bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early-stage multi-differentiated gastric carcinosarcoma and post-resection local recurrence: a case report
Authors: Shioya Akihiro , Kurose Nozomu , Mizutani Kenichi , Kumagai Motona , Kawaura Ken , Nakamura Naohiko , Kosaka Takeo , Motono Nozomu , Uramoto Hidetaka , Yamada Sohsuke 
Published: August 2020

Abstract
Background Carcinosarcoma is a rare neoplasm with a poor prognosis that is most often discovered at an advanced stage; a gastric carcinosarcoma is even rarer than carcinosarcomas originating in other organs, such as the uterus. We report our experience with an early-stage multi-differentiated gastric carcinosarcoma.Case presentation A 68-year-old male patient presented with anemia, and his fecal occult blood test was positive. An endoscopic examination was conducted which revealed a hemorrhagic, irregular, protruding lesion in the stomach. The lesion was diagnosed as an adenocarcinoma by histopathological examination of the biopsy specimen, and a segmental gastrectomy was performed. A 41 × 29 × 18 mm3 protruding lesion was observed in the resection specimen, and histologically confirmed to be a gastric carcinosarcoma with mixed adenocarcinomatous and sarcomatous composition. Tumor invasion was limited to the submucosa. Besides the adenocarcinomatous portion, neuroendocrine differentiation and AFP-positive gastric carcinoma were present in the carcinomatous portion of the tumor; in the sarcomatous portion, chondrosarcomatous, leiomyosarcomatous, and rhabdomyosarcomatous components were observed in addition to the undifferentiated sarcomatous component. Furthermore, the tumor included SALL4-positive germ cell-like cells. Despite early-stage detection, the cancer recurred locally 14 months after tumor resection, which necessitated a total gastrectomy. At the 2-month follow-up after the total gastrectomy, the patient was alive. This patient had developed an esophageal squamous cell carcinoma and primary lung adenosquamous carcinoma, both of which were resected. Conclusions Few cases of early-stage gastric carcinosarcoma have been reported, but there are no reports of recurrence to date. Local recurrence as in this patient, and even in early-stage cases, requires cautious surveillance to check for post-resection recurrence and metastasis. The etiopathogenesis of carcinosarcoma has not yet been elucidated; however, in the present case, despite the tumor’s relatively small size, it exhibited various types of differentiation in both the carcinomatous and sarcomatous components and a proliferative germ cell-like portion, which suggests that the monoclonal origin hypothesis may be a valid theory for the carcinosarcoma.
Mode of Bacterial Killing Affects the Inflammatory Response and Associated Organ Dysfunctions in a Porcine E. coli Intensive Care Sepsis Model&nbsp;
Authors: Skorup Paul , Maudsdotter Lisa , Lipcsey Miklós , Larsson Anders , Sjölin Jan 
Published: August 2020

Abstract
Background: Sepsis is often treated with penicillin-binding protein 3 (PBP-3) acting b-lactam antibiotics, such as piperacillin-tazobactam, cefotaxime and meropenem. They cause considerable bacterial structural changes and have in vitro been associated with an increased inflammatory response. In a clinically relevant large animal sepsis model our primary aim was to investigate whether bacteria killed by a PBP-3-active antibiotic has a greater effect on the early inflammatory response and organ dysfunction compared with corresponding amounts of live or heat-killed bacteria. A secondary aim was to determine whether the addition of an aminoglycoside could mitigate the cefuroxime-induced response.Method: Killed or live Escherichia coli were administrated as a 3-hour (h) infusion to 16 healthy pigs in a prospective, randomized controlled interventional experimental study. Cefuroxime was chosen as the PBP-3-active antibiotic and tobramycin represented the aminoglycosides. The animals were randomized to receive I) bacteria killed by cefuroxime, II) live bacteria, III) bacteria killed by heat or IV) bacteria killed by the combination of cefuroxime and tobramycin. Plasma endotoxin, tumor necrosis factor alpha, interleukin-6, interleukin-10, leukocytes and organ function were recorded at the start of the experiment and then hourly for 6 h. Results: Differences in dynamics of concentration over time between the four treatment groups were found for the three cytokines (p<0.001). Animals receiving cefuroxime-killed bacteria demonstrated higher responses than those receiving live (p<0.05) or heat-killed bacteria (p<0.01). The addition of tobramycin reduced the cefuroxime-induced responses (p<0.001). The cytokine responses were associated with leucocyte activation that was further associated with pulmonary dysfunction and increases in lactate (p<0.01).Conclusions: In comparison with live or heat-killed bacteria, bacteria killed by a PBP-3-active antibiotic induced an increased inflammatory response that appears to be associated with deteriorated organ and cellular function. The addition of an aminoglycoside to the PBP-3-active antibiotic reduced that response.
Performance of Mattis dementia rating scale-Chinese Version in patients with mild cognitive impairment and Alzheimer's disease
Authors: Qian Shuxia , Chen Keliang , Guan Qiaobing , Guo Qihao 
Published: August 2020

Abstract
Background: To identify the applicability of the Chinese Version of Mattis Dementia Rating Scale (DRS-CV).Methods: The DRS-CV was administered to 483 participants, including 136 normal controls, 167 patients with mild cognition impairment (MCI), and 180 patients with Alzheimer’s disease (AD). Receiver Operating Characteristic (ROC) curve was used to evaluate the sensitivity and specificity of the scale.Results: The scores of DRS-CV were ranked in the order of NC >MCI > mild AD > moderate AD group. Memory was the sensitive function affected at a relatively earlier stage of AD. ROC curve analysis indicated the DRS-CV total score and memory subscale showed excellent sensitivity and specificity in the discrimination between MCI from mild AD and mild AD from moderate AD, but poor sensitivity and specificity in the discrimination between MCI and NC.Conclusion: The DRS-CV is useful to the early diagnosis and severity of AD, not to the early identification of MCI.
Platelet adhesion and aggregate formation controlled by immobilised and soluble VWF
Authors: Schneider Matthias F. , Fallah Mohammad A. , Mess Christian , Obser Tobias , Schneppenheim Reinhard , Alexander-Katz Alfredo , Schneider Stefan W. , Huck Volker 
Published: August 2020

Abstract
BackgroundIt has been demonstrated that von Willebrand factor (VWF) mediated platelet-endothelium and platelet-platelet interactions are shear dependent. The VWF's mobility under dynamic conditions (e.g. flow) is pivotal to platelet adhesion and VWF-mediated aggregate formation in the cascade of VWF-platelet interactions in haemostasis.ResultsCombining microfluidic tools with fluorescence and reflection interference contrast microscopy (RICM), here we show, that specific deletions in the A-domains of the biopolymer VWF affect both, adhesion and aggregation properties independently. Intuitively, the deletion of the A1-domain led to a significant decrease in both adhesion and aggregate formation of platelets. Nevertheless, the deletion of the A2-domain revealed a completely different picture, with a significant increase in formation of rolling aggregates (gain of function). We predict that the A2-domain effectively ‘masks’ the potential between the platelet glycoprotein (GP) Ib and the VWF A1-domain. Furthermore, the deletion of the A3-domain led to no significant variation in either of the two functional characteristics.ConclusionsThese data demonstrate that the macroscopic functional properties i.e. adhesion and aggregate formation cannot simply be assigned to the properties of one particular domain, but have to be explained by cooperative phenomena. The absence or presence of molecular entities likewise affects the properties (thermodynamic phenomenology) of its neighbours, therefore altering the macromolecular function.
The relationship between the level of μ -opioid receptor (μORs) and postoperative analgesic use in patients undergoing septoplasty: A prospective randomized controlled trial.
Authors: GENCER MUZAFFER , Göçmen Ayşe Yeşim 
Published: August 2020

Abstract
Background : In this study, the μ-Opioid receptor activity was assessed pre-operatively for its association with postoperative pain level and second analgesic requirement in patients undergoing septoplasty. Methods : In our prospective study,120 adult patients underwent septoplasty from June 2015 to January 2019 were randomly divided into 2 pre-operative groups. The first group (n=60) was patients given tramadol (1-2 mg/kg) for post-operative analgesia, and the second group (control group)(n=60) was initially prescribed only fentanyl (1 µg/ kg-i.v.) in the induction. Acetaminophen with codeine analgesic 325/30 mg (p.o.) was used as an rescue painkiller in the post-operative period. The μ-Opioid receptor activity was investigated in pre-operative blood samples and compared to post-operative pain level and time required for second round of analgesic administration. The visual analogue score (VAS) was used to evaluate the post-operative pain degree (0 no pain; 10 worst pain). The patients’ post-operative VAS scores were evaluated upon arrival to recovery room, and at the 1st, 3rd, 7th, 10th, and 24 th hour post-operative period. Results: Demographic data and peri-operative variables were similar in both study group (p<0.05).There was no significant difference between the receptor levels in both groups and the mean receptor level was 200.94±15.34 pg/mL (max:489.92±22.36 pg/mL, min:94.56±11.23 pg/mL).In patients who used tramadol as the levels of μ-Opioid receptors increased, VAS scores of patients and second analgesic use decreased in post-operative period.The VAS scores in patients with higher receptor levels were lower in the recovery room (p<0.05), 1st (p<0.05) and 3rd hours (p<0.05).The VAS scores were lower in the tramadol group compared to the control group (p<0.05).Number of secondary analgesic requirement was significantly lower in patients of the tramadol group with higher receptor levels compared to the ones with lower receptor (p<0.05) for arrival at the recovery room and 1 st hour.Patients in the tramadol group needed a second pain killer much later than patients in the control group.Conclusions: Our study demonstrates that patients with higher μOR levels have a higher efficacy of opioid analgesic agents and an lesser need for additional analgesic agents. Trial registration: This trial was registered retrospectively (The ACTRN: ACTRN12619001652167, registration date:26/11/2019).
Complications to 6 months following total hip or knee arthroplasty: Observations from an Australian clinical outcomes registry
Authors: Heo Sung Mu , Harris Ian , Naylor Justine , Lewin Adriane 
Published: August 2020

Abstract
Background: Total hip and total knee arthroplasty (THA/TKA) are increasing in incidence annually. While these procedures are effective in improving pain and function, there is a risk of complications. Methods: Using data from an arthroplasty registry, we described complication rates including reasons for reoperation and readmission from the acute period to six months following THA and TKA in an Australian context. Data collection at 6 months was conducted via telephone interview, and included patient-reported complications such as joint stiffness, swelling and paraesthesia. We used logistic regression to identify risk factors for complications. Results: In the 8,444 procedures included for analysis, major complications were reported by 9.5% and 14.4% of THA and TKA patients, respectively, whilst minor complications were reported by 34.0% and 46.6% of THA and TKA patients, respectively. Overall complications rates were 39.7% and 53.6% for THA and TKA patients, respectively. In THA patients, factors associated with increased risk for complications included increased BMI, previous THA and bilateral surgery, whereas in TKA patient factors were heart disease, neurological disease, and pre-operative back pain and arthritis in a separate joint. Female gender and previous TKA were identified as protective factors for minor complications in TKA patients.Conclusion: We found moderate rates of major and high rates of minor postoperative complications following THA and TKA in Australia and have identified several patient factors associated with these complications. Efforts should be focused on identifying patients with higher risk and optimising pre- and post-operative care to reduce the rates of these complications.
Health variations among breast-cancer patients from different disease states: Evidence from China
Authors: Yang Qing , Yu Xuexin , Zhang Wei 
Published: August 2020

Abstract
Background

To obtain health utility data for different disease status of breast cancer in China in order to obtain important parameters in health economics modeling. To explore the feasibility of establishing a breast cancer health utility mapping model in China.

Methods

Multivariate regression models, including linear regression model, ordinal logistic regression model and Tobit model, were employed to analyz. Subgroup analyses were performed to analyze variations in sub-dimensional health attributes derived from FACT-B and EQ-5D-5L. A mapping function was used to estimate health utility from quality of life.

Results

446 breast cancer patients with different disease states were analyzed. The utility of breast cancer patients with P state(without cancer recurrence and metastasis), R state(with cancer recurrence within a year), S state(with primary and recurrent breast cancer for the second year and above) and M state(metastasis cancer) were 0.81 (SD ±0.23), 0.90 (SD ±0.12), 0.78 (SD ±0.31), and 0.74 (SD ±0.27), respectively. All scores, including the FACT-B domain, showed a positive correlation( p <0.001). Multivariate analysis suggested that patients in R and M state had lower scores in overall quality of life (R,β = -9.45, p < 0.01; M, β = -6.72, P <0.05). Patients in M state had a lower probability of achieving higher health utility compared with patients in P state (β = -0.11, p < 0.05). Estimated health utilities derived from quality of life, using mapping function, were significantly correlated with directly measured health utilities ( p <0.001).

Conclusions

We obtained the health utility and HRQoL scores of Chinese breast cancer patients with different disease states. Mapping health utilities from quality of life in four disease states could be a plausible approach in health economic analysis, while the mapping function may need further revise.
Metagenomic insights into the diversity of carbohydrate-degrading enzymes in the yak fecal microbial community
Authors: Gong Ga , Zhou Saisai , Luo Runbo , Gesang Zhuoma , Suolang Sizhu 
Published: August 2020

Abstract
Background: Yaks are able to utilize the gastrointestinal microbiota to digest plant materials. Although the cellulolytic bacteria in the yak rumen have been reported, there is still limited information on the diversity of the major microorganisms and putative carbohydrate-metabolizing enzymes for the degradation of complex lignocellulosic biomass in its gut ecosystem. Results: Here, this study aimed to decode biomass-degrading genes and genomes in the yak fecal microbiota using deep metagenome sequencing. A comprehensive catalog comprising 4.5 million microbial genes from the yak feces were established based on metagenomic assemblies from 92 Gb sequencing data. We identified a full spectrum of genes encoding carbohydrate-active enzymes, three-quarters of which were assigned to highly diversified enzyme families involved in the breakdown of complex dietary carbohydrates, including 120 families of glycoside hydrolases, 25 families of polysaccharide lyases, and 15 families of carbohydrate esterases. Inference of taxonomic assignments to the carbohydrate-degrading genes revealed the major microbial contributors were Bacteroidaceae, Ruminococcaceae, Rikenellaceae, Clostridiaceae, and Prevotellaceae. Furthermore, 68 prokaryotic genomes were reconstructed and the genes encoding glycoside hydrolases involved in plant-derived polysaccharide degradation were identified in these uncultured genomes, many of which were novel species with lignocellulolytic capability. Conclusions: Our findings shed light on a great diversity of carbohydrate-degrading enzymes in the yak gut microbial community and uncultured species, which provides a useful genetic resource for future studies on the discovery of novel enzymes for industrial applications.
The rs28757157 and rs59429575 polymorphisms in CYP19A1 are associated with lung cancer in Chinese Han population
Authors: Zhang Chan , Cheng Yujing , Chen Wanlu , Li Qi , Dai Run , Wang Yajie , Yang Tonghua 
Published: August 2020

Abstract
Background: Lung cancer is the leading cause of cancer death globally. Recent studies have revealed that the CYP19A1 gene played a crucial role in cancer initiation and development. The aim of this study was to assess the association of CYP19A1 genetic polymorphisms with the risk of lung cancer in the Chinese Han population. Method: This study randomly recruited 507 lung cancer patients and 505 healthy controls. The genotypes of four SNPs of CYP19A1 gene were identified by Agena MassARRY technique. Genetic model analysis was used to assess the association between genetic variation and lung cancer risk. Odds ratio (OR) values and 95% confidence intervals (CIs) were provided for the evaluation of the lung cancer risk effect. Results: Rs28757157 and rs59429575 polymorphisms of CYP19A1 were significantly correlated with the risk of lung cancer. In stratified analysis, rs28757157 was associated with increased cancer risk in smokers and individuals aged ≤ 60 years. Meanwhile, rs59429575 was identified as a risk biomarker in females and lung adenocarcinoma patients (p < 0.05). While rs28757157 exerted a protective role among people with a BMI greater than 24 (p = 0.033). Conclusions: This study identified two new SNPs (rs28757157 and rs59429575) of CYP19A1 associated with lung cancer in Chinese Han population. These findings provide data support for further functional studies of CYP19A1 in lung cancer.
A systematic review of patient prioritization tools in non-emergency healthcare services
Authors: Dery Julien , Ruiz Angel , Routhier François , Bélanger Valérie , Côté André , Ait-Kadi Daoud , Gagnon Marie-Pierre , Deslauriers Simon , Pecora Ana Tereza Lopes , Redondo Eduardo , Allaire Anne-Sophie , Lamontagne Marie-Eve 
Published: August 2020

Abstract
Background. Patient prioritization is a strategy used to manage access to healthcare services. Patient prioritization tools (PPT) contribute to supporting the prioritization decision process, and to its transparency and fairness. Patient prioritization tools can take various forms and are highly dependent on the particular context of application. Consequently, the sets of criteria change from one context to another, especially when used in non-emergency settings. This paper systematically synthesizes and analyzes the published evidence concerning the development and challenges related to the validation and implementation of PPTs in non-emergency settings.Methods. We conducted a systematic mixed studies review. We searched evidence in five databases to select articles based on eligibility criteria, and information of included articles was extracted using an extraction grid. The methodological quality of the studies was assessed by using the Mixed Methods Appraisal Tool. The article selection process, data extraction, and quality appraisal were performed by at least two reviewers independently.Results. We included 48 studies listing 34 different patient prioritization tools. Most of them are designed for managing access to elective surgeries in hospital settings. Two thirds of the tools were investigated based on reliability or validity. Inconclusive results were found regarding the impact of PPTs on patient waiting times. Advantages associated with PPT use were found mostly in relationship to acceptability of the tools by clinicians and increased transparency and equity for patients.Conclusions. This review describes the development and validation processes of PPTs used in non-urgent healthcare settings. Despite the large number of PPTs studied, implementation into clinical practice seems to be an open challenge. Based on the findings of this review, recommendations are proposed to develop, validate, and implement such tools in clinical settings.Systematic review registration: PROSPERO CRD42018107205
Relevant factors for early liver transplantation after Kasai portoenterostomy
Authors: Ge Liang , Zhan Jianghua , Gao Wei , Zhao Shengqiao , Xu Xiaodan , Dou Ran 
Published: August 2020

Abstract
Background：To explore the relevant factors for early liver transplantation (LT) after Kasai portoenterostomy (KP).Methods：Retrospective analysis was performed for 200 children with biliary atresia, who underwent LT with hepatic failure after KP. According to the interval between KP and LT, they were divided into three groups: G1 (≤6-month), G2 (6-month~2-year) and G3 (>2-year). Gender, age of Kasai portoenterostomy, jaundice-clearance, cholangitis after KP and liver function indexes before LT were compared among the three groups.Results：The proportion of patients with age of KP (≤90-day) in G1 was lower than that in G3 (P=0.003). Jaundice-clearance occurred in 6 (7.6%), 26(28.6%) and 26 (86.7%) patients after KP in G1, G2 and G3 respectively (P<0.001). There were statistical differences in the incidence of early cholangitis, late cholangitis and repeated cholangitis among the three groups (P=0.035, <0.001 and 0.022). The native liver survival (NLS) rate of children at operation age >90-day was lower than that of children at operation age ≤90-day (P=0.002). The NLS rate of the children with jaundice-clearance after KP was significantly better than that of the children without jaundice-clearance (P<0.001). The NLS rate of the children with early cholangitis after operation was lower than that in children without early cholangitis (P=0.026). The NLS rate of patients of G2 and G3 with cholangitis after KP was lower than that in children without cholangitis (P=0.017). Multiple logistic regression analysis showed uncleared jaundice after KP was a risk factor for the NLS survival time in patients.Conclusion：The age of KP (>90-day), jaundice-unclear and early cholangitis could reduce the NLS time after KP, which were related to early liver transplantation. Jaundice-unclear was a risk factor for early liver transplantation.