bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of trends in hospital volume over time on patient outcomes for high-risk surgery
Authors: Payet Cécile , Polazzi Stéphanie , Lifante Jean-Christophe , Cotte Eddy , Grinberg Daniel , Carty Matthew J , Sanchez Stéphane , Rabilloud Muriel , Duclos Antoine 
Published: February 2020

Abstract
Background

The “practice makes perfect” concept considers the more frequent a hospital performs a procedure, the better the outcome of the procedure. We aimed to study this concept by investigating whether patient outcomes improve in hospitals with a significantly increased volume of high-risk surgery over time and whether a learning effect existed at the individual hospital level.

Methods

We included all patients who underwent one of ten digestive, cardiovascular and orthopaedic procedures between 2010 and 2014 from the French nationwide hospitals database. For each procedure, we identified three groups of hospitals according to volume trend (increased, decreased, or no change). In-hospital mortality, reoperation, and unplanned hospital readmission within 30 days were compared between groups using Cox regressions, taking into account clustering of patients within hospitals and potential confounders. Individual hospital learning effect was investigated by considering the interaction between hospital groups and procedure year.

Results

Over 5 years, 759,928 patients from 694 hospitals were analysed. Patients’ mortality in hospitals with procedure volume increase or decrease over time did not clearly differ from those in hospitals with unchanged volume across the studied procedures (e.g., Hazard Ratios [95%] of 1.04 [0.93-1.17] and 1.08 [0.97-1.21] respectively for colectomy). Furthermore, patient outcomes did not improve or deteriorate in hospitals with increased or decreased volume of procedures over time (e.g., 1.01 [0.95-1.08] and 0.99 [0.92-1.05] respectively for colectomy).

Conclusions

Trend in hospital volume over time does not appear to influence patient outcomes based on real-world data.
Does zero-profile anchored cage accompanied by a higher postoperative subsidence compared with cage-plate construct? A meta-analysis
Authors: Lu Yingjie , Fang Yuepeng , Shen Xu , Lu Dongdong , Zhou Liyu , Gan Minfeng , Zhu Xuesong 
Published: February 2020

Abstract
Background: The zero-profile anchored cage ( ZP ) has been widely used for its lower occurrence of dysphagia. However, it is still controversial whether it has the same stability as the cage-plate construct (CP) and increases the incidence of postoperative subsidence. We compared the rate of subsidence after anterior cervical discectomy and fusion (ACDF) with ZP and CP to determine whether the zero-profile device had a higher subsidence rate. Methods: We performed a meta-analysis of studies that compared the subsidence rates of ZP and CP. An extensive and systematic search covered the Medline, Embase and Web of Science databases according to the PRISMA guidelines and identified ten articles that satisfied our inclusion criteria. Relevant clinical and radiological data were extracted and analyzed by RevMan 5.3 software. Results: Ten trials involving 626 patients were included in this meta-analysis. The incidence of postoperative subsidence in the ZP group was significantly higher than that in the CP group [15.1% (89/588) vs. 8.8% (51/581), OR = 1.97 (1.34, 2.89), P = 0.0005]. In the subgroup analysis, we found that the definition of subsidence did not affect the higher subsidence rate in the ZP group. Considering the quantity of operative segments, there was no significant difference in the incidence of subsidence between the two groups after single-level fusion (OR 1.43, 95% CI 0.61-3.37, P = 0.41). However, the subsidence rate of the ZP group was significantly higher than that of the CP group (OR 2.61, 95% CI 1.55-4.40, P = 0.0003) after multilevel (≥2-level) procedures. There were no significant differences in intraoperative blood loss, JOA score, NDI score, fusion rate or cervical alignment in the final follow-up between the two groups. In addition, the CP group had a longer operation time and a higher incidence of dysphagia than the ZP group at each follow-up time. Conclusion: Based on the limited evidence, we suggest that ZP has a higher risk of postoperative subsidence than CP, although with elevated swallowing discomfort. A high-quality, multi-center randomized controlled trial is required to validate our results in the future.
Toxicity evaluation of recombinant Fim-C Salmonella typhi Protein on ddY Mice for Typhoid Vaccine Development
Authors: Nurjayadi Muktiningsih , Mangunwardoyo Wibowo - , Agustini Kurnia - , Wulandari Gina Riesky , Astuti Gina - , Chasanah Nunung Iswatun , Kartika Irma Ratna 
Published: February 2020

Abstract
Background: Typhoid fever is caused by Salmonella typhi infection, commonly occurs in developing countries from bad sanitation and living conditions. Vaccination against the fever has been developed by means of induction of antibody through introduction of Fim-C, one of the virulence factor proteins on the cell surface of the bacterium. Recently, we have cloned and overexpressed the protein in Escherichia coli . The 31 kDa recombinant Fim-C induced immune response upon introduction to ddY mice at a concentration of 40-60 µg/mL, indicating its potency as an anti-typhoid fever vaccine candidate. Objective: In this study, the safety of the protein was evaluated through abnormal and acute toxicity test in ddY mice, as well as determine its lethal dose (LD50). Methods: Forty of equal number male and female mice were recruited and observed according to the physiology, body weight and temperature, and mortality rate was performed on fourteenth days after immunization. Results: No abnormalities were observed at 25 µg/mL while 60% mortality occurred at 125 µg/mL. The latter observation correlates with our finding that the LD50 of the recombinant Fim-C was 123.5 µg/mL. Conclusion: Our results suggest that the recombinant Fim-C protein is safe for use as anti typhoid fever vaccine.
Patient-evaluated cognitive function measured with smartphones and the association with objective cognitive function, perceived stress, quality of life and function capacity in patients with bipolar disorder
Authors: Faurholt-Jepsen Maria , Miskowiak Kamilla Woznica , Frost Mads , Christensen Ellen Marrgethe , Þórarinsdóttir Helga , Bardram Jakob Eyvind , Vinberg Maj , Kessing Lars Vedel 
Published: February 2020

Abstract
Background Cognitive impairments in patients with bipolar disorder (BD) have been associated with reduced functioning. Aims: To investigate the association between 1) patient-evaluated cognitive function measured daily using smartphones and stress, quality of life and functioning, respectively, and 2) patient-evaluated cognitive function and objectively-measured cognitive function with neuropsychological tests. Methods Data from two randomized controlled trials were combined. Patients with BD (N=117) and healthy controls (HC) (N=40) evaluated their cognitive function daily for six to nine months using a smartphone. Patients completed the objective cognition screening tool, the Screen for Cognitive Impairment in Psychiatry and were rated with the Functional Assessment Short Test. Raters were blinded to smartphone data. Participants completed the Perceived Stress Scale and the WHO Quality of Life questionnaires. Data was collected at multiple time points per participant. P-values below 0.0023 were considered statistically significant. Results Patient-evaluated cognitive function was statistically significant associated with perceived stress, quality of life and functioning, respectively (all p-values<0.0001). There was no association between patient-evaluated cognitive function and objectively-measured cognitive function ( B:0.0009, 95% CI: 0.0017; 0.016, p=0.015 ). Patients exhibited cognitive impairments in subjectively evaluated cognitive function in comparison with HC despite being in full or partly remission ( B: -0.36, 95% CI: -0.039; -0.032, p<0.0001 ). Conclusion The present association between patient-evaluated cognitive function on smartphones and perceived stress, quality of life and functional capacity suggests that smartphones can provide a valid tool to assess disability in remitted BD. Smartphone-based ratings of cognition could not provide insights into objective cognitive function.
CD107a+ (LAMP-1) cytotoxic CD8+ T-cells in lupus nephritis patients
Authors: Wiechmann Anika , Wilde Benjamin , Amann Kerstin , Abdulahad Wayel H. , Kribben Andreas , Lang Karl Sebastian , Witzke Oliver , Dolff Sebastian 
Published: February 2020

Abstract
Background: Cytotoxic CD8 + T-cells play a pivotal role in the pathogenesis of systemic lupus erythematosus (SLE). The aim of this study was to investigate the role of CD107a (LAMP-1) on cytotoxic CD8 + T-cells in SLE-patients in particular with lupus nephritis. Methods: Peripheral blood of SLE-patients (n=31) and healthy controls (n=21) was analyzed for the expression of CD314 and CD107a by flow cytometry. Kidney biopsies of lupus nephritis patients were investigated for the presence of CD8 + and C107a + cells by immunohistochemistry. Results: The percentages of CD107a + on CD8 + T-cells were significantly decreased in SLE-patients as compared to healthy controls (40.2 ±18.5 % vs. 47.9 ± 15.0 %, p=0.02). This was even more significant in SLE-patients with inactive disease. There was a significant correlation between the percentages of CD107a + CD8 + T-cells and SLEDAI. The evaluation of lupus nephritis biopsies showed a significant number of CD107a + CD8 + T-cells mainly located in the peritubular infiltrates. The intrarenal expression of CD107a + was significantly correlated with proteinuria. Conclusion: These results demonstrate that CD8 + T-cells of patients with systemic lupus erythematosus have an altered expression of CD107a which seems to be associated with disease activity. The proof of intrarenal CD107a + CD8 + suggests a role in the pathogenesis of lupus nephritis.
Neurofeedback training of control network improves SSVEP-based BCI performance in children
Authors: Jingnan Sun , He Jing , Gao Xiaorong 
Published: February 2020

Abstract
Background: In the past 20 years, neural engineering has made unprecedented progress in the interpretation of brain information (e.g., brain-computer interfaces) and neuromodulation (e.g., electromagnetic stimulation and neurofeedback). However, the study of improving the performance of the brain-computer interface (BCI) using the neuromodulation method rarely exists. The present study designs a neurofeedback training method to improve the performance of steady-state visual evoked potential (SSVEP) BCI and further explores its underlying mechanisms. Methods: As parietal lobe is the sole hub of information transmission, up-regulating alpha-band power of the parietal lobe by neurofeedback training was present as a new neural modulating method to improve SSVEP-based BCI in this study. Results: After this neurofeedback training (NFT), the signal-to-noise ratio (SNR), accuracy, and information transfer rate (ITR) of SSVEP-based BCI were increased by 5.8%, 4.7%, and 15.6% respectively. However, no improvement has been observed in the control group in which the subjects do not participate in NFT. What’s more, a general reinforcement of the information flow from the parietal lobe to the occipital lobe was also observed. Evidence from the network analysis and attention test further indicate that NFT improves attention via developing the control ability of the parietal lobe and then enhances the above SSVEP indicators. Conclusion: Up-regulating parietal alpha-amplitude using neurofeedback training significantly improves the SSVEP-baesd BCI performance through modulating the control network. The study validates an effective neuromodulation method, and possibly also contributes to explaining the function of the parietal lobe in the control network.
Efficacy of brief dynamic interpersonal therapy in patients with major depressive disorder: a prospective, multicenter randomized controlled trial protocol
Authors: Wang Lanlan , Wang Qian , Jiang Wenhui , Luo Jianfeng , Tong Jun , Li Xiaosi , Fang Fang , Wang Hongyan , Zhao Wenqing , Koszycki Diana , Qiu Jianyin 
Published: February 2020

Abstract
Background : Dynamic Interpersonal Psychotherapy (DIT) is a brief manualized depression-focused intervention. This paper describes a study protocol of a multi-site, three-arm randomized controlled trial comparing medication plus DIT to medication alone and medication plus an active control psychotherapy in the treatment of major depressive disorder (MDD). Methods : 240 patients with MDD will be randomly allocated on a 1:1:1 basis to the treatment conditions, with 80 patients in each group. Patients will be assessed pre-and post-intervention and at 6- and 12-months follow-up with the 17-item Hamilton Depression Scale (HAMD-17) and Hamilton Anxiety Scale (HAMA-14) administered by blind evaluators, and the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder-7-item scale(GAD-7), side effect reaction scale (TESS), and The Self-Assessment Scale of the Overall Efficacy and Satisfaction of Patients (SASE). The primary outcome is change from baseline in HAMD-17 scores. Secondary outcomes include rates of response, remission and relapse, change from baseline in self-report depression and measures of anxious symptomatology, and subjective satisfaction of patients. Discussion: This will be the first multicentered RCT in China to assess the potential efficacy of psychotherapy for MDD. The study has the potential to inform clinical treatment guidelines for the treatment of MDD in China. Trial registration : ChiCTR，ChiCTR1800016970， Registered on July 5 th 2018 - Retrospectively registered, http://www.chictr.org.cn/showprojen.aspx?proj=28786 . Key words : Depression; Dynamic Interpersonal Therapy; Multicenter randomized controlled trial,
SIK2 Promotes Cisplatin Resistance Induced by Aerobic Glycolysis in Breast Cancer Cells through PI3K/AKT/mTOR Signaling Pathway
Authors: Zong Shoukai , Dai Wei , Fang Wencheng , Guo Xiangting , Wang Kai 
Published: February 2020

Abstract
Objective This study aimed to investigate the effect of SIK2 on cisplatin resistance induced by aerobic glycolysis in breast cancer cells and its potential mechanism. Methods qRT-PCR and Western blot were used to detect SIK2 mRNA and protein levels. Cisplatin (DDP) resistant cell lines of breast cancer cells were established, CCK-8 was used to measure and evaluate the viability, and Transwell was used to evaluate the cell invasion capability. Flow cytometry was adopted to evaluate the apoptosis rate. The glycolysis level was evaluated by measuring glucose consumption and lactic acid production. The protein levels of p-PI3K, p- protein kinase B (Akt) and p-mTOR were determined by western blot. Results SIK2 is highly expressed in breast cancer tissues and cells compared with adjacent tissues and normal human breast epithelial cells, and has higher diagnostic value for breast cancer. Silencing SIK2 expression can inhibit proliferation and invasion of breast cancer cells and induce their apoptosis. In addition, SIK2 knockdown inhibits glycolysis, reverses the resistance of drug-resistant cells to cisplatin, and inhibits PI3K/AKT/mTOR signaling pathway. When LY294002 is used to inhibit PI3K/AKT/mTOR signaling pathway, the effect of Sh-SIK2 on aerobic glycolysis of breast cancer cells can be reversed. Conclusion SIK2 can promote cisplatin resistance caused by aerobic glycolysis of breast cancer cells through PI3K/AKT/mTOR signaling pathway, which may be a new target to improve cisplatin resistance of breast cancer cells.
The effect of paraspinal muscle-splitting microscopic-assisted discectomy versus percutaneous endoscopic lumbar discectomy on patients in the treatment of far-lateral lumbar disc herniation
Authors: KONG LEI , Xu Hong Guang 
Published: February 2020

Abstract
Background

Minimally invasive surgery includes percutaneous endoscopic lumbar discectomy and the microscopic tubular technique. This study aimed to compare the two techniques and evaluate the outcome of the procedure.

Methods

We retrospectively analyzed patients with far-lateral lumbar disc herniation (FLLDH) from June 2015 to October 2018. Twenty-six patients underwent paraspinal muscle-splitting microscopic-assisted discectomy (MD), and 30 underwent percutaneous endoscopic lumbar discectomy (PELD) surgery. Data included the duration of the operation, duration of intraoperative radiation exposure and average hospitalization. Pre- and postoperative pain scores and neurological functions were recorded using visual analogue scale (VAS) score and Oswestry disability index (ODI).

Results

A total of 56 patients remained in the study over the 12–24 months. The mean operating time was 65.83 ± 16.64 min in the PELD group, the mean duration of radiation exposure was 2.87±1.19 min and average hospitalization was 3.43 days. The mean operating time was 44.96 ± 16.87 min in the MD group, the mean duration of radiation exposure was 0.78±0.32 min and average hospitalization was 4.12 days. All patients in both groups showed significant improvement of VAS and ODI scores after surgery and until final follow-up.

Conclusion

Both techniques are minimally invasive, effective, and safe for treating far-lateral lumbar disc herniation in selected patients. Compared with the PELD technique, the MD procedure affords a wider field of vision during operation, shorter operation time, fewer postoperative complications, and a shorter learning curve.
Is Routine Chemical Thromboprophylaxis Necessary in Patients Undergoing Unicompartmental Knee Arthroplasty?
Authors: Xu Xingquan , Yao Yao , Yan Wenqiang , Yan Wenjin , Xu Jia , Chen Dongyang , Xu Zhihong , Jiang Qing , Shi Dongquan 
Published: February 2020

Abstract
Background This study aimed to determine the prevalence ofvenous thromboembolism (VTE) in patients undergoing unicompartmental knee arthroplasty (UKA) 3 days and 3 months postoperatively and figure out whether routine chemical thromboprophylaxis was necessary.Methods The medical records of 146 patients who underwent unilateral UKA at our institution were reviewed. The length of hospital stays after the surgery of the patients was 5.6 ± 2.7 days (3–23 days). All patients underwent pneumatic leg compression, rehabilitation exercises, pain management, and chemical deep vein thrombosis (DVT) prophylaxis from the day of surgery to 3 days after the surgery. From the fourth day to discharge, chemical prophylaxis was stopped. After discharge, only rehabilitation exercises were encouraged. All patients underwent bilateral venography or ultrasound preoperatively and 3 days postoperatively to detect DVT. They completed the follow-up review 3 months after the surgery; 108 patients had ultrasound tests again.Results DVT was detected in 9 (6.2%) of the 146 patients 3 days after the surgery and in 8 (7.4%) of the 108 patients 3 months after the surgery. No symptomatic or proximal DVT was observed. No patient exhibited pulmonary embolism–related symptoms. After discharge, six DVTs (66.7%) dissolved, and 6 (5.6%) were newly formed. No significant difference in demographics and surgery-related factors was detected between DVT and no-DVT groups at both time points.Conclusions Routine chemical thromboprophylaxis in patients undergoing UKA with pain management and rehabilitation exercises may not be necessary.
Gender discrepancy of incidence and risk factors of metabolic syndrome among rural Chinese from 2012-2013 to 2015-2017
Authors: Yu Shasha , Guo Xiaofan , Li Guangxiao , Yang Hongmei , Sun Guozhe , Zheng Liqiang , Sun Yingxian 
Published: February 2020

Abstract
Background: We reported a relatively high rate of MetS in rural Northeast residents in 2012-2013. Many strategies like health knowledge propagation and lifestyle modification have been taken to help rural residents decrease metabolic disorders. Hence, we held the present follow-up study in order to figure the changes of metabolic parameters and the possible reasons together with the evaluation of MetS incidence and associated risk factors.Methods: A population-based sample of 8147 rural Northeast Chinese residents aged ≥ 35 years at baseline were followed up from 2012-2013 to 2015-2017. MetS was diagnosed following the unify criteria in 2009 using the Asian specific criteria.Results: Among residents with MetS at baseline, value of systolic, diastolic blood pressure, total cholesterol, HDL-C decreased while waist circumference increased in both genders in follow-up. Discrepancy of trend in body mass index, LDL-C and estimated GFR existed between male and female. Besides, triglyceride increased, and fast glucose decreased in female only. The alterations of dietary pattern might be accountable for those changes. Among residents without MetS at baseline, the cumulative incidence of newly diagnosed MetS was 24.0% (25.8% for male; 22.3% for female). As the number of metabolic disorders increased at baseline, the incidence of MetS also increased (zero metabolic disorder: 8.3%; one metabolic disorder: 17.1%; two metabolic disorders: 35.4%). In male residents, bad living habits like smoking and drinking were associated with increasing risk of Mets while in female, higher risk of MetS was more likely relevant to dietary pattern.Conclusion: Metabolic parameters changes during the past years and seem to be associated with alteration of diet pattern. Incidence of MetS still high among rural Northeast Chinese. The risk factors of higher incidence of MetS show gender discrepancy which make the prophylaxis and control of MetS more effective and directive in rural residents.
The effectiveness of Information-Motivation and Behavioral skills (IMB) model of self-care in early pregnancy to prevent gestational diabetes mellitus in Iranian overweight and obese women: A Randomized Controlled Trial
Authors: Motahari-Tabari Narges Sadat , Faramarzi Mahbobeh , Shirvani Marjan Ahmad , Bakhtiari Afsaneh , Omidvar Shabnam , Nasiriamiri Fatemeh 
Published: February 2020

Abstract
Background: Gestational diabetes is one of the most common metabolic dysfunction in pregnancy and as overweight and obesity are of the major risk factors, this study aimed to determine the effect of Information-Motivation and Behavioral skills (IMB) model-based counseling on preventing gestational diabetes in overweight and obese pregnant women. Methods: A randomised controlled trial (RCT) was conducted involving pregnant women who are overweight (BMI >25 to 29.9 k/gm2) or obese (BMI >30 k/gm2), at the 12 to 16 weeks gestation and recruited from the Prenatal Clinic of Rohani Educational Hospital in Babol medical university, Iran, women in the intervention group will receive a program informed four sessions by the Information-Motivation and Behavioral skills. The control group received routine care. Blood glucose was measured before and 8 weeks after the intervention. Descriptive and inferential statistics including mean, standard deviation, frequency, t-test, chi-square and ANCOVA were used. Results: The prevalence of gestational diabetes was lower in the intervention group than the routine care group (10% and 29.9%, respectively, RR=0.33, CI 95% (0.15- 0.74) p=0.004) as well as mean fasting blood glucose (d=0.28, P=0.07), and glucose tolerance test at the first and second hour (d= 0.41 and d=0.73, respectively, p<0.01). Conclusions: Our data suggest that women that IMB model-based counseling on self-care in early pregnancy in overweight and obese pregnant women can be effective in preventing gestational diabetes. Keywords: Gestational Diabetes, Obesity, Overweight, Information-Motivation-Behavioral Skills Model Name of the registry: Comparison of the effectiveness of counseling based on health promoting behaviors on fasting blood glucose and glucose tolerance test in pregnant and overweight and obese women IRCT registration number: IRCT20120125008822N3Registration date: 2018-07-05, 1397/04/14Registration timing: prospective https://en.irct.ir/trial/32150