bluuebunny/crossref_metadata_2025_split huggingface dataset:
UBR-Box containing protein, UBR5, is over-expressed in human lung adenocarcinoma and is a potential therapeutic target
Authors: Saurabh Kumar , Shah Parag P , Doll Mark , Siskind Leah J , Beverly Levi J. 
Published: August 2020

Abstract
Background: N-end rule ubiquitination pathway is known to be disrupted in many diseases, including cancer. UBR5, an E3 ubiquitin ligase, is mutated and/or overexpressed in human lung cancer cells suggesting its pathological role in cancer. Methods: We determined expression of UBR5 protein in multiple lung cancer cell lines and human patient samples. Using immunoprecipitation followed by mass spectrometry we determined the UBR5 interacting proteins. The impact of loss of UBR5 for lung adenocarcinoma cell lines was analyzed using cell viability, clonogenic assays and in vivo xenograft models in nude mice. Additional Western blot analysis was performed to assess the loss of UBR5 on downstream signaling. Statistical analysis was done by one-way ANOVA for in vitro studies and Wilcoxon paired t-test for tumor volumes in vivo. Results: We show variability of UBR5 expression levels in lung adenocarcinoma cell lines and in primary human patient samples. To gain better insight into the role that UBR5 may play in lung cancer progression we performed unbiased interactome analyses for UBR5. Data indicate that UBR5 has a wide range of interacting protein partners that are known to be involved in critical cellular processes such as DNA damage, proliferation and cell cycle regulation. We have demonstrated that shRNA-mediated loss of UBR5 decreases cell viability and clonogenic potential of lung adenocarcinoma cell lines. In addition, we found decreased levels of activated AKT signaling after the loss of UBR5 in lung adenocarcinoma cell lines using multiple means of UBR5 knockdown/knockout. Furthermore, we demonstrated that loss of UBR5 in lung adenocarcinoma cells results in significant reduction of tumor volume in nude mice. Conclusions: These findings demonstrate that deregulation of the N-end rule ubiquitination pathway plays a crucial role in the etiology of some human cancers, and blocking this pathway via UBR5-specific inhibitors, may represent a unique therapeutic target for human cancers.
Homeobox proteins are potential biomarkers and therapeutic targets in gastric cancer: a systematic review and meta-analysis
Authors: Jin Xiao , Dai Lu , Ma lan Yi , Wang yan Jia , Yan hao Hai , Jin Ye , Zhu juan Xiao , Liu Zheng 
Published: August 2020

Abstract
Background: An increasing number of studies have described the aberrant expression of homeobox (HOX) proteins in gastric cancer (GC), which is critically associated with the prognosis and clinicopathological characteristics of GC. This study was conducted to investigate the clinical value and potential mechanisms of HOX proteins in GC. Methods: A comprehensive search of PubMed, EMBASE, Web of Science and Cochrane Library was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. The pooled hazard ratio (HR) with its 95% confidence interval (95% CI) and the pooled odds ratio (OR) with its 95% CI were used to assess the effects of HOX protein expression on the prognosis and clinicopathological features of GC, respectively. Results: Nineteen studies involving 3775 patients were selected for this study. Heterogeneity among HRs of overall survival (OS) was markedly high (I2=90.5%, p=0.000). According to the subgroup analysis, increased expression of HOX proteins in the downregulated subgroup was associated with a good prognosis for patients with GC (pooled HR: 0.46, 95% CI: 0.36-0.59, I2=3.1%, p=0.377), while the overexpression of HOX proteins in the upregulated subgroup correlated with a reduced OS (pooled HR: 2.59, 95% CI: 1.79-3.74, I2=73.5%, p=0.000). The aberrant expression of HOX proteins was crucially related to the TNM stage, depth of tumour invasion, tumour size, lymph node metastasis, distant metastasis, vascular invasion, histological differentiation and Lauren classification in patients with GC. In addition, the molecular mechanisms by which HOX proteins regulate the tumorigenesis and development of GC were also explored. Conclusions: HOX proteins play vital roles in GC progression and might serve as prognostic markers for GC. Novel therapeutic strategies targeting HOX proteins are promising for GC prevention and therapy.
Elective removal vs. retaining of hardware after osteosynthesis in asymptomatic patients – A scoping review.
Authors: Prediger Barbara , Mathes Tim , Probst Christian , Pieper Dawid 
Published: August 2020

Abstract
BackgroundOsteosynthesis is the internal fixation of fractures or osteotomy by mechanical devices (also called hardware). After bone healing, there are two options: One is to remove the hardware, the other is to leave it in place. The removal of the hardware in patients without medical indication (elective) is controversially discussed. We performed a scoping review to identify evidence on the elective removal of hardware in asymptomatic patients compared to retaining of the hardware to check feasibility of performing a health technology assessment. In addition, we wanted to find out which type of evidence is available.MethodsA systematic literature search was performed in Pubmed, Embase, EconLit and Cinahl (11/2019). We included studies comparing asymptomatic patients with an internal fixation in the lower or upper extremities whose internal fixation was electively (without medical indication) removed or retained. We did not restrict inclusion to any effectiveness/safety outcome and considered any comparative study design as eligible. Study selection and data extraction was performed by two reviewers. ResultsWe identified 13476 titles/abstracts. Of these we obtained 115 full-text publications which were assessed in detail against the inclusion criteria. We included 13 studies (1 RCT, 4 cohort studies, 8 before-after studies) and identified two ongoing RCTs. Nine assessed the removal of the internal fixation in the lower extremities (six of these syndesmotic screws in ankle fractures only) and two in the upper extremities. One study analysed the effectiveness of hardware removal in children in all types of extremity fractures. Outcomes reported included various scales measuring functionality, pain and clinical assessments (e.g. range of motion) and health-related quality of life.ConclusionsWe identified 13 studies that evaluated the effectiveness/safety of hardware removal in the extremities. The follow up times were short, the patient groups small and the ways of measurement differed. In general clinical heterogeneity was high. Evidence on selected topics e.g. syndesmotic screw removal is available nevertheless not sufficient to allow a meaningful assessment of effectiveness.
Impact of DRGs-based inpatient service management on the performance of regional inpatient services in Shanghai, China: an interrupted time series study, 2013-2019
Authors: feng lvfan , Tian Yuan , He Mei , Tang Jie , Peng Ying , Dong Chenjie , Xu Wenzhong , Wang Tao , He Jiangjiang 
Published: August 2020

Abstract
Background: The asymmetry of information brings difficulty for government to manage public hospitals. Therefore, Jiading District of Shanghai has been establishing DRGs-based inpatient service management system (ISMS) to effectively compare the output of different hospitals through DRGs, reward desired hospital performance and enhance inpatient service capacity. However, the impact of the implementation of DRGs-based inpatient service management (ISM) policy in Jiading district is still unknow. We therefore conducted this study to evaluate the impact of DRGs-based ISM policy on the performance of inpatient service since its implementation in Jiading District, Shanghai, China in 2017.Methods: Using an interrupted time series design, we analyzed quarterly data of seven DRGs-based performance measures from the ISMS which covered all five public hospitals in Jiading District from 2013 to 2019. We utilized the segmented linear regression model to assess the change of level and trend of performance indicators before and after ISM policy. Dickey–Fuller test was used to examine the stationary of the data. Durbin-Watson test was performed to check the series autocorrelation of indicators.Results: Significant changes in the following indicators were observed since the implementation of ISM policy. The case-mix index (CMI) level decreased by 0.103 (P < 0.05), the trend increased by 0.008 (P < 0.05). The total weight level decreased by 3719.05 (P < 0.05), and the trend increased by 250.13 (P < 0.05). The time efficiency index (TEI) level increased by 0.12 (P < 0.05), and the trend decreased by 0.01 (P < 0.05). The cost efficiency index (CEI) level increased by 0.31 (P < 0.05), and the trend decreased by 0.02 (P < 0.05). No significant difference was found in the change of DRGs number, inpatient mortality of low-risk group cases (IMLRG) and inpatient mortality of medium-to-low risk group cases (IMMLRG).Conclusions: Findings highlight the role of ISM policy in improving the capacity and efficiency of regional inpatient service. Three prerequisites, including a good information system, high-quality EMR data, and a management team, are needed for other countries to implement their own ISM policy to help government manage public hospitals and improve the performance of regional inpatient service.
Cost-effectiveness analysis of malaria rapid diagnostic test in the elimination setting
Authors: Du Yanqiu , Ling Xiaoxiao , Jin Jiajie , Zhou Huayun , Zhu Si , Zhu Guoding , Wang Wei , Cao Jun , Huang Jiayan 
Published: August 2020

Abstract
Background: As more and more countries approaching the goal of malaria elimination, malaria rapid diagnostic tests (RDT) was recomendated to be a diagnostic strategy to achieve and maintain the statute of malaria free, as it’s less requirments on equipment and experitise than microscopic examination. But there are very few economic evaluations to confirm whether RDT was cost-effective in the setting of malaria elimination. This research aimed to offer evidence for helping decision making on malaria diagnosis strategy.Methods: A cost-effectiveness analysis was conducted to compare RDT with microscopy examination for malaria diagnosis, by using a decision tree model. There were three strategies of malaria diagnostic testing evaluated in the model, 1) microscopy, 2) RDT, 3) RDT followed by microscopy. The effect indicator was defined as the number of malaria cases treated appropriately. Based on the joint perspective of health sector and patient, costs data were collected from hospital information systems, key informant interviews, and patient surveys. Data collection was conducted in Jiangsu from September 2018 to January 2019. Epidemiological data were obtained from local malaria surveillance reports. A hypothetical cohort of 300 000 febrile patients were simulated to calculate the total cost and effect of each strategy. One-way, two-way, and probabilistic sensitivity analysis were performed to test the robustness of the result.Results: The results showed that RDT strategy was the most effective (245 cases) but also the most costly (United States Dollar [USD] 4.47 million) compared to using microscopy alone (238 cases, USD 3.63 million), and RDT followed by microscopy (221 cases, USD 2.75 million). There was no strategy dominated. One-way sensitivity analysis reflected that the result was sensitive to the change in labor cost and two-way sensitivity analysis indicated that the result was not sensitive to the proportion of falciparum malaria. The result of Monte Carlo simulation showed that RDT strategy had higher effects and higher cost than other strategies with a high probability.Conclusions: Compared to microscopy and RDT followed by microscopy, RDT strategy had higher effects and higher cost in the setting of malaria elimination.
Adolescents Nutritional Status and its association with Academic Performance in South Ethiopia; a facility-based cross-sectional study
Authors: Katiso Selamawit Woldeyohanes , Kerbo Amene Abebe , Dake Samson Kastro 
Published: August 2020

Abstract
Background: Though evidence about the magnitude of malnutrition is well established in Ethiopia, the evidence is scarce about the association of nutritional status with academic performance among adolescents. Thus, this study aimed at determining the association of nutritional status with academic performance among adolescents attending secondary schools in Wolaita Sodo town, Southern Ethiopia.Methods: A facility-based cross-sectional study was conducted among 670 systematically selected adolescents in secondary schools of Wolaita Sodo town from April to June 2019. The academic performance of the adolescents was measured using the average mark score of two consecutive semester's results of the overall subjects. Data were analyzed with STATA software Version 15. Descriptive statistics, Pearson Correlation, and linear regression were used in the statistical analysis. A p-value <0.05 was considered as statistically significant.Results: The mean academic performance of students was 69.21±0.42 (95% CI: 68.34%-70.02%). An average mark score of students increased by 1.89 (β=1.89; 95 %CI: 1.14, 2.64) for a unit increase in BMI for age z-score. Being female decreased an average mark score by 2.63 (β=-2.63; 95 %CI: -4.28, -0.98) and being from a separated parents decreased by 4.73 (β=-4. 73; 95 %CI: -6.73, -2.74). An average mark score of students from the lowest wealth class decreased by 9.92(-9.92; 95 %CI: -12.79, -7.04) as compared to students from the highest wealth class. Attending private schools increased the average mark score of students by 4.18 (β=4.18; 95 %CI: 2.46, 5.90). Conclusion: This study has ascertained that poor academic performance was reported among undernourished students, girls, students whose parents were separated, students of low wealth status households, and students enrolled to public schools. Launching nutritional interventions, household income generating activities targeting lowest wealth status households, and giving tutorial classes for female students were recommended.
Work environment-related factors and nurses’ health outcomes: A cross-sectional study in Lebanese hospitals
Authors: ELBEJJANI Martine , Ahad Mary Abed Al , SIMON Michael , AUSSERHOFER Dietmar , DUMIT Nuhad , HUIJER Huda ABU-SAAD , Dhaini Suzanne R 
Published: August 2020

Abstract
Background: Worldwide, studies show that nurses’ health is related to some work environment factors; however, data on nursing tasks’ allocation and self-perceived workload are lacking, particularly for Lebanese nurses. We assessed the relationship of several work environment factors (overall workload and specific temporal, physical, mental, effort, frustration, and performance demands (NASA Task Load Index), staffing resources adequacy and leadership (Practice Environment Scale of Nursing Work Index), teamwork climate (Safety Attitudes Questionnaire), and nursing task allocation (Basel Extent of Rationing of Nursing Care) with self-reported musculoskeletal, cardiovascular, skin, and mental health diseases (Work Ability Index) and emotional exhaustion (Maslach Burnout Inventory) among Lebanese nurses. Methods: A cross-sectional self-report survey was distributed to all 289 registered nurses (RNs) in the medical, surgical, and pediatric units in two university-affiliated hospitals in Lebanon; 170 RNs provided complete data. Adjusted multivariable logistic regression models were used to assess the relationship of work environment factors with health conditions. Results: The most prevalent outcomes were musculoskeletal disease (69%), emotional exhaustion (59%), and mental health problems (56%); 70% of RNs had ≥2 and 35.29% had ≥4 co-occurring health problems. Musculoskeletal disorders were associated with higher overall (OR=1.36 (95%CI=1.03, 1.80)), temporal (OR=1.30 (95%CI=1.09, 1.55)), and physical demands (OR=1.20 (95%CI=1.03, 1.49)), more nursing tasks allocation to RNs (OR=1.11 (95%CI=1.01, 1.23)) and lower teamwork climate (OR=0.60 (95%CI=0.36, 0.98). Higher odds of mental/emotional problems were related to higher overall, temporal, frustration, and effort demands, and lower teamwork climate, performance satisfaction, and resources adequacy (increased odds ranging from 18% to 88%). Work-environment factors were related to higher co-occurrence of health problems. Conclusions: Results show high health burden and co-morbidity among Lebanese RNs and highlight the value of more comprehensive approaches towards improving many work environment factors (including team climate, various components of workload, resources, and nursing tasks’ allocation) to reduce this burden.
DHPV: A Distributed Algorithm for Large-Scale Graph Partitioning
Authors: Adoni Wilfried Yves Hamilton , Nahhal Tarik , Krichen Moez , byed Abdeltif El , Assayad Ismail 
Published: August 2020

Abstract
Big graphs are part of the movement of "Not Only SQL" databases (also called NoSQL) focusing on the relationships between data, rather than the values themselves. The data is stored in vertices while the edges model the interactions or relationships between these data. They offer flexibility in handling data that is strongly connected to each other. The analysis of a big graph generally involves exploring all of its vertices. Thus, this operation is costly in time and resources because big graphs are generally composed of millions of vertices connected through billions of edges. Consequently, the graph algorithms are expansive compared to the size of the big graph, and are therefore ineffective for data exploration. Thus, partitioning the graph stands out as an efficient and less expensive alternative for exploring a big graph. This technique consists in partitioning the graph into a set of k sub-graphs in order to reduce the complexity of the queries. Nevertheless, it presents many challenges because it is an NP-complete problem. In this article, we present DPHV (Distributed Placement of Hub-Vertices) an efficient parallel and distributed heuristic for large-scale graph partitioning. An application on a real-world graphs demonstrates the feasibility and reliability of our method. The experiments carried on a 10-nodes Spark cluster proved that the proposed methodology achieves significant gain in term of time and outperforms JA-BE-JA, Greedy, DFEP.
Economic impact of clinical decision support interventions based on electronic health records
Authors: Lewkowicz Daniel , Wohlbrandt Attila , Boettinger Erwin 
Published: August 2020

Abstract
Background Unnecessary healthcare utilization, non-adherence to current clinical guidelines, or insufficient personalized care are perpetual challenges and remain potential major cost-drivers for healthcare systems around the world. Implementing decision support systems into clinical care is promised to improve quality of care and thereby yield substantial effects on reducing healthcare expenditure. In this article, we evaluate the economic impact of clinical decision support (CDS) interventions based on electronic health records (EHR). Methods We searched for studies published after 2014 using MEDLINE, CENTRAL, WEB OF SCIENCE, EBSCO, and TUFTS CEA registry databases that encompass an economic evaluation or consider cost outcome measures of EHR based CDS interventions. Thereupon, we identified best practice application areas and categorized the investigated interventions according to an existing taxonomy of front-end CDS tools. Results and discussion Twenty-seven studies are investigated in this review. Of those, twenty-two studies indicate a reduction of healthcare expenditure after implementing an EHR based CDS system, especially towards prevalent application areas, such as unnecessary laboratory testing, duplicate order entry, efficient transfusion practice, or reduction of antibiotic prescriptions. On the contrary, order facilitators and undiscovered malfunctions revealed to be threats and could lead to new cost drivers in healthcare. While high upfront and maintenance costs of CDS systems are a worldwide implementation barrier, most studies do not consider implementation cost. Finally, four included economic evaluation studies report mixed monetary outcome results and thus highlight the importance of further high-quality economic evaluations for these CDS systems. Conclusion Current research studies lack consideration of comparative cost-outcome metrics as well as detailed cost components in their analyses. Nonetheless, the positive economic impact of EHR based CDS interventions is highly promising, especially with regard to reducing waste in healthcare.
Leishmania infection and blood sources analysis in Phlebotomus chinensis (Diptera: Psychodidae) along extension region of the Loess Plateau, China
Authors: Chen Hanming , Chen Huiying , Tao Feng , Gao Jingpeng , Li Kaili , Shi Hua , Peng Heng , Ma Yajun 
Published: August 2020

Abstract
Background Visceral leishmaniasis (VL) was one of the most important parasitic diseases in China, caused by Leishmania protozoans and transmitted by sand flies. Recently VL cases have reappeared in China, including the extension region of the Loess Plateau. The purpose of this study was to collect fundamental data on the host-vector VL system in the Loess Plateau to assist in the development of prevention and control measures.Methods Sand flies were collected by light traps from rural areas in Shanxian, Henan, China in 2015, as well as in Wuxiang and Yangquan, Shanxi, China in 2017. The blood sources of sand flies were analyzed by PCR detecting the host-specific mitochondrial cytochrome b (mtDNA Cyt b) gene fragments. Leishmania infection in sand flies was detected by amplifying and sequencing ribosomal DNA internal transcribed spacer 1 (ITS1). The Leishmania specific antibodies in the sera of local dogs were detected by ELISA kit. Results Blood sources showed diversity in the extension region of the Loess Plateau, including human, chicken, dog, cattle, pig and goat. Multiple blood sources within a sand fly were observed in samples from Yangquan (17/118, 14.4%) and Wuxiang (12/108, 11.1%). Leishmania DNA was detected in sand flies collected from Yangquan with minimum infection rate of 1.00%. The ITS1 sequences were conserved with the Leishmania donovani complex. The positive rate of Leishmania specific antibodies in dogs was 5.97%. Conclusions This study detected the blood sources and Leishmania parasites infection of sand flies by molecular methods in the extension region of Loess Plateau, China. A high epidemic risk of leishmaniasis is currently indicated by the results as the infection of Leishmania in sand flies, the extensive blood sources of sand flies including humans, and positive antibody of Leishmania in local dog sera. Given the recent increase of VL cases, asymptomatic patients, dogs and other potential infected animals should be screened and treated. Furthermore, the density of sand flies needs to be controlled and personal protection should be strengthened.