bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patients´ Values in Nordic General Practice; A Report From the QUALICOPC Study.
Authors: Eide Torunn Bjerve , Straand Jørund , Brænd Anja Maria 
Published: September 2020

Abstract
Background. Patients’ expectations and preferences are important for improving the quality of care. We have explored Nordic patients´ views of the importance of different aspects of quality in general practice. Methods. In the Nordic countries, patients were recruited in general practitioners’ (GPs´) waiting rooms and asked to fill in a questionnaire ranking the importance of 47 statements reflecting five domains concerning quality of care in general practice: communication, involvement, accessibility, continuity, and comprehensiveness. Questionnaire items rated as important or very important by ≥ 90% of participants in all countries were considered to be universally of high importance. Logistic regression was used to identify associations between assessments and patient characteristics.Results. 707 patients responded, ranging from 82 (Iceland) to 209 (Denmark) per country. 90 % or more of patients in each country rated ten statements as important or very important: six pertained to communication with the GP, three to patient involvement and one to comprehensiveness of care. No items regarding accessibility or continuity of care exceeded the 90% limit in all countries. The item most frequently rated as very important was “I understand what the GP explains”. Female patients were more likely than males (OR=2.9; 95%CI 1.5-5.5) to value that a GP treats them as a person rather than just a medical problem, and also that they receive instructions regarding what to do if things went wrong (1.7; 1.2-2.2). Older patients >65 years put less emphasis than those aged <35 on whether the GP takes them seriously (0.4; 0.3-0.5), and also on the importance of receiving instructions for what to do if something went wrong (0.5; 0.4-0.7). Patients with chronic disease were less concerned (0.6; 0.4-0.8), with receiving instructions, but valued strongly that a GP knows when to refer them (2.2; 1.5-3.3). Conclusion. Patients in all countries assigned high value to the communication with their GP. Availability was also deemed important by patients, but came secondary to good communication quality. The organisational framework for general practice organisation must allow for acceptable quality of communication as well as availability.
Fecal Calprotectin in patients with Infantile Colic: A case-control study
Authors: Khoshnevisasl Parisa , sadeghzadeh mansour , Mahmoudirad Neda , Motamed Nima 
Published: September 2020

Abstract
Back groundThe precise etiology of infantile colic has not been elucidated after many years of research. In this study, we aimed to determine the association of fecal calprotectin with infantile colic.MethodThis case control study was performed on colicky infants referred to pediatrics clinics in Zanjan over a 6-month period. Infantile colic was clinically defined based on wessel criteria. The control group consisted of healthy infants matched for age, sex, weight, and type of feeding with the case group. Fecal calprotectin levels were measured in both groups by the ELISA method.ResultsForty infants were divided equally into case and control groups. The cases consisted of 11 boys (55%) and 9 girls (45%) with a mean age of 63 days and in the control group there was 12 boys (60%) and 8 girls (40%) with mean age of 48 days. Fecal calprotectin was positive in 17 (85%) cases and 6 (30%) controls. This difference was statistically significant. There was no significant difference in fecal calprotectin regarding sex, age, weight and type of nutrition in both colicky infants and controlsConclusionFecal calprotectin levels in colicky infants were significantly higher than healthy infants.
Outcomes of a medical second opinion programme before knee arthroplasty: A prospective cohort study
Authors: Weigl Martin , Pietzner Jens , Kisch Rebecca , Paulus Alexander , Jansson Volkmar , Grill Eva 
Published: September 2020

Abstract
Background: German social legislation gives patients the right to obtain a second opinion before elective surgery and defines quality criteria for reimbursement by statutory health insurance. However, the effects of second opinions before elective surgery are largely unknown. The aim of this study was to evaluate the effects of a second opinion programme in patients recommended for knee arthroplasty.Methods: The largest statutory health insurance funds in Bavaria offered patients to whom knee arthroplasty was recommended participation in a second opinion programme with personal presentation to an experienced knee surgeon. In this cohort study, consecutive patients from this second opinion programme who signed informed consent were included from 07/10/2016 to 14/02/2020. Data were collected before and after the second opinion visit.Results: A total of 141 (66%) of 215 second opinion patients participated in the evaluation study. The second opinion physician recommended knee arthroplasty to 40% of the patients, later knee arthroplasty if the conditions worsened to 40%, and no knee arthroplasty to 20%. The frequency of undecided patients decreased from 41% to 12%. After the second opinion, the patients were more confident in their decision according to the decision confidence scale (before: 5.4 ± 3.0; after: 7.8 ± 2.5; p < 0.001). Logistic regression analyses showed that higher radiological severity of osteoarthritis on the Kellgren/Lawrence scale (p = 0.001) and lower knee-joint-specific quality of life on the KOOS questionnaire (p = 0.041) were associated with the recommendation for knee arthroplasty by the second opinion physician. The patients rated their satisfaction with the second opinion programme with a mean grade of 1.35 (± 0.60) on a scale from 1 to 5.Conclusion: The second opinion of an experienced knee surgeon frequently deviates from the initial recommendation for knee arthroplasty. The results of this study suggest that a second opinion may improve adherence to guidelines for indications of knee arthroplasty. From the patient perspective, the second opinion reduces uncertainties in their treatment decision.
Efficacy of immunohistochemical staining in detecting Helicobacter pylori in Saudi patients with minimal and atypical infection
Authors: Akeel Mohammed Abdulraheem , Elhafey Ahmed , Shehata Atef , Elmakki Erwa , Aboshouk Thanaa , Ageely Hussein , Mahfouz Mohammed Salih 
Published: September 2020

Abstract
Background

Gastric Helicobacter pylori infection is diagnosed based on histopathological evaluation of gastric mucosal biopsies, urease test, urea breath test, H. pylori culturing, or direct detection using polymerase chain reaction (PCR). This study aimed to evaluate the efficacy of immunohistochemical (IHC) staining in detecting H. pylori in gastric biopsies from dyspeptic patients with minimal and/or atypical infection. Gastric biopsies from 50 patients with chronic gastritis were subjected to routine haematoxylin and eosin (H&E), modified Giemsa, and IHC staining. The results of staining were compared with those of quantitative real-time PCR (qRT-PCR).
Results

The qRT-PCR analysis identified 32 (64%) H. pylori-positive cases, whereas IHC, H&E, and modified Giemsa staining identified 29 (58%), 27 (54%), and 21 (42%) positive cases. The false-positive rates of H&E and modified Giemsa staining were 16% and 14%, respectively. The sensitivity of IHC staining (87.50%) was higher than that of H&E (59.38%) and modified Giemsa (43.75%) staining. The specificity of H&E, modified Giemsa, and IHC staining was 55.56%, 61.11%, and 94.44%, respectively. IHC staining exhibited the highest diagnostic accuracy (90%), followed by H&E (58%) and modified Giemsa (50%) staining. Active gastritis, intestinal metaplasia, and lymphoid follicles were detected in 32 (64%), 4 (8%), and 22 (44%) cases, respectively, and all of these cases were H. pylori positive.
Conclusions

H. pylori can be detected using routine H&E or modified Giemsa staining. However, the high sensitivity, specificity, and diagnostic accuracy of IHC staining minimise the false-positive/negative results and enable H. pylori detection in cases with minimal or atypical infection. Moreover, IHC can be an alternative diagnostic method to qRT-PCR for detection of H. pylori in such cases.
GnRH Antagonist Versus Modified Prolonged GnRH Agonist Protocol&nbsp;in Polycystic Ovary Syndrome&nbsp;(PCOS): Analysis Using Propensity Score Matching
Authors: Xia Leizhen , Tian Lifeng , Tan Jun , Zhang Shanshan , Wu Qiong-Fang 
Published: September 2020

Abstract
Background: Women with polycystic ovary syndrome (PCOS) have been reported with low pregnancy rate and high OHSS risk in in vitro fertilization (IVF) programs due to the decreased endometrial receptivity and high ovarian reserve. The aim of the study was to compare the effectiveness, safety and economic cost of GnRH antagonist (GnRH-ant) and modified prolonged GnRH agonist (mGnRH-a) protocol in PCOS patients.Methods: This study was a retrospective cohort study that included 2164 women with (PCOS) undergoing assisted reproductive technology (ART) treatment from January 2014 to April 2019. Among them, 2018 women received mGnRH-a treatment and 146 women received GnRH antagonist (GnRH-ant) treatment. The two groups were matched by propensity scores with a ratio of 1:4 (GnRH-ant versus mGnRH-a) accounting for potential confounding factors. The primary outcomes were the live birth rate (LBR), incidence of moderate-to-severe OHSS and the cost of controlled ovarian hyperstimulation (COH). LBR was defined as live birth per started treatment cycle after first fresh or frozen embryo transfer.Results: Women with the mGnRH-a protocol had an increased endometrial thickness on HCG injection day, compared with GnRH-ant protocol (10.84 vs. 9.62, P<0.001), furthermore, the number of transferable embryos on day 3 (7 vs. 5, P=0.022), clinical pregnancy rate (67.81% vs. 52.74%, P=0.0007), implantation rate (56.05%, vs. 43.44%, P<0.001) and live birth rate (58.22% vs. 41.78%, P=0.0004) were also significantly higher in the mGnRH-a protocol group. However, there were no significant differences in the incidence of moderate-to-severe OHSS (4.28% vs. 2.05%, P=0.333), the incidence of severe OHSS (0.17% vs. 0%, P=1) and the cost of COH (RMB: 7736.9 vs. 8046.54, P=0.113). Conclusion: The mGnRH-a protocol has a higher live birth rate than GnRH-ant protocol with the similar safety and economic cost among infertile women with PCOS.
Structure formation of black hole jets triggered by electron-scale physics
Authors: Kawashima Tomohisa , Ishiguro Seiji , Moritaka Toseo , Horiuchi Ritoku , Tomisaka Kohji 
Published: September 2020

Abstract
Jets are ubiquitous in the universe[1,2]. The radio jet is a beamed plasma flow with relativistic speed accelerated by a supermassive black hole in some galaxies. Recent observations of the relativistic jet in the elliptical galaxy M87 have discovered a triple-ridge sub-structure in the jet at a distance of one thousand Schwartzchild radius from the black hole [3,4]. The triple-ridge structure may be the first strong evidence of the spine-sheath structure consisting of the fast spine region (jet spine) and relatively slow sheath region (jet sheath), which was hypothetically introduced to explain observational features in various unresolved relativistic jets [5,6]. However, the formation mechanism of such a spine-brightened jet is quite enigmatic. Here we report that the combination of the magnetic pinching force induced by an electron-scale shear-instability called Mushroom instability[7] and the high-energy electron ejections by the subsequent magnetic reconnection leads to the drastic accumulation of high-energy electrons in the center of the cylindrical jet. The concentration of high-energy electrons towards the jet center indicates the appearance of bright jet-spine as observed in M87. Thus, the electron-scale, microscopic processes would play an important role in the structure formation and generation of high-energy components in the relativistic jets.

Rererences:
[1] Frank, A. etal. Jets and Outflows from Star to Cloud: Observations ConfrontTheory. InBeuther, H., Klessen, R. S., Dullemond, C. P. & Henning, T. (eds.) Protostars and Planets VI, 451 (2014).
[2] Blandford, R., Meier, D. & Readhead, A. Relativistic Jets from Active Galactic Nuclei. ARA&A 57, 467–509 (2019).
[3] Asada, K., Nakamura, M. & Pu, H.-Y. Indication of the Black Hole Powered Jet in M87 by VSOP Observations. ApJ833, 56 (2016).
[4] Hada, K. The Structure and Propagation of the Misaligned Jet M87. Galaxies 5, 2 (2017).
[5] Laing, R. A. & Bridle, A. H. Relativistic models and the jet velocity field in the radio galaxy3C 31. MNRAS 336, 328–352 (2002).
[6] Ghisellini, G., Tavecchio, F. & Chiaberge, M. Structured jets in TeV BL Lac objectsand radiogalaxies. Implications for the observed properties. A&A 432, 401–410 (2005).
[7] Alves, E. P., Grismayer, T., Fonseca, R. A. & Silva, L. O. Transverse electron-scale instability in relativistic shear flows. PhRvE 92, 021101 (2015).
Rate of protein synthesis is reduced in peripheral blood mononuclear cells (PBMCs) from Fragile X individuals
Authors: Dionne Olivier , Lortie Audrey , Gagnon Florence , Corbin François 
Published: September 2020

Abstract
Background: Fragile X syndrome (FXS) is the leading inherited cause of intellectual disability and is caused by the loss of expression of the Fragile X mental retardation protein (FMRP). In animal model of FXS, the absence of FMRP leads to an aberrant rate of neuronal protein synthesis, which in turn is believed to be at the origin of defects regarding spine morphology and synaptic plasticity. Normalisation of protein synthesis in these models has been associated with a rescue of FXS behavioral and biochemicals phenotype, thus establishing the rate of protein synthesis as one of the most promising monitoring biomarker for FXS. However, rate of protein synthesis alteration in fragile X individuals is not well characterizedMethod: We applied a robust radiolabeled assay to measure rate of protein synthesis in freshly extracted peripheral blood mononuclear cells (PBMCs) and blood platelets. We ultimately settle on PBMCs to measure and compare rate of protein synthesis in 13 males with fragile X and 14 matched controls individuals. Results: Using this method, we measured a 26.9% decrease (p = 0,0193) in the rate of protein synthesis in fragile X individuals PBMCs. Furthermore, the rate of protein synthesis measurements obtained were highly reproducible, highlighting the robustness of the method. Conclusion: Our work presents the first evidence of a diminution of the rate of protein synthesis in a human peripheral model of fragile X. Our results also support the finding of previous studies using brain PET imaging in Fragile X individuals. Since our assay only requires a simple venous puncture, it could be used in other cases of intellectual disability in order to determine if an aberrant rate of protein synthesis is a common general mechanism leading to impairment in synaptic plasticity and to intellectual disability.
Prognosis and risk factors of cardiac valve calcification in Chinese end-stage renal disease patients
Authors: Xiong Jian-qiong , Chen Xue-mei , Liang Chun-ting , Du Xiao-Gang 
Published: September 2020

Abstract
Background

Cardiac valve calcification (CVC) was an important risk factor for cardiovascular complication. But the prevalence, clinical features and risk factors for CVC in ESRD patients were not fully clear at present. In this study, we explored the possible risk factors and clinical characteristics of CVC happened in Chinese ESRD patients.
Methods

We conducted a retrospective case-control study on 433 cases of ESRD patients who received maintenance dialysis (MHD) for at least 3 months in the First Affiliated Hospital of Chongqing Medical University from October 2014 to December 2015. 93 patients were confirmed to happen cardiac valve calcification (CVC) by echocardiography, and 200 patients without CVC in the same period as control, matched with age and gender. The demographic data, clinical characteristics, and laboratory parameters of the two groups were analyzed.
Results

Of 433 cases of ESRD patients, the average annual incidence of CVC was 30.3%. The most common calcification was in aortic valve, followed by mitral valve. Dialysis age (P = 0.006, OR = 2.25), serum calcium (P = 0.046, OR = 2.04), diabetes (P = 0.037, OR = 1.81), and pulse pressure ( P < 0.001, OR = 3.22) were the risk factors of CVC, but serum albumin ( P = 0.047, OR = 0.54) was a protective factor for CVC. The ESRD patients with CVC were also more likely to suffer from arrhythmia, heart failure and coronary heart disease (CHD), and the all-cause mortality also increased significantly.
Conclusions

High prevalence of CVC happened in Chinese ESRD patients, which was a risk signal for severe atherosclerosis, more morbidity and mortality of cardiovascular events in ESRD patients. Dialysis age, serum calcium, diabetes, and pulse pressure were the independent risk factors of CVC in ESRD patients, while serum albumin was a protective factor.
Companion diagnostic for the chloroquine use in the treatment of COVID-19: systems biology report of candidate markers.
Authors: SOUCHELNYTSKYI SERHIY , Souchelnytskyi Nazariy 
Published: September 2020

Abstract
BACKGROUND

Chloroquine is used for the treatment of COVID-19 patients. However, efficacy of the chloroquine has been under discussion. Variability of clinical outputs of the drug application requires implementation of a companion diagnostic that would allow monitoring responsiveness to chloroquine. The first line of such markers would be markers already used in clinics. Analysis of reported mechanisms of COVID-19 and chloroquine may lead to such markers.
METHODS

Systemic analysis of molecular mechanisms and markers engaged by chloroquine and COVID-19 virus was performed. The networks of regulatory mechanisms were explored for an intersection and relevance to clinical markers.
RESULTS

Reported here systemic analysis describes the intersection of molecular mechanisms of chloroquine and processes engaged by COVID-19. 266 nodes provide insight into the mechanisms of chloroquine impact on the infection and represent a pool of companion diagnostic markers. As an example, an intersection with the markers of heart arrhythmia retrieved 19 nodes. Thirteen of them were reported in human plasma: levels of albumin, amyloid precursor protein, and endoglin correlate with adverse cardiac effects.
CONCLUSIONS

Reported nodes are the candidate markers for companion diagnostic of the chloroquine application to COVID-19 patients. Some of these markers are already used in the clinic and their interpretation may contribute to monitoring for adverse effects of chloroquine.
What is the Added Value of CT-angiography in Patients with Transient Ischemic Attack?
Authors: Herpertz Gerrit U. , Maier Ilko L. , Bähr Mathias , Psychiogios Marios-Nikos , Liman Jan 
Published: September 2020

Abstract
BackgroundTransient ischemic attack (TIA) is an important predictor for a pending stroke. Guidelines recommend similar workup for TIA-patients as for stroke patients to directly assess the extra- and intracranial arteries via Computed tomography angiography (CTA) regarding vascular pathologies with direct therapeutic implications. Aim of our study was a systematic analysis of CTA-findings in TIA-patients and evaluate possible predictive TIA scores for ipsilateral vascular pathology.MethodsWe analysed data from TIA patients admitted to our University Medical Centre, between September 2015 and March 2018. Following subgroups were identified: 1) no- or low-grade-stenosis (<50%) 2) ipsilateral high-risk vascular pathology and 3) high risk findings needing surgical or interventional treatment. As predictive tools for ipsilateral vascular findings we used the ABCD2-, the ABCD3- and the SPI-II score.ResultsOf 833 patients, 549 (65.9%) underwent initial CTA in the emergency department. In 126 (23.0%) patients, ipsilateral vascular findings were identified from which 40 (7.3%) needed treatment. The ABCD2-, ABCD3- and SPI-II-scores were not predictive for ipsilateral vascular pathologies. We identified male sex (OR 1.58, 1.06-2.36 95% CI; p=0.026), coronary heart disease (OR 1.88, 1.17-3.02 95% CI; p=0.009) and short duration of symptoms (OR 0.7, 0.55-0,89 95% CI; p=0.004) as predictors for ipsilateral vascular pathologies. ConclusionMore than every fifth TIA-patient had relevant vascular findings revealed by acute CTA. TIA-scores were not predictive for these findings. Male patients with a history of coronary heart disease and short duration of symptoms most likely might benefit from acute CTA to streamline further diagnostics and therapy.
Identification of Prognostic Signature Based on the Copy Number Variation (CNV) and Expression in Acute Myeloid Leukemia
Authors: Niu Changchun , Wu Di , Li Alexander J. , Qin Kevin H. , Hu Daniel A. , Wang Eric J. , Tucker Andrew Blake , He Fang , Huang Linjuan , Wang Hao , Liu Qing , Ni Na , Shi Deyao , Zhao Xia , Wan Yafang , Li Tian , He Tong-Chuan , Liao Pu 
Published: September 2020

Abstract
Purpose Acute myeloid leukemia (AML) is caused by multiple genetic alterations in the hematopoietic progenitors, and molecular genetic analysis has provided useful information for AML diagnosis and prognosis. However, an integrative understanding about the prognosis value of specific copy number variation (CNV) and CNV-modulated gene expression has been limited. Methods We conducted an integrative analysis of CNV profiling and gene expression using data from the TARGET and TCGA AML cohorts. The CNV data from TCGA were analyzed using the GISTIC. CNV survival analysis and mRNA survival analysis were conducted with the Multivariate Cox proportional hazards regression model using R software with “survminer” and “survival” packages. KEGG cancer panel genes were extracted from the cancer related pathways from Kyoto Encyclopedia of Genes and Genomes (KEGG). The R package “circlize” was used for mapping the CNV genes to chromosomes. Results From this investigation, we observed distinct CNV patterns in the AML risk groups as well as the expression of 251 genes significantly modulated by CNV in both cohorts. There were 102 CNV genes (located at 7q31-34, 16q24) associated with clinical outcomes in AML, which were identified in the TARGET cohort and validated in the TCGA cohort, three of which being miRNA genes (MIR29A, MIR183, MIR335) that overlapped with a KEGG cancer panel. Five genes were identified whose expressions were modulated by CNV and significantly associated with clinical outcomes, and among them, the deletion of SEMA4D and CBFB were found to potentially have protective effects against AML. Moreover, the distribution of CNV in these five CNV-modulated genes was independent of the risk groups, which suggests that they are independent prognosis factors. Conclusion Overall, this study identified 102 CNV genes and five CNV-modulated gene expressions that are crucial for developing new modes of prognosis evaluation and target therapy for AML.