bluuebunny/crossref_metadata_2025_split huggingface dataset:
The prognostic significance of inflammation-based scores in patients with ampullary carcinoma after pancreaticoduodenectomy
Authors: Sun Shuxin , He Chaobin , Wang Jun , Huang Xin , Wu Jiali , Li Shengping 
Published: May 2020

Abstract
Background: Growing evidence indicates that systemic inflammatory response plays an important role in cancer development and progression. Several inflammatory markers have been reported to be associated with the clinical outcomes in patients with various types of cancer. This study was designed to evaluate the prognostic value of the inflammatory indexes in patients suffering from ampullary cancer (AC) who underwent pancreaticoduodenectomy (PD).Methods:We retrospectively reviewed a database of 358 patients with AC who underwent PD between 2009 and 2018. R software was used to compare the area under the time-dependent receiver operating characteristic (ROC) curves (AUROCs) of the inflammation-based indexes, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), modified Glasgow Prognostic Score (mGPS), prognostic nutritional index (PNI) and prognostic index (PI), in terms of their predictive value of survival. The survival differences of these indexes were compared by Kaplan-Meier method and univariate and multivariate analyses were performed to determine the prognostic factors of progress-free survival (PFS) and overall survival (OS).Results:The estimated 1-, 2-, and 3-year OS and PFS rates were 83.9%, 65.8%, 55.2% and 58.0%, 42.8%, 37.8%, respectively, for the entire cohort. The survival differences were significant in terms of OS and PFS when they were stratified by these inflammation-based indexes. The comparisons of AUROCs of these inflammation-based indexes illustrated that NLR and PI displayed highest prognostic value, compared to other indexes. When NLR and PI were combined, NLR-PI showed even higher AUROC values and was identified as a significant prognostic factor in terms of OS and PFS.Conclusion:Specific inflammatory indexes, such as NLR, PLR and PI, were found to be able to predict the OS or PFS of patients. As a novel inflammatory index, the level of NLR-PI, which can be regarded as a more useful prognostic index, exhibited strong predictive power for predicting prognosis of patients with AC after PD procedure.
Thermodynamic Control on Biogeography and Functioning of Rare-Biosphere Propionate Syntrophs in Paddy Field Soils
Authors: Jin Yidan , Jiao Shuo , Lu Yahai 
Published: May 2020

Abstract
Background

Global biogeochemical processes are not only gauged by dominant taxa of soil microbiome but also depend on the critical functions of “rare biosphere” members. Here we evaluated the biogeographical pattern of “rare biosphere” propionate-oxidizing syntrophs in 113 paddy soil samples collected across eastern China.
Results

The relative abundance, functioning capacity and growth potential of propionate-oxidizing syntrophs were analyzed to provide a panoramic view of syntroph biogeographical distribution at the continental scale. The relative abundances of four syntroph genera, Syntrophobacter, Pelotomaculum, Smithella and Syntrophomonas were significantly greater at the warm low latitudes than at the cool high latitudes. Correspondingly, the functioning potential of propionate degradation was greater in the low latitude soils compared with the high latitude soils. The slow rate of propionate degradation in high latitude soils resulted in a greater fold change in increase of the relative abundance, probably due to the growth rate-yield tradeoff relationship. The mean annual temperature (MAT) is the most important factor shaping the biogeographical pattern of propionate-oxidizing syntrophs, with the next factor to be the total S content (TS) in soil.
Conclusions

We suggest that the effect of MAT is related to the Gibbs free energy change, in which the endergonic tension of propionate oxidation is leveraged with the increase of MAT. The TS effect is likely due to that some propionate syntrophs can facultatively perform sulfate respiration.
Physician Assistants in Geriatric Medicine
Authors: Honda Trenton J. , Kozikowski Andrzej , Segal-Gidan Freddi , Hooker Roderick 
Published: May 2020

Abstract
Background
The US population is aging. As of 2020, over 16% of adults, or over 52 million people, are age 65 or older. With a population that is increasingly "gray," the nation is short of medical providers who specialize in geriatrics. The number of geriatrician physicians per 10,000 adults 65 years and older has decreased since 2000, and geriatricians were approximately 5,300 in 2018. Nurse practitioners in geriatric care are an order of magnitude smaller, numbering 598 in 2018. Considering that the projected geriatrician needs by 2030 will be over 30,000, the trajectory of geriatricians is becoming increasingly inadequate for the aging population. Physician assistants (PA) are another class of providers that are filling this need, although little is known about their distribution in geriatric patient care.
Methods
The National Commission on Certification of Physician Assistants databank provided the number and characteristics of PAs in geriatric medicine. PAs in geriatrics, their distribution, income, was compared to certified PAs. Analysis included descriptive statistics, Chi-Square and Wilcoxon Rank Sum tests for comparisons between PAs practicing in geriatrics vs. all other clinical specialties. For all analyses where a comparison between PAs in geriatrics and other specialties was made, a P value of .05 or less was considered statistically significant. Statistical analyses were conducted using R
Results
As of 2018, there were 794 certified PAs, or 0.8% of the PA workforce, specifically in geriatrics. This cadre has grown significantly 2010 both in total number (increasing over 400%) and as a percentage of the PA workforce. The median age of PAs in geriatrics is 45 years, and 79% are female. Almost half (46%) of the PA geriatric workforce are in extended care facilities or nursing homes - which differs from PAs in non-geriatric medicine specialties (0.3%). Another 8% work in federal government facilities with an additional 8% in rehabilitation facilities. In 2018, the median annual income for this PA cadre was $106,680.
Conclusions
As the American population continues to age, the relative growth of PAs in geriatric medicine makes them a natural part of the solution to the projected physician geriatrician deficit.
Comparison of problem-based and team-based learning on Chinese basic medical education for clinical medicine: a pilot study
Authors: Gan Lixi , Deng Xiaoxin , Chen Haibin , Liu Caixia , Yang Miao , Lin Changmin , Gao Fenfei 
Published: May 2020

Abstract
Background

Since being proposed half a century ago, problem-based learning (PBL) and team-based learning (TBL) have been two popular teaching approaches used in Chinese basic medical education. To compensate for the shortcomings of lecture-based learning (LBL), both PBL and TBL can greatly benefit students. This study compares the differences of PBL and TBL on active learning and final academic scores in Chinese basic medical curriculum at Shantou University Medical College (SUMC).
Methods

Ten Year 4 and thirteen Year 3 medical students, enrolled in 2015 and 2016 at SUMC, were selected for TBL and PBL, respectively. In the homeostasis module, a basic-medical curriculum used in China, TBL was used for Year 4 students at their 3rd year, and PBL was used for Year 3 students. Student feedback was collected through a questionnaire. Academic achievement was based on their final examination scores. Each grade used the same final examination paper, which included both memorization and clinical application questions, as students in the traditional LBL class. Quantitative data were analyzed by t- and nonparametric tests.
Results

All students completed the questionnaire. Most students (PBL:62%, TBL:90%) thought the teaching approach they used was good for training clinical thinking, but PBL required more time and imposed a greater study burden. However, PBL students received higher scores than LBL students for clinical application essays (p < 0.05), whereas there were no differences in memorization problem scores. Final academic scores showed no significant differences between TBL and LBL students (p > 0.05).
Conclusion

Despite the differences in the culture of learning between China and the West, TBL and PBL are two popular teaching approaches among Chinese medical students. In Chinese basic medical education, PBL is more effective in training clinical thinking, while in TBL, students spend less time with problems and are helped by the professors. The relevant assessment system and teacher training system should be perfected.
Managerial features and outcome in neonatal intensive care units: results from a cluster analysis
Authors: Fanelli Simone , Bellù Roberto , Zangrandi Antonello , Gagliardi Luigi , Zanini Rinaldo 
Published: May 2020

Abstract
Background Healthcare organisations differ in performance even if they are located in the same country or region. Suitable managerial practices and organisational processes can lead to better health outcomes. As a result, hospitals are constantly looking for managerial arrangements that can improve outcomes and keep costs down. This study aims to identify different managerial models in neonatal intensive care units (NICUs) and their impact on a large number of outcomes.Methods The research was conducted in Italy, within the SONAR project. SONAR’s aim was to identify the characteristics of NICUs, monitor outcomes and promote best practices. This study includes 51 of the 63 NICUs that took part in the SONAR project. Questionnaires on the activities and managerial features were administered to doctors and nurses working in NICU. 643 questionnaires were analysed from doctors and a total of 1,601 from nurses. A cluster analysis was performed to identify managerial models of NICUs.Results Three managerial models emerged from cluster analysis: traditional, collaborative and individualistic. The results showed that there is an association between managerial models and neonatal outcomes, and have important implications for three categories of management: top management, middle management, and regional health system managers.Conclusions NICU is one of the most expensive and complex areas in healthcare organisations. Health management needs to assess NICU strategically in order to develop models to improve outcomes. This study provides useful insights for management to draft the managerial characteristics of NICUs in order to achieve better results in terms of clinical outcome.
Assessing perceived organ donation competencies among pediatric intensivists in Saudi Arabia: A national survey
Authors: Kazzaz Yasser , Daar Omar 
Published: May 2020

Abstract
Background
As increasing the number of organ donations presents a global challenge, and Saudi Arabia is no different, Intensivists can play a major role in the process. The purpose of this study was to investigate Saudi pediatric intensivists’ perception of their comfort and the importance of organ donation competencies.
Methods
We conducted a cross-sectional survey whose sampling frame included 100 pediatric intensivists. We assessed 14 competencies categorized into four domains: the general donation, donation after brain death (DBD), neurological determination of death, and medicolegal, religious, and ethical domains. Then we investigated the association between these competencies and physicians’ characteristics.
Results
With a response rate of 76%, we found that 40–60% of the surveyed pediatric intensivists rated their comfort in 6 out of 14 competencies as high or very high. There was a statistically significant gap in the intensivists’ perception of 10 competencies (i.e., high importance but low comfort levels). Ordinal regression showed that comfort levels with the general donation, neurological determination of death, and medicolegal, religious, and ethical domains were higher in intensivists who were frequently involved with DBD than those who had never been exposed.
Conclusions
Pediatric intensivists expressed low comfort levels with organ donation competencies. The pediatric intensive care community should invest in educational opportunities in the country to boost the low levels of organ donation.
In vitro antibacterial activity of telithromycin against Enterococcus spp. isolated from China
Authors: Xiong Yanpeng , Chen Junwen , Sun Xiang , Xu Guangjian , Li Peiyu , Deng Qiwen , Yu Zhijian , Chen Zhong , Zheng Jinxin 
Published: May 2020

Abstract
Background: Enterococci has resistant to a wide range of antimicrobials, and the treatment of enterococcal infection has always been an issue of concern. This study aimed to explore the new ketolides antimicrobials-telithromycin, against the planktonic cells and biofilms of enterococci. The minimum inhibitory concentration (MIC) of telithromycin was determined. The sequence types (STs) and genotypes of resistance to erythromycin in enterococci were detected. Furthermore, the effect of telithromycin against the biofilms of enterococci were investigated.Results: A total of 280 Enterococcus faecalis and 122 Enterococcus faecium isolates were collected from individual inpatients in China. Telithromycin showed excellent activity against the E. faecalis and E. faecium strains no matter sensitive or resistant to erythromycin with erm A, erm B or erm C, with the MIC50 at 2 μg/mL and 4 μg/mL, respectively. The predominant STs of E. faecalis isolates were ST16, ST30, ST179, and ST18, ST78, ST80 were the predominant STs of E. faecium isolates. Moreover, 87.1% (135/158) and 80.4% (41/51) isolates of the predominant STs carried the erm genes in E. faecalis and E. faecium isolates, respectively. The subinhibitory concentration of telithromycin (at 1/4× and 1/8× MICs) significantly inhibited the biofilm formation of 16 E. faecalis isolates. Telithromycin (at 8× MIC) indicated the removal effect on the established biofilms of 8 E. faecalis isolates, and combined with ampicillin eradicated more biofilms than telithromycin or ampicillin alone.Conclusion: Telithromycin showed an excellent activity against the planktonic cells of E. faecalis and E. faecium, and against the biofilms of E. faecalis.
Cellular-Mesenchymal to Epithelial Transition Factor Upregulates Aquaporin 3 Expression in Human Breast Cancer Cells
Authors: Zhu Fanshuang , Chen Lijie , Zhou Yixing , An Jiaxiang , Wu Zenggui , Hu Jinxi , Ma Zhaosheng , Cao Feilin 
Published: May 2020

Abstract
Background

Aquaporin 3 (AQP3) and Cellular-mesenchymal to epithelial transition factor (c-Met) are both overexpressed in human breast cancer and highly related to proliferation and migration. However, it is still unclear whether c-Met is associated with AQP3. The study objective was to explore the relationship between c-Met and AQP3 in human breast cancer.
Methods

We used immunohistochemistry to determine the expression of AQP3 and c-Met in breast cancer tissue specimens and analysed whether there was any correlation between the two molecules. Real-time quantitative polymerase chain reaction and Western blotting were used to detect AQP3 expression in MCF-7 and MDA-MB-231 cells after human hepatocyte growth factor (hHGF) treatment and/or transfection with c-Met silencing small interfering (si)RNA. Additionally, cell migration was examined with a wound scratch assay.
Results

Based on the immunohistochemical results combined with the clinicopathological data of 59 breast cancer patients, c-Met exhibited a significant correlation with AQP3 in breast cancer tissue. Studies have shown that hHGF can increase c-Met phosphorylation, and we discovered that the hHGF-induced increase in AQP3 expression was dose dependent. However, after reducing c-Met expression with c-Met-specific siRNA, AQP3 expression decreased accordingly. Additionally, the wound scratch assay showed that AQP3-specific siRNA or c-Met-specific siRNA significantly inhibited breast cancer cell migration, which was promoted by hHGF.
Conclusions

Our study indicated that AQP3 expression was regulated by c-Met in human breast cancer. These discoveries may help us comprehend the mechanisms underlying breast cancer development and invasion and offer another possibility for targeted treatment of breast cancer.
Relative prevalence of anxiety and depression in cubital tunnel syndrome patients and associated factors
Authors: jia siming , Shi Xiaoying , Liu Guanglian , Wang Li , Zhang Xiaoran , Ma Xuelin , Li Jia , Shao Xinzhong 
Published: May 2020

Abstract
Purpose: Cubital tunnel syndrome (CuTS) is the second most common peripheral entrapment neuropathy. This study aimed to assess the prevalence of anxiety and depressive symptoms and explore associated factors among CuTS patients.Methods: This is a cross-controlled study. We used the Hospital Anxiety and Depression Scale to assess the prevalence of depression and anxiety. We calculated the proportion of depression and anxiety symptoms and compared characteristics between groups. Univariate analysis and multivariate regression were carried out to identify variables that were independently associated with anxiety and depression.Results: A total of 246 individuals diagnosed with CuTS were included. The results of the HADS demonstrated that 17.8% (n = 44) of the patients presented possible/probable depression, and 14.2% (n = 35) presented possible/probable anxiety. Logistic regression analysis revealed that diabetes Mellitus was independently associated with depression. And modified McGowan grade was independently associated with anxiety.Conclusions: Patients with cubital tunnel syndrome were at an increased risk of anxiety and depression. Abnormal mental states may have a negative impact in the course and outcome of the disease. Early screening for anxiety and depression in CuTS patients should be recommended.
Gender, reproductive output covariation and their role on gene diversity of Pinus koraiensis seed orchard crops
Authors: Kang Kyu-Suk , Park Ji-Min , Kang Hye-In , Yeom Da-Bin , El-Kassaby Yousry A. , Lee Kyung-Mi 
Published: May 2020

Abstract
Background: Gender and fertility variation have an impact on mating dynamics in a population because they affect the gene exchange among parental members and the genetic composition of the resultant seed crops. Fertility is the proportional gametic contribution of parents to their progeny. An effective number of parents, derivative of effective population size, is the probability that two alleles randomly chosen from the gamete gene pool originated from the same parent. The effective number of parents is directly related to the fertility variation among parents, which should be monitored for manipulating gene diversity of seed crops. We formulated a fundamental equation of estimating the effective number of parents and applied it to a seed production population.Results: Effective number of parents (Np) was derived from fertility variation (Y) considering covariance (correlation coefficient, r) between maternal and paternal fertility. The Y was calculated from the coefficient of variation in reproductive outputs and divided into female (yf) and male (ym) fertility variation in the population under study. The Np was estimated from the parental Y estimated by the fertility variation of maternal (yf) and paternal (ym) parents. The gene diversity of seed crops was monitored by Y and Np. in a 1.5 generation Pinus koraiensis seed orchard as a case of monoecious species. A large variation of female and male strobili production was observed among the studied 52 parents for four consecutive years, showing statistically significant across all studied years. Parental balance curve showed greater distortion in paternal parents than maternal parents. The Y ranged from 1.879 to 4.035 with greater ym than yf, and the Np varied from 14.8 to 36.8. When pooled, the relative effective number of parents was improved as 80.0% of the census number. Conclusions: We recommend the use of fertility variation (i.e., CV, Y), Person’s product-moment correlation (r) and effective number of parents (Np) as tools for gauging gene diversity of seed crops in production populations. For increasing Np and gene diversity, additional management options such as mixing seed-lots, equal cone harvest and application of supplemental-mass-pollination are recommended.
Inter-limb differences in total hip arthroplasty patients four to five years after surgery: a cross-sectional study
Authors: John Stefanie , Weizel David , Heumann Anna Sophie , Fischer Anja , Orlowski Katja , Mrkor Kai-Uwe , Edelmann-Nusser Jürgen , Witte Kerstin 
Published: May 2020

Abstract
BackgroundːTotal hip arthroplasty (THA) is a successful method to reduce pain in end-stage hip osteoarthritis (OA) patients. If the pre-operatively existing deficits in the affected limb are persisting years after THA has not been thoroughly researched. Therefore, the aim of the study was to investigate potential side-to-side differences in long-time THA patients.MethodsːSixteen patients (age: 65.20 ± 5.32 years), who had undergone unilateral THA four to five years ago and ten, healthy, age-matched controls (age = 60.85 ± 7.57 years) were examined for maximum isometric hip muscle strength, range of motion (ROM) of the hip joint, balance and gait on both limbs. Paired t-testes were used to assess the inter-limb differences in THA patients and controls and unpaired t-tests were applied to investigate differences between the two groups.ResultsːIn THA patients, significant deficits on the operated side were found for the center of pressure (COP) length, hip abduction torque and ROM of hip extension with small to medium effects. Compared to the controls, THA patients demonstrated highly significantly reduced hip strength in flexion, extension, abduction and adduction as well as limited ROM in hip flexion and abduction.ConclusionsːA few side-to-side difference were present in THA patients four to five years after the surgery, although the general hip muscle weakness and restricted hip ROM compared to the controls was more severe. Postoperative training focusing on strengthening hip muscles should be continued months and years after the surgery in order to compensate persisting deficits.Trial registrationːDRKS, DRKS00016945. Registered 12 March 2019 – Retrospectively registered, http://www.drks.de/DRKS00016945