bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of laparoscopic-assisted transanal total mesorectal excision(ta-TME) for locally advanced, distal rectal cancer in men with difficult pelvic conditions after neoadjuvant chemoradiation therapy
Authors: Li Yingjie , He Guoli , Wang Lin , Dong Qiushi , Liu Xinzhi , Leng Jiahua , Zhang Xiao , Sun Tingting , Zhang Yue , Yao Yunfeng , Wu Aiwen 
Published: August 2020

Abstract
BackgroundTo evaluate the use of laparoscopic-assisted transanal, total mesorectal excision (ta-TME) in men with difficult pelvic anatomy in an attempt to optimize anal sphincteric preservation, determine the completeness of TME, and determine postoperative morbidity and mortality.MethodsTwenty male patients（laparoscopic-assisted transanal total mesorectal excision, A group）with difficult pelvic anatomy (narrow pelvis) who were diagnosed as rectal cancer underwent a Ta-TME surgery from January 2017 to January 2018 at Peking University Cancer Hospital. We matched these 20 patients with 2 other groups of patients who underwent either a laparoscopic transabdominal TME （LA group）or an open transabdominal TME（OP group）according to age, sex, BMI, distance of tumor from the anal verge, and diameter of the tumor. All 3 groups of patients had undergone preoperative neoadjuvant chemoradiation therapy. The efficacy and safety of Ta-TME were evaluated according to operative time, blood loss, postoperative hospital stay, and postoperative complications. Outcomes of Ta-TME were evaluated by comparing the rate of a positive circumferential resection margin, the integrity of the TME, and the rate of sphincter preservation among the 3 groups. We also analyzed whether operative time could be shortened using a laparoscopically assisted Ta-TME through optimizing the surgical procedure.ResultsWhen comparing Ta-TME（TA group）, laparoscopic transabdominal TME(LA group), and open transabdominal TME（OP group, the respective mean blood loss(100mL, 100mL, 100mL, p=0.335),postoperative hospital stay(9 days,9 days,7 days),number of harvested lymph nodes(7, 6, 7,), positive circumferential resection margin rate(0%, 0%, 5%), rate of pathologic complete response(5%,10%,10%,), and integrity of TME showed no statistical differences across groups (p>0.5 for all). In contrast, there were significant differences in operation time(302 min, 253 min, 135 min),rate preservation of the anal sphincter(100%, 30%, 45%,), and the creation of a protective diverting ileostomy(100%, 30%, 45%, p<0.05 for all).ConclusionThe rate of anal sphincter preservation in the Ta-TME group was considerably greater than the other groups, but the safety of the operation did not differ among the 3 groups. The Ta-TME required a diverting ileostomy in all cases, and the total operation time for Ta-TME was greater than that of laparoscopic and open transabdominal TME. We believe that experience and appropriate procedure of the steps of the Ta-TME may lead to a decrease in the operation time.
Assessment of Online Patient Education Materials Designed for People with Age-Related Macular Degeneration
Authors: Fortuna Jennifer K , Riddering Anne , Shuster Linda , Lopez-Jeng Cassie 
Published: August 2020

Abstract
Background: Age-related macular degeneration (AMD) is a chronic eye condition that leads to permanent vision loss in the central visual field. AMD makes reading challenging and inefficient. People with AMD often find it difficult to access, process and understand written patient education materials (PEMs). To promote health literacy, the demands of written PEMs must match the literacy capacities of the target audience. This study aims to evaluate the readability (grade level) and suitability (appropriateness) of online PEMs designed for people with AMD. Methods: Online PEMs were sourced from websites of national organizations providing patient education materials designed for people with AMD. The Flesch-Kincaid Grade Level formula and the Suitability Assessment of Materials instrument were used to assess the readability and suitability of PEMs. Descriptive statistics were used to compare online PEMs by organization based on national guidelines for readability level (≤ sixth grade) and the recommended suitability score (≥ 70%) for “superior” material.Results: One hundred online PEMs were evaluated from websites of 16 professional organizations. The mean readability level was 9.3 (range 5.0-16.6). The mean suitability score was 53% (range 18%-78%). Only six (6%) of PEMs achieved the recommended guidelines for readability level and suitability score.Conclusion: The majority of online PEMs designed for people with AMD were written above the recommended readability level, and below the suggested suitability score. To promote health literacy, the demands of written health information must match the reading capacities of the target audience. Heeding to evidence-based guidelines for providing written information to patients with low health literacy and low vision is beneficial for both patients and health care providers. Future research is warranted.
Individualized hemodynamic optimization guided by indirect measurement of respiratory exchange ratio in major surgery: study protocol for a randomized controlled trial (OPHIQUE study)
Authors: BAR Stéphane , Boivin Pierre , Amine Younes El , Descamps Richard , Moussa Mouhamed , Arab Osama Abou , Fischer Marc-Olivier , Dupont Hervé , Lorne Emmanuel , Guinot Pierre-Grégoire 
Published: August 2020

Abstract
BackgroundObservational studies have suggested that a high respiratory exchange ratio (RER) is associated with the occurrence of postoperative complications. The study’s primary objective is to demonstrate that the incidence of postoperative complications is lower in an interventional group (patients monitored using a hemodynamic algorithm that incorporates the RER) than in a control group (treated according to standard practice).MethodsWe shall perform a prospective, multicenter, randomized, open-label, superiority trial of consecutive patients undergoing major non-cardiac surgery (i.e. abdominal, vascular and orthopedic surgery). The control group will be treated according to the current guidelines on standard hemodynamic care. The interventional group will be treated according an algorithm based on the RER. The primary outcome will be the occurrence of at least one complication within the 7 days following surgery. The secondary outcomes will be the length of hospital stay, the total number of complications per patient, 30-day mortality, the total intraoperative volume of fluids administered, the Sequential [sepsis-related] Organ Failure Assessment (SOFA) score, and laboratory data on postoperative days 1, 2 and 7. A total of 350 patients will be included.DiscussionIn the operating theater, the RER is potentially a continuously available, easy-to-read, indirect marker of tissue hypoperfusion and postoperative complications. If the RER predicts the occurrence of tissue hypoperfusion, it can help the physician to provide personalized hemodynamic management and limit the side effects related to excessive hemodynamic optimization (volume overload, vasoconstriction, etc.).Trial registrationClinicalTrials.gov identifier: NCT03852147. Registered on February 25th, 2019.
The cost-effectiveness of government actions to reduce sodium intake through salt substitutes in Vietnam
Authors: Taylor Colman , Hoek Annet C , Deltetto Irene , Peacock Adrian , Ha Do Thi Phuong , Sieburg Michael , Hoang Dolly , Trieu Kathy , Cobb Laura K , Jan Stephen , Webster Jacqui 
Published: August 2020

Abstract
Background Dietary sodium reduction is recommended to reduce the burden of cardiovascular disease. In Vietnam food products including salt, fish sauce and bot canh contribute to ~70% of dietary sodium intake. Reduced sodium versions of these products can be produced by replacing some of the sodium chloride with potassium chloride. We aimed to assess the cost-effectiveness of three alternative approaches to introducing reduced sodium products onto the market with a view to lowering population sodium intake in Vietnam.Methods The three salt substitution strategies included voluntary, subsidised and regulatory approaches targeting salt, fish sauce and bot canh products. Costs were modelled using the WHO-CHOICE methodology. A Markov cohort model was developed to evaluate the cost-effectiveness of each strategy versus no intervention from the government perspective. The model linked each intervention strategy to assumed changes in levels of sodium intake and then to systolic blood pressure. Changes in SBP were linked to a probability of ischaemic heart disease or stroke. The model followed people over their lifetime to assess average costs and quality adjusted life years (QALYs) gained for each strategy. Results The voluntary salt substitution strategy was assumed to require no investment by government. Following ramp up (years 6+), the average annual costs for the subsidised and regulatory strategies were 21,808,968,902 ₫ (US$ 977,354) and 12,949,953,247 ₫ (US$ 580,410) respectively. Relative to no intervention, all three salt substitution strategies were found to be cost-effective. Cost savings were driven by reductions in strokes (32,595; 768,384; 2,366,480) and IHD events (22,830; 537,157; 1,648,590) for the voluntary, subsidised & regulatory strategies, respectively. The voluntary strategy was least cost-effective (-3,445 ₫ US$ -0.15; 0.009 QALYs gained) followed by the subsidised strategy (-43,189 ₫ US$ -1.86; 0.022 QALYs gained) and the regulatory strategy delivered the highest cost savings and health gains (-243,530 ₫ US$ -10.49; 0.074 QALYs gained). Conclusion This research shows that all three modelled salt substitution strategies would be good value for money relative to no intervention in Vietnam. The subsidised alternative would require the highest level of government investment, however the implementation costs will be exceeded by healthcare savings assuming a reasonable time horizon is considered.
Development and Validation of a Nomogram to Predict the Mortality Risk in Elderly Patients With ARF：A Retrospective Study in the Mimic-III Database
Authors: Qin Chen , Jie Weng , Ruonan Hou , Xiaoming Zhou , Zhiliang Zhou , Ying Chen , Liang Wang , Wang Zhiyi , Junnan Xu 
Published: August 2020

Abstract
Background: To explore the risk factors of prognosis in elderly patients with acute respiratory failure (ARF), and to develop a nomogram model to predict the short-term mortality risk of ARF.Methods: A total of 1432 patients were included in this study from MIMIC-III database. 759 patients were categorized into the training set and 673 patients were categorized into the validation set. Demographical, laboratory variables, SOFA score and APS-III score were collected within the first 24 h after the ICU admission. The univariate and multivariate logistic regression were used to identify risk factors from the training data set. A nomogram model was developed to predict the mortality risk of ARF patients within 30 days according to the risk factors.Results: Multivariate logistic regression analysis showed that the heart rate, respiratory rate, systolic pressure, SPO2, albumin and 24 h urine output were independent prognostic factors for 30-day mortality in ARF patients. A nomogram was established based on above independent prognostic factors. This nomogram had C-index of 0.741 (95% CI: 0.7058–0.7766), and the C-index was 0.687 (95%CI: 0.6458-0.7272) in the validation set. The calibration curves both in training and validation set were close to the ideal model. The SOFA had a C-index of 0.653 and the APS-III had a C-index of 0.707 in predicting 30-day mortality. The predictive performance of our nomogram is better than the SOFA score and APS-III score. Conclusions: Our nomogram performed better than APS-III and SOFA scores and should be useful as decision support on the prediction of mortality risk in elderly patients with ARF.
Apical Periodontitis in Endodontically Treated Teeth: Cross-sectional Study of New Investigated Risk Factors
Authors: OUARTI IMANE EL , SANAA CHALA , SAKOUT MAJID , FAIZA ABDALLAOUI 
Published: August 2020

Abstract
Background: The present study aimed at investigating risk factors associated to apical periodontitis in endodontically treated teeth and highlight the potential risk of some factors not assessed before in previous studies. Methods:A total of 358 endodontically treated teeth were evaluated after more than 1-year period in a Moroccan population according to predetermined criteria. Studied parameters were assessed clinically and radiographically. The association between coronal restoration quality, cavity design, periodontal status, root canal filling quality, coronal restoration related features, presence or absence of the opposing dentition and the periapical status was determined. Data were analyzed using chi-square test, odds ratio and logistic regression.Results:The present study revealed that gingival health, coronal restoration with CL II cavity design, and root canal filling quality influenced periapical status of endodontically treated teeth. Multivariate analysis showed that this association was statistically significant for gingival inflammation (95% IC: 1.08-3.91, OR: 2.05, p=0.02), inadequate coronal restoration (95%IC: 1.16-4.04, OR: 2.16, p: 0.01), inadequate root canal filling length and homogeneity (95%IC: 1.24-3.01, OR: 1.93, P:0.004), (95%IC: 1.41-4.44, OR: 2.50, p:0.002) respectively. Conclusions:The present study revealed that inadequate coronal restorations especially with large proximal margins (CL II cavity design) and gingival inflammation increased the risk of apical periodontitis in endodontically treated teeth.
Effect of Root Canal Disinfection with 980 µm Diode Laser on Post-operative Pain after Endodontic Treatment in Teeth with Apical Periodontitis: A Randomized Clinical Trial
Authors: Kaplan Tuna , Sezgin Güzide Pelin , Kaplan Sema Sönmez 
Published: August 2020

Abstract
Background: This study aims to assess the effect of root canal disinfection with a 980 µm diode laser following chemomechanical root canal preparation on the severity of pain after root canal treatment (RCT).Methods: In present study, asymptomatic, single-rooted teeth with periapical index (PAI) score 3 or 4 were included. All patients were treated with two visits of root canal treatment including dressing with calcium hydroxide. Patients were randomly divided into two groups (n: 28). ‘Control (no laser)’: The final irrigation was performed using 5ml 2.5% NaOCI, followed by 5 ml 17% EDTA and 5 ml distilled water. ‘Laser Disinfection (LD)’: Root canals were irradiated with 980 µm diode laser after final irrigation at both visits. The pain levels were evaluated using visual analog scale (VAS) after 8, 24, 48 hours and 7 days. In addition, analgesic intake and time intervals were recorded by patients. The collected data were statistically analyzed with the Chi-square and Mann-Whitney U test (p<0.05).Results: The average pain level in the control group after 24 hours was significantly higher than that in the laser group after the first appointment (p<0.05). The average pain level after the second appointment was statistically higher at 24 h and 48 h in the control group (p<0.05). PP levels at 24-hs after the first appointment were higher than the second appointment only in the control group (p<0.05). After first appointment, analgesic use in the control group at 8 h (40%) and 24 h (23%) were significantly higher than LD group (p<0.05).Conclusions: Root canal disinfection with diode laser may reduce PP in single-rooted teeth with PAI score 3 or 4.Trial registration: Effect of the Diode Laser on Post-operative Pain After Endodontic Treatment in Teeth with Apical Periodontitis: NCT04486196. Registered 24 July 2020 - Retrospectively registered, http://clinicaltrials.gov/ct2/show/NCT04486196Clinical Trials ID: NCT04486196
Sestrin2 Was Involved in Airway Remodeling in COPD: A Multi-level Research
Authors: Zhang Da-Wei , Wei Yuan-Yuan , Ji Shuang , Fei Guang-He 
Published: August 2020

Abstract
Background. Airway remodeling is a major pathological characteristic of chronic obstructive pulmonary disease (COPD), which is greatly associated with oxidative stress. Sestrin2 has recently drawn attention as a representative antioxidant protein. However, the underlying correlation between sestrin2 and airway remodeling in COPD has not yet been clarified.Methods. A total of 124 subjects were enrolled in this study, including 62 control subjects and 62 COPD patients. The pathological changes in airway tissues were showed by different staining methods. The expression of sestrin2 and matrix metalloproteinase 9 (MMP9) in airway tissues was assessed by Immunohistochemistry staining. Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum concentrations of sestrin2 and MMP9. The airway parameters on computed tomography (CT) of all participants were measured for the evaluation of airway remodeling. Serum sestrin2 concentrations' relationship with MMP9 and airway parameters on chest CT was further analyzed. Results. In patients with COPD, staining results of airway structure showed noticeable pathological changes of remodeling, including cilia cluttered, subepithelial fibrosis, and reticular basement membrane (Rbm) fragmentation. Compared with control subjects, the expression of sestrin2 and MMP9 was significantly increased in both human airway tissues and serum. Typical imaging characteristics of airway remodeling and increased airway parameters were found on chest CT. Additionally, the serum sestrin2 concentration was positively correlated with serum MMP9 concentration and airway parameters on chest CT.Conclusion. Increased expression of sestrin2 is related to airway remodeling in COPD at three levels including histology, biomarkers and imaging. It is demonstrated for the first time that sestrin2 may be a novel biomarker for airway remodeling in COPD.
Selection of surgical treatment approaches for old osteoporotic vertebral compression fractures: A Retrospective Study of 238 Cases
Authors: Xu Zhengwei , Hao Dingjun , Dong Liang , Yan Liang , He Baorong 
Published: August 2020

Abstract
Background
As the population ages, osteoporotic vertebral compression fractures (OVCF) are increasing, as are acute and chronic pain episodes and progressive spinal deformities. Therefore, the aim of our study was to investigate the treatment of symptomatic old osteoporotic vertebral compression fractures.
Methods
A retrospective study was designed to enroll patients with symptomatic old OVCFs from June 2013 to 2016. According to the complexity of the disease, the patients were divided into I to V grades, and the surgical methods were developed according to the grades. Postoperative visual analog score (VAS), oswestry disability index (ODI) scores, sagittal index (SI) and ASIA grades of neurological function were observed.
Results
VAS score, ODI score and SI of all patients were significantly improved as compared with that before surgery, and the results of the final follow-up were statistically significant in comparison to preoperative outcome (P˂0.05). All the 16 patients with nerve injury showed significant improvement after surgery. The AISA grade were improved from grade C (14 cases), grade D (2 case) to grade D (4 cases) and grade E (12 cases).
Conclusion
Old OVCFs are difficult to treat. Graded surgery can better restore spinal stability and improve clinical outcomes.
Optimized duration of antituberculosis treatment for managing female genital tuberculosis: real-world experience from a high prevalence region in Eastern China
Authors: Sun Jian , Wang Wenjie , Ding Jing , Cheng Yusheng , Zhou Yunfeng , Yang Jianghua 
Published: August 2020

Abstract
Background Duration of antituberculosis therapy (ATT) for managing female genital tuberculosis (FGTB) is controversial with the intermittent regimen no more advocated. We therefore conducted a prospective, real-world research to compare 6 months and 9 months of ATT.Methods Between 2012 and 2018, 109 drug-susceptible patients newly diagnosed with FGTB and/or tuberculous peritonitis (genital, 13; peritoneal, 34; mixed, 62) received naïve treatment for 9-12 months and further 18-month follow-up. Data on disease features at baseline and long-term outcome (intent-to-treat) were compared between group A (aged 18-35 yr) and group B (aged 36-81 yr). Efficacy and side effects of treatment were compared within each group 6 months and 9 months from ATT initiation (per-protocol), respectively. Results In contrast to group B at baseline, group A had more clinical evidence predicting active tuberculosis (P < 0.05), severer performance of genital lesions and pelvic adhensions (P < 0.05), more signs of active pulmonary tuberculosis (P < 0.01), and less performance of only TBP (P < 0.01). Intent-to-treat analysis showed higher incidence of overall single side effects and poor compliance in group B (P < 0.05), and similar recurrence rate between 2 groups. Per-protocol analysis showed increased complete response rate (P < 0.01) and similar incidence of side effects (P > 0.05) in group A, similar complete response rate (P > 0.05) and increased incidence of overall single side effects (P < 0.05) in group B at 9-month duration.Conclusions Younger females with FGTB had a greater risk of systemic infection of tuberculosis compared to older ones. Nine-month ATT using daily therapy proved to be beneficial for younger patients at reproductive age. Six-month option was suitable for older patients for reducing side effects and poor compliance in the duration of treatment.
Profiling the inhibitory receptors LAG-3, TIM-3, and TIGIT in renal cell carcinoma reveals malignancy
Authors: Takamatsu Kimiharu , Tanaka Nobuyuki , Hakozaki Kyohei , Takahashi Ryohei , Mikami Shuji , Shinojima Toshiaki , Sasaki Takashi , Sato Yusuke , Kume Haruki , Ogawa Seishi , Kakimi Kazuhiro , Kamatani Takashi , Miya Fuyuki , Tsunoda Tatsuhiko , Nishihara Hiroshi , Mizuno Ryuichi , Oya Mototsugu 
Published: August 2020

Abstract
A cutting edge therapy for future immuno-oncology is targeting a new series of inhibitory receptors (IRs): LAG-3, TIM-3, and TIGIT. Both immunogenomic analyses and diagnostic platforms to distinguish candidates and predict good responders to these IR-related agents are vital in clinical pathology. By applying an automated single-cell count for immunolabeled LAG-3, TIM-3, and TIGIT, we revealed that individual IR levels with exclusive domination in each tumour can be valid biomarkers for profiling human renal cell carcinoma (RCC). We uncovered the immunogenomic landscape associated with individual IR levels in human RCC tumours with metastases in various organs and histological subtypes. We then externally validated our results and devised a workflow with optimal biomarker cut-offs for discriminating the tumour profiles of LAG-3, TIM-3, and TIGIT. The discrimination of LAG-3, TIM-3, and TIGIT profiles in tumours may have a broad impact on investigations on immunotherapy responses after targeting a new series of IRs.