bluuebunny/crossref_metadata_2025_split huggingface dataset:
Elevated 1-Year Mortality Rate in Males Sustaining Low-Energy Proximal Femur Fractures and Subgroup Analysis Utilizing Age-Adjusted Charlson Comorbidity Index
Authors: Schultz Kyle A. , Westcott Benjamin A. , Barber Kimberly R. , Sandrock Todd A. 
Published: January 2020

Introduction: Low-energy proximal femur fractures are common in the aging population and the ability to identify patients at increased mortality risk provides surgeons information to improve informed decision-making with patients and families. We evaluated for gender differences in 1-year mortality after sustaining low-energy proximal femur fractures with subgroup analysis to identify the impact of fracture location, age, and comorbidities on mortality. Materials and Methods: Patients ≥40 years of age sustaining a low-energy proximal femur fracture identified at our institution between January 1, 2014, and December 31, 2017. International Classification of Diseases, Ninth Revision and International Classification of Diseases, Tenth Revision codes were used to identify comorbidities for calculation of the age-adjusted Charlson comorbidity index (ACCI). The county clerk database was searched to identify mortality within 1 year of injury. One-year mortality rates were calculated and multiple comparisons were made between genders controlling for age, fracture location, and/or ACCI. Results: Women presented with low-energy proximal femur fractures at a rate of almost 3:1 to men at our institution ( P = .001). Men demonstrated a significantly increased ACCI at presentation (5.35 ± 2.55 vs 4.86 ± 1.77, P = .03). Men had an increased 1-year mortality rate for all (31.3% vs 21.5%, P = .004) and intertrochanteric (IT) fractures (36.2% vs 22.9%, P = .008). Controlling for ACCI, gender, and fracture location, men demonstrated increased mortality rate with IT fractures ( P = .002) and trended toward but did not reach significance with femoral neck fractures ( P = .07). Discussion: Men presenting with low-energy femur fractures are at an increased mortality risk compared to women. On average, men present with an overall worse health status as identified by ACCI, which could predispose these patients not only to fractures themselves but also impair their ability to recover from injury. Conclusion: Men are at an increased 1-year mortality risk after sustaining proximal femur fractures.
Low levels of HIV-1 drug resistance mutations in patients who achieved viral re-suppression without regimen switch: a retrospective study
Authors: Onwuamah Chika K. , Okpokwu Jonathan , Audu Rosemary , Imade Godwin , Meloni Seema T. , Okwuraiwe Azuka , Chebu Philippe , Musa Adesola Z. , Chaplin Beth , Dalhatu Ibrahim , Agbaji Oche , Samuels Jay , Ezechi Oliver , Ahmed Mukhtar , Odaibo Georgina , Olaleye David O. , Okonkwo Prosper , Salako Babatunde Lawal , Raizes Elliot , Yang Chunfu , Kanki Phyllis J. , Idigbe Emmanuel O. 
Published: January 2020

Abstract
Background
We identified a HIV-positive cohort in virologic failure (VF) who re-suppressed without drug switch. We characterized their drug resistance mutations (DRM) and adherence profiles to learn how to better manage HIV drug resistance.
A retrospective cohort study utilizing clinical data and stored samples. Patients received ART at three Nigerian treatment centres. Plasma samples stored when they were in VF were genotyped.

Result
Of 126 patients with samples available, 57 were successfully genotyped. From ART initiation, the proportion of patients with adherence ≥90% increased steadily from 54% at first high viral load (VL) to 67% at confirmed VF, and 81% at time of re-suppressed VL. Sixteen (28%) patients had at least one DRM. Forty-six (81%) patients had full susceptibility to the three drugs in their first-line (1 L) regimen. Thirteen (23%) were resistant to at least one antiretroviral drug but three were resistant to drugs not used in Nigeria. Ten patients had resistance to their 1 L drug(s) and six were fully susceptible to the three drugs in the recommended second-line regimen.

Conclusion
This cohort had little drug resistance mutations. We conclude that if adherence is not assured, patients could exhibit virologic failure without having developed mutations associated with drug resistance.
Differential expression of IDA (INFLORESCENCE DEFICIENT IN ABSCISSION)-like genes in Nicotiana benthamiana during corolla abscission, stem growth and water stress
Authors: Ventimilla Daniel , Domingo Concha , González-Ibeas Daniel , Talon Manuel , Tadeo Francisco R. 
Published: January 2020

AbstractBackgroundIDA (INFLORESCENCE DEFICIENT IN ABSCISSION)-like signaling peptides and the associated HAE (HAESA)-like family of receptor kinases were originally reported in the model plantArabidopsis thaliana(Arabidopsis) to be deeply involved in the regulation of abscission. Actually, IDA peptides, as cell-to-cell communication elements, appear to be implicated in many developmental processes that rely on cell separation events, and even in the responses to abiotic stresses. However, the knowledge related to the molecular machinery regulating abscission in economically important crops is scarce. In this work, we determined the conservation and phylogeny of theIDA-like andHAE-like gene families in relevant species of the Solanaceae family and analyzed the expression of these genes in the allopolyploidNicotiana benthamiana,in order to identify members involved in abscission, stem growth and in the response to drought conditions.ResultsThe phylogenetic relationships among theIDA-like members of the Solanaceae studied, grouped the two pairs of NbenIDA1 and NbenIDA2 protein homeologs with the Arabidopsis prepropeptides related to abscission. Analysis of promoter regions searching for regulatory elements showed that these two pairs of homeologs contained both hormonal and drought response elements, althoughNbenIDA2Alacked the hormonal regulatory elements. Expression analyses showed that the pair ofNbenIDA1homeologs were upregulated during corolla abscission.NbenIDA1andNbenIDA2pairs showed tissue differential expression under water stress conditions, sinceNbenIDA1homeologs were highly expressed in stressed leaves whileNbenIDA2homeologs, especiallyNbenIDA2B, were highly expressed in stressed roots. In non-stressed active growing plants, nodes and internodes were the tissues with the highest expression levels of all members of theIDA-like family and their putativeHAE-like receptors.ConclusionOur results suggest that the pair ofNbenIDA1homeologs are involved in the natural process of corolla abscission while both pairs ofNbenIDA1andNbenIDA2homeologs are implicated in the response to water stress. The data also suggest that IDA peptides may be important during stem growth and development. These results provide additional evidence that the functional module formed by IDA peptides and its receptor kinases, as defined in Arabidopsis, may also be conserved in Solanaceae.
Anesthetic management of a patient with a continuous-flow left ventricular assist device for video-assisted thoracoscopic surgery: a case report
Authors: Iwata Shihoko , Yokokawa Sumire , Sato Mihoshi , Ozaki Makoto 
Published: January 2020

Abstract
Background
As patients with left ventricular assist device (LVAD) have long expected survival, the incidence of noncardiac surgery in this patient population is increasing. Here, we present the anesthetic management of a patient with a continuous-flow LVAD who underwent video-assisted thoracic surgery (VATS).

Case presentation
A 37-year-old man with LVAD was scheduled to undergo VATS because of repeated spontaneous pneumothorax. Generally, patients with these devices have marginal right heart function; therefore, it is important to avoid factors that worsen pulmonary vascular resistance (PVR). However, VATS requires one-lung ventilation (OLV) and it tends to cause increase in PVR, leading to right heart failure.
In the present case, when the patient was set in a lateral decubitus position and progressive hypoxia was observed during OLV, transesophageal echocardiography demonstrated a dilated right ventricle and a temporally flattened interventricular septum, and the central venous pressure increased to approximately 20 mmHg. Because we anticipated deterioration of right heart function, dobutamine and milrinone were administered and/or respirator settings were changed to decrease PVR for maintaining LVAD performance. Finally, resection of a bulla was completed, and the patient was discharged in stable condition on postoperative day 37.

Conclusions
The anesthetic management of a patient with LVAD during VATS is challenging because the possible hemodynamic changes induced by hypoxia associated with OLV affect LVAD performance and right heart function. In our experience, VATS that requires OLV will be well tolerated in a patient with LVAD with preserved right heart function, and a multidisciplinary approach to maintain right heart function will be needed.
The prognostic role of platelet-to-lymphocyte ratio on overall survival in gastric cancer: a systematic review and meta-analysis
Authors: Cao Weijuan , Yao Xiaomin , Cen Danwei , Zhi Yajun , Zhu Ningwei , Xu Liyong 
Published: January 2020

Abstract
Background
This study aimed to summarize the previously published literature on the role of platelet-to-lymphocyte ratio (PLR) on overall survival (OS) in patients with gastric cancer.

Methods
We systematically searched PubMed, EmBase, and the Cochrane library to identify eligible studies to review. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using the random-effects model. Sensitivity and subgroup analyses were performed, and publication bias was assessed.

Results
A total of 28 studies comprising 15,617 patients with gastric cancer were included in this meta-analysis. The pooled results indicated that elevated PLR was associated with poor OS (HR: 1.37; 95% CI: 1.24–1.51; P < 0.001). A significant publication bias was observed (Egger test, P = 0.036; Begg test, P = 0.017). After adjusting for publication bias using the trim and fill method, an adjusted pooled HR of 1.19 (95% CI: 1.08–1.33; P = 0.001) was observed. Subgroup analyses indicated an elevated PLR in retrospective studies. Studies conducted in Turkey, the UK, the USA, and Costa Rica; studies with a sample size of < 1000, with < 70% male patients, and with patients treated with chemotherapy; studies with PLR cutoff value of ≥200; and studies with lower quality as determined by the Newcastle-Ottawa Scale all showed greater harmful effects on OS than their corresponding subsets (P < 0.05).

Conclusions
An elevated PLR was associated with poor OS in patients with gastric cancer. These results might differ between studies due to differences in design, country of origin, sample size, sex proportion, treatment strategy, PLR cutoff value, and study quality.
Analysis of the relationship between MIR155HG variants and gastric Cancer susceptibility
Authors: Zou Wenjing , Li Xu , Li Cheng , Liu Dan , Lv Yanyan , Yang Ying , Ye Nan , Guo Dan , He Shuixiang 
Published: January 2020

Abstract
Background
Gastric cancer is one of the most common cancers in the world and a major cause of cancer-related death. This study aims to determine whether genetic variations in MIR155HG could be associated with gastric cancer risk.

Materials & methods
A total of 506 gastric cancer patients and 500 healthy controls were enrolled in this study. Genotypes were examined with the MassARRAY platform and data management and analysis were conducted with the Typer Software. Odds ratios (OR) and 95% confidence intervals (CIs) were calculated with logistic regression adjusting for age and gender to evaluate the associations between SNPs with gastric cancer in genetic model analysis.

Results
The “CC” genotype of rs4143370 decreased the risk of gastric cancer in genotype model (p = 0.020) and recessive model (p = 0.018). Inversely, the “CC” genotype of rs1893650 increased the risk of gastric cancer in genotype model (p = 0.023) and recessive model (p = 0.014). Stratified analysis showed that rs11911469 was associated with an increased risk of gastric cancer only among the male group in the dominant model (p = 0.039) and additive model (p = 0.030). The haplotype analysis showed a strong linkage disequilibrium among these six SNPs (rs4143370, rs77699734, rs11911469, rs1893650, rs34904192 and rs928883).

Conclusion
This study confirmed the relationship between SNPs of MIR155HG and the gastric cancer risk among the Chinese Han population. Our data may provide a new perspective to understand the aetiology of gastric cancer.
High-normal PaCO2 values might be associated with worse outcome in patients with subarachnoid hemorrhage – a retrospective cohort study
Authors: Reiff Tilman , Barthel Oliver , Schönenberger Silvia , Mundiyanapurath Sibu 
Published: January 2020

Abstract
Background
While both hypercapnia and hypocapnia are harmful in patients with subarachnoid hemorrhage (SAH), it is unknown whether high-normal PaCO2 values are better than low-normal values. We hypothesized that high-normal PaCO2 values have more detrimental than beneficial effects on outcome.

Methods
Consecutive patients with aneurysmal subarachnoid hemorrhage (aSAH) requiring mechanical ventilation treated in a tertiary care university hospital were retrospectively analyzed regarding the influence of PaCO2 on favorable outcome, defined as modified Rankin scale score < 3 at discharge. Primary endpoint was the difference in the proportion of PaCO2 values above 40 mmHg in relation to all measured PaCO2 values between patients with favorable and unfavorable outcome.

Results
150 patients were included. Median age was 57 years (p25:50, p75:64), median Hunt-Hess score was 4 (p25:3, p75:5). PaCO2 values were mainly within normal range (median 39.0, p25:37.5, p75:41.4). Patients with favorable outcome had a lower proportion of high-normal PaCO2 values above 40 mmHg compared to patients with unfavorable outcome (0.21 (p25:0.13, p75:0.50) vs. 0.4 (p25:0.29, p75:0.59)) resulting in a lower chance for favorable outcome (OR 0.04, 95% CI 0.00–0.55, p = 0.017). In multivariable analysis adjusted for Hunt-Hess score, pneumonia and length of stay, elevated PaCO2 remained an independent predictor of outcome (OR 0.05, 95% CI 0.00–0.81, p = 0.035).

Conclusions
A higher proportion of PaCO2 values above 40 mmHg was an independent predictor of outcome in patients with aSAH in our study. The results need to be confirmed in a prospective trial.
Nomogram for prediction of gestational diabetes mellitus in urban, Chinese, pregnant women
Authors: Guo Fei , Yang Shuai , Zhang Yong , Yang Xi , Zhang Chen , Fan Jianxia 
Published: January 2020

Abstract
Background
This study sought to develop and validate a nomogram for prediction of gestational diabetes mellitus (GDM) in an urban, Chinese, antenatal population.

Methods
Age, pre-pregnancy body mass index (BMI), fasting plasma glucose (FPG) in the first trimester and diabetes in first degree relatives were incorporated as validated risk factors. A prediction model (nomogram) for GDM was developed using multiple logistic regression analysis, from a retrospective study conducted on 3956 women who underwent their first antenatal visit during 2015 in Shanghai. Performance of the nomogram was assessed through discrimination and calibration. We refined the predicting model with t-distributed stochastic neighbor embedding (t-SNE) to distinguish GDM from non-GDM. The results were validated using bootstrap resampling and a prospective cohort of 6572 women during 2016 at the same institution.

Results
Advanced age, pre-pregnancy BMI, high first-trimester, fasting, plasma glucose, and, a family history of diabetes were positively correlated with the development of GDM. This model had an area under the receiver operating characteristic (ROC) curve of 0.69 [95% CI:0.67–0.72, p < 0.0001]. The calibration curve for probability of GDM showed good consistency between nomogram prediction and actual observation. In the validation cohort, the ROC curve was 0.70 [95% CI: 0.68–0.72, p < 0.0001] and the calibration plot was well calibrated. In exploratory and validation cohorts, the distinct regions of GDM and non-GDM were distinctly separated in the t-SNE, generating transitional boundaries in the image by color difference. Decision curve analysis showed that the model had a positive net benefit at threshold between 0.05 and 0.78.

Conclusions
This study demonstrates the ability of our model to predict the development of GDM in women, during early stage of pregnancy.
Childbirth care in Egypt: a repeat cross-sectional analysis using Demographic and Health Surveys between 1995 and 2014 examining use of care, provider mix and immediate postpartum care content
Authors: Pugliese-Garcia Miguel , Radovich Emma , Campbell Oona M. R. , Hassanein Nevine , Khalil Karima , Benova Lenka 
Published: January 2020

Abstract
Background
Egypt has achieved important reductions in maternal and neonatal mortality and experienced increases in the proportion of births attended by skilled professionals. However, substandard care has been highlighted as one of the avoidable causes behind persisting maternal deaths. This paper describes changes over time in the use of childbirth care in Egypt, focusing on location and sector of provision (public versus private) and the content of immediate postpartum care.

Methods
We used five Demographic and Health Surveys conducted in Egypt between 1995 and 2014 to explore national and regional trends in childbirth care. To assess content of care in 2014, we calculated the caesarean section rate and the percentage of women delivering in a facility who reported receiving four components of immediate postpartum care for themselves and their newborn.

Results
Between 1995 and 2014, the percentage of women delivering in health facilities increased from 35 to 87% and women delivering with a skilled birth attendant from 49 to 92%. The percentage of women delivering in a private facility nearly quadrupled from 16 to 63%. In 2010–2014, fewer than 2% of women delivering in public or private facilities received all four immediate postpartum care components measured.

Conclusions
Egypt achieved large increases in the percentage of women delivering in facilities and with skilled birth attendants. However, most women and newborns did not receive essential elements of high quality immediate postpartum care. The large shift to private facilities may highlight failures of public providers to meet women’s expectations. Additionally, the content (quality) of childbirth care needs to improve in both sectors. Immediate action is required to understand and address the drivers of poor quality, including insufficient resources, perverse incentives, poor compliance and enforcement of existing standards, and providers’ behaviours moving between private and public sectors. Otherwise, Egypt risks undermining the benefits of high coverage because of substandard quality childbirth care.
Identification of dissociation factors in pancreatic Cancer using a mass spectrometry-based proteomic approach
Authors: Liu Peng , Kong Lingming , Liang Keke , Wu Yunhao , Jin Haoyi , Song Bing , Tan Xiaodong 
Published: January 2020

Abstract
Backgroud
Pancreatic cancer is a highly malignant tumor of the digestive system. This secretome of pancreatic cancer is key to its progression and metastasis. But different methods of protein extraction affect the final results. In other words, the real secretion of proteins in cancer cells has been changed. Based on mass spectrometry, we analyze the secretome from the serum-containing and serum-free medium, using different protein pretreatment methods. This study aims to identify dissociation factors in pancreatic cancer.

Methods
In this study, pancreatic cancer cells were cultured in serum-containing or serum-free medium, and the corresponding supernatants were extracted as samples. Subsequently, the above samples were separated by size exclusion chromatography (SEC), and peptide segments were identified by LC-MS/MS. The final results were identified via the hamster secreted protein database and a public database.

Results
Although the number of identified proteins in the serum-free medium group was high, the real secretion of proteins in pancreatic cancer cells was changed. There were six significant secreted proteins in the serum-containing medium group. Survival analysis via the TCGA database suggested that patients with higher expression levels of YWHAG showed a worse overall survival rate than those with lower YWHAG expression.

Conclusions
Our study demonstrated the results in the serum-containing medium group were more similar to the real secretome of pancreatic cancer cells. YWHAG could be used as a prognostic indicator for pancreatic cancer.
Space-time clustering of childhood leukemia in Colombia: a nationwide study
Authors: Rodriguez-Villamizar Laura Andrea , Rojas Díaz Marcela Pilar , Acuña Merchán Lizbeth Alexandra , Moreno-Corzo Feisar Enrique , Ramírez-Barbosa Paula 
Published: January 2020

Abstract
Background
Leukemia is the most common cancer in childhood. The estimated incidence rate of childhood leukemia in Colombia is one of the highest in America and little is known about its spatial distribution.

Purpose
To explore the presence of space-time clustering of childhood leukemia in Colombia.

Methods
We included children less than 15 years of age with confirmed diagnosis of acute leukemia reported to the national surveillance system for cancer between 2009 and 2017. Kulldorff’s spatio-temporal scan statistics were used with municipality and year of diagnosis as units for spatial and temporal analysis.

Results
There were 3846 cases of childhood leukemia between 2009 and 2017 with a specific mean incidence rate of 33 cases per million person-years in children aged 0–14 years. We identified five spatial clusters of childhood leukemia in different regions of the country and specific time clustering during the study period.

Conclusion
Childhood leukemia seems to cluster in space and time in some regions of Colombia suggesting a common etiologic factor or conditions to be studied.
Pathological complete response due to a prolonged time interval between preoperative chemoradiation and surgery in locally advanced rectal cancer: analysis from the German StuDoQ|Rectalcarcinoma registry
Authors: Lichthardt Sven , Wagner Johanna , Löb Stefan , Matthes Niels , Kastner Caroline , Anger Friedrich , Germer Christoph-Thomas , Wiegering Armin 
Published: January 2020

Abstract
Background
Preoperative chemoradiotherapy is the recommended standard of care for patients with local advanced rectal cancer. However, it remains unclear, whether a prolonged time interval to surgery results in an increased perioperative morbidity, reduced TME quality or better pathological response. Aim of this study was to determine the time interval for best pathological response and perioperative outcome compared to current recommended interval of 6 to 8 weeks.

Methods
This is a retrospective analysis of the German StuDoQ|Rectalcarcinoma registry. Patients were grouped for the time intervals of “less than 6 weeks”, “6 to 8 weeks”, “8 to 10 weeks” and “more than 10 weeks”. Primary endpoint was pathological response, secondary endpoint TME quality and complications according to Clavien-Dindo classification.

Results
Due to our inclusion criteria (preoperative chemoradiation, surgery in curative intention, M0), 1.809 of 9.560 patients were suitable for analysis. We observed a trend for increased rates of pathological complete response (pCR: ypT0ypN0) and pathological good response (pGR: ypT0-1ypN0) for groups with a prolonged time interval which was not significant. Ultimately, it led to a steady state of pCR (16.5%) and pGR (22.6%) in “8 to 10” and “more than 10” weeks. We were not able to observe any differences between the subgroups in perioperative morbidity, proportion of rectal extirpation (for cancer of the lower third) or difference in TME quality.

Conclusion
A prolonged time interval between neoadjuvant chemoradiation can be performed, as the rate of pCR seems to be increased without influencing perioperative morbidity.