bluuebunny/crossref_metadata_2025_split huggingface dataset:
Uncharted waters: Mesenchymal stem cell Treatment for Pediatric Refractory Rheumatic Diseases; A Single Center Case Series
Authors: Wong Stephen Chee-Yung , Medrano Leah C , Hoftman Alice D , Jones Olcay Y , McCurdy Deborah K 
Published: April 2021

Abstract
Background:With the advent of innovative therapies including biologics and Janus kinase inhibitors, children with rheumatic diseases are more likely to have improved outcomes. Yet, despite these advances, some children do not respond, or they, or their parents fear adverse events and seek other alternatives. Increasingly, there are private companies that offer mesenchymal stem cells (MSC) as an alternative and describe it as a more natural therapy for rheumatic diseases, often insinuating that there will be a cure. Mesenchymal stem cells have immunomodulatory properties, and transplantation of these stem cells have been used to successfully treat immunologic conditions like graft-versus-host disease. More recently, MSC research in adults with lupus has been encouraging, but the clinical trials are still underway and in most, mesenchymal stem cell therapy is not a standalone treatment. This retrospective case series will highlight three cases of children with refractory autoimmune disease whose parents sought out and received MSC therapy as a self-decision without first seeking medical advice from our specialty. In our cases, the three families felt that their children were improved and in two believed that their child was cured. Mesenchymal stem cells have the potential of beneficial immunomodulation and may be a powerful tool in the therapy of rheumatic disease, but well controlled clinical trials are necessary and should be designed and monitored by experts in childhood rheumatic disease. Case Presentation:Three children with three different rheumatic diseases; systemic lupus erythematosus, mixed connective tissue disease and juvenile idiopathic arthritis were under the care of pediatric rheumatology at a large, tertiary-care, teaching institution. Multiple non-biologic and biologic disease-modifying anti-rheumatic drugs failed to significantly decrease disease activity, and as a result, the families chose to undergo MSC therapy. After transplantation, all children improved per patient and parent report and tapered off conventional immunosuppressive drugs. No serious adverse events occurred in these three patients. Conclusion:The three cases presented in this study reflect comparable beneficial outcomes and minimal risks published in adult studies. These were not controlled studies, however, and benefit was reported rather than documented. These cases suggest that MSC transplantation may prove a promising adjunctive treatment option; however, further research, development of standardized infusion therapy protocols, and well-designed and monitored clinical trials are essential.
Life in the Wheat Litter: Effects of Future Climate on Microbiome and Function During the Early Phase of Decomposition
Authors: Wahdan Sara , Hossen Shakhawat , Tanunchai Benjawan , Sansupa Chakriya , Schädler Martin , Noll Matthias , Wu Yu-Ting , Buscot François , Purahong Witoon 
Published: April 2021

Abstract
Even though it is widely acknowledged that litter decomposition can be impacted by climate change, the feedback of the corresponding functional roles of decomposing microbes to climate change is understood to a lesser extent. Litter decomposition is linked to the corresponding functioning of the microbiome, but the feedback to climate change is so far scarcely studied. This study used a field experimental facility settled in Central Germany to analyze the effects of ambient climate vs. future climate, which is expected in 50 – 70 years, on mass loss and physicochemical parameters of wheat straw in agricultural cropland at the early phase of litter decomposition process. Additionally, the effects of climate change were assessed on microbial richness, community compositions, interactions and their functions (production of extracellular enzymes), as well as litter physicochemical factors shaping their colonization. The initial physicochemical properties of wheat litter did not change between both climate conditions, however, future climate significantly accelerated litter mass loss as compared with ambient one. Using MiSeq Illumina sequencing, we found that future climate significantly increased fungal richness and altered fungal communities over time, while bacterial communities were more resistant in wheat residues. Fungi corresponded to different physicochemical factors of litter under ambient (C, Ca2+ and pH) and future (C/N, N, P, K+, Ca2+ and pH) climate conditions. Moreover, a highly correlative interactions between richness of bacteria and fungi were detected under future climate. Furthermore, the co-occurrence network patterns among dominant microorganisms inhabiting wheat residues were strongly distinct between future and ambient climates. Activity of microbial β-glucosidase and N-acetylglucosaminidase in wheat straw were significantly higher under future climate. Such high enzymatic activities were coupled with a significant positive correlation between microbial (both bacteria and fungi) richness and community compositions with these two enzymatic activities only under future climate. Overall, we provide evidence that future climate significantly impacted the early-phase of wheat litter decomposition through direct effects on fungal communities and through indirect effects on microbial interactions and corresponding enzymes production.
Translation of the Tonsil and Adenoid Health Status Instrument to the Arabic Language
Authors: Haddad Ghassan , Barazi Randa 
Published: April 2021

Abstract
Background: Adenotonsillectomy is one of the most commonly performed pediatric surgeries worldwide. To date, no questionnaire assessing the quality of life of patients post-operatively exists in the Arabic language. Our objective is to translate the Tonsil and Adenoid Health Status Instrument from English to Arabic and evaluate its internal consistency. We then attempt to use the translated questionnaire to assess the change in quality of life of patients undergoing adenotonsillectomy. Methods: Translation of the English TAHSI was performed using the guidelines for cross-cultural translation of quality of life measures. The obtained version of the questionnaire in Arabic was used on 141 patients enrolled prospectively over 3 years to assess for validity and internal consistency. Patients were enrolled from the pediatric otolaryngology clinic at the American University of Beirut Medical Center. Results: Cronbach alpha coefficients for the pre-operative and post-operative translated questionnaires were 0.79 and 0.78 respectively, confirming adequate internal consistency. Mean total pre-operative score was 28.88 ± 10.80, significantly higher than the mean post-operative score of 5.00 ± 5.57 (p<0.0001) showing an improvement in quality of life after surgery. Conclusion: In this study we successfully translated the Tonsil and Adenoid Health Status Instrument from English to Arabic. The questionnaire obtained is the only available quality of life measurement tool in Arabic specific to adenotonsillectomy. It was used to show that adenotonsillectomy significantly improves the quality of life of patients.
Quantitative Reduction of Gut Microbiota-Derived Short-Chain Fatty Acids in Stool and Serum in Diabetic Kidney Disease
Authors: Zhong Chenyu , Dai Zhiwei , Chai Lingxiong , Wu Lingping , Li Jianhui , Guo Weiying , Zhang Jie , Zhang Qun , Xue Congping , Lin Haixue , Luo Qun , cai kedan 
Published: April 2021

Abstract
ObjectivesPrevious studies found the dysbiosis of intestinal microbiota in individuals with diabetic kidney disease (DKD),especially the decreased SCFA-producing bacteria. We aimed to investigate stool and serum short-chain fatty acids (SCFAs), gut microbiota-derived metabolites, in individuals with DKD and the correlations. MethodsA total of 30 participants with DKD, 30 participants with type 2 diabetes mellitus (DM) and 30 normal controls (NC) in HwaMei Hospital were recruited from 1/1/2018 to 12/31/2019. Participants with DKD were divided into low estimated glomerular filtration rate (eGFR) (eGFR<60ml/min, n=14) and high eGFR (eGFR≥60ml/min, n=16) subgroups. Stool and serum were measured for SCFAs with gas chromatograph-mass spectrometry.ResultsThe group with DKD showed markedly lower levels of fecal acetate, propionate and butyrate versus NC group (P<0.05), and the lowest fecal total SCFAs concentration among the the groups. The group with DKD also had a lower serum caproate concentration than that with diabetes (P<0.05). In the univariate regression analysis, fecal and serum acetate correlated with eGFR in the group with DKD (OR= 1.013, P=0.072; OR=1.017, P=0.032). The correlation between serum total SCFAs and eGFR showed statistical significance (OR= 0.019, P=0.024) unadjusted and a borderline significance (OR= 1.024, P =0.063) when adjusted for Hb and LDL. The decrease in serum acetate and total SCFAs were found of borderline significant correlation in both subgroups (P=0.055, P=0.050). ConclusionThis study provides evidence that in individuals with DKD, serum and fecal SCFAs levels (fecal level in particular) were lowered, and there was a correlation between lower SCFAs and a worsened renal function.
Investigating the Medical Tourism Supply Chain in Shiraz, Iran: A Hybrid Grounded Theory and Rough DEMATEL Method
Authors: Haqbin Arash , Shojaei Payam , Ronaghi Mohammad Hossein , Fazelzadeh Omid 
Published: April 2021

Abstract
Background: This study sought to provide a comprehensive analysis of the medical tourism supply chain (MTSC) in Shiraz, Iran, to improve the city’s potential tourism market share in the post-COVID-19 future. In doing so, the study relied on a mixed research methodology. Primarily, interviews were conducted with 12 stakeholders involved in Shiraz’s MTSC, including general policymakers, managers of private/public healthcare providers, travel agency managers, and managers of medical tourism companies. The data were collected through semi-structured interviews and were then analyzed according to the systematic approach of grounded theory (GT).Results: The results helped to configure a model that analyzed Shiraz’s MTSC, which included 6 main dimensions, 17 sub-dimensions, and 48 criteria. To detect any interrelationships among the criteria, the model was further analyzed quantitatively through the rough Decision making trial and evaluation laboratory (DEMATEL) method.Conclusion: Proposing a novel methodology in medical tourism research, the study could practically contribute to different stakeholders in the medical tourism industry in Shiraz.
Arsenic in Pteris vittata is localized to the cell wall in a water-soluble state
Authors: Sugawara Kazuki , Hayashi Hiroshi , Inoue Chihiro 
Published: April 2021

Abstract
Pteris vittata L., a hyperaccumulator of As, has great potential in environmental remediation. Localization analysis of As and Ca, K, S, and P in arsenic-exposed and unexposed P. vittata pinnae was performed using an electron probe micro analyzer. A comparison of section preparation methods revealed that the As in P. vittata is water-soluble and not tightly bound to the tissue. Further elemental mapping revealed that the localization of S was not consistent with that of As. Therefore, the formation of a complex of low-molecular-weight thiols and As, which is a common detoxification mechanism in plants, may be a limited in P. vittata. It was confirmed that As was localized around the cell wall when the cell was in a healthy state, and that the distribution of As expanded to the whole cell when the cell was damaged. These results suggest that P. vittata may retain As extracellularly to inhibit damage to healthy cells. However, in the periphery of pinnae, which is more susceptible to damage, As was distributed throughout the cell, eventually leading to browning.
Serum soluble (pro)renin receptor level as a prognostic factor in patients undergoing maintenance hemodialysis
Authors: Amari Yoshifumi , Morimoto Satoshi , Suda Chikahito , Iida Takeshi , Yurugi Takatomi , Oyama Yasuo , Aoyama Naoki , Nakajima Fumitaka , Ichihara Atsuhiro , Okuda Hidenobu 
Published: April 2021

Abstract
The (pro)renin receptor [(P)RR)] is a multifunctional protein that is cleaved to generate the soluble (P)RR [s(P)RR], reflecting the status of the tissue renin-angiotensin system and/or activity of the (P)RR. The serum s(P)RR level is associated with arteriosclerosis, independent of other risk factors, in patients undergoing hemodialysis (HD). This study was conducted to investigate whether the s(P)RR level was associated with new-onset cardiovascular events or malignant diseases and poor prognosis in patients undergoing HD. Overall, 258 patients [70 (61–76) years, 146 males] undergoing maintenance HD were prospectively followed up for 60 months. We investigated the relationships between s(P)RR levels and new-onset cardiovascular events/ malignant diseases and mortality during the follow-up period using Cox proportional hazard analyses. The cumulative incidence of new-onset cardiovascular events (P = 0.009) and deaths (P < 0.001), but not of malignant diseases, was significantly greater in patients with higher serum s(P)RR level (≥ 29.8 ng/ml) than in those with lower s(P)RR level (< 29.8 ng/ml). A high serum s(P)RR level was independently correlated with cardiovascular mortality (95% CI 1.001–1.083, P = 0.046). The serum s(P)RR level was associated with cardiovascular events and mortality, thus qualifying as a biomarker for identifying patients requiring intensive care.
Conservative Versus Tailored Surgical Treatment in Patients With First Time Lateral Patella Dislocation: a Randomized-controlled Trial
Authors: Liebensteiner Michael , Keiler Alexander , Attal Rene El , Balcarek Peter , Dirisamer Florian , Giesinger Johannes , Seitlinger Gerd , Nelitz Manfred , Keshmiri Armin , Frings Jannik , Becher Christoph , Kappel Paola , Wagner Daniel , Pagenstert Geert 
Published: April 2021

Abstract
BackgroundPatellar instability has a high incidence and occurs particularly in young and female patients. If the patella dislocates for the first time, treatment is usually conservative. However, this cautious approach carries the risk of recurrence and of secondary pathologies such as osteochondral fractures. An initial surgical treatment could possibly avoid these consequences of recurrent patella dislocation.MethodsA prospective, randomized-controlled trial design is applied. Patients with unilateral first-time patella dislocation will be considered for participation. Study participants will be randomized to either conservative treatment or to a tailored patella stabilizing treatment. In the conservative group patients will use a knee brace and will be prescribed outpatient physical therapy. The surgical treatment will be performed in a tailored manner, addressing the pathologic anatomy that predisposes to patella dislocation.The Banff Patellofemoral Instability-Instrument 2.0, recurrence rate, apprehension test, joint degeneration and the Patella Instability Severity Score will serve as outcome parameters. The main analysis will focus on the difference in change of the scores between the two groups within a two-year follow-up.Statistical analysis will use linear mixed models. Power analysis was done for the comparison of the two study arms at 2-year follow-up with regard to the BPII score. A sample size of N=64 per study arm (128 overall) provides 80% power (alpha=0.05, two-tailed) to detect a difference of 0.5 standard deviations in a t-test for independent samples.DiscussionAlthough several studies have already dealt with this issue, there is still no consensus on the ideal treatment concept for primary patellar dislocation. Moreover, most of these studies show a unified surgical group, which means that all patients were treated with the same surgical procedure. This is regarded as a major limitation as surgical treatment of patella dislocation should depend on the patient’s anatomic pathologies leading to patellar instability. To our knowledge, this is the first study investigating whether patients with primary patella dislocation are better treated conservatively or operatively with tailored surgery to stabilize the patella.Trial registrationThe study will be prospectively registered in the publicly accessible database www.clinicaltrials.gov.
The viral accelerated NF-κB pathway drives COVID-19-associated coagulopathy via excessive transcription of tissue factor and plasminogen activator inhibitor 1 – case report
Authors: Leitzke Marco , Correia Joao-Carlos , Schönknecht Peter Oskar Dieter 
Published: April 2021

Abstract
The current COVID-19 pandemic creates new clinical challenges almost daily, especially in terms of individual prognoses, diagnostics involving newly discovered pathogenic mechanisms, and the appearance of SARS-CoV-2 mutations. In terms of the thromboembolic complications frequently occurring in COVID-19 patients, there is new evidence that pathognomonic COVID-19-associated coagulopathy (CAC) differs considerably from the coagulant malfunction of common disseminated intravascular coagulation. Thus, bleeding is a rare complication in the initial stages of the disease, whereas thrombotic formations can be seen autopticly in the vasculature of several organs. Therefore, it is speculated that most thromboembolic complications are thrombotic rather than embolic, and CAC is more likely to be a pro-coagulant form of coagulopathy. The reasons for these key differences have remained unknown until very recently. The relationship between SARS-CoV-2 infection and the virus-related acceleration of the transcriptional nuclear factor kappa B (NF-κB)-pathway, with the accompanied excessive downstream release of NF-κB-dependent proteins, is undisputed. Therefore, the roles of the NF-κB-transcribed anti-fibrinolytic plasminogen activator inhibitor (PAI 1) and NF-κB-dependent tissue factor (TF) have become worthy of attention. Inappropriate TF action results in enhanced fibrin clot formation, whereas overexpression of PAI 1 prevents appropriate fibrinolytic reactions. CAC is interpreted as critically contributing to overall COVID-19 pathology and is most likely an independent risk factor for mortality.
Changes in Urban Heat Island Effect with the Development of Newtowns
Authors: Lee Kyungil , Kim Yoonji , Sung Hyun Chan , Kim Seung Hee , Jeon Seong Woo 
Published: April 2021

Abstract
Newtown is a planned city built over a short time period. It is suitable for climate and thermal research, particularly formulating urban planning strategies to analyse problems such as urban heat islands (UHIs). Herein, a comprehensive approach was demonstrated for determining changes in UHI distribution during 1989–2048 in two Newtowns with different urban planning. A significant increase in built-up areas was observed from 1989 (< 5%) to 2018 (> 40%) in both Newtowns. However, this increase significantly varied (approximately 12.25%) with urban planning in the areas where UHIs occurred before and after development. Moreover, without effective mitigation, the built-up area in each Newtown is estimated to increase to approximately 60%, and the surface UHI intensity in most areas to increase by 4 °C in 2048. Thus, these results combined with architectural assessment models can improve the understanding of thermal environmental impacts of urbanisation and help mitigate heat island hazards.
Synthesis, Characterization and Comparison of Photo-catalytic Efficiency of Fe3O4/SiO2/TiO2, SrFe12O19/SiO2/TiO2 and Fe3O4/SiO2/ZnO Core/shell/shell Nano-structures
Authors: Bavarsiha Fatemeh , Dadashian Saeideh , Montazeri-Pour Mehdi , Ghasemy-Piranloo Fardin , Rajabi Masoud 
Published: April 2021

Abstract
In this research work, three magnetic composites of Fe3O4/SiO2/TiO2, SrFe12O19/SiO2/TiO2 and Fe3O4/SiO2/ZnO with core/shell/shell structures were successfully prepared by the sol-gel method. For this purpose, in the first step, soft magnetic and hard magnetic powders of Fe3O4 and SrFe12O19 were synthesized using carbon reduction and co-precipitation routes, respectively. In the second step, silica coating was performed by controlling the hydrolysis and condensation of the tetraethyl orthosilicate (TEOS) precursor on the magnetic cores. In the third step, a coating of TiO2 or ZnO photo-catalytic shells was made on as-prepared composites using precursors of titanium n-butoxide (TNBT) or zinc nitrate hexahydrate, respectively. The as-prepared magnetically separable photo-catalysts were characterized using XRD, FESEM, TEM and VSM. The results of the FESEM and TEM analyses confirmed the formation of the core/shell/shell structures. The saturation magnetization of the Fe3O4/SiO2/TiO2, SrFe12O19/SiO2/TiO2 and Fe3O4/SiO2/ZnO photo-catalytic materials was 41.5 emu/g, 33 emu/g and 49 emu/g, respectively. Evaluation of the photo-catalytic activity of Fe3O4/SiO2/TiO2, SrFe12O19/SiO2/TiO2 and Fe3O4/SiO2/ZnO composites by using methylene blue (MB) shows degradation percentages of 84%, 80% and 58%, respectively, under UV illumination.
Protective Effect and Mechanism of Shengmai Formula in Ultrafine Particle Matter-Mediated Atherosclerosis and Myocardial Ischemic Injury
Authors: Yang Ting , Qu Shuiqing , Yang Yuanmin , Zhang Yu , Deng Shuoqiu , Zheng Zhongyuan , Liu Hui , Wang Xi , Chen Lina , Zhu Xiaoxin , Li Yujie 
Published: April 2021

Abstract
Background: Long-term exposure to ultrafine particulate matter (UFPM) has been shown to enhance the development of atherosclerosis and impair myocardial function, leading to myocardial infarction (MI). The Shengmai (SM) formula is a kind of traditional Chinese medicine for cardiovascular diseases, which has been used in clinic for thousands of years. It is composed of Red ginseng, dwarf lilyturf tuber (Ophiopogon japonicus), and Chinese magnolia vine fruit and has been reported to improve myocardial ischemia and combat oxidative stress (OS) injury. The aim of this study was to explore the protective role of SM and the mechanism by which it acts against UFPM-induced cardiovascular injury. This study is expected to provide a basis for the development of potential adaptive signature of SM in the prevention of atherosclerotic cardiovascular disease (ASCVD) and premature death from global air pollution exposure.Results: Pretreatment with SM reduced plaque vulnerability, improved cardiac systolic function, decreased the OS response, and attenuated UFPM-induced reactive oxygen species production and mitochondrial damage. In addition, mice pretreated with SM showed a smaller MI area. In vitro data further demonstrated that compared with the UFPM group, pretreatment with SM significantly increased the expression of nuclear factor erythroid 2-related factor2 (Nrf2) and HO-1, and to some extent protected the antioxidant defense system.Conclusion: These results indicate that SM can inhibit the OS reaction in myocardial infarction mice, avoid cardiovascular injury induced by UFPM in atherosclerosis (AS)+MI mice, and improve cardiac function. Furthermore, the Keap1-Nrf2/HO-1 antioxidant signaling pathways might be involved during these processes. It is suggested that SM has a potential protective effect on the ASCVD population with prolonged exposure to excess particulate matter concentration.