bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pengaruh Citra Rumah Sakit, Kualitas Layanan Terhadap Kepuasan dan Loyalitas Pasien BPJS Rawat Inap
Authors: Oktoriani Ervita Nindy 
Published: April 2023

Rumah sakit sebagai institusi yang bergerak di bidang jasa dimana pelayanannya merupakan tolok ukur penilaian kinerja. Salah satu tolok ukurnya adalah kualitas pelayanan yang diterima oleh pasien dari sebuah rumah sakit, oleh sebab itu sudah menjadi kewajiban pihak manajemen rumah sakit untuk menjaga hubungan baik dengan pasien untuk menciptakan sebuah nilai kepuasan yang maksimal. Penelitian ini menggunakan penelitian kuantitatif dengan tujuan untuk menganalisis secara empiris pengaruh variable independent yaitu Citra RumahÂ SakitÂ danÂ KualitasÂ pelayananÂ terhadap variabel independen yaitu kepuasan pasien dan loyalitas pasien. Hasil penelitian menunjukkan bahwa seluruh hipotesis dalam penelitian ini dapat diterima, yakni 1) Citra berpengaruh positif dan signifikan terhadap kepuasan pasien BPJS Rawat Inap Di RSUD X. 2) Kualitas layanan berpengaruh positif dan signifikan terhadap kepuasan pasien BPJS Rawat Inap Di RSUD X. 3) Citra berpengaruh positif dan signifikan terhadap loyalitas pasien BPJS Rawat Inap Di RSUD X. 4) Kualitas layanan berpengaruh positif dan signifikan terhadap loyalitas pasien BPJS Rawat Inap Di RSUD X. 5) Kepuasan pasien berpengaruh positif dan signifikan terhadap loyalitas pasien BPJS Rawat Inap Di RSUD X. 6) Citra berpengaruh positif dan signifikan terhadap loyalitas melalui kepuasan pasien BPJS Rawat Inap Di RSUD X.7) Kualitas layanan berpengaruh positif dan signifikan terhadap loyalitas melalui kepuasan pasien BPJS Rawat Inap Di RSUD X.
Modern features of the delivery complicated premature rupture of membrane at term
Authors: Kaganova M. A. , Spiridonova N. V. , Kaganova T. I. , Nesterenko S. A. 
Published: April 2023

Premature rupture of membranes (PROM) is diagnosed in 6–26.5% of full-term pregnancies. An analysis of the characteristics of labor and the frequency of complications in tPROM could allow us to identify «weak» points and optimize the managing this category of patients.The aim of the study was to assess the characteristics of labor during full-term pregnancy (at 37.0–41.0 weeks), complicated by premature rupture of the membranes.Materials and methods. A prospective analysis of the course of labor and the postpartum period was carried out in 425 patients with singleton pregnancy in cephalic presentation, 37,0–41,0 weeks of gestation, women of low and moderate risk groups, without contraindications to vaginal delivery.. As a complication of the pregnancy, 310 of them had PPROM (main group) and 115 women in labor went into labor with intact fetal membrane (comparison group). The features of the delivery and postpartum complications were analyzed.Results: The features of delivery patients with PROM was the longer duration of rupture – 4.7 times higher than in the comparison group (p<0.001), the second stage of labor – in the main group more an average of 7 minutes (p=0.008). The frequency of abnomally labor activity in the main group, such as abnormally slow or protracted labor (primary and secondary), was 2 times higher than it was in the comparison group. The diagnosis of «cervical dystocia» was observed in 27 cases (8.7%) only in the group with PROM. In the main group, oxytocin was used in 165 patients (53.2%), which is more than 2 times higher than in the comparison group – 25 (21.7%, p<0.001), respectively, the total dose of oxytocin used was higher at vaginal delivery: 8 .06 (0.44) U and 1.06 (0.46) U (p<0.001). The differences in this parameter at patents of both group with C-section were not signifcant. Medical analgesia in the main group was required 2 times more often than in the comparison group (83.5 and 43.5%; <0.001).The problem of tPROM is a higher percentage of operative delivery and obstetric trauma. Thus, in our study, the incidence of C-section was 54 cases (17.4%) compared with the another group – 2 cases (1.7%), vaginal operative delivery – 20 cases (6.5%) and 3 (2.6%)%) respectively (Xi=21.88; Df=2; p<0.001), cervical ruptures: 11.3% (p=0.002), episiotomies: 8.3% (p=0.099). The frequency of postpartum septic complications was comparable in groups, but high level of leukocyts and antibiotic therapy were more often in patients with PROM.Conclusion: the management of labor in patients with PROM is associated with a high percentage of the use of oxytocin, antibacterial therapy, various methods of medical analgesia, and operative delivery.
Retinoic acid receptor regulation of decision-making for cell differentiation
Authors: Brown Geoffrey 
Published: April 2023

All-trans retinoic acid (ATRA) activation of retinoic acid receptors (RARs) is crucial to an organism’s proper development as established by findings for mouse foetuses from dams fed a vitamin A-deficient diet. ATRA influences decision-making by embryonic stem (ES) cells for differentiation including lineage fate. From studies of knockout mice, RARα and RARγ regulate haematopoiesis whereby active RARα modulates the frequency of decision-making for myeloid differentiation, but is not essential for myelopoiesis, and active RARγ supports stem cell self-renewal and maintenance. From studies of zebrafish embryo development, active RARγ plays a negative role in stem cell decision-making for differentiation whereby, in the absence of exogenous ATRA, selective agonism of RARγ disrupted stem cell decision-making for differentiation patterning for development. From transactivation studies, 0.24 nM ATRA transactivated RARγ and 19.3 nM (80-fold more) was needed to transactivate RARα. Therefore, the dose of ATRA that cells are exposed to in vivo, from gradients created by cells that synthesize and metabolize, is important to RARγ versus RARα and RARγ activation and balancing of the involvements in modulating stem cell maintenance versus decision-making for differentiation. RARγ activation favours stemness whereas concomitant or temporal activation of RARγ and RARα favours differentiation. Crosstalk with signalling events that are provoked by membrane receptors is also important.
Effects of paternal obesity on maternal-neonatal outcomes and long-term prognosis in adolescents
Authors: Lin Yingying , Chen Zhiwei , Qian Qinfang , Wang Yanxia , Xiu Xiaoyan , Ou Ping , Fang Jiaoning , Li Guobo 
Published: April 2023

ObjectiveThis study evaluated whether paternal body mass index (BMI) before pregnancy was a risk factor for maternal-neonatal outcomes and long-term prognosis in offspring.MethodsThis study included 29,518 participants from eight cities in Fujian, China using a stratified cluster random sampling method from May to September 2019. They were divided into four groups based on paternal BMI. Univariate and multivariate logistic regression were used to explore the relationship between paternal BMI groups, maternal-neonatal outcomes, and long-term prognosis in offspring. Further subgroup analysis was conducted to examine the stability of the risk. ResultsThe incidences of hypertensive disorder complicating pregnancy (HDCP), cesarean delivery, gestational weight gain (GWG) over guideline, and macrosomia were significantly higher in the paternal overweight and obesity group. Importantly, this study demonstrated that the incidence of asthma, hand-foot-and-mouth disease (HFMD), anemia, dental caries, and obesity of adolescents in paternal obesity increased. Furthermore, logistic regression and subgroup analysis confirm paternal obesity is a risk factor for HDCP, cesarean delivery, and macrosomia. It caused poor long-term prognosis in adolescents, including asthma, dental caries, and HFMD.ConclusionsPaternal obesity is a risk factor for adverse maternal-neonatal outcomes and poor long-term prognosis in adolescents. In addition to focusing on maternal weight, expectant fathers should pay more attention to weight management since BMI is a modifiable risk factor. Preventing paternal obesity can lead to better maternal and child outcomes. It would provide new opportunities for chronic diseases.
Obstructive sleep apnea risk and determinant factors among type 2 diabetes mellitus patients at the chronic illness clinic of the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia
Authors: Worku Abebe , Ayele Eleni , Alemu Shitaye , Legese Gebrehiwot Lema , Yimam Samrawit Meles , Kassaw Getasew , Diress Mengistie , Asres Mezgebu Silamsaw 
Published: April 2023

IntroductionObstructive sleep apnea is a sleep complaint among type 2 diabetes mellitus patients that has a deleterious effect on health with immediate and long-term impacts. Despite its impacts, data on the magnitude and predictors of obstructive sleep apnea among type 2 diabetes mellitus patients in Ethiopia is still limited. Thus, this study was conducted to determine how common a high risk of obstructive sleep apnea is and its predictors among type 2 diabetes mellitus patients receiving follow-up care at the chronic illness follow-up clinic at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2022.MethodsAn institution-based cross-sectional study was conducted. Interviewer-administered questionnaires and physical measurements with standard instruments were used to collect the required data. The collected data were entered into EpiData 4.6 and exported into STATA 14. Both Bivariable and multivariable binary logistic regression analyses were done to identify factors associated with a high risk of obstructive sleep apnea. Variables with a p-value ≤0.05 in the multivariable logistic regression analysis were declared as significantly associated with a high risk of obstructive sleep apnea.ResultsA total of 319 type 2 diabetes mellitus patients with a median age of 58 years participated in our current study. The overall prevalence of a high risk of obstructive sleep apnea among the study participants was 31.97% (95%CI: 27.06, 37.32). On multivariable logistic analysis, a neck circumference of ≥40 cm (AOR=4.33, 95%CI 1.37, 13.72), physical inactivity (AOR=2.29, 95%CI 1.15, 4.53), comorbid hypertension (AOR=4.52, 95%CI 2.30, 9.18), and male sex (AOR=8.01, 95%CI 3.02, 21.24) were associated with a high risk of obstructive sleep apnea.Conclusion and recommendationThe prevalence of a high risk of obstructive sleep apnea among type 2 diabetes mellitus patients remains high. A neck circumference of ≥40 cm, physical inactivity, comorbid hypertension, and male sex were significantly associated with a high risk of obstructive sleep apnea among type 2 diabetes mellitus patients. Screening and evaluation of type 2 diabetes mellitus patients for obstructive sleep apnea are recommended to avoid the negative impacts.
Pan-cancer analysis of ADAMs: A promising biomarker for prognosis and response to chemotherapy and immunotherapy
Authors: Ma Bo , Yu Riyue 
Published: April 2023

Background: Members of a disintegrin and metalloproteinase (ADAM) family play a vital role in cancer development. However, a comprehensive analysis of the landscape of the ADAM family in pan-cancer remains to be performed.Methods: The correlation of the expression level and prognostic value with ADAMs in a pan-cancer cohort and the relationship between ADAMs and the stemness score, tumour microenvironment (TME), chemotherapy-related drug sensitivity, immune subtype, and immunotherapy outcome were investigated.Results: ADAMs were differentially expressed between tumour and para-carcinoma tissues in the pan-cancer cohort, and the expression of ADAMs was significantly correlated with patient prognosis. Furthermore, ADAMs were significantly correlated with the stromal score and immune score based on the TME analysis. Additionally, ADAMs were also correlated with DNAss and RNAss in the pan-cancer cohort. On investigating the CellMiner database, ADAMs were revealed to be significantly correlated with the sensitivity of various drugs, including raloxifene and tamoxifen. Moreover, in the IMvigor210 and GSE78220 cohorts, ADAMs were correlated with immunotherapy response and immune activation genes. Furthermore, quantitative real-time polymerase chain reaction (qRT-PCR) and immunohistochemistry (IHC) were utilised to determine the differential level of ADAM9 in cancer and para-carcinoma tissues in patients’ samples.Conclusion: This study elucidates the importance of ADAMs in cancer progression and lays a foundation for further exploration of ADAMs as potential pan-cancer targets.
GCK exonic mutations induce abnormal biochemical activities and result in GCK-MODY
Authors: Dai Tongtong , Yang Yun , Zhang Juanjuan , Ma Xiaoyu , Chen Lifen , Zhang Caiping , Lv Sheng , Li Lin , Tang Renqiao , Zhen Ni , Lu Wenli , Li Chuanyin , Hu Ronggui , Xiao Yuan , Dong Zhiya 
Published: April 2023

Objective: Glucokinase-maturity-onset diabetes of the young (GCK-MODY; MODY2) is a rare genetic disorder caused by mutations in the glucokinase (GCK) gene. It is often under- or misdiagnosed in clinical practice, but correct diagnosis can be facilitated by genetic testing. In this study, we examined the genes of three patients diagnosed with GCK-MODY and tested their biochemical properties, such as protein stability and half-life, to explore the function of the mutant proteins and identify the pathogenic mechanism of GCK-MODY.Methods: Three patients with increased blood glucose levels were diagnosed with MODY2 according to the diagnostic guidelines of GCK-MODY proposed by the International Society for Pediatric and Adolescent Diabetes (ISPAD) in 2018. Next-generation sequencing (whole exome detection) was performed to detect gene mutations. The GCK gene and its mutations were introduced into the pCDNA3.0 and pGEX-4T-1 vectors. Following protein purification, enzyme activity assay, and protein immunoblotting, the enzyme activity of GCK was determined, along with the ubiquitination level of the mutant GCK protein.Results: Genetic testing revealed three mutations in the GCK gene of the three patients, including c.574C&gt;T (p.R192W), c.758G&gt;A (p.C253Y), and c.794G&gt;A (p.G265D). The biochemical characteristics of the protein encoded by wild-type GCK and mutant GCK were different, compared to wild-type GCK, the enzyme activity encoded by the mutant GCK was reduced, suggesting thermal instability of the mutant GST-GCK. The protein stability and expression levels of the mutant GCK were reduced, and the enzyme activity of GCK was negatively correlated with the levels of fasting blood glucose and HbA1c. In addition, ubiquitination of the mutant GCK protein was higher than that of the wild-type, suggesting a higher degradation rate of mutant GCK than WT-GCK.Conclusion:GCK mutations lead to changes in the biochemical characteristics of its encoded proteins. The enzyme activities, protein expression, and protein stability of GCK may be reduced in patients with GCK gene mutations, which further causes glucose metabolism disorders and induces MODY2.
Host A-to-I RNA editing signatures in intracellular bacterial and single-strand RNA viral infections
Authors: Wei Zhi-Yuan , Wang Zhi-Xin , Li Jia-Huan , Wen Yan-Shuo , Gao Di , Xia Shou-Yue , Li Yu-Ning , Pan Xu-Bin , Liu Yan-Shan , Jin Yun-Yun , Chen Jian-Huan 
Published: April 2023

BackgroundMicrobial infection is accompanied by remodeling of the host transcriptome. Involvement of A-to-I RNA editing has been reported during viral infection but remains to be elucidated during intracellular bacterial infections.ResultsHerein we analyzed A-to-I RNA editing during intracellular bacterial infections based on 18 RNA-Seq datasets of 210 mouse samples involving 7 tissue types and 8 intracellular bacterial pathogens (IBPs), and identified a consensus signature of RNA editing for IBP infections, mainly involving neutrophil-mediated innate immunity and lipid metabolism. Further comparison of host RNA editing patterns revealed remarkable similarities between pneumonia caused by IBPs and single-strand RNA (ssRNA) viruses, such as altered editing enzyme expression, editing site numbers, and levels. In addition, functional enrichment analysis of genes with RNA editing highlighted that the Rab GTPase family played a common and vital role in the host immune response to IBP and ssRNA viral infections, which was indicated by the consistent up-regulated RNA editing of Ras-related protein Rab27a. Nevertheless, dramatic differences between IBP and viral infections were also observed, and clearly distinguished the two types of intracellular infections.ConclusionOur study showed transcriptome-wide host A-to-I RNA editing alteration during IBP and ssRNA viral infections. By identifying and comparing consensus signatures of host A-to-I RNA editing, our analysis implicates the importance of host A-to-I RNA editing during these infections and provides new insights into the diagnosis and treatment of infectious diseases.
A tryptophan metabolite prevents depletion of circulating endothelial progenitor cells in systemic low-grade inflammation
Authors: Mannarino Massimo R. , Bianconi Vanessa , Scalisi Giulia , Franceschini Luca , Manni Giorgia , Cucci Alessia , Bagaglia Francesco , Mencarelli Giulia , Giglioni Francesco , Ricciuti Doriana , Figorilli Filippo , Pieroni Benedetta , Cosentini Elena , Padiglioni Eleonora , Colangelo Cecilia , Fuchs Dietmar , Puccetti Paolo , Follenzi Antonia , Pirro Matteo , Gargaro Marco , Fallarino Francesca 
Published: April 2023

BackgroundChronic systemic inflammation reduces the bioavailability of circulating endothelial progenitor cells (EPCs). Indoleamine 2,3-dioxygenase 1 (IDO1), a key enzyme of immune tolerance catalyzing the initial step of tryptophan degradation along the so-called l-kynurenine (l-kyn) pathway, that is induced by inflammatory stimuli and exerts anti-inflammatory effects. A specific relationship between IDO1 activity and circulating EPC numbers has not yet been investigated.MethodsIn this study, circulating EPCs were examined in mice treated with low doses of lipopolysaccharide (LPS) to mimic low-grade inflammation. Moreover, the association between IDO1 activity and circulating EPCs was studied in a cohort of 277 patients with variable systemic low-grade inflammation.ResultsRepeated low doses of LPS caused a decrease in circulating EPCs and l-kyn supplementation, mimicking IDO1 activation, significantly increased EPC numbers under homeostatic conditions preventing EPC decline in low-grade endotoxemia. Accordingly, in patients with variable systemic low-grade inflammation, there was a significant interaction between IDO1 activity and high-sensitivity C-reactive protein (hs-CRP) in predicting circulating EPCs, with high hs-CRP associated with significantly lower EPCs at low IDO1 activity but not at high IDO1 activity.InterpretationOverall, these findings demonstrate that systemic low-grade inflammation reduces circulating EPCs. However, high IDO1 activity and l-kyn supplementation limit circulating EPC loss in low-grade inflammation.
Association between treatment failure in patients with early syphilis and penicillin resistance-related gene mutations of Treponema pallidum: Protocol for a multicentre nested case–control study
Authors: Mi Hong-Fei , Shen Xu , Chen Xiao-Qing , Zhang Xiao-Luo , Ke Wu-Jian , Xiao Yao 
Published: April 2023

BackgroundThe widespread occurrence of syphilis remains a global public health problem. Although penicillin has been recommended as the first-line therapy for syphilis for more than 70 years, treatment failure occurs in 10–20% of patients with early syphilis. Recent studies have reported varied single-nucleotide polymorphisms (SNPs) of Treponema pallidum related to penicillin resistance. The clinical relevance of these SNPs to treatment failure in patients with early syphilis is unresolved. In this work, a protocol is developed to evaluate the association between treatment failure in patients with early syphilis and penicillin resistance-related gene mutations of T. pallidum.MethodsA multicentre nested case–control study is designed, and patients who are diagnosed with early syphilis and treated with penicillin will be recruited for the study cohort. Before the first treatment, baseline information and biological specimens will be collected from the subjects, and serological tests for syphilis will be performed. Each participant will be followed up at 1, 3, 6, 9, and 12 months after the first treatment, and the clinical manifestations and serum non-treponemal test titres will be evaluated at each follow-up. Patients who will fail treatment are defined as cases, and those who will respond to treatment are defined as controls. Tests for SNPs related to penicillin-binding proteins and Tp47 will be performed in these cases and controls. Survival analysis is used performed to identify gene mutations of T. pallidum related to penicillin resistance and their combinations associated with treatment failure.DiscussionThis protocol provides a practical clinical study design that illustrates the role of gene mutations of T. pallidum related to penicillin resistance in the treatment outcome of patients with early syphilis.
Identification of DYNLT1 associated with proliferation, relapse, and metastasis in breast cancer
Authors: Miao Sen , Ju Gaoda , Jiang Chonghua , Xue Bing , Zhao Lihua , Zhang Rui , Diao Han , Yu Xingzhou , Zhang Linlin , Pan Xiaozao , Zhang Hua , Zang Lijuan , Wang Lei , Zhou Tianhao 
Published: April 2023

BackgroundBreast cancer (BC) is the most common malignant disease worldwide. Although the survival rate is improved in recent years, the prognosis is still bleak once recurrence and metastasis occur. It is vital to investigate more efficient biomarkers for predicting the metastasis and relapse of BC. DYNLT1 has been reported that participating in the progression of multiple cancers. However, there is still a lack of study about the correlation between DYNLT1 and BC.MethodsIn this study, we evaluated and validated the expression pattern and prognostic implication of DYNLT1 in BC with multiple public cohorts and BC tumor microarrays (TMAs) of paraffin-embedded tissues collected from the Affiliated Hospital of Jining Medical University. The response biomarkers for immune therapy, such as tumor mutational burden (TMB), between different DYNLT1 expression level BC samples were investigated using data from the TCGA-BRCA cohort utilizing public online tools. In addition, colony formation and transwell assay were conducted to verify the effects of DYNLT1 in BC cell line proliferation and invasion.ResultsThe results demonstrated that DYNLT1 overexpressed in BC and predicted poor relapse-free survival in our own BC TMA cohort. In addition, DYNLT1 induced BC development by promoting MDA-MB-231 cell proliferation migration, and metastasis.ConclusionAltogether, our findings proposed that DYNLT1 could be a diagnostic and prognostic indicator in BC.