bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deciphering The Complex Circulating Immune Cell Microenvironment in Chronic Lymphocytic Leukemia Using Patient Similarity Networks
Authors: Mikulkova Zuzana , Manukyan Gayane , Turcsanyi Peter , Urbanova Renata , Savara Jakub , Ochodkova Eliska , Kudelka Milos , Brychtová Yvona , Molinsky Jan , Simkovic Martin , Starostka David , Novak Jan , Janca Ondrej , Dihel Martin , Ryznerova Pavlina , Mohammad Lekaa , Papajik Tomas , Kriegova Eva 
Published: July 2020

Abstract
Background: The tissue microenvironment in chronic lymphocytic leukemia (CLL) plays a key role in promoting neoplastic cell survival, proliferation, and drug resistance. There is a lack of complex characterization of CLL blood microenvironment and its clinical impact. Methods: Immunophenotypic profiles of circulating immune cells in 244 CLL patients (untreated, n=123; novel agents, n=67; previous immunochemotherapy, n=54) and age/sex-matched healthy controls (n=52) were assessed using flow cytometry and analyzed by multivariate patient similarity networks (PSNs). Results: Our study revealed high inter-individual heterogeneity in distribution and activation status of bystander immune cells in CLL, depending on the bulk of CLL cells. High CLL counts were associated with low activation status on circulating monocytes, T and NK cells and vice versa low CLL counts with high activation of immune cells, reaching levels in controls. Regarding treatment, the highest activation of immune cells, particularly of intermediate and non-classical monocytes, was evident in patients treated with novel agents. Clustering and visualization using PSNs confirmed low activation of immune cells in progressive disease, irrespectively of IgHV status and Binet stage. Calculating time-to-event endpoint, patients with high intermediate monocytes (>5.4%), predominantly low activated, were associated with 2.5-fold higher likelihood (95% CI 1.421-4.403, P =0.002) of event than those with low percentage of intermediate monocytes. Conclusions: Activation of circulating immune cells are dependent on the CLL cell counts and used therapy, with the lowest activation in patients with progressive disease. Percentage and activation of intermediate monocytes could be of prognostic value in CLL.
High Anti-Müllerian Hormone Level is Associated with A Lower Chromosomal Aberration Rate in Miscarried Conceptus From Women with Early Spontaneous Abortion
Authors: Mu Mingkun , Sun Simin , Zheng Wei , Yang Chen , Yang Shuheng , Zu Ruowen , Zhang Linlin , Gao Jinshuang , Li Jing , Wang Xingling , Guan Yichun 
Published: July 2020

Abstract
Background: Approximately 10-15% of clinically recognized pregnancies end in abortion. Most miscarriages occur as early spontaneous abortions. There are many factors leading to early spontaneous abortion, and 50–60% of such cases are associated with chromosomal abnormalities. The reason for this occurrence is not clear, but advanced age is a risk factor for chromosomal aberration in miscarried conceptus from women with early spontaneous abortion. As a marker of ovarian reserve, anti-Müllerian hormone (AMH) is negatively correlated with age. As women become older, AMH levels decrease. The objective of this study was to investigate whether different anti-Müllerian hormone (AMH) levels are associated with chromosomal aberration rate in miscarried conceptus from women who experience early spontaneous abortion.Methods: We collected the clinical history and miscarried conceptus of 434 women with early spontaneous abortion from January 2016 to June 2019. The women were divided into three groups according to AMH level (Group 1: low AMH <1.1 ng/ml [N =13], Group 2: normal AMH 1.1–4.5 ng/ml [N = 138], and Group 3: high AMH≥4.5 ng/ml [N =283]). Clinical history included age, anti-Müllerian hormone (AMH) level, number of previous abortions, estradiol (E2) level, luteinizing hormone (LH) level, follicle-stimulating hormone (FSH) level, infertile years, body mass index (BMI) and infertility factors. The miscarried conceptus was submitted for chromosomal copy number variation (CNV) analysis in the gene testing laboratory of the Third Affiliated Hospital of Zhengzhou University. Results: There were significant differences in age (39.5±4.3 vs. 33.0±5.3v s. 29.7±3.9, P＜0.001), E2 (187.9±513.4 vs. 92.9±160.6 vs. 66.5±139.3, P=0.019), LH (5.1±3.9 vs. 4.5±2.5 vs. 5.4±3.5, P=0.039), and FSH (10.7±5.6 vs. 7.3±2.6 vs. 6.4±2.1, P＜0.001) in different AMH groups. There were no significant differences in infertility years, BMI and infertility factors among the three groups.There was a significant difference in chromosomal aberration rate between different AMH groups (76.9% vs. 67.4% vs. 53.7%, Groups 2 vs. 3, respectively, P=0.008, OR 0.797, 95% CI 0.680-0.934). With the increase in AMH level, the chromosomal aberration rate in miscarried conceptus decreased gradually. After age stratification, the chromosomal aberration rate in miscarried conceptus was still significantly different among AMH groups, with a similar trend in women ≥35 years old (88.9% versus 76.0% versus 51.5%, P2 vs. 3 = 0.021, OR 0.678, 95% CI 0.470-0.977). There was the same trend in the younger group (＜35 years), but there was no significant difference (88.9% vs. 76.0% vs. 51.5).Conclusions: These findings indicate that high AMH level was associated with reduced risk of chromosomal aberration rate, especially in women of advanced age (≥35 years).
Clinical Features and Risk Factors Associated with Mortality in Critically ill Children Requiring Continuous Renal Replacement Therapy
Authors: Duyu Muhterem , Turkozkan Ceren 
Published: July 2020

Abstract
Background: The aims of this study were to describe the epidemiology and demographic characteristics of critically ill children requiring continuous renal replacement therapy (CRRT) at our pediatric intensive care unit (PICU) and to explore risk factors associated with mortality. Methods: A retrospective cohort of 121 critically ill children who received CRRT from May 2015 to May 2020 in the PICU of a tertiary healthcare institution was evalauted. The demographic information, admission diagnosis, indication for CRRT, clinical variables at the initiation of CRRT, time related variables and the laboratory results at initiation of CRRT were compared between survivors and non-survivors.Results: The most common diagnoses were renal disease (30.6%), hemato-oncological disease (12.4%), and sepsis (11.6%). The overall mortality was 29.8%. When compared according to diagnosis at admission, we found that patients with hemato-oncologic disease (73.3%) and those with pneumonia/respiratory failure (72.7%) had the highest mortality, while patients with renal disease had the lowest mortality (5.4%). The most common CRRT indications were: electrolyte or acid base imbalance (38.8%), acute kidney injury (29.8%) and fluid overload (14.9%). There was no relationship between mortality and indication for CRRT. The time interval between PICU admission and CRRT initiation was also unassociated with mortality (p=0.146). In patients diagnosed with sepsis, time until the initiation of CRRT was significantly shorter in survivors compared to non-survivors (p=0.004). Based on multivariate logistic regression, presence of comorbidity (odds ratio: 5.71; %95 CI: 1.16-27.97), being diagnosed with pneumonia/respiratory failure at admission (odds ratio: 16.16; %95 CI: 1.56-167.01), and high lactate level at the initiation of CRRT (odds ratio: 1.43; %95 CI: 1.17-1.79) were independently associated with mortality.Conclusions: In the context of the population studied mortality rate was lower than previously reported. In critically ill children requiring CRRT, mortality seems to be related to underlying disease, presence of comorbidity, and high lactate levels at CRRT initiation. We also found that early initiation of CRRT in sepsis can reduce mortality.
Microbiota community assembly in wild rice (Oryza longistaminata) in response to drought stress shows phylogenetic conservation, stochasticity, and aboveground-belowground patterns
Authors: ding xia , Peng Xiaojue , Chen Zhichao , Li Yingjie , Mao Lihui , Xie Hongwei , Cai Yaohui 
Published: July 2020

Abstract
Background

Drought is a global environmental stress that limits crop yields. Microbial communities control many biogeochemical processes, and a predictive understanding of how crop microbial communities assemble in response to drought stress is central to addressing the challenges caused by drought. Little is known about the microbiome assembly processes in rice-ecosystems, particularly with regard to their environmental adaptation. Wild rice may serve as a source of superior drought tolerance candidate for rice breeding. There is an urgent need to explore wild rice resistance mechanisms to drought stress. Here, we evaluated the effect of drought stress on the microbial community recruitment and assembly in the endosphere (leaf, stem, and root) and rhizosphere of Oryza longistaminata.
Results

Species replacement was the dominant process shaping microbial community composition under drought stress. O. longistaminata recruited the phyla Actinobacteria and Fusobacteria, the genus Streptomyces, and phototrophic prokaryotes to improve its fitness. The host exerted strong effects on microbiome assembly, and the responses of the microbial community structure to the drought environment showed above- and belowground patterns. Drought reduced taxonomic α-diversity and destabilized co-occurrence network properties in the leaves and stems, but not in the roots and rhizosphere. Drought promoted the restructuring and strengthening of belowground network links to more strongly interconnect network properties. The drought response of the microbiome was phylogenetically conserved. Stochastic (neutral) processes acted on microbial community reassembly in response to drought stress across all four compartments.
Conclusions

Our results provide new insight into the mechanisms through which drought alters microbial community assembly in drought-tolerant wild rice and reveal a potential strategy for manipulating plant microbiomes to improve crop fitness.
Assessment of Chronic Disease Self-management in Patients With Chronic Heart Failure Based on the MCID of Patient-reported Outcomes by the Multilevel Model
Authors: Tian Jing , Zhao Jinghua , Zhang Qing , Ren Jia , Han Linai , Li Jing , Zhang Yanbo , Han Qinghua 
Published: July 2020

Abstract
Purpose:The minimal clinically important difference (MCID) of a patient-reported outcome (PRO) represents the threshold value of the change in the score for that PRO. It is deemed to have an important implication in clinical management. This study was performed to evaluate the clinical significance of chronic disease self-management (CDSM) for patients with chronic heart failure based on the MCID of the chronic heart failure - PRO measure (CHF-PROM).Methods: A multicenter, prospective cohort study of 555 patients with heart failure were enrolled from May 2017 to May 2019. Advice of CDSM was provided in written form at discharge to all patients. Information regarding CHF-PROM and CDSM were collected during follow-up. Multilevel models were applied to dynamically evaluate the effects of CDSM for CHF-PROM scores, as well as its physical and psychological domains. MCID changes of the PRO were introduced and compared with β values of CDSM obtained from the multi-level models to further evaluate the clinical significance.Results: Scores for CHF-PROM improved significantly after discharge. The multilevel models showed that a regular schedule, avoidance of over-eating, a low-sodium diet and exercise increased scores on CHF-PROM. Compared with the MCID, avoidance of over-eating almost every day (13.60 vs. 10.71) and maintenance of a regular schedule often (12.03 vs. 10.71) reached clinical significance for the overall summary. Avoidance of over-eating (4.56 vs. 4.14) and a regular schedule almost every day (4.76 vs. 4.14) reached clinical significance for the physical scores. Avoidance of over-eating often (5.73 vs. 5.35) and a regular schedule almost every day (6.36 vs. 5.35) demonstrated clinical significance for the psychological scores.Conclusions: This study observed an association of avoidance of over-eating and maintenance of a regular schedule with the improvement of CHF-PROM. It provides further evidence for management of heart failure.Trial registration: 2018LL128, RegisteredJanuary 2, 2018-Prospective registered, http://www.sxmu.edu.cn/.
SARS-COV-2 infection during pregnancy, a risk factor for eclampsia or neurological manifestations of COVID-19? Case report.
Authors: Rodriguez Alejandro Garcia , Contreras Sergio Marcos , Manovel Santiago Manuel Fernandez , Vidal Jose Miguel Marcos , Buron Fernando Diez , Fernandez Camino Fernandez , Gonzalez Maria del Carmen Riveira 
Published: July 2020

Abstract
Background: There are no published cases of tonic-clonic seizures and posterior bilateral blindness during pregnancy and SARS-COV-2 infection. We do not just face new and unknown manifestations, but also how different patients groups are affected by SARS-Cov-2 infection, like pregnant women. COVID-19, preeclampsia, eclampsia and posterior reversible leukoencephalopathy share endothelium damage and similar pathophysiology. Case presentation: We present a case of a 35 years old pregnant woman, who comes to our hospital because of tonic-clonic seizures at home and SARS-COV-2 infection. After Caesarean section, we initiate antihypertensive treatment with labetalol, amlodipine and captopril. Few hour after C-section, she develops blindness with total recuperation after 72 hours, normal brain CT scan and normal CT angiography. She had normal pregnancy control and no other symptoms before tonic-clonic seizures development. Conclusion: SARS-COV-2 infection could promote brain endothelial damage and facilitate neurological complications during pregnancy.
Relationship Between Maternal Meat Consumption During Pregnancy and Umbilical Cord Ferritin Concentration
Authors: Castro Mario Moraes , Camacho Fabiola Ruth Castedo , Ceriani Florencia , Fares Nelson , Herrera Tamara Isabel , Ferreira Catalina Vaz , Arocena Elsa , Girona Alejandra , Cavalleri Fiorella , Colistro Valentina , Borbonet Daniel 
Published: July 2020

Abstract
Background: Nutrition during pregnancy impacts the health of the fetus and the newborn, with effects at the epigenetic level determining long-term neurological consequences. Iron requirements in pregnancy are estimated at 27 mg/day. The best absorbed heme iron is found in meat: beef, pork, poultry, and fish.The determination of ferritin in umbilical cord blood can be used to assess iron deposits reached during the fetal stage. Ferritin levels were associated with long-term effects on child development.Methods: A descriptive, observational study with prospectively collected data was carried out during one-year period at the Department of Neonatology of the Pereira Rossell Hospital Center (CHPR) in Montevideo, Uruguay. A total of 188 patients met the inclusion criteria. Umbilical cord blood was drawn following a strict cord clamping after one minute of life. Ferritin was measured using the chemoimmunofluorescence method. A maternal nutritional survey was applied, using a qualitative-quantitative form measuring the frequency of consumption of iron source foods and approximated quantities consumed during the last trimester of pregnancy. This survey was focused on maternal consumption of beef as the major heminic iron source in Uruguay. The relationship between these variables was analysed.Results: Latent iron deficiency (ferritin in the umbilical cord <100 ng / ml) was associated with less consumption of beef during pregnancy. Fisher p-value: 0.0133, OR: 3.71, 95% CI [1.25 - 11.05].Conclusions: This study considers adequate evidence that low levels of total iron and meat consumption during pregnancy will determine an increased risk of latent iron deficiency and lower levels of ferritin in newborns, and therefore, greater risk of long-term adverse effects on myelination and neurocognitive development.
Evidence based decision making and COVID-19: what a posteriori probability distributions speak.
Authors: Bhandari Sudhir , Tak Amit , Shukla Jyotsna , Patel Bhoopendra , Shaktawat Ajit Singh , Singhal Sanjay , Gupta Jitendra , Kakkar Shivankan , Dube Amitabh , Dia Sunita , Dia Mahendra , Wehner Todd C 
Published: July 2020

Abstract
Background: In the absence of a vaccine for coronavirus disease-19, the management of the current pandemic revolves around public health measures such as social distancing, lockdown, and contact tracing. A number of epidemiological models are used in decision making and for generating research intelligence. The models require information regarding the structures of social contact between different ages and genders. The present study fosters evidence-based decision making by estimating various a posteriori probability distributions from data of COVID-19 patients. Patients and Methods: In this retrospective observational study, 987 real-time RT-PCR SARS CoV-2 positive patients from SMS Medical College, Jaipur, India were enrolled after approval of the institutional ethics committee. The data regarding age, gender, and outcome were collected from case sheets. The univariate and bivariate distributions of COVID-19 cases with respect to age, gender, and outcome were estimated. The age distribution of COVID-19 cases was compared with the age distribution of general population using goodness of fit c2 test. The independence of attributes in bivariate distributions was evaluated using the chi square test for independence.Results: The age group ‘25-29’ has shown highest probability of COVID-19 cases (P[25-29] = 0.14, 95% CI: 0.12- 0.16). The men (P[Male] = 0.62, 95%CI: 0.59-0.65) were dominant sufferers. The most common outcome was recovery (P[Recovered] = 0.79, 95%CI: 0.76-0.81) followed by admitted cases (P[Active]= 0.13, 95%CI: 0.11-0.15) and death (P[Death] = 0.08, 95%CI: 0.06-0.10). The age distribution of COVID-19 cases differs significantly from the age distribution of the general population (c2 = 399.04, p < 0.001). The bivariate distribution of COVID-19 across age and outcome was not independent (c2 =106.21, df = 32, p < 0.001).Conclusion: The age, gender, and outcome distributions helps in evaluating disease dynamics and the social structure of the community. The knowledge of patterns of disease frequency helps in optimum allocation of limited resources and manpower. The study provides information for various epidemiological models, to decide the duration of lockdown.
Prognostic nomogram to predict overall survival for patients with perihilar cholangiocarcinoma: A population-based study of SEER database
Authors: Wang Chendong , Gong Huanyu , Zhang Zhiyuan , Fang Danzhou , Wu Huiqun 
Published: July 2020

Abstract
Background

Perihilar cholangiocarcinoma (pCCA) is a highly aggressive malignancy with poor prognosis. Accurate prediction is of great significance for patients’ survival outcome. The present study aimed to propose a prognostic nomogram for predicting the overall survival (OS) for patients with pCCA.

Methods

We conducted a retrospective analysis in a total of 940 patients enrolled from the Surveillance, Epidemiology, and End Results (SEER) program and developed a nomogram based on the prognostic factors identified from the cox regression analysis. Concordance index (C-index), risk group stratification and calibration curves were adopted to test the discrimination and calibration ability of the nomogram with bootstrap method. Decision curves were also plotted to evaluate net benefits in clinical use against TNM staging system.

Results

On the basis of multivariate analysis, five independent prognostic factors including age, summary stage, surgery, chemotherapy, together with radiation were selected and entered into the nomogram model. The C-index of the model was significantly higher than TNM system in the training set (0.703 vs 0.572, P<0.001), which was also proved in the validation set (0.718 vs 0.588, p<0.001). The calibration curves for 1-, 2-, and 3-year OS probabilities exhibited good agreements between the nomogram-predicted and the actual observation. Decision curves displayed that the nomogram obtained more net benefits than TNM staging system in clinical context. The OS curves of two distinct risk groups stratified by nomogram-predicted survival outcome illustrated statistical difference.

Conclusions

We established and validated an easy-to-use prognostic nomogram, which can provide more accurate individualized prediction and assistance in decision making for pCCA patients.
Internal Metal(loid)s Are Potentially Involved in the Association Between Ambient Fine Particulate Matter and Blood Pressure: A Repeated-Measurement Study in North China
Authors: Lan Changxin , Li Qi , Wang Bin , Xue Tao , Chen Junxi , Jiangtulu Bahabieke , Ge Shufang , Wang Xuepeng , Gao Miaomiao , Yu Yanxin , Xu Ying , Zhao Xiuge , Li Zhiwen 
Published: July 2020

Abstract
Background

The effects of ambient fine particulate matter (PM 2.5 ) exposure on blood pressure have been widely reported. However, there remains uncertainty regarding the underlying roles of particulate matter components. We aimed to investigate the association between ambient PM 2.5 exposure and blood pressure, as well as the potential mediating effects of trace metal(loid)s, in a repeated-measurement study that enrolled women of childbearing age.

Methods

Our study included 35 participants from Hebei Province, China, each of whom was visited five times. During each visit, questionnaire surveys were conducted, blood pressure was measured, and blood was collected. The daily PM 2.5 exposure for all participants was estimated according to their residential addresses using a spatiotemporal model that combined monitoring data with satellite measurements and chemical-transport model simulations. This model was used to calculate average PM 2.5 concentrations 1, 3, 7, 15, 30, and 60 days prior to each visit. Serum concentrations of various trace metal(loid)s were measured using an inductively coupled plasma-mass spectrometer. A linear mixed-effects model was used to investigate associations among study variables.

Results

PM 2.5 concentration was positively associated with both systolic and diastolic blood pressures, with or without adjustments for potential confounders. Likewise, PM 2.5 concentration was positively associated with serum concentrations of manganese and arsenic, and negatively associated with serum concentrations of nickel, tin, and chromium. Only the serum concentration of molybdenum was negatively associated with systolic blood pressure.

Conclusion

Ambient PM 2.5 exposure may contribute to elevated blood pressure, potentially by interfering with internal metal(loid) intake in the human body.
Fear of COVID-19 and Mental Health: The Role of Mindfulness in During Time of Crisis
Authors: Belen Hacer 
Published: July 2020

Abstract
The novel Coronavirus disease (COVID-19) is impactful on all aspects of individuals’ lives, particularly mental health due to the fear associated with the pandemic. Thus, current study explored the relationship between fear of COVID-19 and mental health aspects, namely anxiety and depression and whether this relationship is mediated by mindfulness. Data were collected from a student sample of 355 participants (71.5 % female and 28.5% males) ranged between in age 18 and 41 (M= 22.41±3.27) and participants completed Fear of COVID-19 Scale, Mindfulness Attention and Awareness Scale and anxiety and depression subscale of SCL-90-R. In terms of the results, correlational analyses indicated that fear of COVID-19 is reversely associated with mindfulness while positive correlations were found with anxiety and depression. Structural equation modeling analyses demonstrated that mindfulness mediated in the relationship between fear of COVID-19 and depression and anxiety. Implications are further discussed.