bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multidisciplinary management of a large pheochromocytoma presenting with cardiogenic shock: a case report
Authors: Maestroni Umberto , Ziglioli Francesco , Baciarello Marco , Bellini Valentina , Dalla Valle Raffaele , Cataldo Simona , Maspero Giada , Bignami Elena 
Published: November 2019

Abstract
Background
Pheochromocytoma is well-known for sudden initial presentations, particularly in younger patients. Hemodynamic instability may cause serious complications and delay a patient’s ability to undergo surgical resection. Larger tumors present a further challenge because of the risk of catecholamine release during manipulations. In the case we present, increases in systemic vascular resistance caused cardiogenic shock, and the size of the lesion prompted surgeons to veer off from their usual approach.

Case presentation
A 38-year-old female patient was admitted to our intensive care unit with hypertension and later cardiogenic shock. Profound systolic dysfunction (left ventricular ejection fraction of 0.12) was noted together with severely increased systemic vascular resistance, and gradually responded to vasodilator infusion. A left-sided 11-cm adrenal mass was found with computed tomography and confirmed a pheochromocytoma with a meta-iodo-benzyl-guanidine scintigraphy. Surgical treatment was carefully planned by the endocrinologist, anesthesiologist and surgeon, and was ultimately successful. After prolonged hemodynamic stabilization, open adrenalectomy and nephrectomy were deemed safer because of lesion size and the apparent invasion of the kidney. Surgery was successful and the patient was discharged home 5 days after surgery. She is free from disease at almost 2 years from the initial event.

Conclusions
Large, invasive pheochromocytoma can be safely and effectively managed with open resection in experienced hands, provided all efforts are made to achieve hemodynamic stabilization and to minimize. Catecholamine release before and during surgery.
Identification and characterization of the GmRD26 soybean promoter in response to abiotic stresses: potential tool for biotechnological application
Authors: Freitas Elinea O. , Melo Bruno P. , Lourenço-Tessutti Isabela T. , Arraes Fabrício B. M. , Amorim Regina M. , Lisei-de-Sá Maria E. , Costa Julia A. , Leite Ana G. B. , Faheem Muhammad , Ferreira Márcio A. , Morgante Carolina V. , Fontes Elizabeth P. B. , Grossi-de-Sa Maria F. 
Published: November 2019

AbstractBackgroundDrought is one of the most harmful abiotic stresses for plants, leading to reduced productivity of several economically important crops and, consequently, considerable losses in the agricultural sector. When plants are exposed to stressful conditions, such as drought and high salinity, they modulate the expression of genes that lead to developmental, biochemical, and physiological changes, which help to overcome the deleterious effects of adverse circumstances. Thus, the search for new specific gene promoter sequences has proved to be a powerful biotechnological strategy to control the expression of key genes involved in water deprivation or multiple stress responses.ResultsThis study aimed to identify and characterize theGmRD26promoter (pGmRD26), which is involved in the regulation of plant responses to drought stress. The expression profile of theGmRD26gene was investigated by qRT-PCR under normal and stress conditions in Williams 82, BR16 and Embrapa48 soybean-cultivars. Our data confirm thatGmRD26is induced under water deficit with different induction folds between analyzed cultivars, which display different genetic background and physiological behaviour under drought. The characterization of theGmRD26promoter was performed under simulated stress conditions with abscisic acid (ABA), polyethylene glycol (PEG) and drought (air dry) onA. thalianaplants containing the complete construct of pGmRD26::GUS(2.054 bp) and two promoter modules, pGmRD26A::GUS(909 pb) and pGmRD26B::GUS(435 bp), controlling the expression of the β-glucuronidase (uidA) gene. Analysis of GUS activity has demonstrated that pGmRD26and pGmRD26Ainduce strong reporter gene expression, as the pAtRD29positive control promoter under ABA and PEG treatment.ConclusionsThe full-length promoter pGmRD26and the pGmRD26Amodule provides an improveduidAtranscription capacity when compared with the other promoter module, especially in response to polyethylene glycol and drought treatments. These data indicate that pGmRD26Amay become a promising biotechnological asset with potential use in the development of modified drought-tolerant plants or other plants designed for stress responses.
Inhibitory effects of ChondroT and its constituent herbs on RANKL-induced osteoclastogenesis
Authors: Guo Rui Hong , Kim Seon-Jong , Choi Chan-hun , Na Chang-su , Kang Bok Yun , Kim Young Ran 
Published: November 2019

Abstract
Background
ChondroT is a complex herbal medicine consisting of water extracts of Ostericum koreanum (Maxim.) Kitag., Lonicera japonica Thunb., Angelica gigas Nakai, Clematis manshurica Rupr., and Phellodendron amurense Rupr. (6:4:4:4:3). Previous studies have reported that ChondroT possesses chondroprotective and anti-inflammatory, anti-osteoarthritic, and anti-hyperuricemic activities. The study is aim to demonstrate the effects of ChondroT and its five constituent herbs on receptor activator of NF-κB ligand (RANKL)-induced osteoclastogenesis and the underlying mechanisms.

Methods
Osteoclastogenesis was identified in bone marrow-derived macrophages (BMDMs) by tartrate-resistant acid phosphatase (TRAP) staining assay, actin ring formation assay and the bone resorption assay. For the molecular mechanisms, activation of RANKL-induced NF-κB and MAPK signaling pathways and the expression levels of osteoclast-specific proteins were investigated by Western blotting. Cell viability was assessed by MTT assay. Actin ring formation and NF-κB translocation were evaluated by immunostaining.

Results
ChondroT and each of its constituent herbs significantly suppressed osteoclast differentiation dose dependently, and decreased actin ring formation as well as bone-resorbing capacity. Mechanistically, ChondroT and its constituent herbs downregulated the expressional levels of osteoclast-specific proteins such as NFATc1, c-Fos, Cathepsin K, and matrix metalloproteinase 9 (MMP9) by suppressing NF-κB translocation to nucleus and MAPKs phosphorylation at different levels. Compared to its five constituent herbs, ChondroT exhibited the best inhibitory efficiency against osteoclastogenesis.

Conclusions
Taken together, ChondroT has anti-osteoclastogenesis properties by inhibiting NF-κB and MAPKs pathways. It could be considered as a potential therapeutic candidate for the treatment of osteoclast-related bone diseases.
The association between health professionals’ international experience and the academic output of their students in Harbin, China
Authors: Liu Tingjiao , Zhang Liming , Zhao Tingting , Chen Nan 
Published: November 2019

Abstract
Background
It is common practice for health professionals in China to have international experience. However, the association between such experience and these professionals’ students’ scientific research ability has not previously been evaluated. Our study aimed to quantify this association among the students of health professionals in China.

Methods
We constructed a self-administered questionnaire and distributed it to all students at Harbin Medical University and its affiliated hospitals, including 257 students (Group A) of health professionals who had studied overseas (“returning” professionals) and 257 age-, enrollment year-, and specialty-matched students (Group B) of health professionals who had not studied overseas (“resident” professionals). SPSS software was used for the data entry and analysis.

Results
The total impact factor (IF) for articles published during their PhD study was 1031.68 in Group A and 727.65 in Group B (P = 0.001), and the number of articles was 297 in Group A and 228 in Group B (P = 0.040). The total IF for articles published by the 151 clinical medicine students of returning professionals during their PhD study was positively correlated with their advisor’s total IF for articles published while abroad (P = 0.019).

Conclusions
This study indicates that medical students may benefit from their advisors’ international experience. Medical education administrators and the government could encourage clinical professionals to study overseas and to prolong the duration of their study abroad. Medical students should consider potential advisors’ overseas experience when choosing a mentor.
Primary health institutions preference by hypertensive patients: effect of distance, trust and quality of management in the rural Heilongjiang province of China
Authors: Liu Jingjing , Yin Hui , Zheng Tong , Ilia Bykov , Wang Xing , Chen Ruohui , Hao Yanhua , Sun Hong , Jiao Mingli , Kang Zheng , Gao Lijun , Wu Qunhong 
Published: November 2019

Abstract
Background
Traditional “inverted triangle” healthcare resources allocation model in China has wasted a lot of health resources. The Chinese health reform began to strengthens the role of the primary health institutions in delivering primary health care especially in rural areas in the background of large development gap between urban-rural health and rapid growth in the incidence of chronic diseases in rural. We take hypertensive patients as an example, to verify the effect of policy implementation through distribution characteristics of rural primary health institutions preference of hypertensive patients and explore the influencing factor that promoting rationalized use of medical care for patients with chronic disease as well as rational allocation of health resources in rural areas.

Methods
A cross-sectional survey was conducted in Heilongjiang, a province in northeastern China by using a self-designed questionnaire. Stratified cluster sampling was used to choose 484 hypertensive patients from two villages in Heilongjiang province in 2010.

Results
About 88.4% of respondents reported preferred primary health institutions (83.5% preferred village clinics and 4.9% preferred township hospitals), 49.4% of respondents knew hypertension management administered by primary health institutions, 53.5% received hypertension education from primary care physicians, more than half of respondents reported that they didn’t receive telephone interviews and family visits from primary care physicians over the past 6 months. Residence closer to the primary health institutions (OR = 10.360), trust in village doctors (OR = 7.323), elders (OR = 3.001), and asked for return visits by primary health physicians (OR = 2.073) promote preferences for primary health institutions.
Conclusions: Accessibility to primary healthcare and doctor-patient trust stimulate patients to choose the primary health institutions. Primary health institutions should improve general approach to hypertension management and enhance the ability of providing basic public health services.
Access to public health services and integral care for women during the puerperal gravid period period in Ceará, Brazil
Authors: de Fátima Vasques Monteiro Maria , Barbosa Caio Parente , Vertamatti Maria Auxiliadora Figueredo , Tavares Maria Nizete Alves , de Oliveira Carvalho Amanda Cordeiro , Alencar Ana Paula Agostinho 
Published: November 2019

Abstract
Background
Over time, the Brazilian health system, a growing country, has been developing to ensure good accessibility to health goods and services. This development is focusing on the principle of universality of access and completeness of health care. In this context, we aimed to evaluate the completeness of care and universality of access for women in their pregnancy and puerperal period in Ceará, Brazil.

Methods
A descriptive, cross-sectional study based on a quantitative approach, using information collected from the database of the regulation system of the state of Ceará and data from the Prenatal Monitoring System. The research population comprised of 1701 women who delivered a baby in an obstetric reference unit in the Health Macro-Region of Cariri, Ceará, Brazil from January to December 2015.

Results
There was a high rate of cesarean delivery (49.7%) and a high waiting time for access to high-risk delivery (32.6%) and neonatal intensive care unit (72.9%). There was also a low percentage (41.1%) of pregnant women undergoing an adequate number of prenatal consultations, dental care (20%), educational activities (15%), visits to the maternity ward (0.1%), laboratory tests of the third trimester (29.2%) and puerperal consultation (37.9%).

Conclusions
It was concluded that the Maternal and Child Health Policy, especially the Rede Cegonha, which is still under development, does not ensure access and completeness of care for women during the prenatal, delivery, and puerperal periods, thus violating their reproductive rights. The results of this study allow a critical analysis by the academia and health managers in search of strategies to improve the services of Rede Cegonha in Brazil.
Comparative iTRAQ proteomics revealed proteins associated with lobed fin regeneration in Bichirs
Authors: Lu Suxiang , Xiong Qian , Du Kang , Gan Xiaoni , Wang Xuzhen , Yang Liandong , Wang Ying , Ge Feng , He Shunping 
Published: November 2019

Abstract
Background
Polypterus senegalus can fully regenerate its pectoral lobed fins, including a complex endoskeleton, with remarkable precision. However, despite the enormous potential of this species for use in medical research, its regeneration mechanisms remain largely unknown.

Methods
To identify the differentially expressed proteins (DEPs) during the early stages of lobed fin regeneration in P. senegalus, we performed a differential proteomic analysis using isobaric tag for relative and absolute quantitation (iTRAQ) approach based quantitative proteome from the pectoral lobed fins at 3 time points. Furthermore, we validated the changes in protein expression with multiple-reaction monitoring (MRM) analysis.

Results
The experiment yielded a total of 3177 proteins and 15,091 unique peptides including 1006 non-redundant (nr) DEPs. Of these, 592 were upregulated while 349 were downregulated after lobed fin amputation when compared to the original tissue. Bioinformatics analyses showed that the DEPs were mainly associated with Ribosome and RNA transport, metabolic, ECM-receptor interaction, Golgi and endoplasmic reticulum, DNA replication, and Regulation of actin cytoskeleton.

Conclusions
To our knowledge, this is the first proteomic research to investigate alterations in protein levels and affected pathways in bichirs’ lobe-fin/limb regeneration. In addition, our study demonstrated a highly dynamic regulation during lobed fin regeneration in P. senegalus. These results not only provide a comprehensive dataset on differentially expressed proteins during the early stages of lobe-fin/limb regeneration but also advance our understanding of the molecular mechanisms underlying lobe-fin/limb regeneration.
An academic perspective of participation in healthcare redesign
Authors: Prior Sarah Jane , Mather Carey , Miller Andrea , Campbell Steven 
Published: November 2019

AbstractHealthcare redesign, based on building collaborative capacity between academic and clinical partners, should create a method to facilitate flow between the key elements of health service improvement. However, utilising the skills and resources of an organisation outside of the health facility may not always have the desired effect. Accountability and mutually respectful relationships are fundamental for collaborative, sustainable and successful completion of clinical research projects. This paper provides an academic perspective of both the benefits of academic involvement in facilitating healthcare redesign processes as well as the potential pitfalls of involving external partner institutions in internal healthcare redesign projects.
A novel epigenetic signature for overall survival prediction in patients with breast cancer
Authors: Bao Xuanwen , Anastasov Natasa , Wang Yanfang , Rosemann Michael 
Published: November 2019

AbstractBackgroundBreast cancer is the most common malignancy in female patients worldwide. Because of its heterogeneity in terms of prognosis and therapeutic response, biomarkers with the potential to predict survival or assist in making treatment decisions in breast cancer patients are essential for an individualised therapy. Epigenetic alterations in the genome of the cancer cells, such as changes in DNA methylation pattern, could be a novel marker with an important role in the initiation and progression of breast cancer.MethodDNA methylation and RNA-seq datasets from The Cancer Genome Atlas (TCGA) were analysed using the Least Absolute Shrinkage and Selection Operator (LASSO) Cox model. Applying gene ontology (GO) and single sample gene set enrichment analysis (ssGSEA) an epigenetic signature associated with the survival of breast cancer patients was constructed that yields the best discrimination between tumour and normal breast tissue. A predictive nomogram was built for the optimal strategy to distinguish between high- and low-risk cases.ResultsThe combination of mRNA-expression and of DNA methylation datasets yielded a 13-gene epigenetic signature that identified subset of breast cancer patients with low overall survival. This high-risk group of tumor cases was marked by upregulation of known cancer-related pathways (e.g. mTOR signalling). Subgroup analysis indicated that this epigenetic signature could distinguish high and low-risk patients also in different molecular or histological tumour subtypes (by Her2-, EGFR- or ER expression or different tumour grades). Using Gene Expression Omnibus (GEO) the 13-gene signature was confirmed in four external breast cancer cohorts.ConclusionAn epigenetic signature was discovered that effectively stratifies breast cancer patients into low and high-risk groups. Since its efficiency appears independent of other known classifiers (such as staging, histology, metastasis status, receptor status), it has a high potential to further improve likely individualised therapy in breast cancer.
Beneficial effects of early empirical administration of appropriate antimicrobials on survival and defervescence in adults with community-onset bacteremia
Authors: Lee Ching-Chi , Lee Chung-Hsun , Yang Chao-Yung , Hsieh Chih-Chia , Tang Hung-Jen , Ko Wen-Chien 
Published: November 2019

Abstract
Background
Bloodstream infections are associated with high morbidity and mortality, both of which contribute substantially to healthcare costs. The effects of early administration of appropriate antimicrobials on the prognosis and timing of defervescence of bacteremic patients remain under debate.

Methods
In a 6-year retrospective, multicenter cohort, adults with community-onset bacteremia at the emergency departments (EDs) were analyzed. The period from ED arrival to appropriate antimicrobial administration and that from appropriate antimicrobial administration to defervescence was regarded as the time-to-appropriate antibiotic (TtAa) and time-to-defervescence (TtD), respectively. The primary study outcome was 30-day mortality after ED arrival. The effects of TtAa on 30-day mortality and delayed defervescence were examined after adjustment for independent predictors of mortality, which were recognized by a multivariate regression analysis.

Results
Of the total 3194 patients, a TtAa-related trend in the 30-day crude (γ = 0.919, P = 0.01) and sepsis-related (γ = 0.909, P = 0.01) mortality rate was evidenced. Each hour of TtAa delay was associated with an average increase in the 30-day crude mortality rate of 0.3% (adjusted odds ratio [AOR], 1.003; P < 0.001) in the entire cohort and 0.4% (AOR, 1.004; P < 0.001) in critically ill patients, respectively, after adjustment of independent predictors of 30-day crude mortality. Of 2469 febrile patients, a TtAa-related trend in the TtD (γ = 0.965, P = 0.002) was exhibited. Each hour of TtAa delay was associated with an average 0.7% increase (AOR, 1.007; P < 0.001) in delayed defervescence (TtD of ≥ 7 days) after adjustment of independent determinants of delayed defervescence. Notably, the adverse impact of the inappropriateness of empirical antimicrobial therapy (TtAa > 24 h) on the TtD was noted, regardless of bacteremia severity, bacteremia sources, or causative microorganisms.

Conclusions
The delay in the TtAa was associated with an increasing risk of delayed defervescence and 30-day mortality for adults with community-onset bacteremia, especially for critically ill patients. Thus, for severe bacteremia episodes, early administration of appropriate empirical antimicrobials should be recommended.
Epigenetic modifications of histones in cancer
Authors: Zhao Zibo , Shilatifard Ali 
Published: November 2019

AbstractThe epigenetic modifications of histones are versatile marks that are intimately connected to development and disease pathogenesis including human cancers. In this review, we will discuss the many different types of histone modifications and the biological processes with which they are involved. Specifically, we review the enzymatic machineries and modifications that are involved in cancer development and progression, and how to apply currently available small molecule inhibitors for histone modifiers as tool compounds to study the functional significance of histone modifications and their clinical implications.