bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does fasting during Ramadan increase the risk of developing Sialadenitis?
Authors: Joachim Michael V. , Ghantous Yasmine , Zaaroura Suleiman , Alkeesh Kutaiba , Zoabi Tameem , El-Naaj Imad Abu 
Published: October 2019

Abstract
Background: Ramadan is a the within the Islamic lunar calendar, where Muslims are required to fast (abstain from food and drink) during the daytime (from sunrise to sunset) for the entire month. Due to connection between fasting, dehydration and siaadenitis, the aim of this study is to determine if there is a higher frequency of sialadenitis among the Muslim population during Ramadan compared to other months of the year. Methods: We conducted a retrospective cross-sectional study using the medical records of 120 Muslim patients admitted through the emergency room (ER) with a diagnosis of sialadenitis over a 5-year period at the Baruch Padeh Medical Center, Poriya and St. Vincent de Paul Hospital, Nazareth – both located in Israel. Results: During the month of Ramadan the admission of Muslims through the emergency room (ER) with a diagnosis of sialadenitis was more than doubled compared to other months of the year – a difference that was found to be statistically significant (p=0.001). Additionally we found that Ramadan patients had significantly higher Leukocyte numbers at admission (p=0.0085) and importantly a significantly higher level of dehydration (BUN/Creatinine rate) (p=0.0001). Conclusion: There is evidence that fasting in Ramadan may increase the risk for developing sialadenitis compared to non-fasting months. Our results suggest that this may be the result of dehydration.
Predicting patient outcomes in psychiatric hospitals with routine data: a machine learning approach
Authors: Wolff Jan , Gary Alexander , Jung Daniela , Normann Claus , Kaier Klaus , Binder Harald , Domschke Katharina , Klimke Ansgar , Franz Michael 
Published: October 2019

Abstract
Background A common problem in machine learning applications is availability of data at the point of decision making. The aim of the present study was to use routine data readily available at admission to predict aspects relevant to the organization of psychiatric hospital care. A further aim was to compare the results of machine learning with those obtained through traditional methods and a naive baseline classifier.Methods The study included consecutively discharged patients between 1st of January 2017 and 31st of December 2018 from nine psychiatric hospitals in Hesse, Germany. We compared the predictive performance achieved by stochastic gradient boosting (GBM) with multiple logistic regression and a naive baseline classifier. We tested the performance of our final models on unseen patients from another calendar year and from different hospitals.Results The study included 45,388 inpatient episodes. The models’ performance, as measured by the area under the Receiver Operating Characteristic curve, varied strongly between the predicted outcomes, with relatively high performance in the prediction of coercive treatment (area under the curve: 0.83) and 1:1 observations (0.80) and relatively poor performance in the prediction of short length of stay (0.69) and non-response to treatment (0.65). The GBM performed slightly better than logistic regression. Both approaches were substantially better than a naive prediction based solely on basic diagnostic grouping.Conclusion The present study has shown that administrative routine data can be used to predict aspects relevant to the organisation of psychiatric hospital care. Future research should investigate the predictive performance that is necessary to provide effective assistance in clinical practice for the benefit of both staff and patients.
Comprehensive Classification of the RNaseH-like domain-containing Proteins in Plants
Authors: Li Shuai , Liu Kunpeng , Sun Qianwen 
Published: October 2019

Abstract
Background R-loop is a nucleic acid structure containing an RNA-DNA hybrid and a displaced single-stranded DNA. Recently, accumulated evidences showed that R-loops occur frequently in various organisms’ genomes and have crucial physiological functions, including replication, transcription and DNA repair. RNaseH-like superfamily (RNHLS) domain-containing proteins, such as RNase H enzymes, RNase H1 and RNase H2, are important in restricting R-loop levels. However, little is known about other RNHLS proteins and their relationship and function on modulating R-loops, especially in plants.Results In this study we characterized 6193 RNHLS proteins from 13 representative plant species, and clustered them into 27 clusters, among which reverse transcriptases and exonucleases are the two largest groups. Moreover, we found there are 691 RNHLS proteins in Arabidopsis, and the catalytic alpha helix and beta sheet domain are conserved among them. Interestingly, each of the Arabidopsis RNHLS proteins is composed of RNHLS domains and other distinctive protein domains. we further found that RNHLS genes are highly expressed in diverse meristems and metabolic tissues. Various RNHLS genes expressed in different tissues grouped together indicate that they work both isolatedly and cooperatively.Conclusions In summary, we systematically analyzed RNHL proteins in plant and found that there are mainly 27 subclusters of them. Most of these proteins are implicated in DNA replication, RNA transcription and nucleic acid degradation. We characterized and classified the RNHLS proteins in plant, which affords new insights on investigation of novel regulatory mechanisms and functions in R-loop biology.
Transcriptomic analysis of bovine monocytes in response to non-cytopathic bovine viral diarrhea virus infection
Authors: HE Yanhua , YANG Yajun , HUANG Xin , ZHANG Yunfen , XIAO Chencheng , ZHAO Xinxia , MA Xusheng , GUO Tao , ZHONG Fagang , CHEN Chuangfu 
Published: October 2019

Abstract
Background: Monocytes are significant players in the detection of invading pathogens, particularly in pathogen defense. Bovine Viral Diarrhea Virus (BVDV) can cause a persistent infection and immune suppression if animals are infected with an non-cytopathic (ncp) biotype. However, its exact role in ncp BVDV-infected bovine monocytes remains poorly understood. To explore the immune suppression mechanisms of ncp BVDV, we used a transcriptomics approach to find genes with differential expression patterns in monocytes during infection with ncp BVDV over time. Results: Bovine monocytes were sampled at 2 and 24 h post-infection (hpi) to represent the early and late stages of an ncp biotype strain of bovine viral diarrhea virus infection. Compared with the non-infected cells, 9959 and 7977 differentially expressed gene (DEGs) were identified at 2 and 24 h hpi, respectively. These DEGs were associated with signal transduction, immune response, apoptotic process, cellular process , binding and cellular component. The differential expression profiles of select the type I interferon signaling pathway , interferon (IFN)-stimulated genes (ISGs), and genes involved in the innate immune response, including IRF7, DDX3X, TLR13, DDX58(RIG-I), MVAS, TLR9, TRAF6, IRF1, IFIT1, STAT1, ISG20, TRIM25, MX1,NLRX1, CYLD, SIKE1 and ZAP70 were confirmed by real-time quantitative PCR and consistent with the RNA-seq data. These results indicated that infection with ncp BVDV could activate type I interferon signaling pathway in bovine monocytes and induces weak ISGs responses, which extends our present understanding how the virus modulates the immune response and leads to better understanding behind the immunopathogenesis of ncp BVDV. Conclusion: Our transciptome anslysis provides useful initial data towards better understanding of the infection mechanisms used by ncp BVDV, while highlighting the potential molecular relationships occurring between the virus and the host’s immune response.
Do partial AZFc deletions affect the sperm retrieval rate in non-mosaic Klinefelter patients undergoing microdissection testicular sperm extraction?
Authors: Huang I-Shen , Fantus Richard J , Chen Wei-Jen , Wren James , Kao Wei-Tang , Huang Eric Yi-Hsiu , Bennett Nelson E , Brannigan Robert E , Huang William J 
Published: October 2019

Abstract
Background The purpose of this study is to evaluate the prognostic factors for sperm retrieval and determine if Y chromosome deletion is associated with deleterious effects. Whether Y chromosome deletion determines the sperm retrieval rate in non-mosaic Klinefelter patients has not yet been addressed.Methods We retrospectively collected medical records of azoospermic patients from Sep 2009 to Dec 2018, and enrolled 66 non-mosaic 47, XXY patients who were receiving mTESE. The predictive values of patients age, serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, prolactin, estradiol and Y chromosome deletion were assessed for successful sperm recovery.Results Testicular sperm recovery was successful in 24 (36.4%) of 66 men. The mean age (36.0 vs. 36.6 years), and levels of FSH (30.0 vs 36.9 IU/L), LH (17.7 vs 21.9 IU/L), testosterone (2.4 vs. 2.1 ng/ml), prolactin (9.1 vs. 8.8 ng/ml), and estradiol (19.4 vs. 22.3 pg/ml) did not show any significant difference when comparing patients with and without successful sperm retrieval. Partial deletion of azoospermic factor c (AZFc) was noted in 5 (20.8%) of 24 patients with successful sperm retrieval, including three b2/b3 and two gr/gr deletion cases, whereas 4 (9.5%) of 42 patients with unsuccessful sperm retrieval were noted to have AZFc partial deletion (one b2/b3 , one sY1206 and two gr/gr deletion), though the difference was not statistically significant (p=0.27)Conclusion According to present results, age and AZFc partial deletion status should not be a deterrent for azoospermic males with non-mosaic Klinefelter syndrome to undergo mTESE.
Features of idiopathic and intermediate uveitis–associated epiretinal membranes on OCT and multi-color imaging
Authors: Wang Xiao , Lin Shaofen , Lu Jing , Liu Qiuhui , Mai Guiying , Liu Ruyuan , Cai Xiaoyu , Sadda SriniVas , Luo Yan , Lu Lin 
Published: October 2019

Abstract
BACKGROUND To characterize the morphologic features of idiopathic epiretinal membrane (iERM) and subtle intermediate uveitis-associated epiretinal membrane (IU-ERM) using optical coherence tomography (OCT) with multi-color imaging.METHODS Forty-three eyes of 36 patients diagnosed as iERM and IU-ERM by fundus examination and ultrasound biomicroscopy were underwent multi-color scanning laser ophthalmoscopy imaging using a Heidelberg Spectralis HRA+OCT. Area and thickness of the ERM, central foveal thickness (CFT), and best-corrected visual acuity (BCVA) were compared between these two groups.RESULTS The ERM area of the IU-ERM group was larger than that of the iERM group (33.03 ± 14.62mm2 vs.13.03 ± 7.00 mm2, P<0.001). The ERM thickness of the IU-ERM group was also thicker than that of iERM group (20.14 ± 1.52 µm vs.17.92 ± 1.28 µm, P<0.001). The BCVA of the eyes with iERM was better (0.10 ± 0.18 vs.0.35 ± 0.28, P<0.001) and the CFT was thinner (217.66 ± 64.21 µm vs. 359.19 ± 128.72 µm, P = 0.002) compared to the IU-ERM group.CONCLUSION IU-ERM was larger and thicker than iERM. OCT with multi-color imaging could faciliate the assessment of ERM morphology, which might aid in differentiating IU-ERM from iERM.
Characteristics of Resting-State Functional Connectivity in Older Adults after the PICMOR Intervention Program: A Preliminary Report
Authors: Sugimoto Hikaru , Kawagoe Toshikazu , Otake-Matsuura Mihoko 
Published: October 2019

Abstract
Background: The present study aimed to provide a basis for future research examining neural mechanisms underlying the beneficial effect of an intervention program named Photo-Integrated Conversation Moderated by Robots (PICMOR) on verbal fluency in older adults, which was identified in our previous study. In this preliminary report, we conducted an additional experiment using resting-state functional magnetic resonance imaging (rsfMRI) and investigated the characteristics of resting-state functional connectivity (rsFC) of participants in the intervention group (INT) by comparing with that of participants in the control group (CONT).Methods: The rsfMRI data were acquired from 31 participants in INT and 30 participants in CONT after the randomized control trial. These data were analyzed by a seed-based approach, in which the left inferior and middle frontal gyrus (IFG/MFG) were selected as seed regions and the rsFCs with them were compared between INT and CONT. To interpret the group difference in the rsFCs, we also conducted regression analyses using individual scores of the phonemic verbal fluency test, which were collected before and after the intervention.Results: We found higher rsFC in INT than in CONT between the left IFG and the temporal pole and MFG. The rsFC strength between the left IFG and temporal pole positively correlated with an increased score in the phonemic verbal fluency test through the intervention period. In contrast, we found lower rsFC in INT than in CONT between the left MFG and the posterior cingulate cortex, precuneus, and postcentral gyrus.Conclusions: Along with our previous findings that greater enhancement of the phonemic verbal fluency score through the intervention period was observed in INT than in CONT, the present findings suggest that the beneficial intervention effect is characterized by enhanced rsFC of the left IFG with semantic and executive control-related regions and suppressed rsFC between the left MFG and default mode network.Trial registration: The trial was retrospectively registered at the UMIN Clinical Trials Registry (UMIN000036667) (Date of registration: 7th May, 2019).
The effect of milrinone on mortality in adult patients: A systematic review of randomized clinical trials with meta-analysis and trial sequential analysis
Authors: Ren Yu-shan , Li Lan-fang , Peng Tao , Tan Yu-jun , Sun Ying , Cheng Guo-liang , Zhang Gui-min , Li Jie 
Published: October 2019

Abstract
OBJECTIVE: Milrinone is commonly used for patients performed coronary artery bypass graft surgery (CABG) because of its effectiveness in decreasing cardiac index and mitral regurgitation. This study was to perform a systematic meta-analysis of existing studies in the past 20 years to evaluate the impact of milrinone on mortality in patients undergoing CABG surgery. EASUREMENTS AND MAIN RESULTS: The network meta-analysis included 723 patients from 16 randomized clinical trials. Overall, there was no significantly difference in mortality between the milrinone group and the placebo/standard care group [11/352 (3.13%) vs. 9/346 (2.60%), risk ratio = 1.18 (0.53–2.62), p for effect = 0.69, I 2 = 0 %] when patients underwent CABG surgery. Besides that, 9 trials (with 440 randomized patients), 4 trials (with 212 randomized patients), and 10 trials (with 470 randomized patients) reported that the occurrence of myocardial infarction (MI), myocardial ischemia, and arrhythmias in the milrinone group were decreased in comparsion with the placebo/standard care group, respectively. Between the milrinone treatment and placebo/standard care groups, the occurrence of myocardial infarction was [5/219 (2.28 %) vs. 25/212 (17.79 %), odds ratio(OR) = 0.19 (0.08–0.49), p value = 0.0005, I 2 = 5%], the occurrence of myocardial ischemia was [12/106 (11.32 %) vs. 41/106 (36.68 %), OR = 0.20 (0.10–0.42), p value <0.0001, I 2 = 0 %], and the occurrence of arrhythmias was [16/234 (6.84 %) vs. 31/236 (13.14 %), OR= 0.46 (0.24–0.88), p value = 0.02, I 2 =0 %]. However, the occurrence of stroke and renal failure, duration of inotropic support (h), need for intra-aortic balloon pump (IABP), and mechanical ventilation (h) between these two groups showed no differences. CONCLUSION: Based on the current results, milrinone might be unable to decrease the mortality in adult CABG surgical patients, but can significantly ameliorate the occurrence of MI, myocardial ischemia, and arrhythmias compared with placebo-treated patients. These results provide evidence for further clinical application of milrinone and therapy strategies for CABG surgery. However, along with milrinone application in clinical use, sufficient randomized clinical trials need to be collected, and the potential benefit and adverse effects should be analyzed and reevaluated.
Prognostic Significance of Stem Cell/ Epithelial-Mesenchymal Transition Markers in Periampullary/Pancreatic Cancers: FGFR1 Is A Novel Marker.
Authors: Chong Yosep , Thakur Nishant , Paik Kwang Yeol , Lee Eun Jung , Kang Chang Suk 
Published: October 2019

Abstract
Background: Periampullary cancers (PAC) including pancreatic, ampulla of Vater (AOV), and common bile duct (CBD) cancers are highly aggressive with lack of useful prognostic markers beyond T stage. However, T staging can be biased due to the anatomic complexity of this region. Recently, several markers related to cancer stem cells and epithelial-mesenchymal transition (EMT) such as octamer transcription factor-4 (Oct4) and fibroblast growth factor receptor 1 (FGFR1) respectively, have been proposed as new promising markers in other solid cancers. The aim of this study was to access the expression and prognostic significance of stem cell/EMT markers in PACs.Methods: Formalin-fixed, paraffin-embedded tissues of surgically excised PACs from the laboratory archives from 1998 to 2014 were evaluated by immunohistochemical staining for stem cell/EMT markers using tissue microarray. The clinicopathologic parameters were documented and statistically analyzed with the immunohistochemical findings. Survival and recurrence data were collected and analyzed.Results: A total of 126 PAC cases were evaluated. The average age was 63 years, with 76 male and 50 female patient samples. The overall survival was statistically related to old age (over 74 years), tumor epicenter (pancreas < CBD < AOV), T stage, tumor size, N stage, lymphatic, vascular, perineural invasion, histologic grade (differentiation), subtype (pancreaticobiliary type < intestinal type), degree of fibrosis, and inflammation. The expression levels of FGFR1 as well as CK20, CDX2, and VEGF were significantly related to overall survival while other stem cell markers were not related. Similar findings were observed for tumor recurrence using disease-free survival. Conclusions: In addition to other clinicopathologic parameters, the degree of fibrosis and expression of FGFR1 were novel markers for overall survival and tumor recurrence. Histologic changes such as extensive fibrosis needs to be investigated further in relation to EMT of PACs.
Germline whole exome sequencing of a family with appendiceal mucinous tumours presenting with pseudomyxoma peritonei
Authors: Lung Mei Sim , Mitchell Catherine A. , Doyle Maria A. , Lynch Andrew C. , Gorringe Kylie L. , Bowtell David D.L. , Campbell Ian G. , Trainer Alison H. 
Published: October 2019

Abstract
Background Familial cases of appendiceal mucinous tumours (AMTs) are extremely rare and the underlying genetic aetiology uncertain. We identified potential predisposing germline genetic variants in a father and daughter with AMTs presenting with pseudomyxoma peritonei (PMP) and correlated these with regions of loss of heterozygosity (LOH) in the tumours. Materials and Methods Through germline whole exome sequencing, we identified novel heterozygous loss-of-function (LoF) (i.e. nonsense, frameshift and essential splice site mutations) and missense variants shared between father and daughter, and validated all LoF variants, and missense variants with a Combined Annotation Dependent Depletion (CADD) scaled score of ≥10. Genome-wide copy number analysis was performed on tumour tissue from both individuals to identify regions of LOH. Results Seventeen novel variants in 17 genes were shared by the father and daughter: a nonsense mutation in REEP5 , an essential splice site mutation in THOP1 , and 15 missense variants. None of these germline variants were located in tumour regions of LOH shared by the father and daughter. Four genes ( EXOG , RANBP2, RANBP6 and TNFRSF1B ) harboured missense variants that fell in a region of LOH in the tumour from the father only, but none showed somatic loss of the wild type allele in the tumour. The REEP5 gene was sequenced in 23 individuals with presumed sporadic PMP; no LoF or rare missense germline variants were identified. Conclusion Germline exome sequencing of a father and daughter with AMTs identified novel candidate predisposing genes. Further studies are required to clarify the role of these genes in familial AMTs.
Implementation and adoption of a health insurance support tool in the electronic health record: A mixed methods analysis within a randomized trial
Authors: Hatch Brigit , Tillotson Carrie , Huguet Nathalie , Marino Miguel , Baron Andrea , Nelson Joan , Sumic Aleksandra , Cohen Deborah , DeVoe Jennifer 
Published: October 2019

Abstract
Background: In addition to delivering vital health care to millions of patients in the United States, community health centers (CHCs) provide needed health insurance outreach and enrollment support to their communities. We developed a health insurance enrollment tracking tool integrated within the electronic health record (EHR) and conducted a hybrid implementation-effectiveness trial in a CHC-based research network to assess tool adoption using two implementation strategies. Methods: CHCs were recruited from the OCHIN practice-based research network. Seven health center systems (23 CHC clinic sites) were recruited and randomized to receive basic educational materials alone (Arm 1), or these materials plus facilitation (Arm 2) during the 18-month study period, September 2016-April 2018. Facilitation consisted of monthly contacts with clinic staff and utilized audit and feedback and guided improvement cycles. We measured total and monthly tool utilization from the EHR. We conducted structured interviews of CHC staff to assess factors associated with tool utilization. Qualitative data were analyzed using an immersion-crystallization approach with barriers and facilitators identified using the Consolidated Framework for Implementation Research. Results: The majority of CHCs in both study arms adopted the enrollment tool. The rate of tool utilization was, on average, higher in Arm 2 compared to Arm 1 (20.0% versus 4.7%, p <0.01). However, by the end of the study period, the rate of tool utilization was similar in both arms; and observed between-arm differences in tool utilization were largely driven by a single, large health center in Arm 2. Perceived relative advantage of the tool was the key factor identified by clinic staff as driving tool utilization. Implementation climate and leadership engagement were also associated with tool utilization. Conclusions: Using basic education materials and low-intensity facilitation, CHCs quickly adopted an EHR-based tool to support critical outreach and enrollment activities aimed at improving access to health insurance in their communities. Though facilitation carried some benefit, a CHC’s perceived relative advantage of the tool was the primary driver of decisions to implement the tool. Trial Registration: ClinicalTrials.gov: NCT02355262, Posted February 4, 2015