bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Characteristics and Predictors of In-hospital Mortality in Patients with Cardiogenic Shock: Results from the RESCUE Registry
Authors: Yang Jeong Hoon , Choi Ki Hong , Ko Young-Guk , Ahn Chul-Min , Yu Cheol Woong , Chun Woo Jung , Jang Woo Jin , Kim Hyun-Joong , Kim Bum Sung , Bae Jang-Whan , Lee Sang Yeub , Kwon Sung Uk , Lee Hyun-Jong , Lee Wang Soo , Jeong Jin-Ok , Park Sang-Don , Lim Seong-Hoon , Cho Sungsoo , Park Taek Kyu , Lee Joo Myung , Song Young Bin , Hahn Joo-Yong , Choi Seung-Hyuk , Gwon Hyeon-Cheol 
Published: November 2020

Abstract
Background: In the current era of mechanical circulatory support, limited data are available on prognosis of cardiogenic shock (CS) caused by various diseases. We investigated the characteristics and predictors of in-hospital mortality in Korean CS patients.Methods: The RESCUE study is a multi-center, retrospective and prospective registry of patients that presented with CS. Between January 2014 and December 2018, 1,247 patients with CS were enrolled from 12 major centers in Korea. The primary outcome was in-hospital mortality. Results: In-hospital mortality rate was 33.6%. The main causes of shock were ischemic heart disease (80.7%), dilated cardiomyopathy (6.1%), myocarditis (3.2%), and non-ischemic ventricular arrhythmia (2.5%). Vasopressors were used in 1081 patients (86.7%). The most frequently used vasopressor was dopamine (63.4%) followed by norepinephrine (57.3%). An intra-aortic balloon pump was used in 314 patients (25.2%) and extracorporeal membrane oxygenator in 496 patients (39.8%). In multi-variable analysis, age ≥70 years, cardiac arrest at presentation, vasoactive-inotrope score >80, continuous renal replacement therapy, and mechanical ventilator were independent predictors for in-hospital mortality.Conclusions: The in-hospital mortality of CS patients remains high despite the high utilization of mechanical circulatory support. Age, cardiac arrest at presentation, amount of vasopressor, and advanced organ failure were poor prognostic factors for in-hospital mortality.Trial registration: RESCUE registry, Clinicaltrials.gov, NCT02985008, Registered 01 January 2014 - Retrospectively and Prospectively registered https://clinicaltrials.gov/ct2/show/NCT02985008.
Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma Presenting as Suspected Cervical Osseous Metastasis : A Case Report and Literature Review
Authors: Chong A-ri , Kim Kweon-cheon , Hong Ran 
Published: November 2020

Abstract
Background : The diffuse sclerosing variant of papillary thyroid carcinoma (DSV-PTC) is an uncommon variant of PTC. Although its histologic features are aggressive, its prognostic significance remains controversial. Case summary : Bone scan of 41-year-old woman with a history of breast and thyroid cancers showed suspected cervical osseous metastasis during the previous cancer follow-up. Further, magnetic resonance imaging was recommended. Preoperative fine needle aspiration cytology showed features of thyroid papillary carcinoma and postoperatively, the mass was diagnosed to DSV-PTC showing features of numerous and diffuse calcification and squamous metaplasia. Conclusion : Herein, we describe the pathologic features, including histologic and fine-needle aspiration cytologic features, and prognostic implications through a literature review.
The One With Highest Tumor Proportion Score of Multiple Core Needle Biopsies From the Tumor Can Best Represent PD-L1 Status Estimated by Whole Surgical Specimen in Non-small Cell Lung Cancer
Authors: Sun Wei , Yang Xin , Wang Haiyue , Wu Jianghua , Chen Mailin , Liu Changling , Hu Di , Huang Xiaozheng , Jia Ling , Kang Qiang , Wu Qi , Diao Xinting , Zhou Lixin , Lin Dongmei 
Published: November 2020

Abstract
AIM: The heterogeneity of PD-L1 status between core needle biopsies (CNBs) from one tumor was not well studied before. The current study attempts to find out the best index using multiple core biopsies from one tumor which can better reflect the actual PD-L1 status. METHODS: Random CNB was performed in surgical specimens from 170 consecutive Non-Small Cell Lung Cancer (NSCLC) samples. 51 cases (41 cases with PD-L1 positive and 10 cases with PD-L1 negative) and 216 matched CNBs were analyzed by DAKO 22C3 PharmDx Link 48 Autostainer. The PD-L1 status was compared between the surgical specimens and matched CNBs. RESULTS: The heterogeneity of PD-L1 status between CNBs from one tumor was observed in 56.1% PD-L1 positive cases. Different tumor proportion score (TPS) statistical forms with regard to the highest, mean, median, weighted average TPS, as well as TPS showed by the longest biopsy specimen and the biopsy with most tumor volume were compared. At a cutoff of 1%, the concordance rates were 94.1%, 88.2%, 90.2%, 86.3%, 86.3% and 86.3%; At a cutoff of 50%, the concordance rates were 92.2%, 86.3%, 84.3%, 82.4%, 82.4% and 86.3%, respectively. The CNB with the highest TPS can best represent PD-L1 status estimated by whole surgical specimen.CONCLUSIONS: The highest TPS among the multiple biopsies is a robust evaluation of the PD-L1 status, but not mean TPS, at the 1% and 50% cutoffs.
Nurses’ Perceptions of Medication Administration Safety in Public Hospitals in the Gauteng Province: A Mixed Method Study
Authors: Blignaut Alwiena J , Coetzee Siedine Knobloch , Ellis Suria M , Klopper Hester C 
Published: November 2020

Abstract
Background: This study was carried out to determine factors perceived to impact on medication administration errors and possible solutions to such errors in medical and surgical units of public hospitals in Gauteng Province, South Africa. More data on this challenge to patient health are needed from low- and middle-income countries like South Africa.Methods: A mixed-methods research design with a sequential approach was used. Data were gathered among 683 (n=280) medication administrators using self-report surveys, and 16 (n=15) nursing unit managers using semi-structured individual interviews.Results: Causes of medication error related to communication, human, environmental and medication factors were considered to have a moderate risk. Workload (M=3.39; SD 0.91), stock problems (M=3.18; SD 0.96) and illegible prescriptions (M=3.05; SD 1.09) pose the greatest threats to medication administration safety. Most participants (n=184; 71.1%) agreed that medication errors never or rarely occurred in their units. The majority of respondents graded overall patient safety as excellent or very good (n=161; 61.5%). With regard to safety culture, nurses felt that they are actively attempting to improve medication safety (n=239; 90.5%), that people support one another in the unit (n=216; 80%), and that their procedures and systems are good at preventing errors (n=210; 80.2%). Participants felt that medication administration errors were rarely reported, and the most apparent reason for not reporting medication administration errors was fear and administrative response. Safety culture items were correlated with medication error incidence, grade of overall patient safety and reasons for non-reporting. Qualitative findings supported the quantitative data, adding knowledge, skill and attitude of staff as further threats to medication administration safety. Adherence to protocols, auditing, education and training, collaboration and support, communication, awareness of changes, resource management and time management were identified as possible solutions to medication administration errors.Conclusions: Solutions aimed at mitigating medication errors should be based on causes identified within a specific context. In the Gauteng Province of South Africa, multidisciplinary collaboration and communication; support of nurses by the hospital administration; hospital systems, procedures and initiatives; better resource management and improved pharmacological training could be seen as the foundation for improved medication administration safety.
Fabrication and characterization of keratin-starch bio-composite film from chicken feather waste and ginger starch
Authors: oluba olarewaju , Obi Chibugo F. , Akpor Oghenerobor B. , Ojeaburu Samuel I. , Adebiyi Feyikemi D. , Adediran Adeolu A. , Oki Makanjuola 
Published: November 2020

Abstract
Background: The disposal of chicken feather through burning or burying is not environmentally compliant due to the accompanying release of greenhouse gas and underground water contamination. Thus, the transformation of this bio-waste into a bio-composite film is considered not only sustainable strategy for disposal of these solid wastes but also an attractive alternative to developing an efficient nanostructure biomaterial from renewable bio resource.Methods: In the present study keratin extracted from chicken feather waste in combination with ginger starch were fabricated into a bio-composite film. The fabricated bio-composite films were characterized, using different analytical techniques.Results: The physicochemical characteristics of ginger starch showed a moisture content of 33.8%, pH of 6.21, amylose and amylopectin contents of 39.1% and 60.9%, respectively. The hydration capacity of the starch was 132.2% while its gelatinization temperature was 65.7 oC. Physical attributes of the bio-composite film, such as surface smoothness and tensile stress increased significantly (p < 0.05) with increasing keratin content, while transparency, solubility significantly (p < 0.05) decreased with increasing keratin level. The various blends of the bio-composite films decayed by over 50% of the original mass after 12 days of complete burial in soil.Conclusion: Based on the results obtained in this study, the addition of keratin to starch bio-composite showed improvement in mechanical properties, such as tensile stress and surface smoothness. The bio-composite film exhibited appropriate stability in water, although future study showed be carried out to evaluate its thermal stability. Nonetheless, the fabricated keratin-starch bio-composite showed desirable characteristics that could be optimized for industrial applications.
Effects of zoledronic acid combined with metformin on bones of DB/DB mice
Authors: Yang Xingyao , Zhao Wen , Ma Wenjie , Yin Xin , Lin Yanshui 
Published: November 2020

Abstract
Background

Diabetic patients are prone to osteoporosis. Both zoledronic acid and metformin have certain anti-osteoporotic effects.Here we explore the anti-osteoporotic effect of the combination of two drugs.
Methods

12-week-old DB/DB mice were divided into DB/DB group, zoledronic acid group,metformin group and zoledronic acid combined with metformin group, WT mice were treated as WT group alone. The mice were killed after ten weeks. Then using Micro-ct to scan the tibia and stain the contralateral lower limbs with HE.
Results

First, we find that the body weight of DB/DB mice treated with metforminre stable and their blood glucose reduce.Second, after HE staining,it is observed under light microscope that there are a large number of adipocytes, few bone trabeculae, few osteoblasts and osteoclasts in the bone marrow cavity in the DB/DB group compared with the WT group, while the number of bone trabeculae in the combined treatment group is higher than that in the zoledronic acid group or metformin group, and a large number of blood cells, blood vessels and adipocytes are found in the bone marrow cavity of the combined drug group compared with the zoledronic acid group. Last, the results of Micro-ct present that, comparing with the DB/DB group and the metformin group,SMI is significantly different(P < 0.05);comparing with the DB/DB group and the zoledronic acid group,Tb.N,Tb.Sp,Conn.D and SMI are significantly different(P < 0.05);BV/TV, Conn.D, SMI, BMD, Tb.N and Tb.Sp in the combination treatment group are significantly difference than those in the DB/DB group(P < 0.05).
Conclusion

In term of the bone mass lose of DB/DB mice, the treatment of the zoledronic acid combined with metformin outperforms that using the zoledronic acid or metformin only.
Re-Appraisal Learning Curve of Laparoscopic Roux-En Y Gastric Bypass: Results of One Hundred and Eight Cases From A Low Volume Unit
Authors: Lo Hung Chieh , Wu Sheng-Mao 
Published: November 2020

Abstract
Background The study aim was to reevaluate the learning curve of laparoscopic Roux-en Y gastric bypass (LRYGB) in the modern era considering a single surgeon’s experience.Methods Except those with body mass index (BMI) >50 kg/m2 needs further discussion; all other patients who met the regional criteria and underwent primary LRYGB were retrospectively enrolled. Those who underwent surgery in 2016-17, 2018 and 2019 by a single surgeon with 10+ years of laparoscopic experience were assigned to groups A, B and C, respectively. Patient demographics and 30-day outcome data, including operation time, length of stay (LOS), emergency room visits, readmission, and reoperation, were compared between groups.Results One hundred and eight patients met the inclusion criteria; 36, 38, and 34 patients were assigned to groups A, B and C, respectively. There were no differences in age, sex distribution or common comorbidities between groups, except group B had a lower BMI (35.1 kg/m2 vs. 37.0 kg/m2) and a higher rate of hypertension (44.7% vs. 22.2%) than group A. The operation time was markedly reduced (96.1 min and 114.9 min, respectively), and the LOS was shortened (2.2 days and 2.9 days, respectively) in group B compared to group A and remained stationary in group C, with no further reduction in 30-day complications.Conclusion The learning process for LRYGB can be shortened to approximately 30 cases if conducted selectively and by experienced laparoscopic surgeons. Further follow-up is required to verify the long-term safety and its applicability to other patient subgroups.
Outpatient care in acute and prehospital emergency medicine by emergency medical and patient transport service over a 10-year period: a retrospective study based on dispatch data from a German emergency medical control center (OFF-RESCUE)
Authors: Schehadat Marc S. , Scherer Guido , Groneberg David A. , Kaps Manfred , Bendels Michael H.K. 
Published: November 2020

Abstract
BackgroundThe number of operations by the German emergency medical service almost doubled between 1994 and 2016. The associated expenses increased by 380 % in a similar period. Operations with treatment on-site, which retrospectively proved to be misallocated (OFF-Missions), have a substantial proportion of the assignment of the emergency medical service (EMS). Besides OFF-Missions, operations with patient transport play a dominant role (named as ON-Missions). The aim of this study is to work out the medical and economic relevance of both operation types.MethodsThis analysis examined N=819,780 missions of the EMS and patient transport service (PTS) in the catchment area of the emergency medical control center (EMCC) Bad Kreuznach over the period from 01/01/2007 to 12/31/2016 in terms of triage and disposition, urban-rural distribution, duration of operations and economic relevance (p<.01).Results53.4 % of ON-Missions are triaged with the indication non-life-threatening patient transport; however, 63.7 % are processed by the devices of the EMS. Within the OFF-Mission cohort, 78.2 % and 85.8 % are triaged or dispatched for the EMS. 74 % of all ON-Missions are located in urban areas, 26 % in rural areas; 81.3 % of rural operations are performed by the EMS. 66 % of OFF-Missions are in cities. 93.2 % of the remaining 34 % of operations in rural locations are also performed by the EMS. The odds for both ON- and OFF-Missions in rural areas are significantly higher than for PTS (ORON 3.6, 95 % CI 3.21-3.30; OROFF 3.18, 95 % CI 3.04-3.32). OFF-Missions last 47.2 minutes (SD 42.3; CI 46.9-47.4), while ON-Missions are processed after 79.7 minutes on average (SD 47.6; CI 79.6-79.9). ON-Missions generated a turnover of more than € 114 million, while OFF-Missions made a loss of almost € 13 million.ConclusionsThis study particularly highlights the increasing utilization of emergency devices; especially in OFF-Missions, the resources of the EMS have a higher number of operations than PTS. OFF-Missions cause immensely high costs due to misallocations from an economic point of view. Appropriate patient management appears necessary from both medical and economic perspective, which requires multiple solution approaches.
Cadmium Stabilization by Sewage Sludge Incineration Ash
Authors: Lyu Zhong , Meng Fanling , Tang Yuanyuan , Shih Kaimin 
Published: November 2020

Abstract
Cadmium (Cd), as a common ingredient in the production process of nickel cadmium batteries, can lead to functional disorder in kidneys, liver, lungs, cardiovascular, immune and reproductive systems. Previous studies have shown that cadmium can be stabilized in ceramic systems using clay as precursor, but the excessive exploitation of nonrenewable clay resources has caused great concerns. Hence, it is essential to find alternatives to substitute nonrenewable clay minerals. Sewage sludge incineration residues, with oxides of aluminum and silicon as major component, have attracted much attention because of the potential resource utilization. In this study, CdO and CdNO 3 was used to simulate cadmium-bearing industrial waste, and the stabilization of cadmium was achieved in ceramic matrix provided by the residues of sewage sludge incineration. Through a 2-hour sintering procedure at temperatures ranging from 800°C to 1000°C, cadmium was found to be incorporated into CdAl 2 Si 2 O 8 . The leachability of cadmium significantly declined in sintered samples when extracted in acidic environment. Meanwhile, samples that were pressed into pellets showed better cadmium stabilization efficiency, compared with powder samples. Therefore, this study suggests a promising technique to stabilize cadmium by the utilization of sewage sludge incineration residues as ceramic precursors. The success implementation of current study will further reduce the environmental burden caused by the release of heavy metals from industrial waste. Moreover, the recycling of sewage sludge incineration residues can be realized, and a waste-to-resource strategy is expected.
Mild thrombocytopenia indicating maternal organ damage in pre-eclampsia: a cross-sectional study
Authors: Mayama Michinori , Morikawa Mamoru , Yamada Takashi , Umazume Takeshi , Noshiro Kiwamu , Nakagawa Kinuko , Saito Yoshihiro , Chiba Kentaro , Kawaguchi Satoshi , Watari Hidemichi 
Published: November 2020

Abstract
BackgroundCurrently, there is a disagreement between guidelines regarding platelet count cut-off values as a sign of maternal organ damage in pre-eclampsia; the American College of Obstetricians and Gynecologists guidelines state a cut-off value of <100× 109/L; however, the International Society for the Study of Hypertension in Pregnancy guidelines specify a cut-off of <150 × 109/L. We evaluated the effect of mild thrombocytopenia: platelet count <150 × 109/L and ≥100 × 109/L on clinical features of pre-eclampsia to examine whether mild thrombocytopenia reflects maternal organ damage in pre-eclampsia. MethodsA total of 264 women were enrolled in this study. Participants were divided into three groups based on platelet count levels at delivery: normal, ≥150 × 109/L; mild thrombocytopenia, <150 × 109/L and ≥100 × 109/L; and severe thrombocytopenia, <100 × 109/L. Risk of severe hypertension, utero-placental dysfunction, maternal organ damage, preterm delivery, and neonatal intensive care unit admission were analyzed based on platelet count levels. Adjusted relative risk were calculated with a Poisson regression analysis with a robust error. ResultsPlatelet counts indicated normal levels in 189 patients, mild thrombocytopenia in 51 patients, and severe thrombocytopenia in 24 patients. The adjusted risk ratios of severe thrombocytopenia were 2.11 [95% confidence interval, 1.61–2.77] for maternal organ damage except thrombocytopenia, 1.24 [1.01–1.53] for preterm delivery <34 gestational weeks, and 1.16 [1.02–1.32] for neonatal intensive care unit admission. On the other hand, the adjusted risk ratios of mild thrombocytopenia were 1.06 [0.86–1.30] for severe hypertension, 1.17 [0.74–1.83] for utero-placental dysfunction, 0.96 [0.41–2.24] for maternal organ damage except thrombocytopenia, 0.89 [0.60–1.31] for preterm delivery <34 gestational weeks, and 0.96 [0.75–1.23] for neonatal intensive care unit admission. ConclusionsMild thrombocytopenia was not related with severe features of pre-eclampsia and would not be suitable as a sign of maternal organ damage.
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.