bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary needle-knife fistulotomy for preventing post-endoscopic retrograde cholangiopancreatography pancreatitis: importance of the endoscopist’s expertise level
Authors: Han Sung Yong , Baek Dong Hoon , Kim Dong Uk , Park Chang Joon , Han In Sub , Kim Gwang Ha , Song Geun Am 
Published: February 2020

Abstract
Background Needle-knife fistulotomy (NKF) is used as a rescue technique for difficult cannulation. However, the data are limited regarding the use of needle-knife fistulotomy for primary biliary cannulation, especially when performed by beginners. To assess the effectiveness and safety of primary NKF for biliary cannulation, and the role of the endoscopist’s expertise level (beginner vs. expert). Methods We retrospectively evaluated the records of 613 patients with naïve papilla and no history of pancreatitis, who underwent bile duct cannulation at a tertiary referral center. The patients were categorized according to the endoscopist’s expertise level and the technique used for bile duct cannulation. We assessed the rates of successful cannulation and adverse events. Results The baseline characteristics did not differ between the pre-defined groups. The incidence rate of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) was significantly affected by the endoscopist’s expertise level in patients who received conventional cannulation with sphincterotomy (11.3% vs. 5.7% for beginner vs. expert, P =0.033), but not in those who received NKF. In the multivariable analysis, a lower expertise level of the biliary endoscopist and longer cannulation time were significant risk factor of post-endoscopic retrograde cholangiopancreatography pancreatitis ( P =0.030, P =0.005) in patients who received conventional cannulation with sphincterotomy but not in those who received NKF. Conclusion Compared to conventional cannulation with sphincterotomy, primary NKF carries a lower risk of PEP regardless of the endoscopist’s level of expertise. Primary NKF may be effective and safe in achieving ductal access in patients with naïve papilla.
Clinical Outcomes of Preimplantation Genetic Testing (PGT) Application in Couples with Chromosomal Inversion, a Study in the Chinese Han Population
Authors: Shao Yuhan , Li Jing , Lu Juanjuan , Li Hongchang , Zhu Yueting , Jiang Wenjie , Yan Junhao 
Published: February 2020

Abstract
Background Chromosomal inversion was considered to have adverse effects on pregnancy outcomes through abnormal gametogenesis. The purpose of this retrospective study was to investigate whether preimplantation genetic testing (PGT) improves pregnancy outcomes for couples with chromosomal inversion. Methods A total of 188 cycles from 165 couples with one chromosomal inversion carrier were divided into two groups: PGT (136 cycles, 125 couples) and non-PGT (52 cycles, 50 couples). Biochemical pregnancy, clinical pregnancy, ongoing pregnancy, miscarriage and live birth rates of their first transfer cycles, as well as cumulative live birth rates of each cycle and euploidy rates, were analyzed. Results There were no statistically significant differences in the pregnancy outcomes between the two groups. The euploidy rate of pericentric inversion carriers was not higher than that of paracentric inversion carriers in PGT group (60.71% vs 50.54%, P=0.073). Similarly, the euploid rate of male carriers was not higher than that of female carriers (61.2% vs 56.1%, P=0.256). Conclusions Due to limitation of retrospective study and small sample size, our current data showed that PGT cannot provide prominent benefits for inversion carriers in the Chinese Han population. Further prospective randomized controlled trials are needed to evaluate the effects of PGT.
Real-world use of ACEI/ARB in diabetic hypertensive patients before the initial diagnosis of obstructive coronary artery disease: patient characteristics and long-term follow-up outcome
Authors: Zhang Yue , Ding Xiaosong , Hua Bing , Liu Qingbo , Chen Hui , Zhao Xue-Qiao , Li Weiping , Li Hongwei 
Published: February 2020

Abstract
Background: Current guidelines recommend angiotensin-converting-enzyme inhibitors (ACEI) /angiotensin receptor blockers (ARB) as a first-line therapy in diabetic hypertensive patients and for secondary prevention in patients with obstructive coronary artery disease (OCAD). However, the effects of using ACEI/ARB before the initial diagnosis of OCAD on major adverse cardiac and cerebral event (MACCE) in diabetic hypertensive patients remain unclear. This study investigated whether using ACEI/ARB before the initial diagnosis of OCAD could be associated with improved clinical outcomes in diabetic hypertensive patients. Methods: A total of 2501 patients with hypertension and diabetes, who were first diagnosed with OCAD by coronary angiography, were included in the analysis. Of the 2501 patients, 1300 did not used ACEI/ARB before the initial diagnosis of OCAD [the ACEI/ARB(-) group]; 1201 did [the ACEI/ARB(+) group]. Propensity score matching at 1:1 was performed to select 1050 patients from each group. Incidence of acute myocardial infarction (AMI), infarct size in patients with AMI, heart function, and subsequent MACCE during a median of 25.4-month follow-up were determined and compared between the 2 groups. Results: Compared with the ACEI/ARB(-) group, the ACEI/ARB(+) group had significantly lower incidence of AMI (22.5% vs. 28.4%, p=0.002), smaller infarct size in patients with AMI (pTNI: 5.7 vs. 6.8 ng/ml, p=0.044; pCKMB: 21.7 vs. 28.7 ng/ml, p=0.028), better heart function (LVEF: 60.0 vs. 58.5%, p=0.002), and lower incidences of non-fatal stroke (2.4% vs. 4.6%, p=0.015) and composite MACCE (23.1% vs. 29.7%, p=0.026). No prior ACEI/ARB therapy was significantly and independently associated with non-fatal stroke and composite MACCE. Conclusions: In diabetic hypertensive patients, treatment with ACEI/ARB before the initial diagnosis with OCAD was associated with decreased incidence of AMI, smaller infarct size, improved heart function, and lower incidences of non-fatal stroke and composite MACCE. Trial registration: retrospectively registered.
Idenfication of a novel signature based on mTORC1 pathway for hepatocellular carcinoma.
Authors: Mo Zhuomao , Luo Shaoju , Cao Zhirui , Hu Hao , Yu Ling , Zhang Shijun 
Published: February 2020

Abstract
Background mTORC1 signal pathway play a role in the initiation and progression of hepatocellular carcinoma (HCC), but no relevant gene signature was developed. This research aimed to explore the potential correlation between mTORC1 signal pathway and HCC and establish the related genes signature. Methods HCC cases were retrieved from The Cancer Genome Atlas (TCGA), International Cancer Genome Consortium (ICGC) and Gene Expression Omnibus (GEO) databases. The genes to be included in mTORC1-assiociated signature were selected by performing univariate, multivariate Cox regression analysis and lasso regression analysis. Then, the signature was verified by survival analysis and multiple receiver operating characteristic (ROC) curve. Furthermore, a nomogram was established and evaluated by C-index, calibration plot and ROC curve. Results The signature was established with the six genes ( ETF1, GSR, SKAP2, HSPD1, CACYBP and PNP ). Under the grouping from signature, patients in the high- risk group showed worse survival than those in the low-risk group in both three datasets. The univariate and multivariate Cox regression analysis indicated that mTORC1 related signature can be the potential independent prognostic factor in HCC. Conclusion The mTORC1 associated gene signature established and validated in our research could be used as a potential prognostic factor in HCC.
A "global" network dysfunction in the mirror neuron system in autism is modulated by task complexity and age: A meta-analysis of neuroimaging studies
Authors: Chan Mei Yan Melody , Han Yvonne M.Y. 
Published: February 2020

Abstract
Background Impaired imitation has been found to be an important factor contributing to social communication deficits in individuals with autism spectrum disorder (ASD). It has been hypothesized that the neural correlates of imitation, the mirror neuron system (MNS), are dysfunctional in ASD, resulting in imitation impairment as one of the key behavioral manifestations in ASD. Previous MNS studies produced inconsistent results, leaving the debate of whether mirror neurons are “broken” in ASD unresolved.Methods This meta-analysis aimed to explore the differences in MNS activation patterns between typically developing (TD) and ASD individuals when they observe/imitate biological motions with/without emotional components. Effect-size signed differential mapping (ES-SDM) was adopted to synthesize the available fMRI data. Results The MNS is dysfunctional in ASD; not only the brain regions containing mirror neurons were affected, the brain regions supporting MNS functioning were also impaired. Second, MNS dysfunction in ASD is modulated by task complexity; differential activation patterns during the presentation of “cold” and “hot” stimuli might be a result of atypical functional connectivity in ASD. Third, MNS dysfunction in ASD individuals is modulated by age. MNS regions were found to show delayed maturation; abnormal lateralization development in some of the brain regions also contributed to the atypical development of the MNS in ASD. Limitations We have attempted to include a comprehensive set of original data for this analysis. However, whole brain analysis data were not obtainable from some of the published papers, these studies could not be included as a result. Moreover, the results indicating the age effect on MNS in ASD could only be generalized to individuals aged 11-37, as MNS activation remains unstudied for populations beyond this age range. Also, the ES-SDM linear regression modelling might not be ideal to illustrate the associations between age and MNS activation; the meta-regression results should be treated with caution. Conclusion There is a “global” rather than a “local” network dysfunction, which may underlie the imitation impairments in individuals with ASD. Task complexity and age modulate the functioning of the MNS, which may explain the previous peculiar results contributing to the unresolved “broken mirror neuron” debate.
Determinants of stunting and underweight among children aged 6 to 59 months in Bussi Islands of Wakiso District, Uganda: a cross-sectional study
Authors: Nsubuga Edirisa Juniour , Muzafaru Ssenyondo , Isunju John Bosco , Mayega Roy William 
Published: February 2020

Abstract
Background: Child malnutrition in rural hard to reach areas of Uganda is higher than that in urban areas and it leads to increased risk of death. It is assumed that the condition is worse in Islands, however, limited research has been conducted on the prevalence and determinants of stunting and underweight among children in the Islands of Uganda. This study assessed the prevalence and determinants of stunting and underweight among children aged 6 to 59 months in Bussi Islands of Wakiso District in Uganda.Methods: A cross-sectional survey using quantitative methods was conducted in the Islands of Wakiso District. 409 households and 409 caretaker-child pairs of children aged 6 to 59 months were got using simple random sampling. Modified poisson regression generated Unadjusted and Adjusted Prevalence Ratios with 95% confidence intervals.Results: Prevalence of stunting and underweight among children was 29.8% and 16.1% respectively. Determinants of stunting were child age of 12 to 23 months and 24 to 35 months (APR: 2.28; 95% CI: 1.29, 4.03 and APR: 1.97; 95% CI: 1.09, 3.56 respectively); household food insecurity (APR: 1.67; 95% CI: 1.15, 2.43); utilisation of more than 80 litres of water in a day by a household (APR: 0.48; 95% CI: 0.24, 0.95); suffering from diarrhoea (APR: 1.79; 95% CI: 1.28, 2.50); receiving of deworming tablets every six months by children (APR: 0.58; 95% CI: 0.42, 0.81) and not suffering from measles (APR: 0.62; 95% CI: 0.42, 0.92). Determinants of underweight were child age of 24 to 35 months (APR: 2.30; 95% CI: 1.13, 5.33), suffering from diarrhoea (APR: 2.06; 95% CI: 1.30, 3.27) and having more than nine household members (APR: 3.18; 95% CI: 1.10, 10.6).Conclusions: Child stunting and underweight are public health problems in Bussi Islands of Wakiso District. Therefore, nutrition interventions in the Islands should focus on the determinants that were identified by this study.
Integrated analyses of rice dark response and leaf color control reveal links with porphyrin and chlorophyll metabolism
Authors: Wang Tianxingzi , Chen Yue , Zhu Zheng , Liu Yuqing , Yan Gaowei , Xu Shan , Xu Haiqing , Yang Ming , Dou Shijuan , Li Liyun , Liu Guozhen 
Published: February 2020

Abstract
Background: Light is a key regulatory signal for rice growth and development. Under dark stress, rice shows leaf yellowing. Whole genome transcriptomic analysis will identify differentially expressed genes (DEG) in dark-treated rice seedlings and DEG-enriched metabolic pathways. Rice leaf color is an essential agronomic trait. Traditional genetic experiments have reported over a hundred of leaf color control (LCC) genes and some of them were also regulated by light signal. Thus, an integrated analysis for the two set of data will be helpful for illustration of the mechanism for both dark-response and leaf color control.Results: Transcriptome changes in response to dark treatment were surveyed by RNA-Seq analysis. About 13,115 differentially expressed genes (DEGs) were identified. One hundred and fifty rice LCC genes were collected. It was found that 102 LCC genes (68.0%) were also dark-response DEGs, which suggests an overlap between dark response and LCC networks. Fifty DEG overlapped LCC genes was associated with chloroplast development. KEGG analysis revealed enrichment of LCC genes in porphyrin and chlorophyll metabolism (PCM) (18/44, 40.9%). Of the 18 LCC genes in the PCM pathway, 15 were dark-response DEGs (83.3%). More interestingly, all of them are involved in a central PCM sub-pathway, chlorophyll biosynthesis.Conclusions: Integrated analysis for dark stress-response and leaf color control identified the correlation between the two processes and mutually supported evidences were obtained. It was found that PCM pathway, particularly chlorophyll biosynthesis process, plays important roles in rice LCC and dark stress-response. This study provides important clues for understanding the mechanisms of dark response and leaf color control and identifying additional LCC genes.
Association Between Intensive Care Unit Occupancy at Discharge, Afterhours Discharges, &amp; Clinical Outcomes: An Historical Cohort Study
Authors: Fergusson Nicholas A , Ahkioon Steve , Ayas Najib , Dhingra Vinay K , Chittock Dean R , Sekhon Mypinder S , Mitra Anish R , Griesdale Donald EG 
Published: February 2020

Abstract
Background: There is a paucity of contemporary, patient-level data evaluating the association between discharge occupancy in the intensive care unit (ICU) and clinical outcomes such as readmission and mortality. Additionally, it is unknown whether increased occupancy at discharge may modify the timing of discharge (i.e. increased afterhours discharge) and further provoke negative clinical consequences. The objective of this single-center historical cohort study was to explore the association between ICU occupancy on the day of discharge and afterhours discharges, 72-hour readmission and 30-day mortality. Methods: This was a historical cohort study of a single large quaternary ICU in Canada. Discharge occupancy was defined as the number of hours of patient care delivered on the day of discharge divided by the total amount of hours of care available for that day (number of funded beds x 24 hours). Afterhours discharge was defined as a discharge between 22:00 and 6:59. Logistic regression models controlling for important covariates were constructed. Adjusted restricted cubic spline models were also created to control for non-linear relationships. Results: A total of 8,862 ICU discharges, representing 7,288 individual patients, between April 1, 2010 and August 10, 2017 were included in this analysis. A total of 1180 (13.3%) afterhours discharges, 408 (4.6%) 72-hour readmissions, and 574 (6.5%) 30-day post discharge deaths occurred. In the adjusted analysis, greater discharge occupancy was associated with afterhours discharges (per 10% increase; adjusted odds ratio (aOR) 1.12, 95% 1.03-120, p = 0.005). Discharge occupancy was not associated with 72-hour readmission (per 10% increase; aOR 0.97, 95% CI 0.87-1.09, p= 0.624) or 30-day mortality (per 10% increase; aOR 1.05, 95% CI 0.95-1.16, p= 0.323). Afterhours discharge was not associated with neither 72-hour readmission (aOR 1.15, 95% CI 0.86-1.54, p= 0.341) nor 30-day mortality (aOR 1.05, 95% CI 0.82-1.36, p= 0.691). Conclusions: Greater ICU occupancy on the day of discharge was associated with a significant increase in afterhours discharges. However, neither discharge occupancy nor afterhours discharge were associated with 72-hr readmission or 30-day mortality. Keywords: Intensive care unit; occupancy; capacity strain; process-of-care; afterhours discharge; readmission; mortality
Computed tomography in the assessment of aneurysmal subarachnoid haemorrhage for clinical outcome: an observational cohort study
Authors: Couret David , Boussen Salah , Cardoso Dan , Alonzo Audrey , Madec Sylvain , Reyre Anthony , Brunel Hervé , Girard Nadine , Graillon Thomas , Dufour Henry , Bruder Nicolas , Simeone Pierre , Meilhac Olivier , Velly Lionel J 
Published: February 2020

Abstract
Background: Aneurysmal subarachnoid haemorrhage (aSAH) is a life-threatening event with major complications such as delayed cerebral infarction (DCI) or acute hydrocephalus and poor neurological outcome. DCI occurs most frequently 7 days after aSAH and can last for a prolonged period. The ability to predict these complications would allow the neuro-intensivist to identify patients at risk and select the most appropriate unit for hospitalization. Methods: A 3-year single-centre retrospective cohort study was conducted in our neuroscience critical care unit. Initial computed tomography (CT) scans in patients hospitalized for aSAH were blindly assessed using eight grading systems: the Fisher scale, modified Fisher scale, Barrow Neurological Institute scale, Hijdra scale, Intraventricular Haemorrhage (IVH) score, Graeb score, and LeRoux score. We evaluated and compared these radiological scales for the early prediction of DCI, acute hydrocephalus, and poor neurological outcome at 3 months. Results: Of 200 patients with aSAH who survived to day 7 and were included for DCI analysis, 39% cases were complicated with DCI. The Hijdra scale was the best predictor for DCI, with a receiver operating characteristic area under the curve (ROCAUC) of 0.80 (95% confidence interval [CI], 0.74–0.85). The ideal cut-off score for all patients was 20/42, with a sensitivity of 85% (95% CI, 75%–94%) and specificity of 63% (95% CI, 54%–71%). The IVH score was the most effective grading system for predicting acute hydrocephalus, with a ROC AUC of 0.85 (95% CI, 0.79–0.89). In multivariate analysis, the Hijdra scale was the only independent predictor of the occurrence of DCI (hazard ratio, 1.18; 95% CI, 1.10–1.27). Conclusions: Although these results have yet to be prospectively confirmed, our findings suggest that the Hijdra scale may be a good predictor of DCI and could be useful in daily clinical practice.
Innovative solutions to enhance safe and green environments for ageing well using stakeholder co-design.
Authors: Hatton Anna L , Haslam Catherine , Bell Sarah , Langley Joe , Woolrych Ryan , Cory Corrina , Brownjohn James MW , Goodwin Victoria A 
Published: February 2020

Abstract
Background There is a need to develop innovative solutions to enhance safe and green physical environments, which optimise health, wellbeing and community participation among older adults. In order to develop solutions that meet the needs of a diverse ageing population, an interdisciplinary approach is needed. Our aim was to identify the needs of older people in relation to ageing well in the environment by bringing together knowledge from different stakeholder and interdisciplinary perspectives. Methods An international consortium (Retrofit living For ageing well through Understanding and Redesign of Built environments consortium: ReFURB) was established in April 2018, including ten core members, to (i) explore cutting-edge solutions to safe living for ageing populations and (ii) develop innovative approaches to everyday physical environments, which bring about health benefits. We used a co-design, interdisciplinary framework involving older adults, carers, physiotherapists, geriatricians, engineers, human movement experts, geographers and psychologists from the UK and Australia. This engaged people in a one day workshop that comprised a series of presentations from international speakers on urban design, social connectedness, hazards and injury prevention, and the physical environment. Small group discussions (facilitated by consortium members) followed presentations to consider the opportunities, challenges and barriers encountered with ageing, which included the use of creative engagement activities (LEGO® Serious Play, mind maps, poster gallery walk), to help participants share personal stories and reflect on the issues raised. Thematic coding was used to synthesise the outputs of the small group work. Results Five themes emerged across the workshops, comprising: access and transport; involvement of the whole community; restoration rather than redesign; assistive and digital technology; and intergenerational approaches. These dimensions related to the physical, social and nature-based qualities of everyday environments, as they pertain to ageing well. Conclusions Co-design was a valuable tool that helped understand the perceptions of stakeholders and essential to develop effective interventions and solutions. Participants highlighted several issues affecting people as they age and key environmental considerations to promote wellbeing, activity, and participation. The consortium identified gaps in the existing evidence base and are now planning activities to further develop research ideas in collaboration with our co-design participants.