bluuebunny/crossref_metadata_2025_split huggingface dataset:
Expression and Prognostic Significance of m6A-Related Genes in TP53-Mutant Non-small-cell Lung Cancer
Authors: Zhao Zhuochen , Wan Junhu , Guo Manman , Wang Yangxia , Yang Zhengwu , Li Zhuofang , Ming Liang 
Published: December 2020

Abstract
BackgroundTP53 is an important tumor suppressor gene located on human chromosome 17. TP53 mutations have been confirmed in more than 60% of tumor patients' somatic cells. N6-methyladenosine is an enzyme that plays an important role in mRNA splicing, translation, and stabilization. It is a common internal modification of nucleotides, that is regulated by methyltransferases ("writer"), binding proteins ("reader"), and demethylases ("eraser"). However, its role in TP53 mutant non-small-cell lung cancer remains unknown. In this study, we investigated 17 common N-6-Methyladenosine regulators' contributions and prognostic values.Methods and MaterialsThe expression sets of 233 TP53 mutant NSCLC and 236 TP53 wild type NSCLC patients were downloaded from the Cancer Genome Atlas (TCGA) databases with their simple nucleotide variation and their clinical messages. 17 m6A regulators were systematically analyzed in our study, which including 8 "writers" (METTL3/14/16, WTAP, RBM15/15B, KIAA1429, ZC3H13), 7 "readers" (YTHDF1/2/3, YTHDC1/2, HNRNPA2B1, HNRNPC), 2 "erasers" (FTO, ALKBH5). Consensus clustering was used to classify TP53 mutant NSCLC and TP53 wild type NSCLC into two subgroups. Univariate and multivariate cox regression were used to construct a prognostic signature and compute risk score based to m6A regulators’ expression in TP53 mutant and wild type NSCLC. Gene Ontology (GO), Gene Set enrich analysis (GSEA), STRING and Cytoscape tools were used to find different signaling pathways and biological processes between TP53 mutant and wild type NSCLC.ResultsWilcox test showed that 9 of 17 m6A regulators were expressed differently between TP53 mutant and wild type NSCLC (p < 0.05). Then consensus clustering has been used for tumor typing and a new way of typing is attempted, while the groups obtained by consensus clustering couldn’t predict prognostic well in mutant and wild type patients (p = 0.121 in wild type and p = 0.089 in mutant). Using univariate cox regression analysis, ALKBH5, HNRNPA2B1 were associated with the prognostic of TP53 mutant patients. Then we built signatures of N-6-Methyladenosine regulators with prognostic ability based on the multivariate cox regression in TP53 mutant cohorts. Moreover, we found that this signature could predict the prognostic in mutant cohort well (p < 0.001, AUG > 0.6). With this signature, patients with TP53 mutations can be divided into high and low risk groups. Finally, we found 338 DEGs between high and low risk groups, then GO enrichment analysis, PPI network was used to analysis different signaling pathways between two groups.ConclusionIn conclusion, our study showed m6A regulators can be used as predictive prognostic tools in TP53 mutant patients.
Lymph Node Maximum Uptake of 18F-ALF-NOTA-PRGD2 II PET/CT Predicts Lung Cancer Survival
Authors: Wei Yuchun , Ma Li , Zheng Jinsong , Pei Yanqing , Qin Xueting , Luan Xiaohui , Zhou Yue , Wang Yongzheng , Yuan Shuanghu 
Published: December 2020

Abstract
Background:Tumor angiogenesis plays a key role in tumor growth, development, and metastasis, so the exploratory study of tumor neovascularization imaging is one of the potential methods to predict survival. This study aims to examine the predictive capacity of 18F-ALF-NOTA-PRGD2 II (denoted 18F-Alfatide II) positron emission tomography (PET)/computed tomography (CT) before antitumor therapy (ATR) in patients with lung cancer.Results The median follow-up was 31 (1.3~57.0) months. Among the patients, 6 were lost to follow-up. The overall survival (OS) and progression-free survival (PFS) were 40.0 (3.50~57.0) months and 21.30 (2.0~56.0) months, respectively. The maximum uptake values (SUVmax) of the metastatic lymph nodes (SUVLN) and tumor node metastasis (TNM) staging were significant predictors of PFS and OS (all P<0.05) in a multivariate Cox regression analysis. Statistical significance was not reached by any other variable in the multivariate analysis. Receiver operating curve (ROC) analysis for survival revealed an area under the curve of 0.93 (P<0.001) for SUVLN and 0.96 for the TNM stage (P<0.001). The SUVLN and TNM stage cutoff values were 2.50 and II, and their sensitivity, specificity and positive and negative prediction were 77.42%, 80.0% and 82.76% and 74.07%; and 87.10%, 60.0% and 72.97% and 78.95%, respectively. Patients with a lower SUVLN and early stage had a longer PFS and OS (all P<0.05).Conclusions For lung cancer, low SUVLN and an early TNM stage (≤stage II) as assessed before ATR by 18F-alfatide II PET/CT represents a favorable subgroup with increased PFS and OS.
Disseminated Intravascular Coagulation Immediately after Trauma Predicts a Poor Prognosis in Severely Injured Patients: A Sub-analysis of a Multicenter Prospective Study on Disseminated Intravascular Coagulation in Trauma
Authors: Wada Takeshi , Shiraishi Atsushi , Gando Satoshi , Yamakawa Kazuma , Fujishima Seitaro , Saitoh Daizoh , Kushimoto Shigeki , Ogura Hiroshi , Abe Toshikazu , Mayumi Toshihiko , Sasaki Junichi , Kotani Joji , Takeyama Naoshi , Tsuruta Ryosuke , Takuma Kiyotsugu , Yamashita Norio , Shiraishi Shin-ichiro , Ikeda Hiroto , Shiino Yasukazu , Tarui Takehiko , Nakada Taka-aki , Hifumi Toru , Okamoto Kohji , Sakamoto Yuichiro , Hagiwara Akiyoshi , Masuno Tomohiko , Ueyama Masashi , Fujimi Satoshi , Umemura Yutaka , Otomo Yasuhiro 
Published: December 2020

Abstract
Background: Trauma patients die from massive bleeding due to DIC with a fibrinolytic phenotype in the early phase, which transforms to DIC with a thrombotic phenotype in the late phase of trauma, contributing to the development of MODS and a consequent poor outcome. The aim of this study is to evaluate the effect of a disseminated intravascular coagulation (DIC) diagnosis on the survival probability and predictive performance of DIC scores for massive transfusion, multiple organ dysfunction syndrome (MODS), and hospital death in severely injured trauma patients.Methods: Severely injured adult patients (Injury Severity Score >16) were prospectively evaluated for their DIC scores and molecular markers of coagulation and fibrinolysis immediately after emergency department presentation (0 h) and 3 h after admission. Organ dysfunction was assessed by the sequential organ failure assessment (SOFA) score at 24 h after admission. The performance of DIC scores in predicting massive transfusion, MODS, and hospital death, and the effect of a DIC diagnosis on the survival probability were investigated.Results: The 276 enrolled patients included 121 DIC and 155 non-DIC patients. DIC patients showed larger transfusion volume and higher SOFA scores than non-DIC patients at 24 h after admission. A DIC diagnosis on admission was associated with a lower survival probability (Log Rank p<0.001), higher frequency of massive transfusion and MODS, and higher mortality rate than no such diagnosis. DIC scores at 0 h and 3 h predicted massive transfusion, MODS, and hospital death with significance (all areas under the receiver operating characteristic curves, p<0.001). Markers of thrombin and plasmin generation and fibrinolysis inhibition also showed a good predictive ability for these three items.Conclusions: A DIC diagnosis on admission was associated with a low survival probability. DIC scores obtained immediately after trauma predicted a poor prognosis of severely injured trauma patients.Trial registration: UMIN-CTR, UMIN000019588. Registered on 16 November 2015.
Metagenomic Next-Generation Sequencing Improves the Prognosis of Patients with Infectious Diseases on Mechanical Ventilation in the Intensive Care Unit (ICU)
Authors: Xi Yin , Zhou Jing , Lin Zhimin , Liang Weibo , Yang Chun , Liu Dongdong , Xu Yonghao , Nong Lingbo , Chen Sibei , Yu Yuheng , He Weiqun , Zhang Jie , Zhang Rong , Pan Ying , Pan Jieyi , Li Jianchun , Chen Qiang , Liu Xiaoqing , Sang Ling , Xu Yuanda , Li Yimin 
Published: December 2020

Abstract
Background: Metagenomic Next-Generation Sequencing (mNGS) has gradually shown its advantages in pathogen identification for clinical infectious disease. However, few studies were conducted on the evaluation between this technique and conventional methods like culture and PCR and the prognosis of patients with infectious diseases on mechanical ventilation in ICUMethods: We conducted this retrospective study from March 2018 to May 2020 in the first Affiliated Hospital of Guangzhou Medical University, a total of 228 patients with suspected infectious diseases on mechanical ventilation were included, including 104 cases of mNGS group and 124 cases of non-mNGS. Statistical analyses were performed between the two groups and subgroup of whether were immunocompromised. The concordance between mNGS, culture and PCR was also assessed.Results: The 28-day mortality rate of the patients in the mNGS group was lower after the baseline difference correction (19.23% vs. 29.03%，p=0.039), indicating that mNGS may improve the prognosis of patients in ICU. And subgroup analysis showed that mNGS could improve the 28-day mortality of nonimmunosuppressive patients（14.06% vs. 29.82%, p=0.018）. According to the analysis of Logistic Regression, not performing mNGS, high APACHE II score and hypertension were independent risk factors for 28-day mortality, which strongly suggested that mNGS was one of the key factors affecting prognosis. A total of 157 samples performed mNGS, 116 of them received both mNGS and culture. mNGS presented advantages of positivity (69.8% double positive and 25.0% mNGS positive only) and concordance (79.0%, match and partly match).Conclusions: mNGS may improve the prognosis and reduce the 28-day mortality rate of patients with infectious diseases on mechanical ventilation in ICU. This technique has shown its advantages comparing with conventional methods, and will be wildly used as a promising technology for infectious disease.
Extracorporeal Membrane Oxygenation in Patients with Burns, Hero or Futile Medical Care? A Systematic Review and Meta-Analysis
Authors: Chiu Yu-Jen , Huang Yu-Chen , Chen Tai-Wei , King Yih-An , Ma Hsu 
Published: December 2020

Abstract
Background

Severely burned patients, particularly when compounded with inhalation injuries, are at high risk for cardiopulmonary failure. Recently, promising studies have stimulated interest in using extracorporeal membrane oxygenation (ECMO) as a potential therapy for burn patients with refractory cardiac and/or respiratory failure. Several observational studies have been reported, but the findings in these vary.
Methods

In this study, we conducted a systematic review and meta-analysis using standardized mortality ratios (SMRs) to elucidate the benefits associated with the use of ECMO in patients with burn and/or inhalation injuries. A literature search using PubMed, EMBASE, MEDLINE, and the Cochrane Library were performed from inception to October 20, 2020. Clinical outcomes in the selected studies were compared.
Results

22 studies were included in the final review and analysis. 13 studies with a total of 75 patients were included in SMR quantitative analysis. The overall pooled mortality rate of burn patients receiving ECMO was 48%. The meta-analysis found that the observed mortality was significantly higher than the predicted mortality in patients receiving ECMO, with a pooled SMR of 2.07 (95% CI: 1.04–4.14). However, in the subgroup of burn patients with inhalation injuries, all patients receiving V-V ECMO had lower mortality rates compared to their predicted mortality rates, with a pooled SMR of 0.95 (95% CI: 0.52–1.73). Other subgroup analyses, including an adult group, pediatric group, V-V setting group, and a V-A setting group reported no benefits from ECMO; however, these results were not statistically significant. Interestingly, the pooled SMR values decreased as the selected patients’ revised Baux scores increased (R=-0.92), indicating that the potential benefits from the ECMO treatment increased as the severity of patients with burns increased, especially when the patients’ revised Baux scores exceeded 90.
Conclusions

Our meta-analysis revealed that burn patients receiving ECMO treatment were at a higher risk of death. However, select patients, including those with inhalation injuries and those with the revised Baux scores over 90, would benefit from ECMO treatment. We suggest that burn patients with inhalation injuries or with revised Baux scores exceeding 90 should be considered for ECMO treatment and early transfer to an ECMO centre.
Avian leukosis virus subgroup J infection influences the gut microbiota composition in chicken
Authors: Chen Yuan , Ni Jiajia , Li Hongwei 
Published: December 2020

Abstract
Background: Avian leukosis virus (ALV) is a major cause of disease in poultry. Probiotics play a critical role in maintaining animal health. Studies have indicated that viral infection can alter the composition of the chicken gut microbiota. We hypothesized that ALV-J infection alters the probiotics composition in the chicken fecal bacterial microbiome. We performed high-throughput 16S rRNA gene sequencing and evaluated the gut microbiota proﬁles using feces from ALV-J-infected and healthy chickens.Results: The relative abundance at the phylum and species levels was calculated. The phylum Proteobacteria was more abundant in ALV-J-infected chickens than in healthy chickens. Additionally, the abundance of the opportunistic pathogen Propionibacterium acnes was significantly increased in ALV-J-infected chickens. Interestingly, ALV-J infection tended to be significantly decreased by the probiotics Lactobacillus helveticus and Lactobacillus reuteriConclusions: The study indicates that ALV-J infection significantly altered the gut microbiota distribution in chickens. Additionally, ALV-J infection significantly influenced the abundance of L. helveticus and L. reuteri in the chicken gut.
An implementation history of primary health care transformation: Alberta’s primary care networks and the people, time and culture of change
Authors: Leslie Myles , Khayatzadeh-Mahani Akram , Birdsell Judy , Forest PG , Henderson Rita , Gray Robin Patricia , Schraeder Kyleigh , Seidel Judy , Zwicker Jennifer , Green Lee A. 
Published: December 2020

Abstract
Background: Primary care, and its transformation into Primary Health Care (PHC), has become an area of intense policy interest around the world. As part of this trend Alberta, Canada, has implemented Primary Care Networks (PCNs). These are decentralized organizations, mandated with supporting the delivery of PHC, funded through capitation, and operating as partnerships between the province’s healthcare administration system and family physicians. This paper provides an implementationhistory of the PCNs, giving a detailed account of how people, time, and culture have interacted to implement bottom up, incremental change in a predominantly Fee-For-Service (FFS) environment.Methods: Our implementation history is built out of an analysis of policy documents and qualitative interviews. We conducted an interpretive analysis of relevant policy documents (n=20) published since the first PCN was established. We then grounded 12 semi-structured interviews in that initial policy analysis. These interviews explored 11 key stakeholders’ perceptions of PHC transformation in Alberta generally, and the formation and evolution of the PCNs specifically. The data from the policy review and the interviews were coded inductively, with participants checking our emerging analyses.Results: Over time, the PCNs have shifted from an initial Frontier Era that emphasized local solutions to local problems and featured few rules, to a present Era of Accountability that features central demands for standardized measures, governance, and co-planning with other elements of the health system. Across both eras, the PCNs have been first and foremost instruments and supporters of family physician authority and autonomy. A core group of people emerged to create the PCNs and, over time, to develop a long-term Quality Improvement (QI) vision and governance plan for them as organizations. The continuing willingness of both these groups to work at understanding and aligning one another’s cultures to achieve the transformation towards PHC has been central to the PCNs’ survival and success.Conclusions: Generalizable lessons from the implementation history of this emerging policy experiment include: The need for flexibility within a broad commitment to improving quality. The importance of time for individuals and organizations to learn about: quality improvement; one another’s cultures; and how best to support the transformation of a system while delivering care locally.
Accuracy of telephone triage in patients suspected of transient ischaemic attack or stroke: A cross-sectional study
Authors: Erkelens Daphne Carmen , Rutten Frans H. , Wouters Loes T. , Dolmans L. Servaas , de Groot Esther , Damoiseaux Roger A. , Zwart Dorien L. 
Published: December 2020

Abstract
Background: The Netherlands Triage Standard (NTS) is a widely used decision support tool for telephone triage at Dutch out-of-hours primary care services (OHS-PC), which, however, has never been validated against clinical outcomes. We aimed to determine the accuracy of the NTS urgency allocation for patients with neurological symptoms suggestive of a transient ischaemic attack (TIA) or stroke, with the clinical outcomes TIA, stroke, and other (neurologic) life-threatening events (LTEs) as the reference. Method: A cross-sectional study of telephone triage recordings of patients with neurological symptoms calling the OHS-PC between 2014 and 2016.The allocated NTS urgencies were derived from the electronic medical records of the OHS-PC. The clinical outcomes were retrieved from the electronic medical records of the patients’ own general practitioners. The accuracy of a high NTS urgency allocation (medical help within three hours) was calculated in terms of sensitivity, specificity, positive and negative predictive values (PPV and NPV) with the clinical outcomes TIA/stroke/other LTEs as the reference. Results: Of 1,269 patients, 635 (50.0%) received the diagnosis TIA/stroke (34.2% TIA/minor stroke, 15.8% major ischaemic or haemorrhagic stroke), and 4.8% other LTEs. For TIA/stroke/other LTEs, the sensitivity and specificity of the NTS urgency allocation were 0.72 (95%CI 0.68-0.75) and 0.48 (95%CI 0.43-0.52), and the PPV and NPV were 0.62 (95%CI 0.60-0.64) and 0.58 (95%CI 0.54-0.62). Conclusions: The NTS decision support tool used in Dutch OHS-PC performed poor to moderately regarding safety (sensitivity) and efficiency (specificity) in allocating adequate urgencies to patients with and without TIA/stroke/other LTEs.
Three redescriptions in Tintinnopsis (Protista: Ciliophora: Tintinnina) from coastal waters of China, with cytology and phylogenetic analyses based on ribosomal RNA genes
Authors: Bai Yang , Wang Rui , Song Wen , Li Lifang , Santoferrara Luciana F. , Hu Xiaozhong 
Published: December 2020

Abstract
Background: The taxonomy of tintinnine ciliates is vastly unresolved because it has traditionally been based on the lorica (a secreted shell) and it has only recently incorporated cytological and molecular information. Tintinnopsis, the most speciose tintinnine genus, is also the most problematic: it is known to be non-monophyletic, but it cannot be revised until more of its species are studied with modern methods.Results: Here, T. hemispiralis Yin, 1956, T. kiaochowensis Yin, 1956, and T. uruguayensis Balech, 1948, from coastal waters of China, were studied. Lorica and cell features were morphometrically investigated in living and protargol-stained specimens, and sequences of three ribosomal RNA (rRNA) loci were phylogenetically analyzed. The three species show a complex ciliary pattern (with ventral, dorsal, and posterior kineties and right, left, and lateral ciliary fields), but differ in lorica morphology, details of the somatic ciliature and rRNA gene sequences. Tintinnopsis hemispiralis is further distinguished by a ciliary tuft (a ribbon of very long cilia originated from the middle portion of the ventral kinety and extending out of the lorica) and multiple macronuclear nodules. Both T. kiaochowensis and T. uruguayensis have two macronuclear nodules, but differ in the number of somatic kineties and the position of the posterior kinety. Two neotypes are fixed for T. hemispiralis and T. kiaochowensis to stabilize the species names objectively, mainly because of the previous unavailability of type materials. By phylogenetic analysis and comparison with closely-related species, we infer that the ciliary tuft and details such as the commencement of the rightmost kinety in the lateral ciliary field are synapomorphies that may help clarify the systematics of Tintinnopsis-like taxa.Conclusion: The redescriptions of three poorly known Tintinnopsis species, namely T. hemispiralis, T. kiaochowensis, and T. uruguayensis firstly revealed their ciliary patterns and rRNA sequences. This study expands knowledge and database of tintinnines and helps in identifying potential synapomorphies for future taxonomic rearrangements.
Clinical characteristics and prognostic factors in elderly patients with COVID-19
Authors: Cheng Qin , Liao Yixuan , Lin Yujing , Tao Liyuan , Wang He , Li Mohan , Ge Qinggang , Li Yanming , Shen Ning 
Published: December 2020

Abstract
Background: The COVID-19 pandemic posed tremendous threats to the world. Elderly patients were among the high-risk population, and apt to experience worse outcomes.Methods: Elderly patients (age ≥60 years old) were enrolled from January 28 to February 29, 2020, in Tongji Hospital, one of designated COVID-19 medical centers in Wuhan, China. A retrospective study was performed to describe clinical characteristics and outcomes of elderly COVID-19 patients. COX regression was used to analyze predictors for 28-day mortality. Linear regression models were constructed to analyze factors associated with length of hospital stay (LOS).Result: A total of 186 elderly patients (aged 70.4 ± 7.1 years, 95 males (51.6%)) were enrolled, 120 patients (64.5%) were severe or critical type, and mortality rate was 16.1%. Patients in non-survival group had a higher smoking rate, more symptoms of dyspnea, lab results indicative of poorer health. Age (HR 1.128, 95% CI 1.066-1.194), lymphocyte count (HR 0.261, 95% CI 0.073-0.930), LDH (HR 1.003, 95% CI 1.002-1.005), procalcitonin (HR 1.061, 95% CI 1.002-1.125), and qSOFA (HR 3.162, 95% CI 1.646-6.072) were independently associated with 28-day mortality. CURB-65 plus LDH on admission were predictors of mortality by ROC analysis (AUROC=0.891). Among surviving patients, consolidation on CTs, elevated ferritin level and neutrophil count were associated with increased LOS.Conclusion: High incidence of comorbidities and mortality were observed in elderly patients. Decreased lymphocyte, older age, higher qSOFA score, procalcitonin and LDH levels were independent factors associated with mortality, CURB-65 plus LDH could be a predictive model of fatal outcome. Consolidation on CTs, elevated ferritin and neutrophil level correlated with increased LOS. Further prospective studies should be performed to test our findings and explore potential treatments.