bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of the effectiveness and safety of intravenous and topical regimens of tranexamic acid in complex tibial plateau fracture: a retrospective study
Authors: Wang Zhimeng , Lu Yao , Wang Qian , Song Leilei , Ma Teng , Ren Cheng , Li Zhong , Yang Jiarui , Zhang Kun , Zhang Bing 
Published: November 2020

Abstract
Background Previous studies have demonstrated the effectiveness and safety of tranexamic acid (TXA) in orthopedic surgery. However, no study has investigated TXA in complex tibial plateau fracture surgery. Therefore, the purpose of this study was to confirm the safety and effectiveness of i.v. (intravenous) TXA and topical TXA.Material and methods This was a retrospective analysis of prospectively collected data. The control group received an equal amount of placebo (physiological saline solution); the i.v. group received 1.0 g TXA by intravenous injection before the tourniquet was inflated and before the surgical incision was closed, and the topical group received 3.0 g TXA in 75 mL of physiological saline solution 5 minutes prior to the final tourniquet release. Perioperative blood loss, vascular events, wound complications, and adverse reactions were compared among the three groups. The pain, knee function, and quality of life (QoL) assessments were based on their corresponding scoring systems.Results Baseline data were comparable for all groups. The i.v. group showed the best results for total blood loss (TBL) and hidden blood loss (HBL) (424.5 ± 49.4 mL and 219.3 ± 33.4 mL, respectively, all P values < 0.001). Patients in the i.v. group had lesser real Hb decrease than those in the control group (0.9 vs 1.5, P＜0.001) and topical group (0.9 vs 1.2, P = 0.026). The blood coagulation level as measured using fibrinolysis (D-dimer) was lower in the i.v. group than in the control and topical groups on POD1 and POD3; however, this difference was not significant; the fibrin-degradation products also showed a similar trend. Patients in the topical group experienced less pain than those in the control group on POD2, POD4, and PO6W. The VAS pain score was 3.6 vs. 4.4 (POD2, P＜0.05), 2.8 vs 3.3 (POD4, P＜0.05), and 2.1 vs. 2.6 (PO6W, P＜0.001) in the topical group vs control group, respectively. No significant differences were identified in vascular events, wound complications, adverse reactions, knee function, and QoL among the three groups.Conclusion To our knowledge, this is the first study that showed both i.v. TXA and topical TXA are safe and effective for complex tibial plateau fractures. The i.v. regimen effectively reduced blood loss during the perioperative period, whereas patients under the topical regimen had less vascular events, wound complications, and a lower incidence of adverse reactions compared to those in the i.v. group.
Assessment of sodium thiosulfate neutralizing effect on micro-hardness of dentin treated with sodium hypochlorite
Authors: Sahebi Safoora , Sobhnamayan Fereshteh , Moazami Fariborz , Naseri Mohammadhasan 
Published: November 2020

Abstract
Background: This study aims to evaluate the ability of sodium thiosulfate (STS) to neutralize the adverse effect of sodium hypochlorite (NaOCl) on dentin micro-hardness.Methods: Fifty single-rooted teeth were longitudinally sectioned. The samples divided into a control and four sample groups (n = 20). All the samples were immersed in different solutions as follows, Control: Normal saline for 15 min, G1and G2: 2.5% NaOCl for 15 min, G3: 2.5% NaOCl for 15 min, followed by 5% STS for 10 min, G4: Normal saline for 15 min followed by 5% STS for 10 min. All groups except G1 incubated for one week before the test. The micro-hardness of samples was measured. Data were analyzed using the Kruskal-Wallis test for pairwise comparisons. A p-value < 0.05 was considered significant.Results: All groups showed a significant decrease in the micro-hardness value compared with the control group. NaOCl for one week (G2) reduced the micro-hardness of dentine compared with samples, tested immediately after immersion in NaOCl (G1) (p < 0.05). NaOCl alone (G2) or treated with STS (G3) resulted in a significant decrease in micro-hardness compared with the STS group (G4) (p < 0.05). Conclusions: STS as a neutralizing agent could not prevent the dentin micro-hardness downturn caused by NaOCl.
Impact of nonsteroidal anti-inflammatory drug administration for 12 months on renal function
Authors: Hayashi Kazuhiro , Miki Kenji , Kajiyama Hiroshi , Ikemoto Tatsunori , Yukioka Masao 
Published: November 2020

Abstract
Background: The use of nonsteroidal anti-inflammatory drugs (NSAIDs) is associated with an increased risk of renal complications. Resolution of renal side effects following NSAID administration has been observed following short-term use. Thus, the aim of the present study was to investigate a series of patients with chronic musculoskeletal pain who underwent long-term NSAIDs administration followed by switching to TA combination tablets to study the impact of NSAID-induced renal side effects.Methods: This was a longitudinal retrospective study of 99 patients with chronic musculoskeletal pain. The patients were administrated NSAIDs daily during the first 12 months followed by daily TA combination tablets for 12 months. Estimated glomerular filtration rate (eGFR) and serum levels of aspartate aminotransferase and alanine transaminase were measured at baseline, after NSAIDs administration, and after TA administration.Results: eGFR was significantly reduced following 12-month NSAIDs administration (median, from 84.0 mL/min/1.73 m2 to 72.8 mL/min/1.73 m2), and the reduction was not shown following the subsequent 12-month TA administration (median, 71.5 mL/min/1.73 m2). Reduction in eGFR was less in patients who received celecoxib (median, -1.8 mL/min/1.73 m2) during the first 12 months. There was no significant difference in aspartate aminotransferase and alanine transaminase in each period.Conclusions: Thus, patients receiving NSAIDs for 12 months displayed both reversible and irreversible reduction of eGFR upon cessation of NSAIDs and switching to TA. Our data highlights the potential safety benefit of utilizing multimodal analgesic therapies to minimize the chronic administration of NSAIDs.
Impact of corticosteroids and immunosuppressive therapies on symptomatic SARS-CoV-2 infection in a large cohort of patients with chronic inflammatory arthritis
Authors: Favalli Ennio Giulio , Bugatti Serena , Klersy Catherine , Biggioggero Martina , Rossi Silvia , De Lucia Orazio , Bobbio-Pallavicini Francesca , Murgo Antonella , Balduzzi Silvia , Caporali Roberto , Montecucco Carlomaurizio 
Published: November 2020

Abstract
Background: Prevalence and outcomes of Coronavirus Disease (COVID)-19 in relation to immunomodulatory medications are still unknown. The aim of the study is to investigate the impact of glucocorticoids and immunosuppressive agents on COVID-19 in a large cohort of patients with chronic immune-mediated inflammatory arthritis.Methods: The study was conducted in the arthritis outpatient clinic at two large Academic Hospitals in the COVID-19 most endemic area of Northern Italy (Lombardy). We circulated a cross-sectional survey exploring the prevalence of Severe Acute Respiratory Syndrome-Coronavirus-2 nasopharyngeal swab positivity and the occurrence of acute respiratory illness (fever and/or cough and/or dyspnea), administered face-to-face or by phone to consecutive patients from 25th February to 20th April 2020. COVID-19 cases were defined as confirmed or highly suspicious according to the World Health Organization criteria. The impact of medications on COVID-19 development was evaluated. Results: The study population included 2050 adults with chronic inflammatory arthritis receiving glucocorticoids, conventional-synthetic (cs), or targeted-synthetic/biological (ts/b) disease-modifying drugs (DMARDs). Laboratory-confirmed COVID-19 and highly suspicious infection were recorded in 1.1% and 1.4% of the population, respectively. Treatment with glucocorticoids was independently associated with increased risk of COVID-19 (adjusted OR [95% CI] ranging from 1.23 [1.04-1.44] to 3.20 [1.97-5.18] depending on the definition used). Conversely, patients treated with ts/bDMARDs were at reduced risk (adjusted OR ranging from 0.46 [0.18-1.21] to 0.47 [0.46-0.48]). No independent effects of csDMARDs, age, sex, and comorbidities were observed.Conclusions: During the COVID-19 outbreak, treatment with immunomodulatory medications appears safe. Conversely, glucocorticoids, even at low-dose, may confer increased risk of infection.Trial registration: retrospectively registered
CDX2 and Reg IV expression and correlation in gastric cancer
Authors: Chai Dandan , Du Huifen , Li Kesheng , Zhang Xueliang , Li Xiaoqin , Zhao Xiaoning , Lian Xiaowen , Xu Yang 
Published: November 2020

Abstract
Background: Ectopic expression of CDX2 is associated with the development and progression of gastric cancer. Previous studies showed that CDX2 may be an upstream regulator of Reg IV expression in gastric cancer, and our previous report showed that Reg IV upregulated SOX9 expression and enhanced cell migration and invasion in gastric cancer cells. However, the regulatory roles of CDX2 have not been clarified in gastric cancer, and the correlation between CDX2 and Reg IV requires further study.Methods: CDX2 and Reg IV were examined in gastric cancer specimens and paired adjacent tissues via real-time PCR and immunohistochemistry (IHC). The association between CDX2 and Reg IV was assessed using the χ2-test and Spearman’s rank correlation. To verify their relationship, knockdown and exogenous expression of CDX2 or Reg IV were performed in AGS and MKN-45 gastric cancer cells, and their expression was subsequently analyzed via a real-time PCR and western blotting. Wound-healing and Transwell assays were used to examine migration and invasion in AGS and MKN-45 cells following CDX2 silencing or overexpression.Results: A positive correlation was observed between CDX2 and Reg IV expression at the mRNA and protein levels in gastric cancer tissues. CDX2 silencing significantly downregulated Reg IV expression, and CDX2 overexpression significantly upregulated Reg IV expression in AGS and MKN-45 cells. Neither Reg IV silencing nor overexpression had any effect on CDX2 protein expression in AGS or MKN-45 cells, even though both affected the expression of CDX2 mRNA. Functionally, CDX2 silencing significantly inhibited cell migration and invasion, and CDX2 overexpression significantly promoted cell migration and invasion in AGS and MKN-45 cells.Conclusions: Our findings demonstrate that CDX2 expression was positively correlated with that of Reg IV in gastric cancer, and CDX2 promoted cell migration and invasion through upregulation of Reg IV expression in AGS and MKN-45 cells.
Effectiveness of introducing a 20-gauge core biopsy needle with a core trap in EUS-FNA/B for diagnosing pancreatic cancer
Authors: Watanabe Shunsuke , Miyoshi Jun , Toki Masao , Kambayashi Komei , Kitada Shuichi , Nosaka Takeshi , Goto Tomoyuki , Ota Hirotaka , Ochiai Kazushige , Gondo Koichi , Ikeuchi Nobuhito , Tsuji Shujiro , Nakamura Kenji , Shibahara Junji , Hisamatsu Tadakazu 
Published: November 2020

Abstract
Background: Endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/B) is a standard method for pathological diagnosis of pancreatic solid lesions. The EchoTip ProCore 20G® (PC20), a 20-gauge biopsy needle with a forward-bevel core trap, has been available in Japan since 2015.Methods: We compared the efficacy of the PC20 with that of the EchoTip ProCore 22G® (PC22) and Acquire 22G® (AC22) in EUS-FNA/B for diagnosing pancreatic cancer. This retrospective study included 191 patients with pancreatic cancer who underwent EUS-FNA/B using the PC20, PC22, or AC22 at our facility from April 2013 to October 2019. We investigated the patients’ clinical characteristics and the diagnostic accuracy and safety of each needle.Results: A sufficient stroke length of puncture was secured in all patients. The maximum length under EUS was shorter with the AC22 (22.1±2.2 mm) than PC20 (30.6±0.7 mm, p<0.01) and PC22 (30.3±0.8 mm, p<0.01). The histological accuracy was 96.4% with the PC20 but only 58.8% with the PC22 (adjusted p (p-adj)<0.0001) and 75.0% with the AC22 (p-adj=0.06). The diagnostic accuracy of the combination of histology and cytology was 96.4% with the PC20, while it was 72.1% with the PC22 (p-adj<0.0001) and 91.7% with the AC22 (p-adj>0.99). One patient (0.9%) in the PC20 group developed mild pancreatitis, but no adverse events occurred with the other needles. Conclusions: The PC20 showed better diagnostic capability than the PC22. The diagnostic efficacy was similar between the PC20 and AC22. The high histological accuracy of the PC20 could be advantageous for lesions in which histological assessment is critical.
Unplanned hospitalizations in patients with locoregionally advanced head and neck cancer treated with (chemo)radiotherapy with and without prophylactic percutaneous endoscopic gastrostomy
Authors: Bojaxhiu Beat , Shrestha Binaya K. , Luterbacher Pascal , Elicin Olgun , Shelan Mohamed , Macpherson Andrew J. S. , Heimgartner Benjamin , Giger Roland , Aebersold Daniel M. , Zaugg Kathrin 
Published: November 2020

Abstract
Background: Current studies about percutaneous endoscopic gastrostomy (PEG) tube placement report equivalent patient outcomes with prophylactic PEG tubes (pPEGs) versus common nutritional support. Unreported was if omitting a pPEG is associated with an increased risk of complications leading to a treatment-related unplanned hospitalization (TRUH). Methods: TRUHs were retrospectively analyzed in patients with advanced head and neck squamous cell carcinoma (n=310) undergoing (chemo)radiotherapy with (pPEG) or without PEG (nPEG). Results: In 88 patients (28%), TRUH was reported. One of the leading causes of TRUH in nPEG patients was inadequate oral intake (n = 16, 13%), and in pPEG patients, complications after PEG tube insertion (n=12, 10%). Risk factors for TRUH were poor performance status, tobacco use, and surgical procedures. Conclusions: Omitting pPEG tube placement without increasing the risk of an unplanned hospitalization (UH) due to dysphagia, dehydration or malnutrition, is an option in patients being carefully monitored . Patients aged >60 years with hypopharyngeal carcinoma, tobacco consumption, and poor performance status appear at risk of PEG tube-related complications leading to an unplanned hospitalization.
Radiographic and Clinical Evidence: Osteoarthritic Knee Can Change Surgical Result for Lumbar Degenerative Disease Patient Undergone Surgery for 3-year Follow-up: A Retrospective Comparative Clinical Study
Authors: Kim Yong-Chan , Kim Ki-Tack , Ha Kee-Yong , Ahn Joonghyun , Ko Seungnam , Luo Qiang , Kim Sung-Min , Kim Mingyu , Yoo Sunin 
Published: November 2020

Abstract
AbstractBackground: There is a paucity of reports clarifying the implication of knee osteoarthritis (OA) on spinal sagittal alignment of patients undergone surgery for lumbar spine. This study aimed to analyze how osteoarthritic knee affects radiographic and clinical results of degenerative lumbar disease patients undergone lumbar fusion.Methods: We retrospectively reviewed the medical records and radiographs of 74 consecutive degenerative lumbar disease patients who underwent posterior instrumentation and fusion surgery between May 2016 and June 2017 and were followed up for minimum 3 years postoperatively. The patients were divided into 2 groups according to the severity of knee OA by Kellgren-Lawrence grading (KLG) scale (group I, KLG 1 or 2 [n=39]; group II, KLG 3 or 4 [n=35]). Patient demographic data, comorbidities, spinal sagittal parameters and clinical scores were extracted and compared at preoperative, postoperative 1 month and the ultimate follow-up between the groups. In radiographic assessment, sagittal alignment parameters and sagittal balance were used. In clinical assessment, the scores of Oswestry disability index (ODI) and Scoliosis Research Society questionnaire (SRS-22) were used. For the frequency analysis of categorical variables across the groups, chi-square test was used and student t tests was used to compare the differences of continuous variables.Results: In radiographic assessment, TLK (thoracolumbar kyphosis), LL (lumbar lordosis), PT (pelvic tilt), C7 SVA (sagittal vertical axis) in both groups improved significantly after surgery (p<0.05). However, LL, PT, C7SVA improved at postoperative 1 month in the group II were not maintained at the ultimate postoperative follow-up. In clinical assessment, preoperative Oswestry disability index (ODI, %) and all SRS-22 subscores of the group I and II were not different (p>0.05). There were significant differences between the groups at the ultimate follow-up in ODI (-25.6 vs -12.1, p<0.001), SRS total score (%) (28 vs 20, p=0.037), function subscore (1.4 vs 0.7, p=0.016), and satisfaction subscore (1.6 vs 0.6, p<0.001).Conclusion: Osteoarthritic knee with KLG 3 or 4 have a negative influence on maintaining postoperative spinal sagittal alignment, balance, and the clinical outcomes achieved immediately by posterior instrumentation and fusion for lumbar degenerative disease.Trial registration: This study was retrospectively registered with approval by the institutional review board(IRB) of our institution(approval number: 2018-11-007).
Multidimensional item response theory to assess psychometric properties of GHQ-12 in parents of school children
Authors: Haem Elham , Doostfatemeh Marziyeh 
Published: November 2020

Abstract
Background: Multidimensional item response theory (MIRT) model provides an ideal foundation to assess psychological properties of a questionnaire designed with multidimensional structure. This study aimed to present the first use of MIRT models to investigate psychometric properties of general health questionnaire (GHQ-12) in parents of school children. Methods: A total of 1104 parents of school children completed the Persian version of GHQ-12 questionnaire. Unidimensional IRT model and MIRT models with two and three factors were applied to model the observed scores for each GHQ-12 item as a function of the subject’s latent traits while taking the correlation between dimensions of the questionnaire into account. The goodness of fit indices were reported for the three models, and items fit were assessed for the best model. Individual items were described in detail through item characteristic curves, and the amount of information carried by different items was presented using information curves. Results: The MIRT analysis with two factors corresponding to psychological distress and social dysfunction provided the best account of the GHQ-12 data. The model showed that all items were fitted adequately. Items varied in their discrimination ranged from 0.86 to 2.35 and 1.18 to 2.41 for psychological distress and social dysfunction, respectively. Moreover, items 8 and 2 provided the least information in psychological distress and social dysfunction dimensions, respectively. Conclusions: The developed framework to evaluate psychometric properties of GHQ-12 can be a suitable alternative to traditional approaches and also unidimensional IRT models, the use of which has been restricted due to multidimensional structure of the questionnaire.
Magnetotelluric study in the Los Lagos Region (Chile) to investigate volcano-tectonic processes in the Southern Andes
Authors: Segovia Maria Jose , Diaz Daniel , Slezak Katarzyna , Zuñiga Felipe 
Published: November 2020

Abstract
In order to analyze the process of subduction of the Nazca and South American plates in the area of the Southern Andes, and its relationship with the tectonic and volcanic regime of the place, magnetotelluric measurements were made through a transversal profile of the Chilean continental margin. The data processing stage included the analysis of dimensional parameters, which as first results showed a three-dimensional environment for periods less than 1s and two-dimensional for periods greater than 10s. In addition, through the geomagnetic transfer function (tipper), the presence of structural electrical anisotropy was identified in the data. After the dimensional analysis, a deep electrical resistivity image was obtained by inverting a 2D and a 3D model. Surface conductive anomalies were obtained beneath the central depression related to the early dehydration of the slab and the serpentinization process of the mantle that coincides in location with a discontinuity in the electrical resistivity of a regional body that we identified as the Nazca plate. A shallow conductive body was located around the Calbuco volcano and was correlated with a magmatic chamber or reservoir which in turn appears to be connected to the Liquiñe Ofqui fault system and the Andean Transverse Fault system. In addition to the serpentinization process, when the oceanic crust reaches a depth of 80 - 100 km, the ascending fluids produced by the dehydration and phase changes of the minerals present in the oceanic plate produce basaltic melts in the wedge of the subcontinental mantle that give rise to an eclogitization process and this explains a large conductivity anomaly present beneath the main mountain range.
Predictive value of HMGB1 for atrial fibrillation recurrence after catheter ablation in paroxysmal atrial fibrillation patients
Authors: Li Xin-xin , Zhao Cui-ting , Li Meng , Yu Hong-xiao , Liu Xi-ping , Zhu Qing , Song Xiao-kun , Wang Yong-huai , Yu Bo , Ma Chun-yan 
Published: November 2020

Abstract
Background: To evaluate the clinical efficacy of serum high-mobility group box-1 (HMGB1) released from the left atrium to predict atrial fibrillation (AF) recurrence in paroxysmal AF (pAF) patients after catheter ablation (CA) at 1-year follow-up.Methods: We included 72 pAF patients who underwent CA. To determine the expression levels of HMGB1, left atrial blood samples were collected from the patients prior to CA and after the procedure through the transseptal sheath placed into the left atrium. Patients were followed-up for AF recurrence after 1 year of CA.Results: A total of 19 (26%) patients of the 72 experienced AF recurrence. No significant differences were noted in the clinical baseline data between the AF recurrence and AF nonrecurrence groups. The level of postoperative HMGB1 (HMGB1post) was higher in the AF recurrence group than in the AF nonrecurrence group (298.51µg/L vs. 278.17 µg/L; P = 0.03). However, no differences were noted in the levels of other biomarkers such as preoperative high-sensitivity C-reactive protein (hs-CRPpre), postoperative hs-CRP (hs-CRPpost), and preoperative HMGB1 (HMGB1pre) between the two groups. Multiple logistic regression analysis revealed that a higher level of serum HMGB1post from the left atrium (HMGB1post: ≥279.35 µg/L) was an independent predictor of AF recurrence (odds ratio [OR]: 5.29 [1.17–23.92], P = 0.04). Receiver operating characteristic (ROC) analysis revealed that HMGB1post had a moderate predictive power for AF recurrence (area under the curve [AUC]: 0.68; sensitivity: 72%; specificity: 68%). The 1-year AF-free survival was significantly lower in patients with a high serum HMGB1post level than in those with a low HMGB1post level (hazard ratio [HR]: 3.81 [1.49–9.75], P = 0.005). Conclusion: In pAF patients who underwent CA, the level of HMGB1 from the left atrium immediately after CA was associated with AF recurrence and demonstrated a moderate predictive power. Thus, we offer a potential predictor to identify pAF patients at high risk of AF recurrence.