bluuebunny/crossref_metadata_2025_split huggingface dataset:
E-Consults: an effective way to decrease clinic wait times in Rheumatology
Authors: Patel Veena , Stewart Diana , Horstman Molly 
Published: May 2020

Abstract
Background To evaluate the effect of E-consults on wait times and resource utilization for positive antinuclear antibody (ANA) referrals in outpatient rheumatology.Methods We conducted a pre-post study of E-consult implementation for positive ANA referrals. We retrospectively reviewed “positive ANA” referrals from 1/2015-3/2017. A statistical process control chart was created to display monthly average wait times for in-person clinic visits and to identify special cause variation. Final Diagnoses, wait times and resource utilization were recorded and compared between E-consults and in-person referrals.Results There were 139 referrals for positive ANA with 126 occurring after E-consult implementation in August 2015. Forty-four percent (55/126) of referrals were E-consults; 76% were resolved after initial electronic rheumatology recommendation. A control chart demonstrated special cause variation in the form of a shift from June 2016 – January 2017, suggesting a temporal association between decreased wait times and the implementation of E-consults. Eleven patients were diagnosed with ANA-associated rheumatic disease; the majority of patients (73%, 86/139) did not have a rheumatologic diagnosis. Overall E-consults utilized more labs than in-person visits, but this was not statistically significant. In-person visit utilized more imaging studies, which was statistically significant.Conclusion E-consults are an effective way to address positive ANA consults without significant resource utilization and were temporally associated with decreased wait times for in-person visits.
Insights on mental health when living with r/Rheumatoid r/Thritis: A descriptive qualitative study of Reddit threads
Authors: Park Jamie Yea Eun , Howren Alyssa M. , Davidson Eileen , De Vera Mary A 
Published: May 2020

Abstract
Background
Online forums, where individuals ask questions, discuss opinions and share experiences provide a valuable pool of publicly available data to better understand impacts of disease and associated complications. Our objective was to systematically search and analyze threads on the social news website, Reddit, to understand experiences of individuals with rheumatoid arthritis (RA) regarding their mental health.
Methods
We conducted a patient-oriented descriptive qualitative study. We identified threads from two subreddits, “r/Thritis” and “r/Rheumatoid”, using keywords such as “mood”, “mental health”, “stressed”, “depressed”, “anxious” over a 1-year period between June 2018 and June 2019. For included threads, we extracted the title, original post, and corresponding comments and responses. We applied thematic analysis using an inductive approach.
Results
Of 81 threads identified, we included 27. We identified four themes: 1) Navigating the management of RA explores how the physical impacts of the disease, lack of health resources/support and the complexity of medications affect mental health; 2) Experiencing impact on relationships and social isolation includes experiencing misconceptions of RA, feeling misunderstood and feeling guilt; 3) Experiencing loss, touches on the helplessness brought by challenges with performing self-defining activities such as self-care, work, and childbearing/parenting; and finally, 4) Experiencing emotional struggles captures how tension between fighting through and despair has led some to suicide ideation and thoughts of death.
Conclusions
Online forums and communities such as Reddit have created opportunities for individuals with RA to share experiences on mental health matters, which they may not necessarily be able to share with others.
Impact of the COVID-19 pandemic on stress and emotional reactions in Israel: A mixed-methods study
Authors: Levkovich Inbar , Shinan-Altman Shiri 
Published: May 2020

Abstract
Objectives
The COVID-19 pandemic has had a profound impact on the public worldwide. This exploratory study sought to identify the pandemic’s psychological impact on the Israeli public using a mixed-methods approach.
Methods
During the COVID-19 outbreak, Israeli adults (N = 1,407) completed a battery of measures assessing psychological variables and perceived threat related to COVID-19. Statistical analyses included tests for between-group differences and Pearson correlations. Qualitative, in-depth, semi-structured interviews (N = 38) were conducted.
Results
The findings of the quantitative study indicate that about half of the public were concerned, afraid and stressed and a fifth perceived they were liable to contract the virus. Moreover, a positive correlation emerged between these feelings and degree of perceived threat. Three major themes emerged from the qualitative study: 1) a sense of shock and chaos; 2) gradual adjustment to the new reality; 3) fears and concerns for self and family members.
Conclusions
The study provides a comprehensive picture of psychological variables and perceived threat related to COVID-19 in Israel. Social distancing is likely to make people feel safer but also to increase their feelings of isolation, stress and frustration and to cause difficulties in many life situations.The findings indicate that the public’s perceived susceptibility and emotional reactions about the COVID-19 should be addressed.
Acromegaly: a Clinical Perspective
Authors: Lawrence Lima , Alkwatli Kenda , Bena James , Prayson Richard , Kshettry Varun , Recinos Pablo , Hatipoglu Betul , Pantalone Kevin M , Weil Robert , Hamrahian Amir H , Kennedy Laurence , Yogi-Morren Divya 
Published: May 2020

Abstract
Background
To examine the clinical and hormonal profiles, comorbidities, treatment patterns, surgical pathology and clinical outcomes of patients diagnosed with acromegaly at the Cleveland Clinic over a 15-year period.
Methods
A retrospective chart review of patients with acromegaly who underwent surgical resection between 2003 and 2018.
Results
A total of 136 patients (62 men; mean age 48.1 years) with biochemical evidence of acromegaly were analyzed. Median insulin-like growth factor 1 (IGF-1) level at diagnosis was 769.0 ng/mL and most patients had a macroadenoma (82.2%). Immunoreactivity to growth hormone (GH) was noted in 124 adenomas, with co-staining in 89 adenomas. Complete visible tumor resection during initial surgery was achieved in 87 patients (64.0%). In this cohort, complete response to surgery alone was observed in 61 patients (70.1%), while 31 out of 65 patients (47.7%) who received additional post-surgical medications and/or radiation therapy achieved complete response. At most recent follow-up, 92 patients achieved eventual complete response by documented normalization of IGF-1 levels. Higher IGF-1 level at diagnosis (P = 0.024) and cavernous sinus invasion (P = 0.028) were predictors for failure to respond to surgery.
Conclusion
In this study, the majority of tumors were macroadenoma, plurihormonal, and treated effectively with surgery alone or surgery with adjuvant medical or radiation therapy. More studies are needed to identify additional molecular biomarkers, tumor characteristics and imaging findings to individualize treatment and better predict treatment outcomes.
Characterization of deltamethrin degradation and metabolic pathway by co-culture of Acinetobacter junii LH-1-1 and Klebsiella pneumoniae BPBA052
Authors: Tang Jie , Hu Qiong , Lei Dan , Wu Min , Zeng Chaoyi , Zhang Qing 
Published: May 2020

Abstract
Deltamethrin and its major metabolite 3-phenoxybenzoic acid (3‐PBA) have caused serious threat to the environment as well as human health, yet little is known about their degradation pathways by bacterial co-cultures. In this study, the growth and degradation kinetics of Acinetobacter junii LH-1-1 and Klebsiella pneumoniae BPBA052 during deltamethrin and 3-PBA degradation were established, respectively. When the inoculum proportion of the strains LH-1-1 and BPBA052 was 7.5:2.5, and LH-1-1 was inoculated 24 h before inoculation of strain BPBA052, 94.25% deltamethrin was degraded and 9.16 mg/L of 3-PBA remained within 72 h, which was 20.36% higher and 10.25 mg/L lesser than that in monoculture of LH-1-1, respectively. And the half-life of deltamethrin was shortened from 38.40 h to 24.58 h. Based on gas chromatography–mass spectrometry, 3-phenoxybenzaldehyde, 1,2-benzenedicarboxylic butyl dacyl ester, and phenol were identified as metabolites during deltamethrin degradation in co-culture. This is the first time that a co-culture degradation pathway of deltamethrin has been proposed based on these identified metabolites. Bioremediation of deltamethrin-contaminated soils with co-culture of strains LH-1-1 and BPBA052 significantly enhanced deltamethrin degradation and 3-PBA removal. This study provides a platform for further studies on deltamethrin and 3-PBA biodegradation mechanism in co-culture, and it also proposes a promising approach for efficient bioremediation of environment contaminated by pyrethroid pesticides and their associated metabolites.
Three rare variants of SOX7 impairing its interaction with GATA4 may be a predisposing factor to complete AVSD
Authors: Li Baolei , Li Zhuoyan , Yang Jianping , Hong Nanchao , Jin Lihui , Xu Yuejuan , Fu Qihua , Sun Kun , Yu Yu , Lu Yanan , Chen Sun 
Published: May 2020

Abstract
Background Atrioventricular septal defects (AVSD) are a complicated subtype of congenital heart defects for which the genetic basis is poorly understood. Many evidences have demonstrated that transcription factor SOX7 which can interact with GATA4 plays a pivotal role in the cardiovascular development. The critical role of GATA4 in the morphogenesis of atrioventricular septum implies SOX7 a potential involvement of AVSD. However, whether SOX7 variants are involved in the pathogenesis of AVSD needs to be explored. Methods 100 sporadic non-syndromic AVSD Chinese Han patients were recruited and the variants of SOX7 in 100 patients were screened by target sequencing. Functional assays were performed to testify the potential pathogenicity of nonsynonymous variants of SOX7 found in these AVSD patients. Results Through target sequencing, we identified three rare variants c.40C>G, c.542G>A, and c.743C>T of SOX7 in 100 sporadic non-syndromic AVSD Chinese Han patients. All mutant sites were highly conserved in mammals. Compared to the wildtype, these variants of SOX7 increased mRNA expression and decreased protein. In the developing murine hearts, SOX7 along with GATA4 expressed highly in the region of atrioventricular cushions. Moreover, SOX7 overexpression promoted the expression of GATA4 in human umbilical vein endothelial cells. Chromatin immunoprecipitation assay uncovered that SOX7 could directly bind to the region of GATA4 promoter. Luciferase assays demonstrated that SOX7 activated GATA4 promoter and the variants impaired the transcriptional activity of SOX7. Furthermore, the variants of SOX7 altered the regulation to the activity of GATA4 on its target genes. Conclusions Our studies provide evidence that deleterious variants in SOX7 are potential contributors to human AVSD and provide novel insights into the etiology of AVSD.
Identifying novel cell glycolysis related gene signature predictive of overall survival in bladder urothelial carcinoma
Authors: Zhao Xin , Li Jia , Li Jiafeng , Xiong Wenjun , Jiang Rui 
Published: May 2020

Abstract
Background: Bladder urothelial carcinoma (BLCA) is the most common pathological type of bladder cancer and featured by a high risk for relapse and metastasis. Although many biomarkers have been developed by data mining and experimental studies to predict the prognosis of BLCA, a single-gene biomarker usually has poor specificity and sensitivity, leading to unsatisfactory prediction. Therefore, novel gene signatures are needed to more accurately predict the prognosis of BLCA.Methods: Data mining was performed for expression profile analysis of 433 mRNA expression data from the TCGA BLCA patients (n=412). Gene Set Enrichment Analysis (GSEA) was used to interpret the glycolysis-related gene sets. Gene signature related to the prognosis of BLCA was identified by univariate and multivariate Cox regression. A risk score was computed based on three genes by linear regression model and its relation with overall survival was investigated by Kaplan-Meier analysis.Results: Three genes (CHPF, AK3, NUP188) were found to be significantly correlated to the overall survival of BLCA patients. Based on the signature composed of these three genes, 412 BLCA patients were divided into high-risk and low-risk groups. The survival time of the high-risk group was significantly shorter than that of the low-risk group, indicating a worse prognosis.Conclusion: A signature composed of three glycolysis-related genes was developed as biomarkers to predict the prognosis of BLCA and to provide a meaningful reference for the clinical treatment of BLCA.
Evaluation of risk factors of vertebral fracture in Japanese female patients with glucocorticoid-induced osteoporosis
Authors: Mori Yu , Izumiyama Takuya , Baba Kazuyoshi , Mori Naoko , Fujii Hiroshi , Ishii Tomonori , Itoi Eiji 
Published: May 2020

Abstract
Background Glucocorticoid-induced osteoporosis and vertebral fracture are common complications in patients on glucocorticoid treatment for rheumatological diseases. The present study aimed to identify the risk factors of vertebral fracture in Japanese female patients with glucocorticoid-induced osteoporosis.Methods This study included 225 Japanese women with glucocorticoid-induced osteoporosis and 72 patients with postmenopausal osteoporosis. All participants were treated with bisphosphonate or denosumab for osteoporosis with active form of vitamin D for at least 3 years. The differences of clinical parameters, including age, disease duration, body mass index (BMI), bone mineral density (BMD), and the dose and treatment duration of glucocorticoid were assessed between patients with and without vertebral fracture. Multivariate logistic regression analysis was also performed to evaluate the association of vertebral fracture with clinical parameters.Results The significant differences related to age, BMD of the hip, disease duration, glucocorticoid treatment duration between patients with and without vertebral fractures were demonstrated. The present study indicated that disease duration, BMI, and the total hip BMD were independent risk factors for vertebral fractures in patients with glucocorticoid-induced osteoporosis.Conclusions Prolonged disease duration, low BMI, and low total hip BMD could be risk factors of vertebral fracture in patients on glucocorticoid treatment for rheumatological diseases.
Risk conditions in children hospitalized with influenza in Norway, 2017-2019
Authors: Hauge Siri Helene , Bakken Inger Johanne , de Blasio Birgitte Freiesleben , Håberg Siri Eldevik 
Published: May 2020

Abstract
Background
Norwegian children are more frequently hospitalized with influenza than adults. Little is known about the characteristics of these children. Our aim was to investigate the presence of pre-existing risk conditions and to determine the duration of influenza hospitalizations in children during two influenza seasons.
Methods
The Norwegian Patient Registry holds data on all hospitalized patients in Norway. We included all patients younger than 18 years hospitalized with a diagnosis of influenza during the influenza seasons 2017-18 and 2018-19. Pre-existing risk conditions for influenza were identified by ICD-10 diagnoses in the Norwegian Patient Registry. In addition, information on asthma diagnoses were also retrieved from the Norwegian Registry for Primary Health Care. To estimate the prevalence of risk conditions in the child population, we obtained diagnoses on all Norwegian children in a two-year period prior to each influenza season. We calculated age-specific rates for hospitalization and risk for being hospitalized with influenza in children with risk conditions.
Results
In total, 1013 children were hospitalized with influenza during the two influenza seasons. Children younger than 6 months had the highest rate of hospitalization, accounting for 13.5% of all admissions (137 children). Hospitalization rates decreased with increasing age. Among children hospitalized with influenza, 25% had one or more pre-existing risk conditions for severe influenza, compared to 5% in the general population under 18 years. Having one or more risk conditions significantly increased the risk of hospitalization, (Odds Ratio (OR) 6.1, 95% confidence interval (CI) 5.0-7.4 in the 2017-18 season, and OR 6.8, 95% CI 5.4–8.4 in the 2018-19 season). Immunocompromised children and children with epilepsy had the highest risk of hospitalization with influenza, followed by children with heart disease and lung disease. The average length of stay in hospital were 4.6 days, and this did not differ with age.
Conclusion
Children with pre-existing risk conditions for influenza had a higher risk of hospitalization for influenza. However, most children (75%) admitted to hospital with influenza in Norway during 2017–2019 did not have pre-existing risk conditions. Influenza vaccination should be promoted in particular for children with risk conditions and pregnant women to protect new-borns.
Are PAMAM dendrimers safe for ocular applications? -- Toxicological evaluation in ocular cells and intraocular tissues
Authors: Qin Chen , Tang Junmei , Wen Shimin , Zhu SiQing , Liu Dong , Chen Hao , Lin Quankui 
Published: May 2020

Abstract
Backgrounds: The human eye is a sophisticated and sensitive sensory organ. Due to its dynamic and static barriers, efficient drug therapy for eye diseases is problematic. Polymeric delivery systems have been rapidly developed to overcome this problem, where polymeric dendrimers have received much attention for their unique structures. However, there is insufficient research on whether dendrimer nanomaterials could be used in ophthalmology. Poly (amidoamine) (PAMAM) is a kind of commercialized and extensively used dendrimer. Herein the ocular cytotoxicity and biosafety of PAMAM dendrimers were deeply evaluated by conducting in vitro and in vivo experiments on ocular systems. The effects of generation (G4.0, G5.0, and G6.0) and concentration on cell metabolism, apoptosis, and oxidative damage were carried out. Ocular irritation and intravitreal injection effects were also measured. Results: The results showed that the cytotoxicity of PAMAM increased with increasing generation number. PAMAM at a concentration that below 50 μg/mL was less harmful to the ocular tissues, whereas it caused apparent damage when above 50 μg/mL in the investigated situation. Moreover, singlet oxygen generation was detected in the cells after 50 μg/mL (and above) PAMAM treatment. The in vivo results show that there is no macroscopic structural change observed from fundus and histopathological section images, whereas it shows more functional impairment according to optical coherence tomography (OCT) and electroretinogram (ERG) when treated by 100 μg/mL PAMAM. Conclusion: Overall, a higher concentration of PAMAM, such as above 50 μg/mL, may cause ocular functional damage. The concentrations that are (or lower than) 50 μg/mL showed good biocompatibility and biosafety in human ocular cells and tissues.
Extraskeletal Ewing’s sarcoma: outcomes and CT features of endoceliac lesions
Authors: Chen Zeyang , Jiao Yang , Liu Zining , Yang Jiejin , Zhang Yuyang , Sun Jiali , Zhao Kang , Pan Shaorong , Wang Pengyuan 
Published: May 2020

Abstract
Background To analyse the clinicopathological features and outcomes of patients with extraskeletal Ewing’s sarcoma (EES). The basic imaging characteristics of endoceliac lesions, which are always misdiagnosed preoperatively, are also summarised.Methods This study involved EES patients admitted to our centre between January 2000 and January 2020. Clinical data from patients with EES (n = 25) and computed tomography (CT) data from patients with endoceliac lesions (n = 8) were retrospectively reviewed.Results The sample comprised 18 males and 7 females with a median age of 30 years (range 1–72 years). Seven patients had EES originating from surface sites and 18 had EES originating from endoceliac sites. The median tumour size was 8.0 cm (range 2.5–17.0 cm). In total, 20% of patients had distant metastasis at diagnosis. In the univariate analyses, tumour size > 8 cm, undergoing surgery, and regional lymph nodes metastasis were risk factors for poor prognosis of EES. In the multivariate analysis, patients undergoing surgery and regional lymph node metastasis were independent predictors of overall survival (OS). Endoceliac EES cases frequently exhibited lobulated contour (87.5%), absence of calcification (75%), severe necrosis or cystic degeneration (75%), heterogeneous enhancement (100%), moderate enhancement (75%), ill-defined borderline (62.5%), and organ invasion (75%). Half of the patients with endoceliac EES had CT features of lymphadenopathy.Conclusions Comprehensive understanding of the clinicopathological and imaging features of EES is beneficial for diagnosis, development of therapeutic strategies, and accurate prediction of prognosis for this rare malignant tumour. The results suggest that evaluation of the status of regional lymph nodes is important for the treatment of EES.
Establishment and characterization of a new gastric cancer cell line, XGC-1
Authors: Peng Jigui , Xu Hao , Cai Jianchun 
Published: May 2020

Abstract
Background
To establish a primary human gastric cancer cell line.
Methods
Fresh gastric cancer tissue samples were separated into a cell suspension, and DMEM/F12 medium containing 10% foetal bovine serum was used for primary culture and subculture. The morphology of the cells was observed under a light microscope, and the cell growth curve was plotted. A soft agar colony formation assay was used to detect the colony formation ability of the cell line. Immunohistochemical methods were used to detect cytokeratin, vimentin and Ki-67, the chromosome G banding method was used to analyse the karyotype of the cells, and the tumourigenic ability of the cells was detected by subcutaneous inoculation of BALB/C nude mice.
Results
We established a gastric cancer cell line from a 68-year-old male patient. This gastric cancer cell line was named XGC-1 and had a doubling time of approximately 48 h. The cell line displayed strong colony formation ability and tumourigenicity in BALB/C nude mice and had complicated chromosomal abnormalities. When nutrients were insufficient, the cells shed and floated in the medium, but adherent growth was observed in nutrient-rich conditions.
Conclusions
The XGC-1 cell line will be useful for future studies of gastric cancer development, progression, metastasis and therapy.