-like syndrome and can present as various other autoimmune diseases as well. Hormones and immunosuppressive agents are effective treatments, and cytokine antagonists can be used in refractory cases. Whole-exome genetic testing should be proactively performed for children with an early age of onset or Behçet-like presentation to achieve early diagnosis and accurate treatment.
Mixed Phenotype Acute Leukemia With Pml-rarα Positive: A Case Report and Literature Review
Authors: Zheng Yanlong , Shen Huafei , Zhu Mingyu , Shi Yuanfei , Jin Jie , Xie Wanzhuo 
Published: September 2020

Abstract
Mixed phenotype acute leukemia (MPAL) is an uncommon type of leukemia. It is one kind of malignant clonal diseases that expresses more than one genealogical specific antigen simultaneously. Most MPAL patients are associated with clonal chromosomal abnormalities and molecular genetic changes, such as t(9;22) (q34;q11) and KMT2A (MLL) rearrangement. These specific abnormalities usually have important guiding significance in MPAL diagnosis, targeted therapy and prognosis judgment. In this paper, we reported a case of MPAL, T/myeloid (M5) with an unfrequent combination of PML-RARα positivity and t(15;17). The treatment was successful with chemotherapy for both AML and ALL with daunorubicin, cytarabine (DA) and vincristine, prednisone (VP). We reported here this suggestive MPAL case of rare disease condition and effective treatment, in order to provide experience for the early diagnosis and treatment of similar patients.
Comparative whole-genome approach to identify traits underlying microbial interactions
Authors: Zoccarato Luca , Sher Daniel , Miki Takeshi , Segrè Daniel , Grossart Hans-Peter 
Published: September 2020

Abstract
BackgroundInteractions among microorganisms affect the structure and function of microbial communities, potentially affecting ecosystem health and biogeochemical cycles. The functional traits mediating microbial interactions are known for several model organisms, but the prevalence of these traits across microbial diversity is unknown.ResultsWe developed a new genomic approach to systematically explore the occurrence of metabolic functions and specific interaction traits, and applied it to 473 sequenced genomes from marine bacteria. The bacteria could be divided into coherent genome functional clusters (GFCs), some of which are consistent with known bacterial ecotypes (e.g. within pico-Cyanobacteria and Vibrio taxa) while others suggest new ecological units (e.g. Marinobacter, Alteromonas and Pseudoalteromonas). Some traits important for microbial interactions, such as the production of and resistance towards antimicrobial compounds and the production of phytohormones, are widely distributed among the GFCs. Other traits, such as the production of siderophores and secretion systems, as well as the production and export of specific B vitamins, are less common. Linked Trait Clusters (LTCs) include traits that may have evolved together, for example chemotaxis, motility and adhesion are linked with regulatory systems involved in virulence and biofilm formation.ConclusionsOur results highlight specific GFCs, such as those comprising Alpha- and Gammaproteobacteria, as particularly poised to interact both synergistically and antagonistically with co-occurring bacteria and phytoplankton. Similar efficient processing of multidimensional microbial information will be increasingly essential for translating genomes into ecosystem understanding across biomes, and identifying the fundamental rules that govern community dynamics and assembly.
Effectiveness of chiropractic modality on chronic low back pain patients, A quasi-experimental study
Authors: Aleali Behdokht , Sharifi Mohammad Hossein , Sousani Malihe , Salehi Alireza 
Published: September 2020

Abstract
BackgroundLow back pain (LBP) is one of the most prevalent diseases in the developed and developing countries, which imposes high socioeconomic burden on both the individual and the community. There are limited studies that explain the clinically meaningful impact of chiropractic modality in chronic LBP.MethodThis is a quasi-experimental study. Participants were patients who had referred to Shiraz private chiropractic clinics with more than three month chronic LBP and had no pathologic abnormalities. Data were collected in two stages, baseline visit and 8 weeks after treatment. The effect of intervention measured throughout three questionnaire including Roland Morris Disability Questionnaire (RMDQ), Numerical Rating Scale (NRS) and self-assessment Global Rating of Change (GRC) questionnaires.Result141 patients analyzed, the mean age of participants was 40.18 ± 10.42 years of old and 40 (28.4%) were male. The mean duration of LBP was 56.73 ± 45.11 months. Before and after intervention, based on RMDQ and NRS data, indicated that the mean difference ± Standard Deviation was 5.54 ± 4.95 and 2.44 ± 1.64 the statistically significant difference (P < 0.001) and (P < 0.001) among all demographic and clinical characteristic variables, except job status. The mean ± SD of GRC was 56.13 ± 33.03%. Based on the RMDQ cut-off point, 88 participants (62%; 95% CI: 50–70) have been affected by chiropractic with a clinically meaningful effect. In addition, the chiropractic may be an effective therapeutic modality in treating patients with mild, moderate, or even severe MRI findings.ConclusionComplementary chiropractic treatment amongst chronic LBP patients may be an appropriate adjuvant to conventional treatments to improve disability and pain intensity reduction in both genders.
Molecular characteristics of Brucella melitensis isolates from humans in Qinghai Province, China
Authors: Zhao Zhijun , Li Jiquan , Ma Li , Xue Hongmei , Yang Xuxin , Zhao Yuanbo , qin Yuming , Yang Xiaowen , Piao Dongri , Zhao Hongyan , Tian Guozhong , Li Qiang , Wang Jianling , Tian Guang , Jiang Hai , Xu Liqing 
Published: September 2020

Abstract
Background
The prevalence of human brucellosis in Qinghai Province has been increasing rapidly, with confirmed cases distributed across 31 counties. However, the epidemiology of brucellosis transmission has not been fully elucidated. To characterize the two isolated strains, multiple locus variable-number tandem repeats analysis (MLVA) and whole-genome single-nucleotide polymorphism (SNP)-based approaches were employed.
Methods
Blood samples were isolated from two males that were confirmed B. melitensis positive following MLVA. Genomic DNA was extracted from these samples, and whole-genome sequencing (WGS) was performed. Next, SNP-based phylogenetic analysis was performed to compare the two strains to 94 B. melitensis strains (complete genome and draft genome) retrieved from online databases.
Results
The two Brucella isolates were identified as B. melitensis biovar 3 (QH2019001 and QH2019005) following conventional biotyping and were found to have differences in their variable number tandem repeats (VNTRs) using MLVA-16. Phylogenetic examination assigned the 96 strains to five genotype groups, with QH2019001 and QH2019005 assigned to the same group, but different subgroups. Moreover, the QH2019005 strain was assigned to a new subgenotype, IIj, within genotype II. These findings were then combined to determine the geographic origin of the two Brucella strains.
Conclusions
Utilizing a whole-genome SNP-based approach enabled differences between the two B. melitensis strains to be more clearly resolved, and facilitated the elucidation of their different evolutionary histories. This approach also revealed that QH2019005 is a member of a new subgenotype (IIj) with an ancient origin in the eastern Mediterranean Sea.
Critical Incidents in Anorexia Nervosa: Patients’ Perspective
Authors: Leppanen Jenni , Tosunlar Lara , Blackburn Rachael , Williams Steven , Tchanturia Kate , Sedgewick Felicity 
Published: September 2020

Abstract
BackgroundAlthough social-emotional difficulties are believed play a key role in anorexia nervosa (AN), there is uncertainty regarding what these difficulties might look like. Previous research has largely focused on a “disease model” of social-emotional processing in AN with little attention paid to positive emotions and experiences. Therefore, the aim of the present study was to obtain a fuller picture of critical life events in AN. MethodsThirty-four participants aged 16-48 with current or past AN completed an online survey describing self-defined positive and difficult critical events.ResultsTwo major themes were identified in the descriptions of positive critical events: Moments of celebration, reflecting external focus, and Unexpected positive outcomes, revealing negative biases. Difficult events were broadly divided into included eating disorder (ED) related and Non-ED life events, involving discussion of relational conflict and feeling unsupported. DiscussionThe findings suggest that AN is largely characterised by negative emotionality and bias. However, people with AN can live rich lives with positive experiences, which reflect reduced self-focused attention and increased “big-picture” thinking. Moreover, people with AN may be open to have their negative expectations challenged through corrective experiences. Together these findings be useful targets for further clinical research.
Synthetic neural-like computing in microbial consortia for pattern recognition
Authors: Li Ximing , Rizik Luna , Daniel Ramez 
Published: September 2020

Abstract
Complex biological systems in nature comprise of cells that act collectively to solve sophisticated tasks. Synthetic biological systems, in contrast, are designed for specific tasks, largely following computational principles including logic gates, analog design, and control theory. Yet such approaches cannot be easily adapted for multiple tasks in biological contexts. Alternatively, artificial neural networks (ANN), comprised of flexible interactions for processing and decision-making, are widely adopted for numerous applications and support adaptive designs. Motivated by the structural similarity between ANNs and cellular networks, here we implemented ANN-like computing in bacteria consortia for recognizing patterns. In cellular ANNs, receiver bacteria collectively interact through quorum sensing (QS) with sender bacteria for decision-making processes. Input patterns formed by chemical inducers, activate sender circuits to produce QS signaling molecules with varying levels. These levels are programmed by tuning the promoter strength acting as weights. We also developed an algorithm based on gradient descent, which is well-accepted in artificial intelligence, to optimize weights and experimentally examined them using 3x3-bit patterns.