bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tumour location determined by preoperative MRI is an independent predictor for positive surgical margin status after Retzius‐sparing robot‐assisted radical prostatectomy
Authors: Li Youjian , Fu Yao , Li Weijian , Xu Linfeng , Zhang Qing , Gao Jie , Li Danyan , Li Xiaogong , Qiu Xuefeng , Guo Hongqian 
Published: March 2020

ObjectiveTo investigate the influence of tumour location zone on positive surgical margin (PSM) status after Retzius‐sparing robot‐assisted radical prostatectomy (RS‐RARP).Materials and MethodsA total of 203 consecutive patients with prostate cancer (PCa) who underwent RS‐RARP at our centre were divided into three cohorts according to the tumour zonal origin described on preoperative magnetic resonance imaging (MRI). Clinical and pathological characteristics were compared among the three groups. The associations of clinicopathological variables with PSM status after RS‐RARP were also evaluated.ResultsThe rates of PSM in patients with transition zone (TZ) and mixed origin tumours were significantly higher than in patients with peripheral zone tumours (P < 0.01). Of the PSMs in patients with TZ and mixed origin cancers, 42.0% and 40.9%, respectively, were located at the anterior part of the gland. On multivariate analysis, presence of a TZ tumour was significantly associated with a higher PSM rate after RS‐RARP (P < 0.01). Sub‐analysis showed that high‐risk patients with TZ tumours had a higher risk of PSM after RS‐RARP (P < 0.01).ConclusionPresence of a TZ tumour is an independent risk factor for PSMs after RS‐RARP. Preoperative identification of TZ tumours might aid surgical planning for the Retzius‐sparing technique, especially in high‐risk patients.
Identification of endogenous 1‐aminopyrene as a novel mediator of progressive chronic kidney disease via aryl hydrocarbon receptor activation
Authors: Miao Hua , Cao Gang , Wu Xia‐Qing , Chen Yuan‐Yuan , Chen Dan‐Qian , Chen Lin , Vaziri Nosratola D. , Feng Ya‐Long , Su Wei , Gao Yi , Zhuang Shougang , Yu Xiao‐Yong , Zhang Li , Guo Yan , Zhao Ying‐Yong 
Published: March 2020

Background and PurposeIncreasing evidence has indicated that the high risk of cardiovascular disease in chronic kidney disease (CKD) patients cannot be sufficiently explained by classic risk factors.Experimental ApproachBased on the least absolute shrinkage and selection operator method, we identified significantly altered renal tissue metabolites during progressive CKD in a 5/6 nephrectomized rat model and in CKD patients.Key ResultsSix aryl‐containing metabolites (ACMs) were significantly increased from Week 1 to Week 20. They were associated with the activation of aryl hydrocarbon receptor (AhR) and its target genes including CYP1A1, CYP1A2 and CYP1B1, which were further validated by molecular docking. Our study further demonstrated that AhR signalling could be activated by ACM in patients with idiopathic membranous nephropathy, diabetic nephropathy and IgA nephropathy. Most importantly, 1‐aminopyrene (AP) showed strong positive and negative correlation with serum creatinine and creatinine clearance, respectively. AP significantly up‐regulated the mRNA expressions of AhR and its three target genes in both mice and NRK‐52E cells, while this effect was partially weakened in AhR small hairpin RNA‐treated mice and NRK‐52E cells. Furthermore, dietary flavonoid supplementation ameliorated CKD and renal fibrosis through partially inhibiting the AhR activity via lowering the ACM levels. The antagonistic effect of flavonoids on AhR was deeply influenced by the number and location of hydroxyl and glycosyl groups.Conclusion and ImplicationsWe uncovered that endogenous AP is a novel mediator of CKD progression via AhR activation; thus, AhR might serve as a promising target for CKD treatment.
Linear triazole‐linked pseudo oligogalactosides as scaffolds for galectin inhibitor development
Authors: Dussouy Christophe , Kishor Chandan , Lambert Annie , Lamoureux Clément , Blanchard Helen , Grandjean Cyrille 
Published: March 2020

AbstractGalectins play key roles in numerous biological processes. Their mode of action depends on their localization which can be extracellular, cytoplasmic, or nuclear and is partly mediated through interactions with β‐galactose containing glycans. Galectins have emerged as novel therapeutic targets notably for the treatment of inflammatory disorders and cancers. This has stimulated the design of carbohydrate‐based inhibitors targeting the carbohydrate recognition domains (CRDs) of the galectins. Pursuing this approach, we reasoned that linear oligogalactosides obtained by straightforward iterative click chemistry could mimic poly‐lactosamine motifs expressed at eukaryote cell surfaces which the extracellular form of galectin‐3, a prominent member of the galectin family, specifically recognizes. Affinities toward galectin‐3 consistently increased with the length of the representative oligogalactosides but without reaching that of oligo‐lactosamines. Elucidation of the X‐ray crystal structures of the galectin‐3 CRD in complex with a synthesized di‐ and tri‐galactoside confirmed that the compounds bind within the carbohydrate‐binding site. The atomic structures revealed that binding interactions mainly occur with the galactose moiety at the non‐reducing end, primarily with subsites C and D of the CRD, differing from oligo‐lactosamine which bind more consistently across the whole groove formed by the five subsites (A‐E) of the galectin‐3 CRD.
Impact of cataract surgery on depression and cognitive function: Systematic review and meta‐analysis
Authors: Pellegrini Marco , Bernabei Federico , Schiavi Costantino , Giannaccare Giuseppe 
Published: March 2020

AbstractImportanceIn elderly people, visual impairment is associated with depressive symptoms and cognitive decline. However, the impact of cataract surgery on depression and cognitive impairment is still controversial.BackgroundTo evaluate the effect of cataract surgery on depression and cognitive status in the elderly.DesignThis study was a meta‐analysis.ParticipantsPatients with age‐related cataract who underwent cataract surgery were recruited for this study.MethodsA literature search was performed on PubMed, Scopus and Web of Science. Data were extracted from selected studies by two independent reviewers. The pooled standardized mean difference (SDM) was estimated using a random‐effects model. Heterogeneity was evaluated using the Q and I2 tests. Multiple sensitivity analyses and assessment of publication bias were performed.Main Outcome MeasuresThe main outcome was a report of a measure of depression or cognitive impairment before and after surgery.ResultsSixteen studies were included: 14 of them reported data on depression and 9 of them on cognitive function. Depression significantly decreased after surgery (SDM = 0.460; 95% CI: 0.223‐0.697; P < .001). In six controlled studies, the reduction of depression was higher in the surgery group than in the control group (SDM = 0.161; 95% CI: 0.027‐0.295; P = .019). Cognitive function significantly improved after surgery (SDM = 0.254; 95% CI: 0.120‐0.388; P < .001). In four controlled studies, the improvement of cognitive function was higher in the surgery group than in the control group (SDM = 0.188; 95% CI: 0.002‐0.374; P = .048). Results were stable after sensitivity analyses.Conclusions and RelevanceThis meta‐analysis provides evidence that cataract surgery has a positive effect on depression and cognitive function in the elderly.
Representativeness of national parks in protecting freshwater biodiversity: A case of Brazilian savanna
Authors: Casarim Ruanny , Caldeira Yuri Malta , Pompeu Paulo Santos 
Published: March 2020

AbstractThe establishment of national parks are an important and often‐used tool to protect biodiversity. However, when considering freshwater ecosystems, many of these areas in Brazil are habitat mosaics in which a small part of the ecosystem is protected and strongly influenced by the surrounding environment. By assessing the fish fauna and their diversity patterns in five national parks (NPs) within the Brazilian savanna, we discuss whether the establishment of new NPs or the expansion of their current conservation limits would potentially conserve additional species. We selected all national parks within the third largest drainage area in Brazil. To sample fish communities, we explored 60 streams through a standardised field protocol. We also simulated the potential impact of the enlargement or implementation of a new national park. Our results reinforce the importance of national parks and their surrounding areas to preserve fish species. The enlargement of national parks would result in an increase of potentially protected species; however, the same achievement would be obtained if their buffer zones were effectively managed and protected. We recommend an alternative conservation approach to increase protection of tropical savanna fish biodiversity, especially in developing countries such as Brazil with scarce financial resources available for management, monitoring and creation of protected areas.
Prophylaxis therapy with bypassing agents in patients with haemophilia A and inhibitors undergoing surgery: A cost analysis in Spain
Authors: Mareque María , Mingot‐Castellano María Eva , López‐Fernández María Fernanda , Álvarez‐Román María Teresa , Oyagüez Itziar 
Published: March 2020

AbstractObjectivesThis study estimated the cost of prophylaxis with activated prothrombin complex concentrate (aPCC) and recombinant activated factor VIIa (rFVIIa) in surgical patients with haemophilia A and inhibitors in Spain.MethodsA decision‐analytic model was developed to estimate the cost to the Spanish National Health System of providing haemostatic coverage in this haemophilia population, with age distribution and average weight derived from the literature, and the annual number of surgeries (0.33 per patient) from local data. Drug costs were calculated from official ex‐factory prices with a 7.5% mandatory deduction and recommended dosing regimens.ResultsThe estimated average costs per patient were €10 100.73 (aPCC) and €14 265.89 (rFVIIa) for dental extraction, €24 043.88 (aPCC) and €62 301.08 (rFVIIa) for minor surgery and €126 595.81 (aPCC) and €347 731.09 (rFVIIa) for major surgery. Assuming an estimated 23 annual surgeries in this population (N = 69), distributed as 19% dental extraction, 50% minor surgery and 31% major surgery, the total annual cost of prophylaxis was €1 209 682.35 with aPCC and €3 221 929.28 with rFVIIa.ConclusionsaPCC costs were 62.5% lower than rFVIIa. Assuming potential clinical equivalence, aPCC is a potentially cost‐saving option for surgical patients with haemophilia A and inhibitors.
Molecular genetic analysis in 21 Chinese families with congenital insensitivity to pain with or without anhidrosis
Authors: Zhao F. , Mao B. , Geng X. , Ren X. , Wang Y. , Guan Y. , Li S. , Li L. , Zhang S. , You Y. , Cao Y. , Yang T. , Zhao X. 
Published: March 2020

Background and purposeHereditary sensory and autonomic neuropathies (HSANs) are a group of clinically and genetically heterogeneous neurological disorders characterized by sensory dysfunctions. Here, 21 affected Chinese families are reported, including 19 with congenital insensitivity to pain with anhidrosis (CIPA; namely HSAN IV) and two with congenital insensitivity to pain (CIP; namely HSAN IID) caused by biallelic variations in NTRK1 and SCN9A, respectively, aiming to identify causative variants in these families and compare how different variants in NTRK1 affect the function of tropomyosin receptor kinase A (TrkA).MethodsRecombinant plasmids harboring the wild‐type and six mutant alleles (p.Gln216*, p.Glu584Lys, p.Leu595Arg, p.Pro684Leu, p.Val709Leu and p.Arg765Cys) of NTRK1 cDNA were constructed and transfected into HEK293 cells.ResultsThe results suggested that the five missense variants only presented a subtle influence on the expression level and glycosylation of TrkA but compromised the receptor phosphorylation. Our findings also suggested that a synonymous variant c.219C>T in NTRK1 may cause aberrant splicing, indicating a potential novel pathogenic mechanism of CIPA. Furthermore, gross deletion of SCN9A was first associated with CIP.ConclusionsThis study identified multiple forms of variants responsible for CIPA/CIP in the Chinese population and might provide new insights into the pathogenesis of CIPA.
Estimation of eco‐efficiency and identification of its influencing factors in China's Yangtze River Delta urban agglomerations
Authors: Zhang Xinlin 
Published: March 2020

AbstractEco‐efficiency is an important indicator which serves as a helpful instrument for the studies of sustainable development. This paper estimated the eco‐efficiency of 26 cities in China's Yangtze River Delta urban agglomerations. Based on different matrixes, Moran's I was applied to analyze the spatial correlation. The spatial Durbin model was applied to analyze the direct and indirect effect of influencing factors. Some conclusions were drawn. (a) The average eco‐efficiency showed an increasing trend. The regional difference of eco‐efficiency decreased and then increased. Shanghai's eco‐efficiency had been the highest. (b) The eco‐efficiency showed positive spatial autocorrelation and it also exhibited significant characteristic of local spatial autocorrelation. (c) Economic development, fixed assets investment, and technological level of one city had a significant positive impact on the eco‐efficiency of the city itself. Industrial structure, fiscal decentralization, and foreign direct investment of a city had a significant negative impact on the eco‐efficiency of the city itself. Changes in the economic development and technological levels in a city had positive impacts on the eco‐efficiency of its neighboring cities. Foreign direct investment had a negative spatial spillover effect. (d) This paper suggested that it is necessary to pay attention to the interaction of influencing factors among cities.
Characteristics of hepatocellular carcinoma arising from Fontan‐associated liver disease
Authors: Sagawa Takaomi , Kogiso Tomomi , Sugiyama Hisashi , Hashimoto Etsuko , Yamamoto Masakazu , Tokushige Katsutoshi 
Published: March 2020

AimHepatocellular carcinoma (HCC) can arise from Fontan‐associated liver disease (FALD); this is known as FALD‐HCC. The clinical features of FALD‐HCC are unclear. Thus, we examined the incidence and clinical characteristics of FALD‐HCC.MethodsFrom 1972 to 2019, 122 patients developed liver disease after undergoing Fontan procedures. HCC was diagnosed in 12 (9.8%) FALD patients. We compared FALD‐HCC and non‐HCC patients.ResultsThe incidence of HCC was 0.8% and 2.9% in FALD 10 and 20 years after the Fontan procedure, respectively. The median age of patients at diagnosis of HCC was 32.5 years (range 20.6–46.1 years), and seven of the 12 patients were men. Patients with FALD‐HCC had a higher incidence of liver cirrhosis and polysplenia than non‐HCC patients. Liver tumors were detected as single nodules in eight patients, and the median diameter was 47 mm (range 11–105 mm). HCC was treated by surgical resection in two patients, transcatheter arterial chemoembolization or chemotherapy in three patients, and proton beam therapy in four patients. Three patients could not be treated because of their poor condition. Four patients died of liver/cardiac failure and HCC, and HCC was controlled in three patients. The survival rate after 25 years was significantly lower in patients with FALD‐HCC than non‐HCC patients (68.6% vs. 97.9%, respectively; P < 0.01).Conclusions: Of the 122 patients with FALD, 12 developed HCC 20 years after surgery. Because complications of HCC are associated with poor prognosis, constant surveillance for HCC should begin 10 years after surgery.
Effect of lower extremity amputation on caregiving burden in caregivers of patients with diabetic foot: Prospective cohort study
Authors: Çamur Savaş , Batıbay Sefa G. , Bayram Serkan 
Published: March 2020

AbstractLower extremity amputation as a treatment of diabetic foot ulcer is probably a major burden for the patient's family and friends, who typically act as caregivers and support the patient in coping with the physical disabilities and emotional distress. In the present prospective study, we investigated the effects of different lower extremity amputation levels for diabetic foot ulcer treatment on caregivers of patients with diabetes using the Zarit Burden Interview (ZBI‐12) scale. Patients with diabetic foot ulcers who underwent unilateral major amputation (above‐below knee) and minor amputation of foot (heel sparing) and their caregivers were requested to volunteer to participate in this study from June 2016 to December 2018. The ZBI‐12 form was completed immediately preoperatively and 3 and 6 months after postoperatively. In the minor amputation group, the mean age of the 51 patients was 72.1 years. In the major amputation group, the mean age of the 88 patients was 73.7 years. Both groups of caregivers of patients with minor amputation and major amputations showed a significant improvement in ZBI‐12 score when compared preoperatively and at 3‐ and 6‐month follow‐up visits. The mean ZBI‐12 score was significantly higher in the major than in the minor amputation group in preoperative and all postoperative visits. The absence of the ankle joint in the below‐ or above‐knee amputation renders it more difficult for the amputee to quickly learn the use of prosthesis, thereby increasing the burden of the patient and caregivers. We found that lower extremity amputation for the treatment of chronic diabetic foot ulcers has significantly favourable effect on the caregiver burden, and thereby heel sparing was considerably more effective for the caregiver burden.
Rat bite as a cause of diabetic foot ulcer in sub‐Saharan Africa
Authors: Abbas Zulfiqarali G. , Lutale Janet K. , Archibald Lennox K. , Jeffcoate William J. 
Published: March 2020

AbstractThere have been relatively few reports of foot ulcers in diabetes resulting from rat bite. The findings were derived from people attending a single specialist service in Dar es Salaam for diabetic foot ulcers (DFUs) between 1 January 1999 and 31 December 2016. Details from people presenting for the first time with an ulcer judged to be caused by rat bite were compared with those with from other causes of foot ulcer. There were 426 first recorded foot ulcer episodes (in 179 people) judged to be caused by rat bite. The affected population was significantly younger (mean 55.9 vs 57.5 years, P = .037) and had a lower body mass index (26.5 vs 27.9, P = .008) than controls with other types of foot ulcer. They also presented significantly sooner (7.8 vs 18.2 days, P < .001) and were more likely to heal (85.8 vs 5.5%, P < .001), even though there was also a trend towards an increased risk of death (9.1% vs 5.3%, P = .032). Rat bite is an uncommon cause of DFU, but is not rare. Although the incidence of ulcer healing is higher than in a general foot ulcer population, the incidence of death is also higher.
Multiple preoperative biomarkers are associated with incidence of surgical site infection following surgeries of ankle fractures
Authors: Liu Dawei , Zhu Yanbin , Chen Wei , Li Ming , Liu Song , Zhang Yingze 
Published: March 2020

AbstractThe aim of the study was to investigate the epidemiologic characteristics of surgical site infection (SSI) following surgeries of ankle fractures. This was a retrospective study. Patients who underwent surgeries for ankle fractures in our hospital between January 2016 and June 2019 were included. Inpatient medical records were inquired for data collection, including demographics, comorbidities, injury‐related data, laboratory biomarkers, and confirmation of the SSI cases. Univariate analyses and multivariate logistic regression analyses were used to identify the independent risk factors. Among the 1532 patients, 45 had a postoperative SSI, indicating the incidence rate of 2.9%. About 18% of SSIs were identified after discharge. Twenty percent of SSIs were caused by mixed bacteria, and 39% were caused by drug‐resistant bacteria. In the final multivariate model, 7 factors including 5 biomarkers were identified to be independently associated with SSI: gender (male vs female, OR, 2.69; 95% CI, 1.33‐4.76), perioperative blood transfusion (OR. 3.02; 95% CI, 1.30‐7.04), albumin <35 g/L (OR, 2.87; 95% CI, 1.31‐6.31), lower high‐density lipoprotein cholesterol (HDL‐C) (OR, 2.34; 95% CI, 1.19‐4.60), haemoglobin (OR, 2.16; 95% CI, 1.03‐4.67), elevated alanine aminotransferase (OR, 2.09; 95% CI, 1.10‐3.95) and neutrophile/lymphocyte rate (NLR, OR, 3.45; 95% CI, 1.33‐6.74). These epidemiologic data on SSI may help counsel patients about the risk of SSI, individualised assessment of the risk factors, and accordingly the risk stratification.
Outcomes of convergent atrial fibrillation ablation with continuous rhythm monitoring
Authors: Larson John , Merchant Faisal M. , Patel Akshar , Ndubisi Nnaemeka M. , Patel Anshul M. , DeLurgio David B. , Lloyd Michael S. , El‐Chami Mikhael F. , Leon Angel R. , Hoskins Michael H. , Keeling W. Brent , Halkos Michael E. , Lattouf Omar M. , Westerman Stacy 
Published: March 2020

AbstractBackgroundOutcomes of catheter ablation for persistent atrial fibrillation (PeAF) are suboptimal. The convergent procedure (CP) may offer improved efficacy by combining endocardial and epicardial ablation.MethodsWe reviewed 113 consecutive patients undergoing the CP at our institution. The cohort was divided into two groups based on the presence (n = 92) or absence (n = 21) of continuous rhythm monitoring (CM) following the CP. Outcomes were reported in two ways. First, using a conventional definition of any atrial fibrillation/atrial tachycardia (AF/AT) recurrence lasting >30 seconds, after a 90 day blanking period. Second, by determining AF/AT burden at relevant time points in the group with CM.ResultsAcross the entire cohort, 88% had either persistent or long‐standing persistent AF, mean duration of AF diagnosis before the CP was 5.1 ± 4.6 years, 45% had undergone at least one prior AF ablation, 31% had impaired left ventricle ejection fraction and 62% met criteria for moderate or severe left atrial enlargement. Mean duration of follow‐up after the CP was 501 ± 355 days. In the entire cohort, survival free from any AF/AT episode >30 seconds at 12 months after the blanking period was 53%. However, among those in the CM group who experienced recurrences, mean burden of AF/AT was generally very low (<5%) and remained stable over the duration of follow‐up. Ten patients (9%) required elective cardioversion outside the 90 day blanking period, 11 patients (9.7%) underwent repeat ablation at a mean of 229 ± 178 days post‐CP and 64% were off AADs at the last follow‐up. Procedural complications decreased significantly following the transition from transdiaphragmatic to sub‐xiphoid surgical access: 23% versus 3.8% (P = .005)ConclusionsIn a large, consecutive series of patients with predominantly PeAF, the CP was capable of reducing AF burden to very low levels (generally <5%), which appeared durable over time. Complication rates associated with the CP decreased significantly with the transition from transdiaphragmatic to sub‐xiphoid surgical access. Future trials will be necessary to determine which patients are most likely to benefit from the convergent approach.