bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transcatheter Arterial Embolization is an Efficient and Safe for Paediatric Blunt Torso Trauma: A Case Control Study
Authors: Gakumazawa Masayasu , Toida Chiaki , Muguruma Takashi , Yogo Naoki , Shinohara Mafumi , Takeuchi Ichiro 
Published: August 2020

Abstract
Background: It remains unclear whether transcatheter arterial embolization (TAE) is as safe and effective for paediatric patients with blunt torso trauma as it is for adults in Japan, owing to few trauma cases and sporadic case reports. The study aimed to compare the efficacy and safety of TAE in paediatric patients (age ≤ 15 years) with blunt torso trauma to those of TAE in adult patients. Methods: This was a single-centre, retrospective chart review study that included blunt torso trauma patients who underwent TAE in the trauma centre from 2012 to 2017. The comparative study was carried out between a “paediatric patient group” and an “adult patient group”.The outcome measures for TAE were the success of haemorrhage control and complications and standardised mortality ratio (SMR). Results: A total of 504 patients with blunt torso trauma were transported to the trauma centre. Among them, 23% (N=114) of patients with blunt torso trauma underwent TAE, including 15 paediatric and 99 adult patients. There was no significant difference between the use of TAE in paediatric and adult patients with blunt torso trauma (29% vs. 22%, P=.221). The median age was 11 (IQR 7–14) years for paediatric patients. The predicted mortality (PMR) rate and SMR for paediatric patients were lower than that for adult patients (18.3% vs. 25.9%, P =.026, and 0.37 vs. 0.54). The rate of effective haemorrhage control without repeated TAE or additional surgical intervention was 93% in paediatric patients, which was similar to that in adult patients (88%). There were no complications in the paediatric patients at our centre. There were no significant differences in the proportion of paediatric patients that underwent surgery before TAE or urgent blood transfusion (33% vs. 26%, P =.566, or 67% vs. 85%, P =.084). Conclusions: It is possible to provide an equal level of care related to TAE for both paediatric and adult patients as it relates to TAE for blunt torso trauma with haemorrhage in the trauma centre. We should prepare alternative haemorrhage control procedures as soon as possible whenever the patients reach a hemodynamic unstable state.
Blind Dates - Potential Killers: Jujube Kernel Caused Enterobrosis Need to be Differentiated with Acute Appendicitis – A Chinese Single Center Case Series Study
Authors: Bao Zhi ye , Zhang Chun hu , Liu Bo qian , Zhu Jia yi , Wang Zhan sheng , Li Ye , Zhang Zhi shuo , Liu Hao 
Published: August 2020

Abstract
Background: Accidentally swallowed date kernels are high risk factors for enterobrosis. Most patients showed no obvious symptoms at the beginning but later developed lower abdominal pain, which should be differentiated with acute appendicitis, especially in elder patients without a clear medical history. This study investigated the clinical features, diagnosis and treatment of enterobrosis caused by accidentally swallowed kernel of Chinese date in adults. Methods: A retrospective analysis was performed on 14 cases of adult patients suffered from date kernel - induced enterobrosis during June 2016 to June 2019. All these patients received treatment in the first hospital of China medical university. Results: Eleven female and three male patients were diagnosed, and they were mainly in the middle to elderly age, with 12/14 patients (86%) above 50 years old. The main clinical manifestations were abdominal pain, with onset times from seven hours to four days, and all patients visited the emergency department. Physical signs of local or diffuse peritonitis were presented as guarding tenderness, rebounding, and increased rigidity. Through full-abdominal enhanced CT examination, high density linear objects were identified at the terminal or distal ileum segments in 11/14 (78%) patients. During emergent laparotomy, enterobrosis were found in all patients. Secondary perforations were also detected in 6/14 (42%) patients on the opposing side of the first puncturing sites. The fusiform kernels with two sharp tips were extracted by minimal enterotomies in 13 patients. In one patient with colonic perforation, sigmoid colostomy was performed. All patients were cured and 93% of them were discharged within two weeks. Conclusions: Full-abdominal enhanced CT examination is of great diagnostic value for the intestinal perforation caused by date kernels, and patients can benefit from early surgical treatment after definite diagnosis. Thorough exploration should be performed to detect whether a second perforation was formed on the contrary site of first piercing site. Caution should be taken to void “blind dates” ingestion, and special tools such as seeders and slicers are recommended to removal kernels in advance, thus prevent the potential killing threats of enterobrosis.
Conflict Affected, Parallel Health Systems: Challenges to Collaboration Between Ethnic and Government Health Systems in Kayin State, Myanmar
Authors: Biesty Colette Pang , Ja Brang Aung , Munslow Barry 
Published: August 2020

Abstract
Background
Myanmar has had a long history of civil wars with its minority ethnic groups and is yet to see a sustainable peace accord. The conflicts have had a significant impact on health in Myanmar, with ethnic populations experiencing inequitable health outcomes. Consequently, to meet the health needs of ethnic people, Ethnic Health Organisations and Community-Based Health Organisations (EHO/CBHOs) created their own health system. The EHO/CBHO and Government health systems, provided by the Myanmar Ministry of Health and Sports (MoHS), remain parallel, despite both stakeholders discussing unification of the health systems within the context of ongoing but unresolved peace processes. EHO/CBHOs discuss the ‘convergence’ of health systems, whilst the MoHS discuss the integration of health providers under their National Health Plan.
Methods
A qualitative study design was used to explore the challenges to collaboration between EHO/CBHOs and the MoHS in Kayin state, Myanmar. 12 health workers from different levels of the Karen EHO/CBHO health system were interviewed. Semi-structured, in-depth interviews were digitally recorded, transcribed, and coded. Data was analysed thematically using the Framework method. Topic guides evolved in an iterative process, as themes emerged inductively from the transcripts. A literature review and observation methods were also utilised to increase validity of the data.
Results
The challenges to collaboration were identified in the following five themes: (1) the current situation is not ‘post conflict’ (2) a lack of trust (3) centralised nature of the MoHS (4) lack of EHO/CBHO health worker accreditation (5) the NHP is not implemented in some ethnic areas.
Conclusions
Ultimately, all five challenges to collaboration stem from the lack of peace in Myanmar. The health systems cannot be ‘converged or ‘integrated’ until there is a peace accord which is acceptable to all actors. EHO/CBHOs want a federal political system, where the health system is devolved, equitable and accessible to all ethnic people. External donors should understand this context and remain neutral by supporting all health actors in a conflict sensitive manner.
Choroidal metastasis from gastric carcinoma:a case report
Authors: Huang Yan-Ying , Zhang Yue , Geng Yan-Hua , Zhu Li-Yan , Sun Ai-Hua 
Published: August 2020

Abstract
BackgroundChoroidal metastasis in patients with gastric cancer is extremely rare. Furthermore, orbital and intraocular metastasis are generally associated with a bad prognosis. Here, we retrospectively report a patient with gastric carcinoma and choroidal metastasis.Case presentationA 59-year-old man with a history of gastric cancer was admitted to the Ophthalmology Department of our hospital due to a one-week history of eye pain; It was only eight months since the gastric cancer was diagnosed. The patient was diagnosed with gastric cancer at a local hospital two years previously, but had then spread to the left femur. The patient then received systemic chemotherapy at the local hospital. However, scans of his eyes in our hospital revealed a choroidal tumor in his left eye. The histopathological and immunohistochemical features of the removed eyeball suggested metastatic carcinoma, most likely originating in the gastrointestinal tract, and were consistent with a moderately well-differentiated gastric cancer.ConclusionsChoroidal metastasis can masquerade as glaucoma. Consequently, choroid metastasis of gastric cancer should be a consideration when a patient with a history of gastric cancer presents with eye pain, impaired vision, or high intraocular pressure.
Revising the Role of Integrin Subunit β4 Expression in Colon Cancer Progression and Survival: A Retrospective Study
Authors: Rademaker Eva , Bastiaannet Esther , Oosting Jan , Dekker-Ensink Neeltje G. , Kuppen Peter J. K. , Miranda Noel F. C. C. De , Liefers Gerrit-Jan 
Published: August 2020

Abstract
Background: Integrin subunit β4 (β4) has been proposed to play an important role in colon cancer progression through its involvement in hemidesmosome disassembly processes and tumor cell migration. However, no consensus has yet been achieved regarding its association with clinical outcomes, particularly in colon cancer. The aim of this study was to reveal the relation between β4 expression and clinicopathological features and colon cancer outcomes.Methods: Expression of β4 was assessed by immunohistochemistry in a large cohort of 651 colon cancer patients, the largest colon cancer cohort so far. Chi-square tests were used to study the association between β4 expression and clinicopathological features while its relation with disease-free survival was assessed by Cox proportional hazard models. Furthermore, a potential relation between levels of ITGB4 expression and patient outcomes was also investigated with the TCGA dataset.Results: No association between β4 expression and disease-free survival was encountered (P = 0.767), which disputes the role of β4 as a biomarker of malignant behavior in colon cancer. Strikingly, loss of β4 expression was instead associated with advanced pathological tumor (pT) stage of the primary tumor. Only 17.9% of the pT1 tumors displayed weak β4 expression level versus 28.1% of pT4 tumors, and 25.0% of the pT1 tumors had a high expression level versus 8.6% of the pT4 tumors (P = 0.012). Additionally, no relation was observed between β4 expression and colon cancer stage (P = 0.138), tumor differentiation grade (P = 0.097) or mismatch repair (MMR) status (P = 0.878).Conclusions: Contradictory reports have suggested opposite roles for β4 expression in (colon) cancer progression. In the present large cohort of colon cancer patients we found that β4 expression was not associated with worse clinical prognosis and tumor differentiation grade, but decreased with advanced pathological tumor stage. Future studies should establish whether loss of β4 expression promotes invasive characteristics of colon cancer cells.
Clinical Course and Management of 73 Hospitalized Moderate Patients with COVID-19 Outside Wuhan
Authors: Peng Xiaojuan , Liu Qi , Chen Zhaolin , Wen Guiyan , Li Qing , Chen Yanfang , Xiong Jie , Meng Xinzhou , Ding Yuanjin , Shi Ying , Tang Shaohui 
Published: August 2020

Abstract
Background: Moderate cases account for the majority in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and can also progress to severe/critical condition. Here, we investigated the clinical course and management of hospitalized moderate SARS-CoV-2 patients.Methods: The medical records and follow-up data were analyzed from the SARS-CoV-2 patients outside Wuhan.Results: A total of 73 moderate patients (38 men, 35 women) were included, with median age of 47.0 (38.5-57.5) years. Among them, only one patient (1.4%) died using active treatment to improve symptoms. The median duration of the four main symptoms cough, fever, chest tightness, and fatigue were about 1-2 weeks; the median duration of the positive nucleic acid test (NAT) results for SARS-CoV-2 was slightly more than 2 weeks; the median hospitalization time was almost four weeks in 72 moderate survivors. The duration of cough and fever was positively correlated with the duration of the positive NAT results. On admission, 50% had lymphopenia; less than 30% had abnormal blood biochemistry findings involving hyperglycemia, liver function and myocardial enzymes. At discharge, the laboratory indexes were substantially improved. Two weeks after discharge, 5.6% survivors experienced a recurrence of the positive NAT results. Conclusions: Moderate SARS-CoV-2 patients have a good prognosis by the active treatment. After discharge, it is necessary that moderate survivors undergo at least a 2-week collective medical observation in quarantine places, which can identify and treat a proportion of patients with re-positive NAT results and to prevent the spread of the potential sources of infection.
Prediction of Biomass in Dry Tropical Forests: an Approach on the Importance of Total Height in the Development of Local and Pan-Tropical Models
Authors: Lima Robson Borges de , Oliveira Cinthia Pereira de , Ferreira Rinaldo Luiz Caraciolo , Silva José Antônio Aleixo da , Silva Emanuel Araújo , Júnior Francisco Tarcísio Alves 
Published: August 2020

Abstract
Background: Dry tropical forests in arid lands cover large areas in Brazil, but few studies report the total biomass stock showing the importance of height measurements, in addition to applying and comparing local and pan-tropical models of biomass prediction for the domain of trees and shrubs found in that environment. Here, we use a biomass data set of 500 trees and shrubs, covering 15 species harvested in a management plan in the state of Pernambuco, in Brazil. We seek to develop local models and compare them with the equations traditionally applied to dry forests - showing the importance of tree height measurements. Due to the non-linear relationships with the independent variables of the tree, we used a nonlinear least squares modeling technique when adjusting models, we adopted the cross-validation procedure. The selection of the models was based on the likelihood measures (AIC), total explained variation (R2) and forecast error (RSE, RMSE and Bias). Results: In summary, our above-ground biomass data set is best represented by the Schumacher-Hall equation: exp [3.5336 + 1.9126 × log (D) + 1.2438 × log (Ht)], which shows that height measurements are essential to estimate accurately biomass. The biggest prediction errors observed when testing pan-tropical models in our data demonstrated the importance of developing new local models and indicated that careful considerations should be made if generic “pantropical” models without height measurements are planned for application in dry forests in Brazil. Conclusions: Thus, local equations can be used for carbon accounting in REDD + and sustainable incentive projects that initiate the development of dry forests and assess ecosystem services.
Oral, but not rectal delivery of epigallocatechin-3-gallate alleviates colitis by regulating the gut microbiota, oxidative stress, inflammation, and barrier integrity
Authors: Wu Zhenhua , Huang Shimeng , Li Tiantian , Li Na , Han Dandan , Zhang Shiyi , Pang Jiaman , Wang Shilan , Zhang Guolong , Wang Junjun 
Published: August 2020

Abstract
Background: Alteration of the gut microbiota may contribute to the development of inflammatory bowel diseases (IBDs). Epigallocatechin-3-gallate (EGCG), a major bioactive constituent of green tea, is known to be beneficial in IBDs alleviation. However, it is unclear whether EGCG attenuates IBDs through direct improvement of gastrointestinal function or indirect alteration of the structure and function of the gut microbiota.Results: We first investigated the therapeutic effects of EGCG on disease severity, oxidative stress, inflammation, barrier function, and gut microbiota in murine colitis model, and further demonstrate it via EGCG pre-supplementation. We revealed that, oral, but not rectal, delivery of EGCG alleviated the severity of colitis through attenuation of anti-oxidative and anti-inflammatory response. Mucin-secreting goblet cell number, barrier function gene expression levels, and the integrity of tight junctions in the colon were also enhanced by oral EGCG. Additionally, we observed distinct EGCG-mediated alternation in the gut microbiome, as highlighted by increased Akkermansia abundance and butyrate production. Furthermore, we revealed that prophylactic oral application of EGCG for 21 days prior to the onset of dextran sodium sulfate (DSS)-induced colitis also ameliorated colonic damage, oxidative stress, and inflammatory response. Prophylactic EGCG significantly enriched Akkermansia, Faecalibaculum, and Bifidobacterium and enhanced acetate, propionate and butyrate production in DSS-treated mice. Moreover, scores of differential microbes, in particular Akkermansia, showed a strong positive correlation with short-chain fatty acids (SCFAs) and antioxidant enzyme levels in both the plasma and colon, but a negative association with inflammatory cytokines and malondialdehyde.Conclusions: EGCG is capable of treating DSS-induced colitis both therapeutically and prophylactically by inducing a pronounced anti-oxidative and anti-inflammatory response. Attenuation of colitis by oral, but not rectal administration of, EGCG suggests an intimate involvement of the gut microbiota. Increased Akkermansia and subsequent protective SCFAs production may be largely responsible for the anti-inflammatory and anti-oxidative function of EGCG, leading to restoration of intestinal epithelial homeostasis of the host. These findings provide novel insights into EGCG-mediated remission of IBDs and the rationale for devising more effective therapeutic strategies for IBDs.
Global research in cartilage defects: a bibliometric and visualized study
Authors: Li Hui , Li Jiaojiao , Dong Shengjie , Chen Yaolong , Zhao Yu , Xing Dan , Lin Jianhao 
Published: August 2020

Abstract
Objective: Cartilage defects represent an area of intense research interest worldwide among basic scientists and clinicians. This study evaluates the current global status of research into cartilage defects and predicts future trends through bibliometric and visualized analyses.Method: Publications from 1980 to 2018 on research into cartilage defects were obtained from the Science Citation Index-Expanded Web of Science. Bibliometric methods were used to analyze and index the source data. For visualization studies, VOSviewer software was used conduct bibliographic coupling, co-authoring, co-citation, and co-occurrence analyses.Result: A total of 9,194 publications were included in this study. The total number of publications in the field is generally on the rise, but in recent years the rate of increase in publications and relative research interest have declined. The USA made the greatest contribution to research on cartilage defects, with the highest number of citations and H-index. The American Journal of Sports Medicine published the highest number of articles, and Harvard University had the highest institutional contribution to the field. The most prominent research directions relating to cartilage defects are clinical studies, tissue engineering studies, chondrocyte-based studies, and stem cell-related studies.Conclusion: The number of publications per year on cartilage defects will likely stabilize in the next 10 years based on current global trends. Future research in the field will likely focus on clinical studies and new directions based on regenerative medicine.
Association Between FSIP2 Mutation and an Improved Prognosis in Patients With Skin Cutaneous Melanoma Treated With Immune Checkpoint Inhibitors
Authors: Ying Haoxuan , Lin Anqi , Zhang Jian , Luo Peng 
Published: August 2020

Abstract
Background

Immune checkpoint inhibitors (ICIs) have been remarkably successful in skin cutaneous melanoma (SKCM), however the response to treatment varies greatly among different patients. Considering that the efficacy of ICI treatment is affected by many factors, we selected the Fibrosheath interacting protein 2 (FSIP2) gene and systematically analyzed its potential as a predictor of ICI treatment prognosis.
Methods

Patient data were collected from an ICI treatment cohort (n = 120) and The Cancer Genome Atlas (TCGA)-SKCM cohort (n = 467). The data was divided into an FSIP2-mutant (MT) group and FSIP2-wild-type (WT) group according to the FSIP2 mutation status. In this study we analyzed the patients’ overall survival rate, tumor mutational burden (TMB), neoantigen load (NAL), copy number variation (CNV), cell infiltration data and immune-related genes. We used gene set enrichment analysis (GSEA) to delineate biological pathways and processes associated with the prognosis of immunotherapy.
Results

The prognosis of SKCM patients with FSIP2-MT receiving ICIs was significantly better than that of those with FSIP2-WT. The patients in the FSIP2-MT group had higher tumor immunogenicity and lower regulatory T cell (Treg) infiltration. Results of GSEA showed that pathways related to tumor progression (MAPK and FGFR), immunomodulation, and IL-2 synthesis inhibition were significantly downregulated in the FSIP2-MT group.
Conclusion

Our research suggests that the FSIP2 gene has the potential to predict the prognosis of ICI treatment. The higher tumor immunogenicity and lower Treg levels may be closely related to the fact that patients with FSIP2-MT can benefit more from ICI treatment.
A Novel Traveling Wave Sandwich Piezoelectric Transducer With Single Phase Drive: Theoretical Modeling , Experimental Validation and Application Investigation
Authors: Wang Liang , Bai Fushi , Hofmann Viktor , Jin Jiamei , Twiefel Jens 
Published: August 2020

Abstract
Most of traditional traveling wave piezoelectric transducers are driven by two phase different excitation signals, leading to a complex control system and seriously limiting their applications in industry. To overcome these issues, a novel traveling wave sandwich piezoelectric transducer with a single-phase drive is proposed in this study. Traveling waves are produced in two driving rings of the transducer while the longitudinal vibration is excited in its sandwich composite beam, due to the coupling property of the combined structure. This results in the production of elliptical motions in the two driving rings to achieve the drive function. An analytical model is firstly developed using the transfer matrix method to analyze the dynamic behavior of the proposed transducer. Its vibration characteristics are measured and compared with computational results to validate the effectiveness of the proposed transfer matrix model. Besides, the driving concept of the transducer is investigated by computing the motion trajectory of surface points of the driving ring and the quality of traveling wave of the driving ring. Additionally, application example investigations on the driving effect of the proposed transducer are carried out by constructing and assembling a tracked mobile system. Experimental results indicated that 1) the assembled tracked mobile system moved in the driving frequency of 19410 Hz corresponding to its maximum mean velocity through frequency sensitivity experiments; 2) motion characteristic and traction performance measurements of the system prototype presented its maximum mean velocity with 59 mm/s and its maximum stalling traction force with 1.65 N, at the excitation voltage of 500 V RMS . These experimental results demonstrate the feasibility of the proposed traveling wave sandwich piezoelectric transducer.