bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diclofenac does not reduce the risk of acute pancreatitis in patients with primary sclerosing cholangitis after endoscopic retrograde cholangiography
Authors: Koskensalo Vilja , Tenca Andrea , Udd Marianne , Lindström Outi , Rainio Mia , Jokelainen Kalle , Kylänpää Leena , Färkkilä Martti 
Published: March 2020

BackgroundThe European Society of Gastrointestinal Endoscopy recommends rectal indomethacin or diclofenac before endoscopic retrograde cholangiopancreatography (ERCP) to prevent post‐ERCP pancreatitis. However, data on the prophylactic effect in patients with primary sclerosing cholangitis (PSC) are lacking.MethodsThis was a retrospective case‐control study. In 2009–2018, a total of 2000 ERCPs were performed in 931 patients with PSC. Case procedures (N  =  1000 after November 2013) were performed after administration of rectal diclofenac. Control procedures (N  =  1000 before November 2013) were performed with the same indication but without diclofenac. Acute post‐ERCP pancreatitis and other ERCP‐related adverse events (AEs) were evaluated.ResultsPost‐ERCP pancreatitis developed in 49 (4.9%) procedures in the diclofenac group and 62 (6.2%) procedures in the control group (p  =  0.241). No difference existed between the groups in terms of the severity of pancreatitis or any other acute AEs. The risk of pancreatitis was elevated in patients with native papilla: 11.4% in the diclofenac group and 8.7% in the control group (p  =  0.294). In adjusted logistic regression, diclofenac did not reduce the risk of pancreatitis (odds ratio (OR) = 1.074, 95% confidence interval 0.708–1.629, p  =  0.737). However, in generalised estimation equations with the advanced model, diclofenac seemed to diminish the risk of pancreatitis (OR = 0.503) but not significantly (p  =  0.110).ConclusionIn this large patient cohort in a low‐risk unit, diclofenac does not seem to reduce the risk of post‐ERCP pancreatitis in patients with PSC. The trend in the pancreatitis rate after ERCP is decreasing. The evaluation of the benefits of diclofenac among PSC patients warrants a randomised controlled study targeted to high‐risk patients and procedures.
Retrospective analysis of cases of intraoperative awareness in a large multi-hospital health system reported in the early postoperative period
Authors: Deis Amanda S. , Schnetz Michael P. , Ibinson James W. , Vogt Keith M. 
Published: March 2020

Abstract
Background
Awareness with recall under general anesthesia remains a rare but important issue that warrants further study.

Methods
We present a series of seven cases of awareness that were identified from provider-reported adverse event data from the electronic anesthesia records of 647,000 general anesthetics.

Results
The low number of identified cases suggests an under-reporting bias. Themes that emerge from this small series can serve as important reminders to anesthesia providers to ensure delivery of an adequate anesthetic for each patient. Commonalities between a majority of our identified anesthetic awareness cases include: obesity, use of total intravenous anesthesia, use of neuromuscular blockade, and either a lack of processed electroencephalogram (EEG) monitoring or documented high depth of consciousness index values. An interesting phenomenon was observed in one case, where adequately-dosed anesthesia was delivered without technical issue, processed EEG monitoring was employed, and the index value suggested an adequate depth of consciousness throughout the case.

Conclusions
Provider-reported adverse event data in the immediate post-operative period are likely insensitive for detecting cases of intraoperative awareness. Though causation cannot firmly be established from our data, themes identified in this series of cases of awareness with recall under general anesthesia provide important reminders for anesthesia providers to maintain vigilance in monitoring depth and dose of anesthesia, particularly with total intravenous anesthesia.
Serum α-synuclein and IL-1β are increased and correlated with measures of disease severity in children with epilepsy: potential prognostic biomarkers?
Authors: Choi Jieun , Kim Soo Yeon , Kim Hunmin , Lim Byung Chan , Hwang Hee , Chae Jong Hee , Kim Ki Joong , Oh Sohee , Kim Eun Young , Shin Jeon-Soo 
Published: March 2020

AbstractBackgroundThe search for noninvasive biomarkers of neuroinflammation and neurodegeneration has focused on various neurological disorders, including epilepsy. We sought to determine whether α-synuclein and cytokines are correlated with the degree of neuroinflammation and/or neurodegeneration in children with epilepsy and with acquired demyelinating disorders of the central nervous system (CNS), as a prototype of autoimmune neuroinflammatory disorders.MethodsWe analyzed serum and exosome levels of α-synuclein and serum proinflammatory and anti-inflammatory cytokines among 115 children with epilepsy and 10 acquired demyelinating disorders of the CNS and compared to 146 controls. Patients were enrolled prospectively and blood was obtained from patients within 48 h after acute afebrile seizure attacks or relapse of neurological symptoms. Acquired demyelinating disorders of the CNS include acute disseminated encephalomyelitis, multiple sclerosis, neuromyelitis optica spectrum disorders, and transverse myelitis. The controls were healthy age-matched children. The serum exosomes were extracted with ExoQuick exosome precipitation solution. Serum α-synuclein levels and serum levels of cytokines including IFN-β, IFN-γ, IL-1β, IL-6, IL-10 and TNF-α were measured using single and multiplex ELISA kits. Data were analyzed and compared with measures of disease severity, such as age at disease onset, duration of disease, and numbers of antiepileptic drug in use.ResultsSerum α-synuclein levels were significantly increased in patients with epilepsy and acquired demyelinating disorders of the CNS compared to controls (both,p < 0.05) and showed correlation with measures of disease severity both in epilepsy (p < 0.05,r = 0.2132) and in acquired demyelinating disorders of the CNS (p < 0.05,r = 0.5892). Exosome α-synuclein showed a significant correlation with serum α-synuclein (p < 0.0001,r = 0.5915). Serum IL-1β levels were correlated only with the numbers of antiepileptic drug used in children with epilepsy (p < 0.001, r = 0.3428), suggesting drug resistant epilepsy.ConclusionsThis is the first study in children demonstrating that serum α-synuclein levels were significantly increased in children with epilepsy and with acquired demyelinating disorders of the CNS and correlated with measures of disease severity. Serum IL-1β levels showed significant correlation only with drug resistance in children with epilepsy. Thus, these data support that serum levels of α-synuclein and IL-1β are potential prognostic biomarkers for disease severity in children with epilepsy.CNS, central nervous system.
Incidence trend of type 1 diabetes mellitus in Serbia
Authors: Vojislav Ciric , Natasa Rancic , Milica Pesic , Slobodan Antic , Radivoj Kocic , Danijela Radojkovic , Sasa Radenkovic 
Published: March 2020

Abstract
Background
The incidence of type 1 diabetes mellitus (T1DM) increased worldwide.
The objective of the paper was to compare the incidence trend of T1DM in children and adolescents aged 0–19 and in adults under 30 years of age in Serbia from 2006 to 2017. Additional aim was to compare incidence rates of T1DM and type 2 diabetes mellitus (T2DM) among adults aged 20–24 and 25–29 years of age.

Methods
Trends and annual percentage change (APC) of the incidence rate with corresponding 95% confidence intervals (CI) were calculated by Joinpoint Regression Analyses.

Results
We found a significant increase of incidence in children aged 5–9 with the APC of 5.7% (95%CI: 2.3–9.1), and in children aged 10–14 with the APC of 2.1% (95%CI: 0.6–3.6). A significant decrease of incidence was determined in adolescents aged 15–19 with the APC -4.9% (95%CI: − 8.9 to – 0.7) and in adults aged 25–29 with the APC -7.3% (95%CI: − 12.5 to − 1.8).

Conclusion
The increase of incidence in children aged 0–14 and its decrease after 15 years of age showed that T1DM is predominantly a metabolic disease of children in Serbia. A significant increase in incidence was recorded in two age groups, namely 5–9 and 10–14 years of age. The highest increase was in children aged 5–9 and the highest incidence rate was in children aged 10–14. An insignificant increasing of T2DM incidence was observed in young adults aged 25–29. The increase in incidence rates in children, but not in young adults, suggests that the precipitating factors of children-onset disease may differ from those of adult-onset T1DM.
Improving medical certification of cause of death: effective strategies and approaches based on experiences from the Data for Health Initiative
Authors: Hart John D. , Sorchik Renee , Bo Khin Sandar , Chowdhury Hafizur R. , Gamage Saman , Joshi Rohina , Kwa Viola , Li Hang , Mahesh Buddhika P. K. , Mclaughlin Deirdre , Mikkelsen Lene , Miki Janet , Napulan Roderick , Rampatige Rasika , Reeve Matthew , Sarmiento Carmina , War Nang Su , Richards Nicola , Riley Ian D. , Lopez Alan D. 
Published: March 2020

Abstract
Background
Accurate and timely cause of death (COD) data are essential for informed public health policymaking. Medical certification of COD generally provides the majority of COD data in a population and is an essential component of civil registration and vital statistics (CRVS) systems. Accurate completion of the medical certificate of cause of death (MCCOD) should be a relatively straightforward procedure for physicians, but mistakes are common. Here, we present three training strategies implemented in five countries supported by the Bloomberg Philanthropies Data for Health (D4H) Initiative at the University of Melbourne (UoM) and evaluate the impact on the quality of certification.

Methods
The three training strategies evaluated were (1) training of trainers (TOT) in the Philippines, Myanmar, and Sri Lanka; (2) direct training of physicians by the UoM D4H in Papua New Guinea (PNG); and (3) the implementation of an online and basic training strategy in Peru. The evaluation involved an assessment of MCCODs before and after training using an assessment tool developed by the University of Melbourne.

Results
The TOT strategy led to reductions in incorrectly completed certificates of between 28% in Sri Lanka and 40% in the Philippines. Following direct training of physicians in PNG, the reduction in incorrectly completed certificates was 30%. In Peru, the reduction in incorrect certificates was 30% after implementation and training on an online system only and 43% after training on both the online system and basic medical certification principles.

Conclusions
The results of this study indicate that a variety of training strategies can produce benefits in the quality of certification, but further improvements are possible. The experiences of D4H suggest several aspects of the strategies that should be further developed to improve outcomes, particularly key stakeholder engagement from early in the intervention and local committees to oversee activities and support an improved culture in hospitals to support better diagnostic skills and practices.
Optimization of perioperative approaches for advanced and late stages of gastric cancer: clinical proposal based on literature evidence, personal experience, and ongoing trials and research
Authors: Beeharry Maneesh Kumarsing , Zhang Tian Qi , Liu Wen Tao , Gang Zhu Zheng 
Published: March 2020

Abstract
Background
The high incidence of gastric cancer (GC) and paradoxical high prevalence of advanced stage GC, amounting to around 2/3 at time of diagnosis, have urged doctors and researchers around the world not only to ameliorate the detection rate of GC at early stages but also to optimize the clinical management of GC at advanced stages.

Content
We hereby recommend a more goal-oriented multimodality approach with objectives to increase survival rate and improve survival status. Based on precision and accurate clinical staging at diagnosis, we suggest that advanced stage GC (AGC) patients should be channeled into different treatment plans according to their disease status where they can be subjected to comprehensive measures involving chemo, radio, immunological, or target therapies depending on the pathophysiological behavior of their tumor. Patients assessed as potentially resectable cT4N + M0 can undergo neoadjuvant chemotherapy with intent of tumor downsizing and downgrading followed by surgery with intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) to decrease the incidence of peritoneal dissemination due to surgical trauma and adjuvant chemotherapy and radiation in cases of bulky nodal metastasis. In cases with distal metastasis, conversion therapy is recommended with the possibility of surgery of curative intent in case of favorable response. The options of alternate treatment options such as trans-catheter arterial chemoembolization (TACE) for limited liver lesions or neoadjuvant intraperitoneal plus systemic chemotherapy (NIPS) for peritoneal carcinomatosis have to be negotiated. With surgery as the cornerstone for cancer treatment, there is acknowledgment of the significance of perioperative comprehensive approaches but there has not been some consensus guiding clinical application. Henceforth, in this review, based on past literature, current guidelines and ongoing clinical trials, we have shared a proposal of the current treatment modalities in practice for the advanced stages of gastric cancer.

Conclusion
Even though surgery is the golden standard of radical cancer treatment, clinical reality shows that without proper perioperative management, patients undergoing radical resections manifest high rates of recurrence and metastasis. Hence, in this review, we have outlined a clinical agenda to optimize the management of advanced stage GC with objective to improve survival outcome and quality of life of patients.
DJ-1 exerts anti-inflammatory effects and regulates NLRX1-TRAF6 via SHP-1 in stroke
Authors: Peng Li , Zhou Yang , Jiang Ning , Wang Tingting , Zhu Jin , Chen Yanlin , Li Linyu , Zhang Jinyan , Yu Shanshan , Zhao Yong 
Published: March 2020

Abstract
Background
Acute inflammation induced by reactive astrocytes after cerebral ischemia/reperfusion (I/R) injury is important for protecting the resultant lesion. Our previous study demonstrated that DJ-1 is abundantly expressed in reactive astrocytes after cerebral I/R injury. Here, we show that DJ-1 negatively regulates the inflammatory response by facilitating the interaction between SHP-1 and TRAF6, thereby inducing the dissociation of NLRX1 from TRAF6.

Methods
We used oxygen-glucose deprivation/reoxygenation (OGD/R) in vitro in primary astrocyte cultures and transient middle cerebral artery occlusion/reperfusion (MCAO/R) in vivo to mimic I/R insult.

Results
The inhibition of DJ-1 expression increased the expression of the inflammatory cytokines TNF-α, IL-1β, and IL-6. DJ-1 knockdown facilitated the interaction between NLRX1 and TRAF6. However, the loss of DJ-1 attenuated the interaction between SHP-1 and TRAF6. In subsequent experiments, a SHP-1 inhibitor altered the interaction between SHP-1 and TRAF6 and facilitated the interaction between NLRX1 and TRAF6 in DJ-1-overexpressing astrocytes.

Conclusion
These findings suggest that DJ-1 exerts an SHP-1-dependent anti-inflammatory effect and induces the dissociation of NLRX1 from TRAF6 during cerebral I/R injury. Thus, DJ-1 may be an efficacious therapeutic target for the treatment of I/R injury.
High-resolution modeling of the selection on local mRNA folding strength in coding sequences across the tree of life
Authors: Peeri Michael , Tuller Tamir 
Published: March 2020

AbstractBackgroundmRNA can form local secondary structure within the protein-coding sequence, and the strength of this structure is thought to influence gene expression regulation. Previous studies suggest that secondary structure strength may be maintained under selection, but the details of this phenomenon are not well understood.ResultsWe perform a comprehensive study of the selection on local mRNA folding strengths considering variation between species across the tree of life. We show for the first time that local folding strength selection tends to follow a conserved characteristic profile in most phyla, with selection for weak folding at the two ends of the coding region and for strong folding elsewhere in the coding sequence, with an additional peak of selection for strong folding located downstream of the start codon. The strength of this pattern varies between species and organism groups, and we highlight contradicting cases.To better understand the underlying evolutionary process, we show that selection strengths in the different regions are strongly correlated, and report four factors which have a clear predictive effect on local mRNA folding selection within the coding sequence in different species.ConclusionsThe correlations observed between selection for local secondary structure strength in the different regions and with the four genomic and environmental factors suggest that they are shaped by the same evolutionary process throughout the coding sequence, and might be maintained under direct selection related to optimization of gene expression and specifically translation regulation.
Comparative analysis of structural and functional aspects of phytoene synthase from Meiothermus taiwanensis strain RP
Authors: Mukherjee Trinetra , Mukhopadhyay Subhra Kanti 
Published: March 2020

Abstract
Purpose
The aim of this study is the in silico characterization of the structure and function of the phytoene synthase (PSY) of a red carotenoid producing thermophile Meiothermus taiwanensis strain RP with a comparative approach.

Methods
PSYs from M. taiwanensis strain RP and other groups of thermophilic, mesophilic and psychrophilic bacteria, plants, protozoa, and algae were analyzed by ExPASy ProtParam, NCBI Conserved Domain Search, SOPMA, PSIPRED, Robetta server, ProQ, and QMEAN, with the superposition of 3-D structures in PyMOL.

Results
RP PSY shows the highest (97.5 %) similarity with M. ruber and the lowest with the psychrophile Gelidibacter algens (36.7 %). The amino acid sequence of RP PSY is one of the shortest, with 275 residues. The instability index of RP PSY is much lower compared with plant sequences. Alanine, arginine, glycine, and leucine residues are the highest in Meiothermus sp., and they have a high amount of alpha-helix. Most of the 32 active site residues are conserved in all the sequences. However, some residues are more prone to substitutions in other PSYs except M. ruber. The three-dimensional structures of M. taiwanensis strain RP, Gelidibacter algens, Thermus thermophiles, Meiothermus ruber, and Brassica napus PSYs were homology modeled, validated, and submitted to Protein Model Databank. The superposition of the 3-D structures shows that their active site region structure is identical.

Conclusion
RP PSY is one of the most stable PSYs and knowledge of its individual properties, similarities, and dissimilarities with other PSYs may be useful for genetic engineering and purification of the protein for improved carotenoid production.
Quantum Hermite–Hadamard inequality by means of a Green function
Authors: Adil Khan Muhammad , Mohammad Noor , Nwaeze Eze R. , Chu Yu-Ming 
Published: March 2020

AbstractThe purpose of this work is to present the quantum Hermite–Hadamard inequality through the Green function approach. While doing this, we deduce some novel quantum identities. Using these identities, we establish some new inequalities in this direction. We contemplate the possibility of expanding the method, outlined herein, to recast the proofs of some known inequalities in the literature.
Effects of school climate and teacher self-efficacy on job satisfaction of mostly STEM teachers: a structural multigroup invariance approach
Authors: Zakariya Yusuf F. 
Published: March 2020

Abstract
Background
Identification and retention of effective teachers in STEM education play cardinal roles in teacher recruitment exercises worldwide. Studies on factors that characterize effective teachers have therefore gained popularity in recent times. Teacher self-efficacy, job satisfaction and school climate are among other factors that have attracted global attention. Thus, proper understanding of the relations between these factors is equally important. The purpose of this study is to validate and cross-validate a model of direct/indirect effects of school climate and teacher self-efficacy on job satisfaction.

Results
The data used for the current study are extracted from a publicly available data of Teaching and Learning International Survey (TALIS) 2018 survey. Structural equation modeling approach was used in the analyses coupled with robust maximum likelihood to ensure accurate estimations in the models. The results of the validated models show a strong direct impact of school climate on job satisfaction, a direct impact of teacher self-efficacy on job satisfaction and a mediating effect of teacher self-efficacy between school climate and job satisfaction. This model exhibits structural invariance in factor loadings, intercepts and regression weights across two independent samples from a population of 3951 lower secondary school teachers in Norway.

Conclusion
The findings of this study do provide empirical evidence for the relations between teacher self-efficacy, job satisfaction and school climate among Norwegian lower secondary school teachers. The cross-validation of these relations was also established using an independent sample to enhance generalization of the findings. Two methodological observations concerning recoding of some items as well as an addition of item cross-loading in the measurement model of the job satisfaction scales are raised and addressed. It is therefore recommended that researchers who will be using TALIS 2018 data should take note of these observations.
Intravenous leiomyomatosis with intracardiac extension managed by one-stage surgical excision: a case presentation
Authors: Bhoil Rohit , Thakur Vijay , Verma Yashwant Singh , Bhoil Sabina , Tomar Ashwani , Pathania Rajnish , Sharma Sanjeev 
Published: March 2020

AbstractBackgroundIntravenous leiomyomatosis is characterized by the extension of pathologically benign smooth muscle tumor into venous channels. Its extension into the heart is a very rare occurrence, which may lead to heart failure and occasionally sudden death. Due to its rarity, the condition is poorly understood and often misdiagnosed.Case presentationWe report a case of intravenous leiomyomatosis with intracardiac extension in a 40 years old woman who underwent hysterectomy for uterine leiomyoma (one year earlier), managed successfully through one-stage surgical approach with main focus on its imaging features.ConclusionThe diagnosis of intravenous leiomyomatosis should be considered in women who present with cardiac symptoms associated with a right atrial mass and who also have a pelvic mass or have previously undergone hysterectomy because of uterine leiomyoma.