bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rural context, single institution prospective outcomes after Enhanced Recovery colorectal surgery protocol implementation
Authors: Smucker Levi , Victory Jennifer , Scribani Melissa , Oceguera Luis , Monzon Raul 
Published: November 2020

Abstract
Background: Rural hospitals face unique challenges to adopting Enhanced Recovery protocols after colorectal surgical procedures. There are few examples of successful implementation in the United States, and fewer yet of prospective, outcomes-based trials. Methods: This study drew data from elective bowel resection prospectively collected, retrospectively analyzed cases 2 years prior (n=214) and 3 years after (n=224) implementing an ERAS protocol at a small, rural health network in upstate New York. Primary outcomes were cost, length-of-stay, readmission rate, and complications.Results: The implementation required changes and buy-in at multiple levels of the institution. There was a statistically significant reduction in mean length of stay (6.9 versus 5.1 days) and per-patient savings to hospital ($3000) after implementation of ERAS protocol. There was no significant change in rate of 30-day readmissions or complications. Conclusions: The authors conclude that for rural-specific barriers to implementation of Enhanced Recovery protocols there are specific organizational strategies that can ultimately yield sustainable endpoints.Trial Registration: The research trial data was retrospectively registered in the following fashion: Original IRB approval was granted 01/25/2016. Study has been reviewed & approved yearly. Request to waive consent was submitted to the IRB & granted with the initial review/approval.
Generation of Dyskeratosis Congenita-like Hematopoietic Stem Cells through the Stable Inhibition of DKC1
Authors: Carrascoso-Rubio Carlos , Zittersteijn Hidde A. , Pintado-Berninches Laura , Fernández-Varas Beatriz , Lozano M. Luz , Manguan-Garcia Cristina , Sastre Leandro , Bueren Juan A. , Perona Rosario , Guenechea Guillermo 
Published: November 2020

Abstract
Dyskeratosis congenita (DC) is a rare telomere biology disorder, which results in different clinical manifestations, including severe bone marrow failure. To date, the only curative treatment for bone marrow failure in DC patients is allogeneic hematopoietic stem cell transplantation. However due to the toxicity associated to this treatment, improved therapies are recommended for DC patients. Here we aimed at generating DC-like human hematopoietic stem cells in which the efficacy of innovative therapies could be investigated. Because X-linked DC is the most frequent form of the disease and is associated with an impaired expression of DKC1, we have generated DC-like hematopoietic stem cells based on the stable knock-down of DKC1 in human CD34+ cells with lentiviral vectors encoding for DKC1 short hairpin RNAs. At a molecular level, DKC1-interfered CD34+ cells showed a decreased expression of TERC, as well as a diminished telomerase activity and increased DNA damage, cell senescence and apoptosis. Moreover, DKC1-interfered human CD34+ cells showed defective clonogenic ability and were incapable of repopulating the hematopoiesis of immunodeficient NSG mice. The development of DC-like hematopoietic stem cells will facilitate the understanding of the molecular and cellular basis of this inherited bone marrow failure syndrome, and will serve as a platform to evaluate the efficacy of new hematopoietic therapies for DC.
Status of MWth Integrated Gasification Fuel Cell (IGFC) Power Generation System Demonstration in China
Authors: Wei Chang , Liu Zhien , Li Chufu , Singh Surinder , Lu Haoren , Gong Yudong , Li Pingping , Wang Hanlin , Yang Xia , Xu Ming , Mu Shujun 
Published: November 2020

Abstract
This paper provides status update of IGFC power generation system being developed at National Institute of Clean-and-Low-Carbon (NICE) at MWth scale. This system is designed to use coal as fuel to produce syngas as a first step similar to integrated gasification combined cycles (IGCC). Subsequently, the solid oxide fuel cell system is used to convert chemical energy to electricity directly through electrochemical reaction without combustion, which is different from IGCC. This system leads to a higher efficiency as compared to a traditional coal-fired power plant. The unreacted fuel in the SOFC system is transported to an oxygen-combustor to be converted to steam and CO2. Through heat recovery system, the steam is condensed and removed, and CO2 is enriched and captured for sequestration or utilization, such as co-electrolysis of CO2 and H2O using curtailed renewable energy for production of syngas. Comprehensive economic analysis for a typical IGFC system was performed and the results were compared with supercritical pulverized coal-fired (SCPC) power plant, showing the cost of electricity (COE) of IGFC could be up to 20% lower than that by SCPC with CO2 capture. The SOFC stacks selected for IGFC development were tested and qualified under both hydrogen and simulated coal syngas fuel showing good consistency and stable long term performance. Experimental results using SOFC stacks and thermodynamic analysis (using ASPEN Plus) indicate that the hydrogen to CO ratio of the syngas is preferred to be 1.68 or higher to avoid carbon deposition inside of the fuel pipe. For lower H2/CO ratio, steam to CO ratio needs to be higher. Besides, the steam needs to be mixed well with the syngas above 100oC and below the temperatures where carbon formation is thermodynamically favored. The 20kW SOFC power generation unit is being developed with design system conditions of 20 kW maximum power, current density of 0.334 A/cm2, DC efficiency of 50.41%, and fuel utilization of 80%. A 100kW-level subsystem will consist of 6 x 20kW power generation units, and the MWth IGFC system will consist of 5 x 100kW-level subsystems.
Artificial Intelligence-Assisted Reduction in Patients’ Waiting Time for Outpatient Procedures: A Matched Case–Control Study
Authors: Li Xiaoqing , Tian Dan , Li Weihua , Dong Bin , Wang Hansong , Yuan Jiajun , Li Biru , Shi Lei , Lin Xulin , Zhao Liebin , Liu Shijian 
Published: November 2020

Abstract
Background: Many studies indicate that patient satisfaction is significantly negatively correlated with waiting time. A well-designed healthcare system should not keep patients waiting too long for appointment and consultation. However, in China, patients spend considerable time waiting, and the actual time spent on diagnosis and treatment in the consulting room is comparatively less.Methods: We developed an artificial intelligence (AI)-assisted module that is embedded in hospital information systems. Through its use, outpatients were automatically recommended an imaging examination or a laboratory test based on their symptoms and chief complaint. Thus, they could get examined or tested before they went to see the doctor. People who saw a doctor in the traditional way were assigned to the conventional group, and those who used the AI-assisted system were assigned to the AI-assisted group. We conducted a 1:1 case–control study that applied propensity score matching to pair the data from patients in a pediatric tertiary hospital between August 1, 2019 and January 31, 2020. Waiting time was defined as the time from registration to preparation for a laboratory test or an imaging examination. The total cost included the registration fee, test fee, examination fee, and drug fee. The Wilcoxon rank-sum test was used to compare the differences in time and cost between the AI-assisted group and the conventional group. The statistical significance level was set at 0.05 for two sides.Results: A total of 12,342 visits were recruited for this study, consisting of 6,171 visits in the conventional group and 6,171 visits in the AI-assisted group. The median waiting time was 0.38 (inter-quartile range: 0.20, 1.33) hours for the AI-assisted group compared with 1.97 (0.76, 3.48) hours for the conventional group (p < 0.05).Conclusions: Using AI can significantly reduce the waiting time of patients for outpatient procedures, and thus, enhance the outpatient process of hospitals.
Requirement for containing etoposide in the initial treatment of lymphoma associated hemophagocytic lymphohistiocytosis
Authors: Song Yue , Wang Jingshi , Wang Yini , Wu Lin , Wang Zhao 
Published: November 2020

Abstract
Background: Hemophagocytic lymphohistiocytosis (HLH) is a severe or even fatal inflammatory status caused by a hereditary or acquired immunoregulatory abnormality. Lymphoma associated hemophagocytic lymphohistiocytosis (LAHS) is a kind of secondary HLH (sHLH). It has the worst prognosis among sHLH. However, there’s still no standard treatment strategy. The argument mainly focuses on whether an HLH-directed or malignancy-directed approach should initially be adopted. Etoposide is one of the key drugs in HLH treatment, also effective in lymphomas. We sought to identify the importance of containing etoposide in initial treatment, comparing with the chemotherapy which directed at lymphoma but without etoposide. Methods: 66 patients diagnosed as LAHS in our center between Jan 1 2015 and Dec 31 2017 were divided into two groups according to weather the initial treatment containing etoposide, or other lymphoma-directed chemotherapy without etoposide. Results: The remission rate of the initial etoposide group (52 patients) is significantly better than that of no initial etoposide group (14 patients) (73.1% vs. 42.9%, p=0.033). The 2-month survival rate (79.8% vs. 46.8%, p=0.035) and overall survival (median survival time 25.8w vs. 7.8w, p=0.048) of the initial etoposide contained group is significantly better. Multivariate cox analysis revealed that for patients without EBV infection (37 cases), initial treatment with etoposide could significantly improve prognosis (p=0.010, Exp(B)=0.183), but for patients with positive EBV, it’s not significant. Conclusions: Containing etoposide is beneficial in the initial treatment of LAHS, weather using the HLH directed or lymphoma directed strategy. It provides higher response rate, lower mortality rate and better survival, especially for EBV negative patients.
Analysis of Anxiety-Related Factors amongst Frontline Dental Staff during the COVID-19 Pandemic in Yichang, China
Authors: Zhao Suli , Cao Jing , Zhang Lin , Liu Beibei , Sun Rongcan 
Published: November 2020

Abstract
Background: Dental staff were characterized with the tolerance of enduring stress and they were at a high risk to respiratory infectious disease. This study compared the anxiety level of the frontline dental staff (FDS) to the general public in Yichang during the coronavirus disease of 2019 (COVID-19) pandemic and examined potential explanatory factors to the differences.Methods: Two online questionnaires were used separately to collect data from FDS and the general public. The Chinese version of Becker Anxiety Inventory (BAI) was included for the assessment of anxiety. Firstly, a Chi-square test was conducted to compare the anxiety state between these two groups. Then, a bivariate analysis using Cramer’s V and Eta squared was conducted to find the potential factors. Lastly, a binary logistic regression was performed to examine the association between potential factors and the anxiety state of FDS.Results: In general, FDS were 4.342 (95% CI: 2.427-7.768) times more likely to suffer from anxiety disorder than the general public. The bivariate analysis showed that age, Level Three Protective Measures (PM-3), conflicts with patients and/or colleagues were moderately associated with the anxiety state of FDS. But the knowledge of COVID-19, the treatment to suspected or confirmed cases both had a weak association with the anxiety among FDS. Conversely, workload, the exposure to potential infectious substance and conducting aerosol generated performance were not significantly related to the anxiety of FDS. As the model indicated, an elder age and PM-3 protective measures could lower the anxiety state of FDS, whereas the conflict with patients or/and colleagues would worsen it.Conclusions: During the COVID-19 pandemic, FDS were more likely to suffer from anxiety disorders than the general public. Sufficient personal protective measures and good relationships with colleagues and patients would help them to maintain good mental health.
Loss of exosomal miR-146a-5p from cancer-associated fibroblasts after androgen deprivation therapy contributes to prostate cancer metastasis
Authors: Zhang Yu , Zhao Jing , Ding Mao , Su Yiming , Cui Di , Jiang Chenyi , Zhao Sheng , Jia Gaozhen , Wang Xiaohai , Ruan Yuan , Jing Yifeng , Xia Shujie , Han Bangmin 
Published: November 2020

Abstract
Background: Androgen deprivation therapy (ADT) is the backbone of therapy for advanced prostate cancer (PCa). Despite the good initial response, castration resistance and metastatic progression will inevitably occur. Cancer-associated fibroblasts (CAFs) may be implicated in promoting metastasis of PCa after ADT. Our aim is to investigate the role and mechanism of CAFs-derived exosomes involving in metastasis of PCa after ADT.Methods: PCa cells were co-cultured with exosomes derived from 10 nM dihydrotestosterone (DHT)-treated (simulating the high androgen level of prostate cancer microenvironment） or ethanol (ETOH) -treated (simulating the castration level of prostate cancer microenvironment after ADT) CAFs, and their migration and invasion differences under castration condition were examined both in vitro and in vivo. The miRNA profiles of exosomes derived from DHT-treated CAFs and matched ETOH-treated CAFs were analysed via next generation sequencing. The transfer of exosomal miR-146a-5p from CAFs to PCa cells was identified by fluorescent microscopy. The function and direct target gene of exosomal miR-146a-5p in PCa cells were confirmed through Transwell assays, luciferase reporter, and western blot.Results: Compared with DHT-treated CAFs, exosomes derived from ETOH-treated CAFs dramatically increased migration and invasion of PCa cells under castration condition. MiR-146a-5p level in exosomes from ETOH-treated CAFs was significantly reduced. The loss of miR-146a-5p may strengthen the epithelial-mesenchymal transition (EMT) to accelerate cancer cells metastasis by modulating epidermal growth factor receptor (EGFR)/ERK pathway.Conclusions: CAFs-derived exosomal miR-146a-5p confers metastasis in PCa cells under ADT through the EGFR/ERK pathway and it may present a new treatment for PCa.
A glycolysis-based three-gene signature predicts survival in patients with lung squamous cell carcinoma
Authors: Huang Guichuan , Zhang Jing , Gong Ling , Huang Yi , Liu Daishun 
Published: November 2020

Abstract
Background: Lung cancer is one of the most lethal and most prevalent malignant tumors worldwide, and lung squamous cell carcinoma (LUSC) is one of major histological subtypes. Although, numerous biomarkers were found to be associated with prognosis in LUSC, the prediction effect of a single gene biomarker is not sufficient, especially for glycolysis-related genes. Therefore, we aimed to develop a novel glycolysis-related gene signature to predict survival of patients with LUSC.Methods: The mRNA expression files and clinical information of LUSC were obtained from The Cancer Genome Atlas (TCGA) dataset.Results: Based on Gene set enrichment analysis (GSEA), we found 5 glycolysis-related gene sets were significantly enriched in LUSC tissues. Univariate and multivariate Cox proportional regression models were conducted to choose prognostic-related gene signature. Based on Cox proportional regression model, a risk score of three-gene signature (including HKDC1, ALDH7A1, and MDH1) was established to divide patients into high-risk and low-risk subgroups. We found that a risk score of three-gene signature was an independent of prognostic indicator in LUSC using multivariate Cox regression analysis. Additionally, based on the cBioPortal database, the rate of alterations in HKDC1, ALDH7A1, and MDH1 genes were 1.9%, 1.1%, and 5% in LUSC patients, respectively. Conclusion: In conclusion, a glycolysis-based three-gene signature could serve as a novel biomarker in predicting prognosis of patients with LUSC, which provided more gene targets to cure LUSC patients.
Sex-dependent differences in the secretome of human endothelial cells
Authors: Cattaneo Maria Grazia , Banfi Cristina , Brioschi Maura , Lattuada Donatella , Vicentini Lucia M. 
Published: November 2020

Abstract
Background: Cellular sex has been rarely considered as a biological variable in preclinical research, even when the pathogenesis of diseases with predictable sex differences is studied. In this perspective, proteomics, and ‘omics approaches in general, can provide powerful tools to obtain comprehensive cellular maps, thus favoring the discovery of still unknown sex-biased physio-pathological mechanisms.Methods: We performed proteomic and gene ontology (GO) analyses of secretome from human serum-deprived male and female endothelial cells (ECs) followed by ELISA validation. Apoptosis was detected by FACS and western blot techniques, and efferocytosis through the ability of the macrophage cell line RAW-264.7 to engulf apoptotic ECs. PTX3 mRNA levels were measured by RT-qPCR. Results: Proteomic and GO analyses of the secretome from starved human male and female ECs demonstrated a significant enrichment in proteins related to cellular responses to stress and to the regulation of apoptosis in the secretome of male ECs. Accordingly, a higher percentage of male ECs underwent apoptosis in response to serum deprivation in comparison to female ECs. Among the secreted proteins, we reliably found higher levels of PTX3 in the male EC secretome. The silencing of PTX3 suggests that male ECs were dependent on its expression to properly carry out the efferocytotic process. At variance, female EC efferocytosis seems to be independent on PTX3 expression. Conclusions: Our results demonstrated that serum-starved male and female ECs possess different secretory phenotypes that might take part in the sex-biased response to cellular stress. We identified PTX3 as a crucial player in the male-specific endothelial response to an apoptotic trigger. This novel and sex-related role for secreted proteins, and mainly for PTX3, may open the way to the discovery of still unknown sex-specific mechanisms and pharmacological targets for the prevention and treatment of endothelial dysfunction at the onset of atherosclerosis and cardiovascular disease.
Dissecting Molecular Mechanisms Underlying H2O2-induced Apoptosis of Mouse Bone Marrow Mesenchymal Stem Cell: Role of Mst1 Inhibition.
Authors: Zhang Qian , Cheng Xianfeng , Zhang Haizhou , Zhang Tao , Wang Zhengjun , Zhang Wenlong , Yu Wancheng 
Published: November 2020

Abstract
BackgroundBone marrow mesenchymal stem cell (BM-MSC) has been shown to treat pulmonary arterial hypertension (PAH). However, excessive reactive oxygen species (ROS) increases the apoptosis of BM-MSCs, leading to poor survival and engraft efficiency. Thus, improving the ability of BM-MSCs to scavenge ROS may considerably enhance the effectiveness of transplantation therapy. Mammalian Ste20-like kinase 1 (Mst1) is a pro-apoptotic molecule which increases ROS production. The aim of this study is to uncover the underlying mechanisms the effect of Mst1 inhibition on the tolerance of BM-MSCs under H2O2 condition.MethodsMst1 expression in BM-MSCs was inhibited via transfection with adenoviruses expressing a short hairpin (sh) RNA directed against Mst1 (Ad-sh-Mst1) and exposure to H2O2. Cell viability was detected by Cell counting Kit 8 (CCK‑8) assay, and cell apoptosis was analyzed by Annexin V-FITC/PI, Caspase 3 Activity Assay kits, and pro caspase 3 expression. ROS level was evaluated by the ROS probe DCFH-DA, mitochondrial membrane potential (ΔΨm) assay, SOD1/2, CAT, and GPx expression. Autophagy was assessed using transmission electron microscopy, stubRFP-sensGFP-LC3 lentivirus and autophagy-related protein expression. The autophagy/Keap1/Nrf2 signal in H2O2-treated BM-MSC/sh-Mst1 was also measured.ResultsMst1 inhibition reduced ROS production, increased antioxidant enzyme SOD1/2, CAT, GPx expression, maintained ΔΨm, and alleviated cell apoptosis in H2O2-treated BM-MSCs. In addition, this phenomenon was closely correlated with the autophagy/Keap1/Nrf2 signal pathway. Moreover, the antioxidant pathway Keap1/Nrf2, was also blocked when autophagy was inhibited by the autophagy inhibitor 3-MA. However, Keap1 or Nrf2 knockout via siRNA had no effect on autophagy activation or suppression.ConclusionMst1 inhibition mediated the cytoprotective action of mBM-MSCs against H2O2-induced oxidative stress injury. The underlying mechanisms involve autophagy activation and the Keap1/Nrf2 signal pathway.
A reverse transcription loop-mediated isothermal amplification for broad coverage detection of Asian and African Zika virus lineages
Authors: Teoh Boon-Teong , Chin Kim-Ling , Samsudin Nur-Izyan , Loong Shih-Keng , Sam Sing-Sin , Tan Kim-Kee , Khor Chee-Sieng , Abd-Jamil Juraina , Zainal Nurhafiza , Wilder-Smith Annelies , Zandi Keivan , AbuBakar Sazaly 
Published: November 2020

Abstract
Background: Early detection of Zika virus (ZIKV) infection during the viremia and viruria facilitates proper patient management and mosquito control measurement to prevent disease spread. Therefore, a cost-effective nucleic acid detection method for the diagnosis of ZIKV infection, especially in resource-deficient settings, is highly required.Methods: In the present study, a single-tube reverse transcription loop-mediated isothermal amplification (RT-LAMP) assay was developed for the detection of both the Asian and African-lineage ZIKV. The detection limit, strain coverage and cross-reactivity of the ZIKV RT-LAMP assay was evaluated. The sensitivity and specificity of the RT-LAMP were also evaluated using a total of 24 simulated clinical samples. The ZIKV quantitative reverse transcription-polymerase chain reaction (qRT-PCR) assay was used as the reference assay.Results: The detection limit of the RT-LAMP assay was 3.73 ZIKV RNA copies (probit analysis, P ≤ 0.05). The RT-LAMP assay detected the ZIKV genomes of both the Asian and African lineages without cross-reacting with other arthropod-borne viruses. The sensitivity and specificity of the RT-LAMP assay were 90% (95% CI = 59.6 – 98.2) and 100% (95% CI = 78.5 – 100.0), respectively. The RT-LAMP assay detected ZIKV genome in 9 of 24 (37.5%) of the simulated clinical samples compared to 10 of 24 (41.7%) by qRT-PCR assay with a high level of concordance (k = 0.913, P < 0.001).Conclusion: The RT-LAMP assay is applicable for the broad coverage detection of both the Asian and African ZIKV strains in resource-deficient settings.