bluuebunny/crossref_metadata_2025_split huggingface dataset:
Applying a General Systems Theory framework in Mental Health Treatment Pathways: the case of the Hellenic Center of Mental Health and Research
Authors: Katrakazas Panagiotis , Grigoriadou Aliki , Koutrouris Dimitrios 
Published: May 2020

Abstract
Language, socio-emotional and cognitive development in children and adolescents with mental health issues is getting increased attention over the last years. Establishing communication patterns and addressing behavioural diversities among this population should be of priority, along with a better understanding in a large variety of patient characteristics within the operational framework of mental healthcare centers. As integrated systems’ approaches are still missing to correlate patients' characteristics and predict treatment services’ efficiency in a macroscopic scale, a General Systems Theory framework is hereby proposed. This framework is applied and tested against the operational framework of the Hellenic Center of Mental Health and Research, in order to identify the need of such an approach and the strong cooperation between medical and population interactions. Using such frameworks as a prerequisite to identify important factors can lead to evaluating their impact on the treatment outcome and depict the complexity of pathways potentially related to the children’s development.
Fungal endophytes of high altitude ethnomedicinal plants as a bioresource of industrially imperative enzymes
Authors: Kapoor Neha , Mushtaque Abu , Gambhir Lokesh 
Published: May 2020

Abstract
Endophytic fungi have been in the spotlight as a reservoir of novel agents with diverse bioactivities. Similarity in chemical diversity with the host plant makes them an amenable target for industrial interventions. A wide range of compounds as secondary metabolites and enzymes are manufactured inside the endophytic fungal factory. However, utilization of endophytic fungi as industrially imperative enzyme producers has been a scarce event. The present study was conducted to bio-prospect the fungal endophytes present in the high altitude medicinal plants of Uttarakhand, as industrially imperative enzyme producers. A total of 58 different endophytic isolates were obtained from Pinus sabiniana, Cinnamomum tamala, Cinnamomum verum, Ocimum tenuiflorum and Rhododendron arboreum. Endophytic fungal colonization was highest, 31%, in Pinus sabiniana. The pure isolates were further explored for the production of amylases, cellulases, proteases and L-asparaginase. Out of 58 isolates, 40 isolates exhibited potent enzyme productivity. #7PSSTB isolate was considered as superlative contender on account of its relatively higher production of all the three enzymes viz. amylases, cellulases, proteases. Partial purification of #7PSSTB extract showed compelling enzymatic activity corroborating the existence of exogenous enzyme in the extract. Interestingly, #9 RASTB, #11 RASTB and #17 RASTB exhibited the production of therapeutically imperative L-asparaginase enzyme. The present study puts the spotlight on endophytic diversity in the high altitude medicinal plants as a source of enzymes of industrial interest. Production of L-asparaginase paves the way of pharmaceutical intervention to explore anti-oncogenic effects in the endophytic fungal repository of high altitude regions.
Shared Content on Facebook Often Propagates Inaccurate or Misleading Information Regarding Covid-19
Authors: Tewfik George , Aziz Rania , Shulman Steven , Naftalovich Rotem , Gilels Sofia 
Published: May 2020

Abstract
With billions of monthly active users, Facebook has an unprecedented ability for the dissemination of information. In healthcare, attempts have been made to utilize this tool for goals such as predicting disease onset; however, shared articles that omit information or propagate incorrect statements may have a negative effect. The goal of this study was to assess the accuracy of information in the nascent months of the 2019-2020 Covid-19 outbreak.The fifty most popular articles on Facebook for the period between November 2019 and March 25, 2020 (as collated by Buzzsumo- a social media analyzing tool) were analyzed by independent researchers and sorted into classifications for accurate, inaccurate and misleading. Following evaluation, 32% of articles were deemed to be accurate, 18% inaccurate, and 50% misleading (as defined by containing both accurate and inaccurate information). To restate, 68% of the 50 most popular articles on Facebook were not accurate during the study period. Impressions, shares and comments on Facebook in a summation of inaccurate and misleading articles were also analyzed in separate fashion and found to be 71.44%, 74.97%, and 80.22% respectively. These numbers outpace the 68% of total articles for which these types of stories account.In addition, shares were individually assessed as they indicate a desire to propagate the information forward on the part of the user, and were found to have occurred 6.61 million times in the inaccurate and misleading group compared to 2.2 million for accurate articles, for a cumulative rate of 74.9% of shares, again outpacing the 68% expected.There is a high rate of both inaccurate and misleading information related to the Covid-19 outbreak on Facebook, as assessed by physician reviewers. This information is not only more prevalent than the accurate information, but also received more engagement via overall impressions, as well as shares and comments. Although there is no clear remedy for this phenomenon, its implications range from general distrust to non-adherence to precaution guidelines or required actions. There is also a question regarding Facebook’s policing of itself and the content on its site, as well as that content published to it from other websites.
Inflammatory Potential of Diet and Risk of Incident Knee Osteoarthritis: A Prospective Cohort Study
Authors: Liu Qiang , Hebert James R. , Shivappa Nitin , Guo Jianjun , Tao Ke , Zeng Chao , Lei Guanghua , Lin Jianhao , Zhang Yuqing 
Published: May 2020

Abstract
Background To examine the relation between inflammatory potential of diet and incident knee osteoarthritis (OA) and the role of BMI in the association of interest.Methods In the Osteoarthritis Initiative, the Dietary inflammatory index (DII®) was calculated based on the Block Brief 2000 Food Frequency Questionnaire and categorized into sex-specific quartiles. Outcomes were incident: (1) radiographic knee OA (ROA) (i.e., a KL grade ≥ 2), (2) symptomatic knee OA (SxOA) (i.e., a combination of a frequent knee pain and ROA). We fitted generalized estimating equation models to examine the association between DII® scores and incident knee OA. We performed mediation analyses to assess the mediation effect of BMI in the DII-OA relation.Results Over a 48-month follow-up period, 232 and 978 knees developed ROA and SxOA, respectively. Compared with the lowest (most anti-inflammatory) quartile of DII®, the odds ratio (OR) of incident ROA for the highest (most pro-inflammatory) quartile of DII® was 1.73 (95% confidence interval (CI): 1.15 to 2.62, P for trend = 0.007). The corresponding OR for SxOA was 1.43 (95% CI: 1.16 to 1.76, P for trend = 0.001). The DII®-OA association was significantly mediated via BMI with an indirect effect of 1.08 (95% CI: 1.04,1.13) for ROA and 1.13 (95% CI: 1.09, 1.16) for SxOA, accounting for 20.4% and 44.5% of total effect, respectively.Conclusions A higher inflammatory potential of diet increased the risk of knee OA. The association was significantly mediated via BMI. Targeting inflammatory potential of diet may be beneficial to reduce risk of knee OA.
The Influence of Low Birth Weight and Smoking on the Male Patients with Premature Coronary Heart Disease: a retrospective case-control study
Authors: Yu Guangwei , Hong Huashan , Wu Wenwei , Chen Lianglong , Lin Xiaohong 
Published: May 2020

Abstract
Background: Low birth weight (LBW) is one of the risk factors for coronary heart disease (CHD). The association of LBW and other risk factors with male patients with premature CHD has not been fully determined. This study aims to assess the association of LBW and other risk factors with the incidence of male patients with premature CHD.Methods We identified hospitalized male patients with premature CHD (CHD group) and healthy male subjects (control group) from January 2013 to December 2018. The differences of demographics, birth weight (BW) and other traditional risk factors were compared between the CHD group and the control group and logistic regression was used to estimate their effects on the risk of premature CHD.Results A total of 384 male subjects were enrolled in the study (183 in the CHD group vs 201 in the control group). There were significant differences in BW, smoking, diabetes and hyperlipidemia between the two groups (2.98±0.35 vs 3.37±0.39kg, P<0.001, 73.22% vs 27.36%, P<0.001, 8.74% vs 3.48%, P=0.033, 53.55% vs 37.31%, P=0.001) respectively. The risk of premature CHD increased significantly with the LBW (OR=4.530, 95% CI：1.331-15.412，P=0.016) and smoking (OR=6.748, 95% CI：4.258-10.693，P<0.001) respectively according to the multivariate logistic regression model. Conclusion LBW and smoking are independently and positively correlated with male patients with premature CHD. A history of LBW should be paid particularly attention in younger men for primordial prevention of premature CHD, especially away from tobacco.
Exosome-mediated miR-21 promotes angiogenesis within esophageal tumor microenvironment by activating PTEN/Akt signaling pathway in Vascular Endothelial Cells
Authors: Wang Tian , Liao Juan , Yang Zijie , Shen Weitao , Gao Zhi kui , Yin Jie chen , Yin Li hong , Liu Ran 
Published: May 2020

Abstract
Background

Angiogenesis, a pivotal component in the tumor microenvironment (TME), boosts tumor growth and metastasis. Cancer-derived exosomes, which have been widely reported to play a crucial role in the establishment of TME can be effective angiogenic modulators. We aim to investigate the contribution of microRNA-21 (miR-21) for angiogenesis which was packaged in cancer-derived exosomes in esophageal squamous cell carcinoma (ESCC).
Methods

The co-cultivation model was constructed to mimic the tumor microenvironment based at a physical level to explore the effects of cancer-derived exosomes on angiogenesis of human umbilical vein endothelial cells (HUVECs). EdU assay, transwell assay and tube formation assay formation experiments were conducted for the evaluation of HUVECs proliferation, migration, and angiogenesis, respectively. In addition, Dual-luciferase reporter (DLR) assay was performed to validate the relationship between miR-21 and its target gene PTEN. Similarly, miR-21 inhibitors and LY294002 was applied to evaluate the regulation of miR-21 via pro-angiogenesis in recipient HUVECs by PTEN/Akt signaling pathway.
Results

After 24 h co-cultivation with EC9706 cells, miR-21 levels in recipient HUVECs was raised. The results from EdU assay, transwell assay and blood vessel formation experiment showed that exosomes which were secreted from EC9706 cells (EC9706-Exo) delivered miR-21 stimulated proliferation, migration and tube formation of HUVECs. DLR assay indicated that miR-21 could directly bind to the 3'-untranslated region (UTR) of PTEN genes, real-time PCR and western blot analysis for PTEN showed it was inhibited by EC9706-Exo shuttled miR-21. Meanwhile, phospho-Akt (p-Akt) (Ser473), one of the downstream genes of PTEN, was significantly increased in recipient HUVECs compared to the control group, while inhibiting miR-21 and PI3K/Akt pathway respectively both led to a sharp decrease in p-Akt levels, suggesting that exosomal miR-21 promote angiogenesis via activating PTEN/Akt signaling pathway.
Conclusion

Exosomal miR-21 acts as a driver of pro-angiogenesis by activating PTEN/Akt signaling pathway, it might serve as a blood-based biomarker for ESCC metastasis. Suppressing the expression or blocking the transmission of these exosome-derived miR-21 might be a novel antiangiogenic therapeutic strategy for ESCC.
RBE-weighted dose conversions for patients with recurrent nasopharyngeal carcinoma receiving carbon-ion radiotherapy from the local effect model to the microdosimetric kinetic model
Authors: Zhang Liwen , Wang Weiwei , Hu Jiyi , Lu Jiade , Kong Lin 
Published: May 2020

Abstract
Background We sought to establish a conversion curve to convert the local effect model I (LEM) based RBE-weighted doses (LEM doses) in patients with locally recurrent nasopharyngeal carcinoma (rNPC) to the microdosimetric kinetic model (MKM) based RBE-weighted dose (MKM doses) model. We also converted the relevant organ at risk (OAR) constraints based on this curve. Methods Data from 13 patients with rNPC receiving carbon-ion radiotherapy (CIRT) in our hospital were collected. LEM in Raystation (V8A, Raystation, Sweden) was used to generate treatment plans. Clinical target volume CTV1(GTV+5mm)was given 63 Gy (RBE) in 21 fractions. Ninety-nine percent of target volumes should be covered by 95% of the prescriptions; the maximum doses of the brainstem and spinal cord were < 45 Gy (RBE) and < 30 Gy (RBE), respectively. The doses covering 20% volumes of optical nerves/chiasms D20 were < 30 Gy (RBE). Then physical doses of the LEM plans were recalculated by using MKM in Raystation to generate MKM plans. A series of the ratio of LEM dose to MKM dose was obtained as the conversion factor to obtain the conversion curve by using an isovolumetric dose method. Using prescriptions and OAR, constraints were converted to MKM doses with this curve. Results Conversion factors (LEM dose/MKM dose) from 1.37±0.02 to 3.09±0.09 corresponded to the LEM fractionated doses from 0.24 Gy (RBE) to 2.86 Gy (RBE), including the doses constraining upon OARs. LEM doses of 30 Gy (RBE) and 45 Gy (RBE) in 21 fractions were converted to MKM doses of 16.64 Gy (RBE) and 30.98 Gy (RBE) in 16 fractions. Conclusions This conversion curve could be used to convert LEM doses to MKM doses for patients with rNPC receiving CIRT, providing dose references for re-irradiation therapy.
Pyruvate dehydrogenase complex deficiency: updating the clinical, metabolic and mutational landscapes
Authors: Pavlu-Pereira Hana , Silva Maria João , Florindo Cristina , Sequeira Sílvia , Ferreira Ana Cristina , Duarte Sofia , Rodrigues Ana Luísa , Janeiro Patrícia , Oliveira Anabela , Gomes Daniel , Bandeira Anabela , Martins Esmeralda , Gomes Roseli , Soares Sérgia , de Almeida Isabel Tavares , Vicente João B , Rivera Isabel 
Published: May 2020

Abstract
Background : Pyruvate dehydrogenase complex (PDC) catalyzes the irreversible decarboxylation of pyruvate into acetyl-CoA which ultimately generates ATP. PDC deficiency can be caused by alterations in any of the genes encoding its several subunits, and the resulting phenotype, though very heterogeneous, mainly affects the neuro-encephalic system. The aim of this study is to describe and discuss the clinic, metabolic and genotypic profiles of thirteen PDC deficient patients, thus seeking to establish possible genotype-phenotype correlations. Results : The mutational spectrum revealed that seven patients (54 %) carry mutations in the PDHA1 gene , encoding the E1α subunit, five patients (38 %) carry mutations in the PDHX gene, encoding the E3 binding protein, and the remaining patient (8 %) harbors mutations in the DLD gene, encoding the E3 subunit. These data corroborate PDHA1 mutations as the predominant cause of PDC deficiency, though revealing a notable prevalence of PDHX mutations among Portuguese patients, most of them carrying a seemingly private mutation (p.R284X). The biochemical analyses revealed high lactate and pyruvate plasma levels whereas de ratio L/P was under 16; enzymatic activities, when compared to control values, revealed to be independent from the genotype and ranged from 8.5% to 30% which may be considered a cut-off value for primary PDC deficiency. Concerning the clinical features, all patients displayed developmental delay/psychomotor retardation, the severity of which seems to correlate with the type and localization of the mutation carried by the patient. The therapeutic options essentially go through the administration of a ketogenic diet and supplementation with thiamine, although arginine aspartate intake revealed to be beneficial in some patients. Moreover, the in silico analysis of the missense mutations present in this PDC deficient population allowed to understand the molecular mechanism underlying these pathogenic variants. Conclusion : The identification of the disease-causing mutations, together with the functional and structural characterization of the mutant protein variants, allows to get insight on the severity of the clinical phenotype and the selection of the most appropriate therapy.
Metabolomics Study of Dried Ginger Extract on Serum and Urine in Blood Stasis Rats Based on UPLC-Q-TOF/MS
Authors: Su Min , Cao Gang , Wang Xiaoli , Daniel Raftery , Hong Yan , Han yanquan 
Published: May 2020

Abstract
Backgroud: According to the theory of traditional Chinese medicine (TCM), blood stasis syndrome (BSS) is the basis for many cardiovascular diseases. Ginger is often used as Chinese medicine (herb medicine) in China and Southeast Asia for the treatment of cardiovascular, respiratory, and digestive diseases. but the specific mechanism is unclear.Methods: After establishing an acute rat model of blood stasis syndrome, blood and urine of 5 groups of rats were collected for analysis of efficacy indicators. Aortic vessels are used for pathological testing. Serum and urine were used for metabolomics, multivariate statistical analysis was used to explore metabolites and metabolic pathways, and the correlation between metabolites and pharmacodynamic indicators was further explored.Results: In this experiment, the model of blood stasis syndrome was successfully established based on changes in vascular disease and the efficacy index. The experimental results show that the efficacy indicators of dried ginger (DG) extracts of different doses have different degrees of changes than model group (MG), and the high dose of dried ginger group (GJH) changes are the most significant (p < 0.05 or p < 0.01). And 22 metabolites (10 in serum and 12 in urine) were identified and contributed to the blood stasis progress. These metabolites mainly involve seven metabolism pathways in different impact-value. Dried ginger has therapeutic effects on BSS rats by regulating multiple metabolic pathways.Conclusion: This study provides an effective method for understanding the metabolic mechanism of dried ginger extracts on BSS.
Luteal Phase Progesterone Support Does Not Improve Ongoing Pregnancies in True Natural Cycle Cryopreserved Blastocyst Stage Embryo Transfers
Authors: Waldman Ian , Racowsky Catherine , Disler Emily , Thomas Ann , Andrea Lanes , Hornstein Mark 
Published: May 2020

Abstract
Background: More than 67% of all embryos transferred in the United States involve frozen-thawed embryos. Progesterone supplementation is necessary in medicated cycles in order to luteinize the endometrium and prepare it for implantation, but little data is available if this is necessary in true natural cycles. We evaluated the use of progesterone luteal phase supplementation for cryopreserved/warmed blastocyst transfers in natural cycles not using an ovulatory trigger.Methods: Retrospective cohort study in a single academic medical center. We studied the use of progesterone supplementation beginning in the luteal phase and continued until 10 weeks gestational age in patients undergoing true natural cycle cryopreserved blastocyst transfer. Our outcome measures were ongoing pregnancy rate, positive serum beta human chorionic gonadotropin (HCG) level, implantation rate, clinical pregnancy rate, miscarriage/abortion rate, ectopic pregnancy rate, and multifetal gestation rate. Categorical data were analyzed utilizing Fisher’s exact test and non-parametric data were analyzed using the Wilcoxon rank sum test. We a priori adjusted for age.Results: 229 patients were included in the analysis with 149 receiving luteal phase progesterone supplementation and 80 receiving no luteal phase support. Patient demographic and cycle characteristics, and embryo quality were similar between the two groups. No difference was seen in ongoing pregnancy rate (49.0% vs. 47.5%, p=0.8738), clinical pregnancy rate (50.3% vs. 47.5%, p= 0.7483), positive HCG rate (62.4% vs. 57.5%, p=0.5965), miscarriage/abortion rate (5.4% vs. 2.5%, p=0.2622), ectopic pregnancy rate (0% vs. 1.3%, p=0.3493), or multifetal gestations (7.4% vs. 3.8%, p=0.3166).Conclusion(s): The addition of progesterone luteal phase support in true natural cycle cryopreserved blastocyst transfers does not improve cycle outcomes. Capsule: Progesterone supplementation as luteal phase support in true natural cycle cryopreserved blastocyst transfers does not improve ongoing pregnancies.
Low serum level of apolipoprotein A1 is an indicator of severity in patients with coronavirus disease 2019
Authors: Yang Yayun , Zhu Zhe , Fan Lingyan , Ye Shuyuan , Lou Kehong , Hua Xin , Huang Zuoan , Shi Qiaoyun , Gao Guosheng 
Published: May 2020

Abstract
Background: Recently, dyslipidemia was observed in the patients of coronavirus disease 2019 (COVID-19), especially in the severe cases. This study aimed to explore the predictive value of blood lipid for the severity of COVID-19.Methods: All patients with COVID-19 who admitted to HwaMei Hospital, University of Chinese Academy of Sciences from January 23 to April 20, 2020 were included in this retrospective study. General clinical characteristics and laboratory data (including blood lipid parameters) were obtained, and their predictive values for the severity were analyzed.Results: 142 consecutive patients with COVID-19 were included. There were 125 cases in the non-severe group and 17 cases in the severe group. Total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (ApoA1) at baseline were significantly lower in the severe group. ApoA1 and interleukin-6 (IL-6) were recognized as independent risk factors for the severity of COVID-19. ApoA1 had the highest area under the receiver operator characteristic curve (AUROC) among all the single markers (AUROC: 0.896, 95% CI: 0.834-0.941). Moreover, the risk model established upon ApoA1 and IL-6 enhanced the predictability (AUROC: 0.977, 95% CI: 0.932-0.995). On the other hand, ApoA1 in the severe group elevated during the treatment, there was no significant difference between the severe and non-severe groups in the recovery stage of disease.Conclusion: The profile of blood lipid in the severe patients with COVID-19 is quite different from that in the non-severe cases. Serum ApoA1 could severe as a good marker to reflect the severity of COVID-19.
Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Metastasis from Breast Cancer: A Preliminary Report on 4 Cases
Authors: Yu Jun-Hui , Feng Yu , Li Xin-Bao , Zhang Cheng-Yan , Shi Feng , An Song-Lin , Liu Gang , Zhang Yan-Bin , Zhang Kai , Ji Zhong-He , Li Bing , Yan Guo-Jun , Li Yan-Ping , Li Yan 
Published: May 2020

Abstract
Background: Breast cancer (BC) has been ranked as the first malignancy most common and the fifth in mortality rate among women in China [1]. Peritoneal metastases from BC is a rare disease and no guideline or international consensus for it. Objective: To summarize our experiences in cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) to treat breast cancer peritoneal carcinomatosis (BC PC). Methods: This is a retrospective study on the 4 BC PC patients underwent CRS+HIPEC at our center. The clinicopathological features and treatment details on the BC PC patients were analyzed. Result: The average age at CRS+HIPEC was 59.8 years. The average duration of CRS+HIPEC was 8.8 h. The median number of resected organ areas was 7. Overall survival from CRS+HIPEC were 31, 28, 16 and 52 months. There were no serious adverse events (SAEs) during perioperative period. Conclusions: The 4 cases provided evidence that integrated therapy with CRS+HIPEC may be a promising strategy to improve outcome for BC PC patients.