bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Value of Cement Augmentation in Patients With Diminished Bone Quality Undergoing Thoracolumbar Fusion Surgery: A Review
Authors: Kolz Joshua M. , Freedman Brett A. , Nassr Ahmad N. 
Published: April 2021

Study Design: Systematic review. Objectives: Osteoporosis predisposes patients undergoing thoracolumbar (TL) fusion to complications and revision surgery. Cement augmentation (CA) improves fixation of pedicle screws to reduce these complications. The goal of this study was to determine the value and cost-effectiveness of CA in TL fusion surgery. Methods: A systematic literature review was performed using an electronic database search to identify articles discussing the cost or value of CA. As limited information was available, the review was expanded to determine the mean cost of primary TL fusion, revision TL fusion, and the prevalence of revision TL fusion to determine the decrease of revision surgery necessary to make CA cost-effective. Results: Two studies were identified discussing the cost and value of CA. The mean cost of CA for two vertebral levels was $10 508, while primary TL fusion was $87 346 and revision TL fusion was $76 825. Using a mean revision rate of 15.4%, the use of CA for TL fusion would need to decrease revision rates by 13.7% to be cost-effective. Comparison studies showed a decreased revision rate of 11.3% with CA, which approaches this value. Conclusion: CA for TL fusion surgery improves biomechanical fixation of pedicle screws and decreases complications and revision surgery in patients with diminished bone quality. The costs of CA are substantial and reported decreases in revision rates approach but do not reach the calculated value to be a cost-effective technique. Future studies will need to focus on the optimal CA technique to decrease complications, revisions, and costs.
Engineering Resistance to Bacterial Blight and Bacterial Leaf Streak in Rice
Authors: Ni Zhe , Cao Yongqiang , Jin Xia , Fu Zhuomin , Li Jianyuan , Mo Xiuyu , He Yongqiang , Tang Jiliang , Huang Sheng 
Published: April 2021

Abstract
Background
Xanthomonas oryzae (Xo) is one of the important pathogenic bacterial groups affecting rice production. Its pathovars Xanthomonas oryzae pv. oryzae (Xoo) and Xanthomonas oryzae pv. oryzicola (Xoc) cause bacterial blight and bacterial leaf streak in rice, respectively. Xo infects host plants by relying mainly on its transcription activator-like effectors (TALEs) that bind to host DNA targets, named effector binding elements (EBEs), and induce the expression of downstream major susceptibility genes. Blocking TALE binding to EBE could increase rice resistance to the corresponding Xo.

Findings
We used CRISPR/Cas9 to edit the EBEs of three major susceptibility genes (OsSWEET11, OsSWEET14 and OsSULTR3;6) in the rice varieties Guihong 1 and Zhonghua 11. Both varieties have a natural one-base mutation in the EBE of another major susceptibility gene (OsSWEET13) which is not induced by the corresponding TALE. Two rice lines GT0105 (from Guihong 1) and ZT0918 (from Zhonghua 11) with target mutations and transgene-free were obtained and showed significantly enhanced resistance to the tested strains of Xoo and Xoc. Furthermore, under simulated field conditions, the morphology and other agronomic traits of GT0105 and ZT0918 were basically the same as those of the wild types.

Conclusions
In this study, we first reported that the engineering rice lines obtained by editing the promoters of susceptibility genes are resistant to Xoo and Xoc, and their original agronomic traits are not affected.
Evaluation of indicators for cyanobacterial risk in 108 temperate lakes using 23 years of environmental monitoring data
Authors: Li J. , Persson K. M. , Pekar H. , Jansson D. 
Published: April 2021

Abstract
Background
Cyanobacterial blooms are of increasing concern for drinking water supply. In Sweden, a survey among drinking water producers showed that the sense of urgency was little. At 60% of the Swedish drinking water treatment plants, operators lacked monitoring strategies. To get a picture of the size of the problem the presence of cyanobacterial risk in 108 Swedish lakes was evaluated from 23 years of environmental monitoring data. The drivers and indicators for cyanobacterial growth were investigated by analyzing water quality in 9 lakes that have more frequent cyanobacteria bio-volume above the WHO drinking water alert level 1: 0.2 mm3L−1.

Results
The study shows that the most common species in those lakes are Anabaena/Dolichospermum and Aphanizomenon followed by Microcystis, Woronichinia and Planktothrix, which can produce a variety of toxins such as anatoxins, cylindrospermopsins, microcystins and saxitoxins, supported by literature study. Our results show that cyanobacterial risk in those problematic 9 lakes are mainly nutrients driven with possibly contribution of increased organic matter. By applying non-linear quantile regression with total phosphorus (TP) as an example, we demonstrated that certain drivers such as TP can be useful for cyanobacterial risk assessment and provide control measures by setting nutrients targets. We also evidenced that cyanobacterial peaks presented at low TN:TP ratio while not necessarily vice versa. We also further evaluated that chlorophyll-a and transparency might be suitable as indicators for cyanobacterial blooms in certain lakes, while for most of the lakes, their connection is low.

Conclusion
Nutrients are main drivers for higher cyanobacterial occurrence in the 9 lakes. We suggest TP concentrations should be investigated thoroughly to provide important knowledge which can be used to set nutrient targets to sustain safe drinking water supply and recreational services. The complexity of indicating cyanobacterial risk in a local condition was also highlighted in this study and future study is suggested. To classify different types of lake and identify their drivers and the similarities of species composition changes in those lakes will be future studied.
The expression and prognostic value of the epidermal growth factor receptor family in glioma
Authors: Xu Bin , Huo Zhengyuan , Huang Hui , Ji Wei , Bian Zheng , Jiao Jiantong , Sun Jun , Shao Junfei 
Published: April 2021

AbstractBackgroundThe epidermal growth factor receptor (EGFR) family belongs to the transmembrane protein receptor of the tyrosine kinase I subfamily and has 4 members: EGFR/ERBB1, ERBB2, ERBB3, and ERBB4. The EGFR family is closely related to the occurrence and development of a variety of cancers.Materials/methodsIn this study, we used multiple online bioinformatics websites, including ONCOMINE, TCGA, CGGA, TIMER, cBioPortal, GeneMANIA and DAVID, to study the expression profiles, prognostic values and immune infiltration correlations of the EGFR family in glioma.ResultsWe found that EGFR and ERBB2 mRNA expression levels were higher in glioblastoma (GBM, WHO IV) than in other grades (WHO grade II & III), while the ERBB3 and ERBB4 mRNA expression levels were the opposite. EGFR and ERBB2 were notably downregulated in IDH mutant gliomas, while ERBB3 and ERBB4 were upregulated, which was associated with a poor prognosis. In addition, correlation analysis between EGFR family expression levels and immune infiltrating levels in glioma showed that EGFR family expression and immune infiltrating levels were significantly correlated. The PPI network of the EGFR family in glioma and enrichment analysis showed that the EGFR family and its interactors mainly participated in the regulation of cell motility, involving integrin receptors and Rho family GTPases.ConclusionsIn summary, the results of this study indicate that the EGFR family members may become potential therapeutic targets and new prognostic markers for glioma.
Intra- and interobserver concordance of a new classification system for myopic maculopathy
Authors: Zhang Rong-rong , Yu Yan , Hou Yin-fen , Wu Chang-fan 
Published: April 2021

Abstract
Background
Myopic maculopathy (MM) is one of the major causes of visual impairment and irreversible blindness in eyes with pathologic myopia (PM). However, the classification of each type of lesion associated with MM has not been determined. Recently, a new MM classification system, known as the ATN grading and classification system, was proposed; it is based on the fundus photographs and optical coherence tomography (OCT) images and includes three variable components: atrophy (A), traction (T), and neovascularization (N). This study aimed to perform an independent evaluation of interobserver and intraobserver agreement for the recently developed ATN grading system for MM.

Methods
This was a retrospective study. Fundus photographs and OCT images of 125 patients (226 eyes) with various MMs were evaluated and classified using the ATN grading of the new MM classification system by four blinded and independent evaluators (2 attending ophthalmologists and 2 ophthalmic residents). All cases were randomly re-evaluated by the same observers after an interval of 6 weeks. The kappa coefficient (κ) and 95% confidence interval (CI) were used to determine the interobserver and intraobserver agreement.

Results
The interobserver agreement was substantial when considering the maculopathy type (A, T, and N). The weighted Fleiss κ values for each MM type (A, T, and N) were 0.651 (95% CI: 0.602–0.700), 0.734 (95% CI: 0.689–0.779), and 0.702 (95% CI: 0.649–0.755), respectively. The interobserver agreement when considering the subtypes was good or excellent, except for stages A1, A2, and N1, in which the weighted κ value was less than 0.6, with moderate agreement. The intraobserver agreement of types and subtypes was excellent, with κ > 0.8. No significant differences were observed between the attending ophthalmologists and residents for interobserver reliability or intraobserver reproducibility.

Conclusions
The ATN classification allows an adequate agreement among ophthalmologists with different qualifications and by the same observer on separate occasions. Future prospective studies should further evaluate whether this classification can be better implemented in clinical decision-making and disease progression assessments.
The prevalence and stressors of job burnout among medical staff in Liaoning, China: a cross-section study
Authors: Guo Youqi , Hu Shu , Liang Fei 
Published: April 2021

AbstractBackgroundSustained attention to the prevalence and associated factors of burnout in China is important for the health care service quality and related reform. In this study, we investigated the prevalence of job burnout among medical staff in Liaoning province, China; performed a survey of subjective perception ranking for the main stressors among respondents; estimated the effect of stresses from work tasks and the relationship with patients on job burnout in order to provide improved strategy and suggestion for hospital administrators.MethodsThe respondents were from 8 hospitals in 3 cities in Liaoning province, China. Data were collected and analyzed including the following sections: (1) demographic characteristics; (2) work situations; (3) ranking of six stressors; (4) job burnout scale; (5) effort-reward imbalance scale; (6) work violence scale; (7) fear of malpractice scale. A total of 1056 individuals became the study objects. A statistical analysis and hierarchical linear regression analysis were performed to explore the prevalence of burnout and the effects of stressors.ResultsThe prevalence of job burnout was 20.5, and 72.9% of all respondents reported a least one symptom of burnout. The respondents who were male, 30–39 years old, had a master’s degree or high and working hours > 60 h per week, came from obstetrics and gynecology or pediatrics profession prone to job burnout. The relationship with patients and work tasks are the top two ranking stressors in the subjective perception survey. Regression analysis showed that the relationship with patients explained 19.2, 16.8 and 2.0% of variance in burnout subscales EE, DP and PA, respectively and work tasks explained 23.5, 16.0 and 5.24% of variance in burnout subscales EE, DP and PA, respectively.ConclusionThe Chinese medical staff had high prevalence of job burnout. Some factors of demographic and work situations were associated with job burnout. The medical staff considered the relationship with patients and work tasks are the two major stressors. These two stressors are also the major indicators associated with job burnout. The hospital administrators should be aware of the risk of burnout. Efforts should be made to ameliorate the status of job burnout.
Divergent airway microbiomes in lung transplant recipients with or without pulmonary infection
Authors: Påhlman Lisa I. , Manoharan Lokeshwaran , Aspelund Anna Stjärne 
Published: April 2021

Abstract
Background
Lung transplant (LTx) recipients are at increased risk for airway infections, but the cause of infection is often difficult to establish with traditional culture-based techniques. The objectives of the study was to compare the airway microbiome in LTx patients with and without ongoing airway infection and identify differences in their microbiome composition.

Methods
LTx recipients were prospectively followed with bronchoalveolar lavage (BAL) during the first year after transplantation. The likelihood of airway infection at the time of sampling was graded based on clinical criteria and BAL cultures, and BAL fluid levels of the inflammatory markers heparin-binding protein (HBP), IL-1β and IL-8 were determined with ELISA. The bacterial microbiome of the samples were analysed with 16S rDNA sequencing and characterized based on richness and evenness. The distance in microbiome composition between samples were determined using Bray–Curtis and weighted and unweighted UniFrac.

Results
A total of 46 samples from 22 patients were included in the study. Samples collected during infection and samples with high levels of inflammation were characterized by loss of bacterial diversity and a significantly different species composition. Burkholderia, Corynebacterium and Staphylococcus were enriched during infection and inflammation, whereas anaerobes and normal oropharyngeal flora were less abundant. The most common findings in BAL cultures, including Pseudomonas aeruginosa, were not enriched during infection.

Conclusion
This study gives important insights into the dynamics of the airway microbiome of LTx recipients, and suggests that lung infections are associated with a disruption in the homeostasis of the microbiome.
Safety of house dust mite subcutaneous immunotherapy in preschool children with respiratory allergic diseases
Authors: Yang Yaqi , Ma Dongxia , Huang Nan , Li Wenjing , Jiang Qing , Wang Yin , Wang Xiaolong , Yang Lin , Zhu Rongfei 
Published: April 2021

Abstract
Background
Allergen immunotherapy (AIT) is the only causal therapy for IgE-mediated allergy. There is less evidence about the safety and efficacy of AIT especially subcutaneous immunotherapy (SCIT) in children under 5 years old. We aimed to investigate the side effects and associated risk factors of house dust mite (HDM) SCIT in preschool children with respiratory allergic diseases.

Methods
The preschool children who had HDM-related allergic rhinitis with/without asthma were enrolled and undergone standardized HDM SCIT in our department from June 2013 to December 2019. Local reactions (LRs) and systemic reactions (SRs) were recorded and categorized according to World Allergy Organization recommendations. Demographic data and other therapeutic-related parameters were also recorded to investigate potential risk factors for these side effects.

Results
A total of 91 children (60 boys, 65.93%; 31 girls, 34.07%; mean age 4.13 years old) were included in the study. Among the 91 patients, 3109 SCIT injections were recorded, 62/91 (68.13%) experienced 186 immediate LRs, 4 /91(4.40%) experienced 6 delayed LRs, 11/91 (12.09%) children experienced 44 immediate SRs, 21/44 (47.73%) were grade 1 SRs, 21/44 (47.73%) were grade 2, 2/44 (4.55%) were grade 3, no grade 4 or 5 SRs occurred. Furthermore, 1/91 (1.10%) experienced 1 delayed SRs, manifested by urticaria 2 days later after allergen injection. 9/91 (9.89%) experienced 2 or more times SRs. Multivariable logistic regression analysis showed BMI (OR 1.506; 95%CI 1.091 to 2.079; p < 0.05) and sIgE against HDM (OR 1.497; 95%CI 1.082 to 2.071; p < 0.05) were risk factors for LRs. No variable was found to correlate with SRs (all p > 0.05).

Conclusions
HDM subcutaneous immunotherapy is considered to be safe in preschool children with respiratory allergic diseases. Higher BMI and HDM sIgE level in children are risk factors for developing LRs. The incidence of SRs and the rate of severe SRs are low in preschool children.
Identification of ZBTB18 as a novel colorectal tumor suppressor gene through genome-wide promoter hypermethylation analysis
Authors: Bazzocco Sarah , Dopeso Higinio , Martínez-Barriocanal Águeda , Anguita Estefanía , Nieto Rocío , Li Jing , García-Vidal Elia , Maggio Valentina , Rodrigues Paulo , de Marcondes Priscila Guimarães , Schwartz Simo , Aaltonen Lauri A. , Sánchez Alex , Mariadason John M. , Arango Diego 
Published: April 2021

Abstract
Background
Cancer initiation and progression are driven by genetic and epigenetic changes. Although genome/exome sequencing has significantly contributed to the characterization of the genetic driver alterations, further investigation is required to systematically identify cancer driver genes regulated by promoter hypermethylation.

Results
Using genome-wide analysis of promoter methylation in 45 colorectal cancer cell lines, we found that higher overall methylation levels were associated with microsatellite instability (MSI), faster proliferation and absence of APC mutations. Because epigenetically silenced genes could represent important oncogenic drivers, we used mRNA expression profiling of colorectal cancer cell lines and primary tumors to identify a subset of 382 (3.9%) genes for which promoter methylation was negatively associated with gene expression. Remarkably, a significant enrichment in zinc finger proteins was observed, including the transcriptional repressor ZBTB18. Re-introduction of ZBTB18 in colon cancer cells significantly reduced proliferation in vitro and in a subcutaneous xenograft mouse model. Moreover, immunohistochemical analysis revealed that ZBTB18 is frequently lost or reduced in colorectal tumors, and reduced ZBTB18 expression was found to be associated with lymph node metastasis and shorter survival of patients with locally advanced colorectal cancer.

Conclusions
We identified a set of 382 genes putatively silenced by promoter methylation in colorectal cancer that could significantly contribute to the oncogenic process. Moreover, as a proof of concept, we demonstrate that the epigenetically silenced gene ZBTB18 has tumor suppressor activity and is a novel prognostic marker for patients with locally advanced colorectal cancer.
Nivolumab-induced hypophysitis followed by acute-onset type 1 diabetes with renal cell carcinoma: a case report
Authors: Kikuchi Fumi , Saheki Takanobu , Imachi Hitomi , Kobayashi Toshihiro , Fukunaga Kensaku , Ibata Tomohiro , Sato Seisuke , Ban Natsuki , Lyu Jingya , Japar Salimah , Murao Koji 
Published: April 2021

Abstract
Background
Immune checkpoint inhibitors have recently become widely used for the management of advanced cancer patients. During the development of immune checkpoint inhibitors (ICPIs), it was quickly recognized that they are associated with autoimmune or autoinflammatory side effects. These toxicities are known as immune-related adverse events (irAEs): common endocrine irAEs include hypophysitis and thyroid dysfunction, and uncommon irAEs include type 1 diabetes mellitus (T1DM).

Case presentation
A 62-year-old Japanese man with metastatic renal cell carcinoma was treated with sunitinib followed by the 10th cycle of treatment with the ICPI nivolumab. He had already had thyroiditis and hypophysitis due to these anti-cancer drugs. On admission, he showed an extremely elevated plasma glucose level (601 mg/dl) and a low C-peptide level, and was diagnosed with acute T1DM. The patient was treated with intravenous fluid infusion and continuous insulin infusion. On the second day, he was switched to multiple daily injections of insulin therapy. Since these treatments, his blood glucose levels have been stable and he has been treated with an additional 10 ICPI treatments for renal cell carcinoma for over a year.

Conclusions
Treatment with ICPIs is expected to increase in the future. There may be cases in which their use for cancer treatment is inevitable despite the side effects. As long as treatment with ICPI continues, multiple side effects can be expected in some cases. It is important to carefully observe the side effects that occur during ICPI treatment and to provide appropriate treatment for each side effect.
Effect of a single, oral administration of selenitetriglycerides, at two dose rates, on blood selenium status and haematological and biochemical parameters in Holstein-Friesian calves
Authors: Żarczyńska Katarzyna , Sobiech Przemysław , Tobolski Dawid , Mee John F. , Illek Josef 
Published: April 2021

AbstractBackgroundSelenitetriglycerides are biologically active, organic forms of selenium formed as a result of the modification of selenic acid and sunflower oil. Studies in rats have shown that they are well absorbed and of low toxicity. There are no published studies on selenitetriglycerides supplementation in calves.ResultsIn this study, selenitetriglycerides were administered once orally on the 2nd day of life at a dose of 0.5 or 1 mg Se/kg body weight to each of six Holstein-Friesian calves while six control calves were not supplemented. Blood for determination of selenium concentration, glutathione peroxidase activity, haematological parameters, aspartate aminotransferase, creatine kinase, and lactate dehydrogenase activities and glucose, total protein, albumin, triglycerides, cholesterol, urea, and creatinine concentration was collected before supplementation (day 0) and 1, 2, 5, 10 and 14 days after supplementation. Selenitetriglycerides administration increased (P < 0.01) serum selenium concentration in supplemented calves as early as day1, from a mean of 63.4 to 184.22 µg/l in calves receiving selenium at a dose of 0.5 mg/kg BW, and from 63.17 to 200.33 µg/l in calves receiving 1 mg/kg. Serum selenium concentrations remained significantly higher compared to the control group throughout the experiment. Glutathione peroxidase activity was higher in supplemented than control calves, significantly so in animals receiving the 1 mg/kg dose of Se on the 10th and 14th days (P < 0.05). There were no significant differences in the haematological and biochemical parameters between the groups.ConclusionsThis experiment showed that supplementation with selenitetriglycerides could significantly improve blood selenium status in calves without adverse effects on haematological or biochemical parameters. These findings are essential prerequisites for future studies on selenitetriglycerides supplementation to manage clinical selenium deficiency in calves.