bluuebunny/crossref_metadata_2025_split huggingface dataset:
Discectomy Combined with Annulus Fibrosus Repair for the Treatment of Lumbar Disc Herniation: A Bayesian analysis of Random Controlled Trials
Authors: Hu Jinlong , Bai Jianzhong , Shi Xueqiang , Fei Wenyong , Wang Hua 
Published: April 2020

Abstract
Objective To investigate clinical effects of discectomy combined with annulus fibrosus (AF) repair for the treatment of lumbar disc herniation. Methods We searched PubMed, Embase, Web of Science, CNKI and WanFang data for studies evaluating discectomy combined with AF repair and discectomy for the treatment lumbar disc herniation. Two reviewers selected studies, assessed quality, and extracted data. This meta-analysis was performed to calculate the weighted mean difference (WMD), risk ratios (RRs), and 95% confidence intervals (CIs). Results Six randomized controlled trials (RCTs) were included in the meta-analysis. The pooled results suggested that the recurrence rate and reoperation rate in the non-repair group versus those in the repair group [RR= 2.64, 95% confidence interval (CI) 1.09, 6.41], [RR=1.33, CI 0.85, 2.10], respectively. The rate of Visual analogue scale (VAS) relief in the repair group was significantly better than in non-repair group [WMD=0.23, CI 0.04, 0.42], and did not increase the incidence of postoperative complications. There were no significant differences between the two surgical procedures in the Oswestry disability index (ODI) reduction [WMD=-0.18, CI -1.50, 1.14], intraoperative blood loss [WMD = -1.23, CI -4.46, 2.00] and the length of the surgical incision [WMD = 0.08, CI -0.01, 0.18]. However, the operation time of the repair group was slightly longer than non-repair group [WMD =6.73, CI 2.80, 10.66]. Conclusion Discectomy combined with AF repair is superior to discectomy regarding postoperative recurrence rate and postoperative pain relief, but the operation time is slightly longer than the latter. There is no significant difference in reoperation rate, intraoperative blood loss, length of the surgical incision, postoperative complication rate, and reduction in ODI between the two surgical procedures.
Use of Immunostaining for the Diagnosis of Lymphovascular Invasion in Superficial Barrett’s Esophageal Adenocarcinoma
Authors: Hosono Isao , Miyahara Ryoji , Furukawa Kazuhiro , Funasaka Kohei , Sawada Tsunaki , Maeda Keiko , Yamamura Takeshi , Ishikawa Takuya , Ohno Eizaburo , Nakamura Masanao , Kawashima Hiroki , Yokoi Takio , Tsukamoto Tetsuya , Hirooka Yoshiki , Fujishiro Mitsuhiro 
Published: April 2020

Abstract
Background: The prevalence of Barrett’s esophageal adenocarcinoma (BEA) is increasing in Japan. Accurate assessment of lymphovascular invasion (LVI) after endoscopic resection or surgery is essential in evaluating treatment response. This study aimed to assess the usefulness of immunostaining in determining the extent of LVI in superficial BEA. Methods: We retrospectively included 41 patients who underwent endoscopic resection or surgery between January 2007 and July 2018. In all cases, 3-µm serial sections from paraffin-embedded resected specimens were used for hematoxylin and eosin (H-E) staining and immunostaining for D2-40 and CD31. Two specialized gastrointestinal pathologists (T.Y. and T.T), blinded to clinical information, independently evaluated the extent of LVI from these specimens. The LVI-positivity rate was evaluated with respect to the depth of invasion, changes in the positivity rate on immunostaining, pathological characteristics of patients with LVI, lymph node metastasis or relapse, and course after treatment. Results: H-E staining alone identified LVI in 7 patients (positivity rate: 17.1%). Depths of invasion were categorized based on extension to the submucosa (SM) or deeper. On immunostaining for D2-40 and CD31, additional positivity was detected in 2 patients with SM1 and 1 SM3, respectively; LVI was detected in 10 patients (positivity rate: 24.4%). LVI-positivity rates with invasion of the superficial muscularis mucosa (SMM)/lamina propria (LPM)/deep muscularis mucosa (DMM), SM 1, 2, and 3 were 0%, 75%, 28.6%, and 55.6%, respectively. Conclusions:Combined H-E staining and immunostaining is useful in diagnosing LVI in superficial BEA, particularly in endoscopically resected specimens.
Differential long-term retention of biological disease-modifying antirheumatic drugs in patients with rheumatoid arthritis by age group from the FIRST registry
Authors: Kawabe Akio , Nakano Kazuhisa , Kubo Satoshi , Asakawa Takeshi , Tanaka Yoshiya 
Published: April 2020

Abstract
Background. The effectiveness and safety of biological disease-modifying antirheumatic drugs (bDMARDs) by age group (<65, 65–74, and ≥75 years) are uncertain. We examined retention rates reflecting the effectiveness and safety of bDMARDs in actual clinical practice for clarifying optimal therapeutic strategies for rheumatoid arthritis (RA) by age groups.Methods. Data of patients who were treated with tumor necrosis factor inhibitors (TNFi), abatacept (ABA), and tocilizumab (TCZ) between February 2011 and April 2017 were retrospectively collected from an observational registry of RA patients. A total of 1,362 patients were enrolled, of which 695 were aged <65 years, 402 were aged 65–74 years, and 265 were aged ≥75 years. Primary outcome was the drug retention rate in adjusted data using inverse probability of treatment weighting based on generalized propensity scores.Results. In patients aged <65 years, three-year retention rates of TNFi, ABA, and TCZ were 43%, 47%, and 69%, respectively (ABA versus TCZ, p = 0.017; TNFi versus TCZ, p = 0.002). In patients aged 65–74 years, three-year retention rates of TNFi, ABA, and TCZ were 44%, 53%, and 60%, respectively (TCZ versus TNFi, p = 0.034). In patients aged ≥75 years, three-year retention rates for TNFi, ABA, and TCZ were 38%, 63%, and 58%, respectively (ABA versus TNFi, p = 0.017).Conclusions. We found that the effectiveness and safety of TCZ were maximal in patients aged <75 years and that patients aged ≥75 years might be suitable candidates for TCZ and ABA therapy. The use of therapeutic strategies appropriate to each age group might improve the outcomes of bDMARD therapy for RA.
Human umbilical cord-derived mesenchymal stem cells ameliorate insulin resistance via PTEN-mediated crosstalk between the PI3K/Akt and Erk/MAPKs signaling pathways in the skeletal muscles of db/db mice
Authors: Chen Guang , Fan Xiao-yan , Zheng Xiao-peng , Jin Yue-lei , Liu Ying , Liu Shuang-chun 
Published: April 2020

Abstract
Background: Globally, 1 in 11 adults have diabetes mellitus and 90% of the cases are type 2 diabetes mellitus. Asia is the epicenter of this global type 2 diabetes mellitus epidemic. Type 2 diabetes mellitus and its complications have contributed significantly to the burden of mortality and disability worldwide. Insulin resistance is a central defect in type 2 diabetes mellitus, and although multiple drugs have been developed to ameliorate insulin resistance, the limitations and accompanying side effects cannot be ignored. Thus more effective methods are required to improve insulin resistance. Methods: In the current study, db/m and db/db mice were injected with human umbilical cord-derived mesenchymal stem cells (HUC-MSCs) via tail vein injection, intraperitoneal injection and skeletal muscle injection. Body weight, fasting blood glucose and the survival rates were monitored. Furthermore, the anti-insulin resistance effects and potential mechanisms of transplanted HUC-MSCs were investigated in db/db mice in vivo. Results: The results showed that HUC-MSC transplantation by skeletal muscle injection was safer compared with tail vein injection and intraperitoneal injection, and the survival rate reached 100% in the skeletal muscle injection transplanted mice. HUC-MSCs can stabilize localization and differentiation in skeletal muscle tissue and significantly ameliorate insulin resistance. Potential regulatory mechanisms are associated with downregulation of inflammation; regulating the balance between PI3K/Akt and ERK/MAPK signaling pathway via PTEN, but was not associated with the IGF-1/IGF-1R signaling pathway. Conclusions: These results suggest HUC-MSC transplantation may be a novel therapeutic direction to prevent insulin resistance and increase insulin sensitivity, and skeletal muscle injection was the safest and most effective way.
Development of a convenient detection method for Trichomonas vaginalis based on loop-mediated isothermal amplification targeting adhesion protein 65
Authors: Li Yuhua , Wang Shuai , Li Haoran , Song Xiaoxiao , Zhang Hao , Duan Yujuan , Luo Chengyang , Wang Bingli , Ji Sifan , Xie Qing , Zhang Zhenchao 
Published: April 2020

Abstract
Background: Trichomoniasis resulting from Trichomonas vaginalis ( T. vaginalis ) has been considered as a commonly seen disease with the transmission way of sex. At present, the detection methods of T. vaginalis mainly include wet mount microscopy, culture, PCR, immunofluorescence and ELISA. However, all of these detection methods exist shortcomings. Methods: In this study, a loop-mediated isothermal amplification (LAMP) assay that targeted the species-specific sequence of adhesion protein 65 (AP65) gene had been conducted to detect T. vaginalis . The optimum reaction system and conditions were optimized in this rapid detection method. Results: The results of sensitivity analysis showed that the LAMP assay targeting the AP65 gene was 1000 times more sensitive than the nested PCR targeting the actin gene commonly used for detection of T. vaginalis , and the detecting limitation of the former was 10 trichomonad. Moreover, the amplification of the target gene AP65 by LAMP assay exhibited high specificity and the product was exclusively from T. vaginalis . The detection technique of LAMP did not exhibit cross-reactivity with the common pathogens of Trichinella spiralis , Toxoplasma gondii , Escherichia coli , Candida albicans , Staphylococcus aureus , Haemophilus . Conclusions: According to the present study, the LAMP assay with the target of AP65 gene, was suitable for the early diagnosis of T. vaginalis infections. Consequently, the LAMP assay was proposed by the current study as a point-of-care examination and an alternative molecular tool which exhibited the potential value in the treatment, control and prevention of trichomoniasis transmission and relevant complication.
Smoking is associated with pneumonia development in lung cancer patients
Authors: Heo Jung Won , Yeo Chang Dong , Park Chan Kwon , Kim Sung Kyoung , Kim Ju Sang , Kim Jin Woo , Kim Seung Joon , Lee Sang Haak , Kang Hye Seon 
Published: April 2020

Abstract
Background: Various host factors can promote pneumonia susceptibility of lung cancer patients. However, data about risk factors for pneumonia in lung cancer patients receiving active treatments such as chemotherapy, radiotherapy, and surgical intervention are limited. Thus, the purpose of this study was to identify risk factors for pneumonia development in lung cancer patients. Methods: The present study used a lung cancer cohort of the Catholic Medical Center at the Catholic University of Korea from January 2015 to December 2018. Pneumonia was defined by the presence of a new or progressive infiltration on chest imaging together with any of the following: new onset purulent sputum, change in character of chronic sputum, and fever. We ruled out noninfectious infiltration such as drug or radiation toxicity and hydrostatic pulmonary edema. We especially excluded those if computed tomography revealed sharp demarcation consolidation or ground glass opacity limited radiation field. Results: A total of 413 patients were enrolled in this study. Pneumonia occurred in 118 (28.6%) patients. The pneumonia group had significantly worse overall survival (OS) than the non -pneumonia group (456.7 ± 35.0 days vs. 813.4 ± 36.1 days, log rank p < 0.001). In patients with pneumonia, OS was shorter in ex-smokers and current smokers than in never smokers (592.0 ± 101.0 days vs. 737.0 ± 102.8 days vs. 1357.0 days, log rank p < 0.001). Age (hazard ratio [HR]: 1.046; 95% confidence interval [CI]: 1.019­–1.074; p = 0.001), clinical stage IV (HR: 1.759; 95% CI: 1.004–3.083; p = 0.048), neutropenia (HR: 2.620; 95% CI: 1.562–4.396; p < 0.001], and smoking (HR: 2.040; 95% CI: 1.100–3.784; p = 0.024) were independent risk factors of pneumonia development in lung cancer patients in multivariate analysis. In subgroup analysis for patients treated with chemotherapy, age (HR: 1.043; 95% CI: 1.012–1.074; p = 0.006), neutropenia (HR: 3.199; 95% CI: 1.826–5.605; p < 0.001), and smoking (HR: 2.125; 95% CI: 1.071–4.216; p = 0.031) were independent risk factors of pneumonia development. Conclusions: Smoking and neutropenia were risk factors affecting pneumonia development in the total group and subgroup of patients with lung cancer.
Effects of Virtual Reality Associated With Serious Games for Upper Limb Rehabilitation in Patients With Multiple Sclerosis. a Randomized Controlled Trial
Authors: Cuesta-Gómez Alicia , Baeza Patricia Sanchez-Herrera , Oña-Simbaña Edwin Daniel , Martínez-Medina Alicia , Ortiz-Comino Carmen , de Quirós Carlos Balaguer-Bernaldo , Jardón-Huete Alberto , Cuerda Roberto Cano-de la 
Published: April 2020

Abstract
Background: Dexterity and activities of daily living limitations on the upper limb (UL) represent one of the most common problems in patients with multiple sclerosis (MS). The aim of this study was to evaluate the effectiveness of the specially developed Serious Games that make use of the Leap Motion Controller (LMC) as main user interface for improving UL grip muscle strength, dexterity, fatigue, quality of life, satisfaction and compliance. Methods: A single-blinded randomized controlled trial was conducted. The sample was randomized into two groups: an experimental group who received treatment based on serious games designed by the research team using the developed LMC based Serious Games for the UL plus conventional rehabilitation, and a control group who received the same conventional rehabilitation for the UL. Both groups received two 60 min sessions per week over a ten-week period. Grip muscle strength, coordination, speed of movements, fine and gross UL dexterity, fatigue, quality of life, satisfaction and compliance were assessed in both groups pre-treatment, post-treatment and in a follow-up period of one month without receiving any treatment. Results : In the experimental group compared to the control group, significant improvements were observed in the post-treatment assessment for coordination, speed of movements, fine and gross UL dexterity. Also, significant results were found in the follow-up in coordination, speed of movements, fine and gross for the more affected side. Conclusions: An experimental protocol using an LMC based Serious Games designed for UL rehabilitation showed improvements for unilateral gross manual dexterity, fine manual dexterity, and coordination in MS patients with high satisfaction and excellent compliance.
Examining the accuracy of trackways for predicting gait selection and speed of locomotion
Authors: Marmol-Guijarro Andres , Nudds Robert , Folkow Lars , Codd Jonathan 
Published: April 2020

Abstract
Background Using Froude numbers (Fr) and relative stride length (stride length: hip height), trackways have been widely used to determine the speed and gait of an animal. This approach, however, is limited by the ability to estimate hip height accurately and by the lack of information related to the substrate properties when the tracks were made, in particular for extinct fauna. By studying the Svalbard ptarmigan moving on snow, we assessed the accuracy of trackway predictions from a species-specific model and two additional Fr based models by ground truthing data extracted from videos as the tracks were being made. Results The species-specific model accounted for more than 60% of the variability in speed for walking and aerial running, but only accounted for 19% when grounded running, likely due to its stabilizing role while moving faster over a changing substrate. The error in speed estimated was 0-35% for all gaits when using the species-specific model, whereas Fr based estimates produced errors up to 55%. The highest errors were associated with the walking gait. The transition between pendular to bouncing gaits fell close to the estimates using relative stride length described for other extant vertebrates. Conversely, the transition from grounded to aerial running appears to be species specific and highly dependent on posture and substrate. Conclusion Altogether, this study highlights that using trackways to derive predictions on the locomotor speed and gait, using stride length as the only predictor, are problematic as accurate predictions require information from the animal in question.
Impact of an Infectious Disease Specialist-Led Postprescription Carbapenem Intervention on Prescribing Behavior in a Japanese Tertiary Hospital: a Before-After Study
Authors: MATONO Takashi , Umeda Yuichi , Uchida Moritsugu , Koga Hidenobu , Kanatani Naoya , Furuno Yoshimi , Yamashita Tomonori , Nakamura Kenichi 
Published: April 2020

Abstract
Background: There are a few infectious disease (ID) specialists in Japan. A solution to promote the implementation of antimicrobial stewardship activities under these resource-limited settings is required.Methods: We compared carbapenem consumption between a 24-month baseline and 12-month intervention periods. During the intervention period, an ID specialist provided daily advises through a chart review and ID consultation service to prescribers against all prolonged carbapenem use (≥ 14 days). Additionally, we send an aggregated table containing the weekly point prevalence amount of each departmental carbapenem use for 7–13 and ≥ 14 days through e-mail to all doctors.Results: Among the 1,241 carbapenem courses during the intervention period, the ID specialist provided a total of 96 instances of feedback regarding carbapenem use for ≥ 14 days, and the feedback acceptance rate was 76%. After the initiation of the intervention, the trend in monthly carbapenem consumption changed (coefficient: -0.62; 95% CI: -1.15 to -0.087, p = 0.024), and its consumption decreased (coefficient: -0.098; 95% CI: -0.16 to -0.039, p = 0.002) without an increase in the consumption of broad-spectrum antimicrobials or in-hospital mortality. Interestingly, the monthly number of carbapenem courses, but not the duration of carbapenem use, significantly decreased (coefficient: -3.02; 95% CI: -4.63 to -1.42, p = 0.001). The carbapenem-related annual estimated savings after the intervention was $83,745, with a 22% cost reduction.Conclusions: Our ID specialist-led daily intervention with weekly feedback regarding long-term carbapenem use was effective in reducing antimicrobial consumption. Such feedback may be useful in changing the prescribing behavior and promoting appropriate antimicrobial usage even in resource-limited settings.
Methylated Septin9: biomarker for diagnosis of cervical cancer in cervical scrapings and for prediction of pelvic lymphatic metastasis in plasma
Authors: Bu Qiaowen , Wu Heng-ying , Wang San-feng , Ma Jian , Lei Wen , Li Yu-han , Zhou Wei-ping , Li Hai-ping , Deng Hua , Luo Jia-qi , He Lu-lu , Zhang Liang , Luo Xi-ping 
Published: April 2020

Abstract
BackgroundAberrant Septin9 methylation in cervical cancer has been rarely studied. In this study we aimed to identify its diagnostic value of cervical cancer in cervical scrapings, and its predictive potential in plasma for pelvic nodal metastasis of cervical cancer.MethodsThe statuses of methylated Septin9 in fresh cervical lesions were first evaluated by using quantitative methylation-specific PCR(qMS-PCR). Subsequently 248 samples of cervical scrapings were collected to explore Septin9 methylation in different severities of cervical lesions; and the relationship between Septin9 methylation in plasma and pelvic nodal metastasis of cervical cancer was further evaluated.ResultsMethylated Septin9 was detected in all cancerous tissues, but not in cervicitis controls (P < 0.0001). The degrees of Septin9 methylation increased with growing severity of cervical lesions in cervical scrapings (P < 0.0001). Methylation analysis of Septin9 demonstrated a satisfactory specificity and area under the curve(AUC) in cervical cancer detection, at an equivalent sensitivity relative to any other test. And methylated Septin9 also yielded a high specificity and AUC in detecting high-grade squamous intraepithelial lesion or cervical cancer(≥ HSIL). Plasma-based Septin9 methylation had a high discriminatory power in predicting pelvic nodal metastasis, with an optimal specificity of 81.48%; additionally an increasing sensitivity from 50% to nearly 80% was found when combined with squamous cell carcinoma antigen(SCC-Ag). ConclusionsIn conclusion, we demonstrated methylated Septin9 to be an innovative diagnostic biomarker for cervical cancer in cervical scrapings and its non-invasive predictive potential in plasma for pelvic nodal metastasis of cervical cancer.
Macro- and individual-level influence factors of depression: multilevel cross-provinces comparison in China
Authors: Wu Nianwei , Gao Bo 
Published: April 2020

Abstract
Background: Rapid social change has given rise to a general increase in psychological pressure, which lead to more and more Chinese people suffering from depression over the past 30 years. However, few literatures reported the influence of macro factors on depression of Chinese .The effects of macro-level and individual-level on depression of Chinese respondents aged 16-97 years were examined in this study. Methods: We conducted a multilevel analysis of the 2018 longitudinal follow up of the Chinese Family Panel Studies (CFPS), with 19072 respondents nested within the 25 Chinese provinces. Data for macro-level are extracted from National Bureau of Statistics of China, including three predictors: gross regional product (GRP) per capita, expenditure for social security and employment (ESSE) and rural and urban household income inequality. Depression is measured with the eight-item short version of the Center for Epidemiologic Studies Depression Scale (CES-D8). Result: We found that respondents who were female,30-59 years, divorced or widowed, less educated, rural residents, less body mass index (BMI) or had lower household income tended to report higher levels of depressive symptoms. After adjustment for individual-level features, a significant macro effect of provinces survives. The respondents who lived in province that were higher GRP, higher ESSE or smaller rural and urban household income inequality reported lower levels of depressive symptoms. Conclusions: Our results have demonstrated that depression is not fully explained by individual features. Economic social factors appear to have an impact on depression and have to be considered when planning for improved public depression. Meanwhile, our research also provides a reference for some provinces to further investigation and improvement of depression. Keywords: China; Individual-level; Macro-level; Influence factors; Depression; Multilevel analysis