bluuebunny/crossref_metadata_2025_split huggingface dataset:
The outcomes of Ilizarov treatment in aseptic nonunions of the tibia stratified by treatment strategies and surgical techniques
Authors: Szelerski Łukasz , Kozłowska Andżelika Pajchert , Żarek Sławomir , Górski Radosław , Małdyk Paweł , Morasiewicz Piotr 
Published: September 2020

Abstract
INTRODUCTIONNonunions of the tibia, particularly those located in the distal third of the bone, are relatively common in clinical practice. There is no gold standard for the treatment of nonunions of the tibia. The purpose of our study was to assess the results of treatment with the Ilizarov method in patients with aseptic nonunions of the tibia, depending on the employed treatment strategies and surgical techniques.MATERIALS AND METHODSA total of 75patients with Ilizarov treatment of aseptic nonunions of the tibia were evaluated in the study. The patients’s mean age at the beginning of treatment was 46years.The mean follow-up period was 10years and 11months.The evaluated patients underwent either closed technique or open technique. The operators used one of two treatment strategies: neutral fixation without compression or continued compression.The following were assessed: rates of union, ASAMI bone scores, ASAMI functional scores, treatment time, complications, duration of hospital stay.RESULTS: Bone union was achieved in all of the75evaluated patients. The results of most analyses showed no significant differences in the assessed variables, except for the ASAMI functional scores, which were higher in the group of patients who underwent closed surgery (Me=6.00vs.Me=4.00).DISCUSSIONWe observed better ASAMI functional score outcomes in the patients who underwent closed fixation than in the open fixation group.The different surgical techniques and treatment strategies had no effect on the number of complications, rates of bone union,length of hospital stay,duration of Ilizarov treatment,or ASAMI bone scores.For managing nonunions of the tibia we recommend the technique of closed fixation without continued compression.The Ilizarov method in the treatment of nonunions of the tibia gives good outcomes.Level of EvidenceDiagnostic Level IV
Association Between Serum High-Density Lipoprotein Cholesterol Concentration and Mortality in Critically Ill Patients: A Retrospective Cohort Study
Authors: Guo Xu , Xu Zhiyu , Qu Hengxing , Woods Ryan Charles , Njobvu Eunice , Zhou Zhongyi , Xie Xiaohong , Tian Jia 
Published: September 2020

Abstract
Background This research aims to explore the association between serum high-density lipoprotein cholesterol (HDL-C) and mortality in patients who are critically ill. MethodsThis was a retrospective cohort study. Data were extracted from an online database named ‘Multiparameter Intelligent Monitoring in Intensive Care III (MIMIC III)’. 3384 patients were included, 967 septic patients and 1380 patients with acute kidney injury (AKI) were screened from all the patients included. The association between HDL-C and hospital mortality in all patients, septic patients and AKI patients was evaluated using HDL-C as a design variable.Results Serum HDL-C (42.4±18.0 VS 45.0±15.2, P<0.001) concentration was significantly lower for non-survivors than survivors. An arc-shaped relationship between HDL-C and mortality was found for the whole group of patients and the AKI subgroup of patients with inflection point at around 30mg/dL; for septic patients, this relationship became ‘U’-shaped with inflection points at around 30mg/dL and 60mg/dL, respectively. Low HDL-C was associated with increased hospital and ICU mortality, longer ICU length of stay (LOS) and hospital LOS compared with medium HDL-C level for all included patients (p<0.01, all) while the differences between high HDL-C and medium HDL-C group were statistically nonsignificant. Similar patterns were found among AKI subgroup of patients. For the sepsis subgroup, low HDL-C group also showed higher hospital and ICU mortality rate (p<0.001, p=0.002, respectively); however, low HDL-C group did not show longer ICU LOS or hospital LOS. Multivariate logistic regression models showed only low HDL-C(<30mg/dL) were associated with increased hospital mortality in all three models(model 1 OR: 1.44, 95% CI 1.05 to 1.97, p=0.022 ; model 2 OR: 1.51, 95% CI 1.01 to 2.27, p=0.044; model 3 OR: 1.69, 95% CI 1.15 to 2.49, p=0.007). In all three models, age, mechanical ventilation use, Sequential Organ Failure Assessment (SOFA) score and Elixhauser comorbidity score were positively associated with mortality.Conclusions Low HDL-C is associated with increased mortality in patients who are critically ill.
Potential Mechanism of Guizhi Decoction in Hypertension Treatment Based on Network Pharmacology and Dahl Salt-Sensitive Rat Model
Authors: Chen Ji-ye , Zhang Yong-jian , Wang Yong-cheng , Zhou Guo-feng , Li Xiao 
Published: September 2020

Abstract
Background

Guizhi decoction (GZD), a classical Chinese herbal formula, has been widely used to treat hypertension, but its underlying mechanisms remain elusive. The present study aimed to explore its therapeutic effects and potential mechanisms in the treatment of hypertension using network pharmacology and experimental validation.
Methods

The active ingredients and corresponding targets were collected from Traditional Chinese Medicine Systems Pharmacology database and Analysis Platform (TCMSP). The targets related to hypertension were identified from multiple databases, and multiple networks were constructed to identify key compounds, hub targets, and main biological processes and pathways of GZD against hypertension. The Surflex-Dock software was used to validate the binding affinity between key targets and their corresponding active compounds. The Dahl salt-sensitive rat model was used to evaluate the therapeutic effects of GZD on hypertension.
Results

A total of 112 active ingredients, 222 targets of GZD and 341 hypertension- related targets were obtained. Furthermore, 56 overlapping targets were identified, five of which were determined as the hub targets to perform experimental verification, including interleukin 6 (IL-6), C-C motif chemokine 2 (CCL2), IL-1β, matrix metalloproteinase 2(MMP-2), and MMP9. Pathway enrichment
Co-expression Network Identification and Clinical Prognostic Evaluation of Hub Genes in Head and Neck Squamous Cell Carcinoma
Authors: Feng Jialian , Han Baoai , Yu Chaosheng , Shen Congxiang , Wen Zhong 
Published: September 2020

Abstract
Background: According to statistics, even with active treatment, the recurrence rate of HNSCC is at 40%-50%. Head and neck cancer remains a challenge for otolaryngologists. Therefore, the identification of new biomarkers is an urgent need for the diagnosis, treatment, and prognosis of malignant tumors of the head and neck. Methods: In this study, transcriptome data from The Cancer Genome Atlas (TCGA) database and the Gene Expression Omnibus (GEO) database were used to identify differentially expressed genes (DEGs). Weighted gene co-expression network analysis (WGCNA) was performed to identify gene modules and hub genes related to head and neck squamous cell carcinoma (HNSCC). Protei-Protei interaction(PPI) network and Cytoscape software were used to analyze the protein interaction network. HNSCC clinical data from the TCGA and Gene Expression Profile Interactive Analysis 2 databases were used to analyze the survival rate of hub genes, and the correlation between hub genes and tumor stage was further analyzed.Results: A total of 2836 and 570 DEGs were identified from the TCGA expression data and GEO gene chip datasets, respectively. We found that the green module had the highest correlation with HNSCC. A total of 15 hub genes were also identified. In the Human Protein Atlas database, we found that thioredoxin reductase 1 (TXNRD1) was overexpressed in HNSCC tumors compared with normal tissues at the transcriptional level. Survival analysis also suggested that TXNRD1 was a poor prognostic factor for HNSCC.Conclusion: Our results indicate that TXNRD1 is very likely to be identified as a potential biomarker and target for HNSCC. However, further research is required to fully reveal its role in HNSCC pathogenesis as well as its value as a prognostic biomarker.
High Nuclear Expression of Yes-Associated Protein 1 (YAP1) Correlates with Metastasis in Patients with Breast Cancer
Authors: Cha Yoon Jin , Bae Soong June , Kim Dooreh , Ahn Sung Gwe , Jeong Joon , Koo Ja Seung , Yoo Tae-Kyung , Park Woo-Chan , Lee Ahwon , Yoon Chang Ik 
Published: September 2020

Abstract
Background: Yes-associated protein 1 (YAP1) is a transcription factor regulated by the Hippo pathway and functions as an oncogene in various solid tumors under dysregulated Hippo pathway. However, the role of YAP1 in breast cancer is controversial. Here, we investigated the impact of different levels of nuclear YAP1 expression on the clinical characteristics and survival outcome of patients with breast cancer.Patients and Methods: Retrospectively obtained 469 breast tumor samples at the Gangnam Severance Hospital were examined for YAP1 expression by immunohistochemistry, and the clinical data were analyzed. External validation was performed using a retrospective cohort and tissues in 489 patients from Severance Hospital.Results: High nuclear YAP1 expression was associated with hormone receptor negativity and aggressive tumor behavior, including lymph node metastasis, high Ki67 labeling index and inferior distant metastasis-free survival (DMFS), and also confirmed in external validation cohort. In patients with triple-negative breast cancer (TNBC), high nuclear YAP1 expression was an independent significant determinant of poor DMFS (HR 1.947, 95% CIs 1.003-3.779, P=0.049).Conclusion: Our findings suggest that nuclear YAP1 expression is a biomarker of adverse prognosis and a potential therapeutic target in patients with breast cancer, especially in TNBC.
Common Causes of Chest Pain in the Emergency Department of Orotta National Referral Hospital, Asmara, Eritrea
Authors: Berhe Selam , Amanuel Naemi 
Published: September 2020

Abstract
BackgroundChest pain is one of the common causes of visits to the emergency department. However, there is scarcity of studies on the causes and prevalence of this common symptom in Eritrea. This retrospective descriptive study was done to determine the prevalence, causes, clinical features, demographics, diagnostic modality and outcome of all patients with the chief complaint of chest pain who presented to the ED of Orotta national referral hospital in Eritrea and the association of demographic characters, diagnostic modality, and clinical features with final diagnosis and outcome.MethodsAfter securing approval by Ministry of Health ethical and research committee, Clinical Service Division and from Orotta National Referral Hospital in Asmara Eritrea, Records of patients 15 years and older presenting with the complaint of chest pain from 1st January 2018 through 31st December 2018 were assessed. A sample of patients who presented with chest pain and did ECG were also included. All data were collected in Microsoft excel software, cleaned and then analyzed using Statistical Package of Social Sciences (SPSS) software version 20.Results855 patients presented with chest pain to the emergency department, out of which 798 patient files were retrieved. Respiratory disease was the most common cause 441(51.6%), with pneumonia the most common diagnosis 415 (94.1%) followed by cardiac cause at 234( 27.4%).Out of the study population 253 study sample were taken with inclusion criteria of those who did an ECG. In these study samples the most common cause was cardiovascular 149(58.9%) out of which the most common illness was ST elevation myocardial infarction 60(23.7%). Out of 253 patients who did electrocardiogram 230(90.9%) were discharged and 23(9.1%) died. 6(26%) of those who died were smokers and 13(56.5%) of those who died were above 69 years old.ConclusionThe main cause of chest pain was found to be respiratory disease, followed by cardiovascular disease in the population study, which was reversed in the sample study (those who did ECG). Age and Smoking were found to affect the prognosis. There were highest mortality rates in STEMI and pulmonary embolism.
The Incidence, Risk Factors and Outcomes of Acute Kidney Injury in Critically Ill Patients Undergoing Emergency Surgery: A Prospective Observational Study
Authors: Hu Linhui , Gao Lu , Zhang Danqing , Hou Yating , Deng Yujun , Fang Heng , Zhang Huidan , He LinLing , Liang Yufan , Xu Jing , Chen Chunbo 
Published: September 2020

Abstract
BackgroundPostoperative acute kidney injury (AKI) is associated with higher morbidity, mortality, and economic burden. However, there is a lack of evaluation of postoperative AKI in highly heterogeneous critically ill patients undergoing emergency surgery. To explore the incidence, risk factors, and prognosis, to clarify the epidemiological status, and to improve the early identification and diagnosis of postoperative AKI, this study was taken.MethodsA prospective observational study was conducted in the general intensive care units of Guangdong Provincial People's Hospital from January 2014 to March 2018. Preoperative variables, intraoperative variables, postoperative variables, and postoperative prognosis data were collected. The diagnosis and staging of postoperative AKI were based on the Kidney Disease: Improving Global Outcomes criteria. They were divided into two groups according to whether postoperative AKI occurred: AKI group and non-AKI group. The baseline characteristics, postoperative AKI incidence, AKI stage, and in-hospital prognosis in all enrolled patients were analyzed prospectively. Multivariate logistic forward stepwise (odds ratio, OR) regression was used to determine the independent risk factors of postoperative AKI. Results were presented using the OR with 95% confidence intervals (CIs).ResultsA total of 383 critically ill patients undergoing emergency surgery, 151 (39.4%) patients among them developed postoperative AKI. Postoperative reoperation, postoperative Acute Physiology and Chronic Health Evaluation (APACHE II) score, postoperative serum lactic acid (LAC), postoperative serum creatinine (sCr) were independent risk factors for postoperative AKI in critically ill patients undergoing emergency surgery, with the adjusted OR (ORadj) of 1.854 ( 95% CI, 1.091 - 3.152), 1.059 ( 95% CI, 1.018 - 1.102), 1. 239 (95% CI, 1.047 - 1.467), and 3.934 (95% CI, 2.426 - 6.382), respectively. Duration of mechanical ventilation, renal replacement therapy, ICU and hospital mortality, ICU and hospital length of stay, total ICU and hospital costs were higher in the AKI group than in the non-AKI group.ConclusionsThe independent risk factors which included postoperative reoperation, postoperative APACHE II score, postoperative LAC, and postoperative sCr could improve the early diagnosis and prevention of postoperative AKI and identify the higher risk of adverse outcomes in critically ill patients undergoing emergency surgery.
A Nano-Platform for in situ Investigations of Ovarian Follicles
Authors: Feugang Jean M. , Ishak Ghassan , Eggert Matthew , Arnold Robert , Willard Scott , Ryan Peter , Gastal Eduardo 
Published: September 2020

Abstract
Background: Despite the growing array of assisted reproductive techniques, there is still a lack of rapid, non-cytotoxic, and minimally invasive in situ approaches for further enhancements through cell targeting. Here we synthesized clinically relevant liposome nanoparticles for real-time cellular targeting and drug (doxorubicin) delivery, using pigs and mares as animal models. In Experiment 1, fluorescently labeled and doxorubicin-loaded (without fluorescent probe) liposomes were injected in cultured pig ovarian follicles to assess plasma membrane binding and intracellular doxorubicin delivery. In Experiment 2, fluorescent liposomes were in vivo injected into small and large ovarian follicles of living mares to assess their binding capability to follicular cells. Twenty-four hours post-injection, all cultured pig follicles were collected while mare samples (i.e., follicle wall fragments, granulosa cells and follicular fluids) were harvested through follicle wall biopsy (FWB), and follicle aspiration and flushing techniques using transvaginal ultrasound-guided approach.Results: All injected follicles were healthy and samples were subjected to fluorescence imaging before and after fixation. Findings revealed successful intrafollicular migration and binding of liposomes to all follicle cell layers (granulosa, theca interna, and theca externa) regardless of the follicle size. The intracellular delivery of doxorubicin was confirmed with the staining of nuclei of follicle cells. Conclusions: This study demonstrates the promising combination of the FWB technique and nanotechnology tools for real-time monitoring of intrafollicular treatment, follicular health and oocyte development, which in turn has the potential to help understand the mechanisms of ovulatory dysfunction and to select high-quatity oocytes for assisted reproduction techniques.
Biomechanical Effects of Position-Loading During Cervical Rotatory Manipulation: A Finite Element Analysis
Authors: Wang Huihao , Zhan Hongsheng , Wang Kuan , Deng Zhen , Li Xiaofei , Yu Zhongxiang 
Published: September 2020

Abstract
Background: Cervical rotatory manipulation(CRM) is one of the most common treatments for neck pain in China. This study utilized a finite element method (FEM) to model the biomechanical effects of positioning during CRM in a normal sitting position. Methods: Passive head kinematics data, including angular displacement in six directions, were recorded. These data were then imported and a finite element model constructed, then validated. Relative angular displacements, and stress on the intervertebral discs and articular surfaces were calculated in a standard symmetry model (SSM) and compared with a pathological model (PM).Results: The results indicate that the intervertebral disc pressure (IDP) at the C2-C3, C3-C4 and C4-C5 discs subjected to CRM with position-loading were lower than the pressures experienced without position-loading. Furthermore, IDP on the target C5-C6 segment during CRM with position-loading in the PM was lower than that without position-loading, the former being close to the IDP of the C5-C6 segment during CRM without position-loading in the SSM. The left articular surface contact pressure of the target C5-C6 segment subjected to CRM towards the right without position-loading in the PM was slightly lower than that of the right articular surface experiencing leftward manipulation and lower than that predicted by the SSM. However, contact pressure of the C5-T1 segment in leftward CRM with position-loading in the PM and C6-T1 in rightward CRM with position-loading in the PM were significantly higher than the standard threshold, especially for contact pressure on the articular surfaces of C5-C6 in leftward CRM with position-loading in the PM. Conclusions: CRM should be considered a promising strategy to mitigate neck pain in patients.
Implementation, Spread and Impact of the Patient Oriented Discharge Summary (Pods) Across Ontario Hospitals: A Mixed Methods Evaluation
Authors: Hahn-Goldberg Shoshana , Huynh Tai , Chaput Audrey , Krahn Murray , Rac Valeria , Tomlinson George , Matelski John , Abrams Howard , Bell Chaim , Madho Craig , Ferguson Christine , Turcotte Ann , Free Connie , Hogan Sheila , Nicholas Bonnie , Oldershaw Betty , Okrainec Karen 
Published: September 2020

Abstract
BACKGROUNDTraditional discharge processes lack a patient-centred focus. This project studied the implementation and effectiveness of an individualized discharge tool across Ontario hospitals. The Patient Oriented Discharge Summary (PODS) is an individualized discharge tool with guidelines that was co-designed with patients and families to enable a patient-centred process. METHODSTwenty one acute-care and rehabilitation hospitals in Ontario, Canada engaged in a supported community of practice and worked over a period of 18 months to implement PODS. An effectiveness-implementation hybrid design using a triangulation approach was used with hospital-collected data, patient and provider surveys, and interviews of project teams. Key outcomes included: reach within and spread outside target populations, change in patient-centred processes, patient and provider experience, understanding of discharge instructions, and healthcare utilization. Statistical methods included linear mixed effects models and generalized estimating equations. RESULTSOf 65,221 discharges across hospitals, 41,884 patients (64%) received a PODS. There was variation in reach and implementation pattern between sites, though none of the between site covariates was significantly associated with implementation success. Both high participation in the community of practice and scoring highly on quality of PODS were associated with higher implementation success. PODS improved family involvement during discharge teaching (7% increase, p=0.026), use of teach-back (11% increase, p<0.001) and discussion of help needed (6% increase, p=0.041). Although unscheduled healthcare utilization decreased with PODS implementation, it was not statistically significant.CONCLUSIONSThis project highlighted the system-wide adaptability and ease of implementing PODS across multiple patient groups and hospital settings. PODS demonstrated an improvement in patient-centred discharge processes linked to quality standards and health outcomes. A community of practice and high quality content may be needed for successful implementation.
Analysis of the Lipid Metabolism and Related Factors Among Male Employees in Guangzhou From 2017 to 2019&nbsp;
Authors: wei wenting , jia yeran , zhan Wenfeng , Li Faping , Zhang Pingyou , Zhang Hongxuan 
Published: September 2020

Abstract
Background: To analyze abnormal plasma lipids during physical examination of adult men in a community hospital and to provide the basis for prevention and control measures. Methods: Fasting serum lipids (TG, TC, LDL-C, HDL-C) were measured in 439 adult men in a community hospital from 2017 to 2019. The results were analyzed by age. Results: The prevalence of dyslipidemia was 15.72%,19.36%, and 20.50% in 2017, 2018, and 2019, respectively. The abnormal rate of HDL-C increased significantly—from 2.96% in 2017 to 9.11% in 2018; it remained at 8.88% in 2019. The abnormal rate of TG and HDL-C increased gradually from age 50 years, and the highest was in those aged 60-65 years. The study also found that TC and LDL-C index levels peaked in the 55-65-year-old group; these levels then decreased with age. TG and LDL-C increased with age while HDL-C decreased with age. The increase in plasma lipid levels and obesity in young people was significantly higher than those in middle-aged people. Conclusion: The rate of dyslipidemia among adult men in Guangzhou increases over time and with age. The prevention and treatment of dyslipidemia (awareness, treatment, and control) should be urgently strengthened to reduce the incidence of cardiovascular and cerebrovascular diseases and improve the level of community health services.