bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identification and analysis of CYP450 supergene family members from the transcriptome of Aralia elata (Miq.) Seem reveal candidate genes for triterpenoid saponin biosynthesis
Authors: Cheng Yao , Liu Hanbing , Tong Xuejiao , Liu Zaimin , Zhang Xin , Li Dalong , Jiang Xinmei , Yu Xihong 
Published: February 2020

Abstract
Background: Members of the cytochrome P450 (CYP450) gene superfamily have been shown to play essential roles in regulating secondary metabolites biosynthesis. However, the systematic identification and bioinformatics analysis of CYP450s have not been reported in Aralia elata (Miq.) Seem , a highly valued medicinal plant. Results: In the present study we conducted the RNA-sequencing (RNA-seq) analysis of the leaves, stems, and roots of A. elata, yielding 66,713 total unigenes. Following the annotation and classification of these unigenes, we were able to identify two pathways and 19 putative genes associated with the synthesis of triterpenoid saponins in these plants, with qRT-PCR subsequently being used to validate these gene expression patterns. Scanning with the CYP450 model from Pfam resulted in the identification of 111 full-length and 143 partial-length CYP450s, with the full-length CYP450s being further clustered into 7 clans and 36 families. Through phylogenetic and conserved motif analyses, we were further able to group these CYP450 proteins into two primary branches: A-type (53%) and non-A type (47%). We further conducted representative protein sequence alignment for these CYP450 family members, with secondary elements being assigned in light of the recently published Arabidopsis CYP90B1 structure. Using the available sequence information, we further identified predicted substrate recognition sites (SRSs) and substrate binding sites within these putative proteins.We further assessed the expression patterns of these 111 CYP450 genes across A. elata tissues, with 12 members of this gene family being selected at random for qRT-PCR validation. From these data, we identified CYP716A295 and CYP716A296 as the candidate genes most likely to be associated with oleanolic acid synthesis, while CYP72A763 was identified as being the most likely to play a role in hederagenin biosynthesis. Finally, we assessed the subcellular localization of these CYP450 proteins within Arabidopsis protoplasts, highlighting the fact that they localize to the endoplasmic reticulum. Conclusions: This study presents a systematic analysis of the CYP450 gene family in A. elata and provided a foundation for further functional characterization of CYP450 genes.
Security considerations for telemedicine systems
Authors: Kim Dong-won , Choi Jin-young , Han Keun-hee 
Published: February 2020

Abstract
Background: In this study, the effects of cybersecurity threats on telemedicine were investigated, and methods to evaluate security risks were considered. Many research institutes and investigation agencies have provided information about cybersecurity incidents in the medical field, between 2009 and 2019. Methods: The scenario information about cybersecurity threats was directly collected through a field survey. Potential threats that can occur in telemedicine services were accurately identified, and objective security requirements were derived by threat modeling using attack trees. The attack occurrence probability and attack success probability according to the importance of telemedicine service assets were included as variables. Results: The introduction of telemedicine guarantees accessibility to medical services for vulnerable areas. However, potential security threats and response measures in the telemedicine environment, which includes users and patients, remote medical devices, home networks, gateway devices, the Internet, and the telemedicine system, have not been considered thus far. Conclusion: This study contributes to the improvement of security by introducing methods to identify and evaluate security threats and preparing security measures for the telemedicine environment.
Clinical implication of plasma exchange on life-threatening antineutrophil cytoplasmic antibody-associated vasculitis
Authors: Park Pil Gyu , Yoo Byung-Woo , Song Jason Jungsik , Park Yong-Beom , Lee Sang-Won 
Published: February 2020

Abstract
Background: We assessed the rate of and the predictor for all-cause mortality in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) patients receiving plasma exchange (PLEX) and evaluated the survival-benefit of PLEX for diffuse alveolar haemorrhage (DAH) between AAV patients receiving PLEX and those not receiving. Methods: We retrospectively reviewed the medical records of 212 AAV patients. Demographic, clinical and laboratory data at the time of PLEX was collected from both 9 patients receiving PLEX and 10 AAV patients with DAH. The follow-up duration was defined as the period from the time of PLEX or DAH occurrence to death for the deceased patients and as that to the last visit for the survived patients. Results: The median age of 9 AAV patients receiving PLEX was 71.0 years and 5 patients were men. Four of 9 patients receiving PLEX died at a median follow-up duration of 92.0 days. Three died of sepsis and one died of no response to PLEX. When patients with DAH receiving PLEX and those not receiving were compared, there were no significant differences in variables between the two groups. The cumulative patients’ survival rate between patients with DAH receiving PLEX and those not receiving were also compared using the Kaplan-Meier survival analysis but no survival-benefit of PLEX for DAH was observed. Conclusion: The rate of all-cause mortality in 9 AAV patients receiving PLEX was assessed as 44.4% and it was controversial that PLEX is beneficial for the improvement of prognosis of AAV-related DAH.
Prevalence and risk factors for HBV and HCV among incarcerated people who inject drugs in Iran: a cross sectional study
Authors: Moradi Ghobad , Mohamadi Parvin , Zarei Bushra , Rasouli Mohammad Aziz , Gouya Mohammad Mehdi , Jafari Saeede 
Published: February 2020

Abstract
Background

This study aimed at determining the prevalence and risk factors of hepatitis B virus (HBV) and hepatitis C virus (HCV) among incarcerated people who inject drugs (PWID) in Iran during 2015-16.

Methods

The required data was obtained from the Iranian national bio-behavioral surveillance surveys (BBSSs), which examined 11988 prisoners who were selected using multi-stage sampling from 55 prisons in 19 provinces during 2015-16. The demographic and behavioral status of these subjects were measured through interviews and HBV and HCV exposure were examined using ELISA test of blood samples. A total of 1387 individuals with a history of drug injection in their lifetime were enrolled into this study. Survey analysis was used to analyze the data. The univariate and multivariate logistic regression were used to investigate the relationships between risk factors and outcome.

Results

The mean age of the incarcerated PWID was 36.83 ± 8.13; of all, 98.46% were male, 50.97% were married, and 96.57% had non-academic education. The prevalence of HCV and HBV was 40.52% and 2.46%, respectively. HCV prevalence was associated with an age≥30 years, being single, non-academic education, prison term>5 years, history of piercing, and extramarital sex in lifetime (P<0.05).

Conclusions

The prevalence of HCV is alarmingly high. However, prison by facilitating the easy access to infected group can be considered as an opportunity to achieve the goal of eliminating HCV in the country. It is recommended to design interventions while considering the risk factors of prison term, piercing, and extramarital sex.
The pattern and magnitude of Dietary Free Sugar (DFS) consumption and dental caries in school children: A systematic review
Authors: Pakdaman A , Zeinab Mahboobi , Reza Yazdani , Leila Azadbakht 
Published: February 2020

Abstract
Background Dietary Free Sugar (DFS) is considered as one of the main risk factor for dental caries development. This systematic review was designed to assess the relationship between pattern and magnitude of Dietary Free Sugar (DFS) consumption and dental caries in school children aged among 6 to 12 years old. Methods An electronic search of the databases consists of Medline/PubMed, Embase, ISI Web of Science and Scopus was conducted using relevant keywords. Longitudinal studies reporting the relationship between DFS and dental caries focused on school children that were published between 2004 and 2019 in English were selected. The title and abstract of the papers were reviewed by 2 independent researchers and irrelevant papers were excluded. After duplicate removal, the full text of the papers was reviewed. The reference search of the selected papers was performed and finally the quality of included papers assessed using the STROBE check list and the main findings were extracted. Results From 2120 articles searched, 12 longitudinal studies included in this review. Three articles report insignificant relationship between DFS consumption of and dental caries. However, Dietary Free Sugar and dental caries were significantly associated in the primary and permanent dentition of children. Frequent intake of sweet foods and drinks especially before bed, consumption of processed starches and soft drink were considered as important risk factors while frequent consumption of water and dairy product had protective effect. Conclusion This study confirms the limitation of dietary free sugar in school children especially in the form of processed starch and sweet snacks especially before bedtime. Still, there is a need for well-designed studies in this field.
Statin Use Is Associated With Reduced Mortality On Mechanically Ventilated Patients: A Retrospective Propensity-Matched Analysis Of MIMIC-III Database
Authors: Lin Qiuhai , Chen Daonan , Xu Jiyao , Miao Congliang , Huang Yuan , Wang Liu , Ge Fangxia , Kang Mei , Tian Rui , Zhu Yong , Zhang Huifang , xie Yun , Wang Ruilan , Du Jiang 
Published: February 2020

Abstract
Objective: Mechanical ventilation can cause injury and inflammatory disorders in the lungs of critically ill patients. We sought to determine whether statin treatment has a protective effect on the outcome of these patients. Methods: A retrospective observational study of ICU patients from the Medical Information Mart for Intensive Care III (MIMIC-III) database. Information on ventilated patients was analyzed using data from the MIMIC-III database. The non-statin cohort was selected using 1:1 propensity matching with the statin cohort by age, sex, severity scores and 29 other variables. Compared with nonusers, the use of statins was associated with improved 28-day survival in the unmatched cohort (HR 0.85 95% CI 0.80~0.90) and matched cohort (HR 0.72 95% CI 0.67~0.77). Statin use was also associated with improved in-hospital survival in both the unmatched cohort (HR 0.90, 95% CI 0.85~0.95) and the matched cohort (HR 0.75 95% CI 0.70~0.80). In the multivariate Cox model, the use of statins was also associated with an improvement in 28-day survival in the unmatched cohort (HR 0.73 95% CI 0.68～0.77) and in the matched cohort (HR 0.73 95% CI 0.68~0.78). The use of statins was associated with longer ICU length of stay (LOS), shorter ventilator-free days (VFDs) and fewer model for end-stage liver disease score (MELD) in the matched cohort. The subgroup analysis results showed improved 28-day survival, but this improvement was not observed in patients with pneumonia, obesity, septicemia or acute respiratory failure. Conclusions: In a population of mechanically ventilated patients, the use of statins may be associated with reduced mortality.
A machine learning-based prediction of hospital mortality in patients with postoperative sepsis
Authors: Yao Ren-qi , Jin Xin , Wang Guo-wei , Yu Yue , Wu Guo-sheng , Li Lin , Xia Zhao-fan , Ren Chao , Yao Yong-ming 
Published: February 2020

Abstract
Background: The incidence of postoperative sepsis is continually increased, while few studies have specifically focused on the risk factors and clinical outcomes associated with the development of sepsis after surgical procedures. The present study aimed to develop a mathematical model for predicting the in-hospital mortality among patients with postoperative sepsis.Methods: Surgical patients in Medical Information Mart for Intensive Care (MIMIC-III) database who simultaneously fulfilled Sepsis 3.0 as well as Agency for Healthcare Research and Quality (AHRQ) criteria during ICU admission were incorporated. We employed both extreme gradient boosting (XGBoost) and stepwise logistic regression model to predict in-hospital mortality among included patients with postoperative sepsis. Consequently, model performance was assessed from the angles of discrimination and calibration.Results: We included 3713 patients who fulfilled our inclusion criteria, in which 397 (10.7%) patients died during hospitalization, while 3316 (89.3%) of them survived through discharge. Fluid-electrolyte disturbance, coagulopathy, renal replacement therapy (RRT), urine output, and cardiovascular surgery were important features related to the in-hospital mortality. The XGBoost model had a better performance in both discriminatory ability (c-statistics, 0.835 [95% CI, 0.786 to 0.877] vs. c-statistics, 0.737 [95% CI, 0.688 to 0.786]) and goodness of fit (visualized by calibration curve) compared to the stepwise logistic regression model. Conclusion: XGBoost model appears to be a better performance in predicting hospital mortality among postoperative septic patients compared to the conventional stepwise logistic regression model. Machine learning-based algorithm might have significant application in the development of early warning system for septic patients following major operations.
Treatment outcomes of severe acute malnutrition and Predictors of Recovery in Under-Five children treated within Outpatient Therapeutic Program in Ethiopia: A systematic review and meta-analysis
Authors: Bitew Zebenay Workneh Workneh , Alemu Ayinalem , Worku Teshager 
Published: February 2020

Abstract
Introduction Severe acute malnutrition affects around 17 million under-five children in the world, of which the highest burden is accounted by Sub-Saharan Africa where Ethiopia is found. Besides few individualized, inconsistent and inconclusive studies, there is no nationally representative study conducted on treatment outcomes of SAM in outpatient therapeutic feeding programs in Ethiopia. This study aimed at estimating the pooled treatment outcomes and predictors of recovery rate among under- five children with SAM in Ethiopia. Methods Both electronic databases (PubMed, Medline (EBSCOhost), EMBASE (Elsevier), CINAHL (EBSCOhost), web of science, Scopus, Science Direct and Food Science and Technology Abstracts (FSTA)) and grey literature sources (Google scholar, Mednar, World Cat and google) were used to retrieve articles. The random effect model was used to estimate the pooled treatment outcomes. Hazard ratios were used to determine the predictors of recovery rate. Cochran’s Q, I 2 , and univariate Meta regression were done for heterogeneity as well as Begg’s & Egger’s tests for publication bias. Results Nineteen articles with a total number of 23395 under-five children with SAM were used for this meta-analysis. The pooled recovery, death, defaulter and non-recovery rates were 70% (95% CI: 64.45, 75.72), 1.69% (95% CI: 1.06, 2.31), 9.7% (95%CI: 7, 12.4), 15.14% (95% CI: 10.11, 20.16), respectively. Diarrhea (HR=0.8, 95% CI: 0.75, 0.94), no edema (HR=0.41, 95% CI: 0.33, 0.50) and amoxicillin (HR=1.81, 95% CI: 1.18, 2.44) were independent predictors of recovery rate of children with SAM in Ethiopia. Publication year was found to be the potential source of heterogeneity among the included studies. Conclusion The treatment outcomes of children with SAM from outpatient therapeutic feeding programs of Ethiopia are lower than the sphere guidelines, WHO and national recommendations. Diarrhea and no edema antagonized the recovery rate of children while amoxicillin enhanced the recovery rate of children from SAM. Community health workers need to be trained. Especial attention should be given while treating children with diarrhea and severe wasting. Community mobilization is also recommended to increase community awareness about the therapeutic foods.
Egyptian Developmental Screening Test For Infants From Birth Up To 30 Months
Authors: Shafie Ali M. El , Omar Zein A.L. , Bashir Mai M. , mahmoud sorour fayez , Basma El-sayedamr M. , Bahbah Wael A. 
Published: February 2020

Abstract
Background: Detecting developmental delays in infants is an ongoing world commitment, especially for those below three years old. it provides appropriate services to them, early inspection enhances the communal quality of resolving difficult issues of this critical period of age. Thus, our main objective lies in developing a sufficient screening test for early evaluation of mental and motor development for infants.Methods: 54 items of motor and mental developmental milestones were adopted from the Baroda Screening Test. Then, researchers enrolled 1600 subjects based on certain inclusion and exclusion criteria. 97 pass level of developmental achievements resembles the threshold of which infants below which, infants are considered delayed.Results: The designed Egyptian Developmental Screening Tool (“EDST”) from birth up to 30 monthswith 50% and 97% pass level curves proves efficacy, reliability, cultural adaptability, and simplicity to use when compared with other peer screening tools. Results revealed a statistically significant difference between Egyptian and Baroda chart at 50% and 97% pass level. A z-score chart for motor and mental development follow up designed by calculating each age group.Conclusions: Developmental screening tests from birth up to 30 months proved consistent reliability and versatility to use in Egypt for early development delay detection. The wide variation of Egyptian infants 'developmental ages on both Egyptian and Baroda charts underpins the Egyptian chart to the Egyptian public. The z-score chart is a rapid and easy follow-up chart for Egyptian infants' development.
Smoking Cessation Counseling: Attitude in the Background of Poor Practice Compliance among Palestinian Primary Health Care Physicians: A cross sectional study
Authors: Maraqa Beesan , Nazzal Zaher , Jabareen Jurouh 
Published: February 2020

Abstract
Background: Health-care systems have primary responsibility for treating tobacco dependence. Despite its proven effectiveness, international studies have shown that provision of smoking cessation advice to patients in primary health care is suboptimal. This study aimed at assessing Palestinian PHC physicians' compliance and attitude towards smoking cessation counseling and their determinants.Methods: the study utilized a cross-sectional study design using a self-reported questionnaire targeted general practitioners, family medicine doctors, obstetrics & gynecologists and dentists working at PHC Centers in Palestine in the period between April to September,2019. Proportionate stratified random sampling method was used. Sociodemograpic, medical experience, if received any training in smoking cessation counseling, smoking history, practice compliance, knowledge, confidence and attitude were assessed. Results: 294 PHC physicians' participated in the study with high response rate. More than a half (53%) were between 31-45 years of age. Most of them (76.5%) were general practitioners seeing more than 30 patients per day (66%) and only 15% (n=40) get training about smoking cessation counseling. Practice compliance was low; only 39 (13.3%) reported compliance to smoking cessation practice. Attitude level among the participant physicians was good as the overall attitude score mean was 75.1 ± 9.6. Positive attitude, assigned as any score ≥65, was observed in 87.7% (n=258) of physicians. Job title, experience and knowledge are predictors of positive attitude towards smoking cessation counseling.Conclusion: Building supportive environment, improving physicians’ capabilities will reflect on their self-efficacy and their con­fidence level and will improve their practice in smoking cessation counseling.
Comparison of three different prophylactic treatments for postoperative nausea and vomiting after total joint arthroplasty under general anesthesia: a randomized clinical trial
Authors: Xie Jinwei , Cai Yingcun , Ma Jun , Huang Qiang , Zhou Zongke , Pei Fuxing 
Published: February 2020

Abstract
Background: Postoperative nausea and vomiting (PONV) after total joint arthroplasty is common and associated with delayed recovery. This study was performed to evaluate the efficacy of three different prophylactic regimens for PONV after total joint arthroplasty under general anesthesia.Methods: Patients undergoing primary total hip or knee arthroplasty were randomized to Group A (8 mg ondansetron), Group B (10 mg dexamethasone plus mosapride), or Group C (three doses of 10 mg dexamethasone plus mosapride). The primary outcome was the incidence of PONV. The secondary outcomes were complete response, rescue antiemetic treatment, opioid consumption, time until first defecation, postoperative appetite score, satisfaction score, length of hospital stay, blood glucose level, and complications.Results: Patients in Group C experienced a lower incidence of severe PONV (1.72%, p<0.001) and a higher incidence of complete response (70.69%, p=0.001) than did patients in Groups A and B. Moreover, less rescue antiemetic treatment and postoperative opioid consumption was needed in Group C (p<0.05). Additionally, a shorter time until first defecation, shorter length of stay, and better postoperative appetite scores and satisfaction scores were detected in patients in Group C. A slight increase in the fasting blood glucose level was observed in Group C, and the complications were comparable among the groups.Conclusion: Prophylactic use of mosapride and three doses of dexamethasone can provide better antiemetic effectiveness, postoperative appetite, bowel function recovery, and pain relief than a single dose or ondansetron only.