bluuebunny/crossref_metadata_2025_split huggingface dataset:
A maternal GOT1 novel variant associated with early-onset severe preeclampsia identified by whole-exome sequencing
Authors: Zhang Lin , Cao Zheng , Feng Fan , Xu Ya-Nan , LI LIN , Gao Hong 
Published: January 2020

Abstract
Purpose This study wants to know the genetic cause of preeclampsia (PE) which is a leading cause of maternal and perinatal death, but the underlying molecular mechanisms that cause PE remain poorly understood. Many single nucleotide polymorphisms have been identified by genome-wide association studies and were found to be associated with PE; however, few studies have used whole-exome sequencing (WES) to identify PE mutations. Methods Five patients with severe early-onset preeclampsia (EOPE) were recruited, and WES was performed on each patient. Sanger sequencing was used to confirm the potential causative genetic mutation. Results After a stringent bioinformatics analysis, a rare mutation in the GOT1 gene, c.44C>G:p.P15R, was found in one patient. Bioinformatics analysis showed that the mutation site is highly conserved across several species and was predicted to be a pathogenic mutation according to several online mutational function prediction software packages. Further structural biology homology modeling suggested that P15R would change the electric environment of enzymatic center, and might affect the binding affinity of substrate or product. Conclusion We demonstrated for the first time that the mutation in GOT1 may be associated with EOPE, the results of this study provide researchers and clinicians with a better understanding of the molecular mechanisms that underlie maternal severe EOPE.
SCreg: A Registration-based Platform to Compare Unicondylar Knee Arthroplasty SPECT/CT Scans
Authors: Dandois Félix , De Buck Stijn , Beckers Lucas , Shah Darshan , Slane Laura , Vandenneucker Hilde , Scheys Lennart 
Published: January 2020

Abstract
Background A combination of conventional computed tomography and single photon emitted computed tomography (SPECT/CT) provides simultaneous data on the intensity and location of osteoblastic activity. Currently, since SPECT/CT scans are not spatially aligned, scans following knee arthroplasty are compared by extracting average and maximal values of osteoblastic activity intensity from large subregions of the structure of interest, which leads to a loss of resolution, and hence, information. Therefore, this paper describes the SPECT/CT registration platform (SCreg) based on the principle of image registration to spatially align SPECT/CT scans following unicondylar knee arthroplasty (UKA) and allow full resolution intra-subject and inter-subject comparisons. Methods SPECT-CT scans of 20 patients were acquired before and 1 year after UKA. Firstly, scans were pre-processed to account for differences in voxel sizes and divided in volumes of interest. This was followed by optimization of registration parameters according to their volumetric agreement, and alignment using a combination of rigid, affine and non-rigid registration. Finally, radiotracer uptakes were normalized, and differences between pre-operative and post-operative activity were computed for each voxel. Wilcoxon signed rank sum test was performed to compare Dice similarity coefficients pre- and post-registration. Results Qualitative and quantitative validation of the platform assessing the correct alignment of SPECT/CT scans resulted in Dice similarity coefficient values over 80% and distances between predefined anatomical landmarks below the fixed threshold of (2;2;0) voxels. Locations of increased and decreased osteoblastic activity obtained during comparisons of osteoblastic activity before and after UKA were mainly consistent with literature. Conclusions Thus, a full resolution comparison performed on the platform could assist surgeons and engineers in optimizing surgical parameters in view of bone remodeling, thereby improving UKA survivorship.
Promoting rational antibiotic prescribing for non-complicated infections: Understanding social influence in primary care networks in Germany
Authors: Poss-Doering Regina , Kamradt Martina , Glassen Katharina , Andres Edith , Kaufmann-Kolle Petra , Wensing Michel 
Published: January 2020

Abstract
Background Primary care networks in Germany are formalized regional collaborations of physicians and other healthcare providers. Common goals are optimized healthcare processes and services for patients, enhanced communication, agency for professional concerns and strengthened economic power. In the ARena study (Sustainable reduction of antibiotic-induced antimicrobial resistance), 14 primary care networks in two federal German states aimed to promote appropriate antibiotics use for acute non-complicated infections by fostering awareness and understanding. Factors related to the role of primary care networks were to be identified. Methods For this study, audio-recorded telephone interviews were conducted with physicians, non-physician health professionals and stakeholder representatives. Pseudonymized verbatim transcripts were coded using thematic analysis. In-depth analysis was based on the inductive categories ‘social support’, ‘social learning’, ‘social normative pressures’ and ‘social contagion’ to reflect social influence processes. Data generated through a survey with physicians and non-physician health professionals were analyzed descriptively to foster understanding of the networks’ potential impact on antibiotic prescribing. Results Social influence processes proved to be relevant regarding knowledge transfer, manifestation of best-practice care and self-reflection. Peer communication was seen as great asset, main reason for membership and affirmative for own perspectives. All interviewed physicians (n=27) considered their network to be a strong support factor for daily routines, introduction of new routines, and continuity of care. They utilized network-offered training programs focusing on best practice guideline-oriented use of antibiotics and considered their networks supportive in dealing with patient expectations. A shared attitude combined with ARena intervention components facilitated reflected management of antibiotic prescribing. Non-physician health professionals (n=11) also valued network peer exchange. They assumed their employers joined networks to offer improved and continuous care. Stakeholders (n=7) expected networks and their members to be drivers for care optimization. Conclusion Primary care networks play a crucial role in providing a platform for professional peer exchange, social support and reassurance. With regards to their impact on antibiotic prescribing for acute non-complicated infections, networks seem to facilitate and amplify quality improvement programs by providing a platform for refreshing awareness, knowledge and self-reflection among care providers. They are well suited to promote a rational use of antibiotics.
Effects of menarche, parity, primiparous age, and reproductive diseases on uterine fibroids of rural women in China
Authors: Wu Bing-Jie , Shao Chun-Yan , Zhu Yun , Huang Kai , Wei Wu , Zhang Xiu-Jun , Hu Cheng-Yang , Zhong Fei 
Published: January 2020

Abstract
Objectives: Given the increasing prevalence of hysteromyoma among the Chinese rural women of childbearing age, it is imperative that more attention should be given to researching risk factors that predispose women to this condition so that early preventive measures may be taken. Our study investigates potential risk factors for uterine fibroids such as participants' demographic characteristics (age, ethnicity, education), physiological characteristics (age at menarche, primiparous age), and the occurrence of several different female reproductive diseases (vaginitis, pelvic inflammatory disease).Methods: 2,200 rural women of reproductive age were screened from a cross-sectional study carried out in the Anhui province. Data was collected by questionnaire surveys, gynecological and laboratory examinations and were subjected to univariate and multivariate analysis to evaluate the risk factors for uterine fibroids.Results: Of the 2,200 women, 440 had uterine fibroids. In general, women with endometriosis, ovarian cysts and early menarche were more likely to suffer from hysteromyoma. Factors including higher parity, late age of first childbirth, and a regular menstrual cycle were protective against uterine fibroids.Conclusions: Our findings indicate that parameters such as earlier age of menarche, early primiparous age，lower parity and a variety of female reproductive diseases could increase the risk of uterine fibroids. These findings may be used to guide the formulation of effective prevention and intervention protocols to improve the reproductive health of rural women.
Emergence of human avian influenza A(H7N9) virus infections in Wenshan City in Southwest China, 2017
Authors: Jiang Li , Zhao Xiaonan , Xu Wen , Zhou Xuehua , Luo Chunrui , Zhou Jiunan , Fu Xiaoqing , Chen Yaoyao , Li Duo 
Published: January 2020

Abstract
Background: The emergence of human infection with avian influenza A(H7N9) virus was reported in Wenshan City, southwestern China in 2017. The study describes the epidemiological and virological features of the outbreak and discusses the origin of the infection. Methods: Poultry exposure and timelines of key events for each patient were collected. Samples derived from the patients, their close contacts, and environments were tested for influenza A(H7N9) virus by real-time reverse transcription polymerase chain reaction. Genetic sequencing and phylogenetic analysis were also conducted. Results: Five patients were reported in the outbreak. An epidemiological investigation showed that all patients had been exposed at live poultry markets. The A(H7N9) isolates from these patients had low pathogenicity in avian species. Both epidemiological investigations of chicken sources and phylogenetic analysis of viral gene sequences indicated that the source of infection was from Guangxi Province, which lies 100 km to the east of Wenshan City. Conclusions: In the study, a sudden emergence of human cases of H7N9 was documented in urban area of Wenshan City. Chickens were an important carrier in the H7N9 virus spreading from Guangxi to Wenshan. Hygienic management of live poultry markets and virological screening of chickens transported across regions should be reinforced to limit the spread of H7N9 virus.
Evaluation of antioxidant and antimicrobial activities of chloroformic and methanolic extracts of 6 important medicinal plants collected from North of Iran
Authors: Ghahari Somayeh , Hadadi Zahra , Nematzadeh Ghorban Ali 
Published: January 2020

Abstract
Background: as possible sources of natural bioactive molecules, the plant essential oils and extracts have been used globally in new antimicrobial compounds, food preservatives, and alternatives to treat infectious disease.Methods: In this research, the antimicrobial activities of chloroformic and methanolic extracts of Sophora flavescens, Rhaponticum repens, Alhagi maurorum, Melia azedarach, Peganum harmala, and Juncus conglomeratus were evaluated against 8 bacteria (S. aureus, B. subtilis, R. toxicus, P. aeruginosa, E. coli, P. syringae, X. campestris, P. viridiflava) and 3 fungi (Pyricularia oryzae, Fusarium oxysporum and Botrytis cinerea), through disc diffusion method. Furthermore, the essential oils of plants with the highest antibacterial activity were analyzed utilizing GC/MS. Moreover, the tested plants were exposed to screening for possible antioxidant effect utilizing DPPH test, guaiacol peroxidas, and catalase enzymes. Besides, the amount of total phenol and flavonoid of these plants was measured. Results: Among the tested plants, methanolic and chloroformic extracts of P. harmala fruits showed the highest antibacterial activity against the tested bacteria. Besides, the investigation of free radical scavenging effects of the tested plants indicated the highest DPPH, protein, guaiacol peroxidase, and catalase in P. harmala, M. azedarach, J. conglomeratus fruits, and J. conglomeratus fruits, respectively. In addition, the phytochemical analysis demonstrated the greatest amounts of total phenolic and flavonoid compositions in J. conglomeratus and P. harmala, respectively.Conclusion: The results indicated that these plants could act as a promising antimicrobial agent, due to their short killing time.
Hypertonic glucose inhibits growth and attenuates virulence factors of multidrug-resistant Pseudomonas aeruginosa by regulating quorum sensing
Authors: Chen Tao , Xu Ye , Xu Wenya , Liao Wenli , Xu Chunquan , Zhang Xiucai , Cao Jianming , Zhou Tieli 
Published: January 2020

Abstract
Background: Pseudomonas aeruginosa is the most common Gram-negative pathogen responsible for chronic wound infections such as diabetic foot infections, which make chronic wound treatment become increasingly difficult and costly, further exacerbated. Hypertonic glucose, a commonly used prolotherapy solution, can accelerate the proliferation of granulation tissue and improve microcirculation in the wound, but the knowledge of the impacts that hypertonic glucose has on wound infecting pathogens has lagged. In this study, we aim to investigate the inhibitory effects of hypertonic glucose on diabetic foot infecting multidrug-resistant P. aeruginosa, to offer a novel approach to control the chronic wound infections caused by P. aeruginosa. Results: Four multidrug-resistant P. aeruginosa clinical strains isolated from diabetic foot ulcers from a tertiary hospital in China and P. aeruginosa PAO1 were studied. Hypertonic glucose had a remarkable inhibitory effect on growth of PAO1 and multidrug-resistant P. aeruginosa strains. Furthermore, hypertonic glucose significantly inhibited the formation of biofilm, the ability of swimming, and the production of virulence factors including pyocyanin and elastase in all P. aeruginosa strains. We examined the expressions of major quorum sensing related genes (lasI, lasR, rhlI, and rhlR) in P.aeruginosa and found these genes were all downregulated after hypertonic glucose treatment. In infection model of Galleria mellonella larvae, groups inoculated with P. aeruginosa strains which were treated with hypertonic glucose showed no increased survival rate than non-hypertonic glucose-treated groups. Conclusions: Our research suggested that hypertonic glucose displayed the ability to inhibit growth, biofilm formation and swimming motility as well as attenuate virulence factors of multidrug-resistant P. aeruginosa via regulating quorum sensing system. Further clinical studies combining hypertonic glucose with traditional antibiotics should be considered in chronic wound infections.
Characteristics of Resting-State Functional Connectivity in Older Adults after the PICMOR Intervention Program: A Preliminary Report
Authors: Sugimoto Hikaru , Kawagoe Toshikazu , Otake-Matsuura Mihoko 
Published: January 2020

Abstract
Background: The present study aimed to provide a basis for future research examining neural mechanisms underlying the beneficial effect of an intervention program named Photo-Integrated Conversation Moderated by Robots (PICMOR) on verbal fluency in older adults, which was identified in our previous randomized controlled trial. In this preliminary report, we conducted an additional experiment after the intervention period using resting-state functional magnetic resonance imaging (rsfMRI). Specifically, we investigated the characteristics of resting-state functional connectivity (rsFC) of the intervention group (INT) by comparing with that of the control group (CONT). Methods: The rsfMRI data were acquired from 31 participants in INT and 30 participants in CONT after the intervention. In the analyses, two of the most important regions in verbal fluency, the left inferior and middle frontal gyri, were selected as seed regions, and the rsFCs were compared between INT and CONT. We also conducted regression analyses for rsFCs using the difference in individual scores of the phonemic verbal fluency test (PVFT) between the pre- and post-intervention periods (i.e., post- minus pre-intervention) as a dependent variable. Results: We found higher rsFC in INT than in CONT between the left inferior frontal gyrus and the temporal pole and middle frontal gyrus. The rsFC strength between the left inferior frontal gyrus and temporal pole positively correlated with an increased PVFT score between the pre- and post-intervention periods. In contrast, we found lower rsFC in INT than in CONT between the left middle frontal gyrus and the posterior cingulate cortex, precuneus, and postcentral gyrus. Conclusions: The present findings suggest that the beneficial intervention effect of PICMOR on verbal fluency is characterized by enhanced rsFC of the left inferior frontal gyrus with semantic and executive control-related regions and suppressed rsFC between the left middle frontal gyrus and default mode network. Although we cannot make any definitive conclusions because of a lack of rsfMRI data before the intervention, this pilot study successfully provides the candidates for rsFCs, reflecting the neural mechanisms underlying the beneficial intervention effect on verbal fluency.
The influence of integrated geriatric outpatient clinic on the health care utility of elderly
Authors: WEI YU-JU , Hsieh Cheng-Fang , Huang Yu-Ting , Huang Ming-Shyan , Fang Tzu-Jung 
Published: January 2020

Abstract
Background: People above age 65 are growing in many countries. Taiwan will be a super-aged society in 2026 and the utility of health care will increase considerably. Our study was aimed to evaluate the efficacy of the geriatric integrated outpatient clinic on health care utility reduction of the elderly. Methods: This was a retrospective case-control study. The patients with age more than 65 years old in the geriatric outpatient clinic (Geri-OPD) and non-geriatric outpatient clinic (non-Geri OPD) with age and sex-matched in a single medical center were included. The numbers of outpatient clinic visits, emergency department visits, hospitalization, and medical expenditure data were collected in the first year and second year. The subgroup analysis by Charlson comorbidity index (CCI) and older age (age≧80 years old) was done between Geri-OPD and non-Geri OPD. Results: Total 6723 patients were included (3796 women and 2927 men). The mean age was 80.42 ± 6.39 years old. There were 1291 (19.2%) patients from the Geri-OPD and 5432 (80.8%) patients from the non-Geri OPD. After one year regular follow-up, those Geri-OPD patients had significantly reduced 5.62±10.85 kinds of drugs in each prescription and 18.18 ± 48.85 clinic visits per year (P<0.01). After two-year follow-up, the clinic visits, emergent department visits, hospitalizations, and the annual medical cost still decreased in the Geri-OPD patients. The Geri-OPD patients have more co-morbidities and higher health care utility than the non-Geri OPD patients. In the subgroup analysis, the patients with higher comorbidities (CCI≧2) and older age (≧80 years old) have significant health care utility reduction in Geri-OPD. The medical utility difference between the Geri-OPD and non-Geri OPD patients also decreased significantly. Conclusion: The geriatric integrated outpatient clinic reduced the medical cost, drug numbers, and the frequency of outpatient clinic visit, emergency department visit and hospitalization in the complicated elder patients. The effect was even better in the second year.
The erosion of ambiguity tolerance and sustainment of perfectionism in undergraduate Medical training: A study of clerkship training effects.
Authors: Ndoja Silvio , Chahine Saad , Saklofske Donald H. , Lanting Brent 
Published: January 2020

Abstract
Background : Medicine is a field that is simultaneously factual and ambiguous. While studies have examined medical trainees’ tolerance of ambiguity (TOA), the extent to which TOA is affected by clinical experiences and its association with other psychological factors such as perfectionism is unknown.
Methods: This was a single cohort study:174 Students in the first (pre) and last (post) 12 weeks of their 3 rd year comprising of 6 core rotations were invited to participate in an online anonymous survey. The survey included demographic information along with published and validated TOA and perfectionism scales. Tolerance of Ambiguity in Medical Students and Doctors (TAMSAD) and The Big Three perfectionism scale-short form (BTPS-SF) were used to assess TOA and perfectionism respectively. Pre-Post mean comparisons and correlations were used to detect the effect of clerkship on TOA, perfectionism and their relationship.
Results: 51 students responded to pre-survey, 62 responded to post-survey. Clerkship was associated with a decrease TOA (p<0.00) with pre-TOA scores at m=59.57 and post TOA at m=43.8. There was a moderate inverse correlation between TOA and perfectionism before clerkship (r=0.32) that increased slightly after clerkship (r=0.39). Clerkship was not significantly associated with levels of perfectionism (P>0.05). Those preferring primary care specialties had significantly lower rigid and total perfectionism scores in pre clerkship than those choosing other specialties, this difference was not found post clerkship.
Conclusion: Clerkship does appear to influence student’s tolerance of ambiguity. However, perfectionism remained unchanged. Further work needs to be done exploring tailoring educational interventions to extremes of TOA and perfectionism.
Medical Education Interest, Exposure, and Career Planning in Subspecialty Trainees
Authors: Marshall Ariela L , Thompson Carrie A. , Cullen Michael W. , Raffals Laura E. , Oxentenko Amy S. 
Published: January 2020

Abstract
Background Medical education encompasses many activities (e.g., teaching, supervision, mentorship, and administration). Little research has explored what the term "medical education" means to trainees or assessed the importance postgraduate medical trainees place on education as part of their career plans. Methods We conducted a survey of fellows in all subspecialty training programs at a three-site academic institution. We asked multiple choice and Likert scale questions to characterize fellows’ perception of, interest and training in medical education. Results One hundred sixty-nine of 530 (31.9%) fellows responded. Fellows were training in subspecialties of internal medicine (49.7%) and surgery (13.0%), among others. Most fellows planned careers in academic medicine (38.5% clinician-educator, 22.5% clinician-investigator, 17.2% academic clinician). Fellows reported that their conception of medical education involved supervising trainees in a clinical capacity (93.5%), teaching in the classroom (89.3%), and providing mentorship for trainees (87.6%). Respondents identified “being an educator” as extremely (43.8%) or moderately (43.2%) important for their future careers. Only 30.2% had received formal training in medical education, but 61.5% felt that formal training should be required for those pursuing careers with strong educational components. Conclusions Most subspecialty fellows surveyed planned careers in academics and felt that medical education was important to their professional future. While less than a third received formal training in education, almost two thirds felt that such training should be required for a career as an educator. This study provides evidence for the creation and promotion of educational training programs for trainees interested in careers involving medical education.