bluuebunny/crossref_metadata_2025 huggingface dataset:
Short-term Outcomes of Robotic- versus Laparoscopic-Assisted Total Gastrectomy for Advanced Gastric Cancer: A Propensity Score Matching Study
Authors: Yang Changdong , Shi Yan , Xie Shaohui , Chen Jun , Zhao Yongliang , Qian Feng , Hao Yingxue , Tang Bo , Yu Pei-Wu
Published: March 2020

Background: Few studies have been designed to evaluate the short-term outcomes between robotic-assisted total gastrectomy (RATG) and laparoscopy-assisted total gastrectomy (LATG) for advanced gastric cancer (AGC). The purpose of this study was to assess the short-term outcomes of RATG compared with LATG for AGC. Methods: We retrospectively evaluated 126 and 257 patients who underwent RATG or LATG, respectively. In addition, we performed propensity score matching (PSM) analysis between RATG and LATG for clinicopathological characteristics to reduce bias and compared short-term surgical outcomes. Results: After PSM, the RATG group had a longer mean operation time (291.14±59.18 vs. 270.34±52.22 min, p=0.003), less intraoperative bleeding (154.37±89.68 vs. 183.77±95.39 ml, p=0.004) and more N2 tier RLNs (9.07±5.34 vs. 7.56±4.50, p=0.016) than the LATG group. Additionally, the total RLNs of the RATG group were almost significantly different compared to that of the LATG group (34.90±13.05 vs. 31.91±12.46, p=0.065).Moreover, no significant differences were found between the two groups in terms of the length of incision, proximal resection margin, distal resection margin, residual disease and postoperative hospital stay. There was no significant difference in the overall complication rate between the RATG and LATG groups after PSM (23.8% vs. 28.6%, p=0.390). Grade II complications accounted for most of the complications in the two cohorts after PSM. The conversion rates were 4.55% and 8.54% in the RATG and LATG groups, respectively, with no significant difference (p=0.145), and the ratio of splenectomy were 1.59% and 0.39% (p=0.253). The mortality rates were 0.8% and 0.4% for the RATG and LATG groups, respectively (p=1.000). Conclusion : This study demonstrates that RATG is comparable to LATG in terms of short-term surgical outcomes.
Determinants of early postnatal care attendance: analysis of the 2016 Uganda Demographic and Health Survey
Authors: Ndugga Patricia , Namiyonga Noor Kassim , Sebuwufu Deogratious
Published: March 2020

Background
The first two days after childbirth present the highest risk of dying for a mother. Providing postnatal care within the first two days after childbirth can help avert maternal mortality because it allows early detection of problems that could result in adverse maternal health outcomes. Unfortunately, knowledge of the uptake of early postnatal care (EPNC), which is imperative for informing policies aimed at reducing maternal mortality, remains low in Uganda. Therefore, the purpose of this study is to investigate the determinants of early postnatal care attendance among Ugandan women.
Methods
This study was based on nationally representative data from the 2016 Uganda Demographic and Health Survey. The study sample comprised 5,471 women (age 15–49) who delivered a child in the 2 years preceding the survey. We used logistic regression to identify factors associated with the use of early postnatal care.
Results
Our findings showed that 50% of mothers used EPNC services for their most recent delivery in the 2 years preceding the survey. Women’s residence, education level, religion, wealth status, marital status, occupation, antenatal care attendance, place of delivery, birth order, perceived accessibility of health facilities, and access to mass media messages were associated with greater use of EPNC. The percentage of women receiving EPNC was much higher among women who delivered at a health facility, either a public facility (63%) or private facility (65%), versus only 9% among women who delivered at home. Multivariate analysis showed that delivery at a health facility was the most important determinant of early postnatal care attendance.
Conclusions
To increase mothers’ use of EPNC services and improve maternal survival in Uganda, programs could promote and strengthen health facility delivery and ensure that EPNC services are provided to all women before discharge. Even so, the fact that only about two-thirds of women who delivered at a health facility received early postpartum care shows substantial room for improvement.
Key words Early postnatal care, Uganda, Demographic and Health Survey, place of delivery
Tight versus standard blood pressure control on the incidence of myocardial infarction and stroke: An observational retrospective cohort study in the general ambulatory setting
Authors: Park Bumsoo , Budzynska Katarzyna , Almasri Nada , Islam Sumaiya , Alyas Fanar , Carolan Rachel L. , Abraham Benjamin E. , Castro-Camero Pamela A. , Shreve Maria E. , Rees Della A. , Lamerato Lois
Published: March 2020

Background: The 2017 American College of Cardiology and American Heart Association guideline defined hypertension as blood pressure (BP) ≥ 130/80 mmHg compared to the traditional definition of ≥ 140/90 mmHg. This change raised much controversy. We conducted this study to evaluate incidences of myocardial infarction (MI) and stroke comparing tight (TBPC) and standard BP control (SBPC).

Methods: The data were collected and analyzed in 2018. We retrospectively identified hypertensive patients for 1 year at our institution who were classified by BP rate across 3 years into 2 groups of TBPC (< 130 mmHg) and SBPC (130-139 mmHg). We compared the incidence of new MI and stroke between the 2 groups across a 2-year follow-up. Multivariate analysis was done to identify independent risk factors.

Results: Of 5640 study patients, the TBPC group showed significantly less incidence of stroke compared to the SBPC group. No differences were found in MI incidence between the 2 groups. Multivariate analysis showed that increased age independently increased the incidence of both MI and stroke, and TBPC independently decreased the incidence of stroke but not of MI.

Conclusions: Our observational study suggests that TBPC may be beneficial in less stroke incidence compared to SBPC but it didn’t seem to affect the incidence of MI. Our study is limited by its retrospective design with potential confounders.
Identification of the Eutrema Salsugineum EsMYB90 gene important for anthocyanin biosynthesis
Authors: Qi Yuting , Gu Caihong , Wang Xingjun , Gao Shiqing , Li Changsheng , Zhao Chuanzhi , Li Chuanshun , Ma Changle , Zhang Quan
Published: March 2020

Abstract
Background: Anthocyanins contribute to coloration and antioxidation effects in different plant tissues. MYB transcription factors have been demonstrated to be a key regulator for anthocyanin synthesis in many plants. However, little information was available about the MYB genes in the halophyte species Eutrema salsugineum .
Result: Here we report the identification of an important anthocyanin biosynthesis regulator Es MYB90 from Eutrema salsugineum , which is a halophyte tolerant to multiple abiotic stresses. Our phylogenetic and localization analyses supported that Es MYB90 is an R2R3 type of MYB transcription factor. Ectopic expression of EsMYB90 in tobacco and Arabidopsis enhanced pigmentation and anthocyanin accumulation in various organs. The transcriptome analysis revealed that 42 genes upregulated by Es MYB90 in 35S : EsMYB90 tobacco transgenic plants are required for anthocyanin biosynthesis. Moreover, our qRT-PCR results showed that Es MYB90 promoted expression of early ( PAL , CHS , and CHI ) and late ( DFR , ANS , and UFGT ) anthocyanin biosynthesis genes in stems, leaves, and flowers of 35S : EsMYB90 tobacco transgenic plants.
Conclusions: Our results indicated that Es MYB90 is a MYB transcription factor, which regulates anthocyanin biosynthesis genes to control anthocyanin biosynthesis. Our work provides a new tool to enhance anthocyanin production in various plants.
Keywords : Anthocyanin, flavonoid, Eutrema salsugineum , R2R3 MYB transcription factor, Es MYB90, transcriptional regulation, anthocyanin biosynthesis genes.
Collagen Coating for Tissue Culture
Authors: McNabb Nicole A. , McCullough Shaun D.
Published: March 2020

This protocol is intended for collagen coating of tissue culture dishes and Transwell® multiple well plates. The attached methods document is a formal version of the information included here.Disclaimer: The information presented here has been reviewed and approved for publication by the US Environ do not necessarily represent Agency policy. Mention of trade names or commercial products does not constitute endorsement or recommendations for use.
Relationship Between Postoperative Lordosis Distribution Index And Adjacent Segment Disease Following L4-S1 Posterior Lumbar Interbody Fusion
Authors: Zheng Guoquan , Wang Chunguo , Wang Tianhao , Hu Wenhao , Ji Quanbo , Hu Fanqi , Li Jianrui , Chaudhary Surendra K , Song Kai , Song Diyu , Zhang Zhifa , Hao Yongyu , Wang Yao , Li Jing , Zheng Qingyuan , Zhang Xuesong , Wang Yan
Published: March 2020

Background: adjacent segment disease (ASD) is an acknowledged problem of posterior lumbar interbody fusion (PLIF). Many studies have been reported concerning the role of lordosis distribution index (LDI) in spinal biomechanics. However, few reports have been published about the impact of LDI on ASD following L4-S1 PLIF.Methods:The study enrolled 200 subjects who underwent L4-S1 PLIF for degenerative spine disease from 2009 to 2014. The average follow-up term was 84 months. Several lower lumbar parameters were measured, including lower lumbar lordosis (LLL), lumbar lordosis (LL) ,pelvic incidence (PI) and LDI on the pre- and postoperative radiograph. Perioperative information, comorbidities and operative data were documented. Kaplan-Meier curves were plotted for the comparisons of ASD-free survival of 3 different types of postoperative LDI subgroups.Results: The incidence of ASD was found to be 8.5%. LL and LLL increased by 3.96°(38.71° vs 42.67° , P＜0.001) and 3.60° (26.22° vs 28.82° , P＜0.001) after lower lumbar fusion surgery, respectively. Lordosis distribution index (LDI) increased by 0.03 (0.66 vs 0.69, P=0.004) postoperatively. A significant difference(P=0.001) was observed when comparing the incidence of ASD among postoperative LDI subgroups.The Kaplan-Meier curves showed a marked difference in ASD-free survival between low and moderate LDI subgroup (Log Rank test, P=0.0012) , high and moderate LDI subgroup (Log Rank test, P=0.0005)Conclusion: Patients with abnormal postoperative LDI were statistically more likely to develop ASD than those who had normal postoperative LDI. Moreover, patients with low postoperative LDI were at greater risk for developing ASD than those with high postoperative LDI over time.
Genome-wide association analysis of fiber fineness and yield in ramie (Boehmeria nivea) using SLAF-seq
Authors: Huang Kunyong , Shi Yaliang , Zhong Yicheng , Zhu Aiguo , Sun Zhimin , Niu Juan , Chen Jing , Luan M , Chen Jianhua
Published: March 2020

Background Ramie is a major natural fiber crop cultivated in East Asia. The improvement of its fiber yield and fineness are important breeding goals. Fiber yield is a complex quantitative trait comprising ramet number, stem diameter, plant height, skin thickness, and ﬁber percentage. The fiber fineness is a crucial trait for ramie fiber quality. However, there are few association studies for fiber yield traits and fiber fineness on ramie, and lack high-density SNP maps in natural ramie population. Results Here, a panel of 112 core ramie germplasms were genotyped by 215,376 consistent single-nucleotide polymorphisms (SNPs) from specific-locus amplified-fragment sequencing (SLAF-seq), and used for genome-wide association study of fiber fineness and yield. Subsequently, the genetic diversity, linkage disequilibrium (LD), and population structure was conducted based on 215,376 SNPs. Population cluster analysis disclosed five subpopulations. Neighbor-joining (NJ) analysis revealed three major clusters. No obvious relationships were identified between them and their geographic origins. The genome-wide linkage disequilibrium (LD) decayed to r 2 = 0.1 was ~11.75 kb in physical distance. One, seven, one, seven, and twenty-seven significant SNP marker associations were detected for fiber fineness (third season), stem diameter (third season), stem skin thickness (third season), fiber percentage (second season), and fiber percentage (third season), respectively. Two promising candidate genes, whole_GLEAN_10029622 and whole_GLEAN_10029638 resided in the significant trait-SNP association for fiber fineness (third season), which annotated as a cotton fiber-expressed protein and an Arabidopsis thaliana homeobox protein ATH1, respectively and validated by qPCR. Conclusions These results provide information for understanding the population structure, LD decay and genetic variation in ramie natural population. The identified loci or genes for fiber fineness and yield may provide the basis for future research on fiber fineness and yield and marker-assisted selection breeding for ramie.
Neuroprotective and anti-inflammatory effect of Hedyotis corymbosa extract on chronic stress-induced depression model of rat-A in vivo and ex vivo study
Authors: Yun Chen , Zheng Tingting , Zhang Jun , Shi Yu , Peng Jiao , Liu Li , Xiao Haitao , Han Yanni , Chen Keke , Zhang Xue , Chen Yun
Published: March 2020

Background: Depression is a well-known mood disorder characterized by persistently low mood and loss of interest and a feeling of sadness. Plants and plant-derived agents have recently attracted the interest of researchers for their therapeutic effects against several illnesses, including mental disorders, and several herbal plants and herbal formulations are useful against experimental depression. In this study, the neuroprotective effects of Hedyotis corymbosa extract were investigated in rats induced with chronic mild stress.Methods: Animals were designated into the following groups: control, 0, 150, and 300 mg of extracts. The dose was given for 30 consecutive days via the oral route. Sucrose preference analysis, forced swim, and open field tests were performed, and serum cortisol and monoamine levels in brain tissue were determined. Expression of brain-derived neurotrophic factor (BDNF) was also examined.Results: Supplementation with extract increased the sucrose preference ratio, locomotor activity, and monoamines and decreased serum cortisol levels. The protein and mRNA expression of BDNF in the brain tissue was decreased by 62.58% and 73% in control rats. However, supplementation with extracts significantly increased BDNF mRNA expression (by 107% and 229.6% in groups 150 mg and 300 mg, respectively). Similarly, the protein expression of BDNF increased by 82.3% and 141.2% in groups 150 mg and 300 mg, respectively.Conclusion: In summary, experimental results suggest that supplementation with extracts of Hedyotis corymbosa may be effective against depression.
Biomarkers of Sepsis: Time for a Reappraisal
Authors: Pierrakos Charalampos , Velissaris Dimitrios , Bisdorff Max , Marshall John C , Vincent Jean-Louis
Published: March 2020

Introduction: Sepsis biomarkers can have important diagnostic, therapeutic, and prognostic functions. In a previous review, we identified 3370 references reporting on 178 different biomarkers related to sepsis. In the present review, we evaluate the progress in the research of sepsis biomarkers.Methods: Using the same methodology as in our previous review, we searched the PubMed database from 2009 until September 2019 using the terms “Biomarker” AND “Sepsis”. There were no restrictions by age or language and all studies, clinical and experimental, were included.Results: We retrieved a total of 5367 new references since our previous review. We identified 258 biomarkers, 80 of which were new compared to our previous list. The majority of biomarkers have been evaluated in fewer than 5 studies, with 81 (31%) being assessed in just a single study. Apart from studies of C-reactive protein (CRP) or procalcitonin (PCT), only 26 biomarkers have been assessed in clinical studies with more than 300 participants. Forty biomarkers have been compared to PCT and/or C-reactive protein CRP for their diagnostic value; 9 were shown to have a better diagnostic value for sepsis than either or both of these biomarkers. Forty-four biomarkers have been evaluated for a role in answering a specific clinical question rather than for their general diagnostic or prognostic properties in sepsis.Conclusions: The number of biomarkers being identified is still increasing although at a slower rate than in the past. Most of the biomarkers have not been well-studied; in particular the clinical role of these biomarkers needs to be better evaluated.
The Burden of Hyperbilirubinemia in Critically Ill Patients with Hematological Malignancies: Post-hoc Analysis of a Prospective Multicenter Multinational Study
Authors: Bisbal Magali , Darmon Michael , Saillard Colombe , Mallet Vincent , Mouliade Charlotte , Lemiale Virginie , Pene Frederic , Kouatchet Achille , Demoule Alexandre , Vincent Francois , Nyunga Martine , Bruneel Fabrice , Lebert Christine , Renault Anne , Meert Anne-Pascale , Benoit Dominique , Hamidfar Rebecca , Jourdain Merce , Azoulay Elie , Mokart Djamel
Published: March 2020

BackgroundThe evidence on the clinical significance of hyperbilirubinemia (HB) in critically ill patients with hematological malignancies is scarce. We therefore studied its burden in a 2010-2011 Franco-Belgian multicenter prospective study designed to evaluate the prognosis of these patients.Patients and methodsThe cohort comprised 893 patients from 17 centers, 61% men, with a median (interquartile range) age of 60 (49 – 70) years, and preferentially with underlying non-Hodgkin lymphoma (32%) or acute myeloid leukemia (27%). HB was defined as a total serum bilirubin ≥ 33 µmol/L at intensive care unit (ICU) admission. Our main goal was to evaluate the relationship between HB and outcome of critically ill hematological patients. Causes and management of HB in the ICU were analyzed as secondary end points.ResultsHB concerned 185 (21%) patients. Cyclosporine and antimicrobial treatments, ascites and cirrhosis, acute kidney injury, neutropenia, and myeloma (adjusted odd ratio [aOR] 0.38, p=0.006) were risk factors. Hospital mortality was 56.3% and 36.3% in patients with and without HB, respectively (p<0.0001 with the log-rank test). Adjusted for severity of illness, the adjusted odds ratio (95% confidence interval) of HB for in-hospital mortality was 1.86 (1.28, 2.72). HB was overlooked by the ICU team for 92 (53%) patients. Overwise, liver workups for HB led to treatment modifications in 32 (40%) patients, including chemotherapy for cancer progression that was associated with reduced mortality with an adjusted odds ratio of 0.23, (p=0.02).ConclusionHB is associated with outcome of critically ill hematological adult patients and should be systematically explored and treated.
Common variant of NOTCH4 gene modulate functional connectivity of occipital cortex and its relationship with schizotypal traits
Authors: Author) xiaohui xie(Former Corresponding , Zu Meidan , Zhang Long , Bai Tongjian , Wei Ling , Huang Wanling , JI Gong-Jun , Qiu Bensheng , Hu Panpan , Tian Yanghua , Author) Kai Wang(New Corresponding
Published: March 2020

Background Schizotypal traits are considered as heritable traits and the endophenotype for schizophrenia. A common variant in NOTCH4 gene, rs204993, has been linked with schizophrenia, but the neural underpinnings are largely unknown. Methods In present study, we compared the difference of brain function between different genotype of rs204993 and its relationship with schizotypal traits among 402 Chinese Han healthy volunteers. The brain function was evaluated with functional connectivity strength (FCS) using resting-state functional magnetic resonance image (rs-fMRI). The schizotypal traits were measured by the schizotypal personality questionnaire (SPQ). Results Our results suggested that the carriers with AA genotype showed reduced FCS in left occipital cortex than the carriers with AG and GG genotype and the carriers with AG genotype showed reduced FCS in left occipital cortex than the carriers with GG genotype. The FCS values in the left occipital lobe were negatively associated with the SPQ scores and its subscale scores within the carriers with GG genotype, but not within the carriers with AA or AG genotype. Conclusions Our results suggested that the common variant in NOTCH4 gene, rs204993, modulate the function of occipital cortex, which may contribute to the schizotypal traits. These findings provided insight for genetic effect on schizotypal traits and its potential neural substrate.
Prevalence and Predictors of Anxiety and Depressive Symptoms among Patients Diagnosed with Oral Cancer in China: A cross-sectional study
Authors: Yuan Lulu , Pan Bochen , Wang Weiren , Wang Lie , Zhang Xujie , Gao Yuqin
Published: March 2020

Background Anxiety and depression are common mental health related problems among patients with cancer. While many psychological variables have been proven to influence anxiety and depressive symptoms, the variables are not mutually exclusive and their integrated effects on patients with oral cancer are yet unknown. Objective To explore the prevalence of anxiety and depressive symptoms among patients with oral cancer, to find out key potentially predictive factors associated with anxiety and depressive symptoms, and to identify the sequence of their contributions. Method A cross-sectional study was carried out for Chinese patients with oral cancer between May 2016 and October 2017 in two Grade-A Tertiary Hospitals in Shenyang, China. 230 patients with oral cancer were interviewed with questionnaires on demographic variables, Zung Self-Rating Anxiety Scale (SAS), Center for Epidemiologic Studies Depression Scale (CES-D), Herth Hope Index (HHI), Social Impact Scale, Multidimensional Scale of Perceived Social Support (MSPSS), Revised Life Orientation Test (LOT-R), Perceived Stress Scale-10 (PSS-10), and General Perceived Self-efficacy Scale(GSE). Chi-square test, nonparametric test, t-test, Spearman test and logistic regression analyses were conducted where appropriate to explore predictive factors of anxiety symptoms and depressive symptoms. Results The prevalence of anxiety symptoms and depressive symptoms in the sample population was 36.96% (85/230) and 65.21% (150/230), respectively. Age (β=0.047, OR=1.049, CI:1.013~1.086), gender (β=1.146, OR=3.147, CI:1.196~8.278), social isolation dimension of stigma (β=0.546, OR=1.726, CI:1.318~2.260), optimism (β=-0.310, OR=0.734, CI:0.594~0.906), and perceived stress (β=0.239, OR=1.270, CI:1.105~1.459) were predictors of anxiety symptoms. Marriage (β=1.158, OR=4.749, CI:1.301~17.330), positive readiness and expectancy dimension of hope (β=-0.476, OR=0.621, CI:0.401~0.961), social isolation dimension of stigma (β=0.329, OR=1.390, CI:1.060~1.823) and perceived stress (β=0.263, OR=1.300, CI:1.138~1.501) were predictors of depressive symptoms among oral cancer patients. Conclusion The prevalence of depressive symptoms was higher than anxiety symptoms among oral cancer patients in China. In addition to higher level of perceived stress and social isolation leading to anxiety and depressive symptoms, lower level of optimism not hope might lead to anxiety symptoms and lower level of hope, especially lower level of active action, might lead to depressive symptoms in oral cancer patients.
Treatment patterns and survival outcomes in advanced hypopharyngeal squamous cell carcinoma
Authors: Tsai Yao-Te , Chen Wen-Cheng , Chien Chih-Yen , Hsu Cheng-Ming , Lee Yi-Chan , Tsai Ming-Shao , Lin Meng-Hung , Lai Chia-Hsuan , Chang Kai-Ping
Published: March 2020

Background This study aimed to evaluate the treatment outcomes of the primary surgery (PS) or concurrent chemoradiotherapy (CCRT) as the initial treatment of hypopharyngeal squamous cell carcinoma (HPSCC). Methods A retrospective cohort study of HPSCC patients with stage III-IV HPSCC in four tertiary referral centers consecutively enrolled from 2003 to 2012, total of 213 (32.6%) patients received PS, and 439 (67.4%) patients received CCRT as their primary treatment. Overall survival (OS) and disease-free survival (DFS) were analyzed by Kaplan-Meier method and Cox regression models. Results The 5-year OS and DFS for patients undergoing PS and CCRT were 45.0% vs 33.1% and 36.2% vs 28.9% ( p < 0.001 and 0.003, respectively). In subgroup analysis, PS was associated with better OS in patients with stage IVA of the disease ( p = 0.002), specifically in those with T4 or N2 classification ( p = 0.021 and 0.002, respectively). Multivariate analysis indicated that stages IVA and IVB and CCRT were independent adverse prognostic factors for OS ( p = 0.004, <0.001, and 0.014, respectively). Furthermore, CCRT was also significantly associated with lower OS rates than PS in stage IVA patients more than 65 years of age and with N2 classification ( p = 0.027 and 0.010, respectively). Conclusions In patients with advanced HPSCC, PS was significantly associated with better prognosis and should be considered a favorable primary treatment in patients with stage IVA of the disease, especially if they are over 65 years of age or have T4 and N2 classification.
Clinical significance of peripheral blood-derived inflammation markers in advanced gastric cancer after radical resection
Authors: Gu Lihu , Chen Bangsheng , Zheng Dingcheng , Mo Jiahang , Yuan Lingling , Mao Feiyan , Zhang Kang , Ng Derry Minyao , Chen Ping , Wang Dongjie
Published: March 2020

Background and objective

The prognostic significance of peripheral blood-derived inflammation markers in patients with gastric cancer (GC) has not been elucidated. This study aimed to investigate the relationship between systemic inflammatory markers and GC prognosis.

Methods

A prospective observational cohort study involving 598 patients was conducted to analyze the prognosis of GC based on systemic inflammatory markers. The following peripheral blood-derived inflammation markers were evaluated: the neutrophil-lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), systemic immune-inflammation index (SII), C-reactive protein/albumin (CRP/Alb) ratio, Glasgow Prognostic Score (GPS), modified Glasgow Prognostic Score (mGPS), prognostic nutrition index (PNI), and prognostic index (PI). The receiver operating characteristics (ROC) curve and the Youden index were used to determine the optimal cutoff values. Univariate and multivariate analysis of prognostic factors was conducted accordingly.

Results

The optimal cutoff values of the PNI, fibrinogen, NLR, PLR, SII, and CRP/Alb were 49.5, 397ng/dl, 2.5, 154, 556, and 0.05, respectively. Multivariate analysis showed that age, PLR, TNM stage, and chemotherapy were the independent prognostic factors for advanced gastric cancer (AGC). Adjuvant chemotherapy improved the long-term prognosis of patients with PLR ≥154, but chemotherapy had no significant effect on the survival of patients with PLR <154.

Conclusions

Our findings show that higher PLR (≥154) is an independent risk factor for poor prognosis in GC patients. Besides, PLR can predict adjuvant chemotherapy (oxaliplatin/5-fluorouracil combination) response in patients with GC after surgery.
Switching fractioned R-CHOP cycles to standard R-CHOP cycles guided by endoscopic ultrasonography in treating patients with primary gastric diffuse large B-cell lymphoma
Authors: Liu Yi-Zhen , Liu Yu-Mei , Zhao Ping , Zhang Qunling , Liu Xiaojian , Lv Fangfang , Hong Xiaonan , Cao Junning , Xue Kai
Published: March 2020

Background: Primary gastric diffuse large B-cell lymphoma (PG-DLBCL) is a common subtype of extranodal non-Hodgkin lymphoma, with R-CHOP as the commonly used treatment regimen. However, full cycles of standard R-CHOP (Rituximab d1, 100% dose of CHOP d2) has the risk of severe bleeding or perforation, even leads to emergency surgery especially for those with deep lesions in their first 1-2 cycles of treatment. Full cycles of fractioned R-CHOP (Rituximab d1, 50% dose of CHOP d2 and d5) increases the safety of treatment but has the risk of resistance to the treatment. This study aims to explore the safety and efficacy of early fractioned R-CHOP cycles followed by standard R-CHOP cycles in patients with PG-DLBCL guided by endoscopic ultrasonography (EUS).Methods: Thirty-one PG-DLBCL patients treated in Shanghai Cancer Center from October 2011 to October 2018 were analyzed in this retrospective study. All patients had lesions infiltrated to at least 3rd layer of stomach (5 layers totally) under EUS at baseline, and received EUS after every 2 cycles’ treatment. Patients switched to standard R-CHOP if they showed the reduced infiltrated layers and restricted lesions after fractioned R-CHOP cycles. Fecal occult blood test and enhanced abdominal CT scan were also referred.Results: 77.4% (24/31) patients successfully switched after two treatment cycles. The ORR, 5-year PFS and OS were 93.5%, 75% and 84%, respectively. No treatment delay or dosage reduction from gastric adverse event was observed. More importantly, none of patients in our study suffered from severe bleeding or perforation during the treatment. Kaplan-Meier analysis showed that PG-DLBCL patients characterized multiple localization (sites >1), large size (≥3cm), having B symptoms, lower serum albumin (ALB) level (≤ 35g/L), and elevated LDH level (>250U/L) associated with worse PFS and OS.Conclusions: Our data indicate that it might be an effective approach in treating deeply infiltrated PG-DLBCL patients by switching fractioned R-CHOP cycles to standard R-CHOP cycles guided by EUS. Further prospective study about the approach is needed to confirm the conclusion.
Long noncoding RNA NEAT1 aggravates osteosarcoma carcinogenesis via regulating the microRNA-579/MMP13 axis
Authors: Wang Lili , Zhou Jingzhen , Zhang Yong , Hu Tao , Sun Yongning
Published: March 2020

Background: Previous studies have suggested that long non-coding RNAs (lncRNAs) were involved in tumorigenesis in various human carcinomas, including osteosarcoma (OS). However, the expression and specific role of lncRNA NEAT1 in OS remain unknown. The current study aimed at revealing the role of lncRNA NEAT1 and its related mechanism in OS.Methods: Expression profiles of lncRNAs in OS tissues were constructed, and lncRNA NEAT1 expression was verified with RT-qPCR followed by sub-localization. LncRNA-microRNA (miRNA) and miRNA-mRNA interactions were predicted. Validation was performed using dual luciferase reporter gene assay, and gain- and loss-of-function experiments. The effects of lncRNA NEAT1, miR-579 and MMP13 on the proliferation, migration and invasion, epithelial-mesenchymal transition (EMT) of OS cells were detected using colony formation, cell counting kit-8 (CCK-8), Transwell assays and Western blot analysis.Results: LncRNA NEAT1 overexpression was observed in OS tissues and cell lines which located in the cytoplasm. Transfection-induced downregulation of lncRNA NEAT1/MMP13 or overexpression of miR-579 blocked the progression of OS cells. LncRNA NEAT1 promotes MMP13 through sponging miR-579.Conclusion: LncRNA NEAT1 might be beneficial for OS aggravation via sponging miR-579 and facilitating MMP13 expression, which represents a candidate marker and target for OS therapy.
Risk factors for common peroneal nerve injury in knee dislocation: a retrospective study
Authors: Tan Lei , wang junfeng , liu xinguang , xin xing , wang xiaohua , yang bin , xing zhili , zhang ke , liu chen
Published: March 2020

Background Knee dislocation is a serious injury, representing less than 0.2% of all orthopedic injuries, and 16% to 40% of these patients suffer an associated injury to the common peroneal nerve (CPN). However, it is still unclear which structures are most intently associated with CPN injury. This study attempts to analyze the potential risk factors for CPN injury and provide clues for a comprehensive diagnosis of knee dislocation. Methods We retrospectively reviewed 153 cases of knee dislocation related to lateral and/or posterior ligament injury between 2015 and 2018. All 153 patients were divided into the CPN injury group or the no-CPN injury group. The baseline characteristics included age, gender, cause of injury, posterior cruciate ligament (PCL) disruption, anterior cruciate ligament (ACL) disruption, popliteofibular ligament and/or tendon of popliteus injury, biceps femoris tendon injury and fibular head fracture. We identified potential variables for a multivariable logistic regression model to identify the major risk factors for CPN injury. Results Multivariate regression analysis revealed the biceps femoris tendon injury and fibular head fracture to be predictive of CPN injury in knee dislocation. Gender, age, cause of injury, ligamentous classification, popliteofibular ligament and/or tendon of popliteus injury, PCL disruption or ACL disruption do not predict CPN injury. Conclusions Biceps femoris tendon injury and fibular head fracture are risk factors of CPN injury in knee dislocation. A better understanding of the risk factors for CPN injury allows surgeons to achieve more accurate diagnoses.
Validating and Updating GRASP: An Evidence-Based Framework for Grading and Assessment of Clinical Predictive Tools
Authors: Khalifa Mohamed , Magrabi Farah , Gallego Blanca
Published: March 2020

Background: When selecting predictive tools, clinicians are challenged with an overwhelming and ever-growing number, most of which have never been implemented or evaluated for comparative effectiveness. To overcome this challenge, the authors developed an evidence-based framework for grading and assessment of predictive tools (GRASP). The objective of this study is to update GRASP and evaluate its reliability. Methods: An online survey was developed to collect responses of a wide international group of experts, who published studies on developing, implementing or evaluating clinical decision support tools. The interrater reliability of the framework, to assign grades to eight predictive tools by two independent users, was evaluated. Results: Among 882 invited experts, 81 provided valid responses. On a five-points Likert scale, experts overall strongly agreed to GRASP evaluation criteria (4.35). Experts strongly agreed to six criteria: predictive performance (4.87) and predictive performance levels (4.44), usability (4.68) and potential effect (4.61), post-implementation impact (4.78) and evidence direction (4.26). Experts somewhat agreed to one criterion: post-implementation impact levels (4.16). Experts were neutral about one criterion; usability is higher than potential effect (2.97). Sixty-four respondents provided recommendations to open-ended questions regarding adding, removing or changing evaluation criteria. Forty-three respondents suggested the potential effect should be higher than the usability. Experts highlighted the importance of reporting quality of studies and strength of evidence supporting grades assigned to predictive tools. Accordingly, GRASP concept and its detailed report were updated. The updated framework’s interrater reliability, to produce accurate and consistent results by two independent users, was tested and found to be initially reliable. Conclusion: The GRASP framework grades predictive tools based on critical appraisal of published evidence across three dimensions: phase of evaluation, level of evidence, and direction of evidence. The final grade of a tool is based on the highest phase of evaluation, supported by the highest level of positive evidence, or mixed evidence that supports positive conclusion. GRASP aims to provide clinicians with a high-level, evidence-based, and comprehensive, yet simple and feasible, approach to evaluate predictive tools, considering their predictive performance before implementation, usability and potential effect during planning for implementation, and post-implementation impact on healthcare outcomes.
The Study of the Association between Immune Monitoring and Pneumonia in Kidney Transplant Recipients Through Machine Learning Models
Authors: Peng Bo , Gong Hang , Tian Han , Zhuang Quan , Li Junhui , Cheng Ke , Ming Yingzi
Published: March 2020

Background Kidney transplantation is the optimal treatment to cure the patients with end-stage renal disease (ESRD). However, the infectious complication, especially pneumonia, is the main cause of mortality in the early stage. Immune monitoring by relevant biomarkers provides direct evidence of immune status. We aimed to study the association between immune monitoring and pneumonia in kidney transplant patients through machine learning models. Methods A total of 146 patients receiving the immune monitoring panel in our center, including 46 pneumonia recipients and 100 stable recipients, were retrospectively reviewed. The immune monitoring panel consisted of the percentages and absolute cell counts of CD3 + CD4 + T cells, CD3 + CD8 + T cells, CD19 + B cells and natural killer (NK) cells, and median fluorescence intensity (MFI) of human leukocyte antigen (HLA)-DR on monocytes and CD64 on neutrophils. The machine learning models of support vector machine (SVM), logistic regression (LR), multi-layer perceptron (MLP) and random forest (RF) were applied for analysis. Results The pneumonia and stable groups showed significant difference in cell counts of each subpopulation and MFI of monocyte HLA-DR and neutrophil CD64. The SVM model by monocyte HLA-DR (MFI), neutrophil CD64 (MFI), CD8 + T cells (cells/μl), NK cells (cell/μl) and TBNK (T cells, B cells and NK cells, cells/μl) had the best performance with the average area under the curve (AUC) of 0.940. The RF model was developed to predict the patients who would progress into severe pneumonia, with the average AUC of 0.760. Conclusions The immune monitoring panel was tightly associated with pneumonia in kidney transplant recipients. The models developed by machine learning techniques identified patients at risk and predicted the prognosis. Based on the results of immune monitoring, better individualized therapy might be achieved.
Echocardiography diagnosis of pregnancy with aortic dissection: a case report
Authors: Wang Jing , Wang Anlong , Zhang Jian , Hou Chunjie
Published: March 2020

Background: We report a case of 34 weeks + gestation with aortic dissection to explore the diagnosis and treatment of this type of pregnant woman and to reduce maternal mortality. Case presentation: This report describes the clinical manifestations of a case of late pregnancy with acute aortic dissection (Stanford A Type). Echocardiography was used to detect the location of the rupture, the extent of exfoliation, the true and false lumen, the presence or absence of thrombus in the false lumen, the degree of aortic regurgitation, etc. After the diagnosis, the patients received surgical treatment as soon as possible. The detection rate and type diagnosis accuracy of ultrasonography for pregnancy complicated with aortic dissection are reliable. The location of the intimal rupture by ultrasound was consistent with the intraoperative findings, and there were no recent complications in the mother and newborn. Conclusion: The third trimester of pregnancy with aortic dissection is dangerous. As a simple, safe and non-invasive method, echocardiography has high clinical value in the diagnosis of pregnant patients with aortic dissection.
Time Trend of Mediastinal Lymph Node Dissection in Stage IA Non-Small Cell Lung Cancer Patient Who Undergo Lobectomy: a Retrospective Study of Surveillance, Epidemiology, and End Results (SEER) database
Authors: Pan Liang , Mo Ran , Zhu Lin hai , Yu Wen feng , Lv Wang , Hu Jian
Published: March 2020

Background: Although lobectomy with mediastinal lymph node dissection (MLND) is the first option for early-stage non-small cell lung cancer (NSCLC) patients, the time trends of MLND in stage IA NSCLC patients who undergo a lobectomy are not clear still.Methods: We included stage IA NSCLC patients who underwent lobectomy or lobectomy with MLND between 2003 and 2013 in the SEER database. The time trend of MLND was compared among patients who underwent a lobectomy.Results: For stage T1a patients, the lobectomy group and lobectomy with MLND group had no differences in postoperative overall survival (OS) (P=0.34) or lung-cancer specific survival (LCSS) (P=0.18) between 2003 and 2013. For stage T1b patients, the OS (P=0.01) and LCSS (P=0.01) were different between the lobectomy group and the lobectomy with MLND group in the period from 2003 to 2009; however, only OS (P=0.04), not LCSS (P=0.14), was different between the lobectomy group and the lobectomy with MLND group between 2009 and 2013. For T1c patients, the OS (P=0.01) and LCSS (P=0.02) were different between the two groups between 2003 and 2009 but not between 2009 and 2013 (P=0.60; P=0.39). From the Cox regression analysis, we found that the factors affecting OS/LCSS in T1b and T1c patients were age, sex, year of diagnosis, histology, and grade, in which year of diagnosis was the obvious factor (HR=0.79, CI=0.71-0.87; HR=0.73, CI=0.64-0.84).Conclusions: There was a time trend in prognosis differences between the lobectomy group and lobectomy with MLND group for T1b and T1c stage NSCLC patients.
Key factors influencing motivation among health extension workers and health care professionals in four regions of Ethiopia: a cross-sectional study
Authors: Adillo Mehiret Abate , Mulissa Zewdie , Desta Befikadu Bitewulign , Alemayehu Abiyou Kiflie , Kefale Abera Biadgo , Keraga Dorka woldesenbet , Gebreselassie Haregeweyni Alemu , Ahmed Yakob Seman , Estifanos Abiy Seifu , Magge Hema , Parry Gareth , Quaife Matthew
Published: March 2020

Background: Although Ethiopia has improved access to health care in recent years, quality of care remains low. Health worker motivation is an important determinant of performance and affects quality of care. This study explores the level and construction of motivation among health extension workers (HEWs) and health care professionals in Ethiopia in baseline data collection of an evaluation of a quality improvement program run by the Institute of Healthcare Improvement (IHI). Methods: We conducted face to face quantitative surveys with providers to elicit motivation level and construction. We sampled 401 health system workers: skilled providers including nurses and midwives (n=110), HEWs (n=210), and non-patient facing health system staff (n=81). Participants completed a 30-item Likert scale ranking tool which asked questions across 17 domains. We used exploratory factor analysis to explore motivation construction, and ordinary least squares (OLS) regression to explore determinants of motivation level and construction. Results: Of the 397 interviewees with complete data, 61% (95% CI 56%-66%) self-reported motivation as “very good” or “excellent”. Significant variation in motivation was seen across regions with Southern Nations Nationalities and People’s Region (SNNPR) being significantly lower score on the Likert scale by 0.35 points (P=0.003). Those who had a medium workload were significantly less motivated compared to participants with a light workload by 0.48 Likert points (P=0.024). The exploratory factor analysis identified a three-factor model to best fit with factors described as: personal and altruistic goals; pride and personal satisfaction; and recognition and support. Personal and altruistic goals varied across regions with Oromia and SNNPR being significantly lower by 0.13 (P=0.018) and 0.12 Likert points (P=0.039) respectively. A regression analysis found that as job satisfaction increased by 1 personal and altruistic goal, increased by 0.34 (P=0.001). Pride and personal satisfaction scores vary among regions with SNNPR being significantly lower by 0.11 Likert points (P=0.051) as compared to Amhara region. Recognition support was significantly higher in health care providers relative to HEWs by 0.12 Likert point (P=0.053). Conclusions: Overall, motivation was high among participants and varied across region, cadre, and age. Workload, leave, and job satisfaction were associated factors with motivation.
Unmet supportive care needs and its relation to quality of life among adult acute leukaemia patients in China: a cross-sectional study
Authors: Yan Jie , Wang Ying , Chen Jingyi , Wang Chunfeng , Lin Yingchun , Hu Rong , Wu Yong
Published: March 2020

Background: Patients with acute leukaemia (AL) usually require prolonged periods of hospitalisation. The treatment and clinical symptoms may lead to patients’ supportive care needs (SCNs) not being met and impairs their quality of life (QoL). Studies on QoL and SCNs among AL patients are limited. This study aimed to identify the unmet SCNs and its relation to QoL of adult AL patients in China.Methods: This multicentre cross-sectional study recruited 346 participants to complete a self-developed questionnaire, detailing demographic information and disease-related variables. A 34-item Supportive Care Needs Survey (SCNS-SF34) was used to identify unmet SCNs, and the Functional Assessment of Cancer Therapy-Leukaemia (FACT-Leu) questionnaire measured patients’ QoL.Results: Unmet SCN rates for the 34 items ranged from17.6% to 81.7%. Patients’ needs were high for health systems and information, but low in the sexual domain. The results reveal nine factors associated with the unmet SCNs of adult AL patients, including marital status, original residence, age, education, occupation, other diseases, chemotherapy course, disease course, and treatment stage (p <0.05). The total score of the FACT-Leu negatively correlated with the SCNS-SF34 in the physical/daily living (r = - 0.527, p <0.01), psychological (r = - 0.688, p <0.01), sexual (r = - 0.170, p <0.01), patient care and support (r = - 0.352, p <0.01), and health systems and information (r = - 0.220, p <0.01) domains.Conclusions: Adult AL patients exhibit a high demand for unmet SCNs, especially in the domain of health systems and information. There was a significant association between patients’ unmet SCNs and QoL. Future research should develop tailored interventions to address the unmet SCNs of adult AL patients, to further improve their QoL.
Is oral lichen planus a risk factor for peri-implant diseases? A systematic review and meta-analysis
Authors: Xiong Xiaoqin , Yu Ting , Xu Tiantian , Wang Xinhong , Qin Wenguang , Gang Luo
Published: March 2020

Background : To evaluate whether oral lichen planus (OLP) is a risk factor for peri-implant diseases (PIDs) with a systematic review and meta-analysis. Methods : Six electronic databases including Medline, Web of Science, etc. were searched. Included studies are observational human studies written in English. Population of interest were those with/without OLP who received dental implant treatment. Follow-up time after implantation is from one month to 20 years. The quality of the included literature regarding risk of bias and methodology was assessed with Newcastle-Ottawa Scale or the Agency for Healthcare Research and Quality. The data involving exposure (OLP), primary outcomes (implants having PIDs) and secondary outcomes (probing depth/PD, bleeding on probing/BOP and bone loss/BL) and potential confounders were extracted. Heterogeneity was assessed by I² tests. Dichotomous data were expressed as risk ratio (RR) and 95% confidence interval (CI) which were calculated with a fixed effect model. Results : Of 139 literatures, two studies were enrolled and evaluated as high quality, which totally contained 68 participants receiving 222 (OLP vs. non-OLP, 112 vs. 110) implants with 12 to 120-month follow-up time. Proportions of implants with PIDs between OLP and non-OLP groups were as follows: 19.6% (22/112) vs. 22.7% (25/110) for PIM; 17.0% (19/112) vs. 10.9% (12/110) for PI. Meta-analysis found no recognizable difference in number of implants with PIDs (PI: RR = 1.49, 95% CI 0.77-2.90, P = 0.24; PIM:RR = 0.88, 95% CI 0.53 -1.46, P = 0.61; PIDs: RR = 1.08, 95% CI 0.75 -1.55, P = 0.68) or BOP (RR = 0.90, 95% CI: 0.70-1.15, P = 0.40) between OLP and non-OLP groups. Conclusions : Available literature regarding the effects of OLP on PIDs remains very limited. Existing evidence seems not support OLP as a suspected risk factor for PIDs. Large-scale prospective trials are required to test the findings. Keywords : dental implants; peri-implant diseases; oral lichen planus; systematic review; meta-analysis.