bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sequential Epiphyseal Cartilage Changes of Femoral Heads in C57BL/6 Female Mice Treated with Excessive Glucocorticoids
Authors: Jin Shengyang , Yang Liang , Meng Chunqing , He Yu , Ma Kaige , Huang Wei , Wang Hong 
Published: December 2020

Objective Excessive use of glucocorticoids (GCs) may cause adverse effects on the skeletal system in children. However, only a few studies have reported the effects of GCs on the epiphyseal cartilage. This study aimed to uncover the subsequent epiphyseal cartilage changes of immature femoral heads after excessive GC treatment in a mouse model and explain the pathological changes preliminarily. Design Female C57BL/6 mice were divided into control and model (excessive GC treatment) groups. The structure of the femoral heads was evaluated by using micro-computed tomography, hematoxylin-eosin staining, and safranin staining analyses. Immunohistochemistry was used to detect angiogenesis and cartilage metabolism. Western blotting and TUNEL staining were used to examine epiphyseal cartilage chondrocyte apoptosis. Primary chondrocytes were isolated from the femoral heads of healthy mice for in vitro studies. The effects of GCs on chondrocyte apoptosis and metabolism were determined by flow cytometry and Western blotting. Results The epiphyseal cartilage ossification had started at 4 weeks posttreatment in a portion of mice; the ossification presented as a sequential process in the model group, while the epiphyseal cartilage maintained an unossified state in the control group. Vascular invasion into the epiphyseal cartilage of the model mice was observed at 4 weeks posttreatment. GCs induced chondrocyte apoptosis and altered chondrocyte metabolism in the epiphyseal cartilage. Conclusions The epiphyseal cartilage ossification accelerated in the femoral heads of female C57BL/6 mice after excessive GC treatment. Increased chondrocyte apoptosis, altered chondrocyte metabolism, as well as increased vascular invasion, are the potential factors influencing epiphyseal cartilage ossification.
Increased risk of second primary tumours in patients with oesophageal squamous cell carcinoma: a nationwide study in a Western population
Authors: van de Ven Steffi E. M. , Falger Janne M. , Verhoeven Rob H. A. , Baatenburg de Jong Robert J. , Spaander Manon C. W. , Bruno Marco J. , Koch Arjun D. 
Published: December 2020

AbstractBackgroundPatients with primary oesophageal squamous cell carcinoma are at risk of developing multiple primary tumours in the upper aero digestive tract. To date, most studies are performed in the Asian population. We aimed to evaluate the risk of multiple primary tumours in the upper aero digestive tract and stomach in patients with oesophageal squamous cell carcinoma in a Western population.MethodsWe performed a nationwide, retrospective cohort study in collaboration with the Netherlands Cancer Registry. Patients with primary oesophageal squamous cell carcinoma, diagnosed between 2000 and 2016, were included. Primary endpoints were synchronous and metachronous multiple primary tumour risk.ResultsThe cohort consisted of 9058 patients, diagnosed with oesophageal squamous cell carcinoma (male: 57.3%, median age 67 years). In 476 patients (5.3%), 545 multiple primary tumours have been diagnosed. Most of them were located in the head and neck region (49.5%). Among all multiple primary tumours, 329 (60.4%) were diagnosed synchronously (<6 months after oesophageal squamous cell carcinoma diagnosis) and 216 (39.6%) metachronously (6 months). Patients with oesophageal squamous cell carcinoma had a significantly increased risk of both synchronous (standardised incidence ratio 10.95, 99% confidence interval 9.40–12.53) and metachronous multiple primary tumours (standardised incidence ratio 4.36, 99% confidence interval 3.56–5.10), compared to the general population. The median interval to metachronous second primary tumour diagnosis was 3.0 years (interquartile range 1.8–5.9).ConclusionApproximately one in 20 patients with primary oesophageal squamous cell carcinoma have a second primary tumour in the upper aero digestive tract or stomach, either at the time of oesophageal squamous cell carcinoma diagnosis or at a later stage. As second primary tumours occur at an increased risk compared to the general population, prospective studies are necessary to investigate the yield and survival benefit of screening for second primary tumours in patients with oesophageal squamous cell carcinoma.
Biomechanics in an Incomplete Versus Complete Supraspinatus Tear: A Cadaveric Study
Authors: Rybalko Danil , Bobko Aimee , Amirouche Farid , Peresada Dmitriy , Hussain Awais , Patetta Michael , Sood Anshum , Koh Jason , Goldberg Benjamin 
Published: December 2020

Background: Degenerative and traumatic changes to the rotator cuff can result in massive and irreparable rotator cuff tears (RCTs). Purpose/Hypothesis: The study objective was to conduct a biomechanical comparison between a small, incomplete RCT and a large, complete RCT. We hypothesized that the incomplete supraspinatus (SS) tear would lead to an incremental loss of abduction force and preserve vertical position of the humeral head, while a complete SS tear would cause superior humeral migration, decrease functional deltoid abduction force, and increase passive range of motion (ROM). Study Design: Controlled laboratory study. Methods: Six cadaveric shoulders were evaluated using a custom testing apparatus. Each shoulder was subjected to 3 conditions: (1) intact/control, (2) 50%, full-thickness, incomplete SS tear, and (3) 100%, complete SS tear. Deltoid abduction force, superior humeral head migration, and passive ROM were measured in static conditions at 0°, 30°, and 60° of glenohumeral abduction, respectively. Results: The intact SS resulted in a mean deltoid abduction force of 2.5, 3.3, and 3.8 N at 0°, 30°, and 60° of abduction, respectively. Compared with the intact shoulder, there was no significant difference in mean abduction force seen in the incomplete tear, while the force was significantly decreased by 52% at 30° of abduction in the complete tear ( P = .009). Compared with the incomplete tear, there were significant decreases in abduction force seen in the complete tear, by 33% and 48% (0.9 N and 1.1 N) at 0° and 30° of abduction, respectively ( P = .04 and .004). The intact configuration experienced a mean superior humeral head migration of 1.5, 1.4, and 1.1 mm at 0°, 30°, and 60° of abduction, respectively. The complete tear resulted in a superior migration of 3.0 and 4.4 mm greater than the intact configuration at 0° and 30° of abduction, respectively ( P = .001). There was a 5° and 10° increase in abduction ROM with 50% and 100% tears, respectively ( P = .003 and .03). Conclusion: An incomplete SS tear does not significantly alter the biomechanics of the shoulder, while a large, complete SS tear leads to a significant superior humeral migration, a decreased deltoid abduction force, and a mild increase in passive ROM. Clinical Relevance: Our findings demonstrate the effects of large SS tears on key biomechanical parameters, as they progress from partial tears.
Return to Work After Distal Femoral Varus Osteotomy
Authors: Puzzitiello Richard N. , Liu Joseph N. , Garcia Grant H. , Redondo Michael L. , Forlenza Enrico M. , Agarwalla Avinesh , Yanke Adam B. , Cole Brian J. 
Published: December 2020

Background: Distal femoral varus osteotomy (DFVO) is a well-described procedure to address valgus deformity of the knee. There is a paucity of information available regarding patients’ ability to return to work (RTW) after DFVO. Purpose: To report the objective findings for RTW rates and times for patients receiving a DFVO for lateral compartment osteoarthritis secondary to valgus deformity of the knee. Study Design: Cohort study; Level of evidence, 3. Methods: This was a retrospective study of patients who received a lateral-wedge opening DFVO. Patients must have worked within 3 years before their operation to be included for analysis. Patients were contacted at a minimum of 2 years postoperatively for interview and questionnaire evaluation, including a subjective work questionnaire, visual analog scale (VAS) for pain, Single Assessment Numerical Evaluation (SANE), and a satisfaction questionnaire. Results: Overall, 32 patients were contacted at a mean follow-up of 7.1 ± 4.1 years (range, 2.2-13.3 years). The mean ± SD age at the time of surgery was 30.8 ± 8.8 years (range, 17.2-46.5 years), and 65.6% of patients were female. Eleven patients (34.4%) received a concomitant meniscal allograft transplant, and 12 (37.5%) received a cartilage grafting procedure. The average VAS pain score decreased significantly from 6.1 preoperatively to 3.2 postoperatively ( P = .03). All patients were able to RTW, at a mean time of 6.0 ± 13.2 months postoperatively (range, 0-72 months). When stratified by work intensity, the average time to return was 13.8, 3.1, 2.7, and 2.9 months for high, moderate, light, and sedentary occupations, respectively. There was no significant difference between these RTW times ( P = .16), although this analysis may have been limited by the small sample size. Four patients whose work was classified as heavy work (50%) and 3 whose work was classified as moderate work (18.8%) either switched jobs or kept the same job with lighter physical duties as a result of their procedures. Conclusion: In a young and active population, DFVO for valgus deformity reliably afforded the ability to RTW within a relatively short time for patients with sedentary, light, and moderate occupational demands. However, patients with moderate- to high-intensity occupational demands may be unable to RTW at their preoperative level.
Prescription of blood pressure lowering treatment after intracerebral haemorrhage: Prospective, population-based cohort study
Authors: Bonello Karl , Nelson Amy PK , Moullaali Tom J , Al-Shahi Salman Rustam ,   for the Lothian Audit of the Treatment of Cerebral Haemorrhage Collaborators
Published: December 2020

Introduction Blood pressure (BP) lowering reduces the risk of recurrent stroke after intracerebral haemorrhage (ICH). However, implementation of BP lowering in clinical practice in the UK is unknown. Patients and methods We identified adults with first-ever incident ICH to quantify the proportion who survived >14 days after hospital discharge and were prescribed BP-lowering medication in a prospective, population-based, inception cohort study in the Lothian region of Scotland during June 2010–May 2012 and January–December 2019. After the first cohort, we analysed reasons for avoiding BP-lowering medication in a sample from the Lothian region of the Scottish Stroke Care Audit during January 2017–November 2017, which informed a quality improvement intervention that was implemented in the second cohort. Results After efforts to improve monitoring and lowering of BP amongst ICH survivors, there was an increase in the proportion of patients prescribed BP-lowering medication at hospital discharge between the first and second population-based cohorts (81/130 [62%] vs. 68/89 [76%]; P = 0.028). Compared with patients not prescribed BP-lowering medication at hospital discharge, patients prescribed BP-lowering medication presented with higher systolic BP (177 vs. 156 mm Hg, P = 0.002 and 180 vs. 149 mm Hg, P < 0.001, in the first and second population-based cohorts, respectively), and were more likely to have pre-morbid hypertension (85% vs. 33%, P < 0.001 and 72% vs. 29%, P < 0.001) and atrial fibrillation (35% vs. 4%, P < 0.001 and 26% vs. 5%, P < 0.034). Conclusion In this population-based study, the proportion of patients with ICH who were prescribed BP-lowering medication at hospital discharge increased after a quality improvement intervention.
Computational identification of biomarker genes for lung cancer considering treatment and non-treatment studies
Authors: Maharjan Mona , Tanvir Raihanul Bari , Chowdhury Kamal , Duan Wenrui , Mondal Ananda Mohan 
Published: December 2020

Abstract
Background
Lung cancer is the number one cancer killer in the world with more than 142,670 deaths estimated in the United States alone in the year 2019. Consequently, there is an overreaching need to identify the key biomarkers for lung cancer. The aim of this study is to computationally identify biomarker genes for lung cancer that can aid in its diagnosis and treatment. The gene expression profiles of two different types of studies, namely non-treatment and treatment, are considered for discovering biomarker genes. In non-treatment studies healthy samples are control and cancer samples are cases. Whereas, in treatment studies, controls are cancer cell lines without treatment and cases are cancer cell lines with treatment.

Results
The Differentially Expressed Genes (DEGs) for lung cancer were isolated from Gene Expression Omnibus (GEO) database using R software tool GEO2R. A total of 407 DEGs (254 upregulated and 153 downregulated) from non-treatment studies and 547 DEGs (133 upregulated and 414 downregulated) from treatment studies were isolated. Two Cytoscape apps, namely, CytoHubba and MCODE, were used for identifying biomarker genes from functional networks developed using DEG genes. This study discovered two distinct sets of biomarker genes – one from non-treatment studies and the other from treatment studies, each set containing 16 genes. Survival analysis results show that most non-treatment biomarker genes have prognostic capability by indicating low-expression groups have higher chance of survival compare to high-expression groups. Whereas, most treatment biomarkers have prognostic capability by indicating high-expression groups have higher chance of survival compare to low-expression groups.

Conclusion
A computational framework is developed to identify biomarker genes for lung cancer using gene expression profiles. Two different types of studies – non-treatment and treatment – are considered for experiment. Most of the biomarker genes from non-treatment studies are part of mitosis and play vital role in DNA repair and cell-cycle regulation. Whereas, most of the biomarker genes from treatment studies are associated to ubiquitination and cellular response to stress. This study discovered a list of biomarkers, which would help experimental scientists to design a lab experiment for further exploration of detail dynamics of lung cancer development.
A comparative study on production of extracellular hydrolytic enzymes of Candida species isolated from patients with surgical site infection and from healthy individuals and their co-relation with antifungal drug resistance
Authors: Erum Rakhshanda , Samad Farkhunda , Khan Adnan , Kazmi Shahana Urooj 
Published: December 2020

AbstractBackgroundSurgical site infection (SSI) is a crucial dilemma of surgery. Patients with SSIs not only face difficulty in treatment but also bear extra cost with high mortality rate. Resistant strains of Candida have emerged as an important nosocomial pathogen. Proteinase and phospholipase are exo- enzymes ofCandidaspecies, have importance with respect to their contribution in diseases. This study focused on prevalence ofCandidaspecies in surgical wound, their resistance to antifungal drugs, co-relation of these resistance with virulence potential ofCandidaspecies and comparison of production level of exo-enzymes ofCandidaspecies isolated from patients with SSIs and healthy individuals to highlights their role in SSIs.ResultsA total of (n = 555) swab samples were investigated. (n = 450) samples were collected from patients with SSIs and (n = 105) were collected from healthy individuals. Samples were subjected for the identification ofCandidaspecies which were subsequently investigated for antifungal susceptibility, MICs and enzymatic activity ofCandidaspecies. Out of 128 strains ofCandidaspp. isolated from SSIs, 54(42.18%) were identified asC. albicansfollowed byC. glabrata32(25%),C. parapsilosis17(13.28%),C. krusei13(10.16%) andC. tropicalis12(9.38%).C. albicansisolates showed 100% susceptibility to voriconazole and amphotericin B followed by itraconazole 98% and fluconazole 89%. Out of 6 fluconazole resistantC. albicans5(83.33%) were able to produce phospholipase while out of 48 fluconazole-susceptible strains 17(35.42%) were found to be phospholipase producer. Out of 54C. albicansisolated from surgical wound 46(85.18%) and 49(90.74%) were found to be phospholipase and proteinase producer respectively, whereas out of 20C. albicansisolates from healthy subjects 14(70%) produce proteinase and 12(60%) produce phospholipase. There were significant statistical differences found between the level of enzyme production byC. albicans, in relation to both sites (P = 0.014).ConclusionStudy revealed that prevalence ofCandidaspecies is high in SSIs. Phospholipase and proteinase activity were more pronounced inCandidaSpecies from surgical wound in contrast to species from healthy individuals suggests these enzymes may have been responsible for the severity of infection in surgical wound patients.
Role of aspartate ammonia-lyase in Pasteurella multocida
Authors: Wang Zui , Li Li , Liu Peng , Wang Chen , Lu Qin , Liu Lina , Wang Xiaozhong , Luo Qingping , Shao Huabin 
Published: December 2020

Abstract
Background
Pasteurella multocida is responsible for a highly infectious and contagious disease in birds, leading to heavy economic losses in the chicken industry. However, the pathogenesis of this disease is poorly understood. We recently identified an aspartate ammonia-lyase (aspA) in P. multocida that was significantly upregulated under iron-restricted conditions, the protein of which could effectively protect chicken flocks against P. multocida. However, the functions of this gene remain unclear. In the present study, we constructed aspA mutant strain △aspA::kan and complementary strain C△aspA::kan to investigate the function of aspA in detail.

Result
Deletion of the aspA gene in P. multocida resulted in a significant reduction in bacterial growth in LB (Luria-Bertani) and MH (Mueller-Hinton) media, which was rescued by supplementation with 20 mM fumarate. The mutant strain △aspA::kan showed significantly growth defects in anaerobic conditions and acid medium, compared with the wild-type strain. Moreover, growth of △aspA::kan was more seriously impaired than that of the wild-type strain under iron-restricted conditions, and this growth recovered after supplementation with iron ions. AspA transcription was negatively regulated by iron conditions, as demonstrated by quantitative reverse transcription-polymerase chain reaction. Although competitive index assay showed the wild-type strain outcompetes the aspA mutant strain and △aspA::kan was significantly more efficient at producing biofilms than the wild-type strain, there was no significant difference in virulence between the mutant and the wild-type strains.

Conclusion
These results demonstrate that aspA is required for bacterial growth in complex medium, and under anaerobic, acid, and iron-limited conditions.
A preoperative mortality risk assessment model for Stanford type A acute aortic dissection
Authors: Kuang Juntao , Yang Jue , Wang Qiuji , Yu Changjiang , Li Ying , Fan Ruixin 
Published: December 2020

Abstract
Background
Acute aortic dissection type A is a life-threatening disease required emergency surgery during acute phase. Different clinical manifestations, laboratory tests, and imaging features of patients with acute aortic dissection type A are the risk factors of preoperative mortality. This study aims to establish a simple and effective preoperative mortality risk assessment model for patients with acute aortic dissection type A.

Methods
A total of 673 Chinese patients with acute aortic dissection type A who were admitted to our hospital were retrospectively included. All patients were unable to receive surgically treatment within 3 days from the onset of disease. The patients included were divided into the survivor and deceased groups, and the endpoint event was preoperative death. Multivariable analysis was used to investigate predictors of preoperative mortality and to develop a prediction model.

Results
Among the 673 patients, 527 patients survived (78.31%) and 146 patients died (21.69%). The developmental dataset had 505 patients, calibration by Hosmer Lemeshow was significant (χ2 = 3.260, df = 8, P = 0.917) and discrimination by area under ROC curve was 0.8448 (95% CI 0.8007–0.8888). The validation dataset had 168 patients, calibration was significant (χ2 = 5.500, df = 8, P = 0.703) and the area under the ROC curve was 0.8086 (95% CI 0.7291–0.8881). The following independent variables increased preoperative mortality: age (OR = 1.008, P = 0.510), abrupt chest pain (OR = 3.534, P < 0.001), lactic in arterial blood gas ≥ 3 mmol/L (OR = 3.636, P < 0.001), inotropic support (OR = 8.615, P < 0.001), electrocardiographic myocardial ischemia (OR = 3.300, P = 0.001), innominate artery involvement (OR = 1.625, P = 0.104), right common carotid artery involvement (OR = 3.487, P = 0.001), superior mesenteric artery involvement (OR = 2.651, P = 0.001), false lumen / true lumen of ascending aorta ≥ 0.75 (OR = 2.221, P = 0.007). Our data suggest that a simple and effective preoperative death risk assessment model has been established.

Conclusions
Using a simple and effective risk assessment model can help clinicians quickly identify high-risk patients and make appropriate medical decisions.
COSMIN Risk of Bias tool to assess the quality of studies on reliability or measurement error of outcome measurement instruments: a Delphi study
Authors: Mokkink L. B. , Boers M. , van der Vleuten C. P. M. , Bouter L. M. , Alonso J. , Patrick D. L. , de Vet H. C. W. , Terwee C. B. 
Published: December 2020

Abstract
Background
Scores on an outcome measurement instrument depend on the type and settings of the instrument used, how instructions are given to patients, how professionals administer and score the instrument, etc. The impact of all these sources of variation on scores can be assessed in studies on reliability and measurement error, if properly designed and analyzed. The aim of this study was to develop standards to assess the quality of studies on reliability and measurement error of clinician-reported outcome measurement instruments, performance-based outcome measurement instrument, and laboratory values.

Methods
We conducted a 3-round Delphi study involving 52 panelists.

Results
Consensus was reached on how a comprehensive research question can be deduced from the design of a reliability study to determine how the results of a study inform us about the quality of the outcome measurement instrument at issue. Consensus was reached on components of outcome measurement instruments, i.e. the potential sources of variation. Next, we reached consensus on standards on design requirements (n = 5), standards on preferred statistical methods for reliability (n = 3) and measurement error (n = 2), and their ratings on a four-point scale. There was one term for a component and one rating of one standard on which no consensus was reached, and therefore required a decision by the steering committee.

Conclusion
We developed a tool that enables researchers with and without thorough knowledge on measurement properties to assess the quality of a study on reliability and measurement error of outcome measurement instruments.