bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intraoperative Driving Pressure and Postoperative Pulmonary Complications After Abdominal Surgery – A Posthoc Propensity Score–Weighted Cohort Analysis of the&nbsp;LAS VEGAS Study Comparing Open to Closed Surgery
Authors: Mazzinari Guido , Neto Ary Serpa , Hemmes Sabrine , Hedenstierna Goran , Jaber Samir , Hiesmayr Michael , Hollmann Markus , Mills Gary , Melo Marcos Vidal , Pearse Rupert , Putensen Christian , Schmid Werner , Severgnini Paolo , Wrigge Hermann , Diaz-Cambronero Oscar , Ball Lorenzo , de Abreu Marcelo Gama , Pelosi Paolo , Schultz Marcus 
Published: November 2020

Abstract
Background: It is uncertain whether associations between driving pressure (ΔP) during and occurrence of pulmonary complications after abdominal surgery depend on the surgical approach. Our primary objective was to test the time–weighted average ΔP (ΔPTW) association with postoperative pulmonary complications and our secondary objective was to test the association between ΔPTW and intraoperative Adverse Events. Methods: We realized a posthoc retrospective propensity score weighted cohort analysis of the ‘Local ASsessment of Ventilatory management during General Anesthesia for Surgery’ (LAS VEGAS) study including patients undergoing abdominal surgery from the study database including data from 146 hospitals across 29 countries. The primary endpoint was a composite of postoperative pulmonary complications. The secondary endpoint was the occurrence of intraoperative adverse events. Results: The analysis included 1,128 and 906 patients undergoing open or closed abdominal surgery repsectively. Absolute postoperative pulmonary complications rate was 5%. While driving pressure was lower in open abdominal surgery patients, time-weighted driving pressure was not different between groups. The association of ΔPTW with occurrence of postoperative pulmonary complications was significant in both groups, with a higher risk ratio in closed than in open abdominal surgery patients (1.11 [95%CI 1.10 to 1.20], P<0.001 vs. 1.05 [95% CI 1.05 to 1.05; P<0.001; risk difference 0.05: [95%CI 0.04 to 0.06], P<0.001). ΔPTW marginal effect estimation showed increased probability of pulmonary complication in both groups with a steeper increase in closed surgery patients at ΔPTW above 20 cmH2O∙hour-1. The association of ΔPTW with occurrence of intraoperative adverse events was also significant in both groups, with higher odds ratio in closed surgery (1.13 [95%CI 1.12 to 1.14]; P<0.001 vs. 1.07 [95%CI 1.05 to 1.10]; P<0.001; difference 0.05 [95%CI 0.03 to 0.07]; p<0.001). Conclusions: Our results show how driving pressure represents a marker for pulmonary complications and adverse events in abdominal surgery regardless of surgical approach.Trial registration: LAS VEGAS was registered at clinicaltrials.gov (trial identifier NCT01601223).
From the Core to the Border of Locally Advanced Rectal Cancer: A Novel MRI-based Clinical-Radiomic Model Early Predicts Treatment Response
Authors: Pizzi Andrea Delli , Chiarelli Antonio , Chiacchiaretta Piero , d'Annibale Martina , Croce Pierpaolo , Rosa Consuelo , Mastrodicasa Domenico , Trebeschi Stefano , Lambregts Doenja , Caposiena Daniele , Serafini Francesco , Basilico Raffaella , Cocco Giulio , Sebastiano Pierluigi Di , Cinalli Sebastiano , Ferretti Antonio , Wise Richard , Genovesi Domenico , Beets-Tan Regina , Caulo Massimo 
Published: November 2020

Abstract
Neoadjuvant chemo-radiotherapy (CRT) followed by total mesorectal excision (TME) represents the standard treatment for patients with locally advanced (³ T3 or N+) rectal cancer (LARC). Approximately 15% of patients with LARC shows a complete response after CRT. The use of pre-treatment MRI as predictive biomarker could help to increase the chance of organ preservation by tailoring the neoadjuvant treatment. We present a novel machine learning model combining pre-treatment MRI-based clinical and radiomic features for the early prediction of treatment response in LARC patients. MRI scans (3.0T, T2-weighted) of 72 patients with LARC were included. Two readers independently segmented each tumor. Radiomic features were extracted from both the “tumor core” (TC) and the “tumor border” (TB). Partial least square (PLS) regression was used as the multivariate, machine learning, algorithm of choice and leave-one-out nested cross-validation was used to optimize hyperparameters of the PLS. The MRI-Based “clinical-radiomic” machine learning model properly predicted the treatment response (AUC=0.793, p =5.6·10-5). Importantly, the prediction improved when combining MRI-based clinical features and radiomic features, the latter extracted from both TC and TB. Prospective validation studies in randomized clinical trials are warranted to better define the role of radiomics in the development of rectal cancer precision medicine.
Performance of Ultrasound in the Clinical Evaluation of Gout and Hyperuricemia
Authors: Cao Ling , Zhao Tianyi , Zhu Xiaoxia , Xie Chunmei , Zheng Shucong , Wan Weiguo , Zou Hejian 
Published: November 2020

Abstract
BackgroundEvaluation of monosodium urate (MSU) crystal deposition and related lesion in joints using ultrasound in gout and hyperuricemia patients. MethodsTotal 202 gout patients and 43 asymptomatic hyperuricemia patients were included, the clinical data and ultrasunic assessment results were collected and statistically analyzed. ResultsDeposition of MSU crystals were found in 25.58% (11/43) of the patients with asymptomatic hyperuricemia and 76.24% (154/202) of the patients with gout. In the all examined 1082 joints from gout patients, 33.09% (358/1082) of them were detected MSU crystals. In MSU crystal positive joints, 77.37% (277/358) of them had history of attacks. Among the joints of gouty arthritis, 56.88% (277/487) of them were found MSU crystals. Double contour sign (DCS), hyperechoic aggregate (HAG) and Tophi were found in 32.65% (159/487), 7.80% (38/487) and 24.64% (120/487) of the joints, respectively. DCS and Tophi, but not HAG, appeared increasingly in gout duration extension. In the patients with more than 15 years of gout history, DCS, Tophi and HAG were found in 48.18%, 40.00%, 6.36% of US assessed joints, respectively. In the gout patients, synovial lesion and bone erosion were found in 17.74% (192/1082) and 7.58% (82/1082) of joints, respectively. Synovial lesion was related with HAG, while bone erosion was related to tophi and DCS. Nephrolithiasis was detected in 20.30% (41/202) of gout patients and 4.65% (2/43) of hyperuricemia patients, indicating nephrolithiasis occurred in more gout patients than in hyperuricemia patients.ConclusionHAG is the early sign of MSU crystal deposition in joints. Early urate lowering therapy (ULT) may reduce HAG and ameliorate synovitis and synovial hypertrophy. DCS and tophi are the risk factors of bone erosion. Early ULT should be considered in the gout patients with DCS or tophi. And nephrolithiasis was remarkably relevant to MSU crystal deposition in joints in gout patients.
The Effects of The General Anesthetic Sevoflurane on Neurotransmission: An Experimental and Computational Study
Authors: Mapelli Jonathan , Gandolfi Daniela , Giuliani Enrico , Casali Stefano , congi luigi , Barbieri Alberto , D'Angelo Egidio , Bigiani Albertino 
Published: November 2020

Abstract
The brain functions can be reversibly modulated by the action of general anesthetics. Despite a wide number of pharmacological studies an extensive analysis of the cellular determinants of anesthesia at the microcircuits level is still missing. Here, by combining patchclamp recordings and mathematical modeling, we examined the impact of sevoflurane, a general anesthetic widely employed in the clinical practice, on neuronal communication. The cerebellar microcircuit was used as a benchmark to analyze the action mechanisms of sevoflurane while a biologically realistic mathematical model was employed to explore at fine grain the molecular targets of anesthetic analyzing its impact on neuronal activity. The sevoflurane altered neurotransmission by strongly increasing GABAergic inhibition while decreasing glutamatergic NMDA activity. These changes caused a notable reduction of spike discharge in cerebellar granule cells (GrCs) following repetitive activation by excitatory mossy fibers (mfs). Unexpectedly, sevoflurane altered GrCs intrinsic excitability promoting action potential generation. Computational modelling revealed that this effect was triggered by an acceleration of persistent sodium current kinetics and by an increase in voltage dependent potassium current conductance. The overall effect was a reduced variability of GrCs responses elicited by mfs supporting the idea that sevoflurane shapes neuronal communication without silencing neural circuits.
The Impact of Pipeline Changes and Temperature Increase in a Hospital Historically Colonised With Legionella.
Authors: Quero Sara , Párraga-Niño Noemí , Garcia-Núñez Marian , Pedro-Botet Maria Luisa , Gavaldà Laura , Mateu Lourdes , Sabrià Miquel , Mòdol Josep Maria 
Published: November 2020

Abstract
Healthcare-related Legionnaires’ disease has a devastating impact on high risk patients, with a case fatality rate of 30-50%. Legionella prevention and control in hospitals is therefore crucial. To control Legionella water colonisation in a hospital setting we evaluated the effect of pipeline improvements and temperature increase, analysing 237 samples over a two-year period (first year: 129, second year: 108). In the first year, 25.58% of samples were positive for Legionella and 16.67% for amoeba. Assessing the distance of the points analysed from the hot water tank, the most distal points presented higher proportion of Legionella colonisation and lower temperatures (nearest points: 6.4% colonised, and temperature 61.4°C; most distal points: 50% and temperature 59.1°C). After the first year, the hot water system was repaired and the temperature stabilised. This led to a dramatic reduction in Legionella colonisation, which was negative in all the samples analysed; however, amoeba colonisation remained stable. This study shows the importance of keeping the temperature stable throughout the circuit, at around 60°C. Special attention should be paid to the most distal points of the circuit; a fall in temperature at these weak points would favour the colonisation and spread of Legionella, because amoeba (the main Legionella reservoir) are not affected by temperature.
Use of Propensity Score Matching to Create Counterfactual Group to Assess Potential HIV Prevention Interventions
Authors: Abaasa Andrew , Mayanja Yunia , Asiki Gershim , Price Matt , Fast Patricia , Ruzagira Eugene , Kaleebu Pontiano , Todd Jim 
Published: November 2020

Abstract
BackgroundThe design of HIV prevention trials in the context of effective HIV preventive methods is a challenge. Alternate designs, including using non-randomised ‘observational control arms’ have been proposed. We used HIV simulated vaccine efficacy trials (SiVETs) to show pitfalls that may arise from using such observational controls and suggest how to conduct the analysis in the face of the pitfalls.MethodsTwo SiVETs were nested within previously established observational cohorts of fisherfolk and female sex workers (FSW) in Uganda. SiVET participants received a licensed Hepatitis B vaccine in a schedule (0, 1 and 6 months) similar to that for a possible HIV vaccine efficacy trial. All participants received HIV counselling and testing every quarter for one year to assess HIV incidence rate ratio (IRR) between SiVET and non-SiVET (observational data). Propensity scores, conditional on baseline characteristics were calculated for SiVET participation and matched between SiVET and non-SiVET in the period before and during the SiVET study. We compared IRR before and after propensity score matching (PSM).Results In total, 3989 participants were enrolled into observational cohorts prior to SiVET, (1575 FF prior to Jul 2012 and 2414 FSW prior to Aug 2014). SiVET enrolled 572 participants (Jul 2012 to Apr 2014 in FF & Aug 2014 to Apr 2017 in FSW), with 953 non-SiVET participants observed in the SiVET concurrent period and 2928 from the pre-SiVET period (before Jul 2012 in FF or before Apr 2014 in FSW). Imbalances in baseline characteristics were observed between SiVET and non-SiVET participants in both periods before PSM. Similarly, HIV incidence was lower in SiVET than non-SiVET; SiVET-concurrent period, IRR= 0.59, 95%CI: 0.31-0.68, p=0.033 and pre-SiVET period, IRR= 0.77, 95%CI: 0.43-1.29, p=0.161. After PSM, participants baseline characteristics were comparable and there were minimal differences in HIV incidence between SiVET and non-SiVET participants. ConclusionThe process of screening for eligibility for efficacy trial selects participants with baseline characteristics different from the source population, confounding any observed differences in HIV incidence. PSM can be a useful tool to adjust the imbalance in the measured participants’ baseline characteristics creating a counterfactual group to estimate the effect of interventions on HIV incidence.
Research on Loading Characteristics of Continuous Miner Based on Coal and Rock Particles Fluidity Effect
Authors: Chen You , Zhang Hong , Li Guohua , Yan Honghong , Zhang Zhihong , Sun Xiaojuan 
Published: November 2020

Abstract
The interaction mechanism between the star wheel arm and coal particles is the theoretical basis for the research of the feeder star wheel device. Based on the discrete element theory, the motion equation of coal particles in the process of coal harrowing with the feeder star wheel was established. With the aid of EDEM software, the coal model of the continuous miner with the simulation structure of coal wall, ground, feeder star wheel, and coal pile was reconstructed. The influence of the parameters includes the number of the arm of the star wheel, the height of the arm, and the inclination angle of the feeder on the loading efficiency and energy consumption of the feeder star wheel was revealed. The results have been shown that the fluidity effect of coal particles in the active zone of the material pile has been observed. The loading efficiency and torque of the feeder star wheel have been affected by this effect. The loading efficiency and energy consumption have been increased with the increase in the number of arm and height of the arm. The loading efficiency of feeder inclination angle 14° is the highest and the energy consumption is the lowest.
Estimation of Thermal Hazards in Surrounding Rock of Subway Tunnel Under Dual Periodic Temperature Boundaries: A Case Study
Authors: Liu Wei , Huang Qingwei , Shi Congling , Qin Yueping 
Published: November 2020

Abstract
Thermal hazards of the surrounding rock of subway tunnels are becoming apparent, in which the heat transfer in the surrounding rock plays a crucial role. Due to the shallow buried depth, the subway tunnel encounters a more complicated heat exchange under the duplicate effects of periodic temperature fluctuation of ground atmosphere and periodic temperature variation of tunnel wind, but this issue has not been fully addressed. In this work, a transient heat transfer model of tunnel surrounding rock based on dual periodic temperature boundaries was established. A solver was developed to estimate the temperature rise and heat transfer of surrounding rock. The correctness of this model was then verified by comparing with previous empirical values and semi-empirical equations. The results show that the temperatures of the surrounding rock at different depths still fluctuate following the simple harmonic waves, and there are some regions that are heavily affected by the duplicate effects, such as the overlying strata of the tunnel. The surrounding rock generally exhibits heat storage in annual cycle, but the total heat storage decreases year by year until it tends to stabilize. Furthermore, the shallower the tunnel is buried, the greater the influence of ground temperature and the higher the temperature rise in the tunnel surrounding rock. This research provides an alternative approach to determine the heat storage of tunnel surrounding rock and evaluates the process of thermal disaster manifestation of subway.
Effect of Pre-Operative Internal Obturator Muscle Mass Index in MRI on Biochemical Recurrence of Prostate Cancer Patients After Radical Prostatectomy: A Multi-Center Study
Authors: Kim Won Tae , Kang Ho Won , Seo Sung Pil , Kim Yong-June , Lee Sang Cheol , Kim Wun-Jae , Cho Bum Sang , Ha Yun Sok , Kwon Tae Gyun , Park Jinsung , Park Seung Chol , Jeong Young Beom , Kang Taek Won , Park Sung-Woo , Yun Seok Joong 
Published: November 2020

Abstract
Purpose: Recent reports show that the pre-operative or post-operative skeletal mass index (sarcopenia) affects survival rates for various cancers; however, the link between prostate cancer survival and sarcopenia is unclear. Therefore, this study examined the effect of the pre-operative internal obturator muscle (IOM) mass index on biochemical recurrence (BCR) of prostate cancer (PCa) patients who underwent radical prostatectomy.Methods: In total, 222 patients, who underwent open or robot-assisted radical prostatectomy at seven centers in 2011 and were followed up for 5 years, were enrolled. BCR was examined in the context of pre-operative IOM mass index and BMI. Results: The mean age of the patients was 67.82 ± 6.23 years, and the mean pre-operative prostate-specific antigen (PSA) level was 11.61 ± 13.22 ng/ml. There was no significant difference in baseline characteristics between the low and high IOM mass index groups (p > 0.05). Age, pre-op PSA level, ECE, and T-stage were not associated with BCR (p = 0.049, p < 0.001, p = 0.001, p = 0.004, respectively). BMI, prostate volume, Gleason score, resection margin, N-stage, M-stage and IOM mass index was not associated with BCR (p > 0.05). Conclusions: Pre-operative IOM mass index was not associated with BCR; however, long-term follow-up is necessary to evaluate cancer-specific and overall survival of PCa patients.
Potential of Hibiscus sabdariffa linn. in managing Fgf21 resistance in diet-induced-obesity rats via miR-34a regulation
Authors: Kartinah Neng Tine , Komara Nisa , Noviati Nuraini Diah , Dewi Syarifah , Yolanda Sophie , Radhina Afifa , Heriyanto Heriyanto , Sianipar Imelda Rosalyn 
Published: November 2020

Abstract
Background
Obesity is a cause of Fgf21 resistance, which affects the browning and thermogenesis process of the adipose tissue. Decreased receptor expression is influenced by microRNA 34a (miR-34a), whose expression is increased in obesity. While Fgf21-based therapies have been widely investigated, the potential activity of Hibiscus sabdariffa Linn extract (HSE) against Fgf21 resistance is unknown. This study aims to determine the effects of HSE on the expression of miR-34a and Fgf21 receptors in white adipose tissue.
Methods
This experimental study used 24 male Sprague-Dawley rats and divided into four groups: Control (N); diet-induced-obesity rats (DIO); DIO rats with HSE 200 mg/kgBW/day and DIO rats with HSE 400 mg/kgBW/day. Rats were fed a high-fat diet for 17 weeks. HSE was administered daily for five weeks. The administration of HSE 400 mg/kg BW/day resulted in the equivalent expression of miR-34a to that of the control (p > 0.05).
Results
Fgfr1 receptor expression was also similar to controls (p > 0.05). Beta-klotho expression was significantly lower than that of Control (p < 0.05) but equivalent to that of DIO rats (p < 0.05).
Conclusions
H. sabdariffa has the potential to reduce Fgf21 resistance in DIO rats through the suppression of miR-34a expression and an increase in the number of Fgfr1 and beta-klotho receptors in adipose tissue.
Testing mechanical chest compression devices for pre-hospital patient transport under resuscitation
Authors: Jörgens Maximilian , Königer Jürgen , Kanz Karl-Georg , Birkholz Tosten , Hübner Heiko , Prückner Stephan , Zwissler Bernhard , Trentzsch Heiko 
Published: November 2020

Abstract
1 Background Mechanical chest compression (mCPR) offers advantages during transport under cardiopulmonary resuscitation. Little is known how devices perform en-route. Aim of the study was to measure performance of mCPR devices of different design during pre-hospital transport. 2 Methods We tested animax mono (AM), autopulse (AP), corpuls cpr (CC) and LUCAS2 (L2). The route had 6 stages (transport on soft stretcher or gurney involving a stairwell, trips with turntable ladder, rescue basket and ambulance including loading/unloading). Stationary mCPR with the respective device served as control. A four-person team carried an intubated and bag-ventilated mannequin under mCPR to assess device-stability (displacement, pressure point correctness), compliance with 2015 ERC guideline criteria for high-quality chest compressions (frequency, proportion of recommended pressure depth and compression-ventilation ratio) and user satisfaction (by standardized questionnaire).3 Results All devices performed comparable to stationary use. Displacement rates ranged from 83% (AM) to 11% (L2). Two incorrect pressure points occurred over 15,962 compressions (0.013%). Guideline-compliant pressure depth was >90% in all devices and compression-ventilation ratio was 40% (AM), 87% (CC, L2 respectively) and 93% (AP). Electrically powered devices showed constant frequencies while muscle-powered AM showed more variability (median 100/min, interquartile range 9). Although physical effort of AM use was comparable (median 4.0 vs. 4.5 on visual scale), participants preferred electrical devices. 4 Conclusion All devices showed good to very good performance although device-stability, guideline compliance and user satisfaction varied by design. Our results underline the importance to check stability and connection to patient under transport.
Community Perception of COVID-19: A Qualitative Approach through Applying the&nbsp;&nbsp;Health Belief Model
Authors: Gishe Gamachu , Hailu Tamirat , Aman Rameto , Dango Sisay 
Published: November 2020

Abstract
Objectives: To explore community perception of COVID -19 pandemic. Methods: In depth exploratory design was utilized. Purposive sampling technique was employed to select 45 participants from all categories of population. Semi-structured interview guide and observation checklist were used to collect data from participants. Thematic analysis was used to analyze the data.Results: Though, at first everyone was scared when the disease outbreak in Ethiopia, currently there are many people who assume as there is no coronavirus in Ethiopia as some of them associate it with politics. Hotels, cafeterias and shopping centers are not as cautious as the first outbreak of the disease. As a result, the street is crowded and the public are restored as usual. Face masks and sanitizer bottles were selling in every corner of the road with no care at all.Conclusions: community perceived susceptibility level of COVID-19 virus was found to be low and therefore, all stakeholders have to work together than focusing on politics where each one is working against each as there will no time for it in the future.