bluuebunny/crossref_metadata_2025_split huggingface dataset:
National systemic lupus erythematosus prospective cohort in Saudi Arabia
Authors: Almaghlouth Ibrahim A. , Hassen Lena M. , Alahmari Hana S. , Bedaiwi Asma , Albarrak Rana , Daghestani Maha , Alqurtas Eman , Alkhalaf Abdulaziz , Bedaiwi Mohammed , Omair Mohammed , Almogairen Sultan , Alarfaj Hussein , Alarfaj Abdulrahman 
Published: August 2021

Abstract
Systemic Lupus erythematosus (SLE) is a chronic multisystem, multifactorial inflammatory autoimmune disease. The SLE patients have 3 times increased risk of mortality based on international data with ethnicity playing an important impact on patients’ morbidity and mortality. Descriptive studies from Saudi Arabia showed variation in clinical features from one region to another. Moreover, reliable inference from these studies is limited by study methodology and lack of translational data using biological samples to understand clinical phenotypes of Saudi SLE patients.
The aim of this report is to describe the prospective study protocol of the National Systemic Lupus Erythematosus Cohort in Saudi Arabia. The purpose of this cohort study is multifold: first, to examine clinical characteristics and molecular phenotypes of Saudi SLE patients in relation to local environment and practices/lifestyles; second, to assess long-term outcomes of SLE in Saudi population and factors that influence favorable outcomes; third, to compare the effectiveness of various treatment regimens in Saudi SLE population.
This study is a longitudinal prospective cohort study of adult, Saudi SLE patients using open cohort study design. Primary outcomes include disease-related outcomes (activity, improvement, and organ damage) and patient-reported outcomes (quality of life). Secondary outcomes include physiological and molecular modifications associated with changes in disease activity states.Results and analysis are in on-going study.
This study provides a source of reliable data for clinical and translational research. This will allow us to have a holistic approach to SLE pathogenesis especially in Saudi population and may take us a step further toward much more personalized medicine.
This protocol has been registered in NIH ClinicalTrial.gov (ClinicalTrial.gov identifier: NCT04604990) on October 27, 2020.
Extensile lateral versus sinus tarsi approach for calcaneal fractures
Authors: Peng Chuangang , Yuan Baoming , Guo Wenlai , Li Na , Tian Heng 
Published: August 2021

Abstract

Background:
Calcaneal fractures are the most common tarsal bone fracture, and are often accompanied by heel pain, local swelling, tenderness, and inability to walk or stand. Surgical intervention results in better reconstruction of the calcaneal anatomy and reduces future complications; however, the optimal incision approach is still controversial. The incision is exposed better with extensile lateral approach (ELA), while the sinus tarsi approach (STA) causes fewer complications. The purpose of this meta-analysis is to compare the outcomes of STA and ELA.

Materials and methods:
Published trials comparing ELA and STA in calcaneal fractures were included in our analysis. The quality of each study was assessed using the revised Jadad scale and the Newcastle–Ottawa scale. Two researchers (CP and BY) independently extracted data from all selected studies. Fixed- or random-effects models with mean differences and odds ratios were used to pool the continuous and dichotomous variables to determine the heterogeneity of the included studies.

Results:
Calcaneal height and calcaneal width had high heterogeneity. Results showed that the incidence of incision complications in STA was lower than that in ELA (P < .001). There was high heterogeneity in operative time (I
2 = 97%), length of hospital stay (I
2 = 98%), Böhler angle (I
2 = 80%), Gissane angle (I
2 = 98%), and American Orthopaedic Foot & Ankle Society scores (I
2 = 73%). No source of heterogeneity was found by sensitivity analysis, subgroup analysis, or regression analysis, and the random-effects model was used. STA operative time was significantly shorter than ELA (P < .001). Length of hospital stay after STA was significantly shorter than after ELA (P = .002). There was no statistical difference in the Böhler and Gissane angles between STA and ELA. Postoperative American Orthopaedic Foot & Ankle Society scores after STA were higher than after ELA (P = .01).

Conclusions:
Results show that, compared with ELA, STA is superior for treating calcaneal fractures due to anatomical reduction of the calcaneus, reduction of incision complications incidence, and shortened operative time and postoperative stay.
Providing care in isolation while awaiting SARS-CoV-2 test results
Authors: Schmidt-Hellerau Kirsten , Meyer-Schwickerath Charlotte , Paul Gregor , Augustin Max , Priesner Vanessa , Rybniker Jan , Suárez Isabelle , Hallek Michael , Burst Volker , Kolibay Felix , Fätkenheuer Gerd , Lehmann Clara , Jung Norma 
Published: August 2021

Abstract
Isolation of confirmed or suspected coronavirus disease 2019 (COVID-19) cases is essential but, as symptoms of COVID-19 are non-specific and test results not immediately available, case identification at admission remains challenging. To inform optimization of triage algorithms, patient flow and patient care, we analyzed characteristics of patients admitted to an isolation ward, both severe acute respiratory syndrome coronavirus 2019 (SARS-CoV-2) positive patients and patients in which initial suspicion was not confirmed after appropriate testing.
Data from patients with confirmed or suspected COVID-19 treated in an isolation unit were analyzed retrospectively. Symptoms, comorbidities and clinical findings were analyzed descriptively and associations between patient characteristics and final SARS-CoV-2 status were assessed using univariate regression.
Eighty three patients (49 SARS-CoV-2 negative and 34 positive) were included in the final analysis. Of initially suspected COVID-19 cases, 59% proved to be SARS-CoV-2-negative. These patients had more comorbidities (Charlson Comorbidity Index median 5(interquartile range [IQR] 2.5, 7) vs 2.7(IQR 1, 4)), and higher proportion of active malignancy than patients with confirmed COVID-19 (47% vs 15%; P = .004), while immunosuppression was frequent in both patient groups (20% vs 21%; P = .984). Of SARS-CoV-2 negative patients, 31% were diagnosed with non-infectious diseases.
A high proportion of patients (59%) triaged to the isolation unit were tested negative for SARS-CoV-2. Of these, many suffered from active malignancy (47%) and were immunosuppressed (20%). Non-infectious diseases were diagnosed in 31%, highlighting the need for appropriate patient flow, timely expert medical care including evaluation for differential diagnostics while providing isolation and ruling out of COVID-19 in these patients with complex underlying diseases.
Association between CYP2B6 c.516G >T variant and acute leukaemia
Authors: Xiong Xuan , Yu Dongke , Gao Qiaoyue , Zhang Yuan , Yin Qinan , Chen Xiaotao , Xiao Hongtao , Tong Rongsheng 
Published: August 2021

Abstract

Background:
Acute leukemia (AL) is a kind of malignant tumor of hematopoietic system. A number of studies have suggested that Single Nucleotide Polymorphisms are significantly associated with risk of AL. Present study performs meta-analysis to evaluate the association between CYP2B6 c.516G>T variant and AL risk.

Methods:
Databases including PubMed, EMBASE, Chinese National Knowledge Infrastructure (CNKI), and Wanfang were searched for literatures to September 30, 2019, both in English and Chinese. Relative risk and its 95% confidence intervals were used to assess the associations. Statistical analyses of this meta-analysis were conducted by using STATA 13.0. software.

Results:
A total of 7 studies, including 1038 cases and 1648 controls, were analyzed. Our results indicated that CYP2B6 c.516G>T variant was significantly related to an increased the risk of AL under dominant model, recessive model, homozygote model, and allelic model. In addition, subgroup analyses were also performed by disease classification, country, and study design. No significant associations were obtained between CYP2B6 c.516G>T variant and the risk of AL under the recessive model in the design of hospital-based (relative risk = 0.98; 95% confidence interval: 0.95–1.01; P
= 0.118).

Conclusion:
Our meta-analysis indicated that the CYP2B6 variant is significantly associated with AL risk, in which CYP2B6 c.516G>T is related to an increased risk of AL.
A retrospective analysis from a single center for 60 COVID-19 patients with asymptomatic, mild to moderate, and severe conditions in Wuxi, China
Authors: Huang Jiehui , Qian Chao , Bian Tao , Chu Meiping , Yin Weiwei , Pang Yonghua , Bai Jinmei , Huang Yanjie 
Published: August 2021

Abstract
The aim of this study was to retrospectively analyze the clinical data of COVID-19 patients with different severity during February 2020 in Wuxi, China.
The present retrospective study included a total of 60 cases who were diagnosed as COVID-19 patients and hospitalized in the Wuxi Fifth People's Hospital during February 2020 to March 2020. Among all patients 14 cases were asymptomatic, 25 cases were with mild stage, 13 cases were with moderate stage, and 8 cases were with severe stage. Basic clinical data as well as clinical characteristics, including temperature, respiratory rate, heart rate, blood gas analysis data, whole blood test data, and the prognosis condition, were collected and analyzed. Statistical analysis was conducted in different severity stage patients.
Among the patients, the median temperature gradually increased from the asymptomatic to the severe patients and the median age increased from the mild to the severe patients with statistical difference. The hospitalization duration was the highest in severe patients. Higher heart rate, as well as lower oxygen partial pressure and oxygenation index were observed in severe patients than the other groups. Besides, higher CRP and globulin levels after admission were found in severe patients, and were gradually increased from the asymptomatic patients to the severe patients. On the contrary, the lymphocyte ratio and count was significant lower in severe patients. We also observed higher D-Dimer levels in the severe patients and the difference was statistical. Among all patients, 2 cases (3.33%) died and other patients were all cured after treatment.
Statistical difference was mainly found mainly in age, hospitalization duration, temperature, CRP levels, O2 partial pressure and oxygenation index, globulin, lymphocyte ratio, and D-Dimer in patients with different severity. The higher CRP levels, lower O2 partial pressure and oxygenation index, higher globulin, lower lymphocyte ratio, and higher D-Dimer might be associated with the patients’ severity.
The relation between antihypertensive treatment and progression of cerebral small vessel disease
Authors: Su Chen , Wu Hao , Yang Xiaoyu , Zhao Bing , Zhao Renliang 
Published: August 2021

Abstract

Background:
Cerebral small vessel disease is relevant to hypertension. We tried to figure out whether antihypertensive treatment is beneficial for this disease.

Methods:
We systematically searched PubMed, Embase, and Cochrane electronic databases for randomized controlled trials about white matter hyperintensities (WMH), brain atrophy, microbleeds, and lacunar infarcts with antihypertensive treatment and performed a meta-analysis.

Results:
We identified 7 trials on white matter hyperintensities and brain atrophy with antihypertensive treatment. Pooled analysis showed antihypertensive treatment performed positively in the progression of WMH (standardized mean difference, −0.22; 95% CI, −0.36 to −0.07, I^2 = 52%). And in the subgroup meta-analysis, only lower SBP controlled level (110–129 mm Hg) had effect on the progression of WMH (standardized mean difference, −0.37; 95% CI, −0.54 to −0.29, I^2 =0). The meta-regression showed larger difference of SBP in treatment groups having a smaller WMH progression. Antihypertensive treatment is not significant in the progression of brain atrophy (standardized mean difference, −0.02; 95% CI, −0.26 to 0.30, I^2 = 85%). Only 1 trial reported the new patients of lacunar infarcts in the follow-up, no association with antihypertensive treatment (odds ratio, 2.2; 95% CI, 0.4–12.1; P = .36).

Conclusions:
Antihypertensive treatment is beneficial for cerebral small vessel disease on white matter hyperintensities progression, but no impact on brain atrophy. And lower SBP level is more effective on the progression of WMH. There is not enough evidence to prove the relationship between antihypertensive treatment and lacunar stroke, microbleeds.
To evaluate the serum cortisol, salivary cortisol, and serum interleukin-1 B level in patients of chronic periodontitis with smoking and stress and without smoking and stress
Authors: Zhang Haiou , Chen Bocheng , Pan Chenyu , Zhang Ansheng 
Published: August 2021

Abstract
The role of cognitive, social and biological factors in the etiology of chronic periodontitis has been reported.
The aim of this study was to evaluate the salivary cortisol level and interleukin-1 B level in patients of Chronic periodontitis in smokers and stress and nonsmokers without stress.
The design of study randomized, prospective, double-blinded, and prospective study.
The total sample size was comprised of 600 subjects between the ages of 20 and 50 years. The sample size was divided into 300 males and 300 females. Out of 600 subjects, 200 subjects comprised of subjects with chronic periodontitis with positive depression level with a history of smoking (Group I), 200 subjects comprised of subjects with chronic periodontitis without depression and without smoking (Group II), and 200 subjects who were taken as the control group comprised of healthy subjects without chronic periodontitis, without depression level, and no smoking history (Group III). Salivary cortisol levels were determined by enzyme-linked immunosorbent assay (ELISA).
The result showed that there was a positive correlation between morning and evening salivary cortisol level in all the groups with correlation coefficient. There was significant higher value of salivary cortisol in Group I patients when compared with Group II and Group III. However, when the comparison of salivary cortisol levels was done between the Group II and Control group, the result showed nonsignificant P value.
It is suggested that stress is positively correlated with the salivary cortisol levels in smokers and nonsmokers.
Over-expression of vitronectin correlates with impaired survival in gastric cancers
Authors: Gong Chao , Hong Haifeng , Xie Jingfeng , Xue Yuqin , Huang Yudian , Zhang Dekun 
Published: August 2021

Abstract
Over-expression of vitronectin (VN) is associated with tumorigenesis. The present study aimed to evaluate the prognostic value of VN expression in gastric cancer.
The least absolute shrinkage and selection operator analysis was performed to screen the hub gene from The Cancer Genome Atlas gastric cancer patients with complete follow-up data, and 347 patients were finally included. Moreover, 102 patients were enrolled from the Affiliated Fuzhou First Hospital of Fujian Medical University. VN expression in paired gastric cancer and adjacent gastric normal tissues was detected using immunohistochemistry, and the clinicopathological significance of VN expression was evaluated. The prognostic significance of VN expression in gastric cancer patients was evaluated using by Kaplan–Meier method and Cox regression analysis and confirmed using Oncomine.
VN was the prognosis relative gene which screened by The Cancer Genome Atlas dataset. Moreover, we identified the VN expression in an external dataset by immunohistochemistry. The result demonstrated that VN expression was remarkedly elevated in gastric cancer tissues (P < .001). High VN expression correlated with higher pathological Tumor-Node-Metastasis stage, and poorer survival outcomes. Cox regression analysis showed that VN expression was independently predictive of overall survival (OS) and disease-free survival (P = .004, P < .001, respectively). A prognostic risk score for OS was built based on VN expression. A meta-analysis from Oncomine datasets revealed that significantly lower VN mRNA levels in gastric cancer correlated with poorer OS.
VN expression could be a prognostic marker of gastric cancer.
Risk factors of delayed recovery from general anesthesia in patients undergoing radical biliary surgery
Authors: Zhang Guohui , Pan Bingbing , Tan Dan , Ling Yingzi 
Published: August 2021

Abstract
Delayed recovery (DR) is very commonly seen in the patients undergoing laparoscopic radical biliary surgery, we aimed to investigate the potential risk factors of DR in the patients undergoing radical biliary surgery, to provide evidences into the management of DR.
Patients who underwent radical biliary surgery from January 1, 2018 to August 31, 2020 were identified. The clinical characteristics and treatment details of DR and no-DR patients were compared and analyzed. Multivariable logistic regression analyses were conducted to identify the potential influencing factors for DR in patients with laparoscopic radical biliary surgery.
We included a total of 168 patients with laparoscopic radical biliary surgery, the incidence of postoperative DR was 25%. There were significant differences on the duration of surgery, duration of anesthesia, and use of intraoperative combined sevoflurane inhalation (all P < .05), and there were not significant differences on American Society of Anesthesiologists, New York Heart Association, tumor-lymph node- metastasis, and estimated blood loss between DR group and control group (all P > .05). Multivariable logistic regression analyses indicated that age ≥70 years (odd ratio [OR] 1.454, 95% confidence interval [CI] 1.146–1.904), body mass index ≥25 kg/m2 (OR 1.303, 95% CI 1.102–1.912), alcohol drinking (OR 2.041, 95% CI 1.336–3.085), smoking (OR 1.128, 95% CI 1.007–2.261), duration of surgery ≥220 minutes (OR 1.239, 95% CI 1.039–1.735), duration of anesthesia ≥230 minutes (OR 1.223, 95% CI 1.013–1.926), intraoperative combined sevoflurane inhalation (OR 1.207, 95% CI 1.008–1.764) were the independent risk factors for DR in patients with radical biliary surgery (all P < .05).
It is clinically necessary to take early countermeasures against various risk factors to reduce the occurrence of DR, and to improve the prognosis of patients.
Single-cell transcriptional profiling reveals the heterogeneity in embryonal rhabdomyosarcoma
Authors: Hong Bo , Xia Tian , Ye Chun-Jing , Zhan Yong , Yang Ran , Liu Jia , Li Yi , Chen Zhi-Xue , Yao Wei , Li Kai , Wang Jia , Dong Kui-Ran , Dong Rui 
Published: August 2021

Abstract
Rhabdomyosarcoma is the most common soft tissue sarcoma in children, and embryonal rhabdomyosarcoma is the most typical type of rhabdomyosarcoma. The heterogeneity, etiology, and origin of embryonal rhabdomyosarcoma remain unknown.
After obtaining the gene expression data of every cell in the tumor tissue by single-cell RNA sequencing, we used the Seurat package in R studio for quality control, analysis, and exploration of the data. All cells are divided into tumor cells and non-tumor cells, and we chose tumor cells by marker genes. Then, we repeated the process to cluster the tumor cells and divided the subgroups by their differentially expressed genes and gene ontology/Kyoto Encyclopedia of Genes and Genomes analysis. Additionally, Monocle 2 was used for pseudo-time analysis to obtain the evolution trajectory of cells in tumor tissues.
Tumor cells were divided into 5 subgroups according to their functions, which were characterized by high proliferation, sensing and adaptation to oxygen availability, enhanced epigenetic modification, enhanced nucleoside phosphonic acid metabolism, and ossification. Evolution trajectory of cells in tumor tissues is obtained.
We used pseudo-time analysis to distinguish between mesenchymal stem cells and fibroblasts, proved that embryonal rhabdomyosarcoma in the pelvic originated from skeletal muscle progenitor cells, showed the evolutionary trajectory of embryonal rhabdomyosarcoma, and improved the method of evaluating the degree of malignancy of embryonal rhabdomyosarcoma.
Aberrant PTEN, PIK3CA, pMAPK, and TP53 expression in human scalp and face angiosarcoma
Authors: Wan Huiying , Zhang Dingding , Hu Weimin , Xie Zhen , Du Qiu , Xia Qiongrong , Wen Taishen , Jia Haiping 
Published: August 2021

Abstract
Angiosarcoma is a rare, highly aggressive malignant tumor originating from endothelial cells that line the lumen of blood or lymphatic vessels. The molecular mechanisms of scalp and face angiosarcoma still need to be elucidated. This study aimed to investigate the expression of phosphatase and tensin homolog (PTEN), phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA), phosphorylated mitogen-activated kinase-like protein (pMAPK), and tumor protein p53 (TP53) in scalp and face angiosarcoma and to assess tumor tissue apoptosis.
The expression and intracellular distribution of PTEN, PIK3CA, pMAPK, and TP53 proteins in 21 specimens of human scalp and face angiosarcoma and 16 specimens of human benign hemangioma were evaluated using immunohistochemistry. Tumor cell apoptosis was assessed by terminal deoxyribonucleotide transferase-mediated dUTP nick end-labeling staining.
Significantly lower PTEN but higher PIK3CA, pMAPK, and TP53 immunostaining were detected in the angiosarcoma specimens than in the benign hemangioma specimens(P < .01). The angiosarcoma tissues exhibited significantly higher apoptosis indices than the benign hemangioma tissues (P < .01). The positive expression rates of PIK3CA, pMAPK, and TP53 were correlated with the degree of tumor differentiation in the human scalp and face angiosarcoma.
The PI3K, MAPK, and TP53 pathways might be involved in angiosarcoma tumorigenesis in humans and may serve as therapeutic targets for the effective treatment of this malignancy.
Lumbar laminotomy and replantation for the treatment of lumbar spinal epidural lipomatosis
Authors: Yang Keshi , Ji Changbin , Luo Dawei , Li Kunpeng , Xu Hui 
Published: August 2021

Abstract

Rationale:
Lumbar spinal epidural lipomatosis (SEL) is a rare condition characterized by excessive overgrowth of extradural fat within the lumbar spinal canal. Surgical decompression is commonly performed to treat symptomatic SELs. Fenestration or laminectomy with epidural fat debulking was a routine surgical procedure according to the literature, that may be causing postoperative lumbar instability. In the present study, we presented a brief report of lumbar SEL and introduced another surgical approach.

Patient concerns:
A 55-year-old man complained of severe low back pain and right leg radicular pain for a year, accompanied by neurogenic intermittent claudication. He received a variety of conservative treatments, including non-steroidal anti-inflammatory drugs, acupuncture, and physical therapy. However, his pain did not diminish. Finally, a posterior epidural mass in the dorsal spine extending from the L3 to L5 level, which caused dural sac compression was found on lumbar magnetic resonance imaging. This mass was homogeneously hyperintense in both T1W1 and T2W1 images, suggestive of epidural fat accumulation.

Diagnoses:
Lumbar SEL.

Interventions:
The patient underwent lumbar laminectomy, epidural fat debulking, and spinous process-vertebral plate in situ replantations.

Outcomes:
The patient presented with complete recovery of radiculopathy and low back pain after surgery. Postoperative magnetic resonance imaging showed that the increased adipose tissue disappeared, and the dural sac compression was relieved. A computed tomography scan revealed the lumbar lamina in situ. He was able to walk normally and remained relatively asymptomatic for 12 months after the operation at the last follow-up visit.

Lessons:
Lumbar laminotomy and replantation provide an ideal option to treat lumbar SEL because it can achieve sufficient and effective decompression, simultaneously reconstruct the anatomy of the spinal canal, and reduce the risk of iatrogenic lumbar instability.