bluuebunny/crossref_metadata_2025_split huggingface dataset:
The prognostic value of modified Glasgow Prognostic Score in pancreatic cancer: a meta-analysis
Authors: Zhang Huan , Ren Dianyun , Jin Xin , Wu Heshui 
Published: September 2020

Abstract
Background
Several studies were conducted to explore the prognostic value of modified Glasgow Prognostic Score (mGPS) in pancreatic cancer, which reported contradictory results. The purpose of this meta-analysis was to summarize and further investigate the correlation between mGPS and overall survival (OS) in pancreatic cancer.

Methods
A systematic literature search was performed in PubMed, EMBASE, ISI Web of Science, Cochrane library databases and OVID to identify eligible studies published from Jan 1, 2011 to June 20, 2020. Pooled hazard ratios (HRs) with corresponding 95% confidence intervals (CIs) were used to detect the prognostic significance of mGPS in patients with pancreatic cancer.

Results
A total of 222 non-repetitive studies were identified, and 20 related studies that explored the association between survival outcomes and mGPS in pancreatic cancer patients were finally enrolled in this meta-analysis. The results showed a significant correlation between high level of mGPS and poor OS (HR = 1.50, 95% CI 1.20–1.89, P < 0.0001). Similar results were observed in the subgroup analyses based on the treatment regimen and research region.

Conclusions
Our study suggested the close association between poor prognosis and high level of mGPS, which will be helpful for future clinical applications in patients with pancreatic cancer.
Neuroprotective effect of Angelica gigas root in a mouse model of ischemic brain injury through MAPK signaling pathway regulation
Authors: Lee Se-Eun , Kim Jung-Hoon , Lim Chiyeon , Cho Suin 
Published: September 2020

AbstractBackgroundThe root ofAngelica gigasNakai (Apiaceae) has been traditionally used as an important herbal medicine to treat blood-deficiency-related disorders in Eastern Asian countries, and recently, it has been recognized as a potential candidate for improving cardiovascular diseases.MethodsIn this study, the neuroprotective effect of a methanol extract ofA. gigasroot (RAGE) was investigated in a mouse stroke model induced by a 90 min transient middle cerebral artery occlusion (tMCAO). Infarction volumes and morphological changes in brain tissues were measured using TTC, cresyl violet, and H&E staining. The neuroprotective mechanism of RAGE was elucidated through investigation of protein expression levels using western blotting, IHC, and ELISA assays. The plasma concentrations of decursin, a major compound in RAGE, were measured after oral administration of RAGE to SD rats.ResultsThe infarction volumes in brain tissues were significantly reduced and the morphological deteriorations in the brain neuron cells were improved in tMCAO mice when pre-treated with RAGE at 1000 mg/(kg bw·d) for two consecutive days. The neuroprotective mechanism of RAGE was confirmed to attenuate ERK-related MAPK signaling pathways in the ipsilateral hippocampus hemisphere in mice. The concentrations of decursin in rat plasma samples showed peak absorption and elimination in vivo after oral administration of RAGE at 100 mg/rat.ConclusionMice administered RAGE before the tMCAO operation had less neuronal cell death than those that were not administered RAGE prior to the operation, and this study provides preclinical evidence for use ofA. gigasin ischemic stroke.
Remote sensing of the impact of flash drought events on terrestrial carbon dynamics over China
Authors: Zhang Miao , Yuan Xing , Otkin Jason A. 
Published: September 2020

Abstract
Background
Flash drought poses a great threat to terrestrial ecosystems and influences carbon dynamics due to its unusually rapid onset and increasing frequency in a warming climate. Understanding the response of regional terrestrial carbon dynamics to flash drought requires long-term observations of carbon fluxes and soil moisture at a large scale. Here, MODIS satellite observations of ecosystem productivity and ERA5 reanalysis modeling of soil moisture are used to detect the response of ecosystems to flash drought over China.

Results
The results show that GPP, NPP, and LAI respond to 79–86% of the flash drought events over China, with highest and lowest response frequency for NPP and LAI, respectively. The discrepancies in the response of GPP, NPP, and LAI to flash drought result from vegetation physiological and structural changes. The negative anomalies of GPP, NPP, and LAI occur within 19 days after the start of flash drought, with the fastest response occurring over North China, and slower responses in southern and northeastern China. Water use efficiency (WUE) is increased in most regions of China except for western regions during flash drought, illustrating the resilience of ecosystems to rapid changes in soil moisture conditions.

Conclusions
This study shows the rapid response of ecosystems to flash drought based on remote-sensing observations, especially for northern China with semiarid climates. Besides, NPP is more sensitive than GPP and LAI to flash drought under the influence of vegetation respiration and physiological regulations. Although the mean WUE increases during flash drought over most of China, western China shows less resilience to flash drought with little changes in WUE during the recovery stage. This study highlights the impacts of flash drought on ecosystems and the necessity to monitor rapid drought intensification.
Identification of risk features for complication in Gaucher’s disease patients: a machine learning analysis of the Spanish registry of Gaucher disease
Authors: Andrade-Campos Marcio M. , de Frutos Laura López , Cebolla Jorge J. , Serrano-Gonzalo Irene , Medrano-Engay Blanca , Roca-Espiau Mercedes , Gomez-Barrera Beatriz , Pérez-Heredia Jorge , Iniguez David , Giraldo Pilar 
Published: September 2020

Abstract
Background
Since enzyme replacement therapy for Gaucher disease (MIM#230800) has become available, both awareness of and the natural history of the disease have changed. However, there remain unmet needs such as the identification of patients at risk of developing bone crisis during therapy and late complications such as cancer or parkinsonism. The Spanish Gaucher Disease Registry has worked since 1993 to compile demographic, clinical, genetic, analytical, imaging and follow-up data from more than 400 patients. The aims of this study were to discover correlations between patients’ characteristics at diagnosis and to identify risk features for the development of late complications; for this a machine learning approach involving correlation networks and decision trees analyses was applied.

Results
A total of 358 patients, 340 type 1 Gaucher disease and 18 type 3 cases were selected. 18% were splenectomyzed and 39% had advanced bone disease. 81% of cases carried heterozygous genotype. 47% of them were diagnosed before the year 2000. Mean age at diagnosis and therapy were 28 and 31.5 years old (y.o.) respectively. 4% developed monoclonal gammopathy undetermined significance or Parkinson Disease, 6% cancer, and 10% died before this study. Previous splenectomy correlates with the development of skeletal complications and severe bone disease (p = 0.005); serum levels of IgA, delayed age at start therapy (> 9.5 y.o. since diagnosis) also correlates with severe bone disease at diagnosis and with the incidence of bone crisis during therapy. High IgG (> 1750 mg/dL) levels and age over 60 y.o. at diagnosis were found to be related with the development of cancer. When modelling the decision tree, patients with a delayed diagnosis and therapy were the most severe and with higher risk of complications.

Conclusions
Our work confirms previous observations, highlights the importance of early diagnosis and therapy and identifies new risk features such as high IgA and IgG levels for long-term complications.
Pulse pressure and end-tidal carbon dioxide for monitoring low native cardiac output during veno-arterial ECLS: a prospective observational study
Authors: Mourad Marc , Eliet Jacob , Zeroual Norddine , Saour Marine , Sentenac Pierre , Manna Federico , Molinari Nicolas , Gandet Thomas , Colson Pascal H. , Gaudard Philippe 
Published: September 2020

AbstractBackgroundVeno-arterial extracorporeal life support (VA-ECLS) results in cardiopulmonary shunting with reduced native cardiac output (NCO). Low NCO occurrence is common and associated with risk of thromboembolic and pulmonary complications. Practical tools for monitoring NCO during VA-ECLS would therefore be valuable. Pulse pressure (PP) and end-tidal carbon dioxide (EtCO2) are known to be related to cardiac output. We have designed a study to test whether PP and EtCO2were efficient for the monitoring of NCO during VA-ECLS.MethodsIn this prospective single-center observational study, patients who underwent a VA-ECLS for cardiogenic shock from January 2016 to October 2017 were included, provided low NCO was suspected by a PP < 20 mmHg. NCO was measured with pulmonary artery catheter or echocardiography and compared to PP and EtCO2. The ability of PP and EtCO2to predict NCO < 1 L/min was evaluated with receiver operating characteristics (ROC) curves.ResultsAmong the 106 patients treated with VA-ECLS for cardiogenic shock during the study period, 26 were studied, allowing the collection of 196 study points. PP and EtCO2relationships with NCO were nonlinear and showed strong correlations for NCO < 2 L/min (r = 0.69 andr = 0.78 respectively). A PP < 15 mmHg and EtCO2 < 14 mmHg had good predictive values for detecting NCO < 1 L/min (area under ROC curve 0.93 [95% CI 0.89–0.96] and 0.97 [95% CI 0.94–0.99] respectively,p = 0.058).ConclusionsPP and EtCO2may offer an accurate real-time monitoring of low NCO events during VA-ECLS support. Further studies are needed to show if their utilization may help to implement therapeutic strategies in order to prevent thromboembolic and respiratory complications associated with VA-ECLS, and to improve patients’ prognosis.Trial registrationNCT03323268, July 12, 2016
Neuroplasticity induced by general anaesthesia: study protocol for a randomised cross-over clinical trial exploring the effects of sevoflurane and propofol on the brain – A 3-T magnetic resonance imaging study of healthy volunteers
Authors: Madsen Signe Sloth , Møller Kirsten , Olsen Karsten Skovgaard , Vestergaard Mark Bitsch , Lindberg Ulrich , Larsson Henrik Bo Wiberg , Mårtensson Johan , Werner Mads U. , Santos Sofia Alexandra Gaspar , Asghar Mohammad Sohail 
Published: September 2020

Abstract
Background
Although used extensively worldwide, the effects of general anaesthesia on the human brain remain largely elusive. Moreover, general anaesthesia may contribute to serious conditions or adverse events such as postoperative cognitive dysfunction and delirium. To understand the basic mechanisms of general anaesthesia, this project aims to study and compare possible de novo neuroplastic changes induced by two commonly used types of general anaesthesia, i.e. inhalation anaesthesia by sevoflurane and intravenously administered anaesthesia by propofol. In addition, we wish to to explore possible associations between neuroplastic changes, neuropsychological adverse effects and subjective changes in fatigue and well-being.

Methods
This is a randomised, participant- and assessor-blinded, cross-over clinical trial. Thirty healthy volunteers (male:female ratio 1:1) will be randomised to general anaesthesia by either sevoflurane or propofol. Multimodal magnetic resonance imaging (MRI) of the brain will be performed before and after general anaesthesia and repeated after 1 and 8 days. Each magnetic resonance imaging session will be accompanied by cognitive testing and questionnaires on fatigue and well-being. After a wash-out period of 4 weeks, the volunteers will receive the other type of anaesthetic (sevoflurane or propofol), followed by the same series of tests. Primary outcomes: changes in T1-weighted 3D anatomy and diffusion tensor imaging. Secondary outcomes: changes in resting-state functional magnetic resonance imaging, fatigue, well-being, cognitive function, correlations between magnetic resonance imaging findings and the clinical outcomes (questionnaires and cognitive function). Exploratory outcomes: changes in cerebral perfusion and oxygen metabolism, lactate, and response to visual stimuli.

Discussion
To the best of our knowledge, this is the most extensive and advanced series of studies with head-to-head comparison of two widely used methods for general anaesthesia. Recruitment was initiated in September 2019.

Trial registration
Approved by the Research Ethics Committee in the Capital Region of Denmark, ref. H-18028925 (6 September 2018). EudraCT and Danish Medicines Agency: 2018-001252-35 (23 March 2018). www.clinicaltrials.gov, ID: NCT04125121. Retrospectively registered on 10 October 2019.
A tai chi/qigong intervention for older adults living with HIV: a study protocol of an exploratory clinical trial
Authors: Ibañez Gladys E. , Fennie Kristopher , Larkey Linda , Hu Nan , Algarin Angel B. , Valdivia Chelsea , Lavretsky Helen 
Published: September 2020

Abstract
Background
Almost half of people living with HIV (PLWH) in the USA are over 50 years of age; this is expected to increase to 70% by 2020. Yet, few interventions exist for older PLWH that address psychological and physical symptoms combined, both prevalent in this population. There is a need to find innovative and accessible interventions that can help older PLWH to manage their symptoms. Mind-body interventions, like tai chi/qigong (TCQ), improve both physical and psychological health. TCQ is a series of slow, low-impact meditative movements that integrates breathwork, meditation, and stances.

Methods
The present study is an exploratory clinical trial that will evaluate the acceptability and feasibility of a 12-week, small group TCQ intervention (n = 24), a sham qigong control condition (n = 24), and a standard of care control condition (n = 24) for older people living with HIV/AIDS. It will also explore any preliminary associations between the TCQ intervention and symptom alleviation. Participants will be recruited from community-based health and social services organizations in Miami, FL, and randomized to one of the 3 conditions.

Discussion
We will assess feasibility and acceptability through questionnaires and adherence to TCQ. We will assess preliminary associations with symptoms such as depression, anxiety, social support, chronic HIV-related fatigue, and clinical outcomes. These will be described through proportions, means, and changes over time through graphing techniques. Outcomes will be assessed at baseline, at post-intervention, and at 3 months follow-up. These preliminary analyses also will provide information necessary to estimate effect size and power needed for a larger clinical trial.

Trial registration
ClinicalTrials.gov NCT03840525. Registered on 16 July 2018.
AST/ALT ratio as a predictor of mortality and exacerbations of PM/DM-ILD in 1 year—a retrospective cohort study with 522 cases
Authors: Li Renjiao , Zhu Wen-Jun , Wang Faping , Tang Xiaoju , Luo Fengming 
Published: September 2020

Abstract
Objective
To assess the associations between aspartate transaminase/alanine transaminase ratio (DRR) and mortality in patients with polymyositis/dermatomyositis-associated interstitial lung disease (PM/DM-ILD).

Patients and methods
This was a retrospective cohort study, which included 522 patients with PM/DM-ILD whose DRR on admission were tested at West China Hospital of Sichuan University during the period from January 1, 2008, to December 31, 2018. Cox regression models were used to estimate hazard ratios for mortality in four predefined DRR strata (≤ 0.91, 0.91–1.26, 1.26–1.73, and > 1.73), after adjusting for age, sex, DRR stratum, diagnosis, overlap syndrome, hemoglobin, platelet count, white blood cell count, the percentage of neutrophils, neutrophil/lymphocyte ratio, albumin, creatine kinase, uric acid/creatinine ratio, triglycerides, or low-density lipoprotein.

Results
Higher DRR (> 1.73) was an independent predictor of 1-year mortality in multivariate Cox regression analysis (hazard ratio 3.423, 95% CI 1.481–7.911, p = .004). Patients with higher DRR more often required the use of mechanical ventilation and readmission for acute exacerbation of PM/DM-ILD at 1-year follow-up.

Conclusion
Higher DRR on admission for PM/DM-ILD patients are associated with increased mortality, risk of mechanical ventilation, and hospitalization in 1-year follow-up. This low-cost, easy-to-obtain, rapidly measured biomarker may be useful in the identification of high-risk PM/DM-ILD patients that could benefit from intensive management.
Protected complex percutaneous coronary intervention and transcatheter aortic valve replacement using extracorporeal membrane oxygenation in a high-risk frail patient: a case report
Authors: Kmiec Lukasz , Holzamer Andreas , Fischer Marcus , Debl Kurt , Zerdzitzki Matthäus , Schmid Christof , Maier Lars , Hilker Michael , Sossalla Samuel 
Published: September 2020

AbstractBackgroundTranscatheter aortic valve replacement has become a routine procedure for patients with severe symptomatic aortic stenosis at increased surgical risk. Not much is known about using prophylactic support with venoarterial extracorporeal membrane oxygenation in patients undergoing transcatheter aortic valve replacement and eventually concomitant complex percutaneous coronary intervention.Case presentationWe present a successful procedure of transcatheter aortic valve replacement and high-risk percutaneous coronary intervention utilizing venoarterial extracorporeal membrane oxygenation for hemodynamic support in a very frail 88-year-old Caucasian woman with severe symptomatic aortic stenosis and coronary bypass grafting in the past.Echocardiography revealed a “low-flow low-gradient” aortic stenosis (mean transvalvular gradient 30 mmHg, aortic valve area 0.4 cm2, significant calcification), a left ventricular ejection fraction of 35%, severe mitral regurgitation with moderate stenosis (mean transvalvular gradient 7 mmHg), with a systolic pulmonary artery pressure of 80 mmHg. Moreover, pre-interventional coronary angiography exposed a severe left main ostial stenosis and sequential subtotal heavily calcified stenosis of the left anterior descending artery . Computed tomographic angiography showed no heavy tortuosity but moderate calcification of the iliofemoral arteries.The procedure was performed under general anesthesia in our hybrid operating room. Extracorporeal membrane oxygenation was established by left femoral percutaneous cannulation using a 21-Fr venous and 15-Fr arterial cannula. Subsequently, complex percutaneous coronary intervention with implantation of two drug-eluting stents from the left main into the left anterior descending artery was performed via a right femoral arterial 7F sheath. Thereafter, a 23-mm Sapien 3 aortic valve prosthesis (Edwards, Irvine, CA, USA) was implanted via right femoral artery in the usual manner, whereby the arterial pigtail catheter for marking the aortic annulus during transcatheter aortic valve replacement was inserted over a Check-Flo® Hemostasis Assembly (Cook Medical, Bloomington, IN, USA) on a Y-adapter via the arterial extracorporeal membrane oxygenation cannula. After extracorporeal membrane oxygenation decannulation, vascular closure was easily performed using the MANTA vascular closure device in order to reduce procedural time and risk of access site complications.ConclusionsIn summary, we demonstrate the feasibility of elective prophylactic extracorporeal membrane oxygenation implementation in selected very high-risk and frail patients undergoing transcatheter aortic valve replacement and percutaneous coronary intervention in order to avoid intraprocedural complications.
Influence of bone condition on implant placement accuracy with computer-guided surgery
Authors: Putra Ramadhan Hardani , Yoda Nobuhiro , Iikubo Masahiro , Kataoka Yoshihiro , Yamauchi Kensuke , Koyama Shigeto , Cooray Upul , Astuti Eha Renwi , Takahashi Tetsu , Sasaki Keiichi 
Published: September 2020

AbstractBackgroundThe impact of the jaw bone condition, such as bone quantity and quality in the implant placement site, affecting the accuracy of implant placement with computer-guided surgery (CGS) remains unclear. Therefore, this study aimed to evaluate the influence of bone condition, i.e., bone density, bone width, and cortical bone thickness at the crestal bone on the accuracy of implant placement with CGS.MethodsA total of 47 tissue-level implants from 25 patients placed in the posterior mandibular area were studied. Implant placement position was planned on the simulation software, Simplant® Pro 16, by superimposing preoperative computed tomography images with stereolithography data of diagnostic wax-up on the dental cast. Implant placement surgery was performed using the surgical guide plate to reflect the planned implant position. The post-surgical dental cast was scanned to determine the position of the placed implant. Linear and vertical deviations between planned and placed implants were calculated. Deviations at both platform and apical of the implant were measured in the bucco-lingual and mesio-distal directions. Intra- and inter-observer variabilities were calculated to ensure measurement reliability. Multiple linear regression analysis was employed to investigate the effect of the bone condition, such as density, width, and cortical bone thickness at the implant site area, on the accuracy of implant placement (α= 0.05).ResultIntra- and inter-observer variabilities of these measurements showed excellent agreement (intra class correlation coefficient ± 0.90). Bone condition significantly influenced the accuracy of implant placement using CGS (p < 0.05). Both bone density and width were found to be significant predictors.ConclusionsLow bone density and/or narrow bucco-lingual width near the alveolar bone crest in the implant placement site might be a risk factor influencing the accuracy of implant placement with CGS.
Immunohistochemical expression of receptors for luteinizing hormone-releasing hormone (LHRHR) in muscle-invasive Urothelial carcinoma of urinary bladder: a potential predictive marker for targeted cytotoxic LHRH hybrid analogs
Authors: Yasir Saba , Fernandez-Castro Gustavo , Bajwa Numra Aslam , Block Norman , Schally Andrew , Cote Richard , Jorda Merce 
Published: September 2020

Abstract
Background
Recurrent disease following failed chemotherapy for muscle-invasive urothelial carcinoma (UC) has no universally accepted treatment guidelines. Receptors for luteinizing hormone-releasing hormone (LHRHR) have recently been identified in urothelial cancer cell lines as well as tissue samples. These receptors can be used as target for cytotoxic hybrid analogs of LHRH. The aim of this study was to determine the frequency of LHRHR expression in muscle invasive UC by immunohistochemistry.

Methods
Fifty-two cases, including TURBTs (31) and cystectomies (21), with at least muscle invasive UC were retrieved. Of 52 patients, 41 (78.8%) were male and 11 (21.1%) were female, with age ranging from 50 to 84 years. Immunohistochemical staining for LHRHR antibody (N-20, Santa Cruz, 1:50) was performed using the LSAB method. Membranous and/or granular cytoplasmic staining was considered as a positive reaction. Scoring was based on the percentage of positive tumor cells; negative (no staining), 1+ (1–25%), 2+ (26–50%), 3+ (51–75%), 4+ (> 75%).

Results
Of 52 UC cases, 32 (61%) were AJCC stage T2, 17 (33%) were T3, and 3 (6%) were T4. Of 52 cases, 30 (58%) were positive and 22 (42%) were negative for LHRHR. Of the 30 positive cases, 16 (53%) were scored 1+, 7 (23%) 2+, 5 (17%) 3+ and 2 (7%) 4 + .

Conclusions
More than half of the cases expressed LHRHR. Two-thirds of cases demonstrated focal (< 50%) immunoreactivity, which may cause false negative results in limited tissue samples. Immunohistochemical expression of LHRHR in UC can be a predictive marker for potential efficacy of LHRH cytotoxic hybrid analogs.