bluuebunny/crossref_metadata_2025_split huggingface dataset:
Minimally invasive surgery for intra-articular calcaneus fractures: A 9-year, single-center, retrospective study of a standardized technique using a 2-point distractor
Authors: Rodemund Christian , Krenn Ronny , Kihm Carl , Leister Iris , Ortmaier Reinhold , Litzlbauer Werner , Schwarz Angelika , Mattiassich Georg 
Published: September 2020

Abstract
Background: A fracture of the calcaneus can be a painful and disabling injury. Treatment modalities may be conservative or operative. Surgical treatment strategies include open reduction and internal fixation (ORIF) techniques, as well as a variety of minimally invasive methods. The aim of this study was to evaluate the treatment options and post-treatment complication rates for intra-articular calcaneal fractures at the Traumacenter Linz over a 9-year period.Methods: All patients with calcaneal fractures treated at the Traumacenter Linz between 2007 and 2015 were included in this study. The patients records were retrospectively reviewed, and the data, including demographic parameters, cause of injury, and the time between injury and operative treatment were analyzed. The number of secondary operative interventions due to soft-tissue complications, hardware removal, and the long-term arthrodesis rate were evaluated. Results: A minimally invasive 2-point-distractor method was used in 85.8% (n=182) of all operatively managed calcaneal fractures (n=212) in our department. The majority of the operations (88.7%) were performed within two days after the accident. The secondary operation rate resulting from wound complications was 2.7% in the 2-point distractor group and 16.7% in the ORIF group. A secondary arthrodesis was performed in 4.7% (n=9) of the subtalar joints in the entire study population. Conclusions:Our data supported the assumption that severe wound complications would be less likely to occur after minimally invasive treatment compared to ORIF treatment. The rate of secondary arthrodesis in the study cohort was comparable to that in the literature.Trial Registration: Not applicable, level of evidence IV.
Significance of druggable targets (PD-L1, KRAS, BRAF, PIK3CA, MSI, and HPV) on curatively resected esophageal squamous cell carcinoma
Authors: Lee Hong Kyu , Kwon Mi Jung , Ra Yong Joon , Lee Hee Sung , Kim Hyoung Soo , Nam Eun Sook , Cho Seong Jin , Park Hye-Rim , Min Soo Kee , Seo Jinwon , Choe Ji-Young , Min Kyueng-Whan , Kang So Young 
Published: September 2020

Abstract
Background: Esophageal squamous cell carcinoma (ESCC) still remains intractable disease with few therapeutic options. Programmed death-ligand 1 (PD-L1), which is essential for immune evasion, is involved in the pathogenesis of ESCC and thus is a potential therapeutic target. PIK3CA, KRAS, and BRAF mutations, microsatellite instability (MSI) caused by deficient mismatch repair (dMMR), and human papillomavirus (HPV) can potentially upregulate PD-L1 expression, which might contribute to the clinical outcome of patients with ESCC. Methods: We investigated the significance of the present druggable markers [PD-L1, PIK3CA, KRAS, and BRAF mutations, MSI caused by deficient dMMR, and HPV] in 64 curatively resected ESCCs, using immunohistochemistry (PD-L1 and MMR protein expression), direct sequencing (KRAS, BRAF, and PIK3CA mutations), real-time PCR (HPV infection), and MSI using quasi-monomorphic markers. Results: PD-L1 expression, PIK3CA mutation, and MSI/dMMR were detected in 35.9%, 12.5%, and 17.2% of ESCCs, respectively. HPV was rarely detected (1.6%) (high-risk HPV68), whereas KRAS and BRAF mutations were not detected in ESCCs. PD-L1-positive tumors were not correlated with PIK3CA mutation or MSI/dMMR (all P>0.05). PD-L1, PIK3CA mutation, and MSI/dMMR characterized the patients associated with light smoking, female and younger age, and younger age and well-differentiated tumors, respectively (all P<0.05). In multivariate analysis, only PD-L1-positivity was an independent favorable prognostic factor for overall survival (OS) and disease-free survival (DFS) (P=0.023, P=0.014). In the PD-L1-negative ESCCs, PIK3CA mutation had a poor prognostic impact on both OS and DFS (P=0.006, P=0.002). Conclusions: PIK3CA mutation may be an alternative prognostic biomarker in PD-L1-negative curatively resected ESCCs that can be optional to identify high-risk patients with worse clinical outcome who require more intensive therapy and follow-up.
Dexmedetomidine versus midazolam on cough and recovery quality after partial and total laryngectomy – a randomized controlled trial.
Authors: Xu Rui , Zhu Yun , Lu Yi , Li Wen Xian , Jia Jie 
Published: September 2020

Abstract
Backgroundː During emergence from anesthesia after partial and total laryngectomy, excessive airway reflex and systemic hypertension may lead to subcutaneous emphysema, hemorrhage or pneumothorax. Methodsː American Society of Anesthesiologist physical status III and IV male adults undergoing elective laryngectomy were recruited and randomly allocated to receive either dexmedetomidine (group D) or midazolam (group M). The primary outcome was incidence and severity of cough. Pulse oximetry results (SpO2), heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were also recorded. The visual analog scale and the Ramsay sedation scale were recorded at the points of wakefulness and departure from the post-anesthesia care unit (PACU). Rescue analgesia consumption, the time of spontaneous breath recovery, duration of the PACU stay, and the incidence of adverse effects were also recorded.Resultsː The prevalence of no coughing was significantly higher in group D than in group M at the points of wakefulness and departure. HR, SBP, and DBP were significantly lower in group D compared with group M, and SpO2 was significantly higher in group D than in group M at the moment of laryngectomy. Pain scores were lower in group D than in group M. The Ramsay score at the point of wakefulness was higher in group D than in group M. There was no difference in time to spontaneous breathing recovery, duration of the PACU stay, and incidence of adverse effects.Conclusionsː Compared with midazolam, dexmedetomidine is an effective alternative to attenuate coughing and hemodynamic changes with a low incidence of adverse events during emergence from anesthesia after partial and total laryngectomy.
Effective inactivation of Nipah virus in serum samples for safe processing in low-containment laboratories
Authors: Watanabe Shumpei , Fukushi Shuetsu , Harada Toshihiko , Shimojima Masayuki , Yoshikawa Tomoki , Kurosu Takeshi , Kaku Yoshihiro , Morikawa Shigeru , Saijo Masayuki 
Published: September 2020

Abstract
Background: Nipah virus (NiV) is an emerging zoonotic paramyxovirus that causes severe encephalitis and respiratory disease with a high mortality rate in humans. During large outbreaks of the viral disease, serological testing of serum samples could be a useful diagnostic tool, which could provide information on not only the diagnosis of NiV disease but also the history of an individual with previous exposure to the virus, thereby supporting disease control. Therefore, an efficient method for the inactivation of NiV in serum samples is required for serological diagnosis. Methods: We determined the optimal conditions for the inactivation of NiV infectivity in human serum using heating and UV treatment. The inactivation method comprised UV irradiation with a cover of aluminum foil for 30 min and heating at 56°C for 30 min. Results: With an optimized protocol for virus inactivation, NiV infectivity in serum samples (containing 6.0 ×10 5 TCID 50 ) was completely inactivated. Conclusions: We developed a recommended protocol for the effective inactivation of NiV. This protocol would enable a regional or local laboratory to safely transport or process samples, including NiV, for serological testing in its biosafety level-2 facility.
Integrated analysis of immune-related genes in endometrial carcinoma
Authors: Wang Yiru , Liu Yunduo , Guan Yue , Li Hao , Liu Yuan , Zhang Mengjun , Cui Ping , Kong Dan , Chen Xiuwei , Yin Hang 
Published: September 2020

Abstract
Background: Exploring novel and sensitive targets is urgent due to the high morbidity of endometrial cancer (EC). The purpose of our study was to explore the transcription factors and immune-related genes in EC and further identify immune-based lncRNA signature as biomarker for predicting survival prognosis.Methods: Transcription factors, aberrantly expressed immune-related genes and immune-related lncRNAs were explored through bioinformatics analysis. Cox regression and the least absolute shrinkage and selection operator (LASSO) analysis were conducted to identify the immune and overall survival (OS) related lncRNAs. The accuracy of model was evaluated by Kaplan-Meier method and receiver operating characteristic (ROC) analysis, and the independent prognostic indicator was identified with Cox analysis. Quantitative real-time polymerase chain reaction (qRT-PCR) were conducted to detect the accuracy of our results.Results: A network of 29 transcription factors and 17 immune-related genes was constructed. Furthermore, four immune-prognosis-related lncRNAs were screened out. Kaplan-Meier survival analysis and time-dependent ROC analysis revealed a satisfactory predictive potential of the 4-lncRNA model. Consistency was achieved among the results from the training set, testing set and entire cohort. The distributed patterns between the high- and low-risk groups could be distinguished in principal component analysis. Comparisons of the risk score and clinical factors confirmed the four-lncRNA-based signature as an independent prognostic indicator. Last, the reliability of the results was verified by qRT-PCR in 29 cases of endometrial carcinoma and in cells.Conclusions: Overall, our study constructed a network of transcription factors and immune-related genes and explored a four immune-related lncRNA signature that could serve as a novel potential biomarker of EC.
Design and rationale of a randomized, double-blind, placebo-controlled, Phase 2/3 study evaluating dociparstat in acute lung injury associated with severe COVID-19
Authors: Lasky Joseph A. , Fuloria Jyotsna , Morrison Marion E. , Lanier Randall , Naderer Odin , Brundage Tom , Melemed Allen 
Published: September 2020

Abstract
Introduction: The COVID-19 Global Pandemic caused by the novel coronavirus, SARS-CoV-2, and the consequent morbidity and mortality attributable to progressive hypoxemia and subsequent respiratory failure, threaten to overrun hospital critical care units globally. New agents that address the hyperinflammatory “cytokine storm” and hypercoagulable pathology seen in these patients may be a promising approach to treat patients, minimize hospital stays, and ensure hospital wards and critical care units are able to operate effectively. Dociparstat sodium (DSTAT) is a glycosaminoglycan derivative of heparin with robust anti-inflammatory properties, with the potential to address underlying causes of coagulation disorders with substantially reduced risk of bleeding compared to commercially available heparin. Methods: This study is a randomized, double-blind, placebo-controlled, Phase 2/3 trial to determine the safety and efficacy of DSTAT added to standard of care, in hospitalized adults with COVID-19 who require supplemental oxygen. Phase 2 will enroll 12 participants in each of two dose escalating cohorts, to confirm the safety of DSTAT in this population. Following review of the data, an additional 50 participants will be enrolled. Contingent upon positive results, Phase 3 will enroll approximately 450 participants randomized to DSTAT or placebo. The primary endpoint is the proportion of participants who survive and do not require mechanical ventilation through day 28. Discussion: Advances in standard of care, recent emergency use authorizations, and positive data with dexamethasone, has likely contributed to an increasing proportion of patients who are surviving without the need for mechanical ventilation. Therefore, examining the time to improvement in the NIAID score will be essential to provide a measure of drug effect on recovery. Analysis of additional endpoints, including supportive biomarkers (e.g., IL-6, HMGB1, soluble-RAGE, D-dimer) will be performed to further define the effect of DSTAT in patients with COVID-19 infection. Trial Registration: ClinicalTrials.gov identifier NCT04389840, Registered 13 May 2020, https://clinicaltrials.gov/ct2/keydates/NCT04389840
Accuracy of remote diagnoses using intraoral scans captured in approximate true color: a pilot and validation study in teledentistry
Authors: Steinmeier Sabrina Jenny , Wiedemeier Daniel , Hämmerle Christoph HF , Mühlemann Sven 
Published: September 2020

Abstract
Background: Intraoral scans (IOS) provide three-dimensional images with approximate true colors representing a possible tool in teledentistry for remote examination. The aim of the present cross-sectional validation study was, therefore, to evaluate the levels of agreement between remote diagnoses derived from IOS and diagnoses based on clinical examinations for assessing dental and periodontal conditions.Methods: The test sample comprised 10 patients representing different clinical conditions. Following the acquisition of IOS (Trios, 3Shape), a full-mouth dental and periodontal examination was done and periapical radiographs were taken. Ten dentists were asked to perform dental and periodontal scorings for each of the ten patients on a tablet computer presenting the IOS. Scores included diagnosis of gingivitis/periodontitis, and evaluated presence as well as amount of plaque and calculus, and presence of teeth exhibiting gingival recession, furcation involvement, erosion, tooth wear, stain, and non-carious cervical lesion, as well as presence of decayed, filled, and crowned teeth and implants. In a second round of assessments, the periapical radiographs were provided and the dentists were able to change the scores. The time for the remote assessment was recorded. The agreement between remote and clinical scorings (reference) was then analyzed descriptively.Results: The mean time for the tele assessment was 3.17 minutes and the additional consultation of the radiographs accounted for another 1.48 minutes. The sensitivity and specificity values were 0.61 and 0.39 for gingivitis and 0.67 and 0.33 for periodontitis, with no relevant changes when radiographs were provided for the diagnosis of periodontitis (0.72 and 0.28). The agreement for dichotomized dental and periodontal indices ranged between 78 and 95%. With the provision of radiographs, the remote examiners were able to detect existing filled teeth, crowned teeth, and implants, whereas the detection of decayed teeth (70%) was not improved.Conclusions: The remote examination using IOS was effective in detecting dental findings, whereas periodontal conditions could not be assessed with the same accuracy. Still, remote assessment of IOS would allow a time-efficient screening and triage of patients. Improvement of the image quality of IOS may further allow to increase the accuracy of remote assessments in dentistry.According to the Swiss Regulation this investigation is not a clinical trial and therefore no registration in a WHO-registry is needed.
Hepatocellular carcinoma: Intratumoral EpCAM-positive cancer stem cell heterogeneity identifies high-risk tumor subtype
Authors: Krause Jenny , von Felden Johann , Casar Christian , Fründt Thorben W. , Galaski Johanna , Schmidt Constantin , Jung Caroline , Ittrich Harald , Weidemann Sören Alexander , Krech Till , Heumann Asmus , Li Jun , Fischer Lutz , Sauter Guido , Lohse Ansgar W. , Wege Henning , Schulze Kornelius 
Published: September 2020

Abstract
Background: The translational interest in the intratumoral heterogeneity of hepatocellular carcinoma (HCC) has been increasing. The dismal prognosis of this pathology is linked to the features of the HCC harbouring cancer stem cell (CSC), represented by EpCAM-expression. However, the extent of the impact of intratumoral distribution of CSC-features both on the recurrence after curative resection, and on clinical outcome remains unknown. To address this, we investigated the spatial heterogeneity of CSC-features with the aim of identifying the unique HCC patient subgroups amenable to adjuvant treatment.Methods: We designed a tissue microarray (TMA) from patients who had received liver resection between 2011 and 2017. Tumor specimens were sampled at multiple locations (n=3-8). EpCAM-positivity was assessed for intensity and proportion by applying a score dividing three groups: (i) negative (E-/-); (ii) heterogeneous (E-/+); and (iii) homogeneous (E+/+). The groups were further analysed with regard to time-to-recurrence (TTR) and recurrence-free-survival (RFS).Results: We included 314 tumor spots from 69 patients (76.8% male, median age 66 years, liver cirrhosis/fibrosis 75.8). The risk factors were alcohol abuse (26.2%), NASH (13.1%), HBV (15.5%), HCV (17.9%) and others (27.4%), representative of a typical Western cohort. E+/+ patients experienced significantly shorter TTR and RFS compared to E+/- (and E-/-) patients (TTR 5 vs. 19 months, p=0.022; RFS 5 vs. 14 vs. 21 months, p=0.016). Only homogeneous EpCAM-positivity correlated with higher AFP levels (>400 ng/ml, p=0.031).Conclusions: Spatial heterogeneity of EpCAM-expression was markedly present in the cohort. Of note, only homogeneous EpCAM-expression correlated significantly with early recurrence, whereas heterogeneous EpCAM-expression was associated with clinical endpoints comparable to EpCAM-negativity. We identified a unique HCC subtype associated with a high risk of tumor recurrence.
Significance of serum branched-chain amino acid to tyrosine ratio measurement in athletes with high skeletal muscle mass
Authors: Tsunekawa Katsuhiko , Matsumoto Ryutaro , Ushiki Kazumi , Martha Larasati , Shoho Yoshifumi , Yanagawa Yoshimaro , Ishigaki Hirotaka , Yoshida Akihiro , Araki Osamu , Nakajima Kiyomi , Kimura Takao , Murakami Masami 
Published: September 2020

Abstract
Background
Few nutritional markers reflect the hypermetabolic state of athletes with high levels of skeletal muscle. Although branched-chain amino acids (BCAA) play crucial roles in protein metabolism in skeletal muscle, the relationship between circulating BCAA concentration and skeletal muscle mass has not been fully understood. The aim of this study is to evaluate the association between skeletal muscle mass and serum BCAA to tyrosine ratio (BTR), a convenient indicator of circulating BCAA, in young Japanese men including wrestling athletes with high skeletal muscle mass.
Methods
The study enrolled 111 young Japanese men: 70 wrestling athletes and 41 controls. None were taking medications or undergoing extreme dietary restriction or an intense exercise regimen. Each participant’s body composition, serum concentrations of albumin and rapid turnover proteins including transthyretin and transferrin, BTR, and thyroid function were assessed.
Results
Compared to the controls, the athletes had significantly higher skeletal muscle index (SMI) (p < 0.001), and lower serum albumin concentration (p < 0.001) and BTR (p < 0.001). Kruskal–Wallis tests showed that serum albumin concentration and BTR were significantly lower in the participants with higher SMI. Serum albumin concentration and BTR were inversely correlated with SMI by multiple regression analysis (logarithmic albumin, β = −0.358, p < 0.001; BTR, β = −0.299, p = 0.001). SMI was inversely and transthyretin was positively correlated with serum albumin (SMI, β = −0.554, p < 0.001; transthyretin, β = 0.379, p < 0.001). Serum concentration of free 3,5,3'-triiodothyronine (FT3) was inversely correlated with BTR, and, along with SMI and albumin, was independent predictor of BTR (SMI, β = −0.321, p < 0.001; FT3, β = −0.253, p = 0.001; logarithmic albumin, β = 0.261, p = 0.003), but was not correlated with SMI or serum albumin. Serum concentrations of rapid turnover proteins were not correlated with BTR.
Conclusions
These results suggest that increased skeletal muscle mass enhances the consumption of circulating BCAAs, facilitated by thyroid hormones independently. Serum BTR may be a useful biomarker to assess the hypermetabolic state of wrestling athletes with high levels of skeletal muscle.
Scabies,&nbsp;Incomplete Lupus Erythematosus&nbsp;and Henoch-Schonlein Purpura: A Case Report
Authors: Wu Yang Fang , Wang Jing Jing , Liu Hui Hui , Chen Wei Xia , Hu Peng 
Published: September 2020

Abstract
Background：Henoch-Schonlein purpura (HSP) is a common autoimmune vasculitis in childhood. Although the detailed etiology of HSP remains unknown, several triggers, especially for infectious agents, have been proved to be associated with HSP onset. Case presentation: In the present report, we describe an unusual patient who suffered from HSP and incomplete lupus erythematosus (ILE) on day 8 after scabies, mainly based on nonthrombocytopenic purpura, abdominal pain, medium proteinuria, positive antinuclear antibody (ANA) and skin scrapings. A course of pulse methylprednisolone (10mg/kg/day) was administered for 6 days, followed by oral prednisone (1mg/kg/day). On day 18, the purpuric rashes almost disappeared, whereas medium proteinuria still existed. In this circumstance, a renal biopsy was performed with the informed consent of the parents. According to the criteria proposed by the International Study of Kidney Disease in Children, this patient was classified as class IIIb. The immunofluorescence microscopy revealed granular deposits of IgA, IgM and C3 in the glomerular mesangium. His proteinuria gradually decreased after treatment of corticosteroids plus mycophenolate mofetil (20mg/kg/day). Conclusions: However, it should be noted that corticosteroids and immunosuppressors may increase the relapse risk of scabies, therefore this patient should be followed up carefully after discharging from our department.
Study on Corrosion Behavior of X80 Steel under Stripping Coating by Sulfate Reducing Bacteria
Authors: Cui Yanyu , Qin Yongxiang , Ding Qingmiao , Gao Yuning 
Published: September 2020

Abstract
Background: At present, microorganism has been considered as important factors that threaten to buried pipelines with disbonded coatings. Aiming at the problem of unknown corrosion mechanism of sulfate-reducing bacteria (SRB), a series of studies have been carried out in this paper. Spectrophotometer and fluorescent labeling technology are used to study the growth and attachment of SRB in the simulated soil solution. The electrochemical behavior of X80 pipeline steel with or without SRB was researched by electrochemical methods such as open circuit potential, dynamic potential polarization curve, and electrochemical impedance spectroscopy. The microscopic morphology of the corrosion products on the surface of the sample was observed with a scanning electron microscope (SEM), and the element content of the corrosion products on the surface of the sample after corrosion was observed using X-ray energy spectrum (EDS) analysis. Results: The results showed that the growth and reproduction of SRB caused the pH of the soil simulated solution to increase, which promoted the corrosion of X80 steel. In addition, the cathode reaction of X80 steel in a sterile environment is the reduction of H+, and the main corrosion product is Fe oxides. When the soil simulation solution contains SRB, the cathodic reaction is controlled by both H+ reduction and sulfide depolarization reactions, and FeS appears in the corrosion products. Conclusion: Although the life cycle of SRB is only about 14 days, the corrosion of X80 steel is greatly promoted by SRB, and even causes corrosion perforation, which will bring huge economic losses and serious safety hazards.