bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low serum albumin, aspartate aminotransferase, and body mass are risk factors for frailty in elderly people with diabetes: possible mechanistic role of dehydroepiandrosterone sulfate – a cross-sectional study
Authors: Yanase Toshihiko , Yanagita Ikumi , Fujihara Yuya , Iwaya Chikayo , Kitajima Yuichi , Tajima Misuzu , Honda Masanao , Teruya Yuji , Asakawa Hideko , Ito Tomoko , Eda Terumi , Yamaguchi Noriko , Kayashima Yumi , Yoshimoto Mihoko , Harada Mayumi , Yoshimoto Shoji , Aida Eiji , Nawata Hajime , Muta Kazuo 
Published: February 2020

Abstract
Background: Relatively low dehydroepiandrosterone sulfate (DHEA-S) and high cortisol/DHEA ratio have been suggested to be associated with frailty, evaluated using a physical scale. However, the significance of these two hormones for frailty in elderly patients with type 2 diabetes mellitus (T2DM) has not been assessed using a wider range of measures of frailty, including physical, mental, and social indices. Methods: We performed a cross-sectional study to investigate the significance of these two hormones for frailty in elderly T2DM patients (n=148; ≥65 years), using a broad assessment, the clinical frailty scale, and to reevaluate the risk factors for frailty in elderly T2DM patients. We compared parameters between the non-frail and frail groups using the unpaired t and Mann-Whitney U tests. The Jonckheere-Therpstra test was used to identify relationships with the severity of frailty and risk factors were identified using binary regression analysis. Results: Simple regression analysis identified a number of significant risk factors for frailty, including DHEAS <70 µg/dL and cortisol/DHEA-S ratio ≥0.2. Multiple regression analysis showed that low albumin (<4.0 g/dl) (odds ratio [OR]=5.79, p <0.001), low aspartate aminotransferase (AST) activity (<25 IU/L) (OR=4.34, p =0.009), and low body mass (BM) (<53 kg) (OR=3.85, p =0.012) were independent risk factors for frailty. A significant decrease in DHEA-S and a significant increase in the cortisol/DHEA-S ratio occurred alongside increases in the severity of frailty. DHEA-S concentration positively correlated with both serum albumin and BM. Conclusions: Hypoalbuminemia, low AST, and low BM are independent risk factors for frailty in elderly T2DM patients, strongly implying relative malnutrition in these frail patients. DHEA-S may be important for the maintenance of liver function and BM. A decrease in DHEA-S and an increase in the cortisol/DHEAS ratio may be involved in the mechanism of the effect of malnutrition in elderly T2DM patients.
Genome-Wide Identification and Functional Analysis of Chitinase Gene Family in Grape
Authors: Zheng Ting , Zhang Kekun , Zhu Xudong , Jiu Songtao , Dong Tianyu , Liu Zhongjie , Guan Le , Jia Haifeng , Fang Jinggui 
Published: February 2020

Abstract
Background: Chitinases, the important resistance-related proteins, are crucial hydrolytic enzymes, which attack fungal pathogens by catalyzing the fungal cell wall degradation. As a large gene family, the VvChis have not been systematically analyzed and effectively investigated in grape. Results: In this study, we identified 42 VvChis in grape by searching the conserved domains, and divided them into A, B, C, D and E groups according to pylogenetic relationships, gene structure and conserved domains analysis. Quantitative real-time PCR (qRT-PCR) and publicly microarray data analysis revealed distinct temporal and spatial expression patterns of VvChis in different tissues at various growth stages. The transcriptional level of most genes was high in the root of ‘Koyho’ and ‘Summer Black’. Combining cis-elements in the promoter, GO and KEGG analysis, and prediction of interaction proteins, we revealed the function of Chitinase. After the pathogen infecting the leaves and berries of grape, the expression levels of VvChis in A, B and E groups showed a significant upward trend, of which VvChi5, VvChi25, VvChi11 (leaf) and VvChi16 (fruit) were the most up-regulated. The interaction between Chi-17 and Metallothionein (MTL) was confirmed by yeast two-hybrid system and bimolecular fluorescence complementation (BiFC). In addition, VvChis in GH18 family were up-regulated under MeJA and ETH treatment, in particular to 500 mg·L -1 ETH、50 μmol·L -1 MeJA; The induction of VvChis by low temperature was more significant than that of high temperature; The expression of VvChis was positively correlated with the concentration of NaCl treatment. Conclusion: This study clarified the member composition and expression pattern of VvChi family in grape, initially explored the disease resistance function of VvChi, and analyzed the response of VvChis to hormones (MeJA and ETH) and environmental stress (temperature and NaCl) signals was analyzed, which laid a foundation for constructing the functional regulation network of VvChi in grapes.
The effect of tree (and cambium) age on genomic prediction for solid wood properties in Norway spruce
Authors: Zhou Linghua , Chen Zhiqiang , Olsson Lars , Grahn Thomas , Karlsson Bo , Wu Harry , Lundqvist Sven-olof , Gil Maria Rosario Garcia 
Published: February 2020

Abstract
Genomic selection (GS) or genomic prediction is considered as a promising approach to accelerate tree breeding and increase genetic gain by shortening breeding cycle. We investigated the predictive ability (PA) of GS based on 484 progeny trees from 62 half-sib families in Norway spruce ( Picea abies (L.) Karst.) for wood density, modulus of elasticity (MOE) and microfibril angle (MFA) measured with SilviScan, as well as for measurements on standing trees by Pilodyn and Hitman instruments. GS predictive abilities (PA) were comparable with those based on pedigree-based selection. The highest PAs were reached with at least 80-90% of the dataset used as training set. Use of different statistical methods had no significant impact on the estimated PAs. We also compared the abilities to predict density, MFA and MOE of 19 year old trees with use of models trained on data from coring at different ages and to different depths into the stem. The comparison indicated that close to the maximal PAs can be reached at age 10-12 by drilling only half way (ringwise) towards the pith, thereby reducing the impact on the tree.
Utilization of sexual and reproductive health services and associated factors among adolescents in youth-friendly service implemented and non-implemented high school of South Ari District, South Omo Zone, Southern Ethiopia, 2019.
Authors: Haile Bayu , Shegaze Mulugeta , Feleke Tesfaye , Glagn Mustefa 
Published: February 2020

Abstract
Background In Ethiopia a number of efforts have been made to support sexual and reproductive health services (SRHS) for adolescents. However, there is limited information regarding the level of SRH utilization and associated factors among adolescents. Therefore, this study aimed to assess the magnitude of utilization of sexual and reproductive health services and associated factors among secondary school adolescents in youth friendly services (YFS) implemented and non-implemented areas of South Ari Woreda, South Omo zone, Southern Ethiopia, 2019. Methods Institution based comparative cross-sectional study with multistage stage sampling procedure was employed. Data were collected by self- administered questionnaire. The collected data were entered in to Epi Data version 4.4.1 software and then exported to SPSS version 20 statistical packages for further analysis. Descriptive statistics were computed and summarized by tables, frequencies, graphs, mean, and proportion. Both Bivariate and multivariable analysis were carried by using binary logistic regression. Variables with a p-value ≤ 0.25 in Bivariate logistic regressions were taken as potential candidate for multivariable logistic regression analysis to control confounders. Association between reproductive health services utilization and associated factors were reported by odds ratio at 95% CI. Variables having p-value less than 0.05 in multivariable logistic regression model were considered as statistically significant. Results The magnitude of SRHS in YFS implemented and non-implemented schools were 33.8% [95% CI (28.2-40.4)] and 9.4% [95% CI (5.6, 13.6)] respectively. Grade ten level adolescents and those who discuss SRH issues with their family members were three times [AOR=3.28, 95% CI (1.7, 6.29)] and [AOR=3.3, 95% CI (1.47, 7.41)] more likely to have sexual and reproductive health care-seeking behavior as compared to grade nine level adolescents and those who didn’t discuss respectively. Furthermore, adolescents who travel less than 30 minutes were six times [AOR=5.72, 95%CI, 2.58, 12.64] more likely to uptake the SRHS as compared to those travel more an hour. Conclusion The magnitude of utilization of SRH services were low in YFS non implemented school when compared to YFS implemented school. There is a need of more efforts to scale up SRHS in YFS non implemented schools among stakeholders at different hierarchies. In addition, it is better to promote open discussion with adolescents at family level, and emphasizes should be given for women education.
Testing Contextualized Word Embeddings to Improve NER in Spanish Clinical Case Narratives
Authors: Akhtyamova Liliya , Martínez Paloma , Verspoor Karin , Cardiff John 
Published: February 2020

Abstract
Background: In the Big Data era there is an increasing need to fully exploit and analyse the huge quantity of information available about health. Natural Language Processing (NLP) technologies can contribute to extract relevant information from unstructured data contained in Electronic Health Records (EHR) such as clinical notes, patient’s discharge summaries and radiology reports among others. Extracted information could help in health-related decision making processes. Named entity recognition (NER) devoted to detect important concepts in texts (diseases, symptoms, drugs, etc.) is a crucial task in information extraction processes especially in languages other than English. In this work, we develop a deep learning-based NLP pipeline for biomedical entity extraction in Spanish clinical narrative. Methods: We explore the use of contextualized word embeddings to enhance named entity recognition in Spanish language clinical text, particularly of pharmacological substances, compounds, and proteins. Various combinations of word and sense embeddings were tested on the evaluation corpus of the PharmacoNER 2019 task, the Spanish Clinical Case Corpus (SPACCC). This data set consists of clinical case sections derived from open access Spanish-language medical publications. Results: NER system integrates in-domain pre-trained Flair and FastText word embeddings, byte-pairwise encoded and the bi-LSTM-based character word embeddings. The system yielded the best performance measure with F-score of 90.84%. Error analysis showed that the main source of errors for the best model is the newly detected false positive entities with the half of that amount of errors belonged to longer than the actual ones detected entities. Conclusions: Our study shows that our deep-learning-based system with domain-specific contextualized embeddings coupled with stacking of complementary embeddings yields superior performance over the system with integrated standard and general-domain word embeddings. With this system, we achieve performance competitive with the state-of-the-art.
Impacts on Energy and Environmental Efficiency by Media Report – Modifies Undesirable Dynamic DEA
Authors: Li Ying , Lin Tai-Yu , Chiu Yung-ho , Chen Huaming , Cen Hongyi 
Published: February 2020

Abstract
Background: Rapid economic growth in China has resulted in a commensurate increase in energy consumption, which in turn has caused an increase in environmental pollution problems. Past research has mainly focused on energy and environmental efficiency analyses with little consideration of the influence of media influence on environmental protection. Further, most studies have used static models and have ignored the dynamic changes over time. Methods : To go some way to filling this research gap, this study developed a modified undesirable Dynamic DEA model that included air quality index (AQI) and CO2 indicators to explore the relationship between energy, the environment and media efficiency in 31 Chinese cities from 2013 to 2016. Results: It was found that: 1. Chongqing, Guangzhou, Nanjing and Shanghai had efficiencies of 1, but Lanzhou, Shijiazhuang, Taiyuan, Xining and Yinchuan needed significant improvements; 2. while Chongqing, Guangzhou, Kunming, Nanning and Shanghai had relatively high media efficiency, the other cities had low efficiency and required improvements; 3. the CO 2 emissions efficiency in most cities was better than the air quality index efficiency; and 4. media reports in most cities were found to have a more positive impact on CO 2 emissions efficiency than AQI efficiency. Conclusions: As environmental awareness enhances the health of civilians and promotes economic growth, the news media needs to promote environmental protection, and should increase its environmental pollution coverage. The quality of media reports on environmental pollution and especially on air pollution need to be improved. Therefore, environmental pollution and awareness media coverage needs to be increased.
Short-Term Outcomes of Mirogabalin in Patients with Peripheral Neuropathic Pain: A Retrospective Study
Authors: Tetsunaga Tomoko , Tetsunaga Tomonori , Nishida Keiichiro , Misawa Haruo , Takigawa Tomoyuki , Yamane Kentaro , Tsuji Hironori , Takei Yoshitaka , Ozaki Toshifumi 
Published: February 2020

Abstract
Background: Mirogabalin, which is approved for the treatment of peripheral neuropathic pain in Japan, is a ligand for the α2δ subunit of voltage-gated calcium channels. Both pregabalin and mirogabalin act as nonselective ligands at the α2δ-1 and α2δ-2 subunits. Mirogabalin has a unique binding profile and long duration of action. Pregabalin has been reported to produce intolerable adverse effects in some patients. This study investigated outcomes associated with mirogabalin in patients with peripheral neuropathic pain who withdrew from treatment with pregabalin. Methods: We retrospectively assessed peripheral neuropathic pain in 187 patients (58 men, 129 women) who were treated with mirogabalin. All patients had been treated with pregabalin and withdrew from therapy due to lack of efficacy or adverse events. The mean age of patients was 72.3 years (range, 30–94 years), and mean duration of disease was 37 months (range, 3–252 months). Results: After treatment with mirogabalin for 1 week, numeric rating scale (NRS) scores decreased significantly compared with baseline, and continued to decrease over time . After 8 weeks, NRS scores improved by ³30% from baseline in 113 patients (69.3%). Twenty-four patients (12.8%) stopped mirogabalin treatment due to adverse events. Somnolence (26.7%), dizziness (12.3%), edema (5.9%), and weight gain (0.5%) were noted as adverse events of mirogabalin. Conclusions: The results of this investigation indicate that mirogabalin is safe and effective for reducing peripheral neuropathic pain.
Long-term efficacy and safety of bone cement-augmented pedicle screw fixation for stage III Kümmell diseaseLong-term efficacy and safety of bone cement-augmented pedicle screw fixation for stage III Kümmell disease
Authors: Mo Guo-ye , Zhou Teng-peng , Li Yong-xian , Guo Hui-zhi , Guo Dan-qing , Luo Pei-jie , Li Dong-xiao , Yuan Kai , Mo Ling , Zhang ShunCong , Tang Yong-chao 
Published: February 2020

Abstract
Purpose This study aimed to evaluate the efficacy and safety of bone cement-augmented pedicle screw fixation for stage III Kümmell disease. Methods Twenty-five patients with stage III Kümmell disease who received bone cement-augmented pedicle screw fixation at the First Affiliated Hospital of Guangzhou University of Chinese Medicine between June 2009 and December 2015 were enrolled. All patients were females with a history of osteoporosis. The vertebral Cobb angle (V-Cobb angle), the fixed segment Cobb Angle (S-Cobb angle), pelvic parameters, visual Analogue Scale (VAS) score, and Oswestry Disability Index (ODI) were assessed preoperatively, postoperatively and at the final follow-up. Complications, loosening rate, operation time, and intraoperative bleeding were recorded. Results The average lumbar vertebral density T-value was -3.68 ± 0.71 SD, and the average age was 71.84 ± 5.39. The V-Cobb angle, S-Cobb angle, and Sagittal Vertical Axis（SVA） were significantly smaller postoperatively compared to the preoperative values. The VAS and ODI at 1 month after surgery were 3.60 ± 1.00 and 36.04 ± 6.12%, respectively, which were both significantly lower than before surgery (VAS: 8.56±1.04, ODI: 77.80 ± 6.57%). Conclusion Bone cement-augmented pedicle screw fixation is a safe and effective treatment for stage III Kümmell disease. It can effectively correct kyphosis, restore and maintain sagittal balance, and maintain spinal stability.
Factors associated with overall survival in patients with non-squamous NSCLC in New Zealand: A comparative analysis by EGFR gene mutation status
Authors: Aye Phyu Sin , McKeage Mark James , Tin Sandar Tin , Khwaounjoo Prashannata , Elwood J Mark 
Published: February 2020

Abstract
Introduction: Non-small cell lung cancer (NSCLC) is increasingly regarded as a heterogeneous group of diseases defined by specific gene mutations. Previous studies reported inconsistent results regarding the influence of epidermal growth factor receptor (EGFR) mutations on overall survival. This study assesses the effect of EGFR mutation on overall survival, and how the effects of other survival predictors are modified by EGFR mutation status, in non-squamous NSCLC patients.Methods: The study was based on a population-based cohort of 1534 non-squamous NSCLC patients who were registered in northern New Zealand between 1 February 2010 and 31 July 2017. Kaplan-Meier analyses and log-rank tests were performed to assess the overall survival among different patient groups. Cox regression survival analyses were used to explore the associations between clinico-pathological factors and overall survival in terms of EGFR mutation status. The factors included were age at diagnosis, sex, ethnicity, smoking status, performance status, metastasis status and site of tumour. Results: In this cohort, 20.2% had an EGFR mutation. The median overall survival was 0.79 years and 2.81 years in EGFR mutation-negative and mutation-positive groups respectively (log-rank p<0.0001). Metastasis status showed large and significant effects on overall survival in both EGFR mutation-negative and mutation-positive groups (hazard ratio, HR=3.6 and 3.3, respectively). In subgroup analyses by mutation status and metastasis status, overall survival decreased with an increase in age and decrease in performance status, and was lower in current smokers in all subgroups. In specific groups, females had lower survival only if mutation-positive; Māori had lower survival compared to NZ Europeans only if the disease was metastatic; and tumour site had significant effects on overall survival only in patients without metastasis. Conclusion: EGFR mutation status and metastasis are the main predictors for overall survival in non-squamous NSCLC patients in northern New Zealand. The effects of age, smoking status and performance status are similar in all subgroups, but the effects of sex, ethnicity and site of tumour vary depending on EGFR mutation and metastasis status.
How Residents MET their training: Resident’s perception of Medical Emergency Team and its contribution to their Training
Authors: Ng Kangqi , Jones Daryl , Tee Augustine 
Published: February 2020

Abstract
Background Medical Emergency Teams (MET) have been implemented in many hospitals to improve patient safety. Few studies examined how residents perceive the MET as part of training. Objective We aimed to evaluate residents’ perceptions of how MET rotation affected training in the core competencies specified by Accreditation Council for Graduate Medical Education (ACGME). Methods We conducted an online survey of 106 residents. They are either junior residents who are in training in internal medicine, non-trainee registrars or senior residents who are training in respiratory or advanced internal medicine. Results We achieved a response rate of 62.3%. More than 90% of residents agreed or strongly agreed that MET contributed positively to their training, made resuscitation of patients safer and more efficient, and disagreed or strongly disagreed that MET made resuscitation of patients more time-consuming or cumbersome. More than 80% agreed or strongly agreed that the MET improved their clinical judgement in medical emergencies, helped achieve their learning goals and exposed them to a wide variety of cases. At least two-thirds thought that the MET posting improved their procedural skills and communication in end of life care discussions. In contrast, 26.6% of respondents agreed or strongly agreed that the MET decreased autonomy of the primary team. One-third felt they needed formal training for the MET posting. Conclusion Our findings suggest that residents perceive participation in MET was beneficial in training and improved patient care. We also found that formal training and consultant oversight may be needed for junior team leaders of MET.
Using procalcitonin (PCT) to guide antibiotics escalation in suspicious infected patients: a new application of PCT in ICU
Authors: Wang Xu , He Huaiwu , Long Yun , Shan Guangliang , Li Dongkai , Zhou Xiang , Su Longxiang , Zhang Qing 
Published: February 2020

Abstract
Background

Empirical antibiotic therapy before pathogen recognition is a tricky problem for suspicious infected patients in ICU. Procalcitonin (PCT) is efficient in degrading antibiotics level without increasing complications for its sensitivity and specificity in bacterial infection. Considering this, we hypothesized that PCT might be significant in indicating timely antibiotics escalation and improve patients’ outcomes.

Methods

This was a single-center retrospective study including patients with suspected infection who were admitted to Peking Union Medical College Hospital from January 2014 to June 2018. Patients were labelled as “antibiotic escalation” or “non-escalation” according to their antimicrobial use 48 h before and after the "PCT alert". “PCT alert” was defined as PCT ≥1.0 ng/mL that had not decreased by at least 10% from the previous day or from baseline, or a single measurement ≥ 1.0 ng/ml. Indicators that possibly influenced the prognosis were collected. 28-day intensive care unit (ICU)-free days were calculated; ICU stays >20 days and ≤20 days were considered nonprolonged ICU stays (nPISs) and prolonged ICU stays (PISs), respectively. Difference analysis and binary logistic regression were performed to determine the factors that influenced the 28-day ICU-free days .

Results

A total of 1109 patients were included, 654 in the PIS group, other 455 in nPIS group. The PIS group had higher rates of pathogen identification (33.94% vs 28.13%, P=0.047) and escalated antibiotic therapy (35.47% vs 20.66%, P<0.001) but a lower proportion of surgical patients (39.45% vs 54.95%, P<0.001) than the nPIS group. Regarding PCT, the values on the 1st day (20.36±43.89 vs 14.89±30.37 ug/L, P=0.014) and on the “alert day” (24.24±46.38 vs 18.75±32.69 ug/L; P=0.021) were higher in the PIS group than nPIS group, but no significant difference in the white blood cell (WBC) count was revealed.
According to the binary logistic regression model, antibiotic escalation (OR=0.552, 95% CI 0.347-0.877, P=0.012) was a negative factor for PIS, while postsurgical status (OR=1.959, 95% CI 1.269-3.023, P=0.002) and age (OR=1.020, 95% CI 1.007-1.034, P=0.003) were positive factors.

Conclusions

PCT is significant in evaluating the effect of empirical antibiotic therapy. Escalating microbial ranks when “alert PCT” appeared can increase 28-day ICU-free days.