bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk of Nonunion with Nonselective NSAIDs, COX-2 Inhibitors, and Opioids
Authors: George Michael D. , Baker Joshua F. , Leonard Charles E. , Mehta Samir , Miano Todd A. , Hennessy Sean 
Published: May 2020

Background:
Cyclooxygenase-2 (COX-2) has been found to be important for fracture-healing in animal models, raising concerns about use of nonsteroidal anti-inflammatory drugs (NSAIDs) and selective COX-2 inhibitors after fractures. We evaluated associations of NSAIDs, COX-2 inhibitors, and opioids with nonunion after long-bone fracture.

Methods:
Using private health insurance claims data from Optum’s de-identified Clinformatics Data Mart database from January 1, 2000, to September 30, 2015, we identified adults with a single long-bone fracture or commonly paired long-bone fractures who had 1 year of available follow-up data. Using multivariable logistic regression models, we examined associations between NSAID, COX-2-inhibitor, or opioid prescription fills after the fracture and the risk of nonunion within 1 year, defined as a nonunion diagnosis with a procedure to treat the nonunion.

Results:
A nonunion diagnosis with a procedure to treat the nonunion was identified after 2,996 (0.9%) of the 339,864 fracture episodes, with rates varying by fracture site. The risk of that outcome was greater in patients who had filled COX-2-inhibitor prescriptions (adjusted odds ratio = 1.84 [95% confidence interval = 1.38 to 2.46]) or opioid prescriptions (1.69 [1.53 to 1.86]), but not in patients who had filled nonselective-NSAID prescriptions (1.07 [0.93 to 1.23]) after the fracture. Results were similar when the outcome definition was changed to just a nonunion diagnosis.

Conclusions:
COX-2 inhibitors, but not nonselective NSAIDs, were associated with a greater risk of nonunion after fracture. Opioids were also associated with nonunion risk, although patients filling prescriptions for opioids may have had more severe fractures.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Can Positive Entrepreneurship Policies Always Improve Social Welfare?
Authors: Li Xiang , Xu Yanmei 
Published: May 2020

AbstractThe entrepreneurship has positive and significant connection with economic growth. Competition would be increased by new entrants in the market; then, social welfare would be improved. Thus, positive entrepreneurship policies are often linked to increased social welfare by authorities. In this paper, we focus on a certain case where potential entrepreneurs are employees of existing firms to test the above ideas. The purpose of our research is to assess the variation of social welfare in the context of employer-restricted separation. Therefore, the model of Cournot competition where employees constitute the only entry threat was used in this paper. The results demonstrate that social welfare would not always be improved even in a good entrepreneurial context. If the deterring strategy is present, the relationship between positive entrepreneurship policies and increased social welfare might not hold, or would depend on the different strategies adopted by the incumbent. Therefore, the sustainability of a positive entrepreneurship policy would be impaired by incumbent firms.
The assessment of beauty salon client awareness of risk factors relating to skin and nail fungal infections of the feety
Authors: Tumala Aleksandra , Marchlewicz Mariola 
Published: May 2020

Abstract

Introduction: Fungal infections of the skin and nails are one of the most common skin diseases in the world. The ever-growing number of fungal infections is caused by genetic factors, lack of prevention and insufficient knowledge about risk factors relating to fungal infections.
The aim of the project was to assess the awareness of beauty salon clients to fungal infections of the skin and nails of the feet, with a particular emphasis on the factors contributing to infection.

Materials and methods: The study was conducted among 125 clients of beauty salons.
The data was collected via an anonymous questionnaire comprising 30 questions.

Results: The majority of respondents (84% of women and 70% of men) considered the swimming pool as the main risk factor for fungal infection of the feet. The respondents listed specialists to whom they would turn after noticing suspicious skin changes on their feet. These were dermatologists (18% of responding women and 38% of responding men) as well as podologist (35% of responding women and 23% of responding men). However, the majority of respondents (45% of responding men and 33% of responding women) would use an over-the-counter antifungal medicine, easily obtained in a pharmacy, in case of suspected fungal nail infection (onychomycosis), without consulting a physician.

Conclusions: Most respondents know the risk factors contributing to fungal infections. However, a high percentage of them have low awareness of the actions to be taken when onychomycosis is suspected.
A Rare Intracerebral Collateral Circulation Pathway from the Contralateral Vertebral Artery to the Ipsilateral Posterior Inferior Cerebellar Artery-V4 Segment Steal
Authors: Liu Yang , Yang Bian , Wang Jianan , Zhang Xiongwei , Miao Yan , Wang Kunyu , Li Chunyan , Qiu Feng 
Published: May 2020

Abstract
Background: Interrupted blood flow during ischemia can be compensated through collateral circulation when a cerebral artery is severely stenotic or occluded. We suppose that potential collateral pathway may exist in patients with vertebral artery occlusive disease (VAOD) around V4 segment due to the ipsilateral posterior inferior cerebellar artery (PICA) is sometimes patented after VAOD in the V4 segment.Methods: We retrospectively examined the medical database of 60 patients with VAOD admitted to the Department of Neurology from the Sixth medical center of the Chinese People's Liberation Army General Hospital and the Second Affiliated Hospital of Qiqihar Medical University from June 2018 to November 2019. The pathways which supplied PICA were investigated by digital subtraction angiography (DSA).Results: 18 patients were proximal to the exit point of the PICA among all 60 patients with VAOD in V4 segment cases, and 7 individuals (11.7%) had the collateral circulation pathway via the contralateral vertebral artery (VA) ® vertebrobasilar junction ® ipsilateral VA ® ipsilateral PICA in the DSA.Conclusions: There is an underestimated intracerebral collateral circulation pathway when VAOD from the contralateral VA to the Ipsilateral PICA, we name this phenomenon "V4 segment steal."
Effects of Cognitive- and Sleep- Related Single Nucleotide Polymorphisms on Cognitive Functions in the Han Chinese Community-dwelling Elderly
Authors: Li Jing , Fu Jiangning , Zheng Zhiwei , Zhu Xinyi , Han Xiaoyan , Li Juan 
Published: May 2020

Abstract
Objective: The genetic biomarkers on Alzheimer’s disease (AD) have been widely studied in different groups. Since the lack of efficacy therapeutic methods for AD, early recognition in preclinical stage becomes increasingly important. Evidence of AD and cognitive-related single nucleotide polymorphisms (SNPs) in high risk population is insufficiency. Our aim was to assess whether these SNPs within cognitive- and sleep- associated genes are correlated with cognitive impairment independently or through gene-gene interactions in community-dwelling elderly in Beijing. Methods: Eight single-nucleotide polymorphisms (SNPs) were genotyped in 2133 Northen Han Chinese elderly from ten communites in Chaoyang District, Beijing. The short version of the Montreal Cognitive Assessment-Beijing (MoCA-s), Ascertain Dementia 8 (AD8), Digit Span Backwards (DSB), Digital Symbol Substitution Test (DSST), and Paired Associative Learning Test (PALT) were used to detect different cognitive domains.Results: Logistic regression analyses showed a significant correlation between APOE (rs429358), ABCC9 (rs11046205) and cognitive impairment, and an interaction between ABCC9 (rs11046205)/APOE promoter (rs405509) and APOE ε4 status. Additionally, we found a significant negative association between the additive model of APOE (rs429358) and MMSE score. Moreover, our analysis revealed that the gene-gene interaction between ABCC9 (rs11046205) and APOE (429358) may contribute to the etiology of congnitive impairment.Conclusions: This study confirmed the independent contribution of AD, memory and sleep-related genes in the cognitive impairment of the community-dwelling elderly in China, as well as through gene-gene interactions.
Dimethylguanidino valeric acid is independently associated with intrahepatic triglyceride content in patients with nonalcoholic fatty liver disease (NAFLD) and decreased after long-term exercise
Authors: Li Jia , Huang Yinxiang , Huang Caoxin , Zhao Yan , Shi Xiulin , Chen Zhen , Wang Liying , Han Lili , Chen Zhong , Li Xuejun 
Published: May 2020

Abstract
Backgrounds: Dimethylguanidino valeric acid (DMGV) is closely associated with nonalcoholic fatty liver disease (NAFLD), the most recommended therapy of NAFLD is Exercise. Our aim was to investigate the correlation between DMGV concentrations and clinical characters in patients with NAFLD, and assessed the effect on DMGV concentrations changes after 6 month exercise training.Methods: NAFLD individuals (n = 220) were selected and randomly divided into control group (n = 74), moderate exercise group (n = 73) and vigorous exercise group (n = 73) with 6 month followed-up. Clinical characteristics were obtained from our previous clinical trial, serum DMGV levels were determined by a validated ultrahigh performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) method.Results: On baseline, DMGV levels were positive associated with age, visceral fat and intrahepatic triglyceride (IHTG) content, and inversely associated with fasting blood glucose and diastolic blood pressure. In addition, the association between DMGV levels and IHTG content remained significant after adjusting other main clinical characters (β coefficient = 0.174, P = 0.018). After 6 month exercise training, IHTG was decreased by both exercise intensities without a significant difference (P = 0.45), however, moderate exercise was more efficient on DMGV decreasing than vigorous exercise (-9.96 to 2.27 ng/ml, P < 0.001 for moderate exercise; -4.53 to 4.56 ng/ml, P = 0.762 for vigorous exercise) with a significant difference (P = 0.047).Conclusions: DMGV was a potential indicator during development and progression of NAFLD, and moderate exercise was more efficient on metabolic changes than vigorous exercise with equal IHTG improvement, suggesting a priority of exercise intensity during NAFLD treatment.ClinicalTrials.gov Identifier: NCT01418027, August 16, 2011
A retrospective analysis of endocirnopathies in 136 Chinese patients with POEMS syndrome
Authors: Shao Yi , Zhang Chao , Xianling Wang , Guo Qinghua , Ba Jianming , Lv Zhaohui , Dou jingtao , Mu Yiming 
Published: May 2020

Abstract
Background: POEMS syndrome is a rare multisystem disease but with a wide spectrum of clinical endocrinopathies. The patients with POEMS syndromes may present with one or more hormone disorders during disease course, but such phenomenon has usually been underestimated. In this report, the prevalence and clinical characteristics of Endocrine abnormalities in a large Chinese cohort with POEMS syndromes were summarized. Methods: Retrospective review of patients with a definite diagnosis of POEMS syndrome in our hospital between January 2000 and January 2020 were performed. The clinical data about endocrine abnormalities were extracted from their medical records and analysis.Results: This study comprised 136 patients (95 male, 41 female) with a median age of 48(40-56) years old. The endocrine abnormalities were more common (127 cases, 93.38%) in patients with POEMS syndromes. The prevalence of single endocrinopathy and multiple endocrinopathies was 12.60% (16/127 cases) and 87.40% (111/127) respectively. The most frequent endocrinopathy was hypogonadism (98/136, 72.06%), followed by hypothyroidism (83/136, 61.03%), hypocalcemia (50/136, 36.76%), hyperprolactinemia (47/136, 34.56%),abnormal glucose metabolism (41/136, 30.15%) and adrenal insufficiency (41/136, 30.15%).In POEMS syndromes, nearly most of endocrine organs could be involved.In patients with multiple endocrinopathies, the percentage of 2, 3, 4, 5 and 6 kind of endocrine axes involved were 29.92%(38/127), 30.71%(39/127), 17.32%(22/127), 7.09%(9/127) and 2.36%(3/127), respectively. It results in complex clinical presentation of hormone disorders, including overt or sublinical situation.Conclusions: In Conclusion, this study provides an overview of the abnormalities observed in a large series in China. Endocrinopathy manifestations in POEMS syndromes are more frequent, and its clinical complicacy should be paid more attention to. To patients with definite diagnosis of POEMS syndromes, early and thorough endocrine evaluation should be performed.
Evolved adaptation to low ultraviolet radiation may be the main cause of malignant melanoma independent of high ultraviolet radiation exposure
Authors: You Wenpeng , Henneberg Renata Jolanta , Coventry Brendon , Henneberg Maciej 
Published: May 2020

Abstract
Objective:The low melanin production (depigmentation) evolved from low ultraviolet radiation may be the principal determinant of malignant melanoma of skin (C43).Design:Country-specific estimates of C43 incidence, daily UVR exposure, skin colour (EEL), socioeconomic status (GDP PPP), magnitude of reduced natural selection (Ibs), ageing, urbanization, percentage of European descendants (Eu%), and depigmentation measured by blonde hair colour, were subjected to statistical analyses. Data were derived from WHO, United Nations, World Bank databases and the literature.Setting:Ecological analysisParticipants:182 individual countries.Main outcome measures:Parametric and non-parametric correlations, partial correlation analyses keeping confounders statistically constant, multivariate regressions and analyses of variance.Results:Worldwide, UVR exposure was in negative correlation with C43 (“rho” = -0.515, p < 0.001). This relationship remained significant and negative in parametric partial correlation (r = -0.513, p < 0.001) when GDP PPP, Ibs, ageing and urbanization were statistically kept constant.In stepwise linear regression analysis, UVR was the variable having greatest negative influence on C43 incidence (R2=0.301).Worldwide, C43 incidence was in strong correlation with Eu% (r = 0.711, p<0.001). The inverse relationships between C43 and UVR exposure (r = -0.498, r<0.001) and Eu% (r = 0.477, p<0.001) remained significant in partial correlation analysis.When C43 incidence rate was standardized on Eu% it did not correlate at all with UVR (“rho”=0.004, p=0.967, n=127). The country-specific depigmentation level strongly correlated with C43 incidence (r = 0.705, p<0.001, n= 48). Partial correlation analysis revealed that C43 correlated to depigmentation significantly (r=0.315, p<0.01). However, UVR showed almost nil correlation with C43 when depigmentation, together with the other four potential confounders was included as the controlled variable.Conclusions:﻿C43 incidence may not be attributable to UVR exposure. Low melanin production, genetically determined, that has adaptively evolved over generations represents an ultimate risk factor for C43.
Genome-wide identification of poplar malectin/malectin-like domain-containing proteins and in-silico expression analyses find novel candidates for signaling and regulation of wood development
Authors: Kumar Vikash , Barbut Félix , Kushwah Sunita , Donev Evgeniy N. , Urbancsok János , Mellerowicz Ewa J. 
Published: May 2020

Abstract
Background: Malectin domain (MD) is a ligand-binding protein motif of pro- and eukaryotes. It is particularly abundant in Viridiplantae, where it occurs as either a single (MD, PF1721) or tandemly duplicated domain (PF12819) called malectin-like domain (MLD). In herbaceous plants, MD- or MLD-containing proteins (MD proteins) are known to regulate development, reproduction, and resistance to various stresses. However, their functions in woody plants have not yet been studied. To unravel their potential role in wood development, we carried out genome-wide identification of MD proteins in the model tree species black cottonwood (Populus trichocarpa), and analyzed their in-silico expression and co-expression networks.Results: P. trichocarpa had 146 MD genes assigned to 14 different clades, two of which were specific to the genus Populus. 87% of these genes were located on chromosomes, the rest being associated with scaffolds. Based on their protein domain organization, and in agreement with the exon-intron structures, the MD genes identified could be classified into five superclades having the following domains: leucine-rich repeat (LRR)-MD-protein kinase (PK), MLD-LRR-PK, MLD-PK (CrRLK1L), MLD-LRR, and MD-Kinesin. Whereas the majority of MD genes were highly expressed in leaves, particularly under stress conditions, eighteen showed a peak of expression during secondary wall formation and their co-expression networks suggested signaling functions in cell wall integrity, pathogen-associated molecular patterns, calcium, ROS, and hormone pathways.Conclusion: P. trichocarpa MD genes exhibit a variety of domain organizations, and include genes apparently specific to Populus, as well as genes with potential involvement in signaling pathways regulating secondary wall formation.
COVID-19 Pneumonia Severity Grading: Test of A Trained Deep Learning Model
Authors: Zhang Ying , Wu Huawei , Song Haitao , Li Xiaoqian , Suo Shiteng , Yin Yan , Xu Jianrong 
Published: May 2020

Abstract
Purpose: To detect affected lung lobes and conduct severity grading of coronavirus disease 2019 (COVID-19) pneumonia on chest CT images using an artificial intelligence (AI) technique.Materials and Methods: We used a deep learning model which was previously developed and trained to extract visual features from chest CT exams for the detection and severity grading of COVID-19 pneumonia. In this retrospective study, we tested this model with COVID-19 pneumonia cases in our institution. The numbers of affected lung lobes and severity grading values were compared for the AI method and manual method via the paired Chi-square test. The severity grading capability of the AI method was evaluated using receiver operating characteristic analysis.Results: A total of 24 cases of confirmed COVID-19 were included (13 men and 11 women). The most frequent CT observation was bilateral ground-glass opacities with consolidation and more than one affected lung lobe. Most cases were mild cases. Compared with the manual method, the AI method presented excellent sensitivity (97.2%) and accuracy (80.8%) but poor specificity (57.1%) in detecting affected lung lobes and good ability (area under the curve=0.795, accuracy=91.6%) in severity grading of COVID-19. Additionally, the time consumed in checking the accuracy of the AI detected lesions within the whole lung was significantly shorter than that of severity assessment by the manual method (t=9.434, p<0.001).Conclusion: The AI method with our model is useful in evaluating the severity grading of COVID-19 pneumonia.
Clinical diversity of cerebral sinovenous thrombosis and arterial ischemic stroke in the neonate: a surveillance study.
Authors: Sorg Anna-Lisa , Klemme Mathias , Kries Rüdiger von , Felderhoff-Müser Ursula , Flemmer Andreas W. , Gerstl Lucia , Dzietko Mark 
Published: May 2020

Abstract
Background

Incidence, risk factors, clinical presentation, onset of symptoms and age at diagnosis differ between arterial ischemic stroke (AIS) and cerebral sinovenous thrombosis (CSVT) in the neonate. Distinguishing these two entities early and clinically can be of eminent importance.
Methods

Active surveillance for AIS and CSVT was performed in 345 German pediatric hospitals. Reported cases were validated with questionnaires. Only cases confirmed by cerebral MRI were included in our analysis. Both groups of patients (AIS and CSVT) were compared with regard to age at diagnose, pattern of clinical symptoms and risk factors.
Results

Data on 144 AIS and 51 CSVT neonatal cases were collected from 2015 to 2017. The relative risk of AIS was 2.8 [95% CI 2.1; 3.9] times higher compared to CSVT. CSVT patients were more likely to be born premature (CSVT 14/48, 29.2%; AIS 19/140, 13.2%; p = 0.02), to have signs of perinatal acidosis (e.g. umbilical artery pH ≤ 7.1 30.2% CSVT vs. 13.5% AIS p = 0.01). Generalized seizures and lethargy were more likely to occur in infants with CSVT (p < 0.0001). Age at onset of symptoms and at time of diagnoses was shifted to older ages in CSVT (p < 0.0001).
Conclusion

The risk for AIS is about three times higher than for CSVT in neonates. A higher proportion of critically ill infants in CSVT and a later onset of symptoms may indicate that perinatal and postnatal risk factors are more important for CSVT than for AIS. The data point to the need for awareness of CSVT in critical ill infants.
Selection and impact of leading edge on boundary layer transition
Authors: Bhatia Dinesh Devraj , Yang Guangjun , Li Guangning , Wang Jian 
Published: May 2020

Abstract
The choice of leading edge aspect ratio (AR) plays a crucial role when planning boundary layer experimental wind tunnel tests on a flat plate. Poor selection of the leading-edge profile hampers the effectiveness of the experiment and increases testing costs associated with interchanging of leading edges to attain accurate results. Thus, the appropriate selection of the leading edge is a very crucial part of the wind tunnel experimental process. The authors, in this paper, argue that the curvature of the leading edge and thus the AR are of paramount importance to attain accurate results from wind tunnel testing. In this paper, the authors have tested 7 different elliptical leading edges and compared their performance with an ideal leading edge with zero thickness. Experimental and computational has been presented for leading edges ranging from AR6 to AR20. Results were evaluated for boundary layer transition onset location and it was found that AR20 has the least influence on the flow structure when compared the ideal leading edge. A study of the flow structure at the stagnation point indicates an increase in adverse pressure gradient with an increase in the AR but also a decrease in the size of the stagnation region. The presence of a higher AR leading edge reduces the turbulent spot production rate which is one of the primary causes of boundary layer transition. The authors have presented a correlation which makes it easier for aerodynamicists to quantify the impact of the leading-edge AR on transition. A case is also presented to compare the relative performance of a wedge and the higher AR leading edge which gives potential researchers the choice between an elliptical or a wedge-shaped leading edge.