bluuebunny/crossref_metadata_2025_split huggingface dataset:
Established fibrous peritoneal metastasis in an immunocompetent mouse model similar to clinical immune microenvironment of gastric cancer&nbsp;
Authors: Fujimori Daisuke , Kinoshita Jun , Yamaguchi Takahisa , Nakamura Yusuke , Gunjigake Katsuya , Ohama Takashi , Sato Koichi , Yamamoto Masami , Tsukamoto Tetsuya , Nomura Sachiyo , Ohta Tetsuo , Fushida Sachio 
Published: October 2020

Abstract
Background Peritoneal metastasis (PM) in gastric cancer (GC) is characterized by diffusely infiltrating and proliferating cancer cells accompanied by extensive stromal fibrosis in the peritoneal space. The prognosis of GC with PM is still poor regardless of the various current treatments. In order to elucidate the cause of difficulties in PM treatment, we compared the tumor immune microenvironment (TME) in primary and PM lesions in GC. In addition, a PM model with fibrous stroma was constructed using immunocompetent mice to determine whether its TME was similar to that in patients. MethodsImmuno-histochemical analyses of infiltrating immune cells were performed in paired primary and PM lesions from 28 patients with GC. A C57BL/6J mouse model with PM was established using the mouse GC cell line YTN16 either with or without co-inoculation of mouse myofibroblast cell line LmcMF with a-SMA expression. The resected PM from each mouse model was analyzed the immunocompetent cells using immunohistochemistry.ResultsThe number of CD8+ cells was significantly lower in PM lesions than in primary lesions (P<0.01). Conversely, the number of CD163+ cells (M2 macrophages) was significantly higher in PM lesions than in primary lesions (P=0.016). Azan staining revealed that YTN16 and LmcMF co-inoculated tumors were more fibrous than tumor with YTN16 alone (P<0.05). Co-inoculated fibrous tumor also showed an invasive growth pattern and higher progression than tumor with YTN16 alone (P=0.045). Additionally, YTN16 and LmcMF co-inoculated tumors showed lower infiltration of CD8+ cells and higher infiltration of M2 macrophages than tumors with YTN16 alone (P<0.05, P<0.05). These results indicate that LmcMF plays as cancer-associated fibroblasts (CAFs) by crosstalk with YTN16 and CAFs contribute tumor progression, invasion, fibrosis, and immune suppression.ConclusionsThis model is the first immunocompetent mouse model similar to TME of human clinical PM with fibrosis. By using this model, new treatment strategies for PM, such as anti-CAFs therapies, may be developed.
Three-Dimensional (3D) Magnetic Resonance Volume Assessment and Loco-regional Failure in Anal Cancer: early evaluation case-control study
Authors: Sekhar Hema , Kochhar Rohit , Carrington Bernadette , Kaye Thomas , Tolan Damian , Saunders Mark , Sperrin Matthew , Sebag-Montefiore David , Herk Marcel van , Renehan Andrew 
Published: October 2020

Abstract
Background: The primary aim was to test the hypothesis that deriving pre-treatment 3D magnetic resonance tumour volume (mrTV) quantification improves performance characteristics for the prediction of loco-regional failure compared with standard maximal tumour diameter (1D) assessment in patients with squamous cell carcinoma of the anus undergoing chemoradiotherapy.Methods: We performed an early evaluation case-control study at two UK centres (2007-2014) in 39 patients with loco-regional failure (cases), and 41 patients disease-free at 3 years (controls). mrTV was determined using the summation of areas method (Volsum). Reproducibility was assessed using intraclass concordance correlation (ICC) and Bland-Altman limits of agreements. We derived receiver operating curves using logistic regression models and expressed accuracy as area under the curve (ROCAUC).Results: The median time per patient for Volsum quantification was 7.00 (inter-quartile range, IQR: 0.57-12.48) minutes. Intra and inter-observer reproducibilities were generally good (ICCs from 0.79 to 0.89) but with wide limits of agreement (intra-observer: -28% to 31%; inter-observer: -28% to 46%). Median mrTVs were greater for cases (32.6 IQR: 21.5-53.1 cm3) than controls (9.9 IQR: 5.7-18.1 cm3, p <0.0001). The ROCAUC for mrT-size predicting loco-regional failure was 0.74 (95% CI: 0.63-0.85) improving to 0.82 (95% CI: 0.72-0.92) when replaced with mrTV (test for ROC differences, p = 0.024).Conclusion: Preliminary results suggest that the replacement of mrTV for mrT-size improves prediction of loco-regional failure after chemoradiotherapy for squamous cell carcinoma of the anus. However, mrTV calculation is time consuming and variation in its reproducibility are drawbacks with the current technology.
The Relationship between Clinical Placement Duration and Students’ Satisfaction with the Quality of Supervision and Learning Environment: A Mediation Analysis.
Authors: González-García Alberto , Strandell-Laine Camilla , Díez-Fernández Ana , Leino-Kilpi Helena , Martínez-Vizcaíno Vicente , Saarikoski Mirko 
Published: October 2020

Abstract
Background: Multiple factors that influence the learning experience of nursing students while they are in clinical training have been identified. Nevertheless, there is no evidence on what is the optimum time a nursing student should remain in the different practice settings for achieving the required competencies nor how this duration of the placement may be influenced by other variables.The aim of the study was examine whether the relationship between the clinical placement duration and total satisfaction with clinical training is mediated by supervisory relationship and learning environment.Method: A mediation analysis was conducted using the data from a cross-sectional study conducted in 17 higher educational institutions from nine European countries with the CLES+T scale (n=1903 pre-registration nursing students). Besides, ANCOVA models were used to assess mean differences in total satisfaction by categories of supervision factors, clinical placement duration and participants’ characteristics.Results: A significant increase of total satisfaction was found as better learning environment participant’s perceived, as well as better was their satisfaction with their supervisor (both p<0.001). Students that considered the supervisor the most important person in practical training were significantly more satisfied as compared with those who considered the nurse teacher as the most important [mean 4.15 (0.89) vs 3.23 (1.16)]; p=0.001]. The satisfaction with the supervisor (IE= 0.101 [95% CI 0.016; 0.183]) and a good learning environment (IE= 0.088 [95% CI 0.003; 0.170]) mediated the relationship between clinical placement duration and total satisfaction perceived by the students.Conclusion: Nursing students with longer clinical placement duration were more satisfied with clinical training as a result of both their satisfaction with their supervisor and the good learning environment perceived. The optimal duration a nursing student should remain in the different practice settings to reach a balance between the achievement of fully competent nurses and the maximum level of satisfaction at the practicum ward should be around seven weeks. The role of nurse teachers and supervisors in contributing the acquisition of competences of nursing students needs to be clarified.
Incidence and predictors of diabetic ketoacidosis among children with diabetes in West and East Gojjam zone referral hospitals Northern Ethiopia, 2019
Authors: assefa birtukan , Zeleke Haymanot , Murugan Rajalakshmi , Wondwossen Kalkidan 
Published: October 2020

Abstract
Background: Recurrent diabetic ketoacidosis in patients with known diabetes mellitus remains a relevant problem in pediatrics with an incidence of 1–10% per patient. Children may die because of cerebral edema and had a significant mortality (24%) and morbidity (35%). Objective: We assessed the incidence and predictors of diabetic ketoacidosis among diabetes children at East and West Gojjam zone referral hospitals, North West Ethiopia, 2019. Methods: An institution-based retrospective follow up study was conducted on children who were registered from January 1, 2014, to January 1, 2019. Epi data version 3.1 & Stata 14 were used for data entering and analysis respectively. Result: Out of 354 children included in the study, 207 (58.5%) developed diabetic ketoacidosis. The overall incidence rate of diabetic ketoacidosis was 2.27/100 children/month of observation. Age <5 years (AHR: 3.52, 95% CI (2.25, 5.49), non-adherence (AHR: 1.54, 95% CI (1.11, 2.14), inappropriate insulin storage (AHR: 1.36, 95% CI (1.008, 1.85), presence of upper respiratory tract infections during diabetic ketoacidosis diagnose (AHR: 2.22, 95% CI (1.11, 4.45) and preceding gastroenteritis (AHR: 2.18, 95% CI (1.07, 4.44) were significant predictors. Conclusion: Age < 5 years old, non-adherence, inappropriate insulin placement at home, preceding gastroenteritis, and presence of upper respiratory tract infections at the time of diabetic ketoacidosis development were significant predictors. Hence, assessing and close monitoring as well as strengthened diabetic education should be given for the above predictors.
Use of the sagittal cobb* angle to guide the rod bending in the treatment of thoracolumbar fractures: a retrospective clinical study
Authors: Shi Zongpo , Wang Gang , Jin Zhen , Wu Tao , Wang Haoran , Sun Jinpeng , Nicolas Yap San Min , Rupesh KC , Yang Kaixiang , Liu Jun 
Published: October 2020

Abstract
Background: Pedicle screw fixation is a well-established technique for thoracolumbar fracture. A large number of studies have shown that the bending angle of the connecting rod has a significant correlation with the postoperative spinal stability. However, no studies have confirmed an objective indicator to guide the bending angle of the connecting rod during the operation. Our study aims to define a sagittal Cobb* angle to guide the bending angle of the connecting rod during surgery.Methods: The frontal and lateral X-ray films in 150 cases of normal thoracolumbar spine were included to measure the normal spinal sagittal Cobb* angle in each segment. The patients who underwent single segment thoracolumbar fractures and pedicle screw internal fixation surgery were included. The radiological parameters included lumbar lordosis (LL), thoracic kyphosis (TK), pelvic tilt (PT), pelvic incidence (PI), sagittal vertical axis (SVA) and sacral slope (SS) were measured. The incidence of adjacent segment degeneration（ASD）two years after surgery were measured.Results: The average values of normal sagittal Cobb* angle in each segment were -5.196±3.318 degrees (T12), 2.279±3.324 degrees (L1), 7.222±2.798 degrees (L2) and 12.417±11.962 degrees (L3) respectively. The LL in the three groups was 35.20±9.12 degrees，46.26±9.68 degrees and 54.24±15.31 degrees, respectively. Comparing with the normal group, there were significant differences in group A and group C respectively (P< 0.05). The results were similar in the parameters of TL, PT and SS. The incidences of SVA>50mm in group A, group B and group C were 23.33%,12.50% and 19.23%, respectively. The parameter of PI in three groups were 41.36±12.69, 44.53±15.27 and 43.38±9.85 degrees，respectively. The incidences of ASD in group A, group B and group C 2 years after surgery were 21.67%，13.75% and 17.95%, respectively.Conclusions: The study confirmed that the sagittal Cobb* angle can be used as a reference angle for bending rods. When the bending angle of the connecting rod is 4 to 8 degrees greater than the corresponding segment sagittal Cobb* angle, the patient's spinal sagittal stability is the best two years after the operation.
BMI, waist to height ratio and waist circumference as a screening tool for hypertension in hospital out patients: a cross-sectional study
Authors: Shrestha Rajan , Khatri Bijay , Upadhyay Madan P. , Bhattarai Janak R. , Kayastha Manish , Upadhyay Sanjib K. 
Published: October 2020

Abstract
BackgroundObesity has become a global epidemic and an important risk factor for non-communicable diseases. Earlier thought to be a problem of developed world, it has now become a problem of low- and middle-income countries like Nepal. In absence of a routine surveillance or a registry system, the actual burden and trend of obesity in Nepal is unknown. Obesity and overweight are recognized risk factors for hypertension and associated with cardiovascular disease. The aim of the study was to find out burden of obesity, using three commonly employed metrics in hospital outpatient setting of a low-income country as predictors of hypertension, and compare ability of different anthropometric measurements through a non-inferiority study to predict hypertension.MethodsThis cross-sectional study was conducted among 40-69 years outpatients in a tertiary Eye and ENT hospital in a semi-urban area of Nepal among randomly selected 2,256 participants from 6,769 outpatients who were evaluated in Health Promotion and risk factor screening service. We did correlation analysis to determine the relationship between anthropometric measurement and blood pressure. The area under the Receiver Operating characteristic curve of Body Mass Index (BMI), Waist to Height Ratio (WHtR) and Waist Circumference (WC) was calculated and compared. ResultsThe prevalence of obesity and overweight by BMI was 16.09% and 42.20% respectively; by Waist-to-Height-Ratio was 32.76% which is two times higher than obesity measured by BMI. High waist circumference was observed among 66.76% participants. Female participants had greater prevalence of high WC (77.46%) than male (53.73%) (p<0.001). Prevalence of hypertension and pre-hypertension was 40.67% and 36.77% respectively. The areas under the curve were significantly higher than 0.5 for BMI (0.593), WHtR (0.602) and WC (0.610).ConclusionWaist circumference correlated well with obesity and hypertension. It also had higher predicting ability than WHtR and BMI to predict hypertension. Waist circumference thus proved to be non-inferior to two other commonly used metrics. It proved superior in detecting obesity in female. This simple and inexpensive tape measurement may play an important role in future diagnosis of obesity and prediction of HTN in resource constrained settings of developing countries.
All-solid-state Ion Synaptic Transistor for Wafer-scale Integration with Electrolyte of a Nanoscale Thickness
Authors: Yu Ji-Man , Lee Chungryeol , Kim Da-Jin , Park Hongkeun , Han Joon-Kyu , Hur Jae , Kim Jin-Ki , Kim Myung-Su , Seo Myungsoo , Im Sung Gap , Choi Yang-Kyu 
Published: October 2020

Abstract
Neuromorphic hardware computing is a promising alternative to von Neumann computing by virtue of its parallel computation, and low power consumption. To implement neuromorphic hardware based on deep neural network (DNN), a number of synaptic devices should be interconnected with neuron devices. For ideal hardware DNN, not only scalability and low power consumption, but also a linear and symmetric conductance change with the large number of conductance levels are required. Here an all-solid-state polymer electrolyte-gated synaptic transistor (pEGST) was fabricated on an entire silicon wafer with CMOS microfabrication and initiated chemical vapor deposition (iCVD) process. The pEGST showed good linearity as well as symmetry in potentiation and depression, conductance levels up to 8,192, and low switching energy smaller than 20 fJ/pulse. Selected 128 levels from 8,192 used to identify handwritten digits in the MNIST database with the aid of a multilayer perceptron, resulting in a recognition rate of 91.7 %.
Lusutrombopag is Effective and Safe in Patients with Chronic Liver Disease and Severe Thrombocytopenia: A Multicenter Retrospective Study
Authors: Nomoto Hiroaki , Morimoto Naoki , Miura Kouichi , Watanabe Shunji , Takaoka Yoshinari , Maeda Hiroshi , Sasaki Takahiro , Koyashiki Yohei , Kurata Hidekazu , Numao Norikatsu , Isoda Norio , Yamamoto Hironori 
Published: October 2020

Abstract
Background: Chronic liver disease (CLD) is often complicated by severe thrombocytopenia (platelet count <50,000/µL). Platelet transfusion has been a gold standard for increasing the platelet count to prevent hemorrhagic events in such patients. Lusutrombopag, a thrombopoietin receptor agonist, can increase the platelet count in such patients when invasive procedures are scheduled. However, we have little information on the effect of lusutrombopag in CLD patients with severe thrombocytopenia in real-world settings.Methods: To investigate the efficacy and safety of lusutrombopag in patients with chronic liver disease and severe thrombocytopenia, we retrospectively investigated 26 CLD patients with a platelet count of <50,000/µL. Lusutrombopag, 3 mg once daily, was administered 8-15 days before scheduled invasive procedures.Results: Among 26 patients who received lusutrombopag, 19 patients (73.1%) patients showed a platelet count of ≥50,000/µL (Group A) and did not require platelet transfusion. The remaining 7 patients (26.9%) did not reached platelet ≥50,000/µL (Group B). The means of platelet increase were 36,000/µL and 13,000/µL in groups A and B, respectively. A low platelet count at baseline was a characteristic of patients in group B. Among 13 patients who repeatedly used lusutrombopag, lusutrombopag significantly increased the platelet count as the initial treatment. No adverse events were noted during or after lusutrombopag treatment. In addition, the degree of platelet increase with lusutrombopag was larger than that in their previous platelet transfusion.Conclusions: Lusutrombopag is effective and safe for CLD patients with a platelet count of <50,000/µL.
Role of Critical Size on Adult life History Traits in Drosophila Melanogaster.
Authors: Sharma Khushboo , Shakarad Mallikarjun N. 
Published: October 2020

Abstract
BackgroundSilver-spoon hypothesis suggests that fitness of individuals is high under good adult conditions provided their development itself has been in good conditions and those who have grown in resource-poor conditions are at a permanent disadvantage. Using two types of Drosophila melanogaster populations grown under two conditions we tested the validity of silver-spoon hypothesis. Three populations were selected for faster pre-adult development as a result of which they had access to food for a shorter duration while the three control populations had access to food for longer duration as growing larvae. In the second set-up the access to food was curtailed immediately on attainment of critical size. We assessed biomolecule levels, copulation latency, copulation duration, life-time realized oviposition and longevity to validate the silver-spoon hypothesis. ResultsRestricted feeding duration as a consequence of selection for faster per-adult development had no fitness consequences in selected populations. However, starvation during post-critical duration resulted in reduced fitness. ConclusionOur results show that the silver-spoon model is applicable only under extreme nutrition curtailment and not applicable to biological systems that have genetically evolved to limit food intake.
Improving the Quality of Nursing Documentation at A Residential Care Home: A Clinical Audit
Authors: Moldskred Preben Søvik , Snibsøer Anne Kristin , Espehaug Birgitte 
Published: October 2020

Abstract
Background: Quality in nursing documentation holds promise to increase patient safety and quality of care. While high-quality nursing documentation implies a comprehensive documentation of the nursing process, nursing records do not always adhere to these documentation criteria. The aim of this quality improvement project was to assess the quality of electronic nursing records in a residential care home using a standardized audit tool and, if necessary, implement a tailored strategy to improve documentation practice.Methods: A criteria-based clinical audit was performed in a residential care home in Norway. Quantitative criteria in the N-Catch II audit instrument was used to give an assessment of electronic nursing records on the following: nursing assessment on admission, nursing diagnoses, aims for nursing care, nursing interventions, and evaluation/progress reports. Each criterium was scored on a 0 - 3 point scale, with standard (complete documentation) coinciding with the highest score. A retrospective audit was conducted on 38 patient records from January to March 2018, followed by the development and execution of an implementation strategy tailored to local barriers. A re-audit was performed on 38 patient records from March to June 2019. Results: None of the investigated patient records at audit fulfilled standards for recommended nursing documentation practice. Mean scores at audit varied from 0.4 (95% confidence interval 0.3 - 0.6) for “aims for nursing care” to 1.1 (0.9 - 1.3) for “nursing diagnoses”. After implementation of a tailored multifaceted intervention strategy, an improvement (p < 0.001) was noted for all criteria except for “evaluation/progress reports” (p = 0.6). The improvement did not lead to standards being met at re-audit, where mean scores varied from 0.9 (0.8 - 1.1) for “evaluation/progress reports” to 1.9 (1.5 - 2.2) for “nursing assessment on admission”.Conclusions: A criteria-based clinical audit with multifaceted tailored interventions that addresses determinants of practice may improve the quality of nursing documentation, but further cycles of the clinical audit process are needed before standards are met and focus can be shifted to sustainment of knowledge use.
Pituitary Adenomas Associated with Intracranial Aneurysms – The Clinical Characteristics, Therapeutic Strategies, and Possible Effects of Vascular Remodeling Factors
Authors: Ogawa Yoshikazu , Watanabe Mika , Tominaga Teiji 
Published: October 2020

Abstract
Objective: Pituitary adenoma coexists with intracranial aneurysms in 2.3% to 3.6%, and intracranial aneurysms is thought to be incidental. On the other hand higher age and cavernous sinus invasion are reported to increase the coexistence rate, so these two diseases may be related. Ten males and 14 females with coexistence of pituitary adenomas and intracranial aneurysms were retrospectively investigated among 923 patients (2.6%). Patients were subdivided into two groups with/without direct attachment of cerebral aneurysms to the pituitary adenomas. The clinical characteristics, therapeutic strategies, and possible effects of vascular remodeling factors were investigated.Results: Twelve patients had functioning pituitary adenomas, and cavernous sinus invasion was identified in 7 of 24 patients. Five of these 7 patients were treated with priority for the cerebral aneurysms until 2007, whereas 14 of 17 patients without involvement of the aneurysm tip in the tumor were treated with priority for pituitary adenomas in the later period. Among vascular remodeling factors strong expression of vascular endothelial growth factor (VEGF) was significantly associated with coexistence of pituitary adenoma and cerebral aneurysm (p < 0.05). So VEGF-induced arterial wall remodeling may be part of the mechanism of association between pituitary adenomas and cerebral aneurysms, suggesting possible causative mechanism.