bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quintuplet Pregnancy Following Transfer of Three Embryos. A Case Report.
Authors: Abusheikha Aya Naim , Abusheikha Naim A. , Khatib Aseil E. 
Published: January 2021

Abstract
Background: This is a rare case of a quintuplet pregnancy of two sets of monozygotic twins (MZT) co-existing with a singleton pregnancy resulting from transfer of three cleaved embryos. This has not been reported previously in humans, and should be kept in mind when replacing multiple embryos using in vitro fertilization.Case Presentation: A 27 year old female had a successful twin livebirth after fetal reduction of unexpected quintuplet pregnancy following transfer of three embryos To ameliorate the adverse implications of multiple gestation, fetal reduction to twins by intracardiac puncture and aspiration was carried out at 11 weeks’ gestation. The patient has now delivered two healthy babies (a boy and a girl) at 35 weeks and 6 days by a lower segment caesarean section. Conclusion: Clinicians should keep in mind that patients undergoing assisted conception may develop monozygotic twinning of the embryos, which may negatively impact the pregnancy and raise an ethical and psychological dilemma for the patient.
The Factors Affecting the Baker Cyst Volume, Emphasis on Cartilage Lesion Degree and Effusion in a Young and Middle-Aged Population
Authors: Saylik Murat , Gokkus Kemal , Sahin Mehmet Sukru 
Published: January 2021

Abstract
Background: The principal aim of this study was to investigate the presence of factors affecting the Baker’s cyst volume in a young and middle-aged population.Methods: 85 patients were treated with open cyst excision with valve and capsule repair, with knee arthroscopy. The cases were categorized in terms of age, effusion, chondral lesion degree, meniscal tear degree, and Lindgren scores. The USG device was used to calculate cyst volume. The IBM-SPSS 22 program was used for the statistical analysis and to assess the relationship between variables using the Spearman correlation tests.Results: The degree of the chondral lesion was moderately and positively correlated with cyst volume in the total population. (Correlation coefficient: 0.469, p<0.05).The degree of the chondral lesion was moderately and positively correlated with the effusion degree of effusion (correlation coefficient: 0.492, p <0.005). The cyst volume was weakly and positively correlated with the degree of effusion. (Correlation coefficient: 0.20, the correlation was at the limits of statistical significance p=0,07<0,08).Conclusion: This study revealed that an increase in chondral lesion severity particularly increases the amount of effusion and cyst volume.
Knee Joint Rotation Axis Is More Laterally Rotated and Valgus Than We Previously Thought
Authors: Zheng Liwen , Song Deye , Luo Yongheng , Wang Wanchun , Mao Xinzhan , Wang Lei 
Published: January 2021

Abstract
Background: Currently, the patient satisfaction rate after receiving TKA is around 80% to 90% and there is still room for further improvement. With the aim to provide reference for improving TKA surgery, stereophotogrammetry was used in this study to evaluate knee joint kinematics.Methods: Multiple MRI images of knee joints flexed at 0, 10, 20... to 100 degrees were scanned in bilateral knees of 45 asymptomatic adult volunteers. After three-dimensional alignment of the femur, the displacement and rotation angles of the tibia flexed at different angles were measured. Contributing factors were tested using One-way ANOVA and chi-square test in SPSS 24.Results: 1)No contributing factors was found to influence rotation axis; 2) Within the range of motion at 0-100° of flexion, the rotation axis exhibited no significant displacement relative to the femur. 3) On the horizontal plane, the lateral rotation angle of knee joint axis was 4.91°±1.84°(3°~7°) relative to transepicondylar axis (TEA) and 7.84°±2.09° relative to posterior condylar axis (PCA); on the coronal plane, the valgus angle of knee joint axis was 3.38°±0.82°(2.5°~5°) relative to tibial plateau, and 6.53°±0.91°(5°~8°) relative to the perpendicular line of the lower limb force line. Conclusion: No contributing factors were found, but the rotation axis of the knee joint is more laterally rotated and valgus than previously thought. These findings may explain the research result of some current literatures, and may provide theoretical rationale for further improvement of knee prosthesis design.
Effect of Dietary Amylose/amylopectin Ratio on Antioxidant Ability and Amino Acid Metabolism of Liver in Weaned Pigs Challenged with Lipopolysaccharide
Authors: yang can , wang min , tang xiaowu , yang huansheng , li fengna , wang yancan , li jianzhong , yin yulong 
Published: January 2021

Abstract
Background: Antioxidant function could be regulated by resistant starch supplementation in rats with kidney disease. It is controversial whether antioxidant ability could be regulated by changing dietary amylose/amylopectin ratio (DAR) when weaned piglets under lipopolysaccharide (LPS) stress.Methods: Sixty male weaned piglets (Duroc × Landrace × Yorkshire, 21 day old, 6.51 ± 0.64 kg) were allotted to 5 dietary treatments with 12 cages per treatment, and fed ad libitum with diets different in DAR (0.00, 0.20, 0.40, 0.60 and 0.80). Feed transformation happened at day 15. On day 29, 12 h before slaughter, pigs were intraperitoneal injected with 100 μg/kg body weight LPS or sterile saline. Results: Results showed that LPS stress caused increase in serum urea nitrogen and glucose concentration (P < 0.05). Serum immunoglobulin G concentration increased after LPS stress in diet 0.80 but decreased in other groups (P<0.05). Serum serine concentrations decreased after LPS stress in diets 0.20 and 0.80 but increased in other groups (P<0.05). All tested hepatic amino acids (AA) increased after LPS stress (P<0.05) but hepatic isoleucine, leucine, threonine, aspartate, serine, glutamate, glycine concentrations decreased after LPS stress in diet 0.20 (P<0.05). Piglets supplemented diet with DAR 0.00 had highest superoxide dismutase (SOD1), nuclear factor 2 (Nrf2) and glutathione peroxidase 1 (GPX1) mRNA expression in liver (P<0.05). Total superoxide dismutase (T-SOD) activity of liver increased in diet 0.00 and 0.80 but decreased in diet 0.40 (P<0.05). Total antioxidant capacity (T-AOC) activity of longissimus dorsi muscle (LM) increased in diets 0.20 and 0.80 but decreased in diet 0.40 (P<0.05). Piglets in diet 0.20 had the highest hepatic glutathione peroxidase activity compared with groups 0.40, 0.60,0.80 (P<0.05). Mn concentration of LM and hepatic Cu decreased after LPS stress in diet 0.20 but increased in diet 0.80 (P<0.05). Piglets in diet 0.80 had the highest hepatic Cu, Fe, Mn, Zn concentrations (P<0.05). Cecal indol(e) concentration was higher in diet 0.00 than in diet 0.80 (P<0.05).Conclusions: Antioxidant ability could be improved by feeding diet with low or high amylose/amylopectin ratio when weaned piglets suffered LPS stress.
Bioinformatics-based Screening of Key Genes for Saponin Metabolism in Quinoa
Authors: Guo Chengang , wei Zhimin , Lyu Wei , Geng Yanlou 
Published: January 2021

Abstract
Quinoa saponins have complex, diverse and evident physiologic activities. However, the key regulatory genes for quinoa saponin metabolism are not yet well studied. The purpose of this study was to explore genes closely related to quinoa saponin metabolism. In this study, the significantly differentially expressed genes in yellow quinoa were firstly screened based on RNA-seq technology. Then, the key genes for saponin metabolism were selected by gene set enrichment analysis (GSEA) and principal component analysis (PCA) statistical methods. Finally, the specificity of the key genes was verified by hierarchical clustering. The results of differential analysis showed that 1654 differentially expressed genes were achieved after pseudogenes deletion. Therein, there were 142 long non-coding genes and 1512 protein-coding genes. Based on GSEA analysis, 116 key candidate genes were found to be significantly correlated with quinoa saponin metabolism. Through PCA dimension reduction analysis, 57 key genes were finally obtained. Hierarchical cluster analysis further demonstrated that these key genes can clearly separate the four groups of samples. The present results could provide references for the breeding of sweet quinoa and would be helpful for the rational utilization of quinoa saponins.
MEOX2 Serves as a Novel Biomarker Associated with Macrophage Infiltration in Esophageal Squamous Cell Carcinoma
Authors: wang zhen , yang han , zhang rusi , luo bin , xu bingchen , zhu zhihua , lin peng 
Published: January 2021

Abstract
BackgroundEsophageal squamous cell carcinoma (ESCC) is a kind of digestive system malignant tumor with high morbidity and mortality worldwide. With the rise of immunotherapy applied in cancer treatment, immune-related mechanisms in ESCC and other digestive system carcinomas are in urgent need of being detected.MethodsIn our study, single-sample gene set enrichment analysis (ssGSEA) was performed at first to analyze the expression profile downloaded from NCBI Gene Expression Omnibus (GEO) database. Then via a series of bioinformatic analyses, including Mann-Whitney test, weighted gene co-expression network analysis (WGCNA), functional enrichment analysis and differentially expressed genes (DEGs) analysis, we identified targeting immunocyte and related genes. Finally, we validated the results in TIMER database.ResultsOur analyses showed that macrophage infiltrating level is obviously higher in advanced stages in ESCC compared with other types of immunocytes. MEOX2 was detected as a biomarker correlated with macrophage infiltration in ESCC and other types of digestive system carcinomas. And MEOX2 expression was strongly associated with mRNA expression of colony-stimulating factor 1 (CSF-1) and CSF-1 receptor (CSF-1R) in these kinds of carcinomas. ConclusionWe speculated that MEOX2 could facilitate macrophage infiltration via CSF-1/CSF-1R signaling in ESCC and other kinds of digestive system carcinomas, which might serve as a novel target in prospective tumor immunotherapy.
A Comprehensive Bioinformatic Analysis of RFC1/2/3/4/5 As Significant Clinical Indicators in The Diagnosis and Prognosis of Low-Grade Glioma
Authors: Wang Yuefeng , Huo Liyun , Ke Zunfu 
Published: January 2021

Abstract
Background: Replication factor C (RFC) proteins play a very important role in nuclear DNA replication, mismatch repair and cell cycle checkpoint pathways. However, the relationship between RFCs and brain tumors is still unclear, especially the diagnostic and prognostic significance of RFCs in low-grade glioma. Methods: In our study, we applied the Oncomine, GEPIA, Human Protein Atlas, cBioPortal, STRING, LinkedOmics and Tumor Immune Estimation Resource (TIMER) databases to analyze the transcriptional and survival data of RFCs in brain and central nervous system (CNS) cancer, especially in low-grade glioma.Results: We found that RFCs were highly expressed in brain and CNS cancer, including low-grade glioma. The transcriptional levels of RFCs were also associated with the tumor stages. Moreover, the survival analysis of RFCs in low-grade glioma patients revealed that enhanced expression of RFCs led to poorer prognosis. RFCs and their 50 frequently altered neighbor genes were found enriched in certain pathways. We also discovered the kinase targets, transcription factor targets and miRNA targets of RFCs in low-grade glioma. RFCs also showed positive correlation with certain infiltrated immune cells in low-grade glioma.Conclusions: These implied that RFCs are the possible biomarkers of the diagnosis and prognosis of low-grade glioma.
Multi Omics Profiling and Clustering Low Grade Glioma Based on Integrated Stress Status
Authors: Ren Xiaolin , Chen Xin , Zhu Chen , Wu Anhua 
Published: January 2021

Abstract
Background: Although the prognosis of low-grade glioma (LGG) is better than that of glioblastoma (GBM), there are still some patients who will develop into high-grade glioma. Integrated stress response contributed to the malignant transformation of tumor. As there is few research focus on the integrated stress status in LGG, it is urgent to profile and re-classify LGG based on integrated stress response (ISR). Methods: Glioma patients were obtained from the Chinese Glioma Genome Atlas ( the Cancer Genome Atlas (TCGA) and GSE16011 cohorts. Statistical 8 analyses were conducted by GraphPad Prism and R language. Results: We quantified four types of integrated stress response respectively. The relationship between the four stress states and the clinical characteristics of LGG was analyzed. Then we re-classified the patients based on these four scores, we found that cluster 1 had the worst prognosis, whereby cluster 3 had the best prognosis. We also established an accurate ISR risk signature to predicting cluster 1. We found that immune response and suppressive immune cell components were more enriched in the high-risk group. We also profiled the genomic difference between low and high risk groups, including the non-missense mutation of drivel genes and the condition of copy number variation (CNV). Conclusion: LGG patients could be divided into four clusters based on the integrated stress status, cluster 1 exhibited malignant transformation trends. ISR signature could reflect the traits of cluster 1 well, high ISR score indicated worse prognosis and enriched inhibitory immune microenvironments.
Chinese Herbal Tanshinol Prevents Osteoporosis via Coordinately Promoting Osteogenesis and Inhibiting Osteoclastogenesis
Authors: wu tailin , wang jianchao , luo jianzhou , lin haitao , wang fei , wei yanzhe , duan chunguang , tao huiren 
Published: January 2021

Abstract
Background: Osteoporosis severely affects patients’ life quality due to increased risks of fragility fractures. Tanshinol is a primary water-soluble compound purified from the Chinese herb Salvia Miltiorrhiza, which exhibits potent antioxidant and anti-inflammatory properties. However, whether Tanshinol functions in preventing and protecting osteoporosis remains unknown. Thus, current study proposed to systematically investigate the protective effects and the underlying mechanisms of Tanshinol in bone marrow mesenchymal stem cells (BM-MSCs) and ovariectomized (OVX) mice model. Materials and methods: Different concentrations of Tanshinol were given to induce differentiation of BM-MSCs respectively, and detected the expression of key markers of osteoclast and osteogenesis. The C57BL/6 mice were divided into control group, model group, low (80 mg/kg×day, i.g), medium (160 mg/kg×day, i.g) and high (240 mg/kg×day, i.g) concentrations Tanshinol groups. After 6 weeks treatment of Tanshinol, mice distal femurs were taken to measure bone mineral density (BMD) and three dimension parameters.Results: In the present study, we for the first time showed that Tanshinol could promote osteogenesis in the mouse BM-MSCs, as seen from the increase of the osteogenic markers such as ALP activity and collagen I. Meanwhile, Tanshinol inhibited the RANKL induced osteoclastogenesis in the bone marrow monocytes (BMMs). Animal studies showed that oral delivery of Tanshinol could attenuate in ovariectomy induced osteoporosis. Molecularly, Tanshinol activated Wnt signal pathway in MSCs while inhibited Akt in BMMs, suggesting these pathways might be involved in the osteoporosis protective role of Tanshinol. Conclusions: our study has revealed a potential application of Salvia miltiorrhiza derivative Tanshinol in the treatment of osteoporosis.
Wei Chang an Pill Alleviates TNBS-induced Ulcerative Colitis Through Inhibition of EMTProcess
Authors: Qi Yaxin , Chai Lijuan , Zhang Min , Jia Sitong , Wang Lin , Wang Yujing , Song Jixiang , Sun Yingjie , Wang Yi , Miao Lin , Zhang Han 
Published: January 2021

Abstract
Background: Wei Chang An pill (WCA) is a traditional Chinese pharmaceutical preparation which has been widely used to treat various gastrointestinal diseases including Ulcerative colitis (UC). The aim of our study was investigate the inhibitory effect and mechanism of WCA in the treatment of 2,4,6-trinitro-benzenesulfonic acid (TNBS)-induced UC in rats.Methods: We established the TNBS-induced UC model and then WCA was administrated orally for one week. Body weight, colon lengths, Disease Activity Index (DAI) score and Colon Mucosa Damage Index (CMDI) score were recorded. The expression of cytokines factors in LPS-stimulated THP-1 cells was recorded to evaluate the anti-inflammatory effects of WCA and its herb active ingredients. Immunohistochemistry and immunofluorescence were used to evaluate the Epithelial-Mesenchymal Transition (EMT) process in UC rats and Caco-2 cells which were induced by LPS-stimulated THP-1 cells uponWCA treatment.Results: WCA significantly decreased the body weight loss, higher DAI and CMDI score, colon length shortening and histological damage in UC rats. Furthermore, both of the activities of myeloperoxidase dismutase (MPO) and the mRNA expressions of cytokine in UC tissues were significantly inhibited. In THP-1 cells, the mRNA expressions of IP-10, TNF-α, IL-6 and IkBα were significantly suppressed by WCA or its active ingredients. In UC rats and Caco-2 cells, both of their EMT process were strongly suppressed by WCA.Conclusion: These results show that through improving inflammatory microenvironment to inhibit the EMT process, WCA retarded the development of UC in rats to play its anti-inflammatory effect.
Complications in GNE myopathy patients: A nationwide repository questionnaire survey in Japan
Authors: Yoshioka Wakako , Shimizu Reiko , Takahashi Yuji , Oda Yuriko , Yoshida Sumiko , Ishihara Nahoko , Nishino Ichizo , Nakamura Harumasa , Mori-Yoshimura Madoka 
Published: January 2021

Abstract
Background

GNE myopathy is a rare autosomal recessive adult-onset distal myopathy caused by biallelic pathogenic variants in GNE. Although some complications associated with GNE myopathy have been reported, little is known about whether they are disease-specific and how often they present. This study aimed to characterize complications of GNE myopathy.
Methods

We conducted a questionnaire survey of GNE myopathy patients registered in a national registry in Japan. The questionnaire requested information regarding immune thrombocytopenia (ITP), cardiac involvement, respiratory involvement, sleep apnea syndrome (SAS), and psychiatric diseases.
Results

The response rate was 62.4% (126/198), yielding a total of 51 male and 75 female participants. Of the participants, 4.1% (5/123) had a diagnosis of ITP, and 16.3% (8/49) of males and 6.6% of females (5/76) had a diagnosis of SAS. In total, 0.8% (1/126) of participants had pervasive developmental disorder and 14.7% (16/109) had a psychiatric disease.
Conclusion

The frequencies of ITP and SAS among Japanese GNE myopathy patients were higher than those observed in the general Japanese population. Routine blood tests and evaluation of sleep-disordered breathing should be considered in order to better manage GNE myopathy patients.
The role of amyloid PET in patient selection for extra-ventricular shunt insertion for the treatment of idiopathic normal pressure hydrocephalus: a pooled analysis
Authors: Mallon Dermot Henry , Malhotra Paresh , Naik Mitesh , Carswell Christopher , Win Zarni 
Published: January 2021

Abstract
Idiopathic Normal Pressure Hydrocephalus (iNPH) can be effectively treated through shunt insertion. However, most shunted patients experience little or no clinical benefit, which suggests suboptimal patient selection. While contentious, multiple studies have reported poorer shunt outcomes associated with concomitant Alzheimer’s disease. Prompted by this observation, multiple studies have assessed the role of amyloid PET, a specific test for Alzheimer’s disease, in patient selection for shunting. Across three relevant studies, a total of 38 patients with suspected iNPH underwent amyloid PET imaging and shunt insertion. Twenty-one patients had a positive clinical response to shunting. 18/28 (64.3%) of patients with a negative amyloid PET and 5/10 (50%) with a positive amyloid PET had a positive response to shunting. The pooled sensitivity, specificity and accuracy was 33.3%, 76.2% and 58.3%. None of these statistics reached statistical significance. The results of this pooled analysis do not support the selection of patients with suspected iNPH for shunting on the basis of amyloid PET alone. However, due to small cohort sizes and weakness in study design, further high-quality studies are required to properly determine the role of amyloid PET in assessing this complex patient group.
Knowledge and Perception of COVID-19 Pandemic During the First Wave (Feb-May 2020): a Web Based Survey Among Italian Healthcare Workers
Authors: Rizzo Caterina , Campagna Ilaria , Pandolfi Elisabetta , Croci Ileana , Russo Luisa , Ciampini Sara , Gesualdo Francesco , Tozzi Alberto Eugenio , Ricotta Lara , Raponi Massimiliano , Atti Marta Luisa Ciofi Degli 
Published: January 2021

Abstract
Background Italy was the first country in Europe to face the coronavirus pandemic. Healthcare workers (HCWs) were at higher risk of contracting COVID-19, because of their closer contact with patients. The present study aimed to analyze HCWs’ knowledge, practices, and attitude towards COVID-19.MethodsWe set up a cross-sectional survey through SurveyMonkey® and circulated the link in Facebook and Whatsapp closed groups. It was conducted in Italy from the end of February to the first week of May 2020. The study participants were general practitioners, pediatricians and other health professionals. Data were collected using a well-structured questionnaire including demographic, scope of knowledge, awareness and practice assessment section.ResultsA total of 958 participants were included. Of these, 320 (33.4%) were general practitioners, 248 (25.9%) were pediatricians and 390 (40.7%) were other health professionals. The highest response rate was from Northern Italy (48.1%), followed by the Center (29.9%) and Southern Italy (22.0%). The reported risk of having contact with a patient affected by Covid-19 was higher in the lockdown period than the pre-lockdown period (19.4% vs 10.2%, p=0.002). Respondents reported to have changed their clinical practice, more during lockdown period (81.1%) than in the pre-lockdown (46.3%). Particularly, they increased the use of masks (87.1%, p<0.001), disinfection and sanitization of doctors’ offices (75.8%, p<0.001), the use of protective glasses (71.2%, p<0.001), alcoholic hand solution (71.2%, p<0.001), and hand washing (31.8%, p=0.028).ConclusionsThe majority of HCWs felt prepared to face the pandemic, and increased significantly their knowledge on infection prevention and control measures less known in the routine clinical practice (such as use of protective glasses and alcoholic hand solution), compared to other well-known measures (such as hand washing). HCWs are at high risk of infection and need extensive knowledge and awareness of the disease to take adequate precautionary measures and they are crucial to disseminate good practices.