bluuebunny/crossref_metadata_2025_split huggingface dataset:
Project ECHO COVID-19: Vulnerable Populations and Telehealth Early in the Pandemic
Authors: Thies Kathleen M. , Gonzalez Melanie , Porto Ariel , Ashley Karen L. , Korman Stephanie , Lamb Mandy 
Published: May 2021

Introduction/Objectives Project ECHO COVID-19 was launched nationwide on March 4, 2020 to disseminate guidance about COVID-19 in a timely and scalable manner to meet the urgent needs of primary care settings, the first line of defense in a pandemic. Methods Data from post-session surveys were analyzed to assess participant satisfaction, knowledge gaps, change in knowledge, and anticipated changes in practice as a result of Project ECHO COVID-19. A content analysis was conducted of the 243 questions and concerns posted by over 2000 participants in the Question and Answer function of Zoom during the first 8 sessions (March 4-April 29, 2020). Results Of 5243 registrants, 49% attended at least one session. Respondents agreed or strongly agreed that didactic sessions (97%) and case presentations (96%) met their learning needs; 93% reported gaining new knowledge, and 88% would implement that knowledge. Only 32% and 53% of respondents anticipated changing workflows and adapting to telehealth, respectively, despite the need for both as the pandemic continued. The content analysis identified 3 categories: clinical operations (eg, testing, triage, telehealth, billing); patient care (diagnosis and treatment of COVID-19, management of high-risk vulnerable populations); and epidemiology (viral spread, implications for public health). Conclusions Care of vulnerable populations and clinical operations should be addressed when planning education and clinical interventions for public health crises. Adapting the Project ECHO model to be more scalable was an effective means of creating a community of practice among health professionals when evidence-based guidance was not available to manage the implications of a pandemic.
Using Predictive Modeling and Supervised Machine Learning to Identify Patients at Risk for Venous Thromboembolism Following Posterior Lumbar Fusion
Authors: Wang Kevin Y. , Ikwuezunma Ijezie , Puvanesarajah Varun , Babu Jacob , Margalit Adam , Raad Micheal , Jain Amit 
Published: May 2021

Study Design: Retrospective review. Objective: To use predictive modeling and machine learning to identify patients at risk for venous thromboembolism (VTE) following posterior lumbar fusion (PLF) for degenerative spinal pathology. Methods: Patients undergoing single-level PLF in the inpatient setting were identified in the National Surgical Quality Improvement Program database. Our outcome measure of VTE included all patients who experienced a pulmonary embolism and/or deep venous thrombosis within 30-days of surgery. Two different methodologies were used to identify VTE risk: 1) a novel predictive model derived from multivariable logistic regression of significant risk factors, and 2) a tree-based extreme gradient boosting (XGBoost) algorithm using preoperative variables. The methods were compared against legacy risk-stratification measures: ASA and Charlson Comorbidity Index (CCI) using area-under-the-curve (AUC) statistic. Results: 13, 500 patients who underwent single-level PLF met the study criteria. Of these, 0.95% had a VTE within 30-days of surgery. The 5 clinical variables found to be significant in the multivariable predictive model were: age > 65, obesity grade II or above, coronary artery disease, functional status, and prolonged operative time. The predictive model exhibited an AUC of 0.716, which was significantly higher than the AUCs of ASA and CCI (all, P < 0.001), and comparable to that of the XGBoost algorithm ( P > 0.05). Conclusion: Predictive analytics and machine learning can be leveraged to aid in identification of patients at risk of VTE following PLF. Surgeons and perioperative teams may find these tools useful to augment clinical decision making risk stratification tool.
The employment of cynomolgus monkey as proprioceptive deficit model of the anterior cruciate ligament
Authors: Zhang Lei , Wang Ruihan , Zhang Ping , Liu Huan , Wang Guoyou , Fu Shijie 
Published: May 2021

Introduction: Clinically, a consensus of the treatment strategies of ACL grade 2 injury is not reached. Therefore, the present study established a proprioceptive deficit model of the ACL via an arthroscope to aid with further studying ACL grade 2 injury and treatment strategies. Materials and Methods: 12 cynomolgus monkeys were randomly divided into the model group and the blank control group. In the model group, 1/4 of the ACL was cut under an arthroscope, whereas no intervention was performed in the blank control group. Physiological data including the maximum degree of knee flexion, the thigh circumstance and the calf circumference were measured, and the Pivot-shift, Anterior and Lachman tests were also performed. Moreover, electrophysiological data including somatosensory evoked potentials (SEPs) and motor nerve conduction velocity (MNCV) were measured. SEPs and MNCV were assessed for the latent period and amplitude. Results: Comparing the data before and after the surgery, in the blank control group, no significant difference was observed. In the model group, significant difference was observed in the Pivot-shift, Anterior drawer and Lachman test ( p < 0.05), indicating the instability of the ACL. Moreover, the latent period of SEPs and MNCV were significantly increased ( p < 0.009), whereas the amplitude of SEPs and MNCV was significantly decreased ( p < 0.009), indicating a degenerated proprioception of the knee joint. Conclusions: Following cutting 1/4 of the ACL, the knee joint became unstable and proprioception was declined. The results indicated that the proprioceptive deficit model of the ACL was successfully established, which could promote further studying ACL injury.
Is it time to administer acellular pertussis vaccine to childbearing age/pregnant women in all areas using whole-cell pertussis vaccination schedule?
Authors: Esteghamati Abdoulreza , Sayyahfar Shirin , Alimohamadi Yousef , Salahi Sarvenaz , Faramarzi Mahmood 
Published: May 2021

Background: Whole-cell pertussis (wP) vaccine administration is still advocated for children under 7 years of age in Iran. However, there is no recommendation for the administration of a dose of tetanus, diphtheria, and acellular pertussis (Tdap) vaccine to childbearing age/pregnant women in the Iranian vaccination program and it has increased the risk of infection through waning immunity during women’s childbearing age life. The study aimed to assess the levels of anti- Bordetella pertussis antibodies in childbearing age women of different ages in Iran. Methods: A cross-sectional study was conducted on a total number of 360 childbearing age women divided into six age groups, with 5-year intervals from 15 to 45 years old, in 2018–2019. Then, the levels of immunoglobulin A (IgA), immunoglobulin M (IgM), and immunoglobulin G (IgG) antibodies against B. pertussis were evaluated using enzyme-linked immunosorbent assay (ELISA). The IBM SPSS Statistics software (version 16.0) (SPSS Inc., Chicago, IL, USA) was used for data analysis. Results: The mean age of the participants was 30.01 ± 8.35 years (range 14–45 years). All the cases were IgM negative, but two IgA-positive individuals (in the age groups of 14–19 and 30–34 years) were reported. Overall, 239 (66.4%) cases were IgG positive. The mean age of IgG-positive cases was 30.37 ± 8.37 years. The IgG-positive cases were mostly in the age groups of 30–34 and 35–39 years [43 (71.1%)]. The odds of IgG positivity were 1.97. The highest odds of IgG positivity were seen in 30–34 and 35–39 years groups (2.52) and the lowest odds were seen in the 20–24 and 25–29 years groups (1.60). Using the Jonckheere–Terpstra test, the increasing trend of IgG changes in different age groups was not statistically significant (Tπ=5.78, p = 0.09). Conclusion: The infants of women of childbearing age might be prone to pertussis in countries using the wP vaccination schedule. It is suggested to administer a dose of Tdap to women before or during pregnancy to increase the immunity of their infants against this disease during early infancy.
Fluctuations in Self-Reported Symptoms Predict Objective Physical Activity in Adults With Type 2 Diabetes
Authors: Zhu Bingqian , Chen Pei , Kim Min Jung , Chen Xiangfang , Quinn Laurie , Fritschi Cynthia 
Published: May 2021

Purpose The purpose of this study was to examine the association between self-reported symptoms including fatigue and sleep disturbance with moderate-intensity physical activity among adults with type 2 diabetes. Methods This report was a secondary analysis of a cross-sectional study. Data from 53 participants with at least 6 days of repeated measures were used. Daytime physical activity and energy expenditure were assessed using a wrist-worn accelerometer at the free-living setting. Fatigue upon awakening was measured using a 0 to 10 scale. Sleep (eg, restorative sleep, sleep duration, and sleep efficiency) was measured using the Consensus Sleep Diary for Morning. Data were analyzed using linear mixed models by including within- and between-person effects. Results Participants were predominantly females (54.7%) with a mean age of 60.3 years. Controlling for the covariates, at the individual level (within-person), fluctuations in restorative sleep and fatigue upon awakening predicted moderate-intensity PA. Similarly, at the individual level, fluctuations in restorative sleep and fatigue upon awakening predicted average hourly energy expenditure. However, at the group level (between-person), no significant associations were found between fatigue and restorative sleep with moderate-intensity physical activity. Conclusions The study findings suggest that within-person fluctuations in fatigue and restorative sleep upon awakening predict daytime moderate-intensity physical activity. At the individual level, reducing fluctuations in fatigue and restorative sleep might encourage participation in physical activity. More research is warranted to uncover the underlying causes of fluctuations in fatigue and restorative sleep. Meanwhile, diabetes care and education specialists should pay attention to the within-person fluctuations of fatigue and sleep.
Role of long noncoding RNA taurine‐upregulated gene 1 in cancers
Authors: Da Miao , Zhuang Jing , Zhou Yani , Qi Quan , Han Shuwen 
Published: May 2021

AbstractLong non-coding RNAs (lncRNAs) are a group of non-protein coding RNAs with a length of more than 200 bp. The lncRNA taurine up-regulated gene 1 (TUG1) is abnormally expressed in many human malignant cancers, where it acts as a competitive endogenous RNA (ceRNA), regulating gene expression by specifically sponging its corresponding microRNAs. In the present review, we summarised the current understanding of the role of lncRNATUG1in cancer cell proliferation, metastasis, angiogenesis, chemotherapeutic drug resistance, radiosensitivity, cell regulation, and cell glycolysis, as well as highlighting its potential application as a clinical biomarker or therapeutic target for malignant cancer. This review provides the basis for new research directions for lncRNATUG1in cancer prevention, diagnosis, and treatment.
Positive selection on two mitochondrial coding genes and adaptation signals in hares (genus Lepus) from China
Authors: Awadi Asma , Ben Slimen Hichem , Schaschl Helmut , Knauer Felix , Suchentrunk Franz 
Published: May 2021

Abstract
Background
Animal mitochondria play a central role in energy production in the cells through the oxidative phosphorylation (OXPHOS) pathway. Recent studies of selection on different mitochondrial OXPHOS genes have revealed the adaptive implications of amino acid changes in these subunits. In hares, climatic variation and/or introgression were suggested to be at the origin of such adaptation. Here we looked for evidence of positive selection in three mitochondrial OXPHOS genes, using tests of selection, protein structure modelling and effects of amino acid substitutions on the protein function and stability. We also used statistical models to test for climate and introgression effects on sites under positive selection.

Results
Our results revealed seven sites under positive selection in ND4 and three sites in Cytb. However, no sites under positive selection were observed in the COX1 gene. All three subunits presented a high number of codons under negative selection. Sites under positive selection were mapped on the tridimensional structure of the predicted models for the respective mitochondrial subunit. Of the ten amino acid replacements inferred to have evolved under positive selection for both subunits, six were located in the transmembrane domain. On the other hand, three codons were identified as sites lining proton translocation channels. Furthermore, four codons were identified as destabilizing with a significant variation of Δ vibrational entropy energy between wild and mutant type. Moreover, our PROVEAN analysis suggested that among all positively selected sites two fixed amino acid replacements altered the protein functioning. Our statistical models indicated significant effects of climate on the presence of ND4 and Cytb protein variants, but no effect by trans-specific mitochondrial DNA introgression, which is not uncommon in a number of hare species.

Conclusions
Positive selection was observed in several codons in two OXPHOS genes. We found that substitutions in the positively selected codons have structural and functional impacts on the encoded proteins. Our results are concordantly suggesting that adaptations have strongly affected the evolution of mtDNA of hare species with potential effects on the protein function. Environmental/climatic changes appear to be a major trigger of this adaptation, whereas trans-specific introgressive hybridization seems to play no major role for the occurrence of protein variants.
Genome-wide identification and functional analysis of U-box E3 ubiquitin ligases gene family related to drought stress response in Chinese white pear (Pyrus bretschneideri)
Authors: Wang Chunmeng , Song Bobo , Dai Yuqin , Zhang Shaoling , Huang Xiaosan 
Published: May 2021

Abstract
Background
The plant U-box (PUB) proteins are a family of ubiquitin ligases (E3) enzymes that involved in diverse biological processes, as well as in responses to plant stress response. However, the characteristics and functional divergence of the PUB gene family have not yet been previously studied in the Chinese white pear (Pyrus bretschneideri).

Results
In the present study, we identified 62 PbrPUBs in Chinese white pear genome. Based on the phylogenetic relationship, 62 PUB genes were clustered into five groups. The results of conserved motif and gene structure analysis supported the classification phylogenetic tree. The PbrPUB genes were unevenly distribution on 17 pear chromosomes, chromosome 15 housed most member of PUB family, with eight PUB genes. Cis-acting element analysis indicated that PUB genes might participate in diverse biological processes, especially in the response to abiotic stresses. Based on RNA-data from ‘Dangshansuli’ at seven tissues, we found that PUB genes exhibited diverse of expression level in seven tissues, and qRT-PCR experiment further supported the reliable of RNA-Seq data. To identify candidate genes associated with resistance, we conducted qRT-PCR experiment the expression level of pear seed plant under four abiotic stresses, including: ABA, dehydration, salt and cold treatment. One candidate PUB gene associated with dehydration stress was selected to conduct further functional experiment. Subcellular localization revealed PbrPUB18 protein was located on cell nucleus. Furthermore, heterologous over-expression of PbrPUB18 in Arabidopsis indicated that the over-expression of PbrPUB18 could enhance resistance in drought treatment. In conclusions, we systematically identified the PUB genes in pear, and provided useful knowledge for functional identification of PUB genes in pear.
Plasma uric acid is related to large arterial stiffness but not to other hemodynamic variables: a study in 606 normotensive and never-medicated hypertensive subjects
Authors: Hamid Humam , Kurra Venla , Choudhary Manoj Kumar , Bouquin Heidi , Niemelä Onni , Kähönen Mika A. P. , Mustonen Jukka T. , Pörsti Ilkka H. , Koskela Jenni K. 
Published: May 2021

Abstract
Background
Elevated level of plasma uric acid (PUA) has been associated with cardiovascular disease, but whether uric acid is an independent risk factor or merely a marker remains controversial.

Methods
We investigated in a cross-sectional setting the association of PUA with hemodynamics in 606 normotensive and never-medicated hypertensive subjects (295 men, 311 women, age range 19–73 years) without cardiovascular disease or gout. In all except 15 individuals, PUA was within the normal range. Supine hemodynamics were recorded using whole-body impedance cardiography and radial tonometric pulse wave analysis.

Results
The mean concentrations of PUA in age, sex and body mass index adjusted quartiles were 234, 278, 314, and 373 µmol/l, respectively. The highest PUA quartile presented with higher aortic to popliteal pulse wave velocity (PWV) than the lowest quartile (8.7 vs. 8.2 m/s, p = 0.026) in analyses additionally adjusted for plasma concentrations of C-reactive protein, low density lipoprotein cholesterol, triglycerides, and mean aortic blood pressure. No differences in radial and aortic blood pressure, wave reflections, heart rate, cardiac output, and systemic vascular resistance were observed between the quartiles. In linear regression analysis, PUA was an independent explanatory factor for PWV (β = 0.168, p < 0.001, R2 of the model 0.591), but not for systolic or diastolic blood pressure. When the regression analysis was performed separately for men and women, PUA was an independent predictor of PWV in both sexes.

Conclusions
PUA concentration was independently and directly associated with large arterial stiffness in individuals without cardiovascular disease and PUA levels predominantly within the normal range. Trial registration ClinicalTrials.gov NCT01742702.
Temporal trends in heart failure mortality in an integrated healthcare delivery system, California, and the US, 2001–2017
Authors: Mefford Matthew T. , Zhuang Zimin , Liang Zhi , Chen Wansu , Koyama Sandra Y. , Taitano Maria T. , Watson Heather L. , Lee Ming-Sum , Sidney Stephen , Reynolds Kristi 
Published: May 2021

AbstractBackgroundIn recent years, decreases in mortality rates attributable to cardiovascular diseases have slowed but mortality attributable to heart failure (HF) has increased.MethodsBetween 2001–2017, trends in age-adjusted mortality with HF as an underlying cause for Kaiser Permanente Southern California (KPSC) members were derived through linkage with state death files and compared with trends among California residents and the US. Average annual percent change (AAPC) and 95% confidence intervals (CI) were calculated using Joinpoint regression. Analyses were repeated examining HF as a contributing cause of death.ResultsIn KPSC, the age-adjusted HF mortality rates were comparable to California but lower than the US, increasing from 23.9 per 100,000 person-years (PY) in 2001 to 44.7 per 100,000 PY in 2017, representing an AAPC of 1.3% (95% CI 0.0%, 2.6%). HF mortality also increased in California from 33.9 to 46.5 per 100,000 PY (AAPC 1.5%, 95% CI 0.3%, 2.7%), while remaining unchanged in the US at 57.9 per 100,000 PY in 2001 and 2017 (AAPC 0.0%, 95% CI − 0.5%, 0.5%). Trends among KPSC members ≥ 65 years old were similar to the overall population, while trends among members 45–64 years old were flat between 2001–2017. Small changes in mortality with HF as a contributing cause were observed in KPSC members between 2001 and 2017, which differed from California and the US.ConclusionLower rates of HF mortality were observed in KPSC compared to the US. Given the aging of the US population and increasing prevalence of HF, it will be important to examine individual and care-related factors driving susceptibility to HF mortality.
Rat bite fever with osteomyelitis and discitis: case report and literature review
Authors: Adams Steven H. , Mahapatra Rahul 
Published: May 2021

Abstract
Background
Rat bite fever (RBF) is a rare systemic febrile illness transmitted by rats. Streptobacillus moniliformis is a pleomorphic Gram-negative bacillus which is the usual etiologic organism for rat bite fever in the United States.

Case presentation
Here we present a case of rat bite fever complicated by vertebral osteomyelitis and discitis. The patient revealed an exposure history of being bitten by pet rats. The patient’s symptoms dramatically improved with a six-week course of cephalexin therapy.

Conclusions
It is important to obtain a thorough zoonotic exposure history and maintain rat bite fever in the differential when considering potential causes of discitis and osteomyelitis.
The contribution of Lynch syndrome to early onset malignancy in Ireland
Authors: Talbot Alice , O’Donovan Emily , Berkley Eileen , Nolan Carmel , Clarke Roisin , Gallagher David 
Published: May 2021

Abstract
Background
Lynch syndrome (LS) is an autosomal dominant hereditary cancer syndrome responsible for 2–4% of hereditary colorectal cancers (CRC). Mismatch repair protein deficiency (dMMR) is a characteristic feature of LS. It has been associated with a poor response to standard chemotherapy in metastatic colorectal cancer (mCRC). There is currently no LS database to monitor trends of disease in Ireland. We aim to centralise LS data in Ireland to assess the burden of LS in Ireland and guide improvements in prevention and treatment of LS-associated cancer.

Methods
A retrospective review was carried out including all medical records for LS patients from two of the three cancer genetics clinics in Ireland between 2000 and 2018 was carried out. Clinicopathological data of probands (n = 57) and affected family members including demographics, mutation status, cancer diagnosis and outcome was recorded. Statistical analysis was carried out using SPSS software.

Results
Fifty-seven families including three-hundred and forty-five individuals affected by cancer were identified. The most common cancers recorded were colorectal (53%), breast (12%) and endometrial (10%). One-hundred and thirty-eight confirmed carriers were identified: 65 path_MLH1 (47%), 43 path_MSH2 (31%), 11 path_MSH6 (8%), 17 path_PMS2 (12%) and two path_EPCAM (1%). Cancer type varied significantly by gene. Median age of first diagnosis was 44.5 years (range 23–81). Half of all deceased patients (n = 11) in this group died within 2.5 years of first diagnosis. These deaths were directly related to cancer in 59% of cases.

Conclusions
Under diagnosis of LS misses a powerful preventive and therapeutic opportunity. LS causes early onset dMMR cancer diagnoses with substantial societal impact. Implementation of ICBs into treatment policy for this small cohort of dMMR mCRC is an achievable therapeutic goal that may significantly improve survival. A prospective database for LS in Ireland is necessary to maximise prevention in this population.