bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lesion distribution characteristics of deep infiltrating endometriosis with ovarian endometrioma: An observational clinical study
Authors: Kwok Hungling , Jiang Hongye , Li Tian , Yang Huan , Fei Hui , Cheng Li , Yao Shuzhong , Chen Shu-Qin 
Published: January 2020

Abstract
Purpose: To investigate the characteristics of deep infiltrating endometriosis (DIE) lesion distribution when associated with ovarian endometrioma (OEM). Methods:The present study analyzed retrospective data obtained by the First Affiliated Hospital of Sun Yat-sen University, between June 2008 to June 2016. A total of 304 patients underwent laparoscopic surgery for complete removal of endometriosis by one experienced surgeon, and histological confirmation of OEM associated with DIE was conducted for each patient. Clinical data were recorded for each patient from medical, operative and pathological reports. Patients were then divided into two groups according to unilateral or bilateral OEM. Patients with unilateral OEM were subsequently divided into two subgroups according to OEM location (left- or right-hand side) and the diameter of the OEM (≤50 and >50 mm). The distribution characteristics of DIE lesions were then compared between the groups. Results:DIE lesions were widely distributed, 30 anatomical sites were involved. Patients with associated unilateral OEM (n=184 patients) had a significantly increased number of DIE lesions when compared with patients with bilateral OEM (n=120 patients; 2.76±1.52 vs. 2.33±1.34; P=0.006). Compared with bilateral OEM with DIE, there was a higher rate of intestinal (39.1% vs. 18.3%; P<0.01) and vaginal (17.4% vs. 6.7%; P<0.01) infiltration by DIE lesions in unilateral OEM with DIE. The mean number of DIE lesions was not significantly correlated with the location or size of the OEM (2.83±1.56 vs. 2.74±1.53; P=0.678; and 2.65±1.42 vs. 2.80±1.43; P=0.518, respectively). There was no significant difference between the groups with OEM ≤50 mm and >50 mm. Conclusion:Lesion distribution characteristics in women diagnosed with histologically proven OEM associated with DIE were frequently multifocal and severe.
Diagnostic and prognostic value of plasma adrenomedullin compared to other biomarkers using Sepsis-3 definitions for sepsis and septic shock
Authors: Yonaha Tetsu , Maruta Toyoaki , Otao Go , Igarashi Koji , Nagata Sayaka , Yano Takeshi , Taniguchi Masahiko , Kitamura Kazuo , Tsuneyoshi Isao 
Published: January 2020

Abstract
Background Sepsis-3, the recent sepsis definitions, was modified based on a scoring system focused on organ failure; however, it would remain a time-consuming process to detect septic patients using these definitions. Adrenomedullin (AM) is a biomarker for diagnosing sepsis and septic shock, monitoring treatment efficacy, and prognosis. We conducted a study to assess the accuracy of AM for diagnosing and prognosing sepsis and septic shock based on the Sepsis-3 definitions.Methods This is a prospective observational single-center study. Patients admitted to the intensive care unit (ICU) were retrospectively categorized as non-sepsis, sepsis, or septic shock by Sepsis-3 definitions. Total AM (tAM) and mature AM (mAM) were measured upon ICU admission. Receiver operating characteristics (ROC) analyses were performed by calculating the area under the curve (AUC) for diagnosis and prognosis of sepsis and septic shock.ResultsA total of 98 patients were enrolled in the final analysis. Among these, 42, 22, and 34 patients were assigned to non-sepsis, sepsis, and septic shock, respectively. tAM and mAM levels significantly increased according to the severity of sepsis. The AUCs of tAM/mAM for diagnosing sepsis and septic shock were 0.879/0.848 and 0.858/0.830, respectively, whereas those of procalcitonin (PCT)/presepsin (PSEP) were 0.822/0.682 and 0.811/0.661, respectively. The AUCs of tAM/mAM on Day 1 and 3 for predicting 28-day mortality of septic patients were 0.669/0.5741 and 0.931/0.892, respectively, whereas those of sequential organ failure assessment (SOFA) score/lactate were 0.669/0.824 and 0.922/0.794, respectively.Conclusions Both tAM and mAM are reliable, early biomarkers to diagnose sepsis and septic shock according to the Sepsis-3 definitions, and are comparable to PCT. Furthermore, AM level on Day 3 is a reliable biomarker to predict 28-day mortality due to sepsis, which is comparable to that of the SOFA score and lactate level.
Age-related differences in the impact of coagulopathy in patients with isolated traumatic brain injury: an observational cohort study
Authors: Takayama Wataru , Endo Akira , Koguchi Hazuki , Murata Kiyoshi , Otomo Yasuhiro 
Published: January 2020

Abstract
Background Although age and trauma-induced coagulopathy (TIC) are well-known predictors of poor outcome after traumatic brain injury (TBI), the interaction effect of these two predictors remains unclear.Objectives We assessed age-related differences in the impact of TIC on the outcome following isolated TBI.Methods We conducted a retrospective observational study in two tertiary emergency critical care medical centers in Japan from 2013 to 2018. A total of 1036 patients with isolated TBI [head abbreviated injury scale (AIS) ≥3, and other AIS <3] were selected, and divided into the non-elderly (n = 501, 16-64 years) and elderly group (n = 535, age ≥65 years). We further evaluated the impact of coagulopathy (international normalized ratio ≥1.2, and/or platelet count <120 × 10 9 /L, and/or fibrinogen ≤150 mg/dL) on TBI outcomes [Glasgow Outcome Scale-Extended (GOS-E) scores, in-hospital mortality, and ventilation-free days (VFD)] in both groups using univariate and multivariate models. Further, we conducted an age-based assessment of the impact of coagulopathy on GOS-E using a generalized additive model.Results The multivariate model showed a significant association of age and coagulopathy with lower GOS-E scores, in-hospital mortality, and shorter VFD in the non-elderly group; however, significant impact of coagulopathy was not observed for all the outcomes in the elderly group. There was a decrease in the correlation degree between coagulopathy and GOS-E scores decreased with age over 65 years old.Conclusions There was a low impact of coagulopathy on functional and survival outcomes in geriatric patients with isolated TBI.
Enhanced Awareness Indicated by Detection Ratio of Dementia with Community-based Active Survey
Authors: Lu Yun-Ru , Jeng Ya-Chung , Lee Wen-Yuan , Hsu Wei-Chih , Yen Amy Ming-Fang , Pan Shin-Liang , Chen Yen-Ching , Chen Sam Li-Sheng , Chen Hsiu-Hsi , Liou Horng-Huei , Wu Tzy-Haw 
Published: January 2020

Abstract
Background: Little is known about how early awareness is enhanced via a community-based active detection of dementia in comparison with the passive detected dementia through routine clinical practice. Methods: To assess the extent of the awareness, the adjusted detection ratio, the ratio of prevalence to incidence was developed by a Bayesian regression model based on a sample of 183 participants from community-based active survey and 1,921,308 subjects from clinical practice. Results: Given 2.91% prevalence estimated from passive detection and 6.59% prevalence on active survey, and 1.83 % incidence for those aged 65 years or older, the detection ratios were higher in active survey than passive detection for those aged 65-79 years (4.23, 95% CI: 2.68-6.69) versus (1.45, 95% CI: 1.43-1.47). Similar findings were also observed for those aged 80 years Conclusions: Active community-based detection was approximately three times that of passive detection due to the enhanced awareness of early detection of dementia. Keywords: Dementia; Early detection; Prevalence; Incidence
Characterization of two in vivo challenge models to measure functional activity of monoclonal antibodies to Plasmodium falciparum circumsporozoite protein
Authors: Raghunandan Rama , Mayer Bryan T , Flores-Garcia Yevel , Gerber Monica W , Gottardo Raphael , Jhun Hugo , Herrera Sonia M , Perez-Ramos Daniel W , Locke Emily , King C Richter , Zavala Fidel 
Published: January 2020

Abstract
Background. New strategies are needed to reduce the incidence of malaria, and promising approaches include the development of vaccines and monoclonal antibodies (mAbs) that target the circumsporozoite protein (CSP). To select the best candidates and speed development, it is essential to standardize preclinical assays to measure the potency of such interventions in animal models. Method. Two assay configurations were studied using transgenic P. berghei expressing P. falciparum full-length circumsporozoite protein. The assays measured 1) reduction in parasite infection of the liver (liver burden) following an intravenous (i.v) administration of sporozoites and 2) protection from parasitemia following mosquito bite challenge. Two human CSP mAbs, AB311 and AB317, were compared for their ability to inhibit infection. Multiple independent experiments were conducted to define assay variability and resultant impact on the ability to discriminate differences in mAb functional activity.Results. Overall, the assays produced highly consistent results in that all individual experiments showed greater functional activity for AB317 compared to AB311 as calculated by the dose required for 50 % inhibition (ID50) as well as the serum concentration required for 50% inhibition (IC50). The data were then used to model experimental designs with adequate statistical power to rigorously screen, compare, and rank order novel anti-CSP mAbs. Conclusion. Our results indicate that in vivo assays described here can provide reliable information for comparing the functional activity of mAbs. Our results also provide guidance regarding selection of the appropriate experimental design, dose selection, and group sizes.
Distinct assembly mechanisms underlie similar biogeographical patterns of rare and abundant bacteria in Tibetan Plateau grassland soils
Authors: Ji Mukan , Kong Weidong , Stegen James , Yue Linyan , Wang Fei , Dong Xiaobin , Cowan Don A , Ferrari Belinda C 
Published: January 2020

Abstract
Background: Bacteria in low abundance represent the majority of Earth’s biodiversity and perform vital ecological functions, but little is known about their biogeography nor the ecological processes that drive their community assembly in terrestrial ecosystems. Here, we investigated the community compositions and phylogenies of rare (relative abundance < 0.1%) and abundant (> 1%) soil bacteria along a transect containing three alpine grassland types (meadow, steppe, and desert) on the Tibetan Plateau. Results: Our results revealed similar biogeographical patterns of rare and abundant bacteria, with their community compositions and phylogenies shifting gradually along the transect. The similar patterns, however, were driven by contrasting community assembly processes, with rare subcommunity being more heavily influenced by stochasticity (72%) than abundant (57%). The composition of abundant subcommunity (80%) was better explained by local (including soil and vegetation factors), geospatial and climatic factors than that of rare subcommunity (41%), while the phylogeny of the rare one (36%) was better explained than that of the abundant one (29%). Variation partitioning analysis indicated that pure local factors consistently explained a higher proportion of the community composition than geospatial factors in both rare (12.3% and 8.7%, respectively) and abundant bacteria (18.3% and 14.1%, respectively). In contrast, the phylogeny of rare subcommunity was explained by local and geospatial factors equally (11.5% and 11.9%, respectively), while that of abundant subcommunity was more explained by geospatial (22.1%) than local factors (11.3%). Furthermore, our results revealed a tighter connection between the community phylogeny and composition in rare than in abundant bacteria. Conclusions: Our results revealed consistent biogeographical patterns of rare and abundant bacteria in grassland soils, but their assembly processes were distinct. We further demonstrated that rare subcommunity was less predictable than the abundant subcommunity by environmental and geospatial factors. Rare and abundant bacteria responded differentially to factors, which was attributed to the distinct life strategies. Our study provides novel insights into the assembly processes and biographical patterns of rare and abundant bacteria in terrestrial ecosystems.
Three-Dimensional Morphological Analysis of the Femoral Neck Torsion Angle - An Anatomical Study.
Authors: Zhang Ru-yi , Su Xiu-yun , Zhao Jing-xin , Li Jian-tao , Zhang Li-cheng , Tang Pei-fu 
Published: January 2020

Abstract
Background: The femoral neck torsion angle (FNTA) is a very important but often neglected parameter in assessments of the anatomical morphology of the femoral neck, and it is often confused with the femoral neck anteversion angle (FNAA) in the current literature. Currently, naked eye or two-dimensional literature (2D) visualization method was used in the literature that the measurement method reported, and the measurement parameters and details are not clearly defined. The objection of this research was to establish a three-dimensional (3D) method to measure the FNTA, and to analyse the anatomical and clinical significance of the results. Methods: Computed tomography (CT) data of 200 patients who received a lower extremity CT angiography examination were selected for the three-dimensional CT (3D CT) reconstruction of bilateral femurs by using Mimics software. The 3D axis of the femoral neck was built, and the FNTAs of the isthmus and the basilar part were measured using the “inertia axes” method. SPSS software was used for statistical analyses. Results: The difference in FNTA was statistically significant between the isthmus and the basilar part (isthmus 30.58 ± 8.90° vs. basilar part 23.79 ± 3.98°; p < 0.01). Significant differences in the FNTA were observed between the sexes (males 31.99 ± 9.25° vs. females 27.49 ± 7.19°; p < 0.01). The increase in FNTA from the basilar part to the isthmus was 6.79 ± 8.06°, and the increase observed in men (7.87 ± 8.57°) was larger than that in women (4.44 ± 6.23°, p < 0.01). However, no significant differences in the values were observed between sides. According to the correlation analysis, height exerted the greatest effect on the FNTA (r = 0.255, p＜0.001), and the stepwise linear regression analysis produced the following final regression model: Y = -27.685 + 35.134 × HEIGHT (p < 0.001, R2 = 0.095). Conclusions: This study provides a new and reliable 3D method for measuring the FNTA. The method and results provide a methodological foundation and theoretical support for the research and development of internal fixation devices and configurations of the space for an implant designed to treat a femoral neck fracture. And, the optimal opening point of the femoral medullary cavity is recommended to be located at the posterior position of the top of the femoral neck cross-section during hip replacement.
Daptomycin for the treatment of gram-positive periprosthetic hip infections: Can daptomycin prevent the implant removal?
Authors: Oe Kenichi , Sawada Masahiro , Kawamura Hiroshi , Ueda Narumi , Nakamura Tomohisa , Iida Hirokazu , Saito Takanori 
Published: January 2020

Abstract
Background: Management of periprosthetic hip infections (PHIs) generally consists of implant removal and thorough debridement, accompanied by appropriate antibiotic therapy. Daptomycin (DAP) is a novel antibiotic, which allowed for implant retention in several patients after treating their infected joints. However, there is no consensus about implant retention or removal during treatment of PHIs. The aim of this study was to examine the effect of DAP, and to determine a surgical treatment strategy. Methods: This study retrospectively evaluated 20 patients between August 2014 and December 2018, divided into implant retention (n = 9) and implant removal groups (n = 11). Infection control and risk of recurrent infection were evaluated. Infection control was defined as not requiring implant removal after the final treatment. Results: Infection control rates in implant retention and implant removal groups were 67% and 90%, respectively. All late chronic infections resulted in failure cases within the implant retention group. In the implant retention group, mean preoperative risk scores for successful cases were significantly higher than those for failure cases (P < 0.05). Conclusions: Patients with low-risk did not require implant removal, suggesting that DAP may be a breakthrough alternative to traditional PHI management.
Development of the “POP” scoring system for predicting obstetric and gynecological diseases in the emergency department: A retrospective cohort study
Authors: OKADA ASAMI , Okada Yohei , Fujita Hiroyuki , Iiduka Ryoji 
Published: January 2020

Abstract
Background: Obstetric and gynecological (OBGY) diseases are among the most important differential diagnoses for young women with acute abdominal pain. However, there are few established clinical prediction rules for screening OBGY diseases in the emergency department (ED). This study aimed to develop a prediction model for diagnosing OBGY diseases in the ED.Methods: This single-center retrospective cohort study included female patients with acute abdominal pain who presented to our emergency department. We developed a logistic regression model for predicting OBGY diseases and assessed its diagnostic ability. This study included young female patients aged between 16 and 49 years old, who had abdominal pain and were examined at the ED from April 2017 to March 2018. Trauma patients and patients referred from another hospital or from the OBGY department of our hospital were excluded.Results: Of 27,991 patients, 740 were included. Sixty-five patients were diagnosed with OBGY diseases (8.8%). The "POP" scoring system [past history of OBGY diseases +1, no other symptoms +1, and peritoneal irritation signs +1] was developed. Cut-off values set between 0 and 1 points, sensitivity at 97%, specificity at 39%, and negative likelihood ratio (LR-) of 0.08 were considered for rule-out, while cut-off values set between 2 and 3 points, sensitivity at 23%, specificity at 99%, and positive likelihood ratio (LR+) of 17.29 were suitable for rule-in.Conclusions: Our "POP" scoring system can be useful for screening of OBGY diseases in the ED.
The growing impact of older patients in the Emergence Department: a 5-year retrospective analysis in Brazil
Authors: Gomes João Carlos Pereira , Dias Roger Daglius , Barros Jacson Venancio , Velasco Irineu Tadeu , Filho Wilson Jacob 
Published: January 2020

Abstract
Background: The average age of the global population is rising at an increasing rate. There is a disproportional increase in Emergency Department (ED) visits by older people worldwide. In the Brazilian health system, complex and severely ill patients and those requiring specialized urgent procedures are referred to tertiary level care. As far as we know, no other study in Latin America has analyzed the impact of demographic changes in tertiary ED attendance.Methods: Aim: To describe the sociodemographic characteristics and outcomes of tertiary Brazilian ED users. Design: Observational cross-sectional analytic study. Setting: Emergency Department, tertiary university hospital, São Paulo, Brazil. Participants: patients aged 18 years or older attending a tertiary ED (2009-2013). The primary outcomes were hospitalization and mortality; the secondary outcome was ICU admission. Age was categorized as ‘young adults’ (18-39y), ‘adults’ (40-59y), ‘young-older adults’ (60-79y), and ‘old-older adults’ (80-109y). Other variables included sex, reason for attendance, time of ED visit, mode of presentation, type of hospitalization, main procedure, length of hospital stay (LOS) and length of ICU stay (ICU-LOS). We calculated descriptive statistics, built generalized linear mixed models for each outcome and estimated Odds Ratios (95% CI) for the independent categorical variables. The significance level was 5% with Bonferroni correction.Results: Older age-groups represented 26.6% of 333,028 ED visits, 40.7% of admissions, 42.7% of ICU admissions and 58% of all deaths. Old-older patients accounted for 5.1% of ED visits, 9.5% of admissions and 10.1% of ICU admissions. Hospitalization, ICU admission and mortality rates increased with older age in both sexes. LOS and ICU-LOS were similar across age-groups. The proportions of visits and admissions attributed to young adults decreased annually, while those of people aged 60 or over increased. The ORs for hospitalization, ICU admission and mortality associated with the old-older group were 3.49 (95% CI = 3.15-3.87), 1.27 (1.15-1.39) and 5.93 (5.29-6.66) respectively, with young adults as the reference.Conclusions: In tertiary ED, age is an important risk factor for hospitalization and mortality, but not for ICU admission. Old-older people are at the greatest risk and demand further subgroup stratification.
Potentialities of multi-b-values diffusion-weighted imaging for predicting efficacy of concurrent chemoradiotherapy in cervical cancer patients
Authors: Liu Bing , Ma Wan-Ling , Zhang Guang-Wen , Sun Zhen , Wei Meng-Qi , Hou Wei-Huan , Hou Bing-Xin , Wei Li-Chun , Huan Yi 
Published: January 2020

Abstract
Purpose: To testify whether multi-b-values DWI can be used to ultra-early predict treatment response of CCRT in cervical cancer patients and to assess the predictive ability of concerning parameters. Methods: 53 patients with biopsy proved cervical cancer were retrospectively recruited in this study. All patients underwent pelvic multi-b-values DWI before and at the 3rd day during treatment. Tumor diffusion parameters were calculated by mono-exponential (apparent diffusion coefficient, ADC), bi-exponential (Dslow, Dfast and fp) and stretched exponential (distributed diffusion coefficient, DDC and α) models. Treatment response was assessed based on RECIST v1.1 at 1 month after the completion of whole CCRT. Parameters were compared using independent t test or Mann-Whitney U test as appropriate. Receiver operating characteristic (ROC) curves was used for statistical evaluations. Results: ADC-T0 (p=0.02), Dslow-T0 (p<0.01), DDC-T0 (p=0.03), ADC-T1 (p<0.01), Dslow-T1 (p<0.01), ΔADC (p=0.04) and Δα (p<0.01) were significant lower in non-CR group patients. ROC analyses showed that ADC-T1 and Δα exhibited high prediction value, with area under the curves of 0.880 and 0.869, respectively. Conclusion: Multi-b-values DWI can be used as a noninvasive technique to assess and predict treatment response in cervical cancer patients at the 3rd day of CCRT. ADC-T1 and Δα can be used to differentiate good responders from poor responders.