bluuebunny/crossref_metadata_2025_split huggingface dataset:
Massive hemothorax due to bleeding from thoracic spinal fractures: a case series and systematic review
Authors: Ninomiya Kohei , Kuriyama Akira , Uchino Hayaki 
Published: September 2020

Abstract
Background
Massive hemothorax secondary to thoracic spinal fractures is rare, and its clinical characteristics, treatment, and prognosis are unknown. We present two cases of thoracic spinal fracture-induced massive hemothorax and a systematic review of previously reported cases.

Methods
This study included patients with traumatic hemothorax from thoracic spinal fractures at a Japanese tertiary care hospital. A systematic review of published cases was undertaken through searches in PubMed, EMBASE, and ICHUSHI from inception to October 13, 2019.

Results
Case 1: An 81-year-old man developed hemodynamic instability from a right hemothorax with multiple rib fractures following a pedestrian–vehicle accident; > 1500 mL blood was evacuated through the intercostal drain. Thoracotomy showed hemorrhage from a T8-burst fracture, and gauze packing was used for hemostasis. Case 2: A 64-year-old man with right hemothorax and hypotension after a fall from height had hemorrhage from a T7-burst fracture, detected on thoracotomy, which was sealed with bone wax. Hypotension recurred during transfer; re-thoracotomy showed bleeding from a T7 fracture, which was packed with bone wax and gauze for hemostasis. The systematic review identified 10 similar cases and analyzed 12 cases, including the abovementioned cases. Inferior part of thoracic spines was prone to injury and induced right-sided hemothorax. Most patients developed hemodynamic instability, and some sustained intra-transfer hemorrhage; direct compression (gauze packing, bone wax, and hemostatic agents) was the commonest hemostatic procedure. The mortality rate was 33.3%.

Conclusions
Hemothorax due to thoracic spinal fracture can be fatal. Thoracotomy with direct compression is necessary in hemodynamically unstable patients.
Real-time AI prediction for major adverse cardiac events in emergency department patients with chest pain
Authors: Zhang Pei-I , Hsu Chien-Chin , Kao Yuan , Chen Chia-Jung , Kuo Ya-Wei , Hsu Shu-Lien , Liu Tzu-Lan , Lin Hung-Jung , Wang Jhi-Joung , Liu Chung-Feng , Huang Chien-Cheng 
Published: September 2020

AbstractBackgroundA big-data-driven and artificial intelligence (AI) with machine learning (ML) approach has never been integrated with the hospital information system (HIS) for predicting major adverse cardiac events (MACE) in patients with chest pain in the emergency department (ED). Therefore, we conducted the present study to clarify it.MethodsIn total, 85,254 ED patients with chest pain in three hospitals between 2009 and 2018 were identified. We randomized the patients into a 70%/30% split for ML model training and testing. We used 14 clinical variables from their electronic health records to construct a random forest model with the synthetic minority oversampling technique preprocessing algorithm to predict acute myocardial infarction (AMI) < 1 month and all-cause mortality < 1 month. Comparisons of the predictive accuracies among random forest, logistic regression, support-vector clustering (SVC), and K-nearest neighbor (KNN) models were also performed.ResultsPredicting MACE using the random forest model produced areas under the curves (AUC) of 0.915 for AMI < 1 month and 0.999 for all-cause mortality < 1 month. The random forest model had better predictive accuracy than logistic regression, SVC, and KNN. We further integrated the AI prediction model with the HIS to assist physicians with decision-making in real time. Validation of the AI prediction model by new patients showed AUCs of 0.907 for AMI < 1 month and 0.888 for all-cause mortality < 1 month.ConclusionsAn AI real-time prediction model is a promising method for assisting physicians in predicting MACE in ED patients with chest pain. Further studies to evaluate the impact on clinical practice are warranted.
It is unprecedented: trial management during the COVID-19 pandemic and beyond
Authors: Mitchell Eleanor J. , Ahmed Khaled , Breeman Suzanne , Cotton Seonaidh , Constable Lynda , Ferry Gillian , Goodman Kirsteen , Hickey Helen , Meakin Garry , Mironov Katy , Quann Niamh , Wakefield Natalie , McDonald Alison 
Published: September 2020

AbstractThe COVID-19 pandemic has presented unique challenges for the clinical trial community, both in the rapid establishment of COVID-19 clinical trials and many existing non-COVID-19 studies either being temporarily paused (whether that is a complete pause or pause in some activities) and/or adapting their processes. Trial managers have played a key role in decision-making, undertaking risk assessments and adapting trial processes, working closely with other members of the research team. This article presents some of the ways in which trial management processes have been altered and the key role that trial managers have played. It has been born out of discussions between trial managers in the UK who are members of the UK Trial Managers’ Network (UKTMN), a national network of trial management professionals managing non-commercial trials.In these unprecedented times, clinical trials have faced many uncertainties and broad-ranging challenges encompassing a range of activities including prioritising patient safety amidst the pandemic, consenting and recruiting new participants into trials, data collection and management and intervention delivery. In many cases, recruitment has been paused whilst mitigations have been put in place to continue data collection. Innovative solutions have been implemented to ensure we continue, where possible, to deliver high-quality clinical trials. Technology has provided many solutions to these challenges, and trial managers have adapted to new ways of working whilst continuing to deliver their clinical trials. Trial management groups are now faced with new uncertainties around re-starting clinical trials, and it is unclear currently how this will go, though working together with sponsors, funders and site teams is clearly a priority.Clinical trial teams have worked together to ensure their trials have adapted quickly whilst ensuring participant safety is given utmost importance. There are clear examples where the trial community have come together to share experiences and expertise, and this should continue in the future to ensure the innovative practices developed become embedded in the design and conduct of clinical trials in the future.
Epigenetic stratification of head and neck cancer survivors reveals differences in lycopene levels, alcohol consumption, and methylation of immune regulatory genes
Authors: Moody Laura , Crowder Sylvia L. , Fruge Andrew D. , Locher Julie L. , Demark-Wahnefried Wendy , Rogers Laura Q. , Delk-Licata Ashley , Carroll William R. , Spencer Sharon A. , Black Molly , Erdman John W. , Chen Hong , Pan Yuan-Xiang , Arthur Anna E. 
Published: September 2020

AbstractBackgroundInflammation has been associated with higher rates of recurrence and mortality in head and neck cancer (HNC). While the biological mechanisms predisposing patients to heightened inflammatory states remain largely unknown, DNA methylation has been proposed to reflect systemic inflammation. In this analysis, we attempt to identify meaningful epigenetic patterns in HNC survivors by stratifying individuals based on DNA methylation profiles in leukocytes.ResultsWe used hierarchical clustering to uncover three distinct methylation patterns among HNC survivors. Each group displayed a unique methylation signature in inflammatory pathways including cytokine and B-cell receptor signaling. Additionally, we examined physiological, clinical, and lifestyle parameters related to inflammation, such as circulating carotenoid and cytokine levels, cancer treatment type, and alcohol consumption. Specifically, we identified one group of survivors who had significant differential methylation of transcriptional and translational regulators as well as genes in the T-cell receptor signaling pathway, including hypermethylation of CD40 ligand (CD40LG) and Tec protein tyrosine kinase (TEC) and hypomethylation ofCD8A. This group also displayed high circulating lycopene levels. We identified another group that had distinctive methylation in the toll-like receptor (TLR) signaling pathway, including hypomethylation ofTLR5, a component of the inhibitor of nuclear factor-kappa B kinase complex (CHUK), and two mitogen-activated protein kinases (MAP3K8andMAP2K3). This group also had hypermethylation of mitochondrial ribosomal genes along with higher rates of alcohol consumption.ConclusionThe correlation between lycopene, alcohol consumption, DNA methylation, and inflammation warrants further investigation and may have implications in future recommendations and interventions to impact health outcomes in HNC survivors.
Surgical management of subhepatic perforated appendicitis: a case report
Authors: Hakim Mumin , Mostafa Rania , Al Shehri Mohammed , Sharawy Sherif 
Published: September 2020

Abstract
Background
Subhepatic appendicitis is an exceedingly rare presentation, accounting for 0.01% of acute appendicitis cases. It is of prime importance to be aware of variants and manage such challenging cases accordingly.

Case presentation
We present a case of a middle-aged Saudi woman with subhepatic perforated appendicitis and peritonitis who underwent an exploratory laparotomy and appendectomy.

Conclusions
The initial diagnosis and surgical management of such patients is challenging due to an atypical presentation. The surgical management of such patients is discussed with a brief review of the literature.
Tabersonine ameliorates osteoblast apoptosis in rats with dexamethasone-induced osteoporosis by regulating the Nrf2/ROS/Bax signalling pathway
Authors: Sun Xi , Gan Lijun , Li Nan , Sun Shuyi , Li Na 
Published: September 2020

AbstractWe explored how tabersonine (Tab) protected against dexamethasone (Dex)-induced osteoporosis. Osteoblasts were treated with Dex (100 µM) with or without Table (5 or 10 µM). We measured cell viability, alkaline phosphatase (ALP) activity, and mitochondrial
superoxide and reactive oxygen species levels. We used flow cytometry to explore the effects of Tab on mitochondrial membrane potential and osteoblast apoptosis. We used RT-PCR and western blotting to examine the effect of Tab on protein expression. We evaluated the effects of Tab on bone histopathology and bone mineral density in rats with Dex-induced osteoporosis. Tab increased cell viability and ALP activity, and reduced the mitochondrial superoxide, reactive oxygen species and matrix metalloproteinase levels and osteoblast apoptosis. Tab significantly reduced the levels of nuclear factor erythroid 2-related factor 2 (Nrf2), haem oxygenase-1 and NAD(P)H quinone dehydrogenase 1. Moreover, it increased the levels of mRNAs encoding runt-related transcription factor 2, bone morphogenetic protein-2 and osterix. These data suggest that Tab ameliorates Dex-induced osteoporosis by regulating the Nrf2 signalling pathway.
Rap1b but not Rap1a in the forebrain is required for learned fear
Authors: Chen Wen-Bing , Pan Han-Qing , He Ye , Wang Xue-Hui , Zhang Wen-Hua , Pan Bing-Xing 
Published: September 2020

Abstract
Background
Fear is an adaptive response across species in the face of threatening cues. It can be either innate or learned through postnatal experience. We have previously shown that genetic deletion of both Rap1a and Rap1b, two isoforms of small GTPase Rap1 in forebrain, causes impairment in auditory fear conditioning. However, the specific roles of these two isoforms are not yet known.

Results
In the present study, employing mice with forebrain-restricted deletion of Rap1a or Rap1b, we found that they are both dispensable for normal acquisition of fear learning. However, Rap1b but not Rap1a knockout (KO) mice displayed impairment in the retrieval of learned fear. Subsequently, we found that the expression of c-Fos, a marker of neuronal activity, is specifically decreased in prelimbic cortex (PL) of Rap1b KO mice after auditory fear conditioning, while remained unaltered in the amygdala and infralimbic cortex (IL). On the other hand, neither Rap1a nor Rap1b knockout altered the innate fear of mice in response to their predator odor, 2,5-Dihydro-2,4,5-Trimethylthiazoline (TMT).

Conclusion
Thus, our results indicate that it is Rap1b but not Rap1a involved in the retrieval process of fear learning, and the learned but not innate fear requires Rap1 signaling in forebrain.
A collaborative healthcare framework for shared healthcare plan with ambient intelligence
Authors: Javed Abdul Rehman , Sarwar Muhammad Usman , Beg Mirza Omer , Asim Muhammad , Baker Thar , Tawfik Hissam 
Published: September 2020

AbstractThe fast propagation of the Internet of Things (IoT) devices has driven to the development of collaborative healthcare frameworks to support the next generation healthcare industry for quality medical healthcare. This paper presents a generalized collaborative framework namedcollaborative shared healthcare plan (CSHCP)for cognitive health and fitness assessment of people using ambient intelligent application and machine learning techniques.CSHCPprovides support for daily physical activity recognition, monitoring, assessment and generate a shared healthcare plan based on collaboration among different stakeholders: doctors, patient guardians, as well as close community circles. The proposed framework shows promising outcomes compared to the existing studies. Furthermore, the proposed framework enhances team communication, coordination, long-term plan management of healthcare information to provide a more efficient and reliable shared healthcare plans to people.
Redox signaling and Alzheimer’s disease: from pathomechanism insights to biomarker discovery and therapy strategy
Authors: Chen Yuan-Yuan , Wang Min-Chang , Wang Yan-Ni , Hu He-He , Liu Qing-Quan , Liu Hai-Jing , Zhao Ying-Yong 
Published: September 2020

Abstract
Aging and average life expectancy have been increasing at a rapid rate, while there is an exponential risk to suffer from brain-related frailties and neurodegenerative diseases as the population ages. Alzheimer’s disease (AD) is the most common neurodegenerative disease worldwide with a projected expectation to blossom into the major challenge in elders and the cases are forecasted to increase about 3-fold in the next 40 years. Considering the etiological factors of AD are too complex to be completely understood, there is almost no effective cure to date, suggesting deeper pathomechanism insights are urgently needed. Metabolites are able to reflect the dynamic processes that are in progress or have happened, and metabolomic may therefore provide a more cost-effective and productive route to disease intervention, especially in the arena for pathomechanism exploration and new biomarker identification. In this review, we primarily focused on how redox signaling was involved in AD-related pathologies and the association between redox signaling and altered metabolic pathways. Moreover, we also expatiated the main redox signaling-associated mechanisms and their cross-talk that may be amenable to mechanism-based therapies. Five natural products with promising efficacy on AD inhibition and the benefit of AD intervention on its complications were highlighted as well.

Graphical Abstract
The distribution of soil morphological characteristics for landslide-impacted Sumbing Volcano, Central Java - Indonesia
Authors: Noviyanto Amir , Sartohadi Junun , Purwanto Benito Heru 
Published: September 2020

AbstractLandslides are the second biggest natural disasters in Indonesia, occurring mostly in volcanic area with thick and clay rich soils. Examining the changes of land surface and soil morphology brought about by a particular landslide is usually the first step required for vegetative rehabilitation. Most examinations to date, however, have been based on general characters rather than on soil morphology, including physical and chemical characteristics of the soil, which are usually locally specific. This study investigates the morphological characteristics of soil in a landslide-prone slope region of Sumbing Volcano, in Central Java Province of Indonesia. The field investigations are conducted at three landslides sites. It starts with interpreting small format areal-photographs which have been geo-corrected, followed by the delineation of landslide zones (i.e. crowns, main scarps, heads, bodies and toes) based on morphological analysis of the landslide sites. Finally, identification of morphological, physical and chemical characteristics of the soil in each of the landslide zones are conducted in the field, along with laboratory tests. The results demonstrate that soil morphology is unique for each of the landslide zones. The characters of the undisturbed soil, as indicated by well-defined genetic horizons, are found in the crown zones. Outcrop of high clay content soil material layers are seen in the main scarp zones. Meanwhile pedoturbation processes are evident in the zone of bodies and toes, suggesting that the soil is prone for erosion. If natural erosions in these zones are not controlled and/or unmitigated, the situation will trigger landslide reactivations. We suggest that in studying landslide, one also considers the characters of soil morphology, as this additional information provides a more complete understanding of both land surface morphology and soil morphology to inform landslide vegetative rehabilitation.
Uptake of the child care expense deduction: exploring factors associated with the use of the child care expense deduction among families with a child under 12 years
Authors: Heidinger Loanna , Findlay Leanne C. , Guèvremont Anne 
Published: September 2020

AbstractThe Canadian government implemented the child care expense deduction in 1972, a policy initiative intended to offset the financial cost of child care for eligible families. Although the deduction has now been in place for almost 50 years, and almost half of all families with a child aged 0–14 years use child care (Sinha, 2014), little research has examined the factors associated with claiming the child care expense deduction. The current study examined the uptake and usage of the child care expense deduction among families with at least one child under the age of 12 in 2011. Furthermore, the family demographic and work characteristics of families who have at least one child under the age of 12 in the household were explored in terms of the characteristics associated with a higher likelihood of claiming the child care expense deduction.
A safe, stable, and convenient three-dimensional device for high Le Fort I osteotomy
Authors: Sugahara Keisuke , Koyachi Masahide , Odaka Kento , Matsunaga Satoru , Katakura Akira 
Published: September 2020

Abstract
Background
Le Fort I osteotomy is a highly effective treatment for skeletal jaw deformities and is commonly performed. High Le Fort I osteotomy is a modified surgical procedure performed for improving the depression of the cheeks by setting the osteotomy higher than the conventional Le Fort I osteotomy. Developments in three-dimensional (3D) technology have popularized the use of 3D printers in various institutions, especially in orthognathic surgeries. In this study, we report a safe and inexpensive method of performing a high Le Fort I osteotomy using a novel 3D device and piezosurgery, which prevent tooth root injury without disturbing the operation field for patients with a short midface and long tooth roots.

Results
A 17-year-old woman presented with facial asymmetry, mandibular protrusion, a short midface, and long tooth roots. We planned high Le Fort I osteotomy and bilateral sagittal split ramus osteotomy. Prevention of damage to the roots of the teeth and the infraorbital nerve and accurate determination of the posterior osteotomy line were crucial for clinical success. Le Fort I osteotomy using 3D devices has been reported previously but were particularly large in size for this case. Additionally, setting the fixing screw of the device was difficult, because of the risk of damage to the roots of the teeth. Therefore, a different surgical technique, other than the conventional Le Fort I osteotomy and 3D device, was required. The left and right parts of the 3D device were fabricated separately, to prevent any interference in the surgical field. Further, the 3D device was designed to accurately cover the bone surface from the piriform aperture to the infra-zygomatic crest with two fixation points (the anterior nasal spine and the piriform aperture), which ensured stabilization of the 3D device. The device is thin and does not interfere with the surgical field. Safe and accurate surgical performance is possible using this device and piezosurgery. The roots of the teeth and the infraorbital nerve were unharmed during the surgery.

Conclusions
This device is considerably smaller than conventional devices and is a simple, low-cost, and efficient method for performing accurate high Le Fort I osteotomy.
Minnesota wild hemp: a crucial botanical source in early cannabinoid discovery
Authors: Filer Crist N. 
Published: September 2020

AbstractRenewed and sustained Cannabis chemistry exploration was initiated by Roger Adams at the University of Illinois Chemistry Department with cooperation from the Treasury Department Narcotics Laboratory in the early 1940’s. This partnership and time investment by both parties made practical sense. Adams was able to explore natural products chemistry and the Narcotics Laboratory began to clarify the chemistry mysteries of Cannabis. Minnesota wild hemp, often viewed as just a roadside weed, was employed as the critical botanical source. Based on its widespread cultivation during World War II, this was also a very pragmatic decision. Although the unique Illinois – Washington D. C. collaboration lasted only a few short years (1939–1942), the stunning results included the isolation and extensive characterization of cannabidiol, the structure elucidation and total synthesis of cannabinol as well as the identification of the tetrahydrocannabinol structure as an intoxicating pharmacophore. Furthermore, this research well prepared many junior chemists for prolific careers in both academia as well as industry, inspired the discoveries of later Cannabis investigators and also provided a successful model of a productive academic-government partnership.