bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Congenital Sternoclavicular Sinus: a Single-institution Retrospective Study of 88 Patients
Authors: Yang Gang , He Taozhen 
Published: December 2020

Abstract
Background Sinus near the sternoclavicular joint was considered as a rare congenital neck abnormality. Though it was reported as a dermoid sinus in some literatures, the embryological origin of the sinus was unclear. This study aimed at reviewing the clinical and histological characteristics and analyzing the possible embryological origin of this malformation in children.Methods The medical records of all patients with congenital sternoclavicular sinus who underwent surgical resection between March 2018 through June 2020 were reviewed retrospectively. The clinical presentations, complications, histological examination, and treatment were analyzed.Results Of the 88 patients with congenital sternoclavicular sinus included, the mean age of surgery was 2.73 ± 1.71 years old. The sinuses occurred on the left side in 73 (83.0%) cases. Sixty-three patients experienced sinus infection and 44 patients underwent incision and drainage before excision. All patients received surgical resection with one patient recurred after surgery. Histopathological examination showed that the sinuses were lined by squamous epithelium in most patients. However, ciliated epithelium was observed in one patient and salivary gland was detected in two patients.Conclusions The congenital sternoclavicular sinus should be excised promptly to prevent recurrent infection. According to the ciliated epithelium and salivary gland were found in the wall of sinus, it should be viewed as the skin side remnant of the fourth branchial cleft rather than a dermoid cyst/sinus.
How to Design a Registry for Undiagnosed Patients in the Framework of Rare Disease Diagnosis – Suggestions on Software, Data Set and Coding System
Authors: Berger Alexandra , Rustemeier Anne-Kathrin , Göbel Jens , Kadioglu Dennis , Britz Vanessa , Schubert Katharina , Mohnike Klaus , Storf Holger , Wagner Thomas OF 
Published: December 2020

Abstract
Background: About 30 million people in the EU and USA, respectively, suffer from a rare disease. Driven by European legislative requirements, national strategies for the improvement of care in rare diseases are being developed. To improve timely and correct diagnosis for patients with rare diseases, the development of a registry for undiagnosed patients was recommended by the German National Action Plan. In this paper we focus on the question on how such a registry for undiagnosed patients can be built and which information it should contain.Results: To develop a registry for undiagnosed patients, a software for data acquisition and storage, an appropriate data set and an applicable terminology/classification system for the data collected is needed. We used the open source software OSSE (Open Source Registry System for Rare Diseases) to build the registry for undiagnosed patients. Our data set is based on the minimal data set for rare disease patient registries recommended for European Rare Disease Registries Platform. We extended this Common Data Set to also include symptoms, clinical findings and other diagnoses. In order to ensure findability, comparability and statistical analysis, symptoms, clinical findings and diagnoses have to be encoded. We evaluated three medical ontologies (SNOMED – CT, HPO and LOINC) for their usefulness. With exact matches of 98% of tested medical terms, a mean number of five deposited synonyms, SNOMED CT seemed to fit our needs best. HPO and LOINC provided 73% and 31% of exacts matches of clinical terms respectively. Allowing more generic codes for a defined symptom, with SNOMED-CT 99%, with HPO 89% and with LOINC 39% of terms could be encoded.Conclusions: With the use of the OSSE software and a data set, which, in addition to the Common Data Set, focuses on symptoms and clinical findings, a functioning and meaningful registry for undiagnosed patients can be implemented. The next step is the implementation of the registry in centres for rare diseases. With the help of medical informatics and big data analysis, case similarity analyses could be realized and aid as a decision-support tool enabling diagnosis of some patients.
Hyperpigmented Spots at Fundus Examination: A New Ocular Sign in Neurofibromatosis Type I
Authors: Moramarco Antonietta , Mallone Fabiana , Sacchetti Marta , Lucchino Luca , Miraglia Emanuele , Roberti Vincenzo , Lambiase Alessandro , Giustini Sandra 
Published: December 2020

Abstract
Background: Neurofibromatosis Type I (NF1), also termed von Recklinghausen disease, is a rare genetic disorder that is transmitted by autosomal dominant inheritance, with complete penetrance and variable expressivity. It is caused by mutation in the NF1 gene on chromosome 17 encoding for neurofibromin, a protein with oncosuppressive activity, and it is 50 % sporadic or inherited.The disease is characterized by a broad spectrum of clinical manifestations, mainly involving the nervous system, the eye and skin, and a predisposition to develop multiple benign and malignant neoplasms. Ocular diagnostic hallmarks of NF1 include optic gliomas, iris Lisch nodules, orbital and eyelid neurofibromas, eyelid café-au-lait spots. Choroidal nodules and microvascular abnormalities have recently been identified as additional NF1-related ocular manifestations. The present study was designed to describe the features and clinical significance of a new sign related to the visual apparatus in NF-1, represented by hyperpigmented spots (HSs) of the fundus oculi.Results: HSs were detected in 60 (24.1%) out of 249 patients with NF1, with a positive predictive value of 100% and a negative predictive value of 44.2%. None of the healthy subjects showed the presence of HSs. HSs were visible under indirect ophthalmoscopy and infrared light, but not appreciable on green reflectance. The location and features of pigmentary lesions matched with the already studied NF1-related choroidal nodules. No significant difference was found between the group of patients (n=60) with ocular HSs and the group of patients (n=189) without ocular pigmented spots in terms of age, gender or severity grading of the disease. A statistically significant association was demonstrated between the presence of HSs and neurofibromas (p=0.047), and between the presence of HSs and NF1-related retinal microvascular abnormalities (p=0.017).Conclusions: we described a new ocular sign represented by HSs of the fundus in NF1. The presence of HSs was not a negative prognostic factor of the disease. Following an in-depth instrumental investigation, we demonstrated that HSs and choroidal nodules were consistent with the same type of lesion, and simple indirect ophthalmoscopy allowed for screening of HSs in NF1.
The Prevalence and Stressors of Job Burnout Among Medical Staff in Liaoning, China: a Cross-section Study
Authors: Guo YouQi , Hu Shu , Liang Fei 
Published: December 2020

Abstract
Background: Sustained attention to the prevalence and associated factors of burnout in China is important for the health care service quality and related reform. In this study, we investigated the prevalence of job burnout among medical staff in Liaoning province, China; performed a survey of subjective perception ranking for the main stressors among respondents; estimated the effect of stresses from work tasks and the relationship with patients on job burnout in order to provide improved strategy and suggestion for hospital administrators.Methods: The respondents were from 8 hospitals in 3 cities in Liaoning province, China. Data were collected and analyzed including the following sections: (1) demographic characteristics; (2)work situations; (3) ranking of six stressors; (4) job burnout scale; (5) effort-reward imbalance scale; (6) work violence scale; (7) Fear of malpractice scale. A total of 1056 individuals became the study objects. A statistical analysis and hierarchical linear regression analysis were performed to explore the prevalence of burnout and the effects of stressors.Results: The prevalence of job burnout was 20.5%, and 72.9% of all respondents reported a least one symptom of burnout. The respondents who were male, 30-39 years old, had master's degree or high and working hour >60 hr per week prone to job burnout. The relationship with patients and work tasks are the top two ranking stressors in the subjective perception survey. Regression analysis showed that the relationship with patients explained 19.4%, 16.9% and 2.0% of variance in burnout subscales EE, DP and PA, respectively and work tasks explained 23.9%, 16.3% and 5.2% of variance in burnout subscales EE, DP and PA, respectively.Conclusion: The Chinese medical staff had high prevalence of job burnout. Some factors of demographic and work situations were associated with job burnout. The medical staff considered the relationship with patients and work tasks are the two major stressors. These two stressors are also the major indicators associated with job burnout. The hospital administrators should be aware of the risk of burnout. Efforts should be made to ameliorate the status of job burnout.
Proteomics Analysis of the Protective Effects of Hesperetin on Coronary Artery injury in Streptozotocin-Induced Type 1 Diabetic Rats
Authors: Xing Guofang , Huo Pingting , Zhang Xinyi , Chen Zhaoyang , Wang Lei , Liu Yu 
Published: December 2020

Abstract
Background: Type 1 and type 2 diabetes both cause damage to the cardiovascular system. Hesperetin, a medicinal product found in foods, has been shown to have various cardioprotective effects. However, the effects of this compound on diabetes-related cardiovascular damage have not been evaluated.Methods: In this study, we aimed to investigate the protective effects of hesperetin on the coronary artery in diabetic rats and to explore its effects on the changes in critical proteins in the coronary artery using proteomics analysis. Results: Hesperetin alleviated coronary artery injury and modulated the expression of various proteins, including S100A8 and S100A9, which functioned in Toll-like receptor 4 binding, Toll-like receptor binding, and RAGE receptor binding. Pathways altered by hesperetin included type I diabetes mellitus, cell adhesion molecules, antigen processing and presentation, and interleukin-17 signaling pathway. Conclusions: In this study, we constructed a protein map of SD rats with type 1 diabetes treated with hesperetin, and found significant changes in three important proteins, S100A8, S100A9 and KNG1.Our findings provided important insights into further studies of the cardiovascular protective effects of hesperetin.
Comparison of Preoperative Trans-thoracic Echocardiography with Intraoperative Findings in Patients with Congenital Heart Disease Undergoing Surgery; A Prospective Observational Study.
Authors: Njem Josiah Miner , Edwin Frank , Tettey Mark 
Published: December 2020

Abstract
OBJECTIVE: To determine the diagnostic accuracy and safety of trans-thoracic echocardiography alone for indicating surgery by correlating preoperative trans-thoracic echocardiography with intra-operative findings in patients with congenital heart disease (CHD) in a low resource, low volume center. METHODOLOGY: The pre-operative trans-thoracic echocardiography and intra-operative findings of two hundred and fifty patients with CHD, undergoing surgery at the National Cardiothoracic Centre (NCTC), Korle Bu Teaching Hospital, from 2012 to 2017 were prospectively compared. Included in this prospective study, were all patients with CHD who had trans-thoracic echocardiography alone at the NCTC. Excluded were patients who were operated at the NCTC based on echocardiography done elsewhere , those who had echocardiography at the NCTC but were operated elsewhere, as well as those whose operative decision were based on cardiac catheterization or CT angiography and patients with acquired heart defects. The analysis included profiling of patients on different demographic and clinical parameters. SPSS software was used for analysis. RESULTS: Of the 250 patients ages ranged from two months to sixty years. The mean was 4 years 95 days, median 1 year 180 days. The female sex accounted for 152 (60.6%). The preoperative trans-thoracic echocardiography correlated with intra-operative findings completely in 228 (91.2%) of patients, affirming the accuracy of this imaging modality. There were however, 19 (7.6%) false negatives and 3 (1.2%) false positive. Neither the false positive nor false negative errors resulted in complications or adversely affected the surgical outcome.CONCLUSION: Based on the results of this study, preoperative transthoracic echocardiography done by cardiologists at the National Cardiothoracic Center, Korle Bu Teaching Hospital Accra, demonstrated a high correlation with intraoperative findings. Echocardiography also proved to be sensitive, accurate and safe for indicating surgery in patients with congenital heart disease.
Integrated effects of bacteria and fungi&nbsp;biofertilizers on morphological traits, antioxidants indices, and polyphenol compounds of quinoa (Chenopodium quinoa Willd.) under salinity condition
Authors: Karimi Giti , Pourakbar Latifeh , Moghaddam Sina Siavash , Popović-Djordjević Jelena 
Published: December 2020

Abstract
It is imperative to assess the potential of halophyte plant species, such as quinoa, in resisting high salinity levels in arid and semi-arid regions where the productivity of crops is dramatically affected. A factorial experiment based on a completely randomized design with three replications was conducted to explore the effect of integrated biofertilizer, on morphological traits, antioxidants, and polyphenol compounds of quinoa under salinity stress. The studied factors included NaCl salinity stress at three levels of 0, 150, and 300 mM (S0, S150, and S300, respectively), Trichoderma (T) fungus at two levels (its use and non-use), and biofertilizer at three levels (control, nitrogen (FN), and phosphorus (FP). The means of the studied traits showed that the highest shoot length and dry weight was related to S0T0FN, the highest root length to S150TFN, the highest root dry weight to S0T0FN, and the highest phenol and flavonoid contents to S300TFP and S0TFN treatments. Among polyphenols, the highest caffeic acid, rutin, coumaric acid, and quercetin were observed in S0TFP, and the highest levels of chlorogenic, rosmarinic, cinnamic acids, and apigenin (mg/kg) were observed in S0TFN. To sum up, Bacteria and fungi biofertilizers were effective on the studied traits at the three salinity levels.
Soil Moisture Remote Sensing Using SIW Cavity Based Metamaterial Perfect Absorber
Authors: Amiri Majid , Abolhasan Mehran , Shariati Negin , Lipman Justin 
Published: December 2020

Abstract
Continuous and accurate sensing of water content in soil is an essential and useful measure in the agriculture industry. Traditional sensors developed to perform this task suffer from limited lifetime and also need to be calibrated regularly. Further, maintenance, support, and deployment of these sensors in remote environments provide additional challenges to the useof conventional soil moisture sensors. In this paper, a metamaterial perfect absorber (MPA) based soil moisture sensor isintroduced. The ability of MPAs to absorb electromagnetic signals with near 100% efficiency facilitates the design of highlyaccurate and low-profile radio frequency (RF) passive sensors. MPA based sensor can be fabricated from highly durablematerials and can therefore be made more resilient than traditional sensors. The creation of channels in the SIW cavity MPA’s substrate to accommodate the soil contact leads to high-resolution sensing. The proposed sensor does not require connectionfor both electromagnetic signals or for adding a testing sample. Importantly, an external power supply is not needed, makingthe MPA based sensor the perfect solution for remote and passive sensing in modern agriculture. The proposed MPA based sensor has three absorption bands due to the various resonance modes of the SIW cavity. By changing the soil moisture level,the absorption peak shifts by 10 MHz, 23.3 MHz, and 60 MHz, which is correlated with the water content percentage at the first, second and third absorption bands, respectively. Finally, a 6×6 cell array with a total size of 312 mm × 312 mm has been fabricated and tested. A strong correlation between measurement and simulation results validates the design procedure.
An R2R3-MYB&nbsp;Transcription Factor PgFLP&nbsp;Directly Activates PgPIN10&nbsp;to Regulate the GSA&nbsp;of Adventitious Root in Pomegranate
Authors: Wang Zenghui , Li Jialin , Yang Xuemei , Tang Haixia , Feng Lijuan , Wang Fei , Tao Jihan , Yin Yanlei 
Published: December 2020

Abstract
Background: The self-rooted seedling is widely used in pomegranate planting industry currently; However, the root system of self-rooted seedling is shallow and poor cold resistance. Therefore, the study of the molecular mechanisms of pomegranate adventitious root gravitropism is very important for developing deep-rooted pomegranate cultivars.Results: We report the pomegranate FOUR LIPS (PgFLP) that play an key role in regulating the gravitropic set-point angle of pomegranate adventitious root in response to gravity signal. In our study, PgFLP directly regulates the transcriptional expression of PgPIN10 by binding to its promoter, thus regulating the GSA of adventitious root in pomegranate. Additionally, the 35S::PgFLP show stronger gravitational response than wild-type, leading to a smaller GSA in Arabidopsis lateral roots, indicating that PgFLP participates in regulating the GSA of adventitious root via PgPIN10 in pomegranate. Conclusion: Our results confirm that the transcriptional regulation of PgPIN10 by R2R3-MYB transcription factor PgFLP in setting the gravitropic set-point angle of pomegranate adventitious root in response to gravity signal.
Determinants of Patient Satisfaction in The United Arab Emirates Health Care Industry
Authors: Sayani Hameedah , Moonesar Immanuel Azaad , Zakzak Lama , Elsholkamy Mona Mostafa 
Published: December 2020

Abstract
Background: The United Arab Emirates is aiming to provide 'world-class healthcare' to its citizens. This study aims to determine the association between overall satisfaction and various aspects of health care services in the United Arab Emirates on a country level. Methods: The data was collected from 5,855 respondents on the affordability, quality, accessibility, and responsiveness dimensions of health care. Besides frequency tables and descriptive statistics, statistical methods, such as Principal Component Analysis and Multiple Regression, were used to reduce and model the association between dependent (overall satisfaction) and independent (affordability, quality, accessibility, and responsiveness) variables. Results: The findings indicated higher satisfaction levels with quality and accessibility and lower satisfaction levels with affordability and responsiveness. Recommendations are provided to address the latter two factors. Conclusion: The study identifies issues in health care service provision in the United Arab Emirates and offers recommendations about enhancing affordability and responsiveness.
A novel Swollenin from Talaromyces leycettanus JCM12802 enhances cellulase hydrolysis towards various substrates
Authors: Zhang Honghai , Wang Yuan , Brunecky Roman , Yao Bin , Xie Xiangming , Zheng Fei , Luo Huiying 
Published: December 2020

Abstract
Background: Swollenins exist within some fungal species such as Trichoderma reesei and Aspergillus niger, and are candidate accessory enzymes for the biodegradation of cellulosic substrates. Swollenins theorized role in biological processes is as promoters in the rearrangement of non-covalent interaction networks formed by cell wall polysaccharides. Such network rearrangements though to be responsible for expanding accessibility for hydrolytic enzyme degradation processes. We hereby report in detail the characterization of a recombinant swollenin and its disruptive activity on cellulosic substrates and its synergistic effects while interacting with cellulases.Results: We have expressed a novel swollenin gene Tlswo consists of an open reading frame encoding 503 amino acids to be identified from Talaromyces leycettanus JCM12802 and successfully expressed it in both Trichoderma reesei and Pichia pastoris. Similar to other fungal swollenins, TlSWO is composed of a N-terminal family 1 carbohydrate binding module (CBM1) followed by a Ser/Thr rich linker connected to an expansin-like domain, followed by a family of 45 endoglucanase-like domains and a group-2 grass pollen allergen domain. From our experimental results, TlSWO demonstrated disruptive activity on Avicel and displayed a synergistic effect with cellobiohydrolases, enhancing its hydrolytic performance up to 132%. We also explored the activity of TlSWO on several model substrates as well as pretreated biomass. Our results indicate that TlSWO is capable of releasing reducing sugars from lichenan, barley β-glucan, carboxymethyl cellulose sodium (CMC-Na) and laminarin. The specific activity of TlSWO towards the substates mentioned above is 9.0 ± 0.100 U/mg, 8.9 ± 0.100U/mg, 2.3 ± 0.002 U/mg and 0.79 ± 0.002 U/mg, respectively. Moreover, further experimentation confirms the fungal swollenin TlSWO exhibits maximum activity at pH 4.0 and 50 ℃.Conclusion: This study reports on a novel swollenin protein capable of enhancing biomass conversion. Experimental data reveals the functional diversity of this swollenin with considerable activity on various substrates. Although the exact catalytic mechanism of swollenin’s remains unknown, the functional diversity of TlSWO broadens its applicability under experimental settings, and suggests it may be a promising candidate for future industrial applications.
Unmet contraceptives needs among Female Sex Workers (FSWs) in semi urban Blantyre, Malawi
Authors: Twizelimana Donatien , Muula Adamson S 
Published: December 2020

Abstract
Background: Research has paid limited attention to understanding factors that are associated with unmet contraceptive needs among female sex workers. In order to fill this knowledge gap, we estimated the prevalence of unmet contraceptive needs and examined associated factors among FSWs in semi urban Blantyre, Malawi. Methods: We used systematic sampling to recruit 290 female sex workers in semi urban Blantyre between February and March 2019. In this cross sectional study, we used questionnaire interviews to collect quantitative data. We calculated the mean and standard deviation for continuous variables and proportions for categorical variables to describe the data. Logistic regression analysis was used to investigate the association between unmet needs (the outcome variable) and explanatory variables such as: having a steady partner, fear of contraceptives’ side effects and having a history of sexually transmitted infections. Results: Out of the 290 study participants 102 (35.2%) reported unmet contraceptive needs. The following factors were significantly associated with unmet contraceptive needs in multivariate analysis: female sex workers’ history of physical and sexual violence by clients [OR 3.38, 95% CI (1.10, 10.43)], p<0.03, participants with a steady partner [OR 3.28, 95% CI (1.89, 5.68)], p<0.001, and participants who feared side effects of contraceptives [OR 2.99, 95% CI (1.73, 5.20)], p<0.001. Conclusion: Reproductive Health services should address barriers to contraceptives use for instance: violence by female sex workers’ clients, fear and misinformation on contraceptives. There is need to improve awareness of contraceptives. Specific health promotion interventions on female sex workers engaged in a steady partnership are recommended. It is important to enhance the knowledge, attitudes, and counseling skills of health care providers in order to address unmet contraceptive needs among female sex workers in semi-urban Blantyre.