bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gene Regulatory Network Analysis Defines Transcriptome Landscape with Alternative Splicing of Human Umbilical Vein Endothelial Cells during Replicative Senescence
Authors: Ohori Momoko , Nakayama Yusuke , Shimizu-Ogasawara Mari , Toyoshiba Hiroyoshi , Nakanishi Atsushi , Aparicio Samuel , Araki Shinsuke 
Published: January 2021

Abstract
BackgroundEndothelial cell senescence is the state of permanent cell cycle arrest and plays a critical role in the pathogenesis of age-related diseases. However, a comprehensive understanding of the gene regulatory network, including genome-wide alternative splicing machinery, involved in endothelial cell senescence is lacking.ResultsWe thoroughly described the transcriptome landscape of replicative senescent human umbilical vein endothelial cells. Genes showing a monotonic increase or decrease in expression with the culture period were defined as hub genes in the co-expression network. Computational network analysis of these genes led to the identification of canonical and non-canonical senescence pathways, such as MYC and SIRT2 signaling, which were down-regulated in metabolism and chromosome organization processes pathways. Additionally, we showed that endothelial cell senescence involves alternative splicing. Importantly, the first and last exon types of splicing, as observed in FLT1 and ACACA, were preferentially altered among the alternatively spliced genes during endothelial senescence. We further identified novel microexons in PRUNE2 and PSAP, each containing 9 nt, which were altered within the specific domain during endothelial senescence.ConclusionsThese findings unveil the comprehensive transcriptome pathway and novel signaling regulated by RNA processing, including gene expression and splicing, in replicative endothelial senescence.
Determinants of Oral Health Behaviour Among Community Health Workers in Kottayam- A Cross-Sectional Study
Authors: P Najmunnisa K , Thomas Susan Thomas , Gomez Mary Shimi S , James Jesline Merly , Narayan Vivek 
Published: January 2021

Abstract
BackgroundBeliefs and attitudes of community health workers affect their oral health behaviour and knowledge which in turn affects their potential to motivate the public to undertake preventive oral health measures. This study was performed to assess knowledge, attitude, and practices as well as determinants of oral health behaviour among community health workers in rural regions of Kerala.MethodsA cross-sectional study was conducted among 123 community healthcare workers at primary health centres in the Ettumanoor block zone, Kottayam. A two-stage cluster sampling method was used. Data regarding knowledge, attitude, and practice of oral health were acquired through self-administered questionnaires and analyzed using SPSS software version 25. Statistical association between responses in different group of health workers were determined by using Chi-square test. Independent t-test and ANOVA were used to test the difference in attitude and knowledge scores. Bivariate and multivariate regression analyses were applied to identify factors associated with the oral health behaviour of community health workers.ResultsAbout 65% of the participants exhibited poor oral health behaviour. A positive attitude has a significant relation with oral health behaviour status of the participants (p=0.003). Community health workers who attended an oral health education program had a better oral health behaviour status when compared to those who had not attended (p=0.006). Conclusions﻿The results emphasize that oral health education should be given to all the community health workers to enhance their awareness about preventive oral health care.
Appendicitis During the COVID-19 Pandemic: Lessons Learnt From a District General Hospital
Authors: Pringle Heather Caroline Mitchell , Donigiewicz Urszula , Bennett Melissa-Rose , Walker Eleanor , Fowler George , Narang Sunil , Ball Susan , Bethune Robert Mackenzie 
Published: January 2021

Abstract
BackgroundThe COVID-19 pandemic dramatically influenced the delivery of healthcare. In line with the UK Royal Colleges’ advice the management of acute appendicitis (AA) changed with greater consideration for non-operative management (NOM) or open appendicectomy when operative management (OM) was sought. We describe our experience of the presentation, management and outcomes for these patients to inform care for future viral pandemics. MethodsThis retrospective, cohort study compared patients diagnosed with AA between March and July 2019 with those during the pandemic period of March to July 2020. Medical records were reviewed to obtain demographics, inflammatory markers, imaging, severity, management, histology, length of stay (LOS) and 90-day outcomes. ResultsThere were 149 and 125 patients in the 2019 and 2020 cohorts respectively. 14 patients (9.4%) had NOM in 2019 versus 31 (24.8%) in 2020 (p = 0.001). In the 2019 operative management (OM) group 125 patients (92.6%) had laparoscopic appendicectomy versus 65 (69.1%) in 2020. 59 patients (39.6%) had a CT in 2019 versus 70 (56%) in 2020. The median LOS was 4 days in 2019 and 3 days in 2020 (p=0.03). Two patients in each year who received NOM had treatment failure (14.3% in 2019 and 6.5% in 2020). Three patients in 2019 who received OM had treatment failure (2.2%). Of 95 patients tested for COVID-19 all but one tested negative.ConclusionDuring the COVID-19 pandemic there was no observed increase in severity of AA, patients had a shorter LOS and were more likely to have imaging. NOM proportionally increased with no observed change in outcomes.
Coagulation Phenotypes in Sepsis and Effects of Recombinant Human Thrombomodulin: An Analysis of Three Multicenter Observational Studies
Authors: Kudo Daisuke , Goto Tadahiro , Uchimido Ryo , Hayakawa Mineji , Yamakawa Kazuma , Abe Toshikazu , Shiraishi Atsushi , Kushimoto Shigeki 
Published: January 2021

Abstract
Background: A recent randomized trial showed that recombinant thrombomodulin did not benefit patients who had sepsis with coagulopathy and organ dysfunction, suggesting that the effects of thrombomodulin are heterogeneous across sepsis phenotypes. We examined the latent phenotypes of sepsis with coagulopathy and the associations between thrombomodulin treatment and 28-day and in-hospital mortality for each phenotype.Methods: This was a secondary analysis of multicenter registries containing data on adult patients (aged ≥16 years) who were admitted to intensive care units for severe sepsis or septic shock in Japan. Three multicenter registries were divided into derivation (two registries) and validation (one registry) cohorts. Phenotypes were derived using k-means with coagulation markers, platelet counts, prothrombin time/international normalized ratios, fibrinogen, fibrinogen/fibrin-degradation-products (FDP), D-dimer, and antithrombin activities. Associations between thrombomodulin treatment and survival outcomes (28-day and in-hospital mortality) were assessed in derived clusters using a generalized estimating equation.Results: Four sepsis phenotypes were derived from 3,694 patients in the derivation cohort. Cluster dA (n = 323) had severe coagulopathy with high FDP and D-dimer levels, severe organ dysfunction, and high mortality. Cluster dB had severe disease with moderate coagulopathy. Clusters dC and dD had moderate and mild disease with and without coagulopathy, respectively. Thrombomodulin was associated with a lower 28-day (adjusted risk difference [RD]: −17.8% [95% CI −28.7% to −6.9%]) and in-hospital (adjusted RD: −17.7% [95% CI −27.6 to −7.8%]) mortality only in cluster dA. Sepsis phenotypes were similar in the validation cohort, and thrombomodulin treatment was also associated with lower 28-day (RD: −24.9% [95%CI ­−49.1% to −0.7%]) and in-hospital mortality (RD: −30.9% [95%CI ­−55.3 to −6.6%]).Conclusions: We identified four coagulation marker-based sepsis phenotypes. The treatment effects of thrombomodulin varied across sepsis phenotypes. This finding will facilitate future trials of thrombomodulin, in which a sepsis phenotype with high FDP and D-dimer can be targeted.
Adrenocortical Adenoma With Myelolipomatous Metaplasia as a Diagnostic Pitfall: A Case Report and Review of the Literature
Authors: Anbardar Mohammad Hossein , Soleimani Neda , Nikeghbalian Saman , Mohebbi Maryam 
Published: January 2021

Abstract
BackgroundAdrenal incidentalomas are often found during investigation for another tumor or unrelated problems. Except for adrenal myelolipoma (second most common primary adrenal incidentaloma following adrenocortical adenomas), adrenal lipomatous tumors are uncommon generally and are often described as case reports in the literature. Since the amount of fat is variable, without the help of advanced imaging techniques, some adrenal lipomatous tumors may be misdiagnosed before pathologic examination. Herein, we report a case of adrenal adenoma with myelolipomatous metaplasia which was excised as a periceliac mass in the setting of recurrent pancreatic cyst.Case reportA 45-year-old woman with hypertension and end stage renal disease presented with recurrence of a pancreatic cyst (previous pathologic report was mucinous cyst adenoma). During exploratory laparatomy, the mentioned pancreatic cyst was tightly attached to the stomach and jejunum. There was also a periceliac round rubbery lesion(firstly diagnosed by endoscopic ultrasound) which was excised for ruling out malignancy. Histologic examination of the periceliac mass was found to be adrenocortical adenoma with foci of myelolipomatous metaplasia. The pancreatic cyst histology was just a pseudocyst.ConclusionOur case highlights the significance of complete evaluation of incidental findings before surgical intervention, even in the setting of another primary tumor. Myelolipoma and myelolipomatous change (metaplasia) are two different entities. Although very similar as to pathogenesis, there are still some differences.
Primary Giant Cell Tumor of the Axis: a Case Report
Authors: Wang Peng , Song Chunhao , Chen Cong , Liu Bo , Jia Jun , Chu Xiangquan 
Published: January 2021

Abstract
Background: Primary giant cell tumor of the axis is a rare. The authors reported a case of a primary giant cell tumor of the axis revealed by cervical pain, and discussed the diagnosis and treatment of giant cell tumor.Case presentation: The patient presented to our clinic with neck pain and unstable gait. X-ray, computed tomography and magnetic resonance imaging showed osteolysis of the body and vertebral arch of the axis. Histologic evaluation gave a conclusion of a giant tumor, grade II. Spondylectomy of the axis was performed by the transoral approach. The local recurrence of the tumor was found 3 months later and the patient refused further therapy.Conclusion: Primary giant cell tumor of the axis is a rare type tumor with poor prognosis. Definitive diagnosis should be based on histopathological morphology and surgical treatment should be performed as soon as possible.
Ipsilateral Synchronous Papillary and Clear Cell Renal Cell Carcinoma: a Case Report and Literature Review
Authors: Yin Jing , Li Baojiang , Zheng Mo 
Published: January 2021

Abstract
Background: The rare disease of ipsilateral synchronous papillary and clear cell renal cell carcinoma was often misdiagnosed as a single tumor with intra-renal metastasis or some other diseases preoperatively. Both of the effective management and long overall survival might be affected as the different prognosis of the two kinds of tumors. Here, we report a case of ipsilateral synchronous papillary and clear cell renal cell carcinoma, and present the clinicopathological features as well as review the literature in China.Case presentation: A 70-year-old man presented with a single mass in the left renal revealed either by ultrasound or CT during a routine physical examination. The tumor was occurred as two isolated masses in the gross finding. Hematoxylin and eosin staining and immunohistochemistry were performed. Papillary cell carcinoma and clear cell renal cell carcinoma were the compositions of the tumors. Immunostainings were as follows: The papillary renal cell carcinoma showed positive for CK7, P504s, Pax8,Vimentin, and scatterly for CD10, the proliferation rates of Ki67 was just 3%; While the clear cell renal cell carcinoma was positive for Pax8,CAIX,Vimentin, and diffusely for CD10, but negative for CK7 and P504s, the Ki67 proliferation rates was 5%. The patient was diagnosed with ipsilateral synchronous papillary and clear cell renal cell carcinoma, and free from the disease 9 months after surgery.Conclusions: Ipsilateral synchronous papillary and clear cell renal cell carcinoma is a rare condition without specific clinical manifestations. The understanding of the computed tomography features and increasing the awareness or experience of the disease may be helpful to improve the preoperative diagnosis accuracy. Precise diagnosis should be based on histopathological morphology and immunostaining. As the different prognosis of the two tumors, optimal surgical treatment should be performed to prolong the survival time.
Sister Mary Joseph Nodules: A Case Report About a Rare Location of Skin Metastasis
Authors: Leyrat Brice , Bernadach Maureen , Ginzac Angeline , Lusho Sejdi , Durando Xavier 
Published: January 2021

Abstract
BackgroundUmbilical skin metastases (or Sister Mary Joseph nodules) are rare. Their presence typically indicates the late manifestation of deep-seated abdominopelvic malignancy. They occur mainly in gynecological cancers, and gastro-intestinal cancers in men. The most common histology is adenocarcinoma (~ 75% of cases), but it can also rarely be squamous cell or undifferentiated carcinoma. These metastases can be present at diagnosis or appear at disease recurrence, and are associated with a very poor prognosis with an average survival of 11 months.Case presentationWe report the clinical case of a 58-year-old man with metastatic pancreatic adenocarcinoma and umbilical cutaneous metastasis after receiving first-line chemotherapy. The diagnosis was established upon liver biopsy in July 2019, after the patient presented with complaint of transfixiant abdominal pain. The first-line treatment consisted of six cycles of modified FOLFIRINOX chemotherapy. However, in November 2019, computed tomography (CT) scan showed disease progression. Second-line treatment with gemcitabine (brand name: Gemzar) led to a 16% decrease of target lesions. During the fourth cycle, three periumbilical indurated nodules appeared. After six cycles, skin infiltration had increased and the patient reported his abdominal pain had intensified. Reassessment by CT scan showed an increase in both hepatic and peritoneal disease progression. Third-line treatment with FOLFIRI, started on April 15, 2020, was not able to control the disease, leading to greater induration and subcutaneous infiltration, which were responsible for the increased pain and ultimate death.ConclusionUmbilical skin metastases are rare and they are associated with advanced metastatic disease and a very poor prognosis. Cases reporting Sister Mary Joseph nodules are needed to better understand the conditions and mechanisms of their appearance and dissemination.
A novel estimator of survival without assumption of censored survival time
Authors: Chen Shee-Ping 
Published: January 2021

Abstract
The Kaplan-Meier estimator is commonly used to analyze time-to-event data, but it may over estimate the survival function when censored events occur. Several methods have been developed to adjust the traditional Kaplan-Meier estimator. Most of these adjusted methods are based on their assumptions for survival time of censored events. We here propose a novel estimator of survival without assumption of censored survival time, and it gives sensible estimates of survival probabilities in various censoring conditions.
Vertical Profiles of Microbial Trace Element Utilization in Marine Environments
Authors: Xu Yinzhen , Liu Qiong , Zhang Yan 
Published: January 2021

Abstract
Background: Biological trace elements are used in small amounts but are required for all living organisms. They are key components of many proteins and enzymes involved in important biological processes. Many trace element-dependent proteins have been characterized in various microbes, but very little is known about their occurrence, functions, and interactions in microbial communities in marine environments, especially in depth-related marine ecosystems. Results: In this study, by analyzing metagenomic data from different geographic locations and water depths in the oceans around the world, we identified the distribution of genes encoding trace element-dependent proteins (for copper, molybdenum, tungsten, cobalt, nickel, and selenium) in a variety of marine samples from the upper ocean to the deep sea, which demonstrates vertical patterns of trace element utilization in marine microbes. More than 63,000 metalloprotein and selenoprotein genes belonging to nearly 100 families were predicted, constituting the largest environmental metalloprotein and selenoprotein gene dataset reported so far. Further examination of the interactions among trace elements revealed significant correlations between some of them (especially molybdenum or tungsten and selenium) and more active elemental crosstalk in the epipelagic zone of the ocean. Comparison of the patterns of trace element utilization across samples suggested that additional unknown factors might play a more important role in shaping trace element utilization in marine microbes living in certain locations. Finally, analysis of the relationship between water depth and metalloprotein/selenoprotein families revealed that the evolution of approximately half of the metalloprotein and selenoprotein families in marine microbial world could be influenced by ocean depth at either the global or the local level. Conclusions: Our findings provide new insights into the utilization and functions of trace elements in marine microbes along a vertical gradient across the ocean.
Development and Psychometric Testing of Quality Nursing Care Scale in Public Hospital Settings in Mongolia
Authors: Tsogbadrakh Basbish , Kunaviktikul Wipada , Akkadechanunt Thitinut , Wichaikhum Orn-Anong , Gaalan Khulan , Badamdorj Oyungoo , Stark Azadeh 
Published: January 2021

Abstract
Background: Quality Nursing Care (QNC) is fundamental to the profession of nursing practice. Perception of QNC differ across the globe because of differences in social norms, cultural values and political ambiance and economy. This study aimed to develop a QNC instrument congruent with the Mongolian (QNCS-M) healthcare system and cultural values and societal norms. Methods: We implemented sequential exploratory mixed-method study to develop and assess performance of QNCS-M. First, we focused on developing the components of QNCS-M and their operational definitions. The field testing consisted of assessing the construct validity and internal consistency reliability. Correlation between QNCS-M and the criterion tool, Quality of Nursing Care Questionnaire-Registered Nurse was evaluated. Inter-item correlation was examined by Spearman rank-order correlation. The internal consistency reliability was analyzed using Cronbach’s α. ANCOVA statistical technique was used to discern social desirability and the interaction between scores of each item and MSCDS. Results: The initial version of QNCS-M contained 66 items of which 7 were deleted after content validity assessment. The total-item correlation analysis yielded to exclusion of another 3 items. Additional 12 items were excluded after inter-item correlation. Results from ANCOVA analysis of the remaining 44 items indicated interaction between social desirability and 6 items. These items were excluded. A total of 38 items remained for exploratory factor analysis. Results from exploratory factor analysis yielded eigenvalues > 1.0 for the 9 domains. Three domains contained items fewer than 3. These domains and 2 items were eliminated, yielding to 6 domains with 36-item. Results from internal consistency reliability yielded an overall Cronbach’s α=.92; the coefficient values for the 6 domains ranging between .72 and .85. Results from test-retest reliability yielded an acceptable performance consistency (Cronbach’s α= .93). Conclusion: Improving the quality of healthcare services delivered by nurses is a priority for the Mongolian government. The development of QNCS-M is a major stride in addressing this concern. The final version of QNCS-M which contains 36 items, loaded into 6 domains, was morphed to the specifics of the Mongolian healthcare systems and cultural values and societal norms. QNCS-M demonstrates a high level of content and construct validity with acceptable reliability.
Stoma Location and Ostomy-Related Quality of Life Among Cancer Survivors with Ostomies: A Pooled Analysis
Authors: Mo Julia , Sun Virginia , Hornbrook Mark C. , Grant Marcia , Ercolano Elizabeth , Malkowicz S. Bruce , Tallman Nancy J. , McCorkle Ruth C. , Krouse Robert S. 
Published: January 2021

Abstract
INTRODUCTION

Ostomies have substantial impacts on many aspects of cancer survivors’ daily lives. We sought to describe how stoma location may affect clothing style, ostomy appliance leakage, skin irritation around the stoma, weight changes after ostomy surgery, and health-related quality of life (HRQOL).

METHODS

A pooled dataset was obtained from three multi-site studies that had used the modified City of Hope Quality of Life-Ostomy questionnaire to measure HRQOL and ostomy-specific concerns in cancer survivors with ostomies. Questions pertaining to stoma location, clothing issues, weight change since ostomy surgery, and HRQOL were analyzed. Ostomy bag change frequency was assessed in two of the three studies. Respondents were categorized by self-reported stoma location quadrant: lower left side, upper left side, lower right side, or upper right side. Predicted means for HRQOL and individual items were generated for every stoma location, adjusting for sex, ostomy type (fecal or urinary), and body mass index (BMI).

RESULTS

Of 607 cancer survivors included in this analysis, abdominal quadrant ostomy groups were: 138 (23%) upper left, 298 (49%) lower left, 51 (8%) upper right, and 120 (20%) lower right. The majority of participants (>50%) reported changing their clothing styles due to their ostomies. Cancer survivors with ostomies on the lower right side had significantly more weight gain after ostomy surgery (p=0.02) and reported more frequent ostomy bag changes or emptying over a 24-hour period. Overall HRQOL did not vary by stoma location, with predicted means of 6.90 to 7.18 (out of 10). Survivors with ostomies on the right half of the abdomen reported statistically significantly different QOL scores spiritual well-being (p=0.031), sleep disruptions (p=0.03), satisfaction with appearance (p<0.001) and interference with social activities (p=0.005) compared to survivors with ostomies on the left half of the abdomen.

DISCUSSION

Stoma location is associated with HRQOL, ostomy bag usage, and difficulties related to adjusting to the ostomy, which may affect long-term survivorship and QOL. Moreover, even after controlling for ostomy type, there were sustained significant differences in ostomy-related QOL associated with stoma location. Our results indicate that stoma location should be considered when designing interventions for cancer survivors with ostomies.