bluuebunny/crossref_metadata_2025_split huggingface dataset:
Measurement of cerebrovascular reserve by multimodal imaging for cerebral arterial occlusion or stenosis patients: protocol of a prospective, randomized, controlled clinical trial
Authors: zhipeng xiao , ke ji , yong lin , jieqing wan , yaohua pan , yichao jin , xiaohua zhang 
Published: December 2019

Abstract
Background Cerebrovascular reactivity (CVR), index of cerebral hemodynamics, might guide the treatment of ischemic stroke. However, the previous studies that the therapeutic strategy of stroke mainly depends on the degree of vascular stenosis with steady-state vascular parameters, such as cerebral blood flow, and CVR factors are not under consideration. Measurement of CVR by multimodal image might improve the prognosis for ischemic stroke. Methods/design The study is a prospective, randomized, paralleled controlled clinical trial to examine the multimodal image evaluation for CVR. A total of 66 eligible patients will be recruited from Renji hospital, Shanghai Jiaotong University School of Medicine. The patients will be categorized based on CVR into two subgroups as follows: CVR>10% group and CVR<10% group. And the patients will be randomly assigned to medical management, percutaneous transluminal angioplasty and stenting, and intracranial and extra-cranial bypass groups in a 1:1:1 ratio. The primary end point is all adverse events and ipsilateral stroke recurrence at 6, 12, 24 months after the management. The secondary outcomes include the CVR, the National Institute of Health stroke scale and the Modified Rankin Scale at 6, 12, 24 months. Discussion Measurement of cerebrovascular reserve by multimodal image is recommended by most recent studies to guide the treatment of ischemic stroke, and thus its efficacy and evaluation accuracy need to be established in randomized controlled settings. This prospective, randomized, paralleled controlled registry study, together with other ongoing studies, will present more evidence for optimal individualized accurate treatment of ischemic stroke.
TOPK Promotes Metastasis of Esophageal Squamous Cell Carcinoma by Activating the Src/GSK3β/STAT3 Signaling Pathway via γ-Catenin
Authors: Jiang Yanan , Zhang Jing , Zhao Jimin , Li Zhenzhen , Chen Hanyong , Qiao Yan , Chen Xinhuan , Liu Kangdong , Dong Ziming 
Published: December 2019

Abstract
Background
Esophageal squamous cell carcinoma (ESCC) is a fatal disease with poor prognosis. The predominant reason for ESCC-related death is distal metastasis. A comprehensive understanding of the molecular mechanism underlying metastasis is needed for improving patient prognosis. T-LAK cell-originated protein kinase (TOPK) is a MAPKK-like kinase, which plays a vital role in various physiological and pathophysiological processes. However, the role of TOPK in ESCC metastasis is unclear.
Methods
Tissue array was used to evaluate the correlation between TOPK expression and ESCC lymph node metastasis. Wound healing assay, transwell assay, and lung metastasis mice model were used to examine the role of TOPK in the migration of ESCC cells in vitro and in vivo. Protein kinase array, mass spectrometry (MS), and molecular modeling were used to examine the pathways and direct target proteins of TOPK that are involved in ESCC metastasis. Additionally, immunofluorescence and western blotting analyses were performed to verify these findings.
Results
The enhanced expression of TOPK was correlated with lymph node metastasis in the ESCC tissues. TOPK knockdown or treatment with the TOPK inhibitor (HI-TOPK-032) decreased the invasion and migration of ESCC cells in vitro. HI-TOPK-032 also inhibited the lung metastasis in ESCC cell xenograft in vivo model. Moreover, TOPK promoted the invasion of ESCC cells by activating the Src/GSK3β/STAT3 and ERK signaling pathways via γ-catenin.
Conclusion
The findings of this study reveal that TOPK is involved in ESCC metastasis and promoted the ESCC cell mobility by activating the Src/GSK3β/STAT3 and ERK signaling pathways. This indicated that TOPK may be a potential molecular therapeutic target for ESCC metastasis.
Efficacy and safety of Guhong injection for treating the Coronary microvascular disease:study protocol for a randomized controlled trial
Authors: Zhuang Jieqin , Liu Shuling , Cai Hairong , Dai Xingzhen , Chen Yanhong , Jin Zilin , Chen Bojun 
Published: December 2019

Abstract
Background: Coronary microvascular disease (CMVD) refers to cardiovascular diseases with normal coronary angiography but evidence of myocardial ischemia or microcirculation lesions, often presenting as angina pectoris attack. Coronary artery of microtubules dysfunction is one of the pathogenesis of coronary heart disease,but the occurrence and development and the current of CMVD intervention therapy remains to be further researched.Chinese traditional medicine (TCM)has advantages in the treatment of cardiovascular diseases, therefore, this article describes an ongoing randomized controlled clinical trial, based on the theory of TCM, for the purpose of evaluating the efficacy and safety of Guhong injection ,a Chinese patent medicine,compared with placebo in patients suffering from CMVD.
Methods/design: This is a multicenter, randomized, parallel arm, open-label, double-blind, placebo-controlled clinical trial. A total of 260 eligible patients will be allocated and randomly assigned, in a ratio of 1:1, to either the experimental group or the control group. The treatment course is 10 consecutive days, with a 8-week follow-up. The primary outcome is the frequency of angina attacks, Secondary outcomes include myocardial metabolites, ecg changes, quantitative score of TCM syndromes, inflammatory response and endothelial function indicators.
Discussion: This trial is strictly designed in accordance with principles and regulations issued by the China Food and Drug Administration (CFDA). The results will provide high quality evidence on the efficacy and safety of Guhong injection in the treatment of CMVD.
Trial registration: Chinese Clinical Trials Registry, ChiCTR1900022902. Registered on 27 April 2019.
Keywords: Guhong injection, Coronary microvascular disease, randomized controlled trial, inflammatory response,endothelial function
A Retrospective Analysis on Metastatic Rate of the Internal Mammary Lymph Node and Its Clinical Significance in Adjuvant Radiotherapy of Breast Cancer Patients
Authors: Li Li , Zhang Hongyan , Wang Linwei , xie Conghua , Zhou Yunfeng , Zhong Yahua 
Published: December 2019

Abstract
Background: There is a discrepancy about the metastatic rate of internal mammary lymph nodes (IMNs) between clinical and pathologic findings. We aimed to investigate the metastatic rate of IMNs and to provide recommendations on target volume delineation of IMNs for adjuvant radiotherapy in breast cancer patients. Methods: We retrospectively analyzed data from 114 breast cancer patients treated with surgery without adjuvant radiotherapy who developed local and/or regional lymph node recurrence/metastasis at our institute from January 2015 to January 2019. Patients with widely lung or pleural metastases were excluded. We first analyzed the recurrence rate with the chest wall, the metastatic rate of internal mammary/anterior mediastinal, ipsilateral axillary and supraclavicular lymph nodes, and then investigated the distribution of the IMNs. Results: Among the 114 included patients, the recurrence rate with the chest wall, metastatic rate of IMNs, IMNs/anterior mediastinal lymph nodes, ipsilateral axillary lymph nodes, and the ipsilateral supraclavicular lymph nodes was 43%, 37.7%, 59.6%, 12.3%, and 22.8%, respectively. The metastatic IMNs were mainly located from the first to the second intercostal space. However, metastatic lymph nodes could also be observed above the upper edge of the first rib. Conclusions: The metastatic rate is high in the IMNs and irradiation of the internal mammary lymphatic chain is required. It is suggested that the upper bound of the internal mammary lymphatic chain should be up to the subclavian vein with a 5-mm margin, thus connecting to the caudal border of supraclavicular clinical target volume in breast cancer patients at high risk of recurrence.
Performance of ultrasonography screening for breast cancer: a systematic review and meta-analysis
Authors: Yang Lei , Wang Shengfeng , Zhang Liwen , Sheng Chao , Song Fengju , Huang Yubei 
Published: December 2019

Abstract
Background To investigate the performance of primary ultrasound (US) screening for breast cancer, and that of supplemental US screening for breast cancer after negative mammography (MAM).Methods Electronic databases (PubMed, Scopus, Wed of Science, and Embase) were systematically searched to identify relevant studies published between January 2003 and May 2018. Only high-quality or fair-quality studies reporting any of the following performance values for supplemental or primary US screening were included: sensitivity, specificity, cancer detected rate (CDR), recall rate (RR), biopsy rate (BR), and proportions of invasive cancers (ProIC) or node-positive cancers (ProNPC) among screening-detected cancers.Results Twenty-three studies were included, including 12 studies in which supplemental US screening was used after negative MAM and 11 joint screening studies in which both MAM and US were used as primary screening methods. Meta-analyses revealed that supplemental US screening could detect 96% [95% confidential intervals (CIs): 82% to 99%] of occult breast cancers missed by MAM and identify 94% (95% CIs: 88% to 97%) of healthy women, with a CDR of 2.9/1000 (95%CIs: 1.8/1000 to 3.9/1000), RR of 8.6% (95%CIs: 4.8% to 13.5%), BR of 3.9% (95%CIs: 2.5% to 5.5%), ProICof 73.9% (95%CIs: 49.0% to 93.7%), and ProNPC of 72.6% (95%CIs: 51.9% to 90.0%). Compared with primary MAM screening, primary US screening led to the recall of significantly more women with positive screening results [1.2% (95%CIs:0.4% to 1.9%), P =0.004] and detected significantly more invasive cancers [20.2% (95%CIs: 7.2% to 33.1%), P = 0.002]. However, there were no significant differences for other performance measures between the two screening methods, including sensitivity, specificity, CDR, BR, and ProNPC.Conclusions Supplemental US screening could detect occult breast cancers missed by MAM, while primary US screening would be considered as comparable to primary MAM screening in certain subgroup of women, but with a higher recall rate and a higher detection rate for invasive cancers.
Clinical and histologic tissue responses of skin incisions closed with glycomer 631 and lactomer 9-1 using subcuticular technique in pigs
Authors: Plavec Tanja , Švara Tanja , Zdovc Irena , Gombač Mitja , Damjanovska Marija , Pintarič Tatjana Stopar , Cvetko Erika , Seliškar Alenka 
Published: December 2019

Abstract
Background: Glycomer 631 and lactomer 9-1 are absorbable suture materials indicated for soft tissue approximation in non-infected wounds. Pigs are often used as surgical models in translational research, however, the reports of tissue reactions to both suture materials in pigs are limited. The aim of this study was to assess clinical and histologic responses of skin incisions closed with subcuticular technique using glycomer 631 and lactomer 9-1 in pigs.
Results: Skin incisions of 17 pigs were closed with glycomer 631 and lactomer 9-1 and clinical reactive score (CRS) including erythema, swelling, discharge, and dehiscence was calculated on postoperative days 7 and 14. Subcuticular tissue reaction was assessed histologically on postoperative day 14 (the presence of extravascular neutrophils, macrophages, multinucleated giant cells, lymphocytes, fibroblasts, bacterial colonies, overall severity of inflammatory response to suture material), and the cumulative score of variables calculated as aggregate tissue irritation score (ATIS). Tissue samples were examined for suture extrusion and evaluated microbiologically. Clinical reactive score did not differ between the suture materials. Only one variable of ATIS, overall severity of inflammatory response, was lower (p = 0.029) when glycomer 631 was used. Suture extrusion was found in 10/17 of incisions closed by glycomer 631 and in 7/13 of incisions closed by lactomer 9-1. Trueperella pyogenes was isolated from the skin and from the area of tissue reaction in six pigs.
Conclusions: No difference in CRS between the suture materials was observed. Glycomer 631 induced less tissue reaction only in terms of overall severity of inflammatory response. Suture extrusion was observed in more than 50% of incisions regardless of the suture material. Trueperella pyogenes was the only pathogen isolated from the tissue surrounding the suture material. Thinner suture material with less knots should be used for subcuticular closure in pigs.
WITHDRAWN: Integration of practice nurse competencies in general practices in Belgium: a qualitative evaluation study of a postgraduate program.
Authors: Matthys Evi , Bogaert Peter Van , Remmen Roy 
Published: December 2019

Abstract
Background Recently, first steps were taken to educate primary care nurses in Belgium and consequently specifically trained practice nurses have only just been introduced in Belgian general practices. Therefore, it is unclear what the experiences of general practitioners (GPs) and trained practice nurses (PNs) are concerning these new multidisciplinary collaborations. With this qualitative study we would like to report new insights in the visions and experiences of GPs and PNs concerning the new postgraduate education for PNs, the current and future roles and responsibilities taken on by trained PNs, and the experienced collaboration between GPs and trained PNs. Methods A qualitative research methodology was chosen, based on the principles of a descriptive qualitative research design. This study was conducted in primary healthcare in Belgium. Four focus group interviews were conducted. A total of twenty PNs and ten GPs participated. The PNs had followed or were currently following the postgraduate program for PNs, all the GPs were experienced in collaborating with a trained PN. Results Four major themes could be derived from the data: practice nurses’ roles and responsibilities, importance of protocol care, consequences of the collaboration, and future opportunities and perspectives. GPs expressed the importance of education for PNs, in order for them to take on more responsibilities in the practices. Trained PNs showed a lot of initiative towards taking on a broader range of tasks. They both expressed the importance of care protocols in support of a good multidisciplinary collaboration. The impact on the daily practice was experienced as far-reaching by GPs. While collaborating with trained PNs, GPs experienced the ability to provide a higher quality of care . Conclusion Both GPs and trained PNs have positive experiences about providing shared care in general practices. GPs were surprised by the initiative, shown by PNs, and by the broad range of tasks nurses took on. The impact of this collaboration on both the daily practice and the quality of patient care, is unanimously experienced as positive, even though it entails a higher workload. GPs have specific future expectations about the PN education and roles.
Cross-sectional study of associations between normal body weight with central obesity and hyperuricemia in Japan
Authors: Shirasawa Takako , Ochiai Hirotaka , Yoshimoto Takahiko , Nagahama Satsue , Watanabe Akihiro , Yoshida Reika , Kokaze Akatsuki 
Published: December 2019

Abstract
Background

Several studies have shown that normal weight with central obesity (NWCO) is associated with cardiovascular disease risk factors such as hypertension, dyslipidemia and diabetes. However, the relationship between NWCO and hyperuricemia has not been studied in detail.

Methods

We investigated the association between NWCO and hyperuricemia among Japanese adults aged 40-64 years who had undergone periodic health examinations between April 2013 and March 2014. Obesity was defined as a body mass index (BMI) ≥25 kg/m2　and central obesity was determined as a waist-to-height ratio (WHtR) ≥0.5. We classified the participants into the following groups based according to having obesity and central obesity: normal weight (BMI 18.5-24.9 kg/m2) without (NW; WHtR <0.5) and with (NWCO) central obesity, and obesity without (OB) and with (OBCO) central obesity. Hyperuricemia was defined as serum uric acid >7.0 and ≥6.0 mg/dL in men and women, respectively, or under medical treatment for hyperuricemia. Alcohol intake was classified as yes (daily and occasional consumption) and none (no alcohol consumption). Odds ratios (OR) and 95% confidence intervals (CI) for hyperuricemia were calculated using a logistic regression model.

Results

We analyzed data derived from 96,863 participants (69,241 men and 27,622 women). The prevalences of hyperuricemia in men and women were respectively, 21.4% and 11.0%, and of participants with NWCO respectively 15.6% and 30.0%. The adjusted OR for hyperuricemia was significantly increased in OBCO compared with NW, regardless of sex (men: OR, 2.12; 95%CI; 2.03-2.21; women: OR, 3.54; 95%CI, 3.21-3.90) and were statistically significant in NWCO compared with NW (men: OR, 1.44; 95%CI, 1.36-1.52; women: OR, 1.41; 95%CI, 1.27-1.57). The results were similar regardless of alcohol consumption.

Conclusions

We found that NWCO and OBCO were associated with hyperuricemia in middle-aged Japanese men and women. Middle-aged Japanese adults with normal weight but having central obesity should be screened using a combination of BMI and WHtR and educated about how to prevent hyperuricemia.
Screening of Cellulolytic Bacteria from Rotten Wood of Qinling (China) for Biomass Degradation and Cloning of Cellulases from Bacillus methylotrophicus
Authors: Ma Lingling , Lu Yingying , Yan Hong , Wang Xin , Yi Yanglei , Shan Yuanyuan , Liu Bianfang , Zhou Yuan , Lv Xin 
Published: December 2019

Abstract
Background
Cellulosic biomass degradation still needs to be paid more attentions as bioenergy is the most likely to replace fossil energy in the future, and more evaluable cellulolytic bacteria isolation will lay a foundation for this filed. Qinling Mountains have unique biodiversity, acting as promising source of cellulose-degrading bacteria exhibiting noteworthy properties. Therefore, the aim of this work was to find potential cellulolytic bacteria and verify the possibility of the cloning of cellulases from the selected powerful bacteria.
Results
In present study, 55 potential cellulolytic bacteria were screened and identified from the rotten wood of Qinling Mountains. Based on the investigation of cellulase activities and degradation effect on different cellulose substrates, Bacillus methylotrophicus 1EJ7, Bacillus subtilis 1AJ3 and Bacillus subtilis 3BJ4 were further applied to hydrolyze wheat straw, corn stover and switchgrass, and the results suggested that B. methylotrophicus 1EJ7 was the most preponderant bacterium, and which also indicated that Bacillus was the main cellulolytic bacteria in rotten wood. Furthermore, scanning electron microscopy (SEM) and X-ray diffraction analysis of micromorphology and crystallinity of wheat straw also verified the significant hydrolyzation. With ascertaining the target sequence of cellulase β-glucosidase (243 aa) and endoglucanase (499 aa) were successfully heterogeneously cloned and expressed from B. methylotrophicus 1EJ7, and which performed a good effect on cellulose degradation with enzyme activity of 1670.15±18.94 U/mL and 0.130±0.002 U/mL, respectively. In addition, based on analysis of amino acid sequence, it found that β-glucosidase were belonged to GH16 family, and endoglucanase was composed of GH5 family catalytic domain and a carbohydrate-binding module of CBM3 family.
Conclusions
Based on the screening, identification and cellulose degradation effect evaluation of cellulolytic bacteria from rotten wood of Qinling Mountains, it found that Bacillus were the predominant species among the isolated strains, and B. methylotrophicus 1EJ7 performed best on cellulose degradation. Meanwhile, the β-glucosidase and endoglucanase were successfully cloned and expressed from B. methylotrophicus for the first time, which provided new materials of both strain and the recombinant enzymes for the study of cellulose degradation and its application in industry.
An integrated intervention for chronic care management in rural Nepal: a type 2 hybrid effectiveness-implementation study
Authors: Schwarz Dan , Dhungana Santosh , Kumar Anirudh , Acharya Bibhav , Agrawal Pawan , Aryal Anu , Baum Aaron , Choudhury Nandini , Citrin David , Dangal Binod , Dhimal Meghnath , Gauchan Bikash , Gupta Tula , Halliday Scott , Karmacharya Biraj , Kishore Sandeep , Koirala Bhagawan , Kshatriya Uday , Levine Erica , Maru Sheela , Rimal Pragya , Sapkota Sabitri , Schwarz Ryan , Shrestha Archana , Thapa Aradhana , Maru Duncan 
Published: December 2019

Abstract
Background In Nepal, the burden of non-communicable, chronic diseases is rapidly rising, and disproportionately affecting low- and middle-income countries. Integrated interventions are essential in strengthening primary care systems and addressing the burden of multiple comorbidities. A growing body of literature supports the involvement of frontline providers, namely mid-level practitioners and community health workers, in chronic care management. Important operational questions remain, however, around the digital, training, and supervisory structures to support the implementation of effective, affordable, and equitable chronic care management programs. Methods A twelve-month, population-level, type 2 hybrid effectiveness-implementation study will be conducted in rural Nepal to evaluate an integrated non-communicable disease care management intervention within Nepal’s new municipal governance structure. The intervention will leverage the government’s planned roll-out of the World Health Organization’s Package of Essential Non-communicable disease interventions (WHO-PEN) program in four municipalities in Nepal, with a study population of 80,000. The intervention will leverage both the WHO-PEN and its cardiovascular disease specific technical guidelines, HEARTS, and include three evidence-based components: 1) non-communicable disease care provision using mid-level practitioners and community health workers; 2) digital clinical decision support tools to ensure delivery of evidence-based care; and 3) training and digitally-supported supervision of mid-level practitioners to provide motivational interviewing for modifiable risk factor optimization, with a focus on medication adherence, and tobacco and alcohol use. The study will evaluate effectiveness using a pre-post design with stepped implementation. The primary outcomes will be disease-specific, “at-goal” metrics of chronic care management; secondary outcomes will include alcohol and tobacco consumption levels. Discussion This is the first population-level, hybrid effectiveness-implementation study of an integrated chronic care management intervention in Nepal. As low- and middle-income countries plan for the Sustainable Development Goals and universal health coverage, the results of this pragmatic study will offer insights into policy and programmatic design for non-communicable disease care management in the future.