bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship of concomitant anti-diabetic drug administration with sodium-glucose co-transporter 2 inhibitor-related ketosis
Authors: Lin Cheng-Wei , Hung Shih-Yuan , Chen I-Wen 
Published: March 2022

Objective The use of sodium-glucose co-transporter 2 inhibitors (SGLT2is) may be associated with ketoacidosis. Therefore, the associated risk factors should be identified. In particular, information regarding the effects of the co-administration of anti-diabetic drugs is lacking. Methods We performed a retrospective study of 68 consecutive patients with diabetes who were taking an SGLT2i and attending a single medical center. After a period of treatment (median 78 days), their circulating ketone concentrations were measured. The concomitant use of other anti-diabetic drugs was analyzed to identify independent risk factors associated with ketosis. Results Twenty-five participants were taking empagliflozin, 23 were taking dapagliflozin, and 20 were taking canagliflozin. During the treatment period, no ketoacidotic events were recorded and their mean circulating ketone concentrations at the end of the study period were similar (0.3 mmol/L in the empagliflozin group, 0.26 mmol/L in the dapagliflozin group, and 0.25 mmol/L in the canagliflozin group). After adjustment for the use of anti-diabetic drugs, pioglitazone was found to be independently associated with a risk of high circulating ketone concentration (B value: 0.361, 95% confidence interval: 0.181–0.541). Conclusion SGLT2i-associated ketoacidosis was found to be infrequent, but the concomitant use of pioglitazone was associated with a higher risk of ketosis.
Multimodal Treatment of Robin Sequence Utilizing Mandibular Distraction Osteogenesis and Continuous Positive Airway Pressure
Authors: Kosyk Mychajlo S. , Carlson Anna R. , Zapatero Zachary D. , Kalmar Christopher L. , Liaquat Sidra , Bartlett Scott P. , Taylor Jesse A. , Cielo Christopher M. , Swanson Jordan W. 
Published: March 2022

Mandibular distraction osteogenesis (MDO) and continuous positive airway pressure (CPAP) may each have a role in effectively treating tongue-based airway obstruction (TBAO) in Robin sequence (RS). This study describes longitudinal outcomes after treatment of TBAO with CPAP and/or MDO. Retrospective cohort study. Tertiary Pediatric Hospital. A total of 129 patients with RS treated with CPAP and/or MDO from 2009 to 2019 were reviewed. Subjects receiving baseline and at least one follow-up polysomnogram were included. 55 who underwent MDO ± CPAP and 9 who received CPAP-only treatment were included. Patient characteristics, feeding, and polysomnographic data were compared and generalized linear mixed modeling performed. Baseline obstructive apnea–hypopnea index (OAHI) was greater in the MDO-treated group (median x˜ = 33.7 [interquartile range: 26.5-54.5] than the CPAP-treated group (x˜ = 20.3[13.3-36.7], P ≤ .033). There was significant reduction in OAHI following treatment with CPAP and MDO modalities, P ≤ .001. SpO2 nadir after MDO was lower in syndromic (x˜ = 85.0[81.0-87.9] compared to nonsyndromic patients (x˜ = 88.4[86.8-90.5], P ≤ .005.) CPAP was utilized following MDO in 2/24 (8.3%) of nonsyndromic and 16/31 (51.6%) of syndromic subjects ( P ≤ .001,) for a median duration of 414 days. Three patients (5%) underwent tracheostomy, all had MDO. Nasogastric tube feeding at hospital discharge was more common following MDO (44, 80%) than CPAP-only (4, 44.4%, P ≤ .036), but did not differ at 6-month follow-up ( P ≥ .376). CPAP appears to effectively reduce obstructive apnea in patients with RS and moderate TBAO and be a useful adjunct in syndromic patients following MDO with improved but persistent obstruction.
Change in country-level COVID-19 lethality is associated with improved testing: no apparent role of medical care or disease-specific knowledge
Authors: Smith Maia P. 
Published: March 2022

Aim: Reductions in the case fatality rate of COVID-19 in the unvaccinated have been credited to improvements in medical care. Here I test whether either of these factors predicts reductions in the case fatality rate, and whether observed reductions are better explicable by improved ascertainment of mild cases. Methods: Using weighted log–log regression, I compute the association between changes in the case fatality rate and test density between 3 July 2020 and 5 January 2021 in 162 countries; and check whether case fatality rate change is associated with either per capita medical spending (proxy for critical care access) or timing of the pandemic (proxy for COVID-specific knowledge). Results: The median test density increased from 175 tests per thousand population to 1200, while the median case fatality rate dropped from 4.1% to 2.0%. While the case fatality rate was higher at both timepoints in Europe/North America than Africa / Asia, its association with test density was similar across countries. For each doubling in test density, the mean case fatality rate decreased by 18% ( P<0.0001) with a median (interquartile rate) country-level decline of 20% (5–30) per doubling of test density. The rate of change of the case fatality rate was not associated with either medical care access or COVID-specific knowledge (all P>0.10). Conclusions: Declines in the case fatality rate were adequately explained by improved testing, with no effect of either medical knowledge or improvements in care. The true lethality of COVID-19 may not have changed much at the population level. Prevention should remain a priority.
Systematic review and cost-effectiveness of pharmacokinetically guided sunitinib individualized treatment for patients with metastatic renal cell carcinoma
Authors: Chen Tingting , Chen Jiahe , Chen Chaoxin , Guo Jianming , He Xin , Zheng Song , Liu Maobai , Zheng Bin 
Published: March 2022

Background: Sunitinib has a narrow therapeutic window, with considerable differences between patients. Dosing based on pharmacokinetics (PK) may help overcome some of those issues. This study aims to evaluate and compare the cost-effectiveness of PK-guided individualized treatment of sunitinib with its standard dose in patients with metastatic renal cell carcinoma (mRCC). Methods: A comprehensive literature search was performed, and relevant values were used to provide information for the decision analysis model. Utility data were derived from published studies, and costs were obtained from the perspective of payers in China and the United States. A Markov model was established to evaluate the associated costs and health outcomes for patients. The primary outputs of the model included lifetime costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio (ICER). One-way and probability sensitivity analyses were conducted to evaluate the potential uncertainties of parameters. Results: Cost-effective analysis showed that the QALY of the PK-guided group increased by 0.83 compared with that in the standard dose group. From the perspective of both countries’ health systems, the cost of PK-guided dose was lower than that of standard dose. Hence, PK-guided treatment was the dominant strategy. One-way and probability sensitivity analyses confirmed the reliability of these results. Conclusion: On the basis of currently available data, PK-guided sunitinib treatment may be a safe, effective, and economical intervention for patients with mRCC.
Multi-Dimensional Social Capital and Farmer’s Willingness to Participate in Environmental Governance
Authors: Wang Yuxin , Qu Wenjing , Zheng Lan , Yao Mei 
Published: March 2022

Background The construction and development of formal institutions has been lagging behind in rural areas of China for decades, so the role of social capital is particularly important. In the context of China’s implementation of the rural revitalization strategy, considering the impact of social capital on farmers’ willingness to participate in environmental governance is profitable to the improvement of rural human settlement environment and the increase in the implementation efficiency of relevant policies. Methods Based on the micro-data of villages in Anhui Province, this paper uses the logit model to explore the effects of social capital of trust, network, and norm on farmers’ willingness to participate in environmental governance. Results The results show that both network social capital and norm social capital have a significant effect on farmers’ willingness to participate in environmental governance, and the marginal effect of network social capital is greater than that of norm social capital. After controlling both social network and social norm, however, the effect of social trust is not evident. With the improvement in farmers’ schooling level and income level, the impact of social network and social norms on farmers’ willingness to participate become gradually insignificant, and social capital appears to be “the capital of the poor.” Conclusion Given the above results, we can improve the willingness of farmers to participate in the village environmental governance and lay a solid foundation for the improvement of rural human settlement environment by cultivating village trust, broadening social network, and creating a social custom of mutual benefit. Implications for Conservation Effective environmental governance is an important measure to achieve sustainable development goals. Farmers’ willingness to participate in environmental governance plays a significant role in improving the effectiveness of rural environmental governance. Accordingly, the study of how social capital affects farmers’ willingness to participate provides not only valuable enlightenment for rural environmental governance and protection, but also a long path for sustainable development and biodiversity protection.
Do the variations in ROI placement technique have influence for prostate ADC measurements?
Authors: Ueno Yoshiko , Tamada Tsutomu , Sofue Keitaro , Urase Yasuyo , Hinata Nobuyuki , Fujisawa Masato , Murakami Takamichi 
Published: March 2022

Background Prostate apparent diffusion coefficient (ADC) values calculated from diffusion-weighted imaging have been used for evaluating prostate cancer (PCa) aggressiveness. However, the way of measuring ADC values has varied depending on the study. Purpose To investigate inter- and intra-reader variability and diagnostic performance of three kinds of shaped 2D regions of interests (ROIs) for tumor ADC measurements in PCa. Material and Methods Seventy-four patients with PCa undergoing 3-T MRI before surgery were included. Histologic findings from radical prostatectomy specimens were reviewed to define each patient’s dominant tumor. Three readers independently measured the tumor ADCs using three different ROI methods: freehand, large-circle, and small-circles ROIs. Readers repeated measurements after 3 weeks. Bland-Altman analysis was performed to evaluate the inter- and intra-reader variability. Receiver Operating Characteristic analysis was used for assessment of tumor aggressiveness for PCa. Results For intra-reader and inter-reader variability, the mean coefficient of repeatability for freehand ROIs, large-circle ROIs, and small-circles ROIs were as follows: 13.7%, 12.4%, and 11.5%; 9.4%, 9.7%, and 9.5%. For differentiating Gleason score (GS) = 3 + 3 from GS ≥ 3 + 4 tumors, the area under the curves were 0.90 for freehand ROIs, 0.89 for large-circle ROIs, and 0.94 small-circles ROIs ( p = 0.31). Conclusion The variations in ROI method did not have a major influence on intra-reader or inter-reader reproducibility or diagnostic performance for prostate ADC measurements.
Understanding Health Care Administrators’ Data and Information Needs for Decision Making during the COVID-19 Pandemic: A Qualitative Study at an Academic Health System
Authors: Guerrier Christina , McDonnell Cara , Magoc Tanja , Fishe Jennifer N. , Harle Christopher A. 
Published: March 2022

Objective. The COVID-19 pandemic created an unprecedented strain on the health care system, and administrators had to make many critical decisions to respond appropriately. This study sought to understand how health care administrators used data and information for decision making during the first 6 mo of the COVID-19 pandemic. Materials and Methods. We conducted semistructured interviews with administrators across University of Florida (UF) Health. We performed an inductive thematic analysis of the transcripts. Results. Four themes emerged from the interviews: 1) common types of health systems or hospital operations data; 2) public health and other external data sources; 3) data interaction, integration, and exchange; and 4) novelty and evolution in data, information, or tools used over time. Participants illustrated the organizational, public health, and regional information they considered essential (e.g., hospital census, community positivity rate, etc.). Participants named specific challenges they faced due to data quality and timeliness. Participants elaborated on the necessity of data integration, validation, and coordination across different boundaries (e.g., different hospital systems in the same metro areas, public health agencies at the local, state, and federal level, etc.). Participants indicated that even within the first 6 mo of the COVID-19 pandemic, the data and tools used for making critical decisions changed. Discussion. While existing medical informatics infrastructure can facilitate decision making in pandemic response, data may not always be readily available in a usable format. Interoperable infrastructure and data standardization across multiple health systems would help provide more reliable and timely information for decision making. Conclusion. Our findings contribute to future discussions of improving data infrastructure and developing harmonized data standards needed to facilitate critical decisions at multiple health care system levels. Highlights The study revealed common health systems or hospital operations data and information used in decision making during the first 6 mo of the COVID-19 pandemic. Participants described commonly used internal data sources, such as resource and financial reports and dashboards, and external data sources, such as federal, state, and local public health data. Participants described challenges including poor timeliness and limited local relevance of external data as well as poor integration of data sources within and across organizational boundaries. Results suggest the need for continued integration and standardization of health data to support health care administrative decision making during pandemics or other emergencies.
Incidence and cost of haemolytic uraemic syndrome in urban China: a national population-based analysis
Authors: Feng Jingnan , Xu Ke , Shi Xinmiao , Xu Lu , Liu Lili , Wang Fang , Zhong Xuhui , Liu Guozhen , Wang Jinxi , Gao Pei , Ding Jie , Wang Shengfeng , Zhan Siyan 
Published: March 2022

Abstract
Background
Haemolytic uraemic syndrome (HUS) is a severe syndrome that causes a substantial burden for patients and their families and is the leading cause of acute kidney injury in children. However, data on the epidemiology and disease burden of HUS in Asia, including China, are limited. We aimed to estimate the incidence and cost of HUS in China.

Methods
Data about HUS from 2012 to 2016 were extracted from the Urban Employee Basic Medical Insurance (UEBMI) and Urban Resident Basic Medical Insurance (URBMI) databases. All cases were identified by ICD code and Chinese diagnostic terms. The 2016 national incidence rates were estimated and stratified by sex, age and season. The associated medical costs were also calculated.

Results
The crude incidence of HUS was 0.66 per 100,000 person-years (95% CI: 0.35 to 1.06), and the standardized incidence was 0.57 (0.19 to 1.18). The incidence of HUS in males was slightly higher than that in females. The age group with the highest incidence of HUS was patients < 1 year old (5.08, 95% CI: 0.23 to 24.87), and the season with the highest incidence was autumn, followed by winter. The average cost of HUS was 2.15 thousand US dollars per patient, which was higher than the national average cost for all inpatients in the same period.

Conclusions
This is the first population-based study on the incidence of HUS in urban China. The age and seasonal distributions of HUS in urban China are different from those in most developed countries, suggesting a difference in aetiology.
Bacterial diversity in the intestinal mucosa of heart failure rats treated with Sini Decoction
Authors: Zhao Zhenyu , Liu Jiahao , Hu Yanzhi , Zhang Xining , Cao Liqin , Dong Zhenhua , Li Lin , Hu Zhixi 
Published: March 2022

Abstract
Background
Sini Decoction (SND), a classic Chinese medicine prescription, has been proved to have a good effect on heart failure (HF), whereas its underlying mechanism is still unclear. In order to explore the therapeutic mechanism of SND, we combined with 16S rRNA gene sequencing to analyze the composition of gut microflora in rats with HF.

Material and methods
Twenty Sprague–Dawley (SD) rats were divided into four groups (n = 5): normal group, model group, SND treatment group (SNT group), and metoprolol (Met) treatment group (Meto group). All the rats except the normal group were intraperitoneally injected with doxorubicin (concentration 2 mg/mL, dose 0.15 mL/100 g) once a week to induce HF. After successfully modeling, SND and Met were gavaged to rats, respectively. After the treatment period, blood was collected for hematological analyses, myocardial tissue and colon tissues were collected for Hematoxylin–Eosin (H&E) staining, and mucosal scrapings were collected for Illumina Miseq high-throughput sequencing.

Results
Echocardiographic results suggested that both left ventricular ejection fraction (LVEF) and left ventricular fraction shortening (LVFS) in Model rats decreased compared with normal rats. The results of H&E staining showed that compared with the model group, the structures of myocardial tissue and colon tissue in the SNT group and Meto group showed a recovery trend. Alpha results showed that the model group had higher species diversity and richness compared with the normal group. After treatment, the richness and diversity of intestinal bacteria in the SNT group were significantly restored, and Met also showed the effect of adjusting bacterial diversity, but its effect on bacterial richness was not ideal. At the Family level, we found that the number of several bacteria associated with HF in the model group increased significantly. Excitingly, SND and Met had shown positive effects in restoring these HF-associated bacteria. Similarly, the results of Linear discriminant analysis (LDA) showed that both SND and Met could reduce the accumulation of bacteria in the model group caused by HF.

Conclusion
Collectively, SND can improve HF by regulating the intestinal flora. This will provide new ideas for the clinical treatment of patients with HF.
KMT2C methyltransferase domain regulated INK4A expression suppresses prostate cancer metastasis
Authors: Limberger Tanja , Schlederer Michaela , Trachtová Karolina , Garces de los Fayos Alonso Ines , Yang Jiaye , Högler Sandra , Sternberg Christina , Bystry Vojtech , Oppelt Jan , Tichý Boris , Schmeidl Margit , Kodajova Petra , Jäger Anton , Neubauer Heidi A. , Oberhuber Monika , Schmalzbauer Belinda S. , Pospisilova Sarka , Dolznig Helmut , Wadsak Wolfgang , Culig Zoran , Turner Suzanne D. , Egger Gerda , Lagger Sabine , Kenner Lukas 
Published: March 2022

Abstract
Background
Frequent truncation mutations of the histone lysine N-methyltransferase KMT2C have been detected by whole exome sequencing studies in various cancers, including malignancies of the prostate. However, the biological consequences of these alterations in prostate cancer have not yet been elucidated.

Methods
To investigate the functional effects of these mutations, we deleted the C-terminal catalytic core motif of Kmt2c specifically in mouse prostate epithelium. We analysed the effect of Kmt2c SET domain deletion in a Pten-deficient PCa mouse model in vivo and of truncation mutations of KMT2C in a large number of prostate cancer patients.

Results
We show here for the first time that impaired KMT2C methyltransferase activity drives proliferation and PIN formation and, when combined with loss of the tumour suppressor PTEN, triggers loss of senescence, metastatic dissemination and dramatically reduces life expectancy. In Kmt2c-mutated tumours we show enrichment of proliferative MYC gene signatures and loss of expression of the cell cycle repressor p16INK4A. In addition, we observe a striking reduction in disease-free survival of patients with KMT2C-mutated prostate cancer.

Conclusions
We identified truncating events of KMT2C as drivers of proliferation and PIN formation. Loss of PTEN and KMT2C in prostate cancer results in loss of senescence, metastatic dissemination and reduced life expectancy. Our data demonstrate the prognostic significance of KMT2C mutation status in prostate cancer patients. Inhibition of the MYC signalling axis may be a viable treatment option for patients with KMT2C truncations and therefore poor prognosis.
Ethnobotanical study of wild edible fruits in eastern Bhutan
Authors: Yangdon Pema , Araki Tetsuya , Rahayu Yen Yen Sally , Norbu Kunzang 
Published: March 2022

Abstract
Background
In the past, wild edible fruits (WEFs) were a significant source of food and nutrition in Bhutan. These nutrient-rich species can enhance food security and alleviate poverty in Bhutan. However, recent developments like the introduction of improved fruit varieties, changes in dietary choices, and infrastructure development are expected to influence indigenous knowledge and consumption of WEFs. We aimed to document the species diversity of WEFs and their uses in eastern Bhutan and examine how the knowledge and consumption of WEFs vary with socio-demographic factors.

Methods
A total of 97 households in two districts were selected to participate in the survey. A semi-structured questionnaire was used to interview a selected adult from each household. Comparative analysis of indigenous knowledge and consumption of WEFs among the socio-demographic factors was performed using one-way ANOVA and a Chi-square test on R software.

Results
The present study reported 52 species of WEFs belonging to 35 families. The prevalence of WEF consumption was found to be 42%. WEF consumption differed significantly between districts, age groups, and indigenous knowledge levels. Similarly, indigenous knowledge of WEFs was significantly associated with districts and age groups.

Conclusions
Eastern Bhutan has a rich diversity of WEFs, but their consumption has been decreasing. Recent agricultural and infrastructure developments may have impacted the consumption and indigenous knowledge of WEFs in this region. Thus, domestication and agro-processing of WEFs should become a major focus in Bhutan to utilize their nutritional value and potential economic benefits to enhance food security in the country. Additionally, incorporating WEF-related knowledge in the school curriculum is essential to educate younger generations on WEFs.