bluuebunny/crossref_metadata_2025_split huggingface dataset:
Robotic low anterior resection for rectal cancer with side-to-end anastomosis in a patient with anal stenosis
Authors: Tajima Yosuke , Hanai Tsunekazu , Katsuno Hidetoshi , Masumori Koji , Koide Yoshikazu , Ashida Keigo , Matsuoka Hiroshi , Hiro Junichiro , Endo Tomoyoshi , Kamiya Tadahiro , Chong Yongchol , Maeda Kotaro , Uyama Ichiro 
Published: December 2020

Abstract
BackgroundColorectal anastomosis using the double stapling technique (DST) has become a standard procedure. However, DST is difficult to perform in patients with anal stenosis because a circular stapler cannot be inserted into the rectum through the anus. Thus, an alternative procedure is required for colorectal anastomosis.Case presentationA 78-year-old woman presented with bloody stool. Colonoscopy and computed tomography revealed advanced low rectal cancer without lymph node or distant metastasis. We initially planned to perform low anterior resection using a double-stapling technique or transanal hand-sewn anastomosis but this would have been too difficult due to anal stenosis and fibrosis caused by a Milligan-Morgan hemorrhoidectomy performed 20 years earlier. The patient had never experienced defecation problems and declined a stoma. Therefore, we inserted an anvil into the rectal stump and fixed it robotically with a purse-string suture followed by insertion of the shaft of the circular stapler from the sigmoidal side. In this way, side-to-end anastomosis was accomplished laparoscopically. The distance from the anus to the anastomosis was 5 cm. The patient was discharged with no anastomotic leakage. Robotic assistance proved extremely useful for low anterior resection with side-to-end anastomosis.ConclusionPerforming side-to-end anastomosis with robotic assistance was extremely useful in this patient with rectal cancer and anal stenosis.
Clinicopathological Characteristics and Differential Diagnosis of Signet-ring Cell Carcinoma of Gastric Pit Epithelium
Authors: Zhang Zhi-Shang , Deng Wei-Yi , Huang Si-Lin , Yang Bin-Feng , Zhu Fang-Heng , Jiang Bo , Wang Su-Nan , Wang Yang-Kun 
Published: December 2020

Abstract
Background:To investigate the clinicopathological characteristics, immunophenotype and differential diagnosis of signet-ring cell carcinoma of gastric pit epithelium. Methods Seven cases of signet-ring cell carcinoma of gastric pit epithelium were studied by histomorphology observation, special staining, immunohistochemical staining and follow-up. Results At the initial stage, the glands proliferated and expanded, and the cells morphologically transformed into signet ring-like atypical cells and then formed clonal hyperplastic signet-ring cell carcinoma, which expanded laterally along the gastric pit, with a length of 3–6 mm. Erosion or mucosal ulcers can be formed on the surface, and the atrophy of fundus or pylorus glands leads to local depression of gastric mucosa. PAS was positive by special staining. Immunophenotype testing included MUC5AC, CKpan, CK20, CEA, villin and CDX2 with positive expression. In cytology, five cell morphologies could be seen: classic, immature, high proliferation, non-nucleus vacuole and degeneration. Three out of seven cases were accompanied by Helicobacter pylori (Hp) infection, accounting for 42.9% of the cases. Conclusion The signet-ring cell carcinoma of gastric pit epithelium originates from the proliferative region of the gastric fundus and the neck of gastric gland, which grows laterally along the gastric pit and is easy to be missed and misdiagnosed. Attention should be paid to the differential diagnosis, and the recognition level of signet-ring cell carcinoma of gastric pit epithelium should be improved.
A Clinical Study on Bone Defect Reconstruction and Functional Recovery in Benign Bone Tumors of the Lower Extremity, Treated by Bone Marrow Mesenchymal Stem Cell Rapid Screening–enrichment–composite System
Authors: Wang Lei , Luo Dinghao , Wu Junxiang , Xie Kai , Guo Yu , Gan Yaokai , Wu Wen , Hao Yongqiang 
Published: December 2020

Abstract
Background: With the development of medical technology, credible options for defect reconstructions after the resection of benign bone tumors of the lower extremities has become a high priority. As the current reconstructive methods commonly used in clinical practice have some flaws, new methods of reconstruction need to be explored. We aimed to prepare a new kind of bioactive scaffold for the repair of bone defects through a stem cell rapid screening–enrichment–composite technology system developed by our team. Furthermore, we aimed to investigate the curative effects of these bioactive scaffolds. Methods: Firstly, cell count, trypan blue exclusion rate and ALP staining were used to evaluate changes in enrichment efficiency, cell activity and osteogenic ability before and after enrichment. Then, the scaffolds were placed under the skin of nude mice to verify their osteogenic effects in vivo. Finally, the scaffolds were used for the reconstruction of bone defects after operations for benign bone tumors in a patient’s lower limb. The healing status of the defect site at 1 and 3 months was assessed by X-ray and the Musculoskeletal Tumor Society (MSTS) score was applied to reflect the recovery of patient limb function. Results: The system effectively enriched stem cells without affecting the activity and osteogenic abilities of the bone marrow mesenchymal stem cells (BMSCs). Meanwhile, the bioactive scaffolds obtained better osteogenic effects. In patients, the active scaffolds showed better bone integration and healing status, and the patients also obtained higher MSTS scores at 1 and 3 months after surgery. Conclusion: As a new technique, the rapid screening–enrichment–composite technology of stem cells demonstrates a better therapeutic effect in the reconstruction of bone defects after surgery for benign bone tumors of the lower extremities, which will further improve patient prognosis.
General Characteristics and Reasons for the Discontinuation of Drug Clinical Trials in Mainland China
Authors: Huo Ben-nian , Ai Mao-lin , Jia Yun-tao , LIU Yao , Yin Nan-ge , Song Lin 
Published: December 2020

Abstract
Background: Although discontinuation is common in clinical trials, no study has been conducted to analyse the current situation and reasons for the suspension or discontinuation of drug clinical trials in China. This study aims to analyse the general characteristics and reasons for the discontinuation of registered clinical trials in mainland China and to identify the associated factors.Methods: Trials with a status of terminated or stopped in the Drug Trial Registration and Information Publication Platform before March 31, 2020, were classified as discontinued trials and included in the analysis. Information related to researchers, studied drugs, the trials and the reasons for discontinuation were recorded. Fisher’s exact and χ2 tests were used to examine the associations of trial characteristics with different issues related to trial discontinuation. Results: Three hundred and twelve discontinued trials were included in this study. The studied drugs were mainly chemical drugs [229 (73.4%)]. The indications of the studied drugs were mainly neoplasms [77 (24.7%)]. The study type was mainly bioequivalence studies [97 (31.1%)]. More than half [177 (56.7%)] of the trials were discontinued because of trial issues, among which the main causes were negative results [69 (22.1%)], protocol issues [41 (13.1%)], and poor recruitment [35 (11.2%)]. Ninety-five (30.4%), 15 (4.8%) and 26 (8.3%) trials were discontinued because of sponsor issues, research centre issues and administration issues, respectively. Study design, blinding status, number of centres, planned sample size and whether participants had been enrolled may have been associated with one to three of the issues related to trial discontinuation.Conclusions: Discontinuation of clinical trials was commonly due to trial issues, sponsor issues, research centre issues and administration issues, such as negative results, and protocol issues. Study design, the number of centres, and sample size may be related to the discontinuation of trials. Careful study designs, smart business decisions, sufficient preparation of supplies such as the research drugs, and whether research centres have enough availability and patients are factors that should be considered before conducting trials.
Inkjet-Printed Wide Range and Highly Linear Signal Processed Systematic Humidity Sensor Array Based on Methylene Blue and Graphene Nanocomposite
Authors: Khan Muhammad Umair , Hassan Gul , Shaukat Rayyan Ali , Saqib Qazi Muhammad , Chougale Mahesh , Kim Jungmin , Bae Jinho 
Published: December 2020

Abstract
This paper proposes a signal processed systematic humidity sensor 3×3 array with all range and highly linear humidity response based on different particle size nanocomposite inks and different interspaces of interdigital electrodes (IDEs) (300, 200, and 100 µm). The fabricated sensors are patterned through a commercial inkjet printer by utilizing nanocomposites of methylene blue and graphene with three different particle sizes of bulk Graphene Flakes (BGF), Graphene Flakes (GF), and Graphene Quantum Dots (GQD), which are employed as an active layer on three types of IDEs with different interspaces of 300, 200, and 100 µm. From 3×3 sensor array, all range linear function (0-100% RH) is achieved by applying linear combination method of nine sensors in signal processing field, where weights for linear combination are required, which are estimated by the least square solution. The humidity sensing array shows a fast response time (Tres) of 0.2 sec and recovery time (Trec) of 0.4 sec. From the results, the proposed humidity sensor array opens a new gateway for a wide range of humidity sensing applications with a linear function.
Mitochondrial DNA Variants in Autism Spectrum Disorder: A Systematic Review
Authors: Xiaoli Liao , Yamin Li 
Published: December 2020

Abstract
Objectives The present review aimed to systematically characterize existing literature regarding the involvement of mtDNA variants in the pathophysiology of ASD. Methods A systematic search of publications in three online databases plus a manual search of reference lists of included articles was performed to collate potentially eligible literature. The study selection and data extraction were conducted by two independent authors, and the discrepancies in each step were settled through discussions.Results From 1874 resulting searched articles, 28 studies remained for this review. These included studies involving 3 studies reported ancient haplogroup variants, 16 studies reported point mutations, 7 studies reported copy number variants, and 8 studies reported deletions, with point mutation being the most common type of disease-related variants.Conclusions Findings generated from this review support mtDNA variants as important contributory components in susceptibility to ASD, since most variants have yet been mapped to specific loci, and the exact pathogenic mechanism remains to be determined.
Gene mutations in the PI3K/Akt signaling pathway were related to immune thrombocytopenia pathogenesis
Authors: Sun Ruijie , Liu Shu-Yan , Zhang Xiao-Mei , Zhu Jing-Jing , Yuan Dai , Shan Ning-Ning 
Published: December 2020

Abstract
Immune thrombocytopenic (ITP) is an autoimmune bleeding disease with genetic susceptibility. In this research, we conducted an in-depth genomic analysis of a cohort of patients and elucidate molecular features associated with disease pathogenesis of ITP. High-molecular-weight genomic DNA was extracted from freshly frozen BMBMCs (bone marrow blood mononuclear cell) in 20 active ITP patients. After this, the samples were subjected to molecular genetic analysis by whole-exome sequencing technique (WES) then, confirmed by sanger sequencing method. The enriched signaling pathway analysis and cellular processes associated with the mutated genes was performed with gene mapping to Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways. The results of this study showed that there were 3998 missense mutations involving 2269 genes in more than 10 individuals. Unique genetic variants including PTEN, INSR and COCH were the most associated with the pathogenesis of ITP. Functional analysis revealed these mutation genes mainly affect Phosphatidylinositol 3 kinase/serine/threonine kinase B (PI3K/Akt) signaling pathways (signal transduction) and platelet activation (immune system). Our finding further demonstrates the functional connections between these variant genes and ITP. Although the substantial mechanism and the impact of genetic variation are required further investigation, the application of next generation sequencing in ITP in this paper is a valuable method to reveal the genetic susceptibility.
Impact of COVID-19 on Health Services Utilization in Province-2 of Nepal: A Qualitative Study Among Community Members and Stakeholders
Authors: Singh Devendra Raj , Sunuwar Dev Ram , Shah Sunil Kumar , Karki Kshitij , Sah Lalita Kumari , Adhikari Bipin , Sah Rajeeb Kumar 
Published: December 2020

Abstract
Background The COVID-19 pandemic is posing unprecedented challenges and threats to the health care system, particularly affecting the effective delivery of essential health services in resource-poor countries such as Nepal. This study aims to explore community perceptions of COVID-19 and their experiences towards health services utilization during the pandemic in Province-2 of Nepal. MethodsThe semi-structured qualitative interviews were conducted among purposively selected participants (n=41) from a mix of rural and urban settings in all districts (n =8) in Province 2 of Nepal. Virtual interviews were conducted between July and August 2020 in local languages. The data were analyzed using thematic network analysis in NVivo 12 Pro. ResultsThe findings of this research are categorized into four global themes: i) Community and stakeholders’ perceptions towards COVID-19; ii) Impact of COVID-19 and lockdown on health services delivery; iii) Community perceptions and experiences of health services during COVID-19; and, iv) COVID-19: testing, isolation, and quarantine services. Most participants shared their experience of being worried and fearful about COVID-19 and reported a lack of awareness, misinformation, and stigma as major factors contributing to the spread of COVID-19. Maternity services, immunization, and supply of essential medicine were found to be the most affected areas of health care delivery during the lockdown. Participants reported that the interruptions of health services were mostly due to the closure of health services at local health facilities, limited involvement of private health sectors during the pandemic, fears of COVID-19 transmission among health workers and within health centers, and disruption of transportation services. In addition, the participants expressed frustrations on poor testing, isolation, and quarantine services related to COVID-19, and poor accountability from governments at all levels towards health services management during the COVID-19 pandemic. ConclusionsThis study found that essential health services were severely affected during the COVID-19 pandemic in all districts of Province-2. It is essential to expand the service coverage and its quality in addition to increasing public-private sector engagement to ensure the essential health services are utilized by the population.
Human papillomavirus infection rate, distribution characteristics, and risk of age in pre- and postmenopausal women
Authors: Shen Yan , Xia Jing , Li Hui hui , Xu Yang , Xu San ping 
Published: December 2020

Abstract
BackgroundThe incidence rate of cervical cancer is increasing yearly. The persistent infection of high-risk Human Papillomavirus (HPV) is the main factor leading to cervical cancer. HPV infection is double peak type. This study aimed at analyzing the HPV distribution characteristics, infection rate, and risk of age in pre- and postmenopausal women. So as to provide reference for the prevention of HPV infection and cervical cancer screening strategy.MethodsA retrospective analysis of 4614 women who underwent cervical cytology, and HPV examination from January 2018 to October 2019 at the healthcare department of Wuhan Union Hospital was done. We explored the characteristics and distribution of HPV infections around the menopause, then comparing the infection rate of HPV in postmenopause and over 65 years old, in order to analyze the influence of different ages on HPV infection.ResultsGenerally, the HPV infection rate was 13.10% (539 / 4115), whereby the high-risk subtype constituted 73.84% (398 / 539) of all positive cases. On the other hand, the HPV39 infection was more common in postmenopausal women; however, there was no significant difference in the distribution of the other types in the pre- and postmenopausal women (Insert p value). The first four subtypes were 52 / 53 / 58 / 16, respectively. The infection rate of HPV in patients with lower genital tract inflammation was significantly higher, P = 0.000, 95% CI: 1.911 (1.416, 2.580) compared with those without lower genital tract inflammation. The results further showed that there was no significant difference between pre- and postmenopausal women in terms of HPV infection rate, but more susceptible to high-risk HPV infection after the age of 65 (P = 0.041). Except for 40 years old to menopause, the infection rate of high-risk HPV in this age group was different from that in postmenopause(P = 0.023,0.729(0.555,0.957)), other age groups had no significant effect on high-risk HPV infection.ConclusionsIt was concluded that whether menopause has nothing to do with HPV infection. Moreover, the infection rate of high-risk HPV increases after 65 years of age; hence the cutoff screening age should be appropriately prolonged.Trial registration: Retrospectively registered.
Spatiotemporal Modelling of COVID-19 Infection Risk in Portugal
Authors: Azevedo Leonardo , Pereira Maria João , Ribeiro Manuel , Soares Amílcar 
Published: December 2020

Abstract
Since its outbreak, the SARS-CoV-2 pandemic has shown complex dynamics in both time and space. These dynamics are the result of a combination of factors, including the spatial distribution of the population’s social and economic levels and its mobility patterns within a given country. After assessing the risk of infection and associated uncertainty based on infection rates by municipality, one of the most important challenges now facing health authorities concerns the ability to predict second waves and interactions with epidemics of other viruses (e.g. influenza). We propose characterizing the local spatiotemporal behaviour of risk of infection based on existing historical data, and classifying the local spatiotemporal patterns of the time series, thus allowing the management of new waves by region. We combined functional data analysis with geostatistical simulation to model the spatiotemporal evolution of infection risk by COVID-19 in mainland Portugal. The daily number of infection data by municipality reported by the Portuguese Directorate-General for Health are used to build time series of infection since the beginning of the outbreak in Portugal. We employ a dimensionality reduction of these curves using functional principal component analysis. The objective of this step is twofold: detect municipalities with a similar temporal evolution, and get a small number of coefficients to describe the temporal pattern of the series. The low-dimension coefficients are then used as experimental data to map the infection time series spatially using geostatistical simulation. With this step, we recover high-resolution maps of COVID-19 infection risk at any time step, allowing the simultaneous modelling of time and space. With the resulting spatiotemporal models, authorities can identify locations where the disease exhibits similar behaviours and, therefore, devise mitigation actions based on previous experience. Also, the models may be used for short-term forecasting as a simple data-driven proxy of full SEIR (susceptible, exposed, infectious, recovered) models.
Inclusive Planning: African Policy Inventory and South African Mobility Case Study on the Exclusion of Persons with Disabilities and Other Vulnerable Groups
Authors: Vanderschuren Marianne J.W.A. , Nnene Obiora 
Published: December 2020

Abstract
BackgroundAlmost half of the African population is under the age of 18 years, while females make up just over half of the overall population. Estimates of the number of persons living with disabilities, on the African continent, range between 60-300 million individuals. Children, the elderly, females and people with disabilities all require amendments to traditional transport planning.MethodThis paper investigates the availability of transport policies and guidelines in 29 different African countries, focussing on the inclusion of persons with disabilities, women and children. A desktop study was conducted, followed by the analysis of secondary data in the case study area, South Africa, demonstrating that the lack of adequate policies, guidelines and appropriate implementation leads to a lack of accessibility, opportunities and social isolation. ResultsThe data analysed revealed that Ghana and Kenya, have the most inclusive policy and legislative framework, while Tanzania has the most inclusive transport related framework. The private sector, NGOs, and NPOs are most active in the inclusion of people living with disabilities in Ghana, Ethiopia, Uganda, Tanzania and South Africa.In South Africa (STATSSA, 2013), over 2.2 million people (4.5% of the population) did not travel at all in the seven days before the interview, as their disability or age prohibits them to do so, or due to a lack of appropriate services. When comparing the trip rates per week, people with disabilities travel significantly less than their abled counterparts, between 65.8% and 27.2% less.ConclusionsThe study concludes that people with disability live less integrated, more isolated lives, due to the lack of accommodating infrastructure and services, in addition to the lack of binding policies, legislation, standards and guidelines. The results underpin the need for Disability Inclusive Planning in the African context and provides recommendations that mitigate the isolation challenges faced by people with disabilities.