bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gene Homologies Identified between Trypanosoma cruzi Antigen 36 and Mammalian TRIM21 Genes Using Bioinformatics Analysis
Authors: Winkler Martin A , Pan Alfred A 
Published: June 2021

Abstract
Background: We previously reported that a Human Ro52 gene sequence (TRIM21) produced a significant stretch of protein sequence homologous to T. cruzi Antigen 36 (Ag 36) protein sequence, when Ag 36 was translated in the second reading frame. Comparison of their respective DNA sequences demonstrated a 114 nucleotide region of both genes having ~70 percent partial homology. After Ro52 was shown to be an E3 Ubiquitin dependent Type I ligase for transcription factors for Interferon genes, we proposed that the Ag 36 gene, which contains a repetitive motif within it, may function to repress Ro52 in the human heart through RNA interference, or other unknown mechanism, giving rise to autoimmunity found in Chronic Chagas Cardiomyopathy (CCC).Results: To test that hypothesis, we compared various mammalian TRIM genes to the T. cruzi Ag 36 DNA sequence using the Needleman-Wunsch algorithm in the http:\\usegalaxy.eu bioinformatics tool base. In addition to human and chimpanzee, TRIM21 comparable gene regions from canine, shrew, ferret, bat, feline, and armadillo, and aardvark showed homology to the gene for Ag 36 ranging from 68 to 30 percent. However, mouse and eight other mammalian species showed no significant homology. Since mice have been shown to have severe cardiac cardiomyopathy after infection, but their TRIM21 was not homologous to Ag 36 in this study, we conclude that the gene homology has no causative link to CCC.Conclusions: In addition to human TRIM21, eight mammalian species showed partial gene homology to T. cruzi Ag 36, and some of these have been demonstrated to have CCC. However, rats and mice TRIM21 showed no partial homology to Ag 36. Since these species have been demonstrated to have CCC, the partial gene homology between Ag36 and TRIM 21 may not be causative or associated with CCC, as was originally hypothesized.
Solitary Lung Metastasis From Primary Prostate Cancer With Normal Prostate Specific Antigen Level: a Case Report and Literature Review
Authors: Maru Natsumi , Okabe Asako , Hino Haruaki , Utsumi Takahiro , Matsui Hiroshi , Taniguchi Yohei , Saito Tomohito , Tsuta Koji , Murakawa Tomohiro 
Published: June 2021

Abstract
Background: Pulmonary involvement from prostate cancer is a well-known condition, but solitary lung metastasis is rare, with its associated clinical characteristics not yet fully elucidated.Case presentation: A 77-year-old man, with a history of radical prostatectomy for primary prostatic carcinoma 14 years prior, presented to our institution with a low-grade fever. Upon consultation, biochemical recurrence was suspected due to a gradual increase in prostate-specific antigen level. Salvage radiation therapy was considered but not performed since there was no recurrent macroscopic tumor. Computed tomography showed a solitary nodule with spiculation located on the upper lobe of the left lung while positron emission tomography suggested malignancy without metastasis. Based on these findings, primary lung cancer was suspected and thoracoscopic left upper lobectomy with lymph node dissection was performed. Pathological diagnosis of the tumor was a solitary lung metastasis of prostate cancer. The postoperative recovery was uneventful. Conclusion: We report a case with normal prostate-specific antigen level, along with a literature review. According to previous case reports, there are some pitfalls leading misdiagnosis as a primary lung tumor. However, we consider that surgical resection is associated with increased diagnostic accuracy and long-term survival.
Hypokalemia in Patients With Eating Disorders Is Associated With Binge-Purge Behavior, Lower Body Mass Index, and Hypoalbuminemia ~Predicting Hypokalemia During Refeeding~
Authors: Funayama Michitaka , Mimura Yu , Takata Taketo , Koreki Akihiro , Ogino Satoyuki , Kurose Shin , Shimizu Yusuke 
Published: June 2021

Abstract
Aim
To identify potential mechanisms underlying hypokalemia in patients with eating disorders
Background
Hypokalemia is frequently found in patients with eating disorders and sometimes leads to life-threatening conditions. The mechanisms underlying hypokalemia have yet to be elucidated except for binge-purge behavior, although other factors, e.g., malnutrition and refeeding, are proposed to induce hypokalemia. In this study, we investigated factors associated with hypokalemia during acute treatment of patients with eating disorders.
Methods
We recruited 52 independent patients from 89 admissions with eating disorders (body mass index, 13.0 ± 3.3) and analyzed serum potassium levels at admission. Similarly, 66 admissions with > 1-week hospitalization were recruited to determine the lowest potassium levels during the refeeding period. We analyzed these levels with multiple linear regression analysis with explanatory variables, including data upon admission and treatment-related indicators.
Results
A lower serum potassium level at admission and a lower nadir potassium level during refeeding were associated with a lower body mass index, hypoalbuminemia, and binge-purge behavior. Similar results were obtained when the analysis included restrictive or binge-purge types as well as the independent patient group. The lowest potassium levels during the refeeding period was observed an average of 2.5 days after admission.
Conclusions
Thus lower body mass index, hypoalbuminemia, and binge-purge behavior might predict hypokalemia among patients with eating disorders both at admission and during refeeding. Our study is the first to demonstrate that malnutrition and refeeding themselves might induce hypokalemia among patients with eating disorders. These factors might be used as indicators to guide clinical approaches for controlling serum potassium levels during refeeding.
Comparison of Vacuum-Assisted Sheath and Normal Sheath in Minimally Invasive Percutaneous Nephrolithotomy: A Systematic Review and Meta-Analysis
Authors: Zhu Ling , Wang Zhenghao , Zhou Ye , Gou Liping , Huang Yan , Zheng Xiaofeng 
Published: June 2021

Abstract
Background
A systematic review and meta-analysis was conducted to compare the safety and efficacy between the vacuum-assisted sheath and conventional sheath in minimally invasive percutaneous nephrolithotomy (MPCNL) in the treatment of nephrolithiasis.
Methods
PubMed, Web of Science, Embase, EBSCO, and Cochrane library databases (updated March 2021) were searched for studies assessing the effect of vacuum-assisted sheath in patients who underwent MPCNL. The search strategy and study selection processes were managed according to the PRISMA statement.
Results
Three randomized controlled trials and two case-controlled trials that satisfied the inclusion criteria were enrolled in this meta-analysis. Overall, the stone-free rate (SFR) in patients who underwent vacuum-assisted sheath was significantly higher than those who underwent conventional sheath (RR = 1.18, 95% CI = 1.08,1.29; P = 0.0002), with insignificant heterogeneity among the studies (I2 = 44%, P = 0.13). In terms of the outcome of complications, vacuum-assisted sheath could bring a benefit to the postoperative infection rate (RR = 0.45, 95%CI = 0.33,0.61; P < 0.00001) with insignificant heterogeneity among the studies (I2 = 0%, P = 0.76). There was no significant difference in blood transfusion rate (RR = 0.54, 95%CI = 0.23,1.29; P = 0.17) with insignificant heterogeneity (I2 = 41%, P = 0.15,). Only two studies reported the perforation and the results were statistically insignificant (RR = 0.25, 95%CI = 0.05,1.17; P = 0.08) with insignificant heterogeneity (I2 = 0%, P = 0.43).
Conclusions
Using vacuum-assisted sheath in MPCNL improves the safety and efficiency compared to the conventional sheath. Vacuum-assisted sheath significantly increases the SFR and reduces complications like postoperative infection, blood transfusion, and perforation
Zone 2 Hybrid Thoracic Endovascular Aortic Repair: Is It a Good Option for All Types of Thoracic Aortic Disease?
Authors: Sohn Bongyeon , Lee Jae Hang , Jung Joon Chul , Chang Hyoung Woo , Kim Dong Jung , Kim Jun Sung , Lim Cheong , Park Kay-Hyun 
Published: June 2021

Abstract
Background
Zone 2 thoracic endovascular aortic repair (TEVAR) is performed for the treatment of various thoracic aortic diseases involving the left subclavian artery. This study aimed to analyze the late clinical outcomes of zone 2 hybrid TEVAR according to the various indications.
Methods
A total of 48 patients who underwent zone 2 TEVAR at our institution between December, 2010 and July, 2020 were enrolled. The indications were aortic aneurysm (AA, n = 15), acute type B aortic dissection (AD, n = 14), penetrating aortic ulcer (PAU, n = 8), traumatic aortic injury (TAI, n = 8), and others (n = 3). The clinical outcomes including early complications and mid-term aortic measurements were retrospectively reviewed.
Results
The technical success rate was 100% and in-hospital mortality occurred in one patient. The early postoperative complications included stroke (n = 1), transient spinal cord ischemia (n = 1), neck wound hematoma (n = 1), and left phrenic or vagus nerve injury (n = 9). In patients with AD, positive remodeling was observed in ten patients (76.9%) (false lumen regression in the entire or thoracic aorta [n = 9], false lumen thrombosis in the thoracic aorta [n = 1]). However, in patients with AA, increased aneurysm was found in six patients (40%). Persistent aneurysmal growth was found in patients with a maximal aortic diameter of > 60 mm on initial imaging (4/6, 50%). No aortic expansion was observed in those with TAI or PAU. Endoleak was noted in five patients (10.4%), and among them, aortic reintervention was required only in patients with large AAs.
Conclusions
Zone 2 hybrid TEVAR was associated with an acceptable early complication rate and provided acceptable mid-term aortic results for patients with AD, PAU, and TAI. However, patients with large AAs were at increased risk of aortic reintervention. In cases of large AA, clinicians should carefully consider whether zone 2 hybrid TEVAR or open surgical repair will be more effective for the patient.
Improved Differentiation of hESC-derived Pancreatic Progenitors by Using Human Fetal Pancreatic Mesenchymal Cells in a Micro-Scalable Three-dimensional Co-culture System
Authors: Ghezelayagh Zahra , Zabihi Mahsa , Zarkesh Ibrahim , Gonçalves Carla A. C. , Larsen Michael , Hagh-parast Newsha , Pakzad Mohammad , Vosough Masoud , Arjmand Babak , Baharvand Hossein , Larijani Bagher , Grapin-Botton Anne , Aghayan Hamid Reza , Tahamtani Yaser 
Published: June 2021

Abstract
Mesenchymal cells of diverse origins differ in gene and protein expression besides producing varying effects on their organ-matched epithelial cells’ maintenance and differentiation capacity. Co-culture with rodent’s tissue-specific pancreatic mesenchyme accelerates proliferation, self-renewal, and differentiation of pancreatic epithelial progenitors. Therefore, in our study, the impact of three-dimensional (3D) co-culture of human fetal pancreatic-derived mesenchymal cells (hFP-MCs) with human embryonic stem cell-derived pancreatic progenitors (hESC-PPs) development towards endocrine and beta cells was assessed. Besides, the ability to maintain scalable cultures combining hFP-MCs and hESC-PPs was investigated. hFP-MCs expressed many markers in common with bone marrow-derived mesenchymal stem cells (BM-MSCs). However, they showed higher expression of DESMIN compared to BM-MSCs. After co-culture of hESC-PPs with hFP-MCs, the pancreatic progenitor (PP) spheroids generated in Matrigel had higher expression of NGN3 and INSULIN than BM-MSCs co-culture group, which shows an inductive impact of pancreatic mesenchyme on hESC-PPs beta-cells maturation. Pancreatic aggregates generated by forced aggregation through scalable AggreWell system showed similar features compared to the spheroids. These aggregates, a combination of hFP-MCs and hESC-PPs can be applied as an appropriate tool for assessing endocrine-niche interactions and developmental processes by mimicking the pancreatic tissue.
Quality of Life and Challenges Experienced by the Surviving Adults With Transfusion Dependent Thalassaemia in Malaysia: A Cross Sectional Study
Authors: Foong Wai Cheng , Chean Kooi Yau , Rahim Fairuz Fadzilah , Goh Ai Sim , Yeoh Seoh Leng , Yeoh Angeline Aing Chiee 
Published: June 2021

Abstract
Background
Improvement in medical management has enabled transfusion dependent thalassaemia (TDT) patients to survive beyond childhood, building families, and contributing to the labour force and society. Knowledge about their adult life would provide guidance on how to support their needs. This study aims to explore the general well-being of adults with TDT, their employment status and challenges.
Methods
We contacted all regional Thalassaemia societies in Malaysia to invite TDT members aged 18 or over to participate. Participants were also recruited from the two participating hospitals. A self-administered questionnaire including ‘CDC Healthy-days’, WHOQOL-BREF and employment measurements was used. Multiple linear regression models were fitted with associations adjusted for several potential confounders.
Results
Of the 196 participants, almost half (45%) had comorbidities and 20% suffered multiple types: bone-related (13%), hormonal (12%), cardiac (3%) and infections (2%), resulting in 23% seeking treatment more than twice monthly. Within a month, they suffered from a mean 3.1 (SD 3.0) days of feeling unhealthy physically, a mean 2.6 (SD 3.5) days mentally unhealthy and their normal daily activities performance were affected for approximately 2.5 (SD 3.3) days - leading to 36% being jobless and 38% of those with a job receiving salaries below RM1000. The mean quality of life (QOL) score (mean (SD) for each QOL domain was: physical health 62.6 (15.5), psychological health 64.7 (15.7), social relationship 64 (15.9), environmental health 60.8 (16.7). Frequent activities limited days, being single, unwillingness to disclose thalassaemia status, presence of comorbidities, discrimination experiences and perceptions about employment difficulties were associated with lower QOL scores. Dissatisfaction with health service provision, conflicting judgement in prioritising between health and job, and poor public empathy were expressed.
Conclusion
Adults with TDT appeared to be fairly positive about their life in spite of high number of dysfunctional days and had perceptions that health services do not meet their needs. They continued to face life disruption in a rather non-supportive community. Supportive approaches and life-skill training are necessary where interventions should be started during childhood. Adjustment to health services should be considered.
Fusion of Fully Integrated Analog Machine Learning Classifier with Electronic Medical Records for Real-Time Prediction of Sepsis Onset
Authors: Sadasivuni Sudarsan , Saha Monjoy , Bhatia Neal , Banerjee Imon , Sanyal Arindam 
Published: June 2021

Abstract
The objective of this work is to develop a fusion artificial intelligence (AI) model that combines patient electronic medical record (EMR) and physiological sensor data to accurately predict early risk of sepsis. The fusion AI model has two components - an on-chip AI model that continuously analyzes patient electrocardiogram (ECG) data and a cloud AI model that combines EMR and prediction scores from on-chip AI model to predict fusion sepsis onset score. The on-chip AI model is designed using analog circuits for sepsis prediction with high energy efficiency for integration with resource constrained wearable device. Combination of EMR and sensor physiological data improves prediction performance compared to EMR or physiological data alone, and the late fusion model has an accuracy of 93% in predicting sepsis 4 hours before onset. The key differentiation of this work over existing sepsis prediction literature is the use of single modality patient vital (ECG) and simple demographic information, instead of comprehensive laboratory test results and multiple vital signs. Such simple configuration and high accuracy makes our solution favorable for real-time, at-home use for self-monitoring.
Role of Matrix Metalloproteinase MMP-2, MMP-9 and Tissue Inhibitor of Metalloproteinase (TIMP-1) in Clinical Progression of Pediatric Acute Lymphoblastic Leukemia
Authors: Saleh Maha , Khalil Mohamed , Abdellateif Mona S. , Ebeid Emad , Kandeel Eman Z. 
Published: June 2021

Abstract
Background: Matrix metalloproteinases (MMPs) play a crucial role in cancer progression and metastasis, however their role in pediatric Acute lymphoblastic leukemia (ALL) is still unrevealed.Methods: The diagnostic, prognostic and predictive value of tissue inhibitor of metalloproteinase (TIMP-1), MMP-2, MMP-9 and CD34+CD38- CSCs were assessed in bone marrow (BM) samples of 76 ALL children using Flow Cytometry analysis. Results: There was a significant increase in TIMP-1 [1.52 (0.41-10) versus 0.91(0.6-1.12); respectively, P<0.001], and CSCs CD84+CD38- [1 (0.03-18.6) versus 0.3 (0.01-1.1), P<0.001] expression in ALL patients compared to controls. While there were no significant differences regarding MMP-2 and MMP-9 expression between the two groups. The sensitivity, specificity, AUC of MMP-2 were (80.3%, 53.3% and 0.568, P=0.404), and that of MMP-9 were (53.9%, 40% and 0.660, P=0.053). While that of TIMP-1 were (78.9%, 100% and 0.892, P<0.001), and that of CSCs CD34+ CD38- were (78.9%, 73.3% and 0.855, P<0.001). There was a significant association between MMP-2 overexpression and MRD at day-15, increased BM blast cell count at diagnosis and at day-15, (P=0.020, P=0.047 and P=0.001). Increased TIMP-1 expression associated with the high-risk disease (P<0.001), increased BM blast cell count at diagnosis and at day-15 (P=0.033 and P=0.001), as well as MRD at day 15 and day 42 (P<0.001 for both). CD34+CD38- CSCs associated with MRD at day-15, increased BM blast cell count at diagnosis and at day-15 (P=0.015, P=0.005 and P=0.003). TIMP-1 overexpression associated with shorter DFS and OS rates (P=0.009 and P=0.048). Multivariate logistic regression analysis showed that both TIMP-1 [OR: 4.224, P=0.046], and CD34+CD38- CSCs [OR: 6.873, P=0.005] are independent diagnostic factors for pediatric ALL.Conclusion: TIMP-1 and CD34+CD38- CSCs could be useful independent diagnostic markers for pediatric ALL. Also, TIMP-1 is a promising prognostic marker for poor outcome of the patients.
Bilateral breast cancer in a 65-year-old man
Authors: Sharbatdaran Arman , Twam Mohammed , Ghorbane Hosseine , Nikbakhsh Novin 
Published: June 2021

Abstract
Globally, breast cancer in men is exceedingly uncommon. The misinterpretation of signs and symptoms and lack of a proper medical history can lead to the progression of rare conditions to advanced stages. We report the case of a 65-year-old man who presented to the clinic complaining about progressive bilateral dull breast pain. He had been diagnosed with bilateral grade II invasive ductal carcinoma three months prior, and he underwent bilateral mastectomy followed by chemotherapy as a part of his treatment plan.
Methodological Guidelines to Estimate Population-based Health Indicators Using Linked Data and/or Machine Learning Techniques
Authors: Haneef Romana , Tijhuis Mariken , Thiébaut Rodolphe , Májek Ondřej , Pristaš Ivan , Tolenan Hanna , Gallay Anne 
Published: June 2021

Abstract
Background: The capacity to use data linkage and artificial intelligence to estimate and predict health indicators varies across European countries. However, the estimation of health indicators from linked administrative data is challenging due to several reasons such as variability in data sources and data collection methods resulting in reduced interoperability at various levels and timeliness, availability of a large number of variables, lack of skills and capacity to link and analyze big data. The main objective of this study is to develop the methodological guidelines calculating population-based health indicators to guide European countries using linked data and/or machine learning (ML) techniques with new methods. Method: We have performed the following step-wise approach systematically to develop the methodological guidelines: i. Scientific literature review, ii. Identification of inspiring examples from European countries, and iii. Developing the checklist of guidelines contents.Results: We have developed the methodological guidelines, which provide a systematic approach for studies using linked data and/or ML-techniques to produce population-based health indicators. These guidelines include a detailed checklist of the following items: rationale and objective of the study (i.e., research question), study design, linked data sources, study population/sample size, study outcomes, data preparation, data analysis (i.e., statistical techniques, sensitivity analysis and potential issues during data analysis) and study limitations. Conclusions: This is the first study to develop the methodological guidelines for studies focused on population health using linked data and/or machine learning techniques. These guidelines would support researchers to adopt and develop a systematic approach for high-quality research methods. There is a need for high-quality research methodologies using more linked data and ML-techniques to develop a structured cross-disciplinary approach for improving the population health information and thereby the population health.
Severe Multi-inflammatory syndrome in children amidst tropical fevers– an overlapping spectrum, its clinical and laboratory attributes from a tertiary care centre in India.
Authors: Chattopadhyay Arpita , Kalra Karnika Saigal , Saikia Diganta , Yadav Varshanjali , Chouksey Juhi , Jajoo Mamta , Sherwal B L 
Published: June 2021

Abstract
Objective: We aim to describe our experience in terms of clinical and laboratory attributes in children with Multi – inflammatory syndrome in children temporally related to COVID-19 (MISC) presenting amidst other prevalent tropical infections.Design: Prospective case series.Setting: A tertiary care hospital pediatric intensive care unit (PICU).Patients: Seventeen children with severe MIS-C managed in PICU.Methods: We did a prospective case series of children (aged ≤ 12 years), admitted to PICU betweenMay 1, 2020 and January 31, 2021, fulfilling the case definition of MIS-C published by World Health Organization (WHO) or Centers for Disease Control and Prevention (CDC). We analysed routinely collected demographic, clinical, laboratory data and echocardiographic findings. We also plotted the variation in trends between survivors and nonsurvivors.Results: 17 critically ill children with no previous comorbidities fulfilled the WHO/CDC classification of MIS-C. Median age at admission was 4 years (range 1y 6 mo-8 years). Fever, rash and conjunctival redness were most prominent symptoms. Myocardial involvement was seen in 70.5% while 76.4% developed shock; Invasive mechanical ventilation was required in 64.7% cases. Inflammation markers were highly raised - median C- reactive protein (mg/L) showed serial reduction in levels - from (median/IQR) 210 (132.6, 246.9) at admission to PICU to 52.3 (42, 120) on Day 3. Median Ferritin (ng/ml) (n=12) was 690 (203, 1324), serum LDH (IU/L) (n=12) was 505 (229.5, 1032) and Mean D-dimer (ng/ml) (n=7) was 5093.85 (1991.65), suggestive of hyperinflammatory syndrome. Although neutrophilia was seen in 16 patients [Mean (SD) - 14,952.9/μl (7175.2)], lymphopenia was uncommon and seen in only 4/17, median (IQR) [3000/μl (2245, 4508)]. 12 patients received intravenous immune globulin, with adjunctive steroid therapy used in two third of the cases. Six patients expired.Conclusions: With our case series we wish to highlight the pattern of clinical and laboratory features in a cohort of severe MISC who were positive for SARSCOV2 antibody. We suggest refining the spectra of phenotypes of MIS-C for tropical countries keeping other exanthematous infections that present with fulminant myocarditis and refractory shock in perspective.