bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bile Leak Reduction with Laparoscopic Versus Open Liver Resection: A Multi‐institutional Propensity Score‐Adjusted Multivariable Regression Analysis
Authors: Smith Alison A. , Monlezun Dominique J. , Martinie John , Iannitti David , Konstantinidis Ioannis , Darden Michael , Parker Geoffrey , Fong Yuman , Buell Joseph F. 
Published: January 2020

AbstractIntroductionThe reported rate of postoperative bile leak is variable between 3 and 33%. Recent data would suggest a minimally invasive approach to liver surgery has decreased this incidence.MethodsThis multi‐institutional case–control study utilized databases from three high‐volume surgeons. All consecutive open and minimally invasive liver resection cases were analyzed in a propensity score‐adjusted multivariable regression. A p value < 0.05 was considered significant.ResultsIn 1388 consecutive liver resections, the average age was 56.9 ± 14.0 years, 730 (52.59%) were male gender, and 599 (43.16%) underwent minimally invasive liver resection. Thirty‐nine (2.81%) in the series were identified with post‐resection bile duct leaks. Leaks were associated with major resections and increased blood loss (p < 0.05). Propensity score‐adjusted multivariable regression identified minimally invasive liver resection significantly and independently reduced the odds of bile duct leak (OR 0.48, p = 0.046) even controlling for BMI, ASA, cirrhosis, major resection, and resection year.ConclusionsOur data suggest the incidence of bile leaks in a large‐volume center series is far less than previously reported and that a minimally invasive approach to liver resection reduces the incidence of postoperative bile leak.
Injury Pattern and Injury Severity of In‐Hospital Deceased Road Traffic Accident Victims in The Netherlands: Dutch Road Traffic Accidents Fatalities
Authors: Leijdesdorff Henry A. , Gillissen Stijn , Schipper Inger B. , Krijnen Pieta 
Published: January 2020

AbstractBackgroundFurther reduction in road traffic accident (RTA) fatalities is a key priority in the European Union. Since data on injury patterns related to mortality in RTAs are scarce, the aim of this study was to analyze injury patterns and injury severity of in‐hospital RTA fatalities in the Netherlands.MethodsAll in‐hospital deceased RTA victims in the Netherlands during the period 2015–2016 were analyzed. Data were obtained from the National Trauma Registry. Injury patterns, injury severity, accident and patient characteristics of road user groups were compared.ResultsA total of 497 deceased RTA victims were analyzed, of which most were bicyclists. All analyzed motorcyclists had an ISS ≥ 16. Head trauma was most frequent in pedestrians (73.7%) and bicyclists (71.3%). Thorax trauma was most frequent in motorcyclists and motorists (60.9% and 65.8%, respectively). RTA victims younger than 25 years were more severely injured (median ISS 38, interquartile range [IQR] 29–46) compared to RTA victims aged over 75 years (median ISS 25, IQR 13–30). More than 10% of the severely injured (ISS ≥ 16) RTA victims was not transported to a level I trauma center. The majority of this group was older than 75 years.ConclusionsFurther prevention of head trauma is needed to reduce RTA fatalities, especially in bicyclists. Also, undertriage of severe trauma in elderly RTA victims is obvious and should be addressed in the early phases of trauma care, especially during prehospital triage and initial care at admission.
Ethics as a Non‐technical Skill for Surgical Education in Sub‐Saharan Africa
Authors: Tarpley Margaret J. , Costas‐Chavarri Ainhoa , Akinyi Beryl , Tarpley John L. 
Published: January 2020

AbstractBackgroundIn recent years, surgical education has increased its focus on the non‐technical skills such as communication and interpersonal relationships while continuing to strive for technical excellence of procedures and patient care. An awareness of the ethical aspects of surgical practice that involve non‐technical skills and judgment is of vital concern to surgical educators and encompasses disparate issues ranging from adequate supervision of trainees to surgical care access.MethodsThis bibliographical research effort seeks to report on ethical challenges from a sub‐Saharan Africa (SSA) perspective as found in the peer‐reviewed literature employing African Journals Online, Bioline, and other sources with African information as well as PubMed and PubMed Central. The principles of autonomy, non‐maleficence, beneficence, and justice offer a framework for a study of issues including: access to care (socioeconomic issues and distance from health facilities); resource utilization and decision making based on availability and cost of resources, including ICU and terminal extubation; informed consent (both communication about reasonable expectations post‐procedure and research participation); research ethics, including local projects and international collaboration; quality and safety including supervision of less experienced professionals; and those religious and cultural issues that may affect any ethical decision making. The religious and cultural environment receives attention because beliefs and traditions affect medical choices ranging from acceptance of procedures, amputations, to end‐of‐life decisions.Results and ConclusionsEthics awareness and ethics education should be a vital component of non‐technical skills training in surgical education and medical practice in SSA for trainees. Continuing professional development of faculty should include an awareness of ethical issues.
Evolving Indications for Lower Limb Amputations in South Africa Offer Opportunities for Health System Improvement
Authors: Khan Muhammad Zafar , Smith Michelle TD , Bruce John L , Kong Victor Y , Clarke Damian L 
Published: January 2020

AbstractBackgroundRapid urbanization and westernization have precipitated dramatic changes in the profile and prevalence of surgical diseases in sub‐Saharan Africa. Disease of lifestyle is now common. We aimed to review our experience with lower‐limb amputations at our surgical service in South Africa.MethodsA single‐center retrospective review of a prospectively collected database was performed of all patients who underwent a lower limb amputation. Inferential and descriptive statistics were performed. Patient demographics, indication, type of amputation, and management were reviewed. The primary outcome was 30‐day in‐patient mortality rate.ResultsOver a 5‐year period (2013–2018), 348 patients underwent lower limb amputations. The median age was 61.5 years. 53.7% were diabetic and 56.3% were hypertensive. 53.2% had associated peripheral vascular disease and 8% preexisting cardiac disease. 30.7% smoked. Guillotine below‐knee amputation was frequently performed (44.5% of amputations). 16.1% of these patients required a further operation. The in‐hospital mortality rate was 8%. Underlying renal disease was an independent risk factor for mortality (p = 0.004).ConclusionCurrently, the most common indications for LLA in South Africa are diabetes mellitus and atherosclerosis. This reflects the changing pattern of disease in the country. There is a major problem with access to health care in rural areas in South Africa with significant delays in getting patients to tertiary units for evaluation by specialists. Foot care and prevention at a primary health care level is also lacking. Global improvements in the healthcare system are needed to improve LLA rates in South Africa.
Real-world outcomes following 12 months of intravitreal aflibercept monotherapy in patients with diabetic macular edema in France: results from the APOLLON study
Authors: Korobelnik Jean-François , Daien Vincent , Faure Céline , Tadayoni Ramin , Giocanti-Auregan Audrey , Dot Corinne , Kodjikian Laurent , Massin Pascale 
Published: January 2020

Abstract
Purpose
To report the effectiveness of intravitreal aflibercept (IVT-AFL) treatment for diabetic macular edema (DME) in French clinical practice.

Methods
APOLLON (NCT02924311) was a prospective, observational cohort study of patients with DME. Effectiveness was evaluated by change from baseline in best-corrected visual acuity (BCVA) at 12 months in treatment-naïve patients (i.e., had not received any anti-vascular endothelial growth factor [anti-VEGF] agent, laser, or steroid at IVT-AFL treatment start) and previously treated patients (i.e., previously treated with anti-VEGF agents other than IVT-AFL, laser, or steroids at IVT-AFL treatment start). Secondary endpoints included change in central retinal thickness (CRT) over 12 months, frequency of injections, and proportion of patients with safety events.

Results
Of the 147 patients followed for at least 12 months and included in the effectiveness analysis, 52.4% (n = 77) were treatment-naïve and 47.6% (n = 70) were previously treated. Mean (standard deviation [SD]) BCVA score at baseline was 62.7 (14.3) Early Treatment Diabetic Retinopathy Study (ETDRS) letters in treatment-naïve patients and 60.0 (13.7) ETDRS letters in previously treated patients. At month 12, mean (SD) change in BCVA was + 7.8 (12.3) letters in treatment-naïve patients and + 5.0 (11.3) letters in previously treated patients. Mean CRT decreased in both patient cohorts. The mean (SD) number of IVT-AFL injections at month 12 was 7.6 (2.5) for treatment-naïve patients and 7.6 (2.3) for previously treated patients. Of 388 patients included in the safety analysis, ocular treatment-emergent adverse events occurred in 54.1% (n = 210) of patients.

Conclusion
IVT-AFL treatment was associated with improvements in functional and anatomic outcomes in both treatment-naïve and previously treated patients with DME in France.
Histone methyltransferases regulate the transcriptional expression of ERα and the proliferation of tamoxifen-resistant breast cancer cells
Authors: Kim Seung-Su , Lee Min-Ho , Lee Mi-Ock 
Published: January 2020

Abstract
Purpose
Although tamoxifen remains the frontline treatment for ERα-positive breast cancers, resistance to this drug limits its clinical efficacy. Most tamoxifen-resistant patients retain ERα expression which may support growth and progression of breast cancers. Therefore, we investigated epigenetic regulation of ERα that may provide a rationale for targeting ERα in these patients.

Methods
Expression levels of the mixed-lineage leukemia (MLL) family of proteins in tamoxifen-resistant breast cancer cells and publicly available breast cancer patient data sets were analyzed. Histone methylation levels in ERα promoter regions were assessed using chromatin immunoprecipitation. Expression levels of ERα and its target gene were analyzed using western blotting and real-time qPCR. Cell-cycle was analyzed by flow cytometry.

Results
The expression of MLL3 and SET-domain-containing 1A (SET1A) were increased in tamoxifen-resistant breast cancers. An MLL3 chromatin immunoprecipitation-sequencing data analysis and chromatin immunoprecipitation experiments for MLL3 and SET1A suggested that these proteins bound to enhancer or intron regions of the ESR1 gene and regulated histone H3K4 methylation status. Depletion of MLL3 or SET1A downregulated the expression level of ERα and inhibited the growth of tamoxifen-resistant breast cancer cells. Additional treatment with fulvestrant resulted in a synergistic reduction of ERα levels and the growth of the cells.

Conclusions
The enhanced expression of MLL3 and SET1A in tamoxifen-resistant breast cancer cells supported the ERα-dependent growth of these cells by increasing ERα expression. Our results suggest that targeting these histone methyltransferases might provide an attractive strategy to overcome endocrine resistance.
A multi-criteria evaluation system for arable land resource assessment
Authors: Li Feipeng , Liu Wei , Lu Zhibo , Mao Lingchen , Xiao Yihua 
Published: January 2020

AbstractThis study proposed a multi-criteria evaluation system for arable land resources by combining the soil integrated fertility index (IFI) with a soil cleanliness index (based on heavy metals and metalloid content). A total of 16 typical arable land units in Chongming District, China, were evaluated using the proposed evaluation system based on 104 collected soil samples in 16 towns. The comprehensive soil evaluation scores of arable lands in 16 towns were in the range of 90.7 to 99.2 with a mean of 96.2, indicating that the arable land in all 16 towns was at the level of excellent (≥ 90.0). Lower cleanliness indices had a significant impact on the final evaluation score. In comparison with single-index evaluation systems (i.e., the IFI or soil cleanliness index), the proposed multi-criteria system better reflects the quality of the soil. In the practice of arable land requisition and subsidy policy, the proposed multi-criteria evaluation system not only encourages farmers to preserve arable lands during farming but also helps agricultural authorities make effective and reliable management decisions.
Sources of stress and scholarly identity: the case of international doctoral students of education in Finland
Authors: Pappa Sotiria , Elomaa Mailis , Perälä-Littunen Satu 
Published: January 2020

AbstractAlthough stressors and coping strategies have been examined in managing stress associated with doctoral education, stress continues to have a permeating and pernicious effect on doctoral students’ experience of their training and, by extension, their future participation in the academic community. International doctoral students have to not only effectively cope with tensions during their training and their socialization in their discipline but also address the values and expectations of higher education institutions in a foreign country. Considering the increase of international doctoral students in Finland, this study focuses on perceived sources of stress in their doctoral training and how their scholarly identity is involved when responding to them. The study draws on thematically analyzed interviews with eleven international doctoral students of educational sciences. The participants, one man and ten women, came from nine countries and conducted research in six Finnish universities. The principal sources of stress identified were intrapersonal regulation, challenges pertaining to doing research, funding and career prospects, and lack of a supportive network. Despite the negative presence of stress, most participants saw stress as a motivating element. However, in order for stress to become a positive and motivational force, participants had to mediate its presence and effects by means of personal resources, ascribing meaning and purpose to their research, and positioning themselves within their academic and social environment. The study argues for stress as a catalyst for scholarly identity negotiation and professional development when perceived positively.
Model-based kernel sum rule: kernel Bayesian inference with probabilistic models
Authors: Nishiyama Yu , Kanagawa Motonobu , Gretton Arthur , Fukumizu Kenji 
Published: January 2020

AbstractKernel Bayesian inference is a principled approach to nonparametric inference in probabilistic graphical models, where probabilistic relationships between variables are learned from data in a nonparametric manner. Various algorithms of kernel Bayesian inference have been developed by combining kernelized basic probabilistic operations such as the kernel sum rule and kernel Bayes’ rule. However, the current framework is fully nonparametric, and it does not allow a user to flexibly combine nonparametric and model-based inferences. This is inefficient when there are good probabilistic models (or simulation models) available for some parts of a graphical model; this is in particular true in scientific fields where “models” are the central topic of study. Our contribution in this paper is to introduce a novel approach, termed the model-based kernel sum rule (Mb-KSR), to combine a probabilistic model and kernel Bayesian inference. By combining the Mb-KSR with the existing kernelized probabilistic rules, one can develop various algorithms for hybrid (i.e., nonparametric and model-based) inferences. As an illustrative example, we consider Bayesian filtering in a state space model, where typically there exists an accurate probabilistic model for the state transition process. We propose a novel filtering method that combines model-based inference for the state transition process and data-driven, nonparametric inference for the observation generating process. We empirically validate our approach with synthetic and real-data experiments, the latter being the problem of vision-based mobile robot localization in robotics, which illustrates the effectiveness of the proposed hybrid approach.
Comparative Assessment of the New PDE7 Inhibitor – GRMS-55 and Lisofylline in Animal Models of Immune-Related Disorders: A PK/PD Modeling Approach
Authors: Świerczek Artur , Pociecha Krzysztof , Ślusarczyk Marietta , Chłoń-Rzepa Grażyna , Baś Sebastian , Mlynarski Jacek , Więckowski Krzysztof , Zadrożna Monika , Nowak Barbara , Wyska Elżbieta 
Published: January 2020

AbstractPurposeThis study aimed to assess the activity of two phosphodiesterase (PDE) inhibitors, namely GRMS-55 and racemic lisofylline ((±)-LSF))in vitroand in animal models of immune-mediated disorders.MethodsInhibition of human recombinant (hr)PDEs and TNF-alpha release from LPS-stimulated whole rat blood by the studied compounds were assessedin vitro. LPS-induced endotoxemia, concanavalin A (ConA)-induced hepatitis, and collagen-induced arthritis (CIA) animal models were used forin vivoevaluation. The potency of the investigated compounds was evaluated using PK/PD and PK/PD/disease progression modeling.ResultsGRMS-55 is a potent hrPDE7A and hrPDE1B inhibitor, while (±)-LSF most strongly inhibits hrPDE3A and hrPDE4B. GRMS-55 decreased TNF-alpha levelsin vivoand CIA progression withIC50of 1.06 and 0.26 mg/L, while (±)-LSF withIC50of 5.80 and 1.06 mg/L, respectively. Moreover, GRMS-55 significantly ameliorated symptoms of ConA-induced hepatitis.ConclusionsPDE4B but not PDE4D inhibition appears to be mainly engaged in anti-inflammatory activity of the studied compounds. GRMS-55 and (±)-LSF seem to be promising candidates for future studies on the treatment of immune-related diseases. The developed PK/PD models may be used to assess the anti-inflammatory and anti-arthritic potency of new compounds for the treatment of rheumatoid arthritis and other inflammatory disorders.
Text2Sign: Towards Sign Language Production Using Neural Machine Translation and Generative Adversarial Networks
Authors: Stoll Stephanie , Camgoz Necati Cihan , Hadfield Simon , Bowden Richard 
Published: January 2020

AbstractWe present a novel approach to automatic Sign Language Production using recent developments in Neural Machine Translation (NMT), Generative Adversarial Networks, and motion generation. Our system is capable of producing sign videos from spoken language sentences. Contrary to current approaches that are dependent on heavily annotated data, our approach requires minimal gloss and skeletal level annotations for training. We achieve this by breaking down the task into dedicated sub-processes. We first translate spoken language sentences into sign pose sequences by combining an NMT network with a Motion Graph. The resulting pose information is then used to condition a generative model that produces photo realistic sign language video sequences. This is the first approach to continuous sign video generation that does not use a classical graphical avatar. We evaluate the translation abilities of our approach on the PHOENIX14TSign Language Translation dataset. We set a baseline for text-to-gloss translation, reporting a BLEU-4 score of 16.34/15.26 on dev/test sets. We further demonstrate the video generation capabilities of our approach for both multi-signer and high-definition settings qualitatively and quantitatively using broadcast quality assessment metrics.
CB1 receptor antagonist rimonabant protects against chronic intermittent hypoxia-induced bone metabolism disorder and destruction in rats
Authors: Dou Zhan-jun , Gao Xiao-Ling , Jia Yan-li , Chen Jie , Yang Jiao-Jiao , Chen Yan , Wu Shu-jie , Liu Tao , Wang Mei-ting , Yang Chong , Zhang Na , Wang Bei 
Published: January 2020

Abstract
Objective
The endocannabinoid system (ECS) regulates bone turn-over and remodeling. Chronic intermittent hypoxia (CIH) occurring during obstructive sleep apnea (OSA) may lead to disorders of the ECS and bone metabolism abnormalities. This study aimed to investigate whether or not the cannabinoid receptor 1 (CB1R) antagonist rimonabant (Ri) alleviates bone metabolism abnormalities and bone destruction induced by chronic intermittent hypoxia (CIH).

Methods
Healthy male Sprague Dawley (SD) rats (n=48) were randomly divided into 6 groups of 8 rats: 2 normal control (NC) groups, 2 intermittent hypoxia (IH) groups, and 2 IH + Ri groups. Rats in NC groups breathed room air for 4 weeks (4w NC group) and 6 weeks (6w NC group). Rats in IH groups experienced IH environment for 4 weeks (4w IH group) and 6 weeks (6w IH group). In addition to the same IH exposure, rats in IH + Ri group were given daily intraperitoneal injection of Ri at the dosage of 1.5 mg/kg/d for 4 weeks (4w IH + Ri group) and 6 weeks (6w IH + Ri group). Levels of serum tartrate-resistant acid phosphatase (TRAP, a marker of bone resorption) were determined by ELISA. Hematoxylin and eosin (HE) staining was performed on bone sections to observe the changes in bone microstructure. Expression of CB1R in bone tissue was determined by immunohistochemistry.

Results
TRAP levels were higher in the 4w IH and 6w IH groups than in the 4w NC and 6w NC groups; TRAP levels were lower in the 4w IH + Ri and 6w IH + Ri groups than in the 4w IH and 6w IH groups. HE staining showed that the morphology of bone cells in the NC group was normal, but the 4w IH group had mild edema of bone cells, reduction in trabecular bone, and destruction of bone microstructure. Changes were more severe in the 6w IH group than 4w IH. The 4w IH + Ri group was slightly improved compared with the 4w IH group. The 6w IH + Ri group was improved compared with the 4w IH + Ri group. The results of immunohistochemistry showed that the expression of CB1R in IH group was significantly higher than that in NC group. The expression of CB1R in the IH + Ri group was lower than that in the IH group. With the prolongation of hypoxia, the expression of CB1R in bone cells of IH group increased. The expression level of CB1R in IH + Ri group decreased with the prolongation of intervention time. Correlation analysis showed that the expression rate of CB1R in bone cells was positively correlated with the level of TRAP in serum.

Conclusion
CIH increases serum TRAP levels and triggers metabolic bone disorder by activating bone CB1R. Intervention with CB1R antagonist (rimonabant) reduces the bone dysmetabolism in the CIH rat model.
Recent developments in the application of oil palm fibers in cement composites
Authors: Momoh Emmanuel Owoichoechi , Osofero Adelaja Israel 
Published: January 2020

AbstractFibers obtained from different parts of the oil palm tree (Elaeis guineensis) have been under investigation for possible use in construction. Studies have been carried out investigating the engineering properties and possible applications of these fibers. However, the experimental methods employed and the values of mechanical and physical properties recorded by various authors are inconsistent. It has therefore become necessary to organize information which would be useful in the design of oil palm fiber cement composites and help researchers and engineers make informed decisions in further research and application. This review provides information about fibers from different parts of the oil palm, their properties, enhancement techniques, current and potential application in cement composites.