bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cervical Cancer Risk Factors at Haji Adam Malik General Hospital Medan 2016-2018
Authors: Fikar Siregar Muhammad Khairi Akbar , Rivany Riza 
Published: December 2021

The incidence of cervical cancer is still quite high. It is never separated from the risk factors that influence it. Some of them are sexually active, relatively young marital age, have high parity, use of contraception, and smoking can increase a woman's potential for cervical cancer. The aim of this study was to determine the characteristics of patients about the risk factors for cervical cancer in Haji Adam Malik General Hospital, Medan in 2016-2018. This research method uses descriptive observational design with cross sectional using medical record data. The results of this study using consecutive sampling techniques, took 100 samples and obtained several characteristics are age of patients, age of marriage, marriage history, number of parities, use of contraception, and smoking history. From this study it can be concluded that the characteristics of the incidence of cervical cancer in the General Hospital of Haji Adam Malik Medan in 2016-2018 are 50-59 years old, marital age ≤ 20 years old, married once, multigravida, uses injection type of hormonal contraception , and not smoking .
PENGARUH MANAJEMEN PENGETAHUAN, BUDAYA ORGANISASI DAN KETERLIBATAN KERJA TERHADAP KINERJA PEGAWAI
Authors: Patulak Lucia Evianti , Sarita Buyung , Hamid Wahyuniati 
Published: December 2021

The objectives of the study are : (1) The effect of knowledge management, organizational culture and work involvement simultaneously have effect on Employees performance at the Secretariat Office of the DPRD of Southeast Sulawesi Province; (2) the effect of partial knowledge management on Employees Performance at the Secretariat Office of the DPRD of Southeast Sulawesi Province; (3) The effect of partial organizational culture on Employees Performance at the Secretariat Office of the DPRD of Southeast Sulawesi Province; (4) The effect of partial Work involvement on Employees Performance at the Secretariat Office of the DPRD of Southeast Sulawesi Province. The research design used was quantitative research. The population of the study were all employees who worked at the Secretariat Office of the DPRD Southeast Sulawesi Province. The analysis used is quantitative analysis using Multiple Linear Regression Analysis. The results of this study found that: (1) knowledge management, organizational culture and work involvement simultaneously have positif and signifikant effect on employee performance at the Secretariat Office of the DPRD Southeast Sulawesi Province; (2) Knowledge management has positip and significant effects on Employees Performance at the Secretariat Office of the DPRD of Southeast Sulawesi Province; (3) Organizational culture has has poositip and significant on Employees Performance at the Secretariat Office of the DPRD of Southeast Sulawesi Province; (4) Work involvement has positif and significant on Employees Performance at the Secretariat Office of the DPRD of Southeast Sulawesi Province
Weather Impact on Acute Myocardial Infarction Hospital Admissions With a New Model for Prediction: A Nationwide Study
Authors: Li Chen-Yu , Wu Po-Jui , Chang Chi-Jen , Lee Chien-Ho , Chung Wen-Jung , Chen Tien-Yu , Tseng Chien-Hao , Wu Chia-Chen , Cheng Cheng-I 
Published: December 2021

Introduction: Cardiovascular disease is one of the leading causes of mortality worldwide. Acute myocardial infarction (AMI) is associated with weather change. The study aimed to investigate if weather change was among the risk factors of coronary artery disease to influence AMI occurrence in Taiwan and to generate a model to predict the probabilities of AMI in specific weather and clinical conditions.Method: This observational study utilized the National Health Insurance Research Database and daily weather reports from Taiwan Central Weather Bureau to evaluate the discharge records of patients diagnosed with AMI from various hospitals in Taiwan between January 1, 2008 and December 31, 2011. Generalized additive models (GAMs) were used to estimate the effective parameters on the trend of the AMI incidence rate with respect to the weather and health factors in the time-series data and to build a model for predicting AMI probabilities.Results: A total of 40,328 discharges were listed. The minimum temperature, maximum wind speed, and antiplatelet therapy were negatively related to the daily AMI incidence; however, a drop of 1° when the air temperature was below 15°C was associated with an increase of 1.6% of AMI incidence. By using the meaningful parameters including medical and weather factors, an estimated GAM was built. The model showed an adequate correlation in both internal and external validation.Conclusion: An increase in AMI occurrence in colder weather has been evidenced in the study, but the influence of wind speed remains uncertain. Our analysis demonstrated that the novel GAM model can predict daily onset rates of AMI in specific weather conditions.
Effects on a Nearby Bridge of Dismantling Temporary Lining During Excavation of a Shallow-Buried Rectangular Tunnel
Authors: Sheng Guilin , Wen Sen , Wu Fei , Liu Shixing , Wang Zhengzheng 
Published: December 2021

It is almost inevitable that when a tunnel is excavated in an urban area, it will pass under an existing bridge. During tunnel excavation, a temporary lining is installed and subsequently removed. However, dismantling temporary lining may affect the stability of a nearby bridge. A numerical model was created and tests were conducted on a large-scale physical model to investigate the effects of dismantling temporary lining on a nearby bridge structure. A novel method of modeling the restraining force at the top of a pier was introduced to make the model more accurate in representing the physical situation. Analysis of the results led to the following conclusions and suggestions. 1. The process of removing temporary lining can have a significant impact on surface settlement and structural deformation of the bridge. 2. The effect of removing the second half temporary lining is greater than that of removing the first half. The key range of the tunnel where this phenomenon is principally observed contains one section of tunnel ahead (i.e., in the direction of tunnel advance) of the bridge span and the two sections to the rear. 3. A 6 m–3 m–6 m mixed dismantling method is recommended for use in the key range, and a rigid cap-connection method is proposed to counteract the considerable effects of dismantling temporary lining.
Putrescine as a Novel Biomarker of Maternal Serum in First Trimester for the Prediction of Gestational Diabetes Mellitus: A Nested Case-Control Study
Authors: Liu Cheng , Wang Yuanyuan , Zheng Wei , Wang Jia , Zhang Ya , Song Wei , Wang Aili , Ma Xu , Li Guanghui 
Published: December 2021

AimsEarly identification of gestational diabetes mellitus (GDM) aims to reduce the risk of adverse maternal and perinatal outcomes. Currently, no acknowledged biomarker has proven clinically useful for the accurate prediction of GDM. In this study, we tested whether serum putrescine level changed in the first trimester and could improve the prediction of GDM.MethodsThis study is a nested case-control study conducted in Beijing Obstetrics and Gynecology Hospital. We examined serum putrescine at 8-12 weeks pregnancy in 47 women with GDM and 47 age- and body mass index (BMI)-matched normoglycaemic women. Anthropometric, clinical and laboratory variables were obtained during the same period. The receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to assess the discrimination and calibration of the prediction models.ResultsSerum putrescine in the first trimester was significantly higher in women who later developed GDM. When using putrescine alone to predict the risk of GDM, the AUC of the nomogram was 0.904 (sensitivity of 100% and specificity of 83%, 95% CI=0.832–0.976, P&lt;0.001). When combined with traditional risk factors (prepregnant BMI and fasting blood glucose), the AUC was 0.951 (sensitivity of 89.4% and specificity of 91.5%, 95% CI=0.906-0.995, P&lt;0.001).ConclusionThis study revealed that GDM women had an elevated level of serum putrescine in the first trimester. Circulating putrescine may serve as a valuable predictive biomarker for GDM.
A Low-Carbohydrate Diet Realizes Medication Withdrawal: A Possible Opportunity for Effective Glycemic Control
Authors: Han Yuxin , Cheng Bingfei , Guo Yanjun , Wang Qing , Yang Nailong , Lin Peng 
Published: December 2021

ObjectiveMultiple studies have confirmed that diet restrictions can effectively realize glycemic control and reduce metabolic risks in patients with type 2 diabetes mellitus (T2DM). In 2018, the American Diabetes Association (ADA) and European Association for the Study of Diabetes (EASD) stated that individuals can select a low-carbohydrate diet (LCD) according to their needs and preferences. Owing to the influence of Chinese traditional eating habits, only a small portion of patients in China have achieved their blood glucose goals. As a result, the Chinese government will incur huge expenditures.MethodThis study recruited 134 T2DM participants and randomly assigned them to the LCD group (n = 67) or the low-fat diet (LFD) group (n = 67). All of the patients had a fixed amount of exercise and were guided by clinicians. After a period of dietary washout, all of the patients received corresponding dietary education according to group. The follow-up time was 6 months. The indicators for anthropometry, glycemic control, and medication application parameters were collected and compared between the two groups.ResultsThere were 121 participants who finally entered the study. The proportions of calories from three major nutrients the participants consumed met the requirements of LCD and LFD. Compared with baseline, the pre-postdifferences of body weight, BMI, and several other indicators were significant except for dosages of insulin used in the LCD group and MES in the LFD group. After the intervention, body weight, body weight index (BMI), fasting blood glucose (FBG), postprandial 2-h blood glucose (PPG), and glycosylated hemoglobin (HbA1c) levels in the LCD group decreased significantly (p &lt; 0.05) compared with the LFD group. The number of patients using lipid-lowering agents was significant higher in the LCD group and lower in the LFD group. However, there was no significant difference between the two groups for antihypertensive, hormone-replacement, and other agents.ConclusionsThe LCD diet can decrease body weight, glycemic levels, MES, and lipid-lowering agents more than the LFD diet, thus decreasing cost burden in Chinese patients with T2DM. Strict diet control and monitoring are the keys to managing diabetes.
Two Novel Disease-Causing Mutations in the LDLR of Familial Hypercholesterolemia
Authors: Hu Haochang , Shu Tian , Ma Jun , Chen Ruoyu , Wang Jian , Wang Shuangshuang , Lin Shaoyi , Chen Xiaomin 
Published: December 2021

As an autosomal dominant disorder, familial hypercholesterolemia (FH) is mainly caused by pathogenic mutations in lipid metabolism-related genes. The aim of this study is to investigate the genetic mutations in FH patients and verify their pathogenicity. First of all, a pedigree investigation was conducted in one family diagnosed with FH using the Dutch Lipid Clinic Network criteria. The high-throughput sequencing was performed on three family members to explore genetic mutations. The effects of low-density lipoprotein receptor (LDLR) variants on their expression levels and activity were further validated by silico analysis and functional studies. The results revealed that LDLC levels of the proband and his daughter were abnormally elevated. The whole-exome sequencing and Sanger sequencing were used to confirm that there were two LDLR missense mutations (LDLR c.226 G &gt; C, c.1003 G &gt; T) in this family. Bioinformatic analysis (Mutationtaster) indicated that these two mutations might be disease-causing variants. In vitro experiments suggested that LDLR c.226 G &gt; C and c.1003 G &gt; T could attenuate the uptake of Dil-LDL by LDLR. In conclusion, the LDLR c.226 G &gt; C and c.1003 G &gt; T variants might be pathogenic for FH by causing uptake dysfunction of the LDLR.
Combination of Radiosensitivity Gene Signature and PD-L1 Status Predicts Clinical Outcome of Patients With Locally Advanced Head and Neck Squamous Cell Carcinoma: A Study Based on The Cancer Genome Atlas Dataset
Authors: Dai Dongjun , Guo Yinglu , Shui Yongjie , Li Jinfan , Jiang Biao , Wei Qichun 
Published: December 2021

Aim: The aim of our study was to investigate the potential predictive value of the combination of radiosensitivity gene signature and PD-L1 expression for the prognosis of locally advanced head and neck squamous cell carcinoma (HNSCC).Methods: The cohort was selected from The Cancer Genome Atlas (TCGA) and classified into the radiosensitive (RS) group and radioresistant (RR) group by a radiosensitivity-related gene signature. The cohort was also grouped as PD-L1-high or PD-L1-low based on PD-L1 mRNA expression. The least absolute shrinkage and selection operator (lasso)-based Cox model was used to select hub survival genes. An independent validation cohort was obtained from the Gene Expression Omnibus (GEO) database.Results: We selected 288 locally advanced HNSCC patients from TCGA. The Kaplan–Meier method found that the RR and PD-L1-high group had a worse survival than others (p = 0.033). The differentially expressed gene (DEG) analysis identified 553 upregulated genes and 486 downregulated genes (p &lt; 0.05, fold change &gt;2) between the RR and PD-L1-high group and others. The univariate Cox analysis of each DEG and subsequent lasso-based Cox model revealed five hub survival genes (POU4F1, IL34, HLF, CBS, and RNF165). A further hub survival gene-based risk score model was constructed, which was validated by an external cohort. We observed that a higher risk score predicted a worse prognosis (p = 0.0013). The area under the receiver operating characteristic curve (AUC) plots showed that this risk score model had good prediction value (1-year AUC = 0.684, 2-year AUC = 0.702, and 3-year AUC = 0.688). Five different deconvolution methods all showed that the B cells were lower in the RR and PD-L1-high group (p &lt; 0.05). Finally, connectivity mapping analysis showed that the histone deacetylase (HDAC) inhibitor trichostatin A might have the potential to reverse the phenotype of RR and PD-L1-high in locally advanced HNSCC (p &lt; 0.05, false discovery rate &lt;0.1).Conclusion: The combination of 31-gene signature and the PD-L1 mRNA expression had a potential predictive value for the prognosis of locally advanced HNSCC who had RT. The B cells were lower in the RR and PD-L1-high group. The identified risk gene signature of locally advanced HNSCC and the potential therapeutic drug trichostatin A for the RR and PD-L1-high group are worth being further studied in a prospective homogenous cohort.
Stabilization of the SNARE Core by Complexin-1 Facilitates Fusion Pore Expansion
Authors: Pierson Josh , Shin Yeon-Kyun 
Published: December 2021

In the neuron, neurotransmitter release is an essential function that must be both consistent and tightly regulated. The continuity of neurotransmitter release is dependent in large part on vesicle recycling. However, the protein factors that dictate the vesicle recycling pathway are elusive. Here, we use a single vesicle-to-supported bilayer fusion assay to investigate complexin-1 (cpx1)’s influence on SNARE-dependent fusion pore expansion. With total internal reflection (TIR) microscopy using a 10 kDa polymer fluorescence probe, we are able to detect the presence of large fusion pores. With cpx1, however, we observe a significant increase of the probability of the formation of large fusion pores. The domain deletion analysis reveals that the SNARE-binding core domain of cpx1 is mainly responsible for its ability to promote the fusion pore expansion. In addition, the results show that cpx1 helps the pore to expand larger, which results in faster release of the polymer probe. Thus, the results demonstrate a reciprocal relationship between event duration and the size of the fusion pore. Based on the data, a hypothetical mechanistic model can be deduced. In this mechanistic model, the cpx1 binding stabilizes the four-helix bundle structure of the SNARE core throughout the fusion pore expansion, whereby the highly curved bilayer within the fusion pore is stabilized by the SNARE pins.
Effects of High-Frequency Repetitive Transcranial Magnetic Stimulation on Upper Limb Dystonia in Patients With Wilson's Disease: A Randomized Controlled Trial
Authors: Hao Wenjie , Wei Taohua , Yang Wenming , Yang Yue , Cheng Ting , Li Xiang , Dong Wei , Jiang Hailin , Qian Nannan , Wang Han , Wang Meixia 
Published: December 2021

Background: Upper limb dystonia is a frequent complication of Wilson's disease (WD). It can lead to poor quality of life and disability. Currently, no effective treatment for it exists. Therefore, we carried out a clinical trial to determine whether high frequency repetitive transcranial magnetic stimulation (rTMS) on the primary motor cortex alleviates upper limb dystonia in WD patients.Methods: This study was a single-center, double-blind, randomized clinical study, included 60 WD patients with upper limb dystonia from a research base of WD in Hefei, China. Participants were randomly divided into a treatment group (TG) and a control group (CG). The TG received rTMS at 10 Hz, while the CG received sham stimulation for 7 consecutive days. Participants were assessed at baseline, after the seventh treatment session, and at 2 and 4 weeks after the seventh treatment session. The primary outcomes included patients' objective muscle tension and stiffness as measured with the MyotonPRO device. The secondary results were scores on clinical scales assessing muscle spasm and motor symptoms, which included the Modified Ashworth Scale (MAS), Unified Wilson's Disease Rating Scale (UWDRS), Burke Fahn Marsden Scale (BFM), and the Activities of Daily Living (ADL) scale.Results: The analysis revealed that after 10 Hz rTMS, muscle tension (P &lt; 0.01) and stiffness (P &lt; 0.01) as measured by the MyotonPRO device decreased significantly in the TG compared to the CG. Moreover, clinically relevant scale scores, including the MAS (P &lt; 0.01), UWDRS (P &lt; 0.01), BFM (P &lt; 0.01), and ADL (P &lt; 0.01) were also significantly reduced.Conclusion: High-frequency rTMS over the primary motor cortex may be an effective complementary and alternative therapy to alleviating upper limb dystonia in WD patients.Clinical Trial Registration:http://www.chictr.org.cn/, identifier: ChiCTR2100046258.
Efficacy and Safety of Docetaxel and Sodium Cantharidinate Combination vs. Either Agent Alone as Second-Line Treatment for Advanced/Metastatic NSCLC With Wild-Type or Unknown EGFR Status: An Open-Label, Randomized Controlled, Prospective, Multi-Center Phase III Trial (Cando-L1)
Authors: Wu Lin , Deng Chao , Zhang Hui , Weng Jie , Wu Youhua , Zeng Shan , Tang Tiegang , Cao Peiguo , Qiu Bo , Zhang Li , Duan Huaxin , Zhang Bing , Zhang Dong , Zhang Taotao , Hu Chunhong 
Published: December 2021

Second-line treatment options for advanced/metastatic non-small cell lung cancer (NSCLC) patients are limited. We aimed to evaluate the efficacy and safety of docetaxel/sodium cantharidinate combination vs. either agent alone as second-line treatment for advanced/metastatic NSCLC patients with wild-type or unknown EGFR status. A randomized, open-label, phase III study was performed at 12 institutions. Patients with failure of first-line platinum regimens were randomized to receive either single-agent sodium cantharivsdinate (SCA) or single-agent docetaxel (DOX) or docetaxel/sodium cantharidinate combination (CON). The primary endpoints were centrally confirmed progression-free survival (PFS) and overall survival (OS). The secondary endpoints were objective response rate (ORR), disease control rate (DCR), quality of life (QoL) and toxicity. A total of 148 patients were enrolled in our study between October 2016 and March 2020. After a median follow-up time of 8.02 months, no significant difference was observed among the three groups in ORR (SCA vs. DOX vs. CON: 6.00% vs. 8.33% vs. 10.00%, respectively; p=0.814) and DCR (74.00% vs. 52.00% vs. 62.50%, respectively; p=0.080). In additional, the mOS was significantly higher in the CON group, compared with the single-agent groups (7.27 vs. 5.03 vs. 9.83 months, respectively; p=0.035), while no significant differences were observed in terms of PFS (2.7 vs. 2.9 vs. 3.1 months, respectively; p=0.740). There was no significant difference in the baseline QoL scores between the three groups (p&gt;0.05); after treatment, life quality in SCA and CON group was significantly better than that in the DOX group (p&lt;0.05). Furthermore, the incidence of adverse events (AEs) in the SCA group was significantly lower (46.00 vs. 79.17 vs. 25.00%, respectively; p=0.038) and the incidence of grade ≥3 AEs was also significantly lower in the SCA group compared with the DOX and CON groups (10.00 vs. 82.00 vs. 30.00%, respectively; p=0.042). Single-agent SCA and single-agent DOX has similar therapeutic efficacy in the second-line treatment of advanced/metastatic NSCLC with wild-type or unknown EGFR status, but single-agent SCA has fewer AEs and better QoL. Also, SCA plus DOX can significantly improve OS and exerted a significant synergistic effect, with good safety and tolerance profile.
Does Confinement Affect Treatment Dropout Rates in Patients With Gambling Disorder? A Nine-Month Observational Study
Authors: Baenas Isabel , Etxandi Mikel , Codina Ester , Granero Roser , Fernández-Aranda Fernando , Gómez-Peña Mónica , Moragas Laura , Rivas Sandra , Potenza Marc N. , Håkansson Anders , del Pino-Gutiérrez Amparo , Mora-Maltas Bernat , Valenciano-Mendoza Eduardo , Menchón José M. , Jiménez-Murcia Susana 
Published: December 2021

Background and Aims: COVID-19 pandemic and confinement have represented a challenge for patients with gambling disorder (GD). Regarding treatment outcome, dropout may have been influenced by these adverse circumstances. The aims of this study were: (a) to analyze treatment dropout rates in patients with GD throughout two periods: during and after the lockdown and (b) to assess clinical features that could represent vulnerability factors for treatment dropout.Methods: The sample consisted of n=86 adults, mostly men (n=79, 91.9%) and with a mean age of 45years old (SD=16.85). Patients were diagnosed with GD according to DSM-5 criteria and were undergoing therapy at a Behavioral Addiction Unit when confinement started. Clinical data were collected through a semi-structured interview and protocolized psychometric assessment. A brief telephone survey related to COVID-19 concerns was also administered at the beginning of the lockdown. Dropout data were evaluated at two moments throughout a nine-month observational period (T1: during the lockdown, and T2: after the lockdown).Results: The risk of dropout during the complete observational period was R=32/86=0.372 (37.2%), the Incidence Density Rate (IDR) ratio T2/T1 being equal to 0.052/0.033=1.60 (p=0.252). Shorter treatment duration (p=0.007), lower anxiety (p=0.025), depressive symptoms (p=0.045) and lower use of adaptive coping strategies (p=0.046) characterized patients who abandoned treatment during the lockdown. Briefer duration of treatment (p=0.001) and higher employment concerns (p=0.044) were highlighted in the individuals who dropped out after the lockdown. Treatment duration was a predictor of dropout in both periods (p=0.005 and p&lt;0.001, respectively).Conclusion: The present results suggest an impact of the COVID-19 pandemic on treatment dropout among patients with GD during and after the lockdown, being treatment duration a predictor of dropout. Assessing vulnerability features in GD may help clinicians identify high-risk individuals and enhance prevention and treatment approaches in future similar situations.