bluuebunny/crossref_metadata_2025_split huggingface dataset:
The long term survival of successfully weaned prolonged mechanical ventilation patients
Authors: Huang Chienhsiu 
Published: March 2020

Abstract
Background Over six years, five hundred and seventy-four patients were admitted to the respiratory care center. Three hundred and ninety-one patients were successfully weaned from the ventilator. How is the long term outcome of these successfully weaned prolonged mechanical ventilation patients? Very few articles were discussing the long term outcome of successfully weaned prolonged mechanical ventilation patients. We will explore this issue in-depth in this article. Methods We analyzed retrospective data from successfully weaned prolonged mechanical ventilation patients to investigate the clinical variables, discharged status, long term survival, the cause of death, end-of-life decisions. Results We can further gather long term follow-up data on 243 patients. The factors between patients who died in the ward and those who survived ≥1 year revealed the poorer survival of patients who died in the ward was due to a higher percentage of end-stage renal disease comorbidity, a higher percentage of malignant comorbidity, higher percentage of ≥ four comorbidities and a higher percentage of signed do-not-resuscitate / do-not-intubate orders. The factors between patients who survived <1 year and those who survived ≥1 year revealed the poorer survival of patients who survived <1 year was due to older age, a higher percentage of signed do-not-resuscitate / do-not-intubate orders. That 81 patients (33.3%) who signed a do-not-resuscitate / do-not-intubate orders, indicates that, at most, 66.7% of survivors were willing to receive mechanical ventilation again. Conclusion The end-of-life decision (signed do-not-resuscitate / do-not-intubate orders) is one of the major influence factors of long term survival of successfully weaned prolonged mechanical ventilation patients. In all, 81 patients (33.3%) in our study signed do-not-resuscitate / do-not-intubate orders, meaning that, at most, 66.7% of survivors were willing to receive mechanical ventilation again.
Regional Registration of Whole Slide Image Stacks Containing Highly Deformed Artefacts
Authors: Paknezhad Mahsa , Loh Sheng Yang Michael , Choudhury Yukti , Koh Valerie Koh Cui , Yong Timothy Tay Kwang , Tan Hui Shan , Kanesvaran Ravindran , Tan Puay Hoon , Peng John Yuen Shyi , Yu Weimiao , Tan Yongcheng Benjamin , Loy Yong Zhen , Tan Min Han , Lee Hwee Kuan 
Published: March 2020

Abstract
Background: High resolution 2D whole slide imaging provides rich information about the tissue structure. This information can be a lot richer if these 2D images can be stacked into a 3D tissue volume. A 3D analysis, however, requires accurate reconstruction of the tissue volume from the 2D image stack. This task is not trivial due to the distortions that each individual tissue slice experiences while cutting and mounting the tissue on the glass slide. Performing registration for the whole tissue slices may be adversely affected by the deformed tissue regions. Consequently, regional registration is found to be more effective. In this paper, we propose an accurate and robust regional registration algorithm for whole slide images which incrementally focuses registration on the area around the region of interest. Results: Using mean similarity index as the metric, the proposed algorithm (mean +- std: 0.84 +- 0.11) followed by a fine registration algorithm (0.86 +- 0.08) outperformed the state-of-the-art linear whole tissue registration algorithm (0.74 +- 0.19) and the regional version of this algorithm (0.81 +- 0.15). The proposed algorithm also outperforms the state-of-the-art nonlinear registration algorithm (original: 0.82 +- 0.12, regional: 0.77 +- 0.22) for whole slide images and a recently proposed patch-based registration algorithm (patch size 256: 0.79 +- 0.16 , patch size 512: 0.77 +- 0.16) for medical images. Conclusion: The proposed algorithm is a more robust and accurate solution to the problem of regional registration of whole slide images in existence of highly deformed regions in the imaged tissue.
Systematic review and meta-analysis of diagnostic delay in axial spondyloarthritis
Authors: Zhao Sizheng , Pittam Bradley , Harrison Nicholas L , Nursiah Karishma , Goodson Nicola J , Hughes David M 
Published: March 2020

Abstract
Background . Delay to diagnosis in axial spondyloarthritis (axSpA) is longer than many other rheumatic diseases. Prolonged delay has been shown to associate with poorer outcomes including functional impairment and quality of life. Our aims were to describe 1) global variation in delay to diagnosis, 2) factors associated with delay, and 3) differences in diagnostic delay between axSpA and psoriatic arthritis (PsA).Methods . We searched Medline, PubMed, EMBASE and Web of Science using a predefined protocol in accordance with PRISMA guidelines. Delay to diagnosis was defined as years between age at symptom onset and age at diagnosis. We pooled mean diagnostic delay using random-effects inverse variance meta-analysis. We examined variations in pooled estimates using pre-specified subgroup analyses and sources of heterogeneity using meta-regression.Results. A total of 54 studies reported mean diagnostic delay in axSpA patients. The pooled mean delay was 6.8 years (95% confidence interval 6.2 to 7.3) with high levels of heterogeneity. Delay to diagnosis did not improve over time when stratifying results by year of publication. Studies from high-income countries (defined by the World Bank) reported longer delay than those from middle-income countries. Factors consistently reported to be associated with longer delay were: lower education levels, younger age at symptom onset and absence of extra-articular manifestations. Pooled estimate for diagnostic delay from 8 PsA studies was significantly shorter, at 2.6 years (95%CI 1.6 to 3.6).Conclusion. For axSpA patients, delay to diagnosis remains unacceptably prolonged in many parts of the world, although some countries have reported remarkable improvements. Patient factors (education) and disease presentation (age at onset and extra-articular manifestations) should inform awareness campaigns to improve delay. Targets for improvement should aim to resemble delays in other spondyloarthritis patients.
PDIA4 correlates with poor prognosis and is a potential biomarker in glioma
Authors: Li Haoyu , Liu Qing , Xiao Kai , Yang Jun , Wu Chao , Sun Jianjun , Chen Xin , Chen Suhua , Han Hongbin , Ma Qianquan , Su Jun 
Published: March 2020

Abstract
Background: Gliomas, characterized by aggressiveness and invasiveness, remain incurable after conventional therapies. The molecular mechanisms driving the progression and maintenance of glioma are still poorly understood.Methods: PDIA4 expression was analyzed via Gene Expression Profiling Interactive Analysis (GEPIA) which data were from TCGA and GTEx databases. We estimated the prognostic value of PDIA4 using Kaplan–Meier survival analysis and the Cox proportional hazard model. The functional enrichment analysis was done by using cluster Profiler package in R language, including gene ontology (GO) analysis comprised of cellular component (CC), molecular function (MF), and biological process (BP), and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway. In addition, correlation between PDIA4 and immunity were analyzed by Protein-protein interaction (PPI) analysis, RNA extraction and Real-time RT-PCR.Results: In this study, we identified PDIA4 was highly expressed in gliomas and closely correlated with poor prognosis. The association with IDH1 and different patterns of gliomas also indicates the potential biological processes that PDIA4 involves in the development of tumor. Mechanistically, PDIA4 interacts with multiple immunological components to promote an immunosuppressive tumor microenvironment (TME).Conclusions: Our results confirm PDIA4 is an efficient biomarker of gliomas, with implications for prognosis and therapeutic strategies.
FOXM1 modulates docetaxel resistance in prostate cancer by regulating KIF20A
Authors: Yu Hongbo , Xu Zheng , wang weiwan , xu zhibin , zhu gangyi , zhang chenyang , lin jianzhong 
Published: March 2020

Abstract
Background：Resistance to docetaxel is an important factor which affects the prognosis in advanced prostate cancer (PCa). The precise mechanisms remain unclear. The transcription factor Forkhead box M1 (FOXM1), participating in cell cycle progress and cell proliferation, has been reported to affect the sensitivity of chemotherapy. The present study aims to explore the role of FOXM1 in docetaxel resistance of PCa and how FOXM1 is associated with kinesin family member 20 A (KIF20A), which has been demonstrated to promote the development of therapeutic resistance in some cancers.Methods: We monitored cell growth by MTT and colony formation assays and cell apoptosis and cell cycle through flow cytometry. Wound-healing and transwell assays were performed to detect cell migration and invasion. Gene expression was analyzedby quantitative reverse transcription polymerase chain reaction (RT-qPCR) and western blotting. We determined the binding of FOXM1 on the KIF20A promoter by the ChIP assay. Tumorigenicity in nude mice was employed to assess tumorigenicity in vivo.Results: FOXM1 knockdown induced cell apoptosis and G2/M cell cycle arrest while hampered cell migration and invasion in docetaxel-resistant PCa cell lines (DU145-DR and VCaP-DR). The opposite trend was found in their parental cells with exogenous FOXM1 overexpression. Furthermore, thiostrepton, a specific inhibitor for FOXM1, significantly attenuated docetaxel resistance in vitro and in vivo. Additionally, we found that FOXM1 and KIF20A were consistently overexpressed and highly correlated in PCa cells and tissues. Further studies demonstrated that FOXM1 regulated the expression of KIF20A at the transcriptional level directly through a Forkhead response element (FHRE) in its promoter. Moreover, KIF20A overexpression could partially reverse the effects of FOXM1 depletion on cell proliferation, cell cycle proteins (cyclinA2, cyclinD1 and cyclinE1) and apoptosis protein (Bcl-2 and PARP).Conclusions: our findings suggest that FOXM1 may promote docetaxel resistance partly through the induction of KIF20A expression and provide insights into novel chemotherapeutic strategies for docetaxel resistance in PCa.
Mortality of severely injured patients after ICU discharge: An underestimated problem?
Authors: Hamsen Uwe , Drotleff Niklas , Lefering Rolf , Gerstmeyer Julius , Schildhauer Thomas Armin , Waydhas Christian 
Published: March 2020

Abstract
Background Most trauma patients admitted to the hospital alive and die later on, decease during the initial care in the emergency department or the intensive care unit (ICU). However, a number of patients pass away after having been discharged from the ICU during the initial hospital stay. On first sight these cases could be seen as “failure to rescue” of potentially salvageable patients. A low rate of such patients might be a potential indicator of quality for trauma care on ICUs and surgical wards. Methods Retrospective analysis of the TraumaRegister DGU® with data from 2015-2017. Patients that died during the initial ICU stay were compared to those who were discharged from the initial ICU stay for at least 24 hours but died later on. Results A total of 82,313 trauma patients were included in the TraumaRegister DGU®. In total, 6,576 patients (8.0%) died during their hospital stay. Out of those, 5,481 were admitted to the ICU alive and 972 patients (17.7%) were discharged from ICU and died later on. Those were older (mean age: 77 vs. 68 years), less severely injured (mean ISS: 23.1 vs. 30.0 points) and had a longer mean ICU length of stay (10 vs. 6 days). A limitation of life-sustaining therapy due to a documented living will was present in 46.1% of all patients who died during their initial ICU stay and in 59.9% of patients who died after discharge from their initial ICU stay. Conclusions 17.7% of all non-surviving severely injured trauma patients died within the hospital after discharge from their initial ICU treatment. Their death can partially be explained by a limitation of therapy due to a living will. In conclusion, the rate of such late deaths may represent patients that died of potentially avoidable or treatable complications.
Exogenous 2-(3,4-Dichlorophenoxy) triethylamine alleviates salinity stress in maize by enhancing photosynthetic capacity, improving water status and maintaining K+/Na+ homeostasis
Authors: Li Lijie , Gu Wanrong , Zhang Liguo , Li Congfeng , Chen Xichang , Qian Chunrong , Wang Zhenhua , Li Wenhua , Zuo Shiyu , Wei Shi 
Published: March 2020

Abstract
Background: Soil salinity restricts plant growth and productivity. 2-(3,4-dichlorophenoxy) triethylamine (DCPTA) can alleviate salinity stress in plants. However, the mechanism of DCPTA-mediated salinity tolerance has not been fully clarified. We aimed to investigate its role in enhancing photosynthetic capacity, improving water status, maintaining K+/Na+ homeostasis and alleviating salinity stress in maize (Zea mays L.).Results: In present study, maize seedlings were grown in nutrient solutions with a combination of NaCl (0, 150 mM) and DCPTA (0, 20, 100, and 400 μM). And photosynthesis, water status, ion homeostasis and the expression of genes involved in ion uptake and transport were evaluated in the maize seedlings. The results demonstrated that DCPTA alleviated the growth inhibition of maize seedlings exposed to salinity stress by increasing the net photosynthetic rate (Pn) and the quantum efficiency of photosystem II (PSII) photochemistry. DCPTA improved the root hydraulic conductivity, which help maintained the water status. A relatively high K+ concentration but a relatively low Na+ concentration and the Na+/K+ ratio were observed in the presence of DCPTA under salinity stress. Additionally, DCPTA altered the expression of four genes (ZmSOS1, ZmHKT1, ZmNHX1 and ZmSKOR) that encode membrane transport proteins responsible for K+/Na+ homeostasis.Conclusions: DCPTA improved the salinity tolerance of maize may be associated with enhanced photosynthetic capacity, maintenance of water status and altered expression of genes involved in ion uptake and transport.
Sickness absence trajectories following labour market participation patterns: a cohort study in Catalonia (Spain), 2012-2014
Authors: Hernando-Rodriguez JC , Serra L , Benavides FG , Ubalde-Lopez M 
Published: March 2020

Abstract
Background Previous studies have investigated the relationship between employment pathways and health-related outcomes based on cross-sectional or longitudinal approaches. However, little is known about the cumulative effects of employment status mobility on sickness absence (SA) over time. The present study aims to examine the association between prior labour market participation (LMP) patterns and SA trajectories from a life course perspective.Methods Cohort study based on a sample of 11,968 salaried workers affiliated with the Spanish Social Security system, who accumulated more than 15 days on SA at least in one quarter during 2012-2014. Individuals were grouped into three different working life stages: early (18-25 years), middle (26-35 years) and late (36-45 years). Sequence analysis and cluster analysis were applied to identify LMP patterns (2002-2011). Latent class growth modelling was used to identify SA trajectories (2012-2014). Finally, multinomial logistic regression models were applied to assess the relationship between LMP patterns and SA trajectories.Results First, seven LMP patterns were obtained: stable employment (63%-81%), increasing employment (5%-22%), without long-term coverage (7%-8%), decreasing employment (4%-10%), fluctuant employment (13%-14%), steeply inflow into unemployment (9%), and steeply labour market exit (7%-9%). Second, four SA trajectories were identified: low stable (values range: 83%-88%), decreasing (5%-9%), increasing (5%-11%) and high stable (7%-16%). Third, no significant associations were observed among LMP patterns and SA trajectories, except for young men, where an increasing employment pattern was significantly associated with a lower risk to increase days on SA (aOR: 0.21 [95% CI: 0.04-0.96]).Conclusions SA trajectories are not related to prior 10-year LMP patterns at any stage of working life. To disentangle this relationship, future research might benefit from considering working life transitions with a quality of work approach framed with contextual factors closer to the SA course.
High Level of Vaccination and Protection Against Hepatitis B with Low Rate of Hepatitis C HCV infection Markers among Hospital Health Care Personnel in North of Iran: A cross-Sectional study.
Authors: Saffar Hiva , Khoshayand Negar , Parsaei Mohammad-Reza , Ghorbani Gholam-Reza , Aarabi Mohsen , Ghara Ali-Asghar Nadi , Saffar Mohammed-Jafar 
Published: March 2020

Abstract
Background : hepatitis B virus (HBV) and C virus (HCV) are among the leading causes of mortality worldwide. Health care personnel (HCP) are subjected to increased risk of these infections. Therefore, HBV vaccination and post-vaccination serologic testing (PVST) are recommended for them.Objectives: study was designed to investigate how well the vaccination guidelines for hospital HCP s were implemented. Moreover, the prevalence rates of HBV and HCV infections were calculated. To determine the presence of immunological memory, vaccinated personnel negative to antibody against HB surface antigen with one dose of HB vaccine were boosted.Methods: from 1 July to 30 November 2017, a cross-Sectional study among HCPs working in public hospitals were conducted. All HCPs from various professional categories potentially at risk of exposure to contaminated sources were included. The information was gathered via interview and self-administered questionnaire. The questions were focused on the demographic characteristics, HB vaccination and immunity status and time elapsed since initial vaccination series, and frequency of needelstick injuries during the past 12 months of their work. HBV seromarkers received a booster dose of the vaccine.Results : A total of 186 out of 766 participants were male and nurses comprised 71% of personnel. Although all HCP were vaccinated, 84% of them completed the course and less than 5% of them received PVST. According to the results, 0.78%, 4.6%, and 83% were serologically positive to HBV surface antigen, antibodies against HBV core, and S antigens, respectively. Approximately, 91% of seronegative participants responded to a booster dose and only 0.91% of the personnel had HCV was Anti-HCV positive.Conclusion : Most HCP received full HBV vaccination course. Although a minority did PVST, the HBV vaccine-induced long-term protection and HBV booster were not required. Therefore, policies should be made to increase the rate PVST after immunization. According to the results, the HCV infection rate was low and thus pre-recruitment screening was not necessary
Gender differences in the efficacy of pioglitazone treatment in nonalcoholic fatty liver disease patients with abnormal glucose metabolism
Authors: Wang Liu , Wu Weiyun , Chang Xinxia , Xia Mingfeng , Gao Jian , Yan Hongmei 
Published: March 2020

Abstract
Background : Pioglitazone is a promising therapeutic method for nonalcoholic steatohepatitis patients with or without type 2 diabetes. However, there is a remarkable variability in treatment response. We analyzed our previous randomized controlled trial to examine the effects of gender and other factors on the efficacy of pioglitazone treatment in liver fat content in Chinese nonalcoholic fatty liver disease (NAFLD) patients with abnormal glucose metabolism.Methods : This is a secondary post hoc analysis of a previous randomized, parallel controlled, open-label clinical trial (RCT)* with an original purpose of evaluating the efficacy of berberine and pioglitazone on NAFLD. The per protocol population (n= 184) was randomly divided into three groups: lifestyle intervention (LSI), LSI plus pioglitazone (PGZ) 15mg qd, and LSI plus BBR 0.5g tid, respectively, for 16 weeks. Proton magnetic resonance spectroscopy ( 1 H MRS) was used to assess liver fat content.Results : As compared with LSI, PGZ plus LSI treatment induced further decreased liver fat content in women [-8.26% (-17.18%, -0.65%), p = 0.025], but relatively increased liver fat content in men [9.79% (0.37%, 19.21%), p = 0.046]. There was a significant interaction between gender and efficacy of pioglitazone before ( p = 0.003) and after ( p = 0.011) adjustment for age, smoking, drinking, baseline BMI, BMI change, and treatment adherence.Conclusion : For Chinese NAFLD patients with abnormal glucose metabolism, pioglitazone treatment is recommended for women, but not for men, based on lifestyle interventions.* Trial registration: Role of Pioglitazone and Berberine in Treatment of Non-Alcoholic Fatty Liver Disease, NCT00633282. Registered 3 March 2008, https://register.clinicaltrials.gov.
Characterizing the human APOE epsilon 4 knock-in transgene in female and male rats with multimodal magnetic resonance imaging
Authors: Kulkarni Praveen , Grant Simone , Morrison Thomas , Cai Xuezhu , Iriah Sade , Kristal Bruce , Honeycutt Jennifer , Brenhouse Heather , Hartner Jochen , Madularu Dan , Ferris Craig 
Published: March 2020

Abstract
Background: The APOE Ɛ4 genotype is the most prevalent genetic risk for Alzheimer's disease (AD). Women carriers of Ɛ4 have higher risk for an early onset of AD than men. Human imaging studies suggest apolipoprotein E4 may affect brain structures associated with cognitive decline in AD many years before disease onset. It was hypothesized that female APOE Ɛ4 carriers would present with decreased cognitive function and neuroradiological evidence of early changes in brain structure and function as compared to male carriers. Methods: Six-month old wild-type (WT) and human APOE Ɛ4 knock-in (TGRA8960), male and female Sprague Dawley rats were studied for changes in brain structure using voxel-based morphometry, alteration in white and gray matter microarchitecture using diffusion weighted imaging with indices of anisotropy, and functional coupling using resting state BOLD functional connectivity. Images from each modality were registered to, and analyzed, using a 3D MRI rat atlas providing site-specific data on over 168 different brain areas. Results: Quantitative volumetric analysis revealed areas involved in memory and arousal were significantly different between Ɛ4 and wild-type (WT) females, with few differences between male genotypes. Diffusion weighted imaging showed few differences between WT and Ɛ4 females, while male genotypes showed significant different measures in fractional anisotropy and apparent diffusion coefficient. Resting state functional connectivity showed Ɛ4 females had greater connectivity between areas involved in cognition, emotion, and arousal compared to WT females, with male Ɛ4 showing few differences from controls. Interestingly, male Ɛ4 showed increased anxiety and decreased performance in spatial and episodic memory tasks compared to WT males, with female genotypes showing little difference across behavioral tests.Conclusion: The sex differences in behavior and diffusion weighted imaging suggest male carriers of the Ɛ4 allele may be more vulnerable to cognitive and emotional complications compared to female carriers early in life. Conversely, the data may also suggest that female carriers are more resilient to cognitive/emotional problems at this stage of life perhaps due to altered brain volumes and enhanced connectivity.