bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ossifying Skeletal Muscle Metastases from Colon Cancer: A Case Report and Literature Review
Authors: Guo Yu , Wang Shuang , Xue Wangsheng , Li Jiannan , Zhao Zeyun , Zhang Mingwei , Shang An , Li Donglin , Wang Min 
Published: December 2020

Abstract
Background: Colon cancer is a common malignant disease of the gastrointestinal tract and usually occurs at the junction of the rectum and sigmoid colon. Lymphatic and hematogenous metastases occur frequently in colon cancer and the most common metastatic sites include the regional liver, lung, peritoneum, bone, and lymph nodes. As a manifestation of advanced tumor spread and metastasis, soft tissue metastasis, especially skeletal muscle metastasis ossification caused by colon cancer, is rare, accounting for less than 1% of metastases.Case presentation: In this study, we report a rare case of a 43-year-old male patient who developed an ossifying skeletal muscle metastasis of the right proximal thigh with severe pain at 5 months after colon cancer was diagnosed, who subsequently from the developed metastasis. The patient was admitted to the hospital because of pain caused by a local mass on his right thigh. Positron emission tomography-computed tomography showed multiple lymphadenopathy metastases around the abdominal aorta without lung or liver metastases. Color ultrasound revealed a mass located in the skeletal muscle and the results of histological biopsy revealed a poorly differentiated adenocarcinoma suspected to be distant metastases from colon cancer and immunohistochemistry showed small woven bone components that were considered to be ossified. Conclusion: Although ossifying skeletal muscle metastases is rare, its potential malignancy is high. With advances in examinations and treatment modality, Positron emission tomography-computed tomography, collagen gel droplet culture drug-sensitivity test and genetic tests are recommended to optimize comprehensive and individual treatment modality to prolong patient survival.
Optimisation of Sample Storage and DNA Extraction for Human Gut Microbiome Studies
Authors: Kazantseva Jekaterina , Malv Esther , Kaleda Aleksei , Kallastu Aili , Meikas Anne 
Published: December 2020

Abstract
Background: New developments in next-generation sequencing technologies and massive data received from this approach open wide prospects for personalised medicine and nutrition studies. Metagenomic analysis of the gut microbiota is paramount for the characterization of human health and wellbeing. Despite the intensive research, there is a huge gap and inconsistency between different studies due to the non-standardised and biased pipeline. Methodical and systemic understanding of every stage in the process is necessary to overcome all bottlenecks and grey zones of gut microbiome studies, where all details and interactions between processes are important. Results: Here we show that an inexpensive, but reliable iSeq 100 platform is an excellent tool to perform the metagenomic analysis of the human gut. Two commercial kits and different starting materials performed similarly regarding the taxonomic distribution of identified bacteria. DNA/RNA Shield preservation reagent proved to be a trustworthy solution for stool samples collection and storage, as the storage of faecal material in DNA/RNA Shield for three weeks at different temperatures and thawing cycles had a low impact on the bacterial distribution. Conclusion: Altogether, a thoroughly elaborated pipeline with close attention to details ensures high reproducibility with significant biological but not technical variations.
Bacterial Colonization and Th17 Immunity are Shaped by Intestinal Sialylation in Neonatal Mice
Authors: Irons Eric E , Gomez Eduardo Cortes , Andersen Valerie , Lau Joseph 
Published: December 2020

Abstract
Background: Interactions between the neonate host and its gut microbiome are central to the development of a healthy immune system. However, the mechanisms by which animals alter early colonization of microbiota for their benefit remain unclear. Host-derived carbohydrates, which can serve as metabolic substrates for the expansion of specific commensal and pathogenic bacteria, are one method by which the host may influence interspecies competition in the microbiome. Here, we investigated the role of early-life expression of the α2,6-sialyltransferase ST6GAL1 in microbiome phylogeny and mucosal immunity. Methods: Intestinal sialylation was characterized by RT-qPCR, immunoblot, microscopy, and sialyltransferase enzyme assays in genetic mouse models at rest or with glucocorticoid receptor modulators. The fecal, upper respiratory, and oral microbiomes of pups expressing or lacking St6gal1 were analyzed by 16S rRNA sequencing. Pooled fecal microbiomes from syngeneic donors were transferred to antibiotic-treated wild-type mice, before analysis of recipient mucosal immune responses by flow cytometry, RT-qPCR, microscopy, and ELISA. Results: ST6GAL1 was highly expressed in duodenal enterocytes between birth and weaning, driving temporary sialylation of the associated glycocalyx and secretion of active ST6GAL1 into the intestinal lumen, with subsequent uptake by colonic goblet cells. Expression was mediated by the P1 promoter of the St6gal1 gene, which was efficiently inhibited by intraperitoneal dexamethasone. At weaning, the fecal microbiome of St6gal1-KO pups was unchanged in diversity but exhibited reductions in Clostridium, Coprobacillus, and Adlercreutzia, along with increased Helicobacter and Bilophila. Transfer of St6gal1-KO microbiome induced an AhR-dependent Th17 response, with expression of T-bet and IL-17, and IL-22-dependent gut lengthening. Conclusions: Intestinal sialylation by the sialyltransferase ST6GAL1 in the neonatal period is a developmentally regulated host mechanism coordinating bacterial colonization in the early gut microbiome. The inability to produce α2,6-sialyl ligands results in microbiome-dependent Th17 inflammation, highlighting a pathway by which intestinal epithelium regulates mucosal immunity. Considering the prevalence of intestinal fucosylation in adult animals, sialic acid may promote an early stage of ecological succession in the developing gut. Trial registration: N/A
The Predictive Factor for Favorable Outcome after Surgical Treatment of Benign Prostate Hyperplasia Performed by Young Urologist - Is Surgical Modality Important in Beginner Urologists?
Authors: Kim Ki Hong , Kim Si Hyun , Yang Hee Jo , Kim Doo Sang , Lee Chang Ho , Jeon Youn Soo 
Published: December 2020

Abstract
Background: To identify predictive factors for favorable outcomes after surgical treatments that were performed by beginner urologists in patients with benign prostate hyperplasia (BPH), we retrospectively evaluated outcomes after holmium laser enucleation of the prostate (HoLEP) and transurethral resection of prostate (TURP) that were performed by two young urologists.Methods: Of 80 patients who were treated with HoLEP or TURP, 31 (HoLEP) and 36 (TURP) patients who were followed up for 3 months were enrolled in this study. Preoperative and perioperative variables were evaluated to identify predictive factors for favorable outcome after surgical treatment for BPH.Results: At 3 months postoperative after HoLEP or TURP, the median decrease in IPSS was 13.0. Patients whose IPSS decreased by over 13 points were categorized into a favorable response group after HoLEP or TURP. Univariate and multivariate logistic regression analyses were performed to identify predictors of favorable outcomes at 3 months after HoLEP or TURP, and the preoperative IPSS was identified as an independent predictor for favorable outcomes. Conclusions: When young urologists plan to perform surgical treatment for BPH, they should consider that the severity of symptoms is the most important factor for favorable outcomes. The type of surgical modality for managing BPH is less important. Trial registration : Soonchunhyang university institutional review board approval (No. 2017-07-022)
Association of Gestational Diabetes Mellitus With Adverse Pregnancy Outcomes and Its Interaction With Maternal Age in Chinese Urban Women
Authors: Wang Xueyin , Zhang Xiaosong , Zhou Min , Juan Juan , Wang Xu 
Published: December 2020

Abstract
Background: The prevalence of gestational diabetes mellitus (GDM) has been dramatically increasing worldwide. The aims of this study were to examine associations of GDM with pregnancy outcomes in Chinese urban women, and to evaluate the interaction between GDM and other major risk factors for the risk of adverse pregnancy outcomes. Methods: A retrospective analysis included 8,844 women who delivered live singletons at ≥28 weeks of gestation between June 2012 and March 2013 among Chinese urban women. Structured questionnaires were used to collect the information on demographic characteristics, lifestyle behavior, medical history and pregnancy outcomes. The diagnosis of GDM was made between 24 and 28 gestational weeks according to the International Association of Diabetes and Pregnancy Study Groups criteria. Logistic regression models were used to assess the association of GDM with pregnancy outcomes, and to examine the interaction between GDM and other major risk factors including maternal age, prepregnancy body mass index and gestational weight gain for the risk of pregnancy outcomes. Results: 13.9% of women were diagnosed with GDM. We found that GDM was associated with higher risk of cesarean delivery (Odds Ratio [OR] =1.69, 95% CI [confidence interval]: 1.48-1.92), preterm birth (OR=1.32, 95% CI: 1.07-1.64), macrosomia (OR=1.69, 95% CI: 1.34-2.13) and large-for-gestational age (LGA, OR=1.43, 95% CI: 1.18-1.73) after adjustment for potential confounders. We also observed the interaction between GDM and maternal age for the risk of cesarean delivery (P for interaction = 0.025), and the prevalence of cesarean delivery was higher in women with GDM than those unaffected of GDM regardless of maternal age (age <35 years: 58.5% vs. 44.3%; age ≥35 years: 67.7% vs. 64.3%). Women aged ≥35 years and above and having GDM had a 2.10-fold increased risk of cesarean delivery compared to those who was under 35 years old and did not having GDM (OR=2.10, 95% CI: 1.48-2.93).Conclusions: GDM was associated with increased risk of cesarean delivery, preterm birth, macrosomia and LGA in Chinese urban women, and there was the interaction between GDM and maternal age for the risk of cesarean delivery.
Implementing an education program for nurse-midwives focused on early essential care for breast milk expression among mothers of preterm infants
Authors: Tanaka Rie , Horiuchi Shigeko 
Published: December 2020

Abstract
BackgroundAlthough breastfeeding guidelines for infants admitted to the neonatal intensive care unit (NICU) have been introduced in Japan, these guidelines have not been reflected in practice. To improve this situation, it is important for nurses and nurse-midwives to acquire knowledge of appropriate care. This study examined changes in the knowledge of appropriate care of nurse-midwives after implementing an educational program focused on early essential care for breast milk expression among mothers of preterm infants. MethodsThis before-after study using a single group enrolled 36 nurse-midwives in one perinatal medical center. The educational program content included nurses’ roles in early essential care for milk expression and the necessary care to promoting breast milk production among mothers of preterm infants. The nurse-midwives' knowledge and attitude on care were investigated three months before (pre-1), just before (pre-2), just after (post-1), and three months after (post-2) the program. The nurse-midwives’ care implementation was investigated at pre-1, pre-2, and post-2. During this time, 11 mothers (before: 7, after: 4) reported the status of milk expression for 10 days after birth. ResultsThe mean knowledge scores of the nurse-midwives at post-1 and post-2 were significantly higher than that at pre-2 (post-1: p < 0.001, post-2: p < 0.001). The attitude on care scores at post-1 and post-2 were significantly higher than that at pre-2 (post-1: p < 0.001, post-2: p = 0.010). The care implementation score at post-2 was significantly higher than that at pre-2 in eight items (e.g., Q7 Explain about the effect of initiating milk expression early and assist mothers in it). However, the educational program did not cause any changes in the mothers’ initiation and frequency of milk expression, and breast milk volume after birth. ConclusionsThe significant increases in the knowledge, attitude on care, and care implementation scores of the nurse-midwives suggest the beneficial effects of the educational program. Further detailed examination of the effects of the program on nurses and nurse-midwives, and identification of methods to reduce barriers to the practice of best evidence in the clinical setting are warranted to improve mothers’ status of milk expression.
Task-shifting to Improve Asthma Education for Malawian Children: a Qualitative Analysis
Authors: Nkhalamba Lovemore , Rylance Sarah , Muula Adamson S. , Mortimer Kevin , Limbani Felix 
Published: December 2020

Abstract
Background:Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We conducted a randomised controlled trial of an enhanced asthma care intervention for children in Malawi, which included reallocation of asthma education tasks to lay-educators. In this qualitative sub-study, we explored the experiences of asthmatic children, their families and lay-educators, to assess the acceptability, facilitators and barriers, and perceived value of the task-shifting asthma education intervention.Methods:We conducted 6 focus group discussions, including 15 children and 28 carers, and individual interviews with 4 lay-educators and a senior nurse. Translated transcripts were coded independently by three researchers and key themes identified. Results:Prior to the intervention, participants reported challenges in asthma care including the busy and sometimes hostile clinical environment, lack of access to information and the erratic supply of medication. The education sessions were well received: participants reported greater understanding of asthma and their treatment and confidence to manage symptoms. The lay-educators appreciated pre-intervention training, written guidelines, , and access to clinical support. Low education levels among carers presented challenges, requiring an open, non-critical and individualised approachDiscussion:Asthma education can be successfully delivered by lay-educators with adequate training, supervision and support, with benefits to the patients, their families and the community. Wider implementation could help address human resource shortages and support progress towards Universal Health Coverage.Trial Registration:The RCT was registered in the Pan African Clinical Trials Registry: PACTR201807211617031
A Situational Analysis of the Specialist Anaesthesia Workforce of East, Central and Southern Africa
Authors: Asingei Juventine , O'Flynn Eric , O'Donovan Diarmuid , Masuka Sophia , Mashava Doreen , Akello Faith , Ulisubisya Mpoki 
Published: December 2020

Abstract
Background: An accurate account of the distribution of qualified anaesthesiologists in East, Central and Southern Africa has been lacking with most of the current publications being estimates of headline figures. As university training programmes, and more recently the College of Anaesthesiologists of East, Central and Southern Africa (CANECSA), work to scale up the anaesthesiology workforce, it is crucial to understand the scope of the need by carrying out an extensive survey. This is key to informing policymakers and stakeholders for tackling the problem of human resources for anaesthesia.Methods: The anaesthesiologist distribution in the eight CANECSA member countries was determined using a combination existing databases and collection of new data from sources such as CANECSA records, national medical council registers, national anaesthesiology society records, as well as data validation through direct and indirect contact with the anaesthesiologists. Data collation and analysis was performed using Microsoft Excel Spreadsheets and SPSS by assessing relevant frequencies and crosstabulations. Data was stored in a cloud-based database managed by CANECSA.Results: 411 qualified anaesthesiologists were identified within the CANECSA member countries, a rate of 0.21 anaesthesiologists per 100,000 population compared to 333 (0.17 anaesthesiologists per 100,000 population) reported by the World Federation of Societies of Anaesthesiology (WFSA) in 2015/2016. Newly quantified details on the distribution of anesthesiologists in the region include: the majority (89.5%) of anaesthesiologists perform clinical work and most (69.3%) are based in the main commercial cities of their countries of practice; only about one third (35.5%) are female; the majority are employed by government institutions (61.6%) and medical-training institutions (59.4%); and almost half (49.2%) of anaesthesiologists whose age was recorded ranged from 30 to 39 years. Conclusion: The numbers of anaesthesiologists in CANECSA member countries are still far below all international recommendations constituting only about 5% of the minimum recommended figures for LMICs. Anaesthesiologist are highly concentrated in the major cities of the region, with few in provincial and rural areas. Nonetheless, all trends suggest huge opportunities for advancing training of more anaesthesiologists through collaborative efforts.
Citizen workshops in public libraries to disseminate and discuss primary care research results: a scaling-up study
Authors: Massougbodji José , Zomahoun Hervé Tchala Vignon , Adisso Evehouenou Lionel , Sawadogo Jasmine , Borde Valérie , Cameron Cynthia , Moisan Hélène , Paquette Jean-Sébastien , Akbaraly Zamzam , Châteauneuf Lëa-Kim , David Geneviève , Légaré France 
Published: December 2020

Abstract
Background

Little is known about engaging patients and stakeholders in the process of scaling up effective knowledge translation interventions targeting the general public. Using an integrated knowledge translation approach, we aimed to scale up and evaluate an effective pilot program of disseminating research results in public libraries.
Methods

We conducted a scaling-up study targeting the general public. Based on our successful pilot project, we co-developed and implemented a larger-scale program of free citizen workshops in public libraries, this time in close research partnership with stakeholders and patient representatives. Citizen workshops, each facilitated by one participating physician and one science communicator, consisted of a 45-min computer-assisted presentation and a 45-min open exchange. Additional scale-up costs included offering financial incentives to stakeholders involved and the purchase of audio-visual equipment. The intervention outcome was knowledge gained. Scale-up outcomes were satisfaction, appropriateness, coverage, time and costs. An evaluation questionnaire was used to collect data of interest. Both quantitative and qualitative analyses were performed.
Results

The workshop theme chosen by patient and stakeholder representatives was the high prevalence of medication overuse among people over 65 years of age. From April to May 2019, 26 workshops were given in 25 public libraries reaching 362 people. Eighteen participating physicians and six science communicators facilitated the workshops. Participants reported significant knowledge gain (mean difference 2.1, 95% CI 2.0–2.2, P < .001). Median score for overall public satisfaction was 9/10 (IQR 8–10). A high level of appropriateness of the workshops was globally rated by the public participants Coverage was 92.6% of the total number of public libraries targeted. Costs were $6,051.84 CAD for workshop design and $22,935.41 CAD for scaling them up.
Conclusion

This project successfully established a large-scale and successful KT bridge between researchers, clinicians, and citizens via public libraries. This study provides a model for a dissemination practice that benefits the general public by both engaging them in the dissemination process and by targeting them directly.
Effectiveness of Decontamination protocols when Analyzing Ancient DNA Preserved in Dental Calculus
Authors: Farrer Andrew , Wright Sterling , Skelly Emily , Eisenhofer Raphael , Dobney Keith , Weyrich Laura 
Published: December 2020

Abstract
Ancient DNA analysis of human oral microbial communities within calcified dental plaque (calculus) has revealed key insights into human health, paleodemography, and cultural behaviors. However, contamination imposes a major concern for paleomicrobiological samples due to their low endogenous DNA content and exposure to environmental sources, calling into question some published results. Decontamination protocols (e.g. an ethylenediaminetetraacetic acid (EDTA) pre-digestion or ultraviolet radiation (UV) and bleach immersion treatments) aim to minimize the exogenous content of the outer surface of ancient calculus samples prior to DNA extraction. While these protocols are efficient, no one has systematically compared them. Here, we compare untreated dental calculus samples to four previously published decontamination protocols: a UV only treatment; a 5% sodium hypochlorite (bleach) immersion treatment; a pre-digestion in EDTA treatment; and a combined UV irradiation and 5% bleach immersion treatment. We examine their efficacy in ancient oral microbiota recovery by applying 16S rRNA gene amplicon and shotgun sequencing to ancient calculus samples from a single site. We identify ancient oral microbiota, as well as soil and skin contaminants. Overall, both the EDTA and UVB treatments are effective at reducing the proportion of environmental taxa while increasing oral taxa in relation to untreated samples.
Metformin extended-release versus metformin immediate-release for adults with type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials
Authors: Abrilla Aedrian A. , Pajes A. Nico Nahar I. , Jimeno Cecilia A. 
Published: December 2020

Abstract
This systematic review aimed to compare the efficacy and tolerability of metformin extended-release (MXR) and the conventional metformin immediate-release (MIR) in adults with type 2 diabetes mellitus (T2DM). PubMed, the Cochrane Library and ClinicalTrials.gov, from database inception to 15 October 2020, and other sources were searched for randomized controlled trials (RCTs) that compared equal daily doses of MXR and MIR in adults with T2DM. Random-effects model meta-analysis was performed to obtain pooled mean difference (MD) of change from baseline for continuous outcomes (glycemic and serum lipid control and anthropometrics) and risk ratio (RR) for dichotomous outcomes (gastrointestinal and serious adverse events). Statistical analysis involving 9 published RCTs with 2609 subjects revealed that MIR was associated with better HbA1c lowering (MD 0.09% [95% confidence interval, 0.02%, 0.17%]) and serum lipid control except LDL-C lowering, while MXR reduced only the cumulative incidence of dyspepsia (RR 0.58 [0.34, 0.98]). MXR and MIR were similar in all other considered outcomes. The use of MXR over MIR among adults with T2DM was associated with statistically worse but likely clinically insignificant HbA1c lowering, similar plasma glucose lowering, and minimal improvement of metformin intolerance. This information may guide patient-physician discussions in choosing between the two formulations.