bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tibial spurs (pes anserinus bony spurs) in children and adolescents: a case series of 21 patients
Authors: Matsunobu Tomoya , Maekawa Akira , Fukushima Suguru , Nabeshima Akira , Iwamoto Yukihide 
Published: August 2020

Abstract
Background: Icicle-like bony spurs that originate from the proximal medial surface of the tibia in young persons have been referred to by various names in the literature. This tibial spur, called pes anserinus bony spurs (PABSs), can present as exostoses, but lacks a cartilage cap which is characteristic feature of osteochondroma. To date, there are only two small case series about the tibial spur, and little information is available. The aim of this study was to describe the characteristics of PABSs in children and adolescents. Methods: This retrospective study analysed patients diagnosed with PABSs on an orthopaedic oncology service from 2013 to 2020. Additionally, in order to estimate the prevalence of PABSs in children and adolescents, we retrospectively reviewed knee X-rays of patients who visited our hospital for other reasons from 2008 to 2020. Results: Thirteen male and 8 female patients with PABSs, with a mean age of 11.7 years, were evaluated. Bilateral spurs were observed in 7 of the 21 patients. Among 28 PABSs in 21 patients, 6 were incidentally identified. Radiological evaluation showed that the average PABS length was 10.6 mm. There was a statistically significant difference in the spur length between incidentally detected PABSs and symptomatic PABSs at the first visit. The prevalence rate of PABSs among children and adolescents was 0.94%. Computed tomography examinations showed that no PABSs occurred at the site of the tendinous insertion of the pes anserinus. Surgical resection was performed in only 2 patients, both of whom were high-performing athletes. Conclusions: This is the first study to describe the clinical and radiological features of PABSs in detail and to report their prevalence in children and adolescents. Although longer PABSs are symptomatic, most PABSs are non-problematic and surgical resection of PABSs should be considered only if pain persists despite conservative treatment.
Perspectives of health practitioners and the key population on predictors of relapse in physical activity and dietary behavior: a concept mapping study
Authors: Roordink Eline , Steenhuis Ingrid H.M. , Kroeze Willemieke , Chinapaw Mai J.M. , Stralen Maartje M. van 
Published: August 2020

Abstract
Background

To prevent people from relapsing into unhealthy habits, insight into predictors of relapse in physical activity and dietary behavior is needed. Therefore, we aimed to explore predictors of relapse in physical activity and dietary behavior from the perspectives of health practitioners and the key population (i.e. adults who recently lost weight and experienced relapse).
Methods

We used concept mapping to collect data among five groups of health practitioners (N = 39) and three key population groups (N = 21). First participants’ ideas on potential predictors were collected. Subsequently, these ideas were individually sorted by relatedness and rated on importance. Concept maps were created for each group using principal component analysis and cluster analysis.
Results

In total 43 predictors were identified, of which the majority belonged to the individual domain compared to the environmental domain. Although the majority of perceived predictors were mentioned by both stakeholder groups, both groups had different opinions regarding the importance of predictors. Also, few predictors were mentioned by all practitioner groups, but not by the key population, and vice versa. Practitioners indicated change in daily structure, stress, lack of effective coping skills, habitual behavior, and lack of self-efficacy regarding losing weight as most important recurrent (i.e. mentioned in all practitioner groups) predictors. The key population indicated lifestyle imbalance or experiencing a life event, lack of perseverance, negative emotional state, abstinence violation effect, decrease in motivation and indulgence as most important recurrent predictors.
Conclusions

Both stakeholder groups predominantly rated individual factors as most important perceived predictors of relapse. The finding that both groups differed in opinion regarding importance of predictors or identified different predictors, may provide an opportunity to enhance lifestyle coaching by ensuring it is patient-centered and tailored.
Association of Serum Bilirubin Levels With Sarcopenia in Patients With Type 2 Diabetes: a Cross-Sectional Study in China
Authors: Wang Chuan , Jin Chen , Liu Jidong , Yin Xiaofei , Wu Chuanlong , Liu Jinbo 
Published: August 2020

Abstract
Background: The prevalence of sarcopenia increased in type 2 diabetes mellitus (T2DM). Elevated oxidative stress and inflammation played important roles in the pathogenesis of diabetic sarcopenia. Bilirubin had been confirmed to possess potential anti-oxidative activity. This study aimed to explore the relationship between bilirubin and sarcopenia in patients with T2DM. Methods: A total of 251 patients (124 men and 127 postmenopausal women) with T2DM aged ≥ 50 years were recruited. Levels of serum total bilirubin (TBIL), direct bilirubin (DBIL) and indirect bilirubin (IBIL) were measured. Muscle mass was measured by dual-energy X-ray absorptiometry (DXA). The relationships between serum bilirubin levels and appendicular skeletal muscle mass index (SMI) were assessed using a Pearson correlation analysis and multiple linear regression analysis in men and women, respectively. Multiple logistic regression analysis was used to evaluate the association of the highest quartile of serum bilirubin levels with sarcopenia.Results: TBIL (r =0.211, p = 0.019) and IBIL (r =0.249, p = 0.005) were positively associated with SMI in men, but not in women. After multiple adjustment in multiple linear regression analysis, TBIL (p = 0.023) and IBIL (p = 0.012) were also significantly associated with SMI in men. In multiple logistic regression analysis, the highest quartile of IBIL showed a decreased OR for sarcopenia (OR=0.243, P = 0.009) in men. Conclusions: Both of TBIL and IBIL were positively associated with muscle mass in men with T2DM. IBIL might have a stronger protective effect on the occurrence of sarcopenia in men with T2DM.
Cardiovascular Outcomes of Antidiabetes Medications by Race/Ethnicity: a systematic review and meta-analysis
Authors: Cai Xiaoling , Dagogo-Jack Sam , Lin Chu , Yang Wenjia , Ji Linong 
Published: August 2020

Abstract
Background: The consistency of cardiovascular risk reduction by antidiabetes medications across racial and ethnic groups remains unclear. The aim of this study was to analyze racial/ethnic patterns in the results of cardiovascular outcomes trials of antidiabetes medications in people with type 2 diabetes.Method: PubMed and Cochrane library databases were searched from the inception dates to December 2019. Cardiovascular outcome trials in type 2 diabetes that randomized participants to active or control treatment and reported results by race/ethnic groups or region were included.Results: A total of 16 studies were included in this meta-analysis. Among White participants, active antidiabetes medication, compared with control treatment, significantly decreased the composite cardiovascular outcomes (OR=0.90, 95% CI 0.86-0.94, p<0.05). Among Asian participants, active antidiabetes medication, compared with control treatment, also significantly decreased the composite cardiovascular outcomes (OR=0.82, 95%CI 0.76-0.90, p<0.05). Among Black participants (OR=0.96, 95% CI 0.69-1.32, p=0.79) and subjects from other groups (mostly Hispanics or Pacific Islanders) (OR=0.92, 95% CI 0.81-1.04, p=0.16), active anti-diabetes medication resulted in nominal but non-significant decreases in the composite cardiovascular outcomes, compared with the control treatment.Conclusions: Antidiabetes drugs demonstrated cardiovascular safety in people with type 2 diabetes from all racial/ethnic groups studied, but achieved significant composite cardiovascular risk reduction only in White and Asian participants, perhaps due to differences in sample size and power.
Alternative Polyadenylation in Response to Temperature Stress Contributes to Gene Regulation in Trees
Authors: Yan Chao , Wang Yupeng , Lyu Tao , Hu Zhikang , Ye Ning , Liu Weixin , Li Jiyuan , Yao Xiaohua , Yin Hengfu 
Published: August 2020

Abstract
Background Genome-wide change of polyadenylation (polyA) sites (also known as alternative polyadenylation, APA) is emerging as an important strategy of gene regulation in response to stress in plants. But little is known in woody perennials that are persistently dealing with multiple abiotic stresses.Results Here, we performed a genome-wide profiling of polyadenylation sites under heat and cold treatments in Populus trichocarpa. Through a comprehensive analysis of polyA tail sequences, we identified 25,919 polyA-site clusters (PACs), and revealed 3429 and 3139 genes shifted polyA sites under heat and cold stresses respectively. We found that a small proportion of genes possessed APA that affected the open reading frames; and some shifts were commonly identified. Functional analysis of genes displaying shifted polyA tails suggested that pathways related to RNA metabolism were linked to regulate the APA events under both heat and cold stresses. Interestingly, we found that the heat stress induced a significantly more antisense PACs comparing to cold and control conditions. Furthermore, we showed that a unique cis-element (AAAAAA) was predominately enriched downstream of PACs in P. trichocarpa genes; and this sequence signal was only absent in shifted PACs under the heat condition, indicating a distinct APA mechanism responsive to heat tolerance. Conclusions This work provides a comprehensive picture of global polyadenylation patterns in response to temperatures stresses in trees. We show that the frequent change of polyA tail is a potential mechanism of gene regulation responsive to stress, which are associated with distinctive sequence signatures.
M2 Macrophage-based Prognostic Nomogram for Gastric Cancer After Surgical Resection: Original Article
Authors: Hu Jianwen , Ma Yongchen , Ma Ju , Yang Yanpeng , Ning Yingze , Zhu Jing , Wang Pengyuan , Chen Guowei , Liu Yuncun 
Published: August 2020

Abstract
Background: A good prediction model is useful to accurately predict patient prognosis. Tumor–node–metastasis (TNM) staging often cannot accurately predict prognosis when used alone. Some researchers have shown infiltration of M2 macrophages in many tumors, which indicates poor prognosis. This approach has the potential to predict prognosis more accurately when used in combination with TNM staging. The present study aimed to develop and validate a nomogram to predict survival in patients with gastric cancer by combining TNM staging and the degree of M2 macrophage infiltration.Methods: Patients undergoing curative resection for gastric cancer between 2008 and 2013 at our hospital were enrolled and assigned into either the training set or the validation set. M2 macrophage markers were evaluated by immunohistochemical staining. A stepwise method was applied to screen variables associated with patient survival time, and a nomogram was constructed to predict patient survival. Concordance index, calibration curve, and decision curve analysis were used to evaluate the discrimination, calibration, and clinical benefit of the model.Results: A multivariate analysis demonstrated that CD163 expression, TNM staging, age, and gender were independent risk factors for overall survival. Thus, these parameters were assessed to develop the nomogram. In the training, validation, and overall datasets, the concordance index was >0.6. The model showed a high degree of discrimination in all three datasets. The five-year survival calibration curves were a very good fit with standard curves in all three datasets, and the model demonstrated good clinical benefit. The prognostic abilities had threshold probabilities of 10%–38% for one-year survival, 10%–75% for three-year survival, and 35%–80% for five-year survival.Conclusions: We combined CD163 expression in macrophages, TNM staging, age, and gender to develop a nomogram to predict five-year overall survival after curative resection for gastric cancer. This model has the potential to provide further diagnostic and prognostic value for patients with gastric cancer.
Characteristics of Tumor Immune Gene and Immune Cell Infiltration during Keloid Formation
Authors: Liu Hao , Shan Mengjie , Wang Youbin , Song Kexin , Liu Shu , Hao Yan 
Published: August 2020

Abstract
Background: Keloids are benign fibroproliferative skin tumors that can cause disfigurement and disability. Although current research has sought to examine keloids from the perspectives of genetics, inflammation, immunity, and tumorigenesis, their pathological mechanisms remain unclear. Methods: In this study, we used three datasets of tumor immune gene expression profiling from the normal skin tissue of keloid patients (N group), inflammation tissue of keloid patients (I group), and keloid tissue of keloid patients (K group) to describe the occurrence and characteristics of keloid development. Tumor immune-related genes were analyzed, and the differentially expressed genes (DEGs) between the three groups were compared. Gene Ontology (GO) categories and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were carried out to determine the main functions of the differentially expressed genes and keloid-related pathways. Results: We identified several genes that may play an important role in keloid development. These genes are CCR1, SELL, CCR7, CD40LG, CD69, CXCL8, ITGAM, ITGAX, CD86, and CXCL9. GO analysis revealed that there were variations in biological processes (BP) between I group and N group, including regulation of lymphocyte activation and T-cell activation. Similar variations were also found between I group and K group, which may play an important role in keloid initiation and formation. Variations in molecular function (MF) were markedly enriched in cytokine receptor binding and receptor ligand activity. Analysis of the KEGG pathway between I group and N group revealed that DEGs were primarily enriched in cytokine−cytokine receptor interaction and viral protein interaction with cytokine and cytokine receptor. We identified a higher proportion of M2 macrophages in N group than in I group, although the difference was not obvious. M1 macrophage production differed significantly between I group and K group. The proportions of CD8+T cells varied significantly between N group and K group. We traced multiple tumor immune-related hub genes from keloid formation and analyzed immune cell subsets in keloid development. Possible molecular mechanisms were described in this study using bioinformatics. Conclusions: These results provide another possibility to elucidate keloid pathogenesis and therapeutic targets in terms of tumor immune gene expression.
Improved Abdomen Hypodermic Embedding for Salvage of the Amputated Fingertip from Tip to Lunula (Tamai Zone Ⅰ)
Authors: Lu Yiming , Wang Bin , Liu Hongjun , Zhang Naichen , Gu Jiaxiang 
Published: August 2020

Abstract
Background To explore the clinical efficacy of a new surgical approach called improved abdomen hypodermic embedding for salvage of the amputated fingertip from tip to lunula (Tamai zone Ⅰ). Methods From September 2015 to June 2017, we treated 18 fingertips from 15 patients with abdomen hypodermic embedding while all the fingertips were completely amputated and failed to vascular anastomose. After 3 weeks, all the fingertips were taken out from abdomen. After 6 months, outcomes were evaluated with DASH score and static two-point finger discrimination. Results 16 fingertips survived completely, 2 fingertips developed partial loss and scar healed by dressing change. All patients were satisfied with the appearance of the fingertips while one woman was not satisfied for ischemic atrophy. The DASH score ranged from 35-46 (average 38), static two-point discrimination was 6--14mm (average 8mm). Conclusions When vascular anastomosis is not feasible in fingertip replantation, improved abdomen hypodermic embedding is a simple and feasible operation for the amputated fingertip from tip to lunula.
Efficacy of dulaglutide to improve Vascular Health indexes in subjects with Type 2 Diabetes: A Randomized Trial
Authors: Tuttolomondo Antonino , Cirrincione Anna , Casuccio Alessandra , Cuore Alessandro Del , Daidone Mario , Chiara Tiziana Di , Maida Carlo , Simonetta Irene , Scaglione Stefania , Pinto Antonio 
Published: August 2020

Abstract
Background: Recent cardiovascular outcome trials have shown significant reductions of major cardiovascular (CV) events with glucagon-like peptide (GLP)-1 receptor agonists. Adjunctive surrogates for cardiovascular risk more recently validated by some studies (23,24) are arterial stiffness and endothelial function indexes. No randomized trials have yet addressed the possible effects of antidiabetic interventional drugs such as GLP1 agonists on endothelial and arterial stiffness indexes as surrogate markers of vascular damageAims: A randomized trial to once-weekly dulaglutide (1.5 mg) added to traditional antidiabetic treatment compared to traditional treatment alone to evaluate some metabolic efficacy endpoints and surrogate vascular efficacy endpoints such as endothelial function and arterial stiffness indexes.Methods: Men and women (aged ≥50 years) with established or newly detected type 2 diabetes whose HbA1c was 9.5% or less on stable doses of up to two oral glucose­lowering drugs with or without basal insulin therapy were eligible. Subcutaneous dulaglutide was initiated at the full dose (1.5 mg/day weekly). Arterial stiffness indexes (pulse wave velocity and augmentation index) and endothelial function index (reactive hyperemia index) were evaluated at baseline and at a three-month and nine-month examination visit. At each visit (at 3 and 9 month follow-up) were also evaluated glycemic variables such as fasting plasma glucose (FPG), HbA1c and lipid variables such as total cholesterol, LDL cholesterol, HDL cholesterol and triglyceride. Results: at a three month follow up subjects treated with dulaglutide in comparison with subjects treated with conventional therapy showed significantly lower serum levels of FBG and significantly lower percentage of HBa1c. At a 9 month follow up subjects treated with dulaglutide in comparison with control subjects treated with conventional therapy showed a significant lowering of diastolic blood pressure, BMI, mean total serum cholesterol, LDL cholesterol, FPGa significantly lower percentage of HBa1C and PWV and higher mean RHI values.Discussion: These findings are consistent with previous studies indicating the strict relationship between cardiovascular risk factors such as systolic blood pressure, total serum cholesterol and LDL levels and cardiovascular events and vascular health surrogate markers.
High rate of increased level of plasma Angiotensin II and its gender difference in COVID-19: an analysis of 55 hospitalized patients with COVID-19 in a single hospital, WuHan, China
Authors: Liu Na , Hong Yan , Chen Ren-Gui , Zhu Heng-Mei 
Published: August 2020

Abstract
Background: 2019 Novel coronavirus disease (COVID-19) is turning into a pandemic globally lately. There were few reports illustrated the expression of Angiotensin II (AngII) in COVID-19. This study aimed to demonstrate the expression of AngII in COVID-19 and how it correlated to the disease.Methods and Results: We enrolled 55 patients with COVID-19 admitted to Renmin Hospital of Wuhan University from January 21st to February 21st, 2020. Demographic data were collected upon admission. COVID-19 nuclear acid, plasma AngII, Renin and aldosterone in the lying position without sodium restriction, and other laboratory indicators were together measured by the laboratory department of our hospital. Of the 55 patients with COVID-19, 34(61.8%) had an increased level of AngII. The severity of COVID-19 and male is positively related with the level of AngII. The level of blood lymphocyte, PCT, ALT, and AST were remarkably severe with those of normal level of AngII (P < 0.05). CD4/CD8 cells ratio was significantly higher than those of normal level of AngII (P < 0.05). The results of binary logistic regression analysis showed that the severity of COVID-19 (OR=4.123) and CD4/CD8 ratio(OR=4.050) were the co-directional impact factor while female(OR=0.146) was inverse impact factor of elevated AngII level.Conclusion: High rate of increased level of AngII and its gender differences were detected in COVID-19 patients. Elevated AngII level were correlated with the severity of COVID-19 and CD4/CD8 ratio.
The Effect of Education on Clinical Practice Guidelines with Shared Decision Making: A Randomized Controlled trial
Authors: Fujimoto Shuhei , Ogawa Tatsuya , Komukai Kanako , Nakayama Takeo 
Published: August 2020

Abstract
Background: To investigate the influence of the evidence-practice gap on physiotherapists and occupational therapists through shared decision making (SDM) education using clinical practice guidelines (CPGs).Methods: The study design was a multicenter, blocked, randomized control trial. Participants included 126 therapists with 42 continuous samplings from the three institutions. Inclusion criteria were being a permanent employee from the institutions. Exclusion criteria were participants with disorders that may cause intervention (visual, auditory, attentional disorder). An allocator assigned masked the participation’s attribution until the allocation was completed. The evaluator and analyzer were masked. For the intervention group, workshop on SDM using the CPGs were conducted. The control group was lecture on the knowledge of CPGs (CPG group) and lecture on the knowledge of SDM (SDM group). The primary outcomes were education, attitudes and beliefs, and interest and perceived role in evidence-based practice (EPIC scale). The secondary outcome was the Evidence based practice (EBP) knowledge. To review the intervention effect of the education on SDM using CPGs, two-factor variance analysis (mixed model) was adopted to conduct Holm’s method in comparison to a post-hoc test.Results: Participants randomized and analysed in each group were 42. The EPIC scale showed significant difference between CPGs with SDM group and the CPG group (CPG with SDM group (mean ± standard deviation, pre/post）：2.4±0.9/4.4±1.7; CPG group：3.0±1.5/3.5±2.0; SDM group ：2.6±1.2/ 3.3±1.8）. The question item on EBP “I learned the foundations for EBP as part of my academic preparation” had significant differences between CPGs with SDM group and CPGs group（CPG with SDM group：1.8±0.8/2.2±1.0; CPG group：2.3±1.1/ 2.0±1.0）.Conclusions: EBP education on the SDM using CPGs increased confidence in using EBP for physiotherapists and occupational therapists.