bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic Impact of Admission High-Sensitivity C-Reactive Protein in Acute Myocardial Infarction Patients With and Without Diabetes Mellitus
Authors: Lucci Claudia , Cosentino Nicola , Genovese Stefano , Campodonico Jeness , Milazzo Valentina , De Metrio Monica , Rondinelli Maurizio , Riggio Daniela , Biondi Maria Luisa , Rubino Mara , Celentano Katia , Bonomi Alice , Capra Nicolò , Veglia Fabrizio , Agostoni Piergiuseppe , Bartorelli Antonio , Marenzi Giancarlo 
Published: August 2020

Abstract
Background: High-sensitivity C-reactive protein (hs-CRP) elevation frequently occurs in acute myocardial infarction (AMI) and is associated with adverse outcomes. Since diabetes mellitus (DM) is characterized by an underlying chronic inflammation, hs-CRP may have a different prognostic power in AMI patients with and without DM. Methods: We prospectively included 2,064 AMI patients; hs-CRP was measured at hospital admission. Patients were grouped according to hs-CRP quartiles and DM status. The primary endpoint was a composite of in-hospital mortality, cardiogenic shock, and acute pulmonary edema. Two-year all-cause mortality was the secondary endpoint. Results: Twenty-six percent (n=548) of patients had DM and they had higher hs-CRP levels than non-DM patients (5.32 vs. 3.24 mg/L; P<0.0001). The primary endpoint incidence in the overall population (7%, 9%, 13%, 22%; P for trend <0.0001), in DM (14%, 9%, 21%, 27%; P=0.0001), and non-DM (5%, 8%, 10%, 19%; P<0.0001) patients increased in parallel with hs-CRP quartiles. The adjusted risk of the primary endpoint increased in parallel with hs-CRP quartiles in DM and non-DM patients but this relationship was less evident in DM patients. In the overall population, the adjusted OR of the primary endpoint associated with an hs-CRP value >2 mg/L was 2.10 (95% CI 1.46-3.00). For the same risk, hs-CRP was 7 and 2 mg/L in patients with and without DM. A similar behavior was observed for the secondary endpoint when the HR associated with an hs-CRP value >2 mg/L found in the overall population was 2.25 (95% CI 1.57-3.22). For the same risk, hs-CRP was 8 and 1.5 mg/L in DM and non-DM patients. Conclusions: This study shows that hs-CRP predicts in-hospital outcome and two-year mortality in AMI patients with and without DM. However, in DM patients, the same risk of developing events as in non-DM patients is associated to higher hs-CRP levels.
Platelet to Lymphocyte Ratio as a Potential Inflammatory Marker Predicting the Effect of Adjuvant Chemotherapy in Stage II Colorectal Cancer Patients
Authors: Fu Yu , Chen Xiaowan , Song Yongxi , Huang Xuanzhang , Chen Quan , Lv Xinger , Gao Peng , Wang Zhenning 
Published: August 2020

Abstract
Background: The effect of adjuvant chemotherapy in stage II colorectal cancer (CRC) patients has been in controversy for a long time. Our study aimed to investigate the ability of several common inflammatory markers to predict the effect of chemotherapy in stage II CRC patients, finding an effective method for clinicians to distinguish chemotherapy-effective population.Methods: A total of 708 stage II CRC patients who underwent radical resection (R0) were included. The Subpopulation Treatment Effect Pattern Plot (STEPP) analysis was used to determine the optimal inflammatory marker and cut-off value. Propensity Score Matching (PSM) was performed to balance discrepancy of the characteristics between the chemotherapy and non-chemotherapy group. Kaplan-Meier method with the log-rank test was used to calculate the restricted mean survival time (RMST) and compare survival difference between chemotherapy and non-chemotherapy patients. Univariate Cox proportional hazard regression analysis was used to calculate Hazard Ratio (HR). Multivariate Cox proportional hazard regression analysis was used to investigate the interaction between the effect of chemotherapy and the clinicopathological characteristics.Results: Platelet to Lymphocyte Ratio (PLR) was chosen as the predictive marker with a cut-off value of 130 according to STEPP. For all the 708 patients, chemotherapy patients had a better OS than non-chemotherapy patients (p=0.007). Besides, the results of subgroup analysis interpreted that PLR was strongly associated with the effect of chemotherapy. In the high-PLR subgroup (PLR>130), chemotherapy patients obtained a significantly better survival benefit than non-chemotherapy patients (p＜0.001). However, in the low PLR subgroup (PLR≤130), such difference of survival benefit between chemotherapy and non-chemotherapy patients was not found (p=0.956). Multivariate Cox survival analysis also found that PLR was the only characteristic associated with the effect of chemotherapy (p interaction=0.027) among all the 11 clinicopathological characteristics. After PSM, no significant difference in OS was found between the chemotherapy group and the non-chemotherapy group (p=0.058). PLR was still the only characteristic associated with the effect of chemotherapy (p interaction=0.038).Conclusions: PLR can be used as an effective marker to predict the effect of adjuvant chemotherapy in stage II CRC patients.
The role of mixed vibronic Qy-Qx bands in the light-harvesting dynamics of the major antenna complex, LHCII
Authors: Arsenault Eric , Yoneda Yusuke , Iwai Masakazu , Niyogi Krishna , Fleming Graham 
Published: August 2020

Abstract
The importance of green light for driving natural photosynthesis has long been underappreciated, however, under the presence of strong illumination, green light actually drives photosynthesis more efficiently than red light. This green light is absorbed by mixed vibronic Qy-Qx states, arising from chlorophyll (Chl)-Chl interactions, although almost nothing is known about these states. Here, we employ polarization-dependent two-dimensional electronic-vibrational spectroscopy to study the origin and dynamics of the mixed vibronic Qy-Qx states of light-harvesting complex II. We show the states in this region dominantly arise from Chl b and demonstrate how it is possible to distinguish between the degree of vibronic Qy versus Qx character. We find that the dynamics for states of predominately Chl b Qy versus Chl b Qx character are markedly different, as excitation persists for significantly longer in the Qx states and there is an oscillatory component to the Qx dynamics, which will be discussed. Our findings demonstrate the central role of electronic-nuclear mixing in efficient light-harvesting and the different functionalities of Chl a and Chl b.
Preoperative Chronic Pain as a Risk Factor for Early Postoperative Cognitive Dysfunction in Elderly Patients Undergoing Hip Joint Replacement Surgery: A Prospective Observational Cohort Study
Authors: Huai Xiaorong , Jiao Yingfu , Gu Xiyao , Zhu Huichen , Chen Lingke , Lu Bingwei , Fan Yichen , Yu Weifeng , Su Diansan , Xie Hong 
Published: August 2020

Abstract
Background: Although there is high overall success rate of major joint replacement surgery, postoperative cognitive dysfunction (POCD) is a very common complication after surgery, increasing morbidity and mortality. Identifying POCD risk factors would be helpful to prevent and decrease the occurrence of POCD. We hypothesised that preoperative chronic pain increases the risk of POCD.Methods: A single-centre, observational, prospective cohort study was conducted from January 2018 to March 2020. All consecutive elderly patients (>65 years) who underwent elective hemiarthroplasty or total hip arthroplasty with general anaesthesia by the same surgeon were enrolled. The patients underwent neuropsychological testing preoperatively and at 7 days and 2 months postoperatively. To determine POCD, a nonsurgical control group was recruited from the general community.Results: Of the 141 patients who finished the neuropsychological testing 7 days after surgery, 61 (43.2%) had preoperative chronic pain. Of the 61 patients, 17 (27.9%) developed POCD; of the 79 patients with no chronic pain, 10 (12.7%) had developed POCD by 7 days after surgery. Multivariate logistic regression analysis identified preoperative chronic pain as a risk factor of POCD assessed 7 days after surgery (odds ratio, 3.335; p = 0.022). There was no significant difference in the POCD incidence 2 months after surgery between patients with and without preoperative chronic pain.Conclusions: Preoperative chronic pain was a risk factor of developing POCD within 7 days after surgery in elderly patients following hip joint replacement surgery.Clinical trial registration: NCT03393676. Registered 10 January 2018, https://register.clinicaltrials.gov/prs/app/action/SelectProtocolsid=S0006RLL&selectaction=Edit&uid=U0003WPM&ts=79&cx=llo35x
Penetrating Atheromatous Ulcer As A Precursor Of Aortic Dissection: A Case Report
Authors: Shah Priya , Polan Erik 
Published: August 2020

Abstract
Background: Acute aortic syndromes include a range of life-threatening conditions with the most familiar entity being aortic dissection. However, variants of aortic dissection also include intimal tear without hematoma, aortic intramural hematoma, and lastly penetrating aortic ulcer (PAU), which will be the focus of this case report. Most PAUs are located in the descending thoracic aorta (85-95%), but they can also occur in the ascending aorta or arch as in the current case. Case Presentation: We report a case of a 77 year old male who presented with chief complaint of intermittent right-handed weakness associated with no numbness or mental status changes. Patient was admitted for stroke workup with unrevealing findings on CT (computed tomography) for acute abnormalities or any hemodynamically significant stenosis on carotid ultrasound. CT angiogram of head/neck revealed a penetrating aortic ulcer of the lateral aspect of the mid to distal ascending aorta. Patient was then transferred for further evaluation to a center of higher level care for further management. Conclusions: Patient was evaluated for surgical repair of penetrating ascending aortic ulcer. Patient underwent serial imaging throughout hospital course which showed grossly similar findings to prior examination and thus no surgical intervention was needed at that time. Patient was recommended to have follow up CT scan in one month to monitor progression of aortic ulcer, however patient lost to follow-up thereafter. Penetrating aortic ulcers are rarely located in the ascending aorta and are considered precursors of life-threatening aortic dissections.
Value of contrast-enhanced CT based radiomic machine learning algorithm in differentiating gastrointestinal stromal tumors with KIT exon 11 mutation: a two-center study
Authors: Liu Bo , Wang Hexiang , Liu Shunli , Yang Shifeng , Song Yancheng , Liu Hao , Zheng Ziwen , Zhao Junjiang , Hou Feng , Jiao Xuelong , Zhang Jian 
Published: August 2020

Abstract
Background Knowing the genetic phenotype of gastrointestinal stromal tumors (GISTs) is essential for patients who receive therapy with tyrosine kinase inhibitors.Methods We enrolled 106 patients (80 in the training set, 26 in the validation set) with clinicopathologically confirmed GISTs from two centers. Preoperative and postoperative clinical characteristics were selected and analyzed to construct the clinical model. Arterial phase (A-phase), venous phase (V-phase), delayed phase (D-phase), and combined radiomics algorithms were generated from the training set based on contrast-enhanced computed tomography (CE-CT) images. Various radiomics feature selection methods were used, namely least absolute shrinkage and selection operator (LASSO); minimum redundancy maximum relevance (mRMR); and generalized linear model (GLM) as a machine-learning classifier. Independent predictive factors were determined to construct preoperative and postoperative radiomics nomograms by multivariate logistic regression analysis. The performances of the clinical model, radiomics algorithm, and radiomics nomogram in distinguishing GISTs with the KIT exon 11 mutation were evaluated by area under the curve (AUC) of the receiver operating characteristic (ROC).Results The combined radiomics algorithm was found to be the best prediction model for differentiating the expression status of the KIT exon 11 mutation (AUC = 0.836; 95% confidence interval (CI), 0.640–0.951) in the validation set. The clinical model, and preoperative and postoperative radiomics nomograms had AUCs of 0.606 (95% CI, 0.397–0.790), 0.715 (95% CI, 0.506–0.873), and 0.679 (95% CI, 0.468–0.847), respectively, with the validation set.Conclusion The radiomics algorithm could distinguish GISTs with the KIT exon 11 mutation based on CE-CT images and could potentially be used for selective genetic analysis to support the precision medicine of GISTs.
The Application of Laparoscopy Combined With Indocyanine Green Fluorescence Imaging Technique for Hepatic Cystic Echinococcosis
Authors: Li Yupeng , Ma Zhigang , Li Zhide , Tuxun Tuerhongjiang , Meng Yuan , Chen Xiong 
Published: August 2020

Abstract
BACKGROUND: With the mature application of laparoscopy in hepatobiliary surgery, laparoscopic treatment of hepatic cystic echinococcosis(CE) has made certain progress. But, due to the inherent limitations of laparoscopy and the growth characteristics of cystic echinococcosis, distinguishing the boundary between cystic lesion and normal hepatic parenchyma is pivotal importance for successful sugery. Indocyanine green(ICG) fluorescence imaging technology can view the boundary of lesion and normal tissue during the treatment of hepatic cystic echinococcosis. Applied laparoscopy combined with ICG fluorescence imaging technique for hepatic cystic echinococcosis may be an effective surgical strategy.AIM: To report and discuss single center experience of indocyanine green fluorescence imaging during laparoscopic management of hepatic cystic echinococcosis patients.METHODS: The clinical data contained nine patients with hepatic cystic echinococcosis who underwent laparoscopic surgery with indocyanine green fluorescence imaging technique in authors’ institution from December 2018 to December 2019 were retrospectively analyzed. Indocyanine green was administered intravenously three days prior to surgery. The fluorescence acquisition system for real-time imaging was used during the surgery and the patients were followed up after surgery. RESULTS: Of reported nine patients, six are male and the remaining three are female. The average age is (36.5 ± 7.6) years with their body weight (70.6 ± 7.2) kg. For all subjects, surgical procedures were performed under laparoscopy with indocyanine green fluorescence system. This technique showed the clear boundary of the hepatic cyst with normal liver paranchyma. Total cystectomy in six patients, subtotal cystectomy in two patients and partial hepatectomy in one patient were performed repectively. The average operation time was 228 ± 54 minutes, blood loss 206.3 ± 120.8 ml. Neither blood transfusion nor post-operative complication was experienced. The average abdominal drainage time was 3.4 ± 0.9 days with hospital stay 5.7 ± 2.1 days. During the 6-12 months follow-up period, neither recurrence nor intraperitoneal implantation was found.CONCLUSION: Applied laparoscopy combined with ICG fluorescence imaging technique for hepatic cystic echinococcosis is safe and feasible. Enhanced boundary image can assist surgeons to complete radical resection and reduce complications.
Initial result of unselective implementation of enhanced recovery after surgery in a low-volume bariatric unit: a feasibility and safety study
Authors: Lo Hung Chieh , Chiu Wen-Kuan , Chiu Yu-Chi , Hsu An-Chih , Tai Yu-Ting 
Published: August 2020

Abstract
Background The feasibility and safety of unselectively applying an enhanced recovery after surgery (ERAS) protocol in a low-volume bariatric unit were determined.Material and methods We retrospectively reviewed all patients undergoing bariatric surgeries under a single surgeon between January 2015 and December 2018. Our ERAS protocol initiated in January 2017 with all patients enrolled unselectively. For those receiving non-primary procedures or with BMI < 32.5 kg/m2 were excluded from this analysis. Demographic features and all 30-day outcome measures, including operation time, length of stay (LOS), ER visits, readmissions, reoperations were collected and compared between the ERAS (2017–2018) and control (2015–2016) groups.Results One hundred eighty-four consecutive patients underwent bariatric surgeries during the study period. Of those fulfilling the inclusion criteria, 62 (40.8%) were treated before and 90 (59.2%) were treated after ERAS implementation. No differences in baseline demographics were found between the groups except ERAS group had more Roux-en-Y gastric bypass procedures (58.9% vs. 12.9%). A markedly reduced operation time (101 min vs. 147 min; p < 0.001) and shortened LOS (2.6 days vs. 3.3 days; p < 0.001) were observed, with significantly more ERAS patients achieving POD1 discharge (45.6% vs. 1.6%; p < 0.001). There were no significant differences in terms of ER visits (2.2% vs. 8%), readmissions (1.1% vs. 4.8%) or total complication rates between the groups (5.5% vs. 9.7%).Conclusion Unselective ERAS implementation in low-volume units is feasible and safe, with significantly reduced operation times and a shortened LOS without increased complications.
Biocatalytic Hybrid Nanoparticles for Degassing and Stabilization of Single Electron Transfer-Living Radical Polymerization in Pickering emulsions
Authors: Guerra Adrian Moreno , Sipponen Mika 
Published: August 2020

Abstract
Synthetic polymers are indispensable in many different applications, but there is a growing need for green processes and natural surfactants for emulsion polymerization. The use of solid particles to stabilize Pickering emulsions is a particularly attractive avenue, but oxygen sensitivity has remained a formidable challenge in controlled polymerization reactions. Here we show that lignin nanoparticles (LNPs) coated with chitosan and glucose oxidase (GOx) enable efficient stabilization of Pickering emulsion and in situ enzymatic degassing of single electron transfer-living radical polymerization (SET-LRP) without extraneous hydrogen peroxide scavengers. The resulting latex dispersions can be purified by aqueous extraction or used to obtain polymer nanocomposites containing uniformly dispersed LNPs. The polymers exhibit high chain-end fidelity that allows for production of a series of well-defined block copolymers as a viable route to more complex architectures.
Visceral Adiposity Index is Associated With Silent Brain Infarct in a Healthy Population
Authors: Nam Ki-Woong , Kwon Hyung-Min , Jeong Han-Yeong , Park Jin-Ho , Kwon Hyuktae , Jeong Su-Min 
Published: August 2020

Abstract
Background
Visceral adiposity index (VAI) is a novel indicator of the mass and function of visceral adipose tissue, and it has been associated with metabolic disease, cardiovascular disease, and subclinical atherosclerosis; however, there is limited information about its association with cerebrovascular diseases, especially in subclinical pathology. In this study, we evaluated the relationship between VAI and silent brain infarct (SBI) in a healthy population.
Methods
We evaluated a consecutive series of healthy volunteers over the age of 40 between January 2006 and December 2013. SBI was defined as an asymptomatic, well-defined lesion with a diameter ≥ 3 mm with the same signal characteristics as the cerebrospinal fluid on T1- or T2 weighted images. VAI was calculated using sex-specific equations as described in previous studies, and was based on a number of parameters including waist circumference, triglycerides, high-density lipoprotein cholesterol, and body mass index.
Results
A total of 2,596 subjects were evaluated (mean age 56y, male sex: 54%), and SBI was found in 218 (8%) participants. In multivariable analysis, VAI (adjusted odds ratio [aOR] = 1.30; 95% confidence interval [CI] = 1.03–1.66; P = 0.030) remained a significant predictor of SBI after adjustment for confounders. On the other hand, visceral adipose tissue area on computed tomography did not show any statistical significance with SBI. The close relationship between VAI and SBI was prominent only in females (aOR = 1.44; 95% CI = 1.00-2.07; P = 0.048). In the evaluation between VAI and the burden of SBI, VAI showed a positive dose-response relationship with the number of SBI lesions (P for trend = 0.037).
Conclusions
High VAI was associated with a higher prevalence and burden of SBI in a neurologically healthy population, especially in females. Our findings indicate that VAI could be used as a simple and convenient predictor for SBI.
Palladium-catalyzed allene synthesis enabled by β-hydrogen elimination from sp2-carbon
Authors: Zhang Ge , Song Yi-Kang , Zhang Fang , Xue Ze-Jian , Li Meng-Yao , Zhang Gui-Shan , Zhu Bin-Bin , Wei Jing , Li Chunsen , Feng Chen-Guo , Lin Guo-Qiang 
Published: August 2020

Abstract
The rational design based on a deep understanding of the present reaction mechanism is an important, viable approach to discover new organic transformations. β-Hydrogen elimination from palladium complexes is an fundamental reaction in palladium catalysis. Normally, the eliminated β-hydrogen has to be attached to a sp3-carbon. We envision that the hydrogen elimination from sp2-carbon is possible by using delicately planed reaction systems, which may offer a new strategy for the preparation of allenes. With this consideration in mind, the palladium-catalyzed cross-coupling of 2,2-diarylvinyl bromides with diazo compounds was realized with a β-vinylic hydrogen elimination from allylic palladium intermediate as the key step. Both aryl diazo carbonyl compounds and N-tosylhydrazones are competent carbene precursors in this reaction. The reaction mechanism was explored by control experiments, KIE studies and DFT calculations
Overweight and Aging Increase the Risk of Atrial Fibrillation After Cardiac Surgery Independently of Left Atrial Size and Left Ventricular Ejection Fraction
Authors: Stefano Pier Luigi , Bugetti Marco , Monaco Guido Del , Popescu Gloria , Pieragnoli Paolo , Ricciardi Giuseppe , Perrotta Laura , Checchi Luca , Rondine Roberto , Bevilacqua Sergio , Marchionni Niccolò , Michelucci Antonio 
Published: August 2020

Abstract
Background: Body mass index (BMI), age, left atrium (LA) dimensions and left ventricular ejection fraction (LVEF) have been linked to post-operative atrial fibrillation (POAF) after cardiac surgery. The aim was to better define the role of these risk factors. Methods: This study evaluated 249 patients (without prior atrial dysrhythmia) undergoing cardiac or aortic surgery . Prior to surgery the following data were collected: age (yrs), BMI (kg/m2), LA diameter (cm), LA area (cm2), LVEF (%), the presence of arterial hypertension (AH) and of diabetes, tyroid stimulating hormone (TSH, mU/L) and, creatinine (mg/dL). Results: Patients with (n. 127, 51%) and without POAF (n. 122, 49%) were compared. No difference was observed for sex, LA diameter, LA area, LVEF, TSH and diabetes. Instead, patients with PoAF had higher values of age, BMI, creatinine and a greater prevalence of AH and Bentall procedures. Multivariable analysis showed that the only independent predictors of PoAF were: age (OR = 1,05, CI 95% 1,025-1,076, p= 0,0001) and BMI (OR=1,095, CI 95% 1,015-1,182, p= 0,019). Conclusions: Results suggest that advanced age and a higher value of BMI are strong risk factors for POAF in patients without previous AF. This even in the presence of comparable LA dimensions and LVEF.