bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk conditions in children hospitalized with influenza in Norway, 2017-2019
Authors: Hauge Siri Helene , Bakken Inger Johanne , de Blasio Birgitte Freiesleben , Håberg Siri Eldevik 
Published: August 2020

Abstract
Background Norwegian children are more frequently hospitalized with influenza than adults. Little is known about the characteristics of these children. Our aim was to investigate the presence of pre-existing risk conditions and to determine the duration of influenza hospitalizations in children during two influenza seasons. Methods The Norwegian Patient Registry holds data on all hospitalized patients in Norway. We included all patients younger than 18 years hospitalized with a diagnosis of influenza during the influenza seasons 2017-18 and 2018-19. Pre-existing risk conditions for influenza were identified by ICD-10 diagnoses in the Norwegian Patient Registry. In addition, information on asthma diagnoses were also retrieved from the Norwegian Registry for Primary Health Care. To estimate the prevalence of risk conditions in the child population, we obtained diagnoses on all Norwegian children in a two-year period prior to each influenza season. We calculated age-specific rates for hospitalization and risk for being hospitalized with influenza in children with risk conditions. Results In total, 1013 children were hospitalized with influenza during the two influenza seasons. Children younger than 6 months had the highest rate of hospitalization, accounting for 13.5% of all admissions (137 children). Hospitalization rates decreased with increasing age. Among children hospitalized with influenza, 25% had one or more pre-existing risk conditions for severe influenza, compared to 5% in the general population under 18 years. Having one or more risk conditions significantly increased the risk of hospitalization, (Odds Ratio (OR) 6.1, 95% confidence interval (CI) 5.0-7.4 in the 2017-18 season, and OR 6.8, 95% CI 5.4-8.4 in the 2018-19 season). Immunocompromised children and children with epilepsy had the highest risk of hospitalization with influenza, followed by children with heart disease and lung disease. The average length of stay in hospital were 4.6 days, and this did not differ with age. Conclusion Children with pre-existing risk conditions for influenza had a higher risk of hospitalization for influenza. However, most children (75%) admitted to hospital with influenza in Norway during 2017-2019 did not have pre-existing risk conditions. Influenza vaccination should be promoted in particular for children with risk conditions and pregnant women to protect new-borns.
Refractory Chronic Urticaria in Adults: Clinical Characterization and Predictors of Severity
Authors: Coutinho Iolanda Alen , Regateiro Frederico Soares , Fernandes Rosa Anita , Pita Joana Sofia , Gomes Raquel , Coelho Constança , Todo-Bom Ana 
Published: August 2020

Abstract
Background: Chronic urticaria (CU) is defined as recurrent urticaria lasting for more than 6 weeks. Objectives: We aimed to characterize the phenotypes of patients with CU refractory to standard dose anti-H1 antihistamine treatment and search for clinical predictors of poor disease control.Methods: Retrospective collection of data regarding clinical characteristics, manifestations, comorbidities, treatment, and disease control of all adult refractory CU patients presenting to the Allergy and Immunology Department during one year. Descriptive and inferential analysis was performed to search for factors associated with disease control. Results: Sixty-one adult patients were included, 74% females, average age 44.5 years (18 to 84 years old). Most patients (78.7%) had initiated CU less than 1 year before enrolment. Chronic spontaneous urticaria (CSU) accounted for 55.7% of the patients and chronic inducible urticaria (ClndU) for 44.3%. Angioedema was present in 55.7% of the patients. Evidence for autoimmunity (positive anti-thyroid peroxidase antibodies, anti-nuclear antibodies or autologous serum test) was found in 45.2% (n=19) of 42 tested patients. High C-reactive protein was presenti in 14.3% (n=6) of 42 patients evaluated; half of these also had positive antinuclear antibodies. Forty-six patients (75.4%) had at least one significant exacerbation, requiring medical appointment, emergency room, hospitalization or job absenteeism. The number of exacerbations correlated with the presence of angioedema (p=0.022), with a recent diagnosis (<1 year), and with higher UAS7 severity (p=0.006). ClndU associated with poor symptom control (p=0.022) but had less exacerbations requiring medical observation or hospitalization (p=0.015). Conclusions: About half of the patients with CU presented autoimmunity. UAS7 severity and Angioedema are associated with disease exacebations. UAS7 and UCT presented unequal accuracy, with UAS7 better associating with the occurrence of exacerbations and treatment dosis. Accurate diagnostic tests, namely autoimmune parameters and inflammatory markers, should be recommended in some individual cases.
β-cell function in black South African women: Associations with insulin clearance and ectopic fat
Authors: Smidt Melony Cathlin Fortuin-de , Mendham Amy E , Hauksson Jon , Alhamud Ali , Stefanovski Darko , Hakim Olah , Swart Jeroen , Goff Louise M , Kahn Steven E , Olsson Tommy , Goedecke Julia H 
Published: August 2020

Abstract
Background: The role of ectopic fat, insulin secretion and clearance in the preservation of β-cell function in black African women with obesity who typically present with hyperinsulinemia is not clear. We aim to examine the associations between disposition index (DI, an estimate of β-cell function), insulin secretion and clearance and ectopic fat deposition.Methods: This is a cross-sectional study of 43 black South African women (age 20-35 years) with obesity (BMI 30-40 kg/m2) and without type 2 diabetes that measured the following: DI, insulin sensitivity (SI), acute insulin response (AIRg), insulin secretion rate (ISR), hepatic insulin extraction and peripheral insulin clearance (frequently-sampled intravenous glucose tolerance test); pancreatic and hepatic fat, visceral adipose tissue (VAT) and abdominal subcutaneous adipose tissue (aSAT) volume (magnetic resonance imaging), intramyocellular (IMCL) and extramyocellular fat content (EMCL) (magnetic resonance spectroscopy). Results: DI correlated positively with peripheral insulin clearance before (β 55.80, p=0.002) and after adjusting for hepatic insulin extraction. Higher DI was associated with lower VAT, pancreatic fat and soleus fat, but VAT explained most of the variance in DI (32%). Additionally, higher first phase ISR (p=0.033) and lower hepatic insulin extraction (p=0.022) associated with lower VAT, independent from SI, rather than with ectopic fat. Conclusion: Peripheral insulin clearance emerged as an important correlate of DI, independent from hepatic insulin extraction. However, VAT was the main determinant of a lower DI above ectopic fat depots. Importantly, VAT, but not ectopic fat, was associated with both lower insulin secretion and higher hepatic insulin extraction, independent from SI, and may provide a novel explanation of these findings in black South African women with obesity.
Evaluating the Efficacy and Safety of the Myrtle (Myrtus Communis) in Treatment and Prognosis of Patients Suspected to Novel Coronavirus (COVID-19) Pneumonia: Study Protocol for a Randomized Controlled Trial
Authors: Azimi Maryam , Hasheminasab Fatemeh Sadat 
Published: August 2020

Abstract
Background: Since December 2019, the outbreak of corona virus pneumonia was observed in China and quickly propagate in all of the world. Nowadays many trials are underway on this disease in which the efficacy of various therapeutic remedies including chemical or natural agents as well as different non pharmacological methods such as acupuncture are evaluated. This study aim at investigating the effect of myrtle fruit for treatment of COVID-19 disease.Methods: We are performing a randomized controlled trial on outpatients clinically suspected to COVID-19 disease in the age range of 18-65 years old with mild to moderate symptoms and without respiratory distress. Patients in both groups (myrtle and control) receive conventional therapy, but those in myrtle group get myrtle preparation in addition to conventional therapy. Intervention will continue for 5 days and the study outcomes including clinical statues as well as mortality rate and adverse effects will be measured up to 14 days.Discussion: The protocol describes the design of an ongoing randomized controlled trial to establish the evidence for the usage of water extract of myrtle fruit in clinically suspected COVID-19 disease and identify any safety concerns.Trial registration: The trial has been registered at the Iranian Registry of Clinical Trials website under the code IRCT20180923041093N3 on March 28th, 2020 (https://www.irct.ir/trial/46721). The results will be disseminated through manuscript publications, and presentations to scientific meetings.
Long noncoding RNA LPP-AS2 promotes glioma tumorigenesis via miR-7-5p/EGFR/PI3K/AKT/c-MYC feedback loop
Authors: Zhang Xiaoming , Niu Wanxiang , Mu Maolin , Hu Shanshan , Niu Chaoshi 
Published: August 2020

Abstract
Background: Glioblastoma is the most common primary malignant intracranial tumor with poor clinical prognosis in adults. Accumulating evidence indicates that long non-coding RNAs (lncRNAs) function as important regulators in cancer progression, including glioblastoma. Here, we identified a new lncRNA LPP antisense RNA-2 (LPP-AS2) and investigated its function and mechanism in the development of glioma.Methods: High-throughput RNA sequencing was performed to discriminate differentially expressed lncRNAs and mRNAs between glioma tissues and normal brain tissues. Expression of LPP-AS2, epidermal growth factor receptor (EGFR) and miR-7-5p in glioma tissues and cell lines was detected by real-time quantitative PCR (RT-qPCR), and the functions of lncRNA LPP-AS2 in glioma were assessed by in vivo and in vitro assays. Insight into the underlying mechanism of competitive endogenous RNAs (ceRNAs) was obtained via bioinformatic analysis, dual luciferase reporter assays, RNA pulldown assays, RNA immunoprecipitation (RIP) and rescue experiments. Results: The results of high-throughput RNA-seq indicated lncRNA LPP-AS2 was upregulated in glioma tissues and further confirmed by RT-qPCR. Higher LPP-AS2 expression was related to a poor prognosis in glioma patients. Based on functional studies, LPP-AS2 depletion inhibited glioma cell proliferation, invasion and promoted apoptosis in vitro and restrained tumor growth in vivo, overexpression of LPP-AS2 resulted in the opposite effects. In addition, LPP-AS2 and EGFR were observed in co-expression networks. LPP-AS2 was found to function as a ceRNA to regulate EGFR expression by sponging miR-7-5p in glioma cells. The result of chromatin immunoprecipitation (ChIP) assays validated that c-MYC binds directly to the promoter region of LPP-AS2. As a downstream protein of EGFR, c-MYC was modulated by LPP-AS2 and in turn enhanced LPP-AS2 expression. Thus, lncRNA LPP-AS2 promoted glioma tumorigenesis via a miR-7-5p/EGFR/PI3K/AKT/c-MYC feedback loop.Conclusions: Our study elucidated that LPP-AS2 acted as an oncogene through a novel molecular pathway in glioma and might be a potential therapeutic approach for glioma diagnosis, therapy and prognosis.
Racial and Ethnic Disparities in Covid-19 Illness Severity Accounting for Concomitant Comorbidities: A Cohort Study
Authors: Ji Hongwei , Achamallah Natalie , Sun Nancy , Botting Patrick , Chen Peter , Cheng Susan , Ebinger Joseph 
Published: August 2020

Abstract
Background Multiple reports have highlighted important racial and ethnic differences in the degree to which Americans may be vulnerable to severe forms of Covid-19 illness. Whether or not racial or ethnic disparities are related to variations in the underlying burden of comorbidities or other predisposing factors remains unclear.Methods We identified patients diagnosed with Covid-19, based on a positive PCR for SARS-CoV-2, from the electronic health record of a large multi-hospital system located in Southern California. We developed an illness severity score, based on the level of care each patient required (not admitted to the hospital; required hospital admission but never required intensive care; required intensive level care but never intubation; and, required intubation during hospitalization) and assessed for associations with clinical and demographic factors for each patient using ordinal logistic regression.Results A total of 571 patients with Covid-19 were identified a majority of whom were male (56%), with a mean age of 55±21 years. There were 81 (14%) patient who identified as African American, and 101 (18%) as Hispanic. A total of 202 (36%) patients required hospitalization without need for intensive care, 43 (8%) required intensive care without intubation, and 64 (11%) required intubation while also receiving intensive care. Of the total sample, African American race (OR 2.33, 95% CI 1.44-3.78, P=0.001) and Hispanic ethnicity (OR 1.97, 95% CI 1.14-3.12, P=0.004) were associated with greater illness severity.Conclusions Racial and ethnic disparities in the severity of Covid-19 illness persist, even when controlling for baseline comorbidities. It remains unclear if these differences are related to variations in physiologic response to SARS-CoV-2, differential timing of presentation or disparities in care.
Diagnostic precision and identification of rare diseases is dependent on distance of residence relative to tertiary medical facilities
Authors: Walter Anna-Lena , Baty Florent , Rassouli Frank , Bilz Stefan , Brutsche Martin Hugo 
Published: August 2020

Abstract
Background: Diagnostic precision and the identification of rare diseases (RDs) is a daily challenge, which needs specialized expertise. We hypothesized, that there is a correlation between the distance of residence to the next tertiary medical facility with specialized care and the diagnostic precision, especially for rare diseases.Results: We found a negative association between diagnostic diversity and travel time to the next tertiary hospital when including all cases throughout the overall International Classification of Diseases version 10 German Modification (ICD-10-GM) diagnosis codes. This was paralleled with a negative association of standardized incidence rates in all groups of rare diseases except for rare teratologic and rare allergic diseases.Conclusion: Our findings indicate a higher risk of being mis-, under- or late diagnosed especially in rare diseases when living more distant to a tertiary medical facility. Greater distance to the next tertiary medical facility basically increases the chance for hospitalization in a non-comprehensive regional hospital with less diagnostic capacity, and, thus, impacts on adapted health care access. Therefore, solutions for overcoming the distance to specialized care as an indicator of health care access are a major goal in the future.
Association of the genetic variants in the Endoplasmic reticulum aminopeptidase 2 gene with ankylosing spondylitis susceptibility
Authors: Ebrazeh Mehrdad , Ezzatifar Fatemeh , Torkamandi Shahram , Mohammadi Fatemeh Sadat , Salimifard Sevda , Hemmatzadeh Maryam , Aslani Saeed , Babaie Farhad , Azizi Gholamreza , Jadidi-Niaragh Farhad , Gowhari-Shabgah Arezoo , Mohammadi Hamed 
Published: August 2020

Abstract
Background: Genetic polymorphisms in the Endoplasmic reticulum aminopeptidase (ERAP) 2 gene has been attributed with the Ankylosing spondylitis (AS) etiopathogenesis. Here we assessed the association of ERAP2 gene single nucleotide polymorphisms (SNPs) with AS predisposition in Iranian patients and determined their effect on the inflammatory state of the patients.Methods: For genotyping of rs2548538, rs2287988, and rs17408150 SNPs using Real-time allelic discrimination approach, DNA was extracted from the whole blood of 250 AS patients and 250 healthy subjects. RNA of the peripheral blood mononuclear cells (PBMCs) was separated, cDNA was synthesized, and transcriptional levels of cytokines, including interleukin (IL)-17A, IL-23, IL-10, and transforming growth factor (TGF)-β were measured. Enzyme-linked immunosorbent assay (ELISA) was used to measure the serum concentration on the cytokines.Results: Three ERAP2 gene SNPs were not associated significantly with AS risk. Nonetheless, rs2287988 and rs17408150 SNPs showed statistically significant association with susceptibility to the disease in those AS subjects who were positive to Human leukocyte antigen (HLA)-B27. Transcriptional level and serum concentration of IL-17A and IL-23 were higher, while those of IL-10 were lower in both AS patients and HLA-B27 positive patient group relative to control group. Nevertheless, ERAP2 gene SNPs in the HLA-B27 positive AS patients did not affect the transcriptional level and serum concentration of cytokines.Conclusions: ERAP2 gene rs2287988 and rs17408150 SNP are associated with susceptibility to AS, but they probably are not determining the levels of IL-17A, IL-23, and IL-10 in this disease.
Community Health Nursing Competency and Psychological and Organizational Empowerment of Public Health Nurses in Taiwan: A Cross-Sectional Survey
Authors: Kuo Ching-Pyng , Hsiao Yu-Ling , Chen Hsiao-Mei , Yang Shang-Yu , Hsieh Pei-Lun 
Published: August 2020

Abstract
Background: This study explored the effect of public health nurses’ current community care nursing competency on the psychological and organizational empowerment of public health services in Taiwan.Method: A cross-sectional survey design and a self-developed structured questionnaire were administered to Taiwanese public health nurses, recruited using a purposive sampling technique, who participated in community health care workshops offered by Ministry of Health and Welfare in 2019.Results: The majority of subjects were aged between 40 and 49 years and reported working in public health for over 10 years. Furthermore, 89.30% of the subjects worked in a Public Health Center. The mean score of Community Care Nursing Competence (CCNC) was 3.92 ± 0.83 (measured using a five-point Likert scale). The mean score in Community Empowerment (CE) was 3.66 ± 0.90, between “Neutral” and “Agree.” The CCNC was positively correlated with the workplace. The CE was positively correlated with age. The CCNC was positively correlated with psychological and organizational empowerment. The stepwise regression revealed that age (B = 0.18, p = .021) and communication competence (B = 0.17, p = .002) positively predicted community empowerment. Conclusions: The study revealed that age and communication competence were crucial factors in public health nurses working in the community. With age and through the accumulation of practical experience, Taiwanese public health nurses’ communication competence may also improve, which can further enhance their psychological and organizational empowerment in the nursing workplace.
ALG3 Contributes to the Malignant Biological Properties of Oral&nbsp;Squamous&nbsp;Cell&nbsp;Carcinoma Cells Through Regulating CDK-Cyclin Pathway
Authors: Shao Peihong , Wei Chengshi , Wang Yun 
Published: August 2020

Abstract
Background: In this study, we planned to investigate the function and potential mechanisms of Alpha-1,3-mannosyltransferase (ALG3) in oral squamous cell carcinoma (OSCC). Methods: Data from The Cancer Genome Atlas (TCGA) was used to analyze ALG3 expression and its effect on the prognosis of patients with OSCC. Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis was applied to explore the signaling pathways related to ALG3. In OSCC cells, ALG3 expression was measured by qPCR and western blot. Cell counting kit-8, colony formation, and transwell assays were implemented to detect the effects of ALG3 on the malignant biological properties OSCC cells. The expression of key proteins related to CDK-Cyclin pathway was detected by western blot. Results: The expression of ALG3 in OSCC samples was higher than that of the control samples, and the increase of ALG3 expression was related to unfavorable prognosis of OSCC patients. Additionally, the elevated expression of ALG3 was associated with pathological stage, lymph node metastasis and primary lesion in OSCC patients. ALG3 depletion blocked the growth, colony formation, invasion and migration of OSCC cells, while over-expression ALG3 reversed these phenomena. Moreover, exhaustion of ALG3 resulted in decreased expression of MCM7, CCNB2, CDK1 and PCNA, while these phenomena were inversed after ALG3 up-regulation. Conclusions: The enhancement of ALG3 expression promoted the aggressive biological behaviors of OSCC cells probably by promoting CDK-Cyclin pathway.
Association between polypharmacy and the persistence of delirium: a retrospective cohort study
Authors: Kurisu Ken , Miyabe Daisuke , Furukawa Yoshiko , Shibayama Osamu , Yoshiuchi Kazuhiro 
Published: August 2020

Abstract
Background: Although the association between polypharmacy and the occurrence of delirium has been well studied, the influence of polypharmacy on the persistence of delirium remains unclear. We aimed to explore the effect of polypharmacy on the persistence of delirium.Methods: This retrospective cohort study was conducted at a tertiary hospital. The medical records of patients diagnosed with delirium who were referred to the Department of Psychosomatic Medicine were reviewed. Presentation with delirium on day 3 was set as the outcome in this study. We counted the number of drugs prescribed on the date of referral, excluding general infusion fluids, nutritional or electrolytic products, and psychotropics. To define polypharmacy, we developed a classification and regression tree (CART) model and drew a receiver operating characteristic (ROC) curve. The odds ratio (OR) of polypharmacy for the persistence of delirium on day 3 was calculated using a logistic regression model with the propensity score as a covariate.Results: We reviewed the data of 113 patients. The CART model and ROC curve indicated an optimal polypharmacy cutoff of six drugs. Polypharmacy was significantly associated with the persistence of delirium both before [OR, 3.02; 95% confidence interval (CI), 1.39–6.81; P = 0.0062] and after (OR, 3.19; 95% CI, 1.32–8.03; P = 0.011) propensity score adjustment.Conclusion: We discovered an association between polypharmacy and worsening courses of delirium and hypothesized that polypharmacy might be a prognostic factor for delirium.