bluuebunny/crossref_metadata_2025_split huggingface dataset:
Suspension Sutures Facilitate Single Incision Laparoscopic-Assisted Rectal Pull-Through for Hirschsprung Disease
Authors: Nguyen Liem Thanh , Tho Anh Nguyen , Thanh Quang Nguyen , Anh Quynh Tran , Duc Hau Bui , Duy Hien Pham 
Published: November 2020

Abstract
BackgroundTo present the surgical technique and long-term follow-up outcomes of single incision laparoscopic-assisted endorectal pull-through (SILEP) with suspension sutures using conventional instruments for Hirschsprung disease. MethodsThe procedure began with a 1cm transumbilical skin incision. Three separate punctures were made onto the fascia for a 5mm scope in the middle, a 5mm and 3mm ports for working instruments on the left and right, respectively. The first suspension suture was performed to secure the sigmoid colon to the abdominal wall. A window was created through the rectal mesentery, and dissection around the rectum was carried out. The second suspension suture was performed to suspense the rectovesical peritoneal fold or the rectovaginal peritoneal fold to the abdominal wall. Dissection around the rectum was continued downward to approximately 1cm below the peritoneal fold. The operation was completed by a transanal approach. Results40 patients underwent SILEP from March 2013 to April 2015. The median age was 2.7 months (ranged from 14 days to17 months). The mean operative time was 94.7 ± 20 minutes. No conversion to open operation was required. Mean hospital stay was 4.1±1.3 days. There were no intraoperative or perioperative complications. Long term follow-up results were obtained in 38 patients. The number of defecation from 1-2 times per day was noted in 36 patients (94.7%) and from 3-4 times per day in 2 patients (5.2%). Two patients had enterocolitis (5.2%).ConclusionSingle site laparoscopic rectal pull-through with suspension sutures using conventional instruments is feasible and safe for Hirschsprung disease with good long-term outcomes.
Sex-specific Plasticity and the Nutritional Geometry of Insulin-Signaling Gene Expression in Drosophila Melanogaster
Authors: McDonald Jeanne M.C. , Nabili Pegah , Thorsen Lily , Jeon Sohee , Shingleton Alexander 
Published: November 2020

Abstract
Background: Sexual-size dimorphism (SSD) is replete among animals, but while the selective pressures that drive the evolution of SSD have been well studied, the developmental mechanisms upon which these pressures act are poorly understood. Ours and others’ research has shown that SSD in Drosophila reflects elevated levels of nutritional plasticity in females versus males, such that SSD increases with dietary intake and body size, a phenomenon called sex-specific plasticity (SSP). Additional data indicate that while body size in both sexes responds to variation in protein level, only female body size is sensitive to variation in carbohydrate level. Here we explore whether these difference in sensitivity at the morphological level are reflected by differences in how the insulin/IGF-signaling (IIS) and TOR-signaling pathways respond to changes in carbohydrates and proteins in females versus males, using a nutritional geometry approach. Results: The IIS-regulated transcripts of 4E-BP and InR most strongly correlated with body size in females and males respectively, but neither responded to carbohydrate level and so could not explain the sex-specific response to body size to dietary carbohydrate. Transcripts regulated by TOR-signaling did, however, respond to dietary carbohydrate in a sex-specific manner. In females, expression of dILP5 positively correlated with body size, while expression of dILP2,3 and 8, was elevated on diets with a low concentration of both carbohydrate and protein. In contrast, we detected lower levels of dILP2 and 5 protein in the brains of females fed on low concentration diets. We could not detect any effect of diet on dILP expression in males.Conclusion: Although females and males show sex-specific transcriptional responses to changes in protein and carbohydrate, the patterns of expression do not support a simple model of the regulation of body-size SSP by either insulin- or TOR-signaling. The data also indicate a complex relationship between carbohydrate and protein level, dILP expression and dILP peptide levels in the brain. In general, diet quality and sex both affect the transcriptional response to changes in diet quantity, and so should be considered in future studies that explore the effect of nutrition on body size.
Mitochondrial Transplantation Improves Stroke-induced Brain Injury: Possible Involvement of Selective Component Recombination
Authors: Xie Qiang , Zeng Jun , Xu Feng , Zheng Yongtao , Li Tianwen , Ren Junwei , Chen Kezhu , Zhang Quan , Xie Rong , Zhu Jianhong 
Published: November 2020

Abstract
Background: Ischemic stroke results in high morbidity and mortality, and mitochondrial dysfunctions play a crucial role in the associated pathological process. Although exogenous mitochondria were used to treat ischemic stroke-induced brain injury, its effects and related mechanisms remain poorly understood, as is the fate of exogenous mitochondria during/after internalization by targeted cells.Methods: The mitochondrial morphology, membrane potential, DNA copy number, mitochondrial stress, metabolic characteristics and tumorigenicity of mNSCs and Neuro-2a cells were evaluated. Hypoxia/reoxygenation-induced cell injury was performed, and after mitochondrial supplementation, the viability, ROS levels, apoptosis and transcriptomic changes were assessed by CCK-8, DCHF-DA probes, flow cytometry, WB and next-generation sequencing analyses. The fate of exogenous mitochondria was further explored using fluorescent dyes and fusion protein analyses during/after internalization by targeted cells. Rat tMCAO models were generated using a suture-occluded method, and at 24 h after mitochondrial transplantation, behavioral changes and brain infarction areas were estimated by multiple score scales and TTC staining, respectively.Results: In this research, we found that mitochondria of Neuro-2a cells had some notable differences compared to that of mNSCs on mitochondrial membrane potential, DNA copy number, stress response and metabolic characteristics, but their shapes were similar and were both no tumorigenicity. Exogenous mitochondrial treatment could increase the cellular viability in an oxygen-dependent pattern, decrease the cellular ROS generation and apoptosis, and alter the transcriptomic characteristics after subjected to hypoxia/reoxygenation in vitro. Selective component recombination might occur during/after internalization of exogenous mitochondria by host cells and was observed with mitochondrial fluorescent dyes and engineered fusion protein. Moreover, mitochondrial transplantation could significantly improve tMCAO-induced rat neurobehavioral deficiency and brain infarction.Conclusions: The results of our present study offer a promising therapeutic strategy for ischemia/reperfusion-induced brain injury and provide preliminary insights regarding the effects and fate of exogenous mitochondria during/after being internalized into host cells.
Populational Level Driving Force of COVID-19 Epidemic and Fatality: A Global Analysis
Authors: Wang Zaisheng , Xie Yewei , Wu Dan , Zheng Lingling , Liao Huipeng , Marley Gifty , Zhang Lei , Tang Weiming 
Published: November 2020

Abstract
BackgroundThe COVID-19 has become a pandemic worldwide. 216 countries and regions reported their occurrence of COVID-19 cases by 19th Sep 2020. Meanwhile, the COVID-19 had infected more than 30 million people and caused almost one million deaths until 19th Sep 2020.MethodWe scoped data related to reported epidemic durations, incidences, fatalities, and epidemic risk factors of the studied countries. Disease Development Speed (DDS), Population-Level Incidence (PLI), and Case-Fatality Rate (CFR) were calculated to assess the COVID-19 pandemic globally. The Spearman rank correlation was applied to further explore the relationship among DDS, PLI, CFR, and their influencing factors.Result216 countries and regions had reported their COVID-19 cases by 19th Sep 2020. Globally, the medians of epidemic duration, DDS, PLI, and CFR were 167 days (IQR: 158-175 days; Range: 110-221 days),4.6 (IQR: 3.1-6.0; Range: 1.8-10.1), 17.0 (IQR: 5.3-56.0; Range: 0.36-1758.3), and 2.2% (IQR: 1.3%-3.5%) respectively. DDS, PLI, and CFR were found enjoying positive correlations with the urban population proportion, UHC (Universal Health Coverage) service coverage, the population with basic handwashing facilities at home, the number of reported deaths, and the number of doctors and nurses.ConclusionNationwide development of the COVID-19, its incidence and fatality suggested regional similarity in the world. National population structure, human resources of medical staff, structure of national health expenditure, and the sanitation facility were revealed as vital risk factors for the COVID-19 in epidemiology.
The Psychological Impact of the COVID-19 Pandemic on Adults With Autism: A Survey Study Across Three Countries
Authors: Oomen Danna , Nijhof Annabel Dineke , Wiersema Jan Roelf 
Published: November 2020

Abstract
BackgroundPrevious studies have reported a negative psychological and mental health impact of the COVID-19 pandemic. This impact is likely to be stronger for people with autism as they are at heightened risk of mental health problems and because the pandemic directly affects social functioning and everyday routines. We therefore examined COVID-19-related changes in mental health, the impact of the pandemic on their social life and routines, satisfaction with pandemic-related information and tips, and participants’ wishes for guidance. MethodsWe used a mixed-method approach, collecting quantitative and qualitative survey data from adults with and without autism across three European countries: Belgium, the Netherlands, and the United Kingdom (N = 1044). ResultsWe found an increase in depression and anxiety symptoms in response to the pandemic for both the non-autism and the autism group, which was greater for adults with autism. Furthermore, adults with autism showed a greater increase in worries about their pets, work, getting medication and food, and their own safety/security. They felt more relieved from social stress, yet experienced the loss of social contact as difficult. Adults with autism also felt more stressed about the loss of routines. Pleasant changes noted by adults with autism were the increase in solidarity and reduced sensory and social overload. Adults with autism frequently reported problems with cancellation of guidance due to the pandemic and expressed their wish for (more) autism-specific information and advice. LimitationsOur sample is likely to reflect some degree of selection bias, and longitudinal studies are needed to determine long-term effects. ConclusionsResults highlight the psychological burden of the pandemic on adults with autism and shed light on how to support them during this COVID-19 pandemic, which is especially important now that the pandemic is likely to have a prolonged course. There is a need for accessible, affordable (continued) support from health services. Guidance may focus on the maintenance of a social network, and adjusting routines to the rapid ongoing changes. Finally, we may learn from the COVID-19-related changes experienced as pleasant by adults with autism to build a more autism-friendly society post-pandemic.
Continuous Noninvasive Blood Gas Estimation in Critically Ill Pediatric Patients With Respiratory Failure
Authors: Dong Junzi , Xu-Wilson Minnan , Conroy Bryan R. , Khemani Robinder G. , Newth Christopher J.L. 
Published: November 2020

Abstract
BackgroundPatients supported by mechanical ventilation require frequent invasive blood gas samples to monitor and adjust the level of support. We developed a transparent and novel blood gas estimation model to provide continuous monitoring of blood pH and arterial CO2 in between gaps of blood draws, using only readily available noninvasive data sources in ventilated patients. MethodsThe model was trained on a derivation dataset (1,883 patients, 12,344 samples) from a tertiary pediatric intensive care center, and tested on a validation dataset (286 patients, 4,030 samples) from the same center obtained at a later time. The model uses pairwise non-linear interactions between predictors and provides point-estimates of blood gas pH and arterial CO2 along with a range of prediction uncertainty.ResultsThe model predicted within Clinical Laboratory Improvement Amendments of 1988 (CLIA) acceptable blood gas machine equivalent in 74% of pH samples and 80% of PCO2 samples. Prediction uncertainty from the model improved estimation accuracy by identifying and abstaining on a minority of high-uncertainty samples.ConclusionsThe proposed model estimates blood gas pH and CO2 accurately in a large percentage of samples. The model’s abstention recommendation coupled with ranked display of top predictors for each estimation lends itself to real-time monitoring of between gaps of blood draws, and the model may be used to help users determine when a new blood draw is required and delay blood draws when not needed.
Blunt Aortic Traumatic Injury Management: An Observational Study in 10 French Trauma Centers.
Authors: Boutin Louis , Caballero Marie-Josée , Guarrigue Delphine , Hammad Emanuelle , Rennuit Isabelle , Delhaye Nathalie , Neuschwander Arthur , Meyer Alain , Bitot Valérie , Mathais Quentin , Boutonnet Mathieu , Julia Pierre , Olaf Mercier , Duranteau Jacques , Hamada Sophie Rym 
Published: November 2020

Abstract
Background: Blunt aortic trauma injury (BTAI) in severe trauma patients is rare but lethal and is the second leading cause of death after brain damage. Development in automotive technology have reduced mortality at the scene of the accident and increased hospital admissions for patients with aortic injury. The aim of this work was to proceed with an epidemiologic analysis of BTAI on a French cohort.Methods: This is a multicentric retrospective study including patients admitted between 2013 and 2018 in 10 French trauma centers and participating in the Traumabase® registry. Demographic, diagnostic and therapeutic data were collected. Severity of aortic injuries was classified according to the Vancouver grades. Results: 209 patients were included, mean age was 43 years (19) and 168 (80%) were men. They had a Red Flag of 2[1-3], an injury severity score of 39 (18.3) and several associated lesions: 4[3-5]. The calculated prevalence of BTAI was 1%.Mechanisms associated with BTAI were high kinetic accidents, with severe thoracic injury. Patients presented with high clinical suspicion for severe hemorrhage. The time to diagnosis increased with the severity of aortic injury (grade 1: 94[74-143] minutes, grade 2: 129[106-143] minutes, grade 3: 117[100-170] minutes, grade 4: 154[112-202] minutes, p=0.02). Overall mortality was 20% and increased with the severity of aortic injury (grades 1: 6%, grades 2: 12%, grades 3: 22% et grades 4: 65%, p<0.001). The delay before death was 1,5[1-4.7] days (grade 1: 2[1.5-3] days, grade 2: 12[1-42.7] days, grade 3: 2[1-6.2] days, grade 4: 1[1-1.5] days, p=0.003).Among deceased patients, 16 (38%) had hemorrhagic shock, 13 (31%) had post-hemorrhagic multiple organ failure, 5 (12%) had cerebral cause, and 8 (19%) had septic shock. Conclusions: Patients with BTAI presented severe trauma with multiple associated injuries, were victims of a high kinetic accident and had an overall 20% mortality with a 65% mortality rate for grade 4 patients. They died of hemorrhagic shock in more than 2/3 of the cases and received endovascular treatment in 2/3 of the case.Trial registration: Advisory Committee for Information Processing in Health Research (CCTIRS, 11.305 bis). National Commission on Informatics and Liberties Data protection agency (CNIL, 911461 and 2211878). National institutional review board requirements (Comité de Protection des Personnes Paris VI, Paris, France).
Is Follow-up Needed for Infants with Graf Type I Hip at Screening?
Authors: Matsubayashi Shohei , Matsuzaki Hiroki , Tsujimoto Ritsu , Osaki Makoto 
Published: November 2020

Abstract
Background: The purpose was to determine if follow-up of infants with Graf Type I hip at screening is required. Methods: Overall, 526 hips in 263 infants (61 males and 202 females) born between April 2015 and March 2018 who underwent primary screening for hip dislocation and presented to our department for secondary hip dislocation examination were included. Among these, 250 (59 males and 191 females) infants had bilateral Graf Type I hips for a total of 500 hips. Ultrasound results and physical examination at the initial visit and after 3 months were compared. X-rays were taken at the age of 1 year, and the proportion of infants with an acetabular index of 30° or greater was evaluated. Results: There were 0 hips that deteriorated from Graf Type I to II or higher among the infants. There were also 25 infants with abduction limitations in flexion at the initial visit, which was still present in 3 out of 23 infants 3 months later. There were 49 infants with asymmetry of the femoral or inguinal skin creases at the initial visit, which was still present in 9 out of 48 infants 3 months later. At the age of 1 year, an acetabular index of 30° or greater was observed in 35 out of 402 hips (8.7%).Conclusion: Ultrasounds at 3 months later were not required in any of the infants with Graf Type I hip at initial diagnosis. Some infants were diagnosed with acetabular dysplasia at the age of 1 year.
Impact of a Novel Boar Pheromone on Weaned Sow Behavior and Reproduction
Authors: Bello Antonio Vela , Río Laura Lafoz del , Reyero David , Merdy Olivier 
Published: November 2020

Abstract
BackgroundReproductive performance on commercial farms depends on the ability to identify sexual behavior and breed females during estrus. The presence of a boar is essential in determining sow sexual behaviors and is greatly mediated by the adult boar odor. This study sought to examine the effects of a novel boar salivary pheromone on weaned sow sexual receptivity and subsequent reproductive performance. MethodsOne hundred weaned sows were randomly assigned to either a control treatment where sows were exposed during heat detection to a live mature boar (BG) or to BOARBETTER® (Vétoquinol, Lure, France), given as a single spray while a boar grunting audio file was played (PG). Sexual behaviors were assessed twice daily during a Back-Pressure Test (BPT). Sows expressing behavioral estrus were mated. Ultrasound was used to assess ovarian activity from weaning until the end of ovulation. Reproductive and prolificacy data were collected until farrowing.ResultsTwelve sows were eliminated from the study because of early ovulation, no ovulation, or infectious disease. Breeding rate did not differ between the two treatments (BG: 100% vs PG: 91%). Sows in the BG had a shorter wean-to-estrus interval (97 vs 108 h) and longer estrus duration than PG sows (57 vs 39 h; p < 0.05). Wean-to-ovulation interval did not differ but onset of estrus to ovulation interval was longer in PG compared with BG sows (40 vs 30 h, p < 0.01). Follicle size at the onset of estrus was larger among PG than BG sows (5.76 vs 5.43 mm, p = 0.04). Timing of ovulation relative to insemination did not differ between the two treatment groups. Pregnancy rates were identical or similar for sows in the two treatment groups (93%) as was number of pigs born per litter.ConclusionsExposing weaning sows to the novel pheromone and the boar grunting sound achieved high estrus detection rate. Estrus was delayed and shortened but sows were successfully bred and were farrowed. Despite the absence of teaser boar, the procedure incorporating the novel pheromone and the boar grunting sound was shown to be efficient for sow breeding.
Laparoscopic Gastrectomy Plus D2 Lymphadenectomy is as Effective as Open Surgery in Terms of Long-Term Survival: A Single-Institution Study on Gastric Cancer.
Authors: Wang Yawei , An Tailai , Wang Yan , Wu Wang , Lu Xiaofang , Jiang Jiling 
Published: November 2020

Abstract
Background: Laparoscopic surgery has been widely accepted to treat early-stage gastric cancer. However, it is still controversial to perform laparoscopic gastrectomy plus D2 lymphadenectomy for locally advanced gastric cancer. We performed the present study to compare the long-term outcomes of patients after laparoscopic or open gastrectomy plus D2 lymphadenectomy . Methods: The clinicopathological data of 182 gastric cancer patients receiving gastrectomy plus D2 lymphadenectomy between January 2011 and December 2015 at Shenzhen Traditional Chinese Medicine Hospital were retrospectively retrieved. The overall survival (OS) and disease-free survival (DFS) of these 182 patients were compared.Results: On the whole, OS (P=0.789) and DFS (P=0.672) of patients receiving laparoscopic gastrectomy plus D2 lymphadenectomy were not significantly different from those of patients receiving open surgery. For stage I patients, laparoscopic gastrectomy plus D2 lymphadenectomy was not significantly different from open surgery in terms of OS (P=0.573) and DFS (P=0.157). Similarly, for stage II patients, laparoscopic gastrectomy plus D2 lymphadenectomy was not significantly different from open surgery in terms of OS (P=0.567) and DFS (P=0.830). For stage III patients, laparoscopic gastrectomy plus D2 lymphadenectomy was not significantly different from open surgery in terms of OS (P=0.773) and DFS (P=0.404). Laparoscopic or open gastrectomy plus D2 lymphadenectomy was not proven by Cox regression analysis to be an independent prognostic factor for OS and DFS.Conclusions: For patients with gastric cancer, laparoscopic gastrectomy plus D2 lymphadenectomy was not inferior to open surgery in terms of long-term outcomes.
A Value-based Steering Model for Healthcare
Authors: Pitkänen Laura , Torkki Paulus , Tolkki Helena , Leskelä Riikka-Leena 
Published: November 2020

Abstract
BackgroundWhen the commissioner of healthcare services is responsible for all health services of a certain population, the commissioner is incentivized to steer service producers towards better value (i.e. outcomes relative to costs). Value-based healthcare provides a setting for creating better value, but it is currently limited to some patient segments, not the whole population, and does not serve the purpose of steering multiple service providers with varying service portfolios and different degrees of specialization. This paper presents a tentative value-based steering model that aims to fill this gap in research and in practice.ResultsWe constructed a value-based steering model which consists of three parts: (1) the principles of steering; (2) the steering process; and (3) Value Steering Canvas, a concrete tool for steering. ConclusionsThe commissioning body can start using value-based steering without changes in legislation or the present service system.