bluuebunny/crossref_metadata_2025_split huggingface dataset:
VA-MENGOC-BC Vaccination Induces Serum and Mucosal Anti Neisseria gonorrhoeae Immune Responses and Reduces the Incidence of Gonorrhea
Authors: Reyes Díaz Laura M. , Lastre González Miriam de S.J.B. , Cuello Maribel , Sierra-González V. Gustavo , Ramos Pupo Raúl , Lantero Maria Isela , Harandi Ali M. , Black Steven , Pérez Oliver 
Published: February 2021

Background:
Overall, there are over 30 different sexually transmitted infections with Neisseria gonorrhoeae being the third most frequent with a reported 78 million cases per year. Gonococcal infection causes genital inflammation, which can be a risk factor for others sexually transmitted infections, particularly human immunodeficiency virus. Gonorrhea is a treatable disease, but recently an increase in antibiotic resistance has been of concern. There are currently no vaccines available. However, parenteral vaccination with anti N. meningitidis serogroup B vaccine has been reported to decrease the incidence of gonococcal burden in New Zealand and in Cuba despite the fact that parenteral vaccination is not deemed to induce mucosal IgA. Here we explore possible mechanisms of protection against gonococcal infection through parenteral meningococcal B vaccination.

Methods:
Ninety-two serum, saliva and oropharyngeal swabs samples of young adults (healthy and Neisseria carriers) of the internal higher school were obtained. They have been vaccinated with VA-MENGOC-BC (MBV) during their infancy and boosted with a third dose during this study. Serum and saliva samples were analyzed by ELISA and Western blot to measured IgG and IgA antibodies against N. meningitidis and N. gonorrhoeae antigens. N. meningitidis carriers were determined by standard microbiologic test. In addition, we reviewed epidemiologic data for N. meningitidis and N. gonorrhoeae infections in Cuba.

Results:
Epidemiologic data show the influence of MBV over gonorrhea incidence suggesting to be dependent of sexual arrival age of vaccines but not over syphilis. Laboratorial data permit the detection of 70 and 22 noncarriers and carriers of N. meningitidis, respectively. Serum anti-MBV antigens (PL) responses were boosted by a third dose and were independent of carriage stages, but saliva anti-PL IgA responses were only present and were significant induced in carriers subjects. Carriers boosted with a third dose of MBV induced similar antigonococcal and -PL saliva IgA and serum IgG responses; meanwhile, serum antigonococcal IgG was significantly lower. In saliva, at least 2 gonococcal antigens were identified by Western blot. Finally, gonococcal-specific mucosal IgA antibody responses, in addition to the serum IgG antibodies, might contributed to the reduction of the incidence of N. gonorrhoeae. We hypothesize that this might have contributed to the observed reductions of the incidence of N. gonorrhoeae.

Conclusion:
These results suggest a mechanism for the influence of a Proteoliposome-based meningococcal BC vaccine on gonococcal incidence.
Comprehensive analysis of gene expression and DNA methylation for preeclampsia progression
Authors: Wang Jianrong , Song Hongxian , Zhang Yanhua 
Published: February 2021

Background:
The purpose of our study is to identify novel preeclampsia (PE)-related methylation genes and uncover the molecular mechanism of PE.

Methods:
All the datasets of gene expression and DNA methylation datasets for PE and normal samples were obtained from the Gene Expression Omnibus database. We first identified the differentially expressed genes (DEGs) and differential methylation genes (DMGs) between PE and normal samples followed by the functional enrichment analysis. Comprehensive analysis of DEGs and DMGs was also conducted for the identification of valuable PE-related biomarkers. The methylation validation was also performed with MassARRAY.

Results:
Three DNA methylation and three gene expression datasets were incorporated. We obtained 1754 DEGs and 99 DMGs in PE samples with the thresholds of p value <0.05, |Δbeta| > 0.1, and p value <0.05, respectively. Functional analysis of DEGs obtained cell adhesion molecules and leukocyte transendothelial migration. Besides, several valuable biomarkers of PE, including OCA2, CDK2AP1, and ADAM12, were identified through the integrated analysis of gene expression and DNA methylation datasets. Four methylation sites (cg03449867, cg09084244, cg09247979, and cg24194674) were validated, among which cg03449867 and cg09084244 were found to be hypermethylated and the related genes of OCA2 and CDK2AP1 were downregulated in PE compared with normal samples simultaneously. cg24194674 was hypomethylated and its correlated gene ADAM12 was upregulated in PE compared with normal samples simultaneously.

Conclusion:
Our study should be helpful for the development of potential biomarkers and therapeutic targets for PE.
Impact of the extent of negative lymph nodes in gastric adenocarcinoma undergoing primary surgical resection: An institutional report
Authors: Chen Yen-Jen , Yeh Shin-Ting , Ou Liang-Hung , Lin Chen-Sung , Chien Chiang-Ting 
Published: February 2021

Background:
Sub-total/total gastrectomy with lymph node dissection (LND) remains an effective therapeutic strategy for resectable gastric adenocarcinomas (GACs). Despite the prognostic significance of positive lymph nodes (PLNs) defined in N-status, few have appraised the impacts of negative lymph nodes (NLNs) and the percentage of NLN (=number of NLNs/number of total lymph nodes [TLNs], %), as well as the extent of TLNs to be dissected in GACs.

Methods:
We retrospectively analyzed 62 GAC patients (mean age of 67.1 years; 41 men) undergoing primary sub-total/total gastrectomy from a single institute. Candidate variables, including the number of NLNs (≤9 and >9) and the percentage of NLN (≤37.5, 37.5-80.6 and >80.6, %), were evaluated to determine their prognostic impacts and hazard ratios (HRs).

Results:
Under the multivariate Cox proportional-hazards regression model, tumor length exceeding 4 cm (p = 0.017; HR = 2.828), perineural invasion (p = 0.037; HR = 3.182), and lower percentage of NLN (p = 0.016 and p = 0.060; HRs = 1.000, 0.327, and 0.333 for subgroups ≤37.5, 37.5-80.6, and >80.6, respectively) were three independent predictors with elevated HRs for poor prognosis. GAC patients with the percentage of NLN > 80.6 were highly related to those with NLNs > 9 (p < 0.001), and GAC patients with NLNs > 9 were highly related to those with TLNs > 15 (p < 0.001). For all 62 GAC or 42 N(+) GAC patients, those who underwent LND with TLNs>15 tended to have more PLNs (p = 0.018, p = 0.003) and more NLNs (p < 0.001, p = 0.029) than did those with TLNs ≤ 15. Among the 42 GAC patients with TLNs > 15, a lower percentage of NLN (p = 0.026 and p = 0.015; HRs = 1.000, 0.272, and 0.180 for subgroups ≤37.5, 37.5-80.6, and >80.6, respectively) remained an independent predictor of poor prognosis.

Conclusion:
The percentage of NLN could predict the prognosis of GAC patients properly. However, an accurate percentage of NLN needs a minimal requirement of TLNs > 15 to detect an adequate number of PLNs and sufficient number of NLNs.
Readmitted Patients With Heart Failure Sick, Tired, and Symptomatic
Authors: Hoke Linda M. , Bradway Christine , Trotta Rebecca L. , Wald Joyce 
Published: February 2021

Background and Objective
Heart failure (HF) readmissions will continue to grow unless we have a better understanding of why patients with HF are readmitted. Our purpose was to gain an understanding, from the patients' perspective, of how patients with HF viewed their discharge instructions and how they felt when they got home and were then readmitted in less than 30 days.

Methods and Results
We used a qualitative descriptive approach using semistructured interviews with 22 patients with HF. Most participants had multimorbidities, were classified as New York Heart Association class III (n = 13) with reduced ejection fraction (n = 20), and were on home inotrope therapy (n = 13). The overarching theme that emerged was that these participants were sick, tired, and symptomatic. Additional categories within this theme highlight discharge instructions as being clear and easily understood; rich descriptions of physical, emotional, and other symptoms leading up to readmission; and reports of daily activities including what “good” and “not good” days looked like. Moreover, when participants experienced an exacerbation of their HF symptoms, they were sick enough to be readmitted to the hospital.

Conclusion
Our findings confirm ongoing challenges with a complex group of sick patients with HF, with the majority on home inotropes with reduced ejection fraction, who developed an unavoidable progression of their illness and subsequent hospital readmission.
Testing the Construct Validity and Responsiveness of the Single-Item Presenteeism Question
Authors: Muramatsu Kenji , Nakao Kyoko , Ide Hiroo , Furui Yuji 
Published: February 2021

Objective:
We tested the construct validity and responsiveness of a single-item instrument for measuring absolute presenteeism—the single-item presenteeism question (SPQ).

Methods:
Two self-report questionnaire surveys were conducted among employees of 24 small- or medium-sized companies (N = 1021) concerning the recognized predictors of presenteeism–absenteeism, subjective health risks, work engagement, and workplace social capital. Responsiveness was measured by determining whether changes in the presence of predictors between the surveys were accompanied by commensurate changes in SPQ presenteeism.

Results:
SPQ presenteeism exhibited significant associations with the predictors, denoting adequate construct validity. Regarding responsiveness, unfavorable changes in most predictors were associated with increased SPQ presenteeism, as expected.

Conclusions:
We confirmed the construct validity and responsiveness of the SPQ—an instrument that can be employed to promote workplace health and productivity management.
Association Between Implementation of a Universal Face Mask Policy for Healthcare Workers in a Health Care System and SARS-CoV-2 Positivity Testing Rate in Healthcare Workers
Authors: Wang Dee Dee , O’Neill William W. , Zervos Marcus J. , McKinnon John E. , Allard David , Alangaden George J. , Schultz Lonni R. , Poisson Laila M. , Chu Betty S. , Kalkanis Steven N. , Suleyman Geehan 
Published: February 2021

Objective:
Examine the effect of a universal facemask policy for healthcare workers (HCW) and incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positivity.

Methods:
Daily number of symptomatic HCW tested, SARS-CoV-2 positivity rates, and HCW job-descriptions were collected pre and post Universal HCW facemask policy (March 26, 2020). Multiple change point regression was used to model positive-test-rate data. SARS-CoV-2 testing and positivity rates were compared for pre-intervention, transition, post-intervention, and follow-up periods.

Results:
Between March 12 and August 10, 2020, 19.2% of HCW were symptomatic for COVID-19 and underwent SARS-CoV-2 testing. A single change point was identified ∼March 28–30 (95% probability). Before the change point, the odds of a tested HCW having a positive result doubled every 4.5 to 7.5 days. Post-change-point, the odds of a tested HCW having a positive result halved every 10.5 to 13.5 days.

Conclusions:
Universal facemasks were associated with reducing HCW's risk of acquiring COVID-19.
Nurse Practitioner-Managed Clinic Reduces Emergency Department Visits for Parents of Children With Problematic Gastrostomy Tubes
Authors: Maselli Kathryn M. , Camacho Linda , Delaplain Patrick T. , Nguyen Michelle V. L. , Mallicote Michael , Philippe-Auguste Michael , Gayer Christopher P. 
Published: February 2021

Background
Gastrostomy tube (G-tube) placement is commonly performed on pediatric patients but has high rates of emergency department (ED) utilization. We hypothesized that a nurse-practitioner-driven G-tube clinic would reduce ED visits and complications and improve provider and patient satisfaction.

Methods
After institutional review board approval, a retrospective chart review was conducted for all patients < 18 years old undergoing G-tube placement between January 2014 and June 2018. Data collected included demographics, indication, and type of G-tube as well as ED visits, clinic visits, and outcomes up to 1-year postoperative. Surveys were distributed to providers and parents to assess attitudes toward the clinic.

Results
There was a decrease in the number of physician clinic visits, but there was no difference in overall 30- or 90-day ED visits after institution of the G-Tube Clinic. In the cohort of patients who had problematic G-tube-related problems, such as granulation, plugged tube, or tube dislodgement, creation of the G-Tube Clinic significantly reduced 30-day (0.37 vs. 0.07, p = .0008), 90-day (0.27 vs. 0.73, p = .0031), and 1-year (0.6 vs. 1.18, p = .014) ED visits. Surgeon and patient satisfaction were improved with clinic implementation.

Conclusions
Implementation of a nurse-practitioner-managed clinic resulted in reduction in 30-day, 90-day, and 1-year ED visits among patients with gastrostomy issues and is associated with high levels of patient and provider satisfaction.
Pre-existing Vestibular Symptoms Are Associated With Acute Vestibular Symptoms After Gamma Knife Therapy for Vestibular Schwannoma
Authors: Bojrab Dennis I. , Fritz Christian G. , Lin Kenny F. , Schutt Christopher A. , Hong Robert S. , Babu Seilesh C. , Chen Peter Y. , Maitz Ann , Bojrab Dennis I. 
Published: February 2021

Objective:
To identify pretreatment variables associated with the development of acute vestibular symptoms after Gamma Knife (GK) treatment for Vestibular Schwannoma (VS).

Study Design:
Retrospective case series.

Setting:
Tertiary neurotology referral center.

Patients:
Patients treated with GK radiosurgery for VS between March 2007 and March 2017 were considered for this study. Patients with neurofibromatosis type II, previous VS surgery, follow-up less than 6 months, or the lack of T2 magnetic resonance imaging (MRI) sequences from the day of treatment were excluded.

Main Outcome Measure(s):
The presence of acute vestibular symptoms arising within 6 months after GK was the main outcome variable. Tumor, patient, and treatment characteristics were gathered from the medical record.

Results:
In total, 98 patients met inclusion criteria. The incidence of acute vestibular symptoms occurring within 6 months after GK treatment was 46.9%. Post-GK vestibular symptoms were reported at a significantly higher frequency among subjects who had reported vestibular symptoms before their treatment (p = 0.001). Tumor size was not associated with a propensity to develop acute vestibular symptoms (p = 0.397). The likelihood of receiving a referral to vestibular rehabilitation services was not significantly different among patients with larger versus smaller tumor size, as defined by 1.6 cm and 1.4 cm thresholds (p = 0.896, p = 0.654).

Conclusions:
Inquiries aimed at revealing a history of vestibular complaints may prove useful in counseling patients on the likelihood of experiencing acute vestibular symptoms after treatment of Vestibular Schwannoma with Gamma Knife therapy.
Morphology and phenotype characteristics of atherosclerotic plaque in patients with acute coronary syndrome: contemporary optical coherence tomography findings
Authors: Gomes Paula Mendonça , Almeida Breno Oliveira , Marinelli Pedrini Stella , Freitas Bárbara Palma , Júnior José Mariani , Lemos Pedro A. , Fonseca Francisco H. , Mintz Gary S. , Caixeta Adriano 
Published: February 2021

Background
Contemporary optical coherence tomography (OCT) findings in patients with acute coronary syndromes (ACS) are still subject of controversy. We sought to use OCT to evaluate plaque morphology and phenotype classification in patients with ACS.

Methods
Using optical coherence tomography, culprit lesions were morphologically classified as plaque rupture, plaque erosion, calcified nodule, thin-cap fibroatheroma, thick-cap fibroatheroma (TCFA) or fibrotic, fibrocalcific or fibrolipidic plaque. Quantitative and qualitative analyses also included cholesterol crystals, neovascularization, spotty calcification and thrombus.

Results
Of the 110 lesions imaged from June 2012 to April 2016, 54 (49%) were in patients with unstable angina (UA), 31 (28%) were in non-ST-elevation myocardial infarction (STEMI) patients and 25 (23%) were in STEMI patients. Compared with STEMI patients, patients with UA/non-STEMI were older and had more hypertension, hypercholesterolemia, known coronary artery disease, prior myocardial infarction and higher use of antiplatelet therapy. More patients with STEMI had lipidic arc >90% (36.6 versus 70.8%, P = 0.003), red and mixed thrombus (12.9 versus 28.0% and 7.1 versus 44.0%, respectively, all P < 0.001), plaque rupture (29.4 versus 76.0%, P < 0.001) and TCFA (57.1 versus 84.0%; P = 0.01). Predictors of plaque rupture were STEMI at presentation (odds ratio: 9.35, 95% confidence interval: 1.66–52.61, P = 0.01) and diabetes mellitus (odds ratio: 6.16, 95% confidence interval: 1.33–28.58, P = 0.02).

Conclusions
In this single-center study, the culprit lesion of patients with STEMI had more lipid, red and mixed thrombus, plaque rupture and TCFA versus patients with UA/non-STEMI. Clinical presentation may be driven by distinct pathophysiologic mechanisms in patients with ACS.
One-year clinical outcome and predictors of ischemic and hemorrhagic events after percutaneous coronary intervention in elderly and very elderly patients
Authors: Monello Alberto , Chiarito Mauro , Pivato Carlo Andrea , Scotti Andrea , Melillo Francesco , Munafò Andrea , Montorfano Matteo , Margonato Alberto , Colombo Antonio , Godino Cosmo 
Published: February 2021

Background
Elderly constitute a high-risk subset of patients but are under-represented in clinical revascularization trials. Our aim was to investigate clinical outcomes and prognosis predictors after percutaneous coronary intervention (PCI) in this population.

Methods
Unrestricted consecutive patients with ≥75 years who underwent PCI from 2012 to 2015 were enrolled. The primary ischemic endpoint was the composite of 1-year myocardial infarction, definite/probable stent thrombosis and target vessel revascularization. The primary bleeding endpoint was defined according to the Bleeding Academic Research Consortium (BARC) classification as BARC ≥ 2.

Results
We enrolled 708 patients (mean age 80 ± 4): 14% were very elderly patients (≥85 years), 27% of patients were diabetic, 23% had chronic kidney disease (CKD), 17% atrial fibrillation and 37% presented acute coronary syndrome. The primary ischemic endpoint was reported in 67 patients (12%): 29 had myocardial infarction (5%), 25 had definite/probable stent thrombosis (4.4%) and 44 had target vessel revascularization (8%). BARC ≥ 2 bleeding was reported in 43 patients (8%). No differences were found in terms of both ischemic and bleeding events between patients with <85 and ≥85 years. Three-vessel disease and use of bare metal stent were independent predictors of the primary ischemic endpoint. Triple antithrombotic therapy and CKD were the only independent predictors of BARC ≥ 2 bleedings.

Conclusions
In our experience, elderly patients reported reassuring efficacy and safety outcomes after PCI, even if ischemic and bleeding events were frequent. Three-vessel disease and the use of bare metal stent were the only predictors of primary ischemic endpoint. Triple antithrombotic therapy and CKD were the only predictors of BARC ≥ 2 bleedings.
Gut microbiota and motoric-cognitive frailty in hospitalized older persons
Authors: Lauretani Fulvio , Longobucco Yari , Maggio Marcello 
Published: February 2021

Purpose of review
In older people, many systems spontaneously change without diseases. Because of the ageing process, the gut microbiota undergoes a reduced species richness, altered balance between species, with an increased interindividual variability. The result is the reduced resilience in the presence of diseases and medications. These changes are more evident in older persons with neurodegenerative diseases and cognitive-motoric frailty.

Recent findings
A relationship between liver alteration, gut microbiota and the presence of viruses and gram-bacteria is conceivable. They determine the acceleration of neurodegenerative diseases with cognitive and motoric frailty. Hospitalization represents one of the stressors for the gut microbiota, producing dysbiosis and increasing the representation of pathobionts. The gut microbiota alterations during hospitalization may be associated with negative clinical outcomes. This phenomenon together with liver dysfunction could produce an acceleration of the trajectory of cognitive-motoric frailty towards disability and mortality. The observation that predisability is associated of both losses of cognition and motoric performance, has allowed introducing a new syndrome, the motoric-cognitive risk syndrome, which is a condition of increased risk of dementia and mobility-disability.

Summary
The interaction between liver and gut microbiota may accelerate the neurodegenerative diseases and represents a promising marker of prognostic trajectories in older patients.
Effectiveness of acupuncture for the recovery of gastrointestinal function of patients with gastric cancer in the postoperative period
Authors: Li Huaiyu , Chen Yun , Hu Ziyi , Jiang Jiawang , Li Renliang , Qiu Qianjie , Ye Jing 
Published: February 2021

Abstract

Background:
Gastric cancer (GC) is the most common malignant tumors in the world and surgical resection remains the primary treatment for it. Postoperative patients often suffer from gastrointestinal dysfunction as the most common side effects of surgery for GC patients. Acupuncture has a regulatory effect on gastrointestinal function. We conducted this study to assess the effectiveness of acupuncture on the restoration of gastrointestinal function of postoperative patients with GC.

Methods:
Seven electronic databases will be searched from inception to November 2020 to identify any relevant study: Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), China National Knowledge Infrastructure (CNKI), Wanfang Database, Chinese Biomedical Literature Database (CBM), and Chinese Scientific Journal Database (VIP database). No restriction on time and language. The primary outcome measure will be the Time to First Flatus and secondary outcome measures include the time of first defecation and the quality of life (QOL) and the number of patients with abdominal distention. We will use EndNote V.9.1 to screen the eligible literature and the I
2 statistic to assess heterogeneity in the included studies. The meta-analysis will be conducted using the Review Manager (RevMan) software (V.5.3).

Results:
Our study aims to systematically assess whether the pooled effects of currently available trials prove effects of acupuncture in improving gastrointestinal function of patients with GC in the postoperative period.

Conclusion:
This study will conduct an evaluation about the efficacy of acupuncture for the recovery of gastrointestinal function of patients with GC in the postoperative period, making up for the lack of relevant clinical evidence.

INPLASY registration number:
INPLASY2020110066.