bluuebunny/crossref_metadata_2025_split huggingface dataset:
Did the Angiodysplasia Associated With Heyde's Syndrome Disappear Spontaneously?: A Case Report
Authors: Li Rui , Zhang Jiechun , Shi Jiaxi , Qing Lijin , Wu Wei 
Published: September 2021

Abstract
Background: Multidisciplinary clinical manifestations of Heyde's syndrome and finite accuracy of corresponding examinations toward Heyde's triad make it easily omitted or misjudged in practice. Moreover, aortic valve replacement is often delayed because of the contradiction between anticoagulation and hemostasis. Herein, we present a rare case of atypical Heyde's syndrome whose confirmed intermittent bleeding angiodysplasia was not observed via mesenteric arteriography again, but severe bleeding was dramatically improved by transcatheter aortic valve implantation(TAVI) following laparotomy.Case presentation: A 64-year-old female experienced refractory gastrointestinal bleeding and deteriorating exertional dyspnea with a history of hypertension. Exploratory laparotomy was performed because the hemorrhage persisted and repeated transfusions. The subsequent histological examination revealed angiodysplasia. Heyde's syndrome was not suspected until she bled again combined with aortic valve stenosis detected by echocardiography 3 years later. TAVI was consequently performed in a stable condition with the invisibility of angiodysplasia. The post-procedure and follow-up were uneventful.Conclusions: The visible figures of angiodysplasia or shortage of HMWM-vWFs should not be indispensable for the clinical diagnosis of Heyde's syndrome. Laparotomy could be a bridging therapy to aortic valve replacement for severe hemorrhagic patients, and TAVI may benefit high-risk patients with a stable condition.
A Qualitative Study on the Psychological Experience of Elder Women With Second Child
Authors: Ge Yurong , Zhang Xin , Zheng Jingyuan , Zeng Fen , Kitili Ike , Chen Qianyi 
Published: September 2021

Abstract
Objective: To explore the psychological changes that may take place in older women with a second child from conception to birth. The study has several aims, including the provision of protection of the overall health level of these women; the maintenance of women's position in the labor market; and the promotion of the implementation of the "comprehensive two-child" policy.Methods: Semi-open interviews were conducted on older women pregnant with their second child. These women were recruited from three tertiary hospitals in one province in western China. The interview content was analyzed using the qualitative research method of Japanese scholar Kinoshita Yasuhito's revised version of grounded theory.Results: Four themes were extracted from the psychological experience of the older women with a second child; these were: Life choice; The mixed feelings of motherhood; The backbone of a family; Second children should be cautious.Conclusion: older women with a second child face physical, psychological, life, and other pressures. To ensure the implementation of the "comprehensive two-child" policy, the Chinese government should speed up the establishment of a fertility support system, including education, medical investment, women’s employment rights protection, and pension burden. Establish and improve relevant policies.
Assembly And Comparative Analysis of The First Complete Mitochondrial Genome of Acer Truncatum Bunge: A Woody Oil-Tree Species Producing Nervonic Acid
Authors: Ma Qiuyue , Wang Yuxiao , Li Shushun , Wen Jing , Zhu Lu , Yan Kunyuan , Du Yiming , Ren Jie , Li Shuxian , Chen Zhu , Bi Changwei , Li Qianzhong 
Published: September 2021

Abstract
Background: Acer truncatum (purpleblow maple) is a woody tree species that produces seeds with high levels of valuable fatty acids (especially nervonic acid). The species is also admired as a landscape plant with high developmental prospects and scientific research value. The A. truncatum chloroplast genome has recently been reported; however, the mitochondrial genome (mitogenome) is still unexplored.Results: We characterized the A. truncatum mitogenome, which was assembled using reads from Pacbio and Illumina sequencing platforms, and performed a comparative analysis against different species of Acer. The circular mitogenome of A. truncatum has a length of 791,052 bp, with a base composition of 27.11% A, 22.21% T, 22.79% G, and 22.89% C. The A. truncatum mitogenome contains 62 genes, including 35 protein-coding genes, 23 tRNA genes, and 4 rRNA genes. We also examined codon usage, sequence repeats, RNA editing, and selective pressure in the A. truncatum mitogenome. To determine the evolutionary and taxonomic status of A. truncatum, we conducted a phylogenetic analysis based on the mitogenomes of A. truncatum and 25 other taxa. We also analyzed gene migration from chloroplast and nuclear genomes to the mitogenome. Finally, we developed a novel NAD1 intron indel marker for distinguishing several Acer species. Conclusions: In this study, we assembled and annotated the mitogenome of A. truncatum, a woody oil-tree species producing nervonic acid. The results of our analyses provide comprehensive information on the A. truncatum mitogenome, which should facilitate evolutionary research and molecular barcoding in Acer.
A Novel Joint Index Based on Peripheral Blood CD4+/CD8+ T Cell Ratio, Albumin Level, and Monocyte Count to Determine the Severity of Major Depressive Disorder
Authors: Zhou Dechun , Yu Hongfeng , Yao Hongfeng , Yuan Shijin , Xia Yan , Huang Lei , Shen Yuedi , Zhang Jun , Chen Wei 
Published: September 2021

Abstract
Background: A peripheral blood laboratory test may be an easy and ideal method for determining major depressive disorder (MDD) severity, because the current depression assessment scales lack sensitivity and objectivity. This study was aimed at exploring the association between laboratory parameters and disease severity.Methods: MDD severity in the training and validation cohorts (n = 99 and 97, respectively) was classified using the Hamilton Depression Scale. Pretreatment laboratory parameters were evaluated. Significant severity-associated factors were identified using a multivariate logistic model and combined to develop a joint index through binary logistic regression analysis. The area under the receiver operating characteristic curve (AUC) was used to evaluate the index,s discriminative performance.Results: In the training cohort, lower CD4+/CD8+ T cell ratio, albumin level, and a higher monocyte percentage (M%) were significantly associated with severe disease (P < 0.05 for all). The index was developed using these factors and calculated as -3.959 CD4+/CD8+ T cell ratio − 0.175 albumin level + 0.522 M% + 8.739, with a sensitivity and specificity of 90% and 70%, respectively. The AUC values for the index in the training and validation cohorts were 0.850 and 0.750, respectively, indicating a good discriminative performance.Conclusion: We identified disease severity-associated laboratory parameters that could be easily evaluated—CD4+/CD8+ T cell ratio, albumin level, and M%—and developed and validated a joint index for discriminating MDD severity.
Assessing Transferability in Systematic Reviews of Health Economic Evaluations – A Review of Methodological Guidance
Authors: Weise Alina , Büchter Roland Brian , Pieper Dawid , Mathes Tim 
Published: September 2021

Abstract
Objective: For assessing cost-effectiveness, Health Technology Assessment (HTA) organisations may use primary economic evaluations (P-HEs) or Systematic Reviews of Health Economic evaluations (SR-HEs). The latter pose the question whether the results from existing P-HEs are transferable across decision contexts (e.g. jurisdictions). A particularly pertinent issue is the high variability of costs and resource needs across jurisdictions. Our objective was to review the methods documents of HTA organisations and compare their recommendations on considering transferability in SR-HE. Methods: We systematically hand searched the webpages of 158 HTA organisations for relevant methods documents from January to March 2019. Two independent reviewers performed searches and selected documents according to pre-defined criteria. One reviewer extracted data in standardised and piloted tables and a second reviewer checked them for accuracy. We synthesized data using tabulations and in a narrative way. Results: We identified 155 potentially relevant documents from 63 HTA organisations. Of these, 7 were included in the synthesis. The included organisations have different aims when preparing a SR-HE (e.g. to determine the need for conducting their own P-HE). The recommendations vary regarding the underlying terminology (e.g. transferability/generalisability), the assessment approaches (e.g. structure), the assessment criteria and the integration in the review process.Conclusion: Only few HTA organisations address the assessment of transferability in their methodological recommendations for SR-HEs. Transferability considerations are related to different purposes. The assessment concepts and criteria are heterogeneous. Developing standards to consider transferability in SR-HEs is desirable.
Sublytic membrane attack complex drives glycolysis and mitochondrial dysfunction with inflammatory consequences in human monocyte-derived macrophages
Authors: Jimenez-Duran Gisela , Kozole Joseph , Heap Rachel E. , Dickinson Eleanor , Kwiatkowski Christopher , Zappacosta Francesca , Annan Roland , Galwey Nicholas , Nichols Eva-Maria , Modis Louise , Triantafilou Martha , Triantafilou Kathy , Booty Lee 
Published: September 2021

Abstract
The complement system is an ancient and critical element of the innate immune system. The terminal step in the complement pathway, the membrane attack complex (MAC), has previously been linked to inflammasome activation and is linked to the pathogenesis of multiple diseases including rheumatoid arthritis and neurodegeneration. Using both metabolomic and proteomic approaches, here we show that in human monocyte-derived macrophages a sublytic concentration of MAC mediates a previously uncharacterised metabolic shift, mitochondrial dysfunction and upregulation of glycolysis-promoting genes. This skewing of metabolism coupled with mitochondrial dysfunction drives ROS-mediated NLRP3 inflammasome activation and subsequent gasdermin D activation and pro-inflammatory cytokine production and release. Together, these data elucidate a novel immunometabolic signalling cascade in MAC-stimulated human macrophages, the consequences of which have implications in considering much needed novel therapeutic options for diseases linked to aberrant complement activation
MORe PREcISE: A Multicenter Prospective Cohort of Patient Reported Outcome Measures in Stroke
Authors: Corrigan Amber E , Carter Ben , Smith Alexander , Pennington Anna , Hewitt Jonathan 
Published: September 2021

Abstract
Background and Purpose: The use of patient reported outcomes measures (PROMs) may offer utility and provide outcome measures that are important for stroke survivors. This study used a stroke specific PROM, which contains Mental health (MH) and Physical Health (PH). The primary aim of this study was to assess the association between the MH and PH measures following a stroke and preexisting health conditions. Methods: A multicenter prospective cohort study at 19 hospital sites across England and Wales during 2019 was conducted. Prevalence of morbidity within PROMs was estimated with 95% confidence intervals (95% CI). The association between each PROM domain and demographic and health conditions were calculated using a multilevel multivariable linear model fitting the adjusted mean difference (aMD). Results: PROM morbidity was high post stroke; 93.2% of the participants reported combined post stroke PROM morbidity. The MH domain was associated with pre-existing: diabetes, previous stroke, age, and sex. The PH domain was found to be associated with gender (female) and previous stroke, Conclusions: Stroke survivors ubiquitously suffer morbidity. Risk factors associated with worsening MH and PH morbidity have implications in clinical management as they offer an opportunity to intervene, particularly to prevent long term mental health. PROMs provide useful outcome measure that matter to stroke survivors.
Experimental Study:Ranging of Sensor and Actuator Data for Real Time Interfacing
Authors: P Aravind , khan Khalid Ali 
Published: September 2021

Abstract
The primary purpose of the paper is to provide a guideline to process control researchers who are interested in the design controllers by their own. This article gives a simple technique to real time sensor and actuator interfacing in and to computer; it is tested in LabVIEW software. It mainly highlights the process of mapping the values of input signal and output signal values to process.
Sustainable Low-Cost Surfactin Production And Optimization By Bacillus Subtilis SNW3, Product Characterization, And Its Suitability For Plant Growth Promotion And Bioremediation of Crude Oil
Authors: Umar Aiman , Zafar Aneeqa , Wali Hasina , Siddique Meh Para , Qazi Muneer Ahmed , Naeem Afshan Hina , Malik Zulfiqar Ali , Ahmed Safia 
Published: September 2021

Abstract
At present time, every nation is absolutely concern about increase agricultural production and bioremediation of petroleum contaminated soil. Hence, with this intention in current study potent natural surfactant (surfactin) was evaluated for low-cost production by Bacillus subtilis SNW3, previously isolated from Fimkessar oil field, Chakwal Pakistan. The best results were obtained using substrates in combination (white beans powder (6% w/v) plus waste frying oil (1.5% w/v) and (0.1% w/v) urea) with surfactin production of about 1.17 g/L contributing 99% reduction in cost required for medium preparation. To the best of our knowledge, no single report is present describing surfactin production by Bacillus subtilis using white beans powder as a culture medium. Surfactin was confirmed as the principal product characterized by thin-layer chromatography (TLC) and Fourier-transform infrared spectroscopy (FTIR). Additionally, produced surfactin display great physicochemical properties of surface tension reduction value (SFT=28.8 mN/m), significant oil displacement activity (ODA=4.9 cm), excessive emulsification ability (E24=69.8 %), and attains critical micelle concentration (CMC) value at 0.58 mg/mL. Furthermore, surfactin exhibits excellent stability over an extensive range of pH (1-11), salinity (1-8%), temperature (20-121°C) and even after autoclaving. Subsequently, surfactin produced proved suitable for bioremediation of crude oil (86%) and as potent plant growth-promoting agent that significantly (P<0.05) increase seed germination and plant growth promotion of chili pepper, lettuce, tomato and pea maximum at concentration of (0.7 g/100 mL), proved as potential agent for agriculture and bioremediation processes by lowering economic and environmental stress.
Factors Influencing Ethnic Disparities in Outcomes after Deceased Donor Kidney Transplantation
Authors: Divers Jasmin , Mohan Sumit , Brown William M. , Pastan Stephen O. , Israni Ajay K. , Gaston Robert S. , Bray Robert , Islam Shahidul , Sakhovskaya Natalia V. , Mena-Gutierrez Alejandra M. , Reeves-Daniel Amber M. , Julian Bruce A. , Freedman Barry I. 
Published: September 2021

Abstract
Background: African American (AA) recipients of deceased-donor (DD) kidney transplants (KT) have shorter allograft survival than recipients of other ethnic groups. Reasons for this disparity encompass complex interactions between donors and recipients characteristics. Methods: Outcomes from 3,872 AA and 19,719 European American (EA) DDs who had one kidney transplanted in an AA recipient and one in an EA recipient were analyzed. Four donor/recipient pair groups (DRP) were studied, AA/AA, AA/EA, EA/AA, and EA/EA. Survival random forests and Cox proportional hazard models were fitted to rank and evaluate modifying effects of DRP on variables associated with allograft survival. These analyses sought to identify factors contributing to the observed disparities in transplant outcomes among AA and EA DDKT recipients. Results: Transplant era, discharge serum creatinine, delayed graft function, and DRP were among the top predictors of allograft survival and mortality among DDKT recipients. Interaction effects between DRP with the kidney donor risk index and transplant era showed significant improvement in allograft survival over time in EA recipients. However, AA recipients appeared to have similar or poorer outcomes for DDKT performed after 2010 versus before 2001; allograft survival hazard ratios (95% CI) were 1.15 (0.74, 1.76) and 1.07 (0.8, 1.45) for AA/AA and EA/AA, compared to 0.62 (0.54, 0.71) and 0.5 (0.41, 0.62) for EA/EA and AA/EA DRP, respectively. Recipient mortality improved over time among all DRP, except unemployed AA/AAs. Relative to DDKT performed pre-2001, employed AA/AAs had HR=0.37 (0.2, 0.69) versus 0.59 (0.31, 1.11) for unemployed AA/AA after 2010. Conclusion: Relative to DDKT performed before 2001, similar or worse overall DCAS was observed among AA/AAs, while EA/EAs experienced considerable improvement regardless of employment status, KDRI, and EPTS. AA recipients of an AA DDKT, especially if unemployed, had worse allograft survival and mortality and did not appear to benefit from advances in care over the past 20 years.
Reinforcing Factors Influencing Patient-physician Relationships: A Content Analysis Study
Authors: Bagheri Masood , Somi Mohammad Hossein , Ghaffarifar Saeideh 
Published: September 2021

Abstract
Background: Building an effective patient-physician relationship is a vital component of a successful health care. Therefore, educating and preparing students to communicate effectively with patients has always been critical. Such a criticism needs to evaluate the current situation and the socio-cultural context in which the communications are built. The aim of this study was to analyze the status of patient-physician relationship and explore factors influencing communication in Tabriz University of Medical Sciences (TUoMS) from the perspective of patients, students and faculty members.Methods: In this content analysis study, data were gathered using focus groups, semi-structured interviews and observations in the field, based on purposive sampling until the data saturation was achieved.Findings: Content analysis resulted in emerging five categories, affecting patient-physician relationship. They included factors related to: physician, patient, environment, socio-cultural context and health care system. Participants related their stratifying experiences of the PPR to 36 factors in five different categories. Among them, the factors related to the physician played the most significant role. Most students stated that they did not receive any practical or theoretical training in a form of a predefined formal program to improve their communication skills.Conclusion: The findings of this study indicated that the current situation of patient-physician relationship at TUoMS is not satisfying and serious and comprehensive interventions are needed to improve the PPR.
Histopathological and Radiographical Evaluation of Caprine Demineralized Bone Matrix in a Critical Ulnar Defect in a Rabbit Model
Authors: Alimi Olawale Alimi , Abuabakar Adamu Abdul , Yakubu Abubakar Sadiq , Shehu Sani Abdullahi , Abdulkadir Salman Zubairu 
Published: September 2021

Abstract
Background: Caprine species satisfy the conditions of an ideal donor animal when compared to bovine species that has been extensively studied and commercialized for bone xenograft. Histopathological and radiological evaluations of caprine demineralized bone matrix (CDBM) were therefore carried out for fracture healing properties for its possible use in bone grafting procedures. Materials and Methods: Twenty-four rabbits were used for this study and were divided randomly into three groups of eight (n=8) rabbits each. Critical bone defect was created on the ulnar diaphysis under xylazine-ketamine anaesthesia for autogenous bone graft (ABG) group, CDBM group and the last group was left unfilled as negative control (NC). Immediate post-grafting radiograph was taken and repeated on days 14, 28, 42 and 56 to monitor the evidence of radiographic healing. The animals were euthanized on day 56 and defect sites were harvested for histopathology. Results: There was a progressive evidence of radiographic healing and bone formation in all the groups with significance difference (P=0.0064). When compared with ABG, NC differ significantly (P<0.0001) whereas the CDBM did not differ significantly (P=0.6765). The histopathology sections of ABG and CDBM showed normal bone tissue while the NC section was predominated by fibrous connective tissue. There was therefore an overall significant difference (P=0.0001) in which CDBM did not differ from ABG (P=0.2946) while NC did (P=0.0005). Conclusion: The ABG and CDBM groups showed a similar healing effect in the critical bone defect. Therefore, CDBM could be used as an effective alternative to ABG in orthopaedics to circumvent the limitations and complications associated with it. Level of Evidence: Not applicable.
Endoscopic variceal ligation combined with sclerotherapy for management of gastroesophageal variceal bleeding in pediatric patients
Authors: Li Ming-Ming , Sun Fang , Huai Man-Xiu , Qu Chun-Ying , Shen Feng , Zhang Yi , Xu Lei-Ming 
Published: September 2021

Abstract
Background

Portal hypertension (PH) frequently gives rise to severe and life-threatening complications, including hemorrhage accompanied by the rupture of esophageal and gastric varices. In contrast to the widely studied guidelines for the management of PH in adults, there remains controversial about the optimal endoscopic management of variceal bleeding in children for secondary prophylaxis. The study aims to determine the efficacy and safety of endoscopic variceal ligation (EVL) and sclerotherapy (EST) to control bleeding in children in our clinical center.
Methods

The retrospective study included 21 children with gastroesophageal variceal bleeding who were treated by endoscopic variceal ligation or sclerotherapy at Xinhua Hospital, Shanghai Jiaotong University School of Medicine between January 2007 and July 2020. The treatment outcome involving short-term hemostatic rate and long-term rebleeding rate were investigated. Adverse events related to the procedures, such as esophageal ulcer, esophageal stricture, abnormal embolization, pneumonia and perforation were also observed.
Results

The 21 pediatric patients who were diagnosed as moderate to severe esophageal varices concurrent with gastric varices experienced EVL or EST successfully. Hemostasis was achieved in 45 of 47 (95.7%) episodes of upper gastrointestinal bleeding. The mean volume of each single aliquot of cyanoacrylate injected was 0.3 ± 0.1 mL (range: 0.1–0.5 mL). Twenty-four patients (75%) reach varices eradication in the EVL group with a median number of procedures before eradication of 2 (1–4) and a median time to eradication of 3.40 months (1.10-13.33). Eleven patients (52.4%) developed rebleeding events, with the mean duration of hemostasis being 11.1 ± 11.6 mo (range: 1.0-39.2 mo). No treatment-related complications, for example, distal embolism, were noted with the exception of abdominal pain in one patient (4.8%).
Conclusions

Endoscopic variceal sclerotherapy or in combination with EVL turns out to be an effective and safe approach to treat variceal hemorrhage in children for secondary prophylaxis.