bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Randomized Trial Evaluating Actual Versus Ideal Body Weight Dosing of Sugammadex in Morbidly Obese Patients&nbsp;
Authors: Horrow Jay C. , Li Wen , Blobner Manfred , Lombard John , Speek Marcel , DeAngelis Matthew , Herring W. Joseph 
Published: August 2020

Abstract
Background: This randomized, double-blind trial evaluated sugammadex-mediated recovery time from rocuronium- or vecuronium-induced moderate (M-) or deep neuromuscular block (D-NMB) in morbidly obese adults dosed by actual (ABW) or ideal body weight (IBW). Methods: Adults with BMI ≥40 kg/m2 were randomized to 1 of 5 groups: M-NMB, sugammadex 2 mg/kg ABW; M-NMB, sugammadex 2 mg/kg IBW; M-NMB, neostigmine 5 mg, and glycopyrrolate 1 mg; D-NMB, sugammadex 4 mg/kg ABW; or D-NMB, sugammadex 4 mg/kg IBW. Supramaximal train of four (TOF) stimulation of the ulnar nerve (TOF-watch SX®) monitored recovery. Primary endpoint was time to TOF ratio ≥0.9 for ABW and IBW groups pooled across NMB agent (NMBA)/blocking depth, analyzed by log-rank test stratified for agent and depth. Prespecified safety outcomes included treatment-emergent bradycardia, tachycardia, and other arrhythmias, and adjudicated hypersensitivity and anaphylaxis. Results: Of 207 patients randomized, 188 received treatment (28% male, BMI 47±5.1 kg/m2, age 48±13 years). Recovery was 1.5 min faster with ABW vs IBW dosing. The sugammadex 2 mg/kg groups recovered 9-fold faster [time 0.11-fold, 95% CI 0.08 to 0.14] than the neostigmine group. ABW (5.3%) and IBW (2.7%) groups had similar incidences of recovery time >10 min (95% CI of difference: -4.8% to 11.0%); 84% for neostigmine group. Re-curarization occurred in one patient each in the 2 mg/kg IBW and neostigmine groups. Prespecified safety outcomes occurred with similar incidences. Conclusions: ABW-based sugammadex dosing yields faster reversal without re-curarization, supporting ABW-based sugammadex dosing in the morbidly obese, irrespective of the depth of NMB or NMBA used. Trial registration: Registered on November 17, 2017, at ClinicalTrials.gov under number NCT03346070. https://clinicaltrials.gov/ct2/show/results/NCT03346070?term=NCT03346070&draw=2&rank=1
Branches and Leaves Growth Patterns in Myricaria laxiflora Remnant Populations Are Affected by Human-altered Water Level Fluctuations
Authors: Guan Shoupeng , Chen Fang-Qing , Zhou Jumei , Huang Yongwen , Fan Dayong 
Published: August 2020

Abstract
Background: The construction of the Three Gorges-Gezhou Dam altered the water level fluctuation pattern in the downstream habitat of the endangered species Myricaria laxiflora. This study investigated how branch and leaf growth traits of M. laxiflora remnant populations changed to adapt the environmental stress caused by human-altered water level fluctuations.Results:Due to such disturbance, branch and leaf growth traits of M. laxiflora populations exhibited significant differences across water level conditions. The number of secondary branches, plant height, and leaf number of the plants in the upper area of the habitat were significantly higher than that in the middle and lower river bank areas. The longest secondary branch length of the plants in the upper and middle region was significantly higher than that in the lower region. The branch and leaf volume of plants in the middle region was significantly higher than that in the upper and lower region. The maximum water content of plants in the middle and lower region was significantly higher than that in the upper region. Principal component analysis showed that the branch and leaf traits of plants changed with decreasing water level toward to decreasing plant height, leaf number and the number of secondary branches, and increasing maximum water content of branch and leaves. Conclusions: The phenotypic plasticity of M. laxiflora plants in branch and leaf growth traits alleviates the impacts of human-regulated water level fluctuations. However, the above ground growth of M. laxiflora plants distributed at the middle and lower areas of the fluctuation zone is still negatively affected.
Misdiagnosis of Spinal Dural Arteriovenous Fistula: An Analysis of 12 Cases
Authors: Yang Baohui , Cao Shuai , He Xijing , Li Haopeng 
Published: August 2020

Abstract
Background: Spinal dural arteriovenous fistula (SDAVF) is a rare spinal vascular disease. The clinical misdiagnosis rate is very high. The highest misdiagnosis rate is reported in orthopedics. The specific reason for misdiagnosis remains unclear. Objective: To investigate the clinical and imaging manifestations of SDAVF, analyze the causes of misdiagnosis, propose countermeasures, and improve the orthopedists and other specialists’ understanding of this disease. Methods: The clinical data, diagnosis and treatment of 12 patients who had SDAVF that was misdiagnosed as a different disease were retrospectively analyzed, and the modified Aminoff-Logue Disability Scale (ALS) scores before and during follow-up were compared. Results: From 2014 to February 2019, 15 patients were diagnosed with SDAVF at our institution. Twelve (80%) were misdiagnosed; of these, 6 (50%) were misdiagnosed more than twice, and 6 patients (50%) were misdiagnosed at least once. The initial diagnoses included lumbar spinal stenosis and lumbar disc herniation (LDH) in 6 patients, cervical spinal stenosis in one patient, benign prostatic hyperplasia (BPH) in one patient, myelitis in 2 patients, and syringomyelia in one patient. After the initial diagnosis, one patient was misdiagnosed with LDH, one was misdiagnosed with subacute combined degeneration of the spinal cord, and 4 were misdiagnosed with myelitis. The clinical manifestations mainly included weakness and numbness of the lower limbs, urinary symptoms, and numbness of the perineal area. In the 12 misdiagnosed patients, magnetic resonance imaging(MRI) showed signs of spinal cord edema and typical or atypical flow-void patterns. One patient had undergone extended cervical decompression and lumbar decompression. All patients eventually underwent microsurgical treatment. The average follow-up duration was 0.9 years. The modified ALS scores showed significant improvement in gait, bladder function and bowel movement, and the differences before and during follow-up were statistically significant (P<0.05). Conclusion: When patients, especially those with bladder and bowel dysfunction, have symptoms such as weakness of the lower limbs and/or numbness, a diagnosis of SDAVF should be considered. Furthermore, if MRI shows signs of spinal cord edema and typical or atypical flow-void patterns, the diagnosis of SDAVF should be strongly considered, and further angiography is needed to confirm the diagnosis.
De novo transcriptome sequencing and anthocyanin metabolite analysis reveals leaf color of Acer pseudosieboldianum in autumn
Authors: Gao Yu-fu , Zhao Dong-hui , Zhang Jia-qi , Chen Jia-shuo , Rong Liping 
Published: August 2020

Abstract
Background

Leaf color is an important ornamental trait of colored-leaf plants. The change of leaf color is closely related to the synthesis and accumulation of anthocyanins in leaves. Acer pseudosieboldianum is a colored-leaf tree native to Northeastern China, however, there was less knowledge in Acer about anthocyanins biosynthesis and many steps of the pathway remain unknown to date.
Results

Anthocyanins metabolite and transcript profiling were conducted using HPLC and ESI-MS/MS system and high-throughput RNA sequencing respectively. The results demonstrated that five anthocyanins were detected in this experiment. It is worth mentioning that Peonidin O-hexoside and Cyanidin 3 5-O-diglucoside were abundant, especially Cyanidin 3 5-O-diglucoside displayed significant differences in content change at two periods, meaning it may be play an important role for the final color. Transcriptome identification showed that a total of 67.47 Gb of clean data were obtained from our sequencing results. Functional annotation of unigenes, including comparison with COG and GO databases, yielded 35,316 unigene annotations. 16,521 differentially expressed genes were identified from a statistical analysis of differentially gene expression. The genes related to leaf color formation including PAL, ANS, DFR, F3H were selected. Also, we screened out the regulatory genes such as MYB, bHLH and WD40. Combined with the detection of metabolites, the gene pathways related to anthocyanin synthesis were analyzed.
Conclusion

Cyanidin 3, 5-O-diglucoside played an important role for the final color. The genes related to leaf color formation including PAL, ANS, DFR, F3H and regulatory genes such as MYB, bHLH and WD40 were selected. This study enriched the available transcriptome information for A. pseudosieboldianum and identified a series of differentially expressed genes related to leaf color, which provides valuable information for further study on the genetic mechanism of leaf color expression in A. pseudosieboldianum.
Genome-Wide Analysis of Basic Helix-Loop-Helix (bHLH) TFs in Sea Buckthorn (Hippophae rhamnoides)
Authors: Diao Songfeng , Liu Hong , Lv Zhongrui , He Caiyun , Duan Aiguo , Zhang Guoyun , Zhang Jianguo 
Published: August 2020

Abstract
Background

The basic helix-loop-helix (bHLH) transcription factor gene family is one of the largest gene families and extensively involved in plant growth, organ development, and stress responses. However, limited studies are available on the gene family in sea buckthorn.
Results

In this study, we focused on 144 HrbHLH genes, exploring their DNA and protein sequences and physicochemical properties. According to their protein sequence similarities, we classified the genes into 15 groups with specific motif structures. In order to explore their expressions, we performed gene expression profiling using RNA-Seq and identified 108 HrbHLH genes that expressed in five sea buckthorn tissue, including root nodule, root, leaf, stem and fruit. Furthermore, we found 11 increased expressed HrbHLH genes during sea buckthorn fruit development. We validated the expression pattern of HrbHLH genes using reverse transcription quantitative real-time PCR.
Conclusions

This study lays the foundation for future studies on gene cloning, transgenes, and biological mechanisms. We performed a genome-wide, systematic analysis of bHLH proteins in sea buckthorn. This comprehensive analysis provides a useful resource that enables further investigation of the physiological roles and molecular functions of the HrbHLH TFs.
A Modified Sinus Tarsi Approach for Treatment of Displaced Intra-articular Calcaneal Fractures Sanders type Ⅱ or Ⅲ Compared to Extended Lateral Approach
Authors: Hu Yao , Zhan Junfeng , Meng Congpeng , Ma Zhida , Zhu Nan , Jing Juehua 
Published: August 2020

Abstract
Background: We have designed a modified sinus tarsi approach (MSTA) to treat sanders type Ⅱ or Ⅲ intra-articular calcaneal fractures, providing sufficient surgical field exposure and operation space, and significantly reducing the rate of wound complications. We compared the radiologic results, clinical outcomes, and complications of patients operated on via the MSTA and the extended lateral approach (ELA) for treatment of displaced intraarticular calcaneal fractures Sanders type Ⅱ or Ⅲ.Methods: We retrospectively studied the utility of the ELA (32 patients, 34 feet) and the MSTA (33 patients, 36 feet) operated on from January 2013 to January 2018. The average follow-up time of the two groups was 58 months. We assessed the preoperative and final x-rays, clinical outcomes and complications at the last follow-up. Clinical outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) score and visual analog scale (VAS).Results: In both groups, the average final width, height, Bohler angle were significantly restored compared with the preoperative width, height, and Bohler. The last follow-up calcaneal length, width, height, Bohler angle, Gissane angle did not differ significantly between the 2 groups. In terms of the clinical outcomes, the average AOFAS score of the ELA group checked to 82.1 points, yielding a 77.8% excellent or good rating, and the average VAS score was 1.76 points. In contrast, the average AOFAS score of the MSTA group checked to 81.0 points, yielding a 79.4% excellent or good rating, and the average VAS score was 1.68 points. There was no significant difference in AOFAS score and VAS score between the 2 groups. The wound-healing complication rate was 2.9% in MSTA group and 22.2% in ELA group (p = .040). 4 cases of sural nerve injury occurred in ELA group, and 2 in MSTA group. 1 cases of peroneal tendon complication only occurred in ELA group.Conclusion: Compared with ELA, MSTA provides similar and favorable radiological and clinical results, and is associated with fewer wound complications. We believe the MSTA is more appropriate in the treatment of Sanders II and III calcaneal intra-articular fractures.
Three-Dimensional Simulation of Crack Propagation in the Central-Cracked Flat and Stiffened Plates Under Uniform Tension
Authors: Valdi Mohammad Hossein Taghizadeh 
Published: August 2020

Abstract
In this paper, the crack propagation behavior in flat and stiffened plates with central-cracked is studied based on the theory of linear elastic fracture mechanics and 3D finite-element method. The magnitude and distribution of the stress intensity factor in a 3D stiffened plates are affected by the out-of-plane bending and loading modes. Initially, for validating this method, the behavior of crack propagation in a central-cracked flat plate (unstiffened), followed by the propagation behavior and the crack arrest effects on stiffened plates by stiffeners, as well as the out-of-plane bending effect on the geometry correction function distribution are studied; However, the results are compared with the results of the referenced article. In order to analyze the effect of stiffeners in preventing crack expansion, stiffeners with variable thickness and height were used. It should also be noted that the crack propagation behavior in the stiffened plate is analyzed in two methods. In the first analysis, after the crack tip reaches to the stiffeners, they have not fracture and the crack only expands in the stiffened plate (in the stiffened plate type 1 and 2). In the second analysis, with the crack growth in the stiffened plate and the crack tip reaching to the stiffeners, Also they fractured and cracks in the stiffened plate and stiffeners are propagated (only in the stiffened plate type 2). In both analyses, the magnitudes ​​of the geometry correction function in the middle-plane, the crack arrest effect by the stiffeners (Δβs), and the out-of-plane bending effect (Δβ) were obtained. Then, the changes in these magnitudes ​​were investigated. It was observed that the stiffeners thickness had a negligible effect on the distribution of the geometry correction function and, in general, the stiffeners had a significant role in preventing the crack growth compared to the flat plate, and the more the crack tip is closer to the adjoining stiffeners; the stiffeners effect in the crack arrest will increases. Furthermore, with attention to the geometry correction function that is studied for different crack sizes, it was determined that the geometry correction function and stress intensity coefficient with increasing the length of the crack in the plate, increase.
Risk Factors for Non-Alcoholic Fatty Liver Disease Among the Patients Admitted to a Teaching Hospital in Sri Lanka: Case Control study
Authors: Nissanka Ayoma , Abeysena Chrishantha 
Published: August 2020

Abstract
Background: The burden of Non-Alcoholic Fatty Liver Disease (NAFLD) was rising globally. It was the disease condition where there was increase fat deposition (≥5%) in the hepatic cells. The objective of this study was to determine the risk factors for NAFLD among the patients admitted to a Teaching Hospital in Sri Lanka.Methods: A case control study was conducted among the 106 cases with NAFLD and 212 unmatched hospital-based controls without having NAFLD. A case was defined based on the presence of fatty liver according to the diagnostic ultrasonographic criteria. Those were increase echogenicity of the liver compared to kidney and spleen, obliteration of vascular architecture, and deep attenuation of ultrasonic signals. There should be at least two out of three criteria to diagnosed as NAFLD. The data was collected by using an interviewer-administered questionnaire. The risk factors were determined by using multiple logistic regression and the results were interpreted by using adjusted odds ratio (AOR) and 95 % confidence interval (95% CI).Results: The risk factors for NAFLD were found as the fast food consumption more than 1 time per week (AOR=9.34, 95% CI= 4.47-19.49), none consumption of coffee (AOR=2.78, 95% CI= 2.78-1.32), family history of liver disease (AOR=12.2, 95% CI= 2.16-67.97), methotrexate usage (AOR=32.02, 95% CI=1.45-707.29), inadequate physical activity (AOR=8.10, 95% CI= 4.04-16.26), high BMI value more ≥23Kg/m2 (AOR=6.17, 95% CI=2.93-12.99) Being a Sinhalese (AOR=12.7, 95% CI=2.03-79.33).Conclusion: There were seven independent risk factors for NAFLD were identified. Among those, most of the risk factors were modifiable risk factors such as inadequate physical activity, High BMI value (≥ 23Kg/m2) with overweight, infrequent coffee consumption, and increase fast-food consumption. It should be taken primary preventive strategies for those modifiable risk factors to prevent NAFLD.
Genome-Wide Analysis of the GRAS Gene Family Exhibited Expansion Model and Functional Differentiation in Sea Buckthorn
Authors: Yu Liyang , Zhang Guoyun , Lyu Zhongrui , He Caiyun , Zhang Jianguo 
Published: August 2020

Abstract
Background: GRAS proteins comprise a large family of transcription factors that experienced extensive replication, and play important roles in many aspects of growth regulatory and environmental signals. However, limited information was available about the GRAS genes in sea buckthorn of Elaeagnaceae. We perform a genome-wide investigation into the expansion model and tissue expression profiling of sea buckthorn GRAS genes based on the comparative genomes methods.Results: In this study, 62 sea buckthorn GRAS (HrGRAS) genes were identified and renamed based on their respective chromosome distribution. Fifty-nine HrGRASs were further classified into nine subgroups and three HrGRASs did not belong to any of the subfamilies according to their phylogenetic features. HrGRAS genes tend to have a representative GRAS domain, few introns and unevenly distributed on chromosomes. Collinear homology dotplot and the median synonymous substitution sites of collinearity blocks distinguished gene pairs with different duplication models and found that segmental duplication was the main driver of the GRAS gene family expansion in sea buckthorn, followed by whole genome duplication and tandem duplication. The all gene pairs from the different duplication models may experience strong purifying selection pressure during evolution processes according to the Ka/Ks ratios. Expression profiles derived from transcriptome data exhibited distinct expression patterns of HrGRAS genes in various tissues and fruit developmental stages. The interaction network analysis of HrGRAS protein found that some HrGRAS proteins interacted with more proteins and retained more copies in sea buckthorn, which indicate that the products of these genes play more important roles in the growth and development of sea buckthorn.Conclusions: Sea buckthorn GRAS gene family was first comprehensively analyzed in this study. This systematic analysis provided a foundation to further understand the expansion and potential functions of GRAS genes with an aim of sea buckthorn crop improvement.
A data driven approach to identify ZM-447439 as a potential repurposed drug to overcome tamoxifen-resistance in breast cancer
Authors: Alakwaa Fadhl M , Benny Paula , Chaudhary Kumardeep , Garmire Lana X 
Published: August 2020

Abstract
Background: Tamoxifen is the most commonly used endocrine therapy (ET) for Breast Cancer (BC) patients expressing estrogen receptors (ER), representing almost 70% of all cases. However, one third of early stage BC patients demonstrate endocrine resistance to tamoxifen over the initial five-year treatment period, prompting significant research effort on identifying other drugs to alleviate tamoxifen resistance in ER + BC patients.Methods: We combined a total of 229 tamoxifen resistant and 363 tamoxifen sensitive tumors and tumor cell lines, to select genes that showed consistency as either up- or down- regulated differential expression among these datasets. We use these genes as the input to identify the drugs and compounds in Library of Integrated Network-Based Cellular Signatures (LINCS) database that can reverse the expression of these genes. With an innovative and comprehensive scoring system, we performed quality assessment on the results and prioritized drugs. Finally, we validated top five drugs using in vitro cell culture experiments.Results: We identified that ZM-447439, an aurora kinase inhibitor, can reverse the gene signatures associated with tamoxifen resistance. This was accomplished by a novel bioinformatics approach and scoring system, screening from over 20,000 small molecules in the Library of Integrated Network-Based Cellular Signatures (LINCS) database. The in vitro cell culture experiments showed that ZM-447439 had high potency to reverse gene expression in the tamoxifen-resistance BC cell line (MCF7-RR).Conclusion: We demonstrate the utility of a bioinformatics repurposing approach to identify candidate drug ZM-447439 with the potential to treat patients with acquired tamoxifen resistance.
Renal Abscess: Invasive Treatment or not
Authors: Xia Mingrui , Liu Jun , Hong Yang , An Lizhe , Xiong Liulin , Huang Xiaobo , Xu Qingquan 
Published: August 2020

Abstract
Objective

To identify possible clinical indicators to guide the choice of treatment in patients with renal abscess.
Methods

According to different treatment methods, 38 patients initially diagnosed with renal abscess and received no prior treatment (antipyretics excepted) in our institution from April 2006 to November 2019 were divided into conservative treatment group and invasive treatment group, with the clinical data of all the cases being analyzed retrospectively.
Results

In the conservative treatment group, 19 patients got success and 1 failed in initial treatment, while in the invasive treatment group, 15 patients got success and 3 failed. Of the 4 patients who failed the initial treatment, 3 had a renal abscess between 3 cm and 5 cm, and 1 failed due to long-term use of bone marrow suppressive drugs. In univariate analysis, there were significant differences between the two groups in the following factors: diabetes mellitus, body temperature ≥ 38.5℃, PLT, RDW, BUN, PLR, AG, WBC in urine, size of abscess. In logistic regression analysis, diabetes mellitus, RDW and size of renal abscess were retained. The cut-off of RDW and size of renal abscess were 14.07% and 3.9 cm respectively.
Conclusions

Size of renal abscess is still the most important factor that determining treatment modalities. Other than size, high RDW and the comorbidity of diabetes mellitus may also be used as the possible clinical indicators for the determination of invasive treatment, especially in patients with renal abscess between 3 ~ 5 cm in size.