bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety of Albumin and Hydroxyethyl Starch as Priming Fluid for Cardiopulmonary Bypass in Cardiac Surgery: A Meta-analysis of Randomized Controlled Trials
Authors: Ye Mingtang , Zang Xiaodong , Ding Peicheng , Wang Ruonan , Chen Feng , Qi Jirong , Yang Zhaocong , Mo Xuming 
Published: November 2020

Abstract
Introduction: Hydroxyethyl starch (HES) has been widely used for volume expansion, but its safety as priming fluid for cardiopulmonary bypass has been questioned recently. The aim of this meta-analysis is to compare the safety of albumin and hydroxyethyl starch as priming fluid for cardiopulmonary bypass.Methods: Pubmed, Embase database and Cochrane Library were searched for randomized controlled trials (RCTs) involving patients who received HES or albumin as priming fluid for cardiopulmonary bypass in cardiac surgery published up to October 2019. Two reviewers independently extracted the valid data, including the length of ICU stay, ventilator time, the length of hospital stay, crystal volume, fresh frozen plasma, platelet input, blood loss, blood platelet count. hemoglobin value, fibrin, APTT, PT, urea, creatinine and urine volume. Meta-analysis was performed with revman version 5.3. Results: Total 9 RCTs involving 452 patients were included in this meta-analysis. Compared with albumin, HES had similar effects on the length of ICU stay(MD = 0.70；95%CI：-0.14 to 1.55；P = 0.10；I2 = 89%);ventilation time(MD = 2.31 ;95%CI-3.93 to 8.55;P = 0.47,I2 = 60%); the length of hospital stay(MD = -0.31;95% CI:-2.00 to 1.37; P = 0.71 ;I2 = 0%); crystal volume(SMD = 0.26;95% CI:-0.09 to 0.61; P = 0.15;I2 = 0%); fresh frozen plasma(SMD = 0.25；95%CI：-0.08 to 0.59；P = 0.66；I2 =0%); platelet input(SMD =-0.17;95% Cl:-0.59 to 0.26;P =0.45;I2 = 0%);blood loss (SMD =0.31;95% Cl:-0.01 to 0.63;P = 0.06;I2 =29%);platelet count (SMD =-0.21;95% cl :-0.54 to 0.11; P = 0.20;I2 = 29% );hemoglobin value(SMD =0.1;95% CI: -0.15 to 0.36;P = 0.42; I2 = 0% ); fibrin (SMD =0.12;95% CI: -0.19 to 0.44 ; P = 0.45; I2 = 0% );APTT(MD =1.13;95% CI: -2.06 to 4.32 ; P = 0.49; I2 = 0%);PT(MD =0.10;95% CI: -0.21 to 0.40,P = 0.52; I2 = 0%);creatinine(SMD =0.09;95% CI: -0.32 to 0.50 ; P = 0.66; I2 = 51% );urine volume(SMD =0.11;95% CI: -0.26 to 0.48 ; P = 0.55; I2 = 43% ).but did not increase urea (SMD =-0.46;95% CI: -0.81 to -0.11; P = 0.01; I2 = 0%).Conclusions: HES was safe and effective compared to albumin as priming fluid for cardiopulmonary bypass because it did not affect renal function, coagulation function, liquid input, or the length of ICU stay and ventilation time of patients.
The effect of oxycodone on postoperative pain and inflammatory cytokine release in elderly patients undergoing laparoscopic gastrectomy
Authors: Lao Wei-long , Song Qi-liang , Jiang Zong-ming , Chen Wen-di , Zheng Xian-he , Chen Zhonghua 
Published: November 2020

Abstract
Background To evaluate the effect of oxycodone on postoperative pain and inflammation in elderly patients undergoing laparoscopic gastrectomy. Methods Sixty patients who were of both sexes, American Society of Anesthesiologists Physical Status (ASA-PS) Class I or II, over 65 years of age and undergoing an elective laparoscopic radical gastrectomy were randomly divided into two groups: an oxycodone group (Group O) and a sufentanil group (Group S). The postoperative analgesia regimen was as follows: 40 mg of parecoxib sodium and 0.1 mg/kg of oxycodone was intravenously injected into Group O before the abdomen closure, while 40 mg of parecoxib sodium and 0.1 μg/kg of sufentanil was injected intravenously into Group S. Both groups were infiltrated with 20 ml of 1% ropivacaine at the end of the operation. The concentrations of IL-6 and IL-10 were measured immediately after the operation and one hour, six hours and twenty-four hours after the operation (T1-4). The numerical rating scale (NRS), the Ramsay sedation score, analgesic-related adverse events, postoperative pulmonary inflammation events and the postoperative stay were recorded. Results Compared with Group S, the serum IL-6 concentrations of Group O decreased at T3 and T4, while the serum IL-10 concentrations increased (P < 0.05). In Group O, the serum IL-6 concentrations at T3 and T4 were lower than those at T1 (P < 0.05). The incidence of postoperative nausea and vomiting（PONV）and pulmonary inflammation in Group O was lower than that in Group S (P < 0.05). At each time point, the NRS of visceral pain in Group O was lower than that in Group S. At six and twenty-four hours after extubation, the NRS of incision pain in Group O was lower than that in Group S (P < 0.05). Conclusion Oxycodone can regulate the level of inflammatory cytokines and reduce postoperative inflammatory response.
Prognostic implications of lymphocyte/C-reactive protein ratio with tumor-infiltrating lymphocytes in resected intrahepatic cholangiocarcinoma
Authors: Miyazaki Katsuki , Morine Yuji , Imura Satoru , Ikemoto Tetsuya , Saito Yu , Yamada Shinichiro , Tokuda Kazunori , Okikawa Shohei , Yamashita Shoko , Oya Takeshi , Tsuneyama Koichi , Shimada Mitsuo 
Published: November 2020

Abstract
Background Lymphocyte/C-reactive protein (CRP) ratio (LCR), is a promising prognostic factor that can reflect tumor inflammation and systemic patient condition. The aim of this study was to investigate whether preoperative LCR can be a prognostic factor for post-surgical outcomes among patients with intrahepatic cholangiocarcinoma (IHCC). We also investigated the relationship between LCR and tumor infiltrating lymphocytes (TILs) to clarify whether systemic host immune parameters reflect local tumor immunity.Methods We enrolled 45 patients who had undergone hepatectomy for IHCC. Patients were divided into low LCR and high LCR groups, according to reactive operating characteristic curve (Cut-off value: 8780). We analyzed their overall survival (OS) and disease-free survival (DFS) with respect to LCR and other clinicopathological factors. We also investigated stromal TILs and numbers of CD8+ TILs in surgical specimens, and the relationship between LCR and TILs.Results Twenty-one patients (46.7%) were associated with low LCR. Low LCR was significantly correlated with older age, high CRP and advanced disease stage, and was a prognostic factor for OS and DFS. And multivariate analysis revealed that low LCR was an independent prognostic factor for worse OS (HR: 2.81 P<0.04). Regarding the relationship between LCR and local tumor immunity, while LCR and levels for stromal TILs were significantly related, LCR and levels for CD8+ TILs were significantly related. Conclusions Preoperative LCR levels could predict the post-surgical prognosis of patients with IHCC, and reflected numbers of intra-tumoral CD8+ TILs.Trial registration This study was approved by Tokushima University Hospital ethics committee and with the approval of corresponding regulatory agencies, and all the experiments were carried out in accordance with the approved guidelines (Tokushima Clinical Trial Management System Number; 3215). All the patients involved in this study signed informed consent forms and agreed to participate.
Development and Validation of Nomograms for Predicting Survival of Elderly Patients with Stage I Small-Cell Lung Cancer
Authors: Yang Yaji , Sun Shusen , Xiong Feng , Xiao Yin , Huang Jing 
Published: November 2020

Abstract
Background There is a lack of predictive models to determine the prognosis of elderly patients diagnosed with Stage I small-cell lung cancer (SCLC). The purpose of this study was to establish a useful nomogram to predict the cancer-specific survival (CSS) in this patient population.Methods Based on the Surveillance, Epidemiology, and End Results registry database, patients aged ≥ 65 years with pathological AJCC (American Joint Committee on Cancer) Stage I SCLC from 2004 to 2014 were identified. The CSS was evaluated by the Kaplan-Meier method. Patients were randomly split into training and validation sets. In the training cohort, univariate analysis and multivariate analysis by using the Cox regression identified risk factors that affected CSS, and the results were utilized to construct a nomogram for prediction of the 1-, 3-, and 5-year CSS rates of elderly patients with Stage I SCLC. The effectiveness of the nomogram was validated internally and externally by the bootstrap method.Results In total, we extracted 1,623 elderly patients with Stage I SCLC. The median CSS was 34 months, and the 5-year CSS was 41 months. Multivariate analysis revealed that histologic type, tumor size, age, and AJCC Stage were significant predictors of CSS. A nomogram was constructed according to the results of multivariate COX analysis. The C-indices of the nomogram for training and validation sets were 0.68 and 0.62, indicating that the nomogram demonstrated a favorable level of discrimination. The calibration curves exhibited satisfactory agreement between the actual observation and nomogram prediction.Conclusion A practical nomogram to predict the CSS of elderly patients with Stage I SCLC is constructed. The predictive tool is helpful for patients counseling and treatment decision making.
Two-Pool Multiplex Long-Amplicon Amplification and Full-Genome Sequencing of SARS-CoV-2
Authors: Liu Hong-jie , Li Jin-Hui , Lin Yan-Feng , Bo Xiao-Chen , Song Hong-Bin , Li Peng , Ni Ming 
Published: November 2020

Abstract
BackgroundSince the first public genome of SARS-CoV-2, over 170,000 genome sequences of the virus have been shared by researchers world-wide (till November 1st 2020). Multiplex PCR targeting SARS-CoV-2 followed by massively parallel sequencing (MPS) and/or nanopore sequencing is a widely used strategy to recover the genome from primary samples. However, the bias of amplification among different amplicons should not be ignored, which might lead to uneven sequencing coverage on the viral genome.MethodsWe aim to develop a novel multiplex PCR panel to achieve an improved coverage evenness of SARS-CoV-2. We adapt long amplicons (~1000-bp) for the panel and thus reduced the number of primer pairs. The panel was validated with clinical samples and sequenced via MPS sequencing systems and a portable nanopore sequencing device MinION. We evaluated the full-genome coverage evenness and its dependence on viral loads of the long amplicon panel; we then compared it with a 98-plex panel provided by the ARTIC network. The accuracy to identify viral genomic variations based on the panel and sequencing with MinION was assessed.ResultsWe developed a two-pool 36-plex panel for full-genome sequencing of SARS-CoV-2, whose amplicon size ranged from 880 to 1027 bp. For samples with a <30 Ct value, >90% viral genome could be recovered with a high sequencing depth (>0.2 mean depth) by using the long-amplicon panel (n = 36), compared with 79-88% highly covered genome region for the ARTIC panel (n = 5). The coverage evenness of the long-amplicon panel was also less affected by low viral titers and not dependent on sequencing data amount. With MinION sequencing, the consensus viral genomes could be reliably recovered. However, a high false positive rate was observed to identify sub-clonal genomic variations with a <0.6 frequency.ConclusionA novel multiplex PCR panel for full-genome sequencing of SARS-CoV-2 with improved coverage evenness and low requirement of data throughput was validated with clinical samples. Amplification of SARS-CoV-2 with the panel followed by MinION sequencing could generate reliable consensus genome sequences, but the detection of non-dominating viral populations within host is error-prone.
Covid-19 in the Oldest-old Population (80 and Older): Clinical Presentation and Prognostic Factors of Severe Disease and Mortality. A Cohort Study.
Authors: Gálvez-Barrón César , Arroyo-Huidobro Marta , Miñarro Antonio , Añaños Gemma , Chamero Antonio , Martín Mireia , Gris Clara , Avalos Jose L , Capielo Anna , Ventosa Ester , Tremosa Gemma , Rodríguez-Molinero Alejandro 
Published: November 2020

Abstract
BACKGROUND The oldest-old population (80 years or older) has the highest lethality from COVID-19. There is little information on the clinical presentation and specific prognostic factors for this group. This trial evaluated the clinical presentation and prognostic factors of severe disease and mortality in the oldest-old population.METHODS Ambispective cohort study of oldest-old patients hospitalized for respiratory infection associated with COVID-19 and with a positive test by real-time polymerase chain reaction. The clinical presentation and the factors associated with severe disease and mortality were evaluated (logistic regression). All patients were followed until discharge or death.RESULTS A total of 103 patients (59.2% female) were included. The most frequent symptoms were fever (68.9%), dyspnoea (60.2%), and cough (39.8%), and 11.7% presented confusion. Fifty-nine patients (57.3%) presented severe disease, and 59 died, with 43 patients (41.7%) presenting both of these. In the multivariate analysis, male sex (OR 0.31, 95% confidence interval [95% CI] 0.13-0.73, p 0.0074) and serum lactate dehydrogenase (LDH) (OR 2.55, 95% CI 1.21-5.37, p 0.0139) were associated with severe disease, and serum sodium was associated with mortality (OR 3.12, 95% CI 1.18-8.26, p 0.0222). No chronic disease or pharmacological treatment were associated with worse outcomes.CONCLUSIONS The typical presenting symptoms of respiratory infection in COVID-19 are less frequent in the oldest-old population. Male sex and LDH level are predictors of severe disease, and serum sodium level predicts of mortality in this population.
Aerosolised fluorescein can quantify FFP mask faceseal leakage: a cost-effective adaptation to the existing point of care fit-test.
Authors: Zaman Sameer , Seligman Henry , Lloyd Freya Hepworth , Patel Keval Tushar , Chappell Digby , O'Hare Danny , Cole Graham D , Francis Darrel P , Petraco Ricardo , Linton Nick W F 
Published: November 2020

Abstract
Background Filtering facepiece (FFP) respirators must provide an adequate faceseal to protect healthcare workers from harmful particles. A qualitative fit-test using bitter-tasting aerosols the commonest way to determine if an FFP mask is safe enough for clinical use. This taste-test is subjective and can be biased by placebo. We propose a cheap and quantitative modification of the taste-test, by measuring the amount of fluorescein staining filter paper behind the FFP mask after a fit-test protocol, using digital image analysis. Methods Medical grade fluorescein was added to bitter-tasting denatonium benzoate solution and Aerosolised during a mask fit-testing protocol. Scientific filter paper was placed on the inner surface of the mask. Participants were asked if they could taste the solution to determine their qualitative ‘pass’ or ‘fail’ result. Filter paper photographs were analysed after the test to quantify total fluorescence (TF). TF levels in the taste-test ‘pass’ and ‘fail’ groups were compared.Results Fifty-six healthcare professionals completed the fluorescein mask fit-test protocol. 32 (57%) ‘passed’ the qualitative (taste) test and the remainder ‘failed’. There was a significant difference in TF between the groups based on their qualitative results (p <0.001). A cut-off of TF = 5.0 x 106 fluorescence units was determined by analysing the precision (78%) and recall (84%) of the fluorescein test. Applying this cut-off resulted in 5 out of 56 participants (9%) being reclassified from ‘pass’ to ‘fail’ by the fluorescein test. 7 out of 56 (12%) participants were reclassified from ‘fail’ to ‘pass’.Conclusions Fluorescein is detectable and sensitive to identify faceseal leaks in FFP masks. The fluorescein fit-test is discriminating in its ability to divide people into ‘pass’ and ‘fail’ groups similarly to the taste-test. The adaptations are low-cost and could be incorporated in the point-of-care setting. After further validation the fluorescein test could increase safety for staff by reducing the number of false ‘pass’ by the taste-test. It could also reassure people who have ‘failed’ the taste-test that they have low levels of fluorescein leak, enabling them to return to clinical practice safely.
Characteristics of Diffusion-Weighted and Blood Oxygen Level-Dependent Magnetic Resonance Imaging in Tubulointerstitial Nephritis: an initial experience.
Authors: Su Tao , Yang Xuedong , Wang Rui , Yang Li , Wang Xiaoying 
Published: November 2020

Abstract
Background: Diffusion weighted(DW) and blood oxygen level-dependent(BOLD) magnetic resonance imaging are classical sequences of functional MR,but the exploration in non-transplanted kidney disease is limited.Objects:To analyze the characteristics of apparent diffusion coefficient(ADC) and R2* value using DW and BOLD imaging in tubulointerstitial nephritis(TIN).Methods: Four acute TIN,thirteen chronic TIN patients and four controls were enrolled.A multiple gradient-echo sequence was used to acquire 12 T2*-weighted images for calculation of R2* map.DW imaging was acquired by combining a single-shot spin-echo echo planar imaging pulse sequence and the additional motion probing gradient pulses along the x,y,z-axes with two b values:0 and 200, as well as 0 and 800 s/mm2.For ATIN,DW and BOLD magnetic resonance were performed at the time of renal biopsy(T0) and the third month(T3).Pathological changes were assessed semi-quantitatively.Correlation analysis were conducted within functional MR,pathological and clinical indexes.Results: In ATIN,ADCs were significantly lower(b was 0,200 s/mm2,2.86±0.19vs.3.39±0.11,b was 0,800 s/mm2,1.76±0.12vs.2.16±0.08,P<0.05) than controls,showing an obvious remission at T3.Cortical and medullary R2* values(CR2*,MR2*) were decreased,significantly recovery at T3 was only observed in MR2*(T0 24.3±2.1vs.T3 32.4±6.6,P<0.05).No relationship was found between fMR and histopathological indexes.MR2* had a close relationship with eGFR(R=0.80,P=0.017) and serum creatinine(R=-0.502,P=0.012).Patients having lower ADC when b was 0,200 s/mm2,showed more increase of ADC(R=-0.956,P=0.044)and MR2*(R=-0.949,P=0.05).In CTIN group, reduced MR2* was disclosed with unchanged CR2* and ADC value.Conclusions: We observed reduction and partial remission of ADC and R2* values in ATIN.Lower ADC when b is 0, 200 s/mm2 is an index indicating reversible injury.MR2* serves as a promising marker reflecting renal function.The pseudo normalization of CR2* with reduced MR2* in CTIN produces an evidence of intra-renal oxygen adaptation that contributing to CKD deterioration.
The emergence of subaerial crust and onset of weathering 3.7 billion years ago
Authors: Roerdink Desiree , Ronen Yuval , Strauss Harald , Mason Paul 
Published: November 2020

Abstract
Reconstructing the emergence and weathering of continental crust in the Archean is crucial for our understanding of early ocean chemistry, biosphere evolution and the onset of plate tectonics. However, considerable disagreement exists between the elemental and isotopic proxies that have been used to trace crustal input into marine sediments and data are scarce prior to 3 billion years ago. Here we show that chemical weathering modified the Sr isotopic composition of seawater as recorded in 3.52-3.20 Ga stratiform barite deposits from three different cratons. Using a combination of Sr, S and O isotope data, barite petrography and a hydrothermal mixing model, we calculate a novel Sr isotope evolution trend for Paleoarchean seawater that is much more radiogenic than the curve previously determined from carbonate rocks. Our findings require the presence and weathering of subaerial and evolved (high Rb/Sr) crust from 3.7 ± 0.1 Ga onwards. This Eoarchean onset of crustal weathering affected the chemistry of the oceans and supplied nutrients to the marine biosphere 500 million years earlier than previously thought.
Strategies for managing N95 mask shortages at water resource recovery facilities during pandemics: a review
Authors: Maal-Bared Rasha , Loudon Jennifer 
Published: November 2020

Abstract
As the numbers of COVID-19 cases grew globally, the severe shortages of health care respiratory protective equipment impacted the ability of water resource recovery facilities (WRRFs) to acquire N95 masks for worker protection. While the Occupational Safety and Health Administration (OSHA) encourages WRRFs to conduct job safety assessments to mitigate risks from bioaerosols, it does not provide clear guidance on respiratory protection requirements, leaving the use of N95 masks across the industry non-standardized and difficult to justify. Strategies need to be developed to cope with shortages during pandemics, and these should take into consideration a WRRF's size and disinfection equipment available. Our objective is to provide an overview of respiratory protection-related practices recommended for health care professionals that apply to WRRFs (e.g., elimination, substitution, extended use, reuse, disinfection). Reviewed N95 mask disinfection strategies included using hydrogen peroxide, autoclaving, moist heat, dry heat, ultraviolet germicidal irradiation (UVGI), ethylene oxide, chlorine and ethanol. Of these, dry heat, autoclaving and UVGI present the most promise for WRRFs, with UVGI being limited to larger utilities. We recommend that WRRFs work closely with disinfection technology manufacturers, mask providers, health and safety staff and inspectors to develop suitable programs to cope with N95 mask shortages during pandemics.
Relational model of public-private partnership in railway transport
Authors: Sirina N. F. , Pershin V. P. 
Published: November 2020

The main task facing the state is the solution of publicly significant issues to achieve public interests. Moreover, not every country has the necessary resources, especially in an unstable economic situation. In this case, increasing the efficiency of natural monopolies in the conjuncture of the transport market becomes the most relevant direction in government activities.The article is devoted to the issues of public-private partnership in railway transport. First of all, projects with private capital that are being implemented should eliminate the limiting sections of the Russian railway network and ensure the development of large industrial regions by creating an extensive transport network, the formation of which is impossible without the participation of the state.To increase the attractiveness of public-private partnership projects, the authors, taking into account the foundations of human capital management, have considered aspects of the additional effect for partners, which are defined by the concept of “relational effect”. Positive dynamics of socially oriented indicators, unaccounted in the agreement of the parties, reflect the presence of benefits from joint activities and positive relational effect, while negative change — about its absence.Based on the studies performed, a mechanism for controlling operating costs based on an integral assessment has been proposed, which makes it possible to analyze the actual direct costs of partners and compare deviations from the established standards. This mechanism is used in the state vertically integrated procedure for centralized training of authorities in public-private partnership. The general algorithm of the relational model of interaction between investment parties is formalized, illustrated by the example of the implementation of a project for the construction of a railway transport infrastructure.Mathematical support for the process of considering information on the project and making a decision on concluding an agreement on public-private partnership was carried out in the program “Automated system for consolidation, selection and control of the implementation of innovative projects of concession forms of management in railway transport”. The results obtained are integrated into the software complex for innovative development of facilities and are tuned for transformation, effective use of the potential of partners, investors, performers and industry enterprises.