bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prediction of risk factors of bronchial mucus plugs in children with Mycoplasma pneumoniae pneumonia
Authors: Zhang Jiahui , Wang Ting , Li Rongrong , Ji Wei , Yan Yongdong , Sun Zhichao , Tan Jiahong , Wu Jinfeng , Huang Li , Chen Zhengrong 
Published: January 2021

Abstract
Background: Recently, many cases of pneumonia in children with Mycoplasma pneumoniae infection have been shown to have varying degrees of intrabronchial mucus plug formation. The clinical, laboratory, radiological characteristics, and treatment of patients with Mycoplasma infection are analyzed in this study. The risk factors for M. pneumoniae pneumonia (MPP) mucus plug formation in children are explored, and a risk factor scoring system is established.Methods: MPP patients treated with bronchoscopy were retrospectively enrolled in the study from February 2015 to December 2019. The children were divided into a mucus plug group and a control group according to the presence or absence of mucus plug formation. The clinical, laboratory, radiological characteristics, and treatment of the two groups of children were compared. Univariate and multivariate logistic regression models were used to identify the risk factors for MPP mucus plug formation. The receiver operating characteristic (ROC) curve was drawn to evaluate the regression model and establish the MPP mucous plug risk factor scoring system.Results: A univariate analysis showed that the children in the mucous group were older and had a longer fever duration, longer hospital stay, higher fever peak, more cases of wheezing symptoms and allergies, and azithromycin or corticosteroids were administered later. In addition, neutrophil, C-reactive protein (CRP), lactate dehydrogenase (LDH), D-dimer (DD), sputum MP-DNA copy number, and total immunoglobulin A (IgA) levels were higher, while prealbumin (PA) levels were lower. The ROC curve analysis showed that children with MPP had PA ≤144.5 mg/L, had used corticosteroids during the course of the illness of ≥4.5 days, CRP ≥12.27 mg/L, an LDH≥462.65 U/L, and there was a possibility of intra-airway mucus formation. The independent risk factors were scored according to their odds ratio (OR) value. Among the 255 children with MPP, the high-risk group had 44 (83.02%) mucus plugs out of 53; the middle-risk group had 35 (34.3%) mucus plugs out of 102; and the low-risk group had 11 (11%) mucus plugs out of 100.Conclusions: PA levels, timing of corticosteroid use (use in the first few days), CRP levels, and LDH levels were independent risk factors for MPP mucus plug formation. This provides a basis for the early identification of MPP in children combined with mucus plug formation.
Time trends in hospital admissions in very elderly patients (≥85 years-old) in Spain: data from the Spanish National Discharge Database (2000 - 2015)
Authors: Fernández Sergio Palacios , Salcedo Mario , Gonzalez-Alcaide Gregorio , Ramos-Rincon Jose-Manuel 
Published: January 2021

Abstract
Background The aging population is an increasing concern in Western hospital systems. The aim of this study was to describe the main characteristics and hospitalization patterns in very elderly inpatients (≥ 85 years) in Spain from 2000 to 2015.Methods Retrospective observational study analyzing data from the minimum basic data set, an administrative registry recording each hospital discharge in Spain since 1997. We collected administrative, economic and clinical data for all discharges between 2000 and 2015 in patients aged 85 years and older, reporting results in three age groups and four time periods to assess differences and compare trends.Results There were 4,387,326 admissions in very elderly patients in Spain from 2000 to 2015, representing 5.32% of total admissions in 2000–2003 and 10.42% in 2012–2015. The pace of growth was faster in older age groups, with an annual percentage increase of 6% in patients aged 85–89 years, 7.79% in those aged 90–94 years, and 8.06% in those aged 95 and older. The proportion of men also rose (37.3% to 39.7%, p<0.001), and they had a higher risk of hospitalization than women (385 discharges/1000 men versus 280 discharges/1000 women in 2012–2015).Mortality decreased from 14.64% in 2000–2003 to 13.83% in 2012–2015 (p<0.001), and mean length of stay from 9.98 days in 2000–2003 to 8.34 days in 2012–2015. Costs per hospital stay increased from 2000 to 2011, from EUR 4611 in 2000–2003 to EUR 5212 in 2008–2011, before dropping to EUR 4824 in 2012–2015. The 10 most frequent discharge diagnoses in the period 2000-2003 were: femoral neck fracture (8.07%), heart failure (7.84%), neoplasms (7.65%), ischemic encephalopathy (6.97%), pneumonia (6.36%), chronic obstructive pulmonary disease (4.23%), ischemic cardiomyopathy (4.2%), other respiratory diseases (3.87%), other alterations of urethra and the urinary tract (3.08%), and cholelithiasis (3.07%). Conclusions The very elderly population is growing in Spanish hospitals, and within this group, patients are getting older and more frequently male. M ean length of stay, cost of stay, and mortality are decreasing. Decompensation of chronic diseases, neoplasms and infections are the most common causes of admission.
CD9, a potential leukemia stem cell marker, regulates drug resistance and leukemia development in acute myeloid leukemia
Authors: Liu Yongliang , Wang Guiqin , Zhang Jiasi , Chen Xue , Xu Huailong , Heng Gang , Chen Jun , Zhao Yongchun , Li Jiatao , Ni Yuanli , Zhang Yingzi , Shan Juanjuan , Qian Cheng 
Published: January 2021

Abstract
Background: Leukemia stem cells (LSCs) are responsible for the initiation, progression and relapse of acute myeloid leukemia (AML). Therefore, a therapeutic strategy targeting LSCs is a potential approach to eradicate AML. In this study, we aimed to identify LSC-specific surface markers and uncover the underlying mechanism of AML LSCs.Methods: Microarray gene expression data were used to investigate candidate AML-LSC-specific markers. CD9 expression in AML cell lines, patients with AML and normal donors was evaluated by flow cytometry (FC). The biological characteristics of CD9-positive (CD9+) cells were analyzed by in vitro proliferation, chemotherapeutic drug resistance, migration and in vivo xenotransplantation assays. The molecular mechanism involved in CD9+ cell function was investigated by gene expression profiling. The effects of alpha-2-macroglobulin (A2M) on CD9+ cells were analyzed with regard to proliferation, drug resistance and migration.Results: CD9, a cell surface protein, was specifically expressed on AML LSCs but barely detected on normal hematopoietic stem cells (HSCs). CD9+ cells exhibit more resistance to chemotherapy drugs and higher migration potential than do CD9-negative (CD9-) cells. More importantly, CD9+ cells possess the ability to reconstitute human AML in immunocompromised mice and promote leukemia growth, suggesting that CD9+ cells define the LSC population. Furthermore, we identified that A2M plays a crucial role in maintaining CD9+ LSC stemness. Knockdown of A2M impairs drug resistance and migration of CD9+ cells.Conclusion: Our findings suggest that CD9 is a new biomarker of AML LSCs and is a promising therapeutic target.
Molecular Detection, not Extended Culture Incubation, Contributes to Diagnosis of Fungal Infection
Authors: Zhu Alex , Qi Chao 
Published: January 2021

Abstract
Background. Despite its low sensitivity, fungal culture remains one of the key methods for diagnosis and treatment of fungal infections, as it identifies the etiology at the genus and species level and offers susceptibility testing. The Manual of Clinical Microbiology recommends that fungal culture screening for all pathogens should routinely be held for 4 weeks to maximize the recovery of slow-growing species. Information on the optimal fungal culture time in this era of expansion of immunocompromised populations is lacking. We reviewed our experience with fungal culture to determine the optimal culture incubation time. In addition, our experience of broad-range ITS PCR for diagnosis of culture-negative fungal infections was also reviewed.Method. Fungal culture and ITS PCR results from January 1, 2013, to December 31, 2017, were reviewed.Results. Ninety-six percent of positive cultures (4058) were detected in the first 7 days of incubation. During the second week of incubation, 2.8% of positives (111) were detected from day 8 to day 10, and 1.7% (71) were detected from day 11 to day 14. Only 0.1% of positive culture were detected in the third week of incubation, and no positive culture was detected in the fourth week of incubation. No clinically significant fungal isolates were recovered after 14 days. Clinically significant pathogens were detected in 0.2% of culture-negative samples by ITS PCR.Conclusion. Extending culture incubation beyond 2 weeks did not generate clinically relevant results. When culture failed to make a laboratory diagnosis, broad-range internal transcribed spacer (ITS) rRNA gene PCR followed by sequencing produced clinically significant results.
Hypothyroidism and Risks of Cerebrovascular Complications Among Patients with Head and Neck Cancer After Radiotherapy
Authors: Liu Chi-Hung , Chang Joseph Tung-Chieh , Lee Tsong-Hai , Chang Pi-Yueh , Chang Chien-Hung , Wu Hsiu-Chuan , Chang Ting-Yu , Huang Kuo-Lun , Lin Chien-Yu , Fan Kang-Hsing , Chang Yeu-Jhy 
Published: January 2021

Abstract
Background: Hypothyroidism (HT) and carotid artery stenosis (CAS) are complications of radiotherapy (RT) in patients with head and neck cancer (HNC). The impact of post-RT HT on CAS progression remains unclear.Methods: Between 2013 and 2014, HNC patients who had ever received RT and were under regular follow-up in our hospital were initially screened. Patients were categorized into euthyroid (EU) and HT groups. Details of RT and HNC were recorded. Total plaque scores and degrees of CAS were measured during annual extracranial duplex follow-up. Patients were monitored for CAS progression to >50% stenosis or ischemic stroke (IS). Cumulative time to CAS progression and IS between the 2 groups were compared. Data were further analyzed based on the use or nonuse of thyroxine of the HT group.Results: 333 HNC patients with RT history were screened. Finally, 216 patients were recruited (94 and 122 patients in the EU and HT groups). Patients of the HT group received higher mean RT doses (HT vs. EU; 7021.55 ± 401.67 vs. 6869.69 ± 425.32 centi-grays, p = 0.02). Multivariate Cox models showed comparable CAS progression (p = 0.24) and IS occurrence (p = 0.51) between the 2 groups. Moreover, no significant difference was observed in time to CAS progression (p = 0.49) or IS (p = 0.31) among patients with EU and HT using and not using thyroxine supplement.Conclusion: Our results did not demonstrate significant effects of HT and thyroxine supplementation on CAS progression and IS incidence in patients with HNC after RT.
Death in hospital following ICU discharge: insights from the LUNG SAFE study
Authors: Madotto Fabiana , McNicholas Bairbre , Rezoagli Emanuele , Pham Tài , Laffey John , Bellani Giacomo 
Published: January 2021

Abstract
Background: To determine the frequency of, and factors associated with, death in hospital following ICU discharge to the ward.Methods: The Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study was an international, multicenter, prospective cohort study of patients with severe respiratory failure, conducted across 459 ICUs from 50 countries globally. This study aimed to understand the frequency and factors associated with death in hospital in patients who survived their ICU stay. We examined outcomes in the subpopulation discharged with no limitations of life sustaining treatments (‘treatment limitations’), and the subpopulations with treatment limitations.Results: 2,186 (94%) patients with no treatment limitations discharged from ICU survived, while 142 (6%) died in hospital. 118 (61%) of patients with treatment limitations survived while 77 (39%) patients died in hospital. Patients without treatment limitations that died in hospital after ICU discharge were older, more likely to have COPD, immunocompromise or chronic renal failure, less likely to have trauma as a risk factor for ARDS. Patients that died post ICU discharge were less likely to receive neuromuscular blockade, or to receive any adjunctive measure, and had a higher pre- ICU discharge non-pulmonary SOFA score. A similar pattern was seen in patients with treatment limitations that died in hospital following ICU discharge.Conclusions: A significant proportion of patients die in hospital following discharge from ICU, with higher mortality in patients with limitations of life-sustaining treatments in place. Non-survivors had higher systemic illness severity scores at ICU discharge than survivors.Trial Registration: ClinicalTrials.gov NCT02010073
Paludification reduces black spruce growth rate but does not alter tree water use efficiency in Canadian boreal forested peatlands
Authors: Beaulne Joannie , Boucher Étienne , Garneau Michelle , Magnan Gabriel 
Published: January 2021

Abstract
Background: Black spruce (Picea mariana (Mill.) BSP)-forested peatlands are widespread ecosystems in boreal North America in which peat accumulation, known as the paludification process, has been shown to induce forest growth decline. However, the ecophysiological mechanisms that lead to growth reductions in black spruce remain unexplored. Trees growing in paludified forests have to deal with continuously evolving environmental conditions (e.g., water table rise, increasing peat thickness) that may require growth mechanism adjustments over time. In this study, we investigated tree ecophysiological mechanisms along a paludification gradient in a boreal forested peatland of eastern Canada by combining peat-based and tree-ring analyses. Carbon and oxygen stable isotopes in tree rings were used to document changes in carbon assimilation rates, stomatal conductance, and water use efficiency. In addition, paleohydrological analyses were performed to evaluate the dynamical ecophysiological adjustments of black spruce trees to site-specific water table variations.Results: Increasing peat accumulation considerably impacted forest growth, but no significant differences in tree water use efficiency (iWUE) were observed between the study sites. Tree-ring isotopic analysis indicates no iWUE decrease over the last 100 years, but rather an important increase at each site up to the 1980s, before iWUE stabilized. Surprisingly, inferred basal area increments did not reflect such trends. Our results suggest that the slower growth rates observed at the most paludified sites are attributable, at least partially, to both lower carbon assimilation rates and stomatal conductance. These findings show that iWUE variations do not necessarily reflect tree ecophysiological adjustments required by changes in growing conditions. Local water table variations induced no changes in ecophysiological mechanisms, but the synchronous shift in iWUE observed at all sites in the mid-1980s suggests a tree response to regional or global factors, such as increasing atmospheric CO2 concentration.Conclusions: Our study shows that paludification induces black spruce growth decline without, however, altering tree water use efficiency in boreal forested peatlands. This is the first attempt in exploring the complex interactions between stem growth, ecophysiological mechanisms, and environmental conditions in paludified sites. Additional research on carbon allocation strategies is of utmost importance to understand the carbon sink capacity of these widespread ecosystems and better predict their response to future climate change.
Randomized Controlled Trial to Evaluate the Safety of Same-Day Discharge After Percutaneous Coronary Intervention (PCI)
Authors: gowani ambreen amir ali , Dhakam Sajid , Noor Ahmed , Iftikhar Imran , Ahmed Faisal , Tufail Mayera 
Published: January 2021

Abstract
Objective: Cardiovascular disease have a large disease burden in developing countries. Percutaneous coronary intervention (PCI) is one of the modalities used to restore the blood flow in atherosclerotic coronary vessels. The aim of this randomized controlled trial was to evaluate the safety of same-day discharge compared to overnight hospital stay after low-risk elective PCI in a tertiary care hospital in Pakistan.Results: From September 2014 to September 2015, a total of 210 patients who underwent low-risk PCI were randomized to overnight stay or same-day discharge. Primary endpoint of the study was a major adverse event, a composite of death, myocardial infarction, repeat revascularization, rehospitalization, and any access site complications (major bleeding or hematoma) after the procedure. No major adverse events were noted within 24 hours in either group. The only reported adverse event was myocardial infarction secondary to stent thrombosis on the third day after PCI in the same-day discharge group. No mortality or access site complications occurred in either group. In our cohort, same-day discharge after low-risk PCI was safe and should be considered for certain patients to eliminate the cost of an overnight hospital stay.clinical trial registry number: NCT02214082. Registered on 11th August 2014
Management of a hospital-wide vancomycin-resistant Enterococcus faecium outbreak in a Dutch general hospital, 2014-2017: successful control using a restrictive screening strategy
Authors: Weterings Veronica , Oosten Anita Van , Nieuwkoop Ellen , Nelson Jolande , Voss Andreas , Wintermans Bas , Lieshout Joris Van , Kluytmans Jan , Veenemans Jacobien 
Published: January 2021

Abstract
BackgroundThe emergence of vancomycin resistant enterococci poses a major problem in healthcare settings. Here we describe a hospital-wide outbreak of vancomycin-resistant Enterococcus faecium in a general hospital in The Netherlands in the period December 2014 – February 2017. Due to late detection of the outbreak, a large cohort of approximately 25,000 (discharged) patients was classified as ‘VRE suspected’. Hereupon a mitigated screening and isolation policy, as compared with the national guideline, was implemented to control the outbreak. MethodsAfter the outbreak was identified, a screening policy consisting of a single rectal swab culture (with enrichment broth) to discontinue isolation and removing ‘VRE suspected’ label in the electronic patient files for readmitted VRE suspected patients, was implemented. In addition to the on admission screening, periodic hospital-wide point prevalence screening, measures to improve compliance with standard infection control precautions and enhanced environmental cleaning were implemented to control the outbreak.ResultsBetween September 2014 and February 2017, 140 patients were identified to be colonised by vanA mediated vancomycin-resistant Enterococcus faecium (VREfm). Two of these patients developed bacteraemia. AFLP typing showed that the outbreak was caused by a single clone. Extensive environmental contamination was found in multiple wards. Within nine months after the detection of the outbreak no new VRE cases were detected.ConclusionWe implemented a control strategy based on targeted screening and isolation in combination with implementation of general precautions and environmental cleaning. The strategy was less stringent than the Dutch national guideline for VRE control. This strategy successfully controlled the outbreak, while it was associated with a reduction in the number of isolation days and the number of cultures taken.
Perceived walking difficulties in Parkinson’s disease – predictors and changes over time
Authors: Lindh-Rengifo Magnus , Jonasson Stina B. , Ullén Susann , Mattsson-Carlgren Niklas , Nilsson Maria H. 
Published: January 2021

Abstract
Background: People with Parkinson’s disease (PD) have described their walking difficulties as linked to activity avoidance, social isolation, reduced independence and quality of life. There is a knowledge gap regarding predictive factors of perceived walking difficulties in people with PD. Such knowledge could be useful when designing intervention studies. This study aimed to investigate how perceived walking difficulties evolve over a 3-year period in people with PD. A specific aim was to identify predictive factors of perceived walking difficulties.Methods: 148 people with PD (mean age 67.9 years) completed the Walk-12G questionnaire (which assesses perceived walking difficulties) at both baseline and the 3-year follow-up. Paired samples t-test was used for comparing baseline and follow-up mean scores. Multivariable linear regression analyses were used to identify predictive factors of perceived walking difficulties. Results: Perceived walking difficulties increased after 3 years: mean Walk-12G score 14.8 versus 18.7, p <0.001. Concerns about falling was the strongest predictor (β=0.445) of perceived walking difficulties, followed by perceived balance problems while dual tasking (β=0.268) and pain (β=0.153). Perceived balance problems while dual tasking was the strongest predictor (β=0.180) of a change in perceived walking difficulties, followed by global cognitive functioning (β=-0.107). Conclusions: Perceived walking difficulties increase over time in people with PD. Both personal factors (i.e. concerns about falling) and motor aspects (i.e. balance problems while dual tasking) seem to have a predictive role. Importantly, our study indicates that also non-motor symptoms (e.g. pain and cognitive functioning) seem to be of importance for future perceived walking difficulties. Future intervention studies that address these factors need to confirm their preventative effect on perceived walking difficulties.
Changes in PCSK 9 and Apolipoprotein B100 in Niemann-Pick Disease After Enzyme Replacement Therapy with Olipudase Alfa
Authors: Garside Bethanie , Ho Jan Hoong , Kwok See , Liu Yifen , Dhage Shaishav , Donn Rachelle , Iqbal Zohaib , Jones Simon A. , Soran Handrean 
Published: January 2021

Abstract
Background: Enzyme replacement therapy (ERT) with olipudase alfa, a recombinant human acid sphingomyelinase (rhASM), is being developed to treat patients with ASM deficiency (ASMD), commonly known as Niemann-Pick Disease (NPD) types A or B. This study assessed the effect of ERT on lipid parameters and inflammatory markers. Methods: Serum and plasma samples from five adults with NPD type B (NPD-B) who received olipudase alfa ERT for 26 weeks were analysed. We also collected fasting blood samples from fifteen age- and sex-matched participants as reference and comparison group. We measured fasting lipid profile, apolipoproteins B48 and B100 (apoB48 and apoB100), apolipoprotein A1 (apoA1), proprotein convertase subtilisin/klexin type 9 ( PCSK9) mass, oxidised low-density lipoprotein (oxLDL), small dense low-density lipoprotein cholesterol (sdLDL-C) and tumour necrosis factor α (TNF-α). Results: Patients with NPD-B, compared with age and sex matched reference group, had higher triglycerides, PCSK9, apoB48, oxLDL and TNF-α and lower high density lipoprotein cholesterol (HDL-C) and apoA1. Treatment with ERT was associated with improved lipid parameters including total cholesterol, triglycerides, low density lipoprotein cholesterol (LDL-C), sdLDL-C, oxLDL and apoB100. Though there was an increase in apoA1, HDL-C was slightly reduced. TNF-α showed a reduction. ApoB100 decreased in parallel with a decrease in total serum PCSK9 mass after ERT. Conclusion: This study demonstrated that patients with NPD-B had a proatherogenic lipid profile and higher circulating TNF-α compared to reference group. There was an improvement in dyslipidaemia after olipudase alfa. It was possible that reductions in LDL-C and apoB100 were driven by reductions in TNF-α and PCSK9 following ERT.