bluuebunny/crossref_metadata_2025_split huggingface dataset:
Holomorphic Immersions of Bi-Disks into 9D Real Hypersurfaces with Levi Signature (2,2)
Authors: Foo Wei Guo , Merker Joël 
Published: September 2020

Abstract
Inspired by an article of R. Bryant on holomorphic immersions of unit disks into Lorentzian CR manifolds, we discuss the application of Cartan’s method to the question of the existence of bi-disk $\mathbb{D}^{2}$ in a smooth $9$D real-analytic real hypersurface $M^{9}\subset \mathbb{C}^{5}$ with Levi signature $(2,2)$ passing through a fixed point. The result is that the lift to $M^{9}\times U(2)$ of the image of the bi-disk in $M^{9}$ must lie in the zero set of two complex-valued functions in $M^{9}\times U(2)$. We then provide an example where one of the functions does not identically vanish, thus obstructing holomorphic immersions.
Design and implementation of a coal-dust removal device for heavy-haul railway tunnels
Authors: Li Yuanjun , Meng Zhigang 
Published: September 2020

Abstract
The Daqin Railway is China's first electrified double-track heavy-haul railway line dedicated to coal transportation. Over the years of operation, the tunnels have been covered with a thick layer of coal dust, which also pervades in the air. Worse is that the coal dust has even buried the rail joints in some sections, making the repair and maintenance of the line difficult. This paper introduces a coal-dust removal device for railway tunnels that integrates pipeline transportation with dust-collection techniques. The device is mainly composed of a power system, a conveying system, a dust-filtration and collection system, and a control and protection system. The key technical elements of the system, such as the dust-extraction method and dust-filtration and collection parameters, are optimized based on the characteristics of the coal dust in the tunnel (obtained via field trials), which greatly enhances the adaptability of the device. Coal-dust removal efficiency reached over 20 t/h, which improves the working environment, reduces the intensity of manual work required and solves the problem of coal-dust removal from the most polluted area—within 500 m of the tunnel entrance.
Rapid thrombelastography predicts perioperative massive blood transfusion in patients undergoing coronary artery bypass grafting
Authors: Lin Chenyao , Fu Yourong , Huang Shuang , Zhou Shuimei , Shen Changxin 
Published: September 2020

Abstract
Massive blood transfusion (MBT) is a relatively common complication of cardiac surgery, which is independently associated with severe postoperative adverse events. However, the value of using rapid thrombotomography (r-TEG) to predict MBT in perioperative period of cardiac surgery has not been explored. This study aimed to identify the effect of r-TEG in predicting MBT for patients undergoing coronary artery bypass grafting (CABG).
This retrospective study included consecutive patients first time undergoing CABG at the Zhongnan Hospital of Wuhan University between March 2015 and November 2017. All the patients had done r-TEG tests before surgery. The MBT was defined as receiving at least 4 units of red blood cells intra-operatively and 5 units postoperatively (1 unit red blood cells from 200 mL whole blood).
Lower preoperative hemoglobin level (P = .001) and longer cardiopulmonary bypass time (P = .001) were the independent risk factors for MBT during surgery, and no components of the r-TEG predicted MBT during surgery. Meanwhile, longer activated clotting time (P < .001), less autologous blood transfusion (P = .001), and older age (P = .008) were the independent risk factors for MBT within 24 hours of surgery.
Preoperative r-TEG activated clotting time can predict the increase of postoperative MBT in patients undergoing CABG. We recommend the careful monitoring of coagulation system with r-TEG, which allows rapid diagnosis of coagulation abnormalities even before the start of surgery.
Incidence and predictors for abnormal liver function during direct-acting antiviral agents in chronic hepatitis C patients
Authors: Liu Yen-Chun , Jeng Wen-Juei , Cheng Ya-Ting , Hsieh Yi-Chung , Teng Wei , Chen Yi-Cheng , Lin Chun-Yen , Chien Rong-Nan , Sheen I-Shyan 
Published: September 2020

Abstract
Abrupt alanine aminotransferase (ALT) elevation during direct-acting antiviral agents (DAA) treatment is an uncommon but noticeable adverse event in chronic hepatitis C (CHC) patients, which may lead to early termination of treatment. This study aims to investigate the incidence, outcome and predictors of the on-treatment ALT elevation during DAA therapy.
CHC patients treated with DAA regimen in Chang Gung Memorial Hospital, Linkou branch during March 2015 to March 2019 were recruited. Prospective scheduled ALT assessment at baseline, 2nd, 4th, 8th, and 12th/24th weeks were recorded. Pretherapy host and viral factors were compared between patients with and without on-treatment ALT elevation. Multivariate logistic regression was used for independent factors for on-treatment ALT elevation.
A total of 1563 CHC patients treated with grazoprevir/elbasvir, glecaprevir/pibrentasvir and sofosbuvir-based regimen were analyzed. On-treatment ALT elevation occurred in 10.9% patients while those treated with glecaprevir/pibrentasvir had the least possibility (5.4%). Only 1.4% patients had ≥grade 3 ALT elevation events. The presence of such events had no impact on sustained virological response 12 rates. Hepatitis B virus coinfection (aOR: 3.599, P < 0.001) and higher pretherapy ALT (1-5x, ≥5x upper limit of normal: aOR: 2.632, P = 0.024, aOR: 4.702, P = .011, respectively) were significant predictors for ALT elevation.
On-treatment ALT elevation occurred in one-tenth CHC patients treated with preferred DAAs but had no impact on sustained virological response rate.
Association of blood pressure with mortality in hemodialysis patients with a tunneled cuffed catheter
Authors: Shimamura Yoshinosuke , Maeda Takuto , Abe Koki , Takizawa Hideki 
Published: September 2020

Abstract
The use of tunneled cuffed catheters (TCCs) for permanent blood access is increasing as the hemodialysis population ages. However, the higher mortality and complication rates associated with their use have been significant concerns. This single-center observational cohort study aimed to investigate clinical factors affecting mortality and complications in Japanese hemodialysis patients with a TCC.
We enrolled 64 consecutive patients receiving hemodialysis through a TCC between 2012 and 2019. The primary outcome was all-cause mortality and the secondary outcome was the incidence of catheter-related complications at 2 years. Cox proportional hazards models were used to examine variables associated with these outcomes.
At 2 years, death from any cause and catheter-related complications occurred in 27/64 (42%) and 23/64 (36%) patients, respectively. There were 14 bacteremia events, 7 catheter obstructions, and 8 instances of restricted blood flow. Multivariate analysis showed that systolic blood pressure (SBP) < 100 mm Hg at the time of catheter insertion was associated with higher all-cause mortality (hazard ratio, 2.59; 95% confidence interval, 1.05–6.41) and catheter-related complications (hazard ratio, 2.57; 95% confidence interval, 1.52–22.2). The Kaplan–Meier analyses also showed that patients with SBP <100 mm Hg had higher mortality (P = .001) and a higher incidence of catheter-related complications (P = .0068).
SBP <100 mm Hg at the time of catheter insertion is associated with mortality and catheter-related complications in hemodialysis patients using a TCC. Further multi-center studies are required to validate our results.
Acupuncture for lateral epicondylitis
Authors: Kim Ha-Na , Goo Bonhyuk , Nam Sang-Soo 
Published: September 2020

Abstract

Background:
Acupuncture has been widely used for relieving pain associated with musculoskeletal disorders, such as lateral epicondylitis. Although the effect of acupuncture on pain has been demonstrated in previous reviews, it is still under debate. This study is aimed at evaluating the efficacy of acupuncture to treat lateral epicondylitis and establishing the evidence systematically.

Methods:
Nine databases will be searched from their inception to May 2020 without language or publication status restrictions, including 3 English databases (MEDLINE, Embase, the Cochrane Central Register of Controlled Trials), 5 Korean databases (Korean Medical Database, KoreaMed, Korean Studies Information Service System, Research Information Service System, Oriental Medicine Advanced Searching Integrated System), and 1 Chinese database (China Knowledge Network Database). Only randomized controlled trials will be included. Pain intensity will be considered as the primary outcome. Secondary outcomes will include the grip strength, total effective rate, and adverse events. Two independent researchers will perform the study selection, data extraction, and quality assessment. The methodological quality of the identified studies will be assessed using the Cochrane Collaboration's risk-of-bias tool. In the meta-analysis, continuous data will be expressed as mean and 95% confidence interval, and dichotomous data will be expressed as risk ratio and 95% confidence interval.

Results:
The results of this study will be submitted to a peer-reviewed journal for publication.

Conclusion:
The results of this study would provide the evidence of whether acupuncture is effective for lateral epicondylitis.

Registration number:
PROSPERO CRD42020186824
Symptomatic pericardial effusion in the setting of asymptomatic COVID-19 infection
Authors: Amoozgar Behzad , Kaushal Varun , Mubashar Umair , Sen Shuvendu , Yousaf Shakeel , Yotsuya Matthew 
Published: September 2020

Abstract

Rationale:
Infection with the severe acute respiratory coronavirus disease 2019 (COVID-19) has been shown to cause multi-organ involvement including cardiopulmonary serosal layers infection and inflammation. As a result, pericarditis and pericardial effusion may occur with or without COVID-19 related respiratory signs. Due to limitations in sensitivity and specificity of current COVID-19 diagnostic studies, cases that trigger high clinical intuition, even with negative serologic and polymerase chain reaction testing results, may necessitate further diagnostic workup to discover the underlying etiology.

Patient concerns:
Here we present a rare case of pericardial effusion in the setting of asymptomatic COVID-19 infection manifesting with the chief complaint of chest pain.

Diagnosis:
While undergoing diagnostic workup, the patients first 2 sets of COVID 19 reverse transcription-polymerase chain reaction (RT-PCR) were negative while a latter RT-PCR test, as well as serology, were positive, leading to the diagnosis of COVID-19 reinfection or subacute presentation of viral infection with pericardial effusion. Echocardiogram depicted large circumferential pericardial effusion with mildly thickened pericardium.

Interventions:
The patient underwent pericardial window placement followed by ibuprofen administration and discharged from the hospital.

Outcomes:
During the follow-up visit patient had no symptoms and echocardiogram demonstrated complete resolution of the effusion.

Lessons:
Due to the possible establishment of pericardial effusions and consecutively tamponade even without any COVID-19 related clinical presentation, it is crucial for clinicians to trust their intuition, conduct the appropriate diagnostic tests, find the underlying diagnosis and prevent the devastating consequences.
Shear wave elastography of the saphenous nerve
Authors: Bedewi Mohamed Abdelmohsen , Elsifey Ayman A. , Kotb Mamdouh A. , Bediwy Abdelmohsen Mohamed , Ahmed Yasmin M. , Swify Sherine Mohamed , Abodonya Ahmed M. 
Published: September 2020

Abstract
The purpose of this study is to study sonoelastographic features of the saphenous nerve.
The study included 72 saphenous nerves in 36 healthy subjects. High resolution ultrasound and Shearwave elastography were used to evaluate the saphenous nerve. Cross sectional area (CSA) and stiffness were measured.
The mean CSA of the saphenous nerve was 5.7 mm2. The mean shear elastic modulus of the saphenous nerve in the short axis was 29.5 kPa. The mean shear elastic modulus of the saphenous nerve in long axis was 29.9 kPa. The saphenous nerve elastic modulus also showed no correlation with CSA in neither the long axis nor short axis. Positive correlation between elasticity measurements in the long and short axes. Age, height, weight, and BMI showed no correlation with saphenous nerve elastic modulus in short or long axes.
The elastic modulus of the saphenous nerve has been determined in healthy subjects and can serve as a reference for future assessment of the saphenous nerve before different procedures.
Study on metabonomics of Chinese herbal medicine in the treatment of type 2 diabetes mellitus complicated with community-acquired pneumonia
Authors: Yang Hongjing , Yue Rensong , Zhou Jie , Zeng Zhu , Wang Lizhen , Long Xiaoqin , Ding Ning , Huang Xiaoying 
Published: September 2020

Abstract

Introduction:
Community-acquired pneumonia (CAP) is the main acute complication of type 2 diabetes mellitus (T2DM) and the main cause of hospitalization for infectious diseases. Unfortunately, in the treatment of type 2 diabetes mellitus complicated with community-acquired pneumonia (T2DM-CAP), modern medicine is still faced with enormous challenges because of insulin resistance and drug-resistant bacteria. In recent decades, clinical and experimental evidence shows that Chinese herbal medicine (CHM) has a certain beneficial effect on diabetes and pneumonia. Therefore, this trial aims to assess the efficacy and safety of CHM plus western medicines for the treatment of T2DM-CAP.

Methods:
We propose a double-blind, placebo-controlled, randomized superiority trial.
A total of 92 participants with T2DM-CAP will be randomly allocated at a 1:1 ratio to either the experimental group, which will receive modified Ban-Xia-Xie-Xin-Decotion and basic treatment, or the control group, which will receive basic treatment only. The study duration will be 14 days. The primary outcome will be the total clinical effective rate. The secondary outcomes are traditional Chinese medicine symptom score scale, pneumonia severity index, usage time of antibiotic, time required for blood sugar to reach the required level, frequency of hypoglycemia, and chest CT. Liquid chromatograph-mass spectrometry method will be used to explore the blood metabolism profiles of the subjects, to explore the pathogenesis of T2DM-CAP and the mechanism of CHM on T2DM-CAP. Adverse events will also be evaluated.

Discussion:
This trial will provide evidence of the effectiveness and safety of traditional CHM in treating patients with T2DM-CAP.

Trial registration number:
ChiCTR2000035204
Development and application of a Chinese Version of the Language Screening Test (CLAST) in post-stroke patients
Authors: Sun Mingyao , Zhan Zhouwei , Chen Bijuan , Xin Jiawei , Chen Xiaochun , Yu Erhan , Lin Lizhen , He Raoli , Pan Xiaodong 
Published: September 2020

AbstractAphasia shows high incidence in stroke patients and seriously impairs language comprehension, verbal communication, and social activities. Therefore, screening aphasic patients during the acute phase of stroke is crucial for language recovery and rehabilitation. The present study developed a Chinese version of the Language Screening Test (CLAST) and validated it in post-stroke patients.The CLAST was adapted from the Language Screening Test developed by Constance et al to incorporate Chinese cultural and linguistic specificities, and administered to 207 acute stroke patients and 89 stabilized aphasic or non-aphasic patients. Based on the Western Aphasia Battery (WAB) test, its reliability and validity were assessed. A cut-off for the CLAST in Chinese patients was determined by ROC curve analysis.The CLAST comprised 5 subtests and 15 items, including 2 subscores, namely expression (8 points, assessing naming, repetition, and automatic speech) and receptive (7 points maximum, evaluating picture recognition, and verbal instructions) indexes. Analysis of the alternate-form reliability of the questionnaire showed a retest correlation coefficient of 0.945 (P < .001). Intraclass correlation coefficients of three rating teams were >0.98 (P < .001). Internal consistency analysis showed a Cronbach's alpha coefficient of 0.909 (P < .001). The non-aphasia group showed higher scores than the aphasia group (14.2 ± 1.3vs10.6 ± 3.8) (P < .01). The questionnaire showed good construct validity by factor analysis. ROC curve analysis showed high sensitivity and specificity for the CLAST, with a cut-off of 13.5.The CLAST is suitable for Chinese post-stroke patients during the acute phase, with high reliability, validity, sensitivity, and specificity.
IRF1-mediated immune cell infiltration is associated with metastasis in colon adenocarcinoma
Authors: Shao Yao-jian , Ni Jun-jie , Wei Shen-yu , Weng Xiong-peng , Shen Meng-die , Jia Yi-xin , Meng Li-na 
Published: September 2020

Abstract

Background:
Evidence suggests that metastasis is chiefly responsible for the poor prognosis of colon adenocarcinoma (COAD). The tumor microenvironment plays a vital role in regulating this biological process. However, the mechanisms involved remain unclear. The aim of this study was to identify crucial metastasis-related biomarkers in the tumor microenvironment and investigate its association with tumor-infiltrating immune cells.

Methods:
We obtained gene expression profiles and clinical information from The Cancer Genome Atlas database. According to the “Estimation of STromal and Immune cells in MAlignant Tumor tissue using Expression data” algorithm, each sample generated the immune and stromal scores. Following correlation analysis, the metastasis-related gene was identified in The Cancer Genome Atlas database and validated in the GSE40967 dataset from Gene Expression Omnibus. The correlation between metastasis-related gene and infiltrating immune cells was assessed using the Tumor IMmune Estimation Resource database.

Results:
The analysis included 332 patients; the metastatic COAD samples showed a low immune score. Correlation analysis results showed that interferon regulatory factor 1 (IRF1) was associated with tumor stage, lymph node metastasis, and distant metastasis. Furthermore, significant associations between IRF1 and CD8+ T cells, T cell (general), dendritic cells, T-helper 1 cells, and T cell exhaustion were demonstrated by Spearmans correlation coefficients and P values.

Conclusions:
The present findings suggest that IRF1 is associated with metastasis and the degree of immune infiltration of CD8+ T cells (general), dendritic cells, T-helper 1 cells, and T cell exhaustion in COAD. These results may provide information for immunotherapy in colon cancer.
The expression of AGGF1, FOXC2, and E-cadherin in esophageal carcinoma and their clinical significance
Authors: Ma Li , Yang Ruixue , Gu Jingxiang , Jiang Hao , Li Hongwei 
Published: September 2020

Abstract
Angiogenic factor with G-patch and FHA domain 1 (AGGF1) is a newly initiator of angiogenesis. Forkhead box C2 (FOXC2) that is a member of the winged spiral transcription factor family plays an important role in epithelial-mesenchymal transition (EMT). Epithelial-cadherin (E-cad) that is an adhesion molecule is also involved in EMT. The purpose of this study is to investigate the expression of AGGF1, FOXC2, and E-cad in esophageal squamous cell carcinoma (ESCC) and their clinical significance.
Immunohistochemistry was performed to investigate the expression of AGGF1, FOXC2, and E-cad in 170 ESCC specimens and corresponding normal esophageal mucosa tissues. Follow-up data was also collected.
The positive rates of AGGF1 and FOXC2 expression were significantly higher in ESCC group when compared with the control group; the positive rate of E-cad expression was significantly lower in ESCC group when compared with the control group. Positive rates of AGGF1, FOXC2, and E-cad expression were significantly associated with grades of differentiation, tumor grades, lymph node metastasis stages, as well as tumor-node-metastasis stages. Kaplan–Meier analysis demonstrated that positive expression of AGGF1 or FOXC2 for ESCC patients had significantly unfavorably overall survival time when compared with patients with negative expression of AGGF1 or FOXC2; and positive expression of E-cad for ESCC patients had significantly longer overall survival time when compared with patients with negative expression of E-cad. Multivariate analysis indicated that AGGF1, FOXC2, and E-cad expression and tumor-node-metastasis stages were postoperative independent prognostic factors for ESCC patients.
AGGF1, FOXC2, and E-cad may be considered promising biomarkers of ESCC patients’ prognosis.
Biomarkers of postmenopausal osteoporosis and interventive mechanism of catgut embedding in acupoints
Authors: Chen Guizhen , Liu Hongyuan , Wu Xiaofeng , Wang Xue , Liang Junquan , Xu Yunxiang 
Published: September 2020

Abstract

Introduction:
Postmenopausal osteoporosis (PMOP), which is a common and frequently occurring age-related metabolic bone disease in perimenopausal women, severely affects patients living quality. Modern medicine therapies for PMOP have several problems such as side reactions, low compliance, and high costs. Thus, nonpharmacological modality is urgently needed. Although acupoint thread embedding treatment is widely used in clinical practice, there is no persuasive evidence of its effect on increasing bone mass for PMOP. This experiment aims to investigate the efficacy and safety of acupoint thread embedding on PMOP and elucidate the correlations among brain neural activation, bone mineral density (BMD), and clinical outcomes with magnetic resonance evidence, thus to explore its neural mechanism.

Methods:
This parallel designed, exploratory randomized, controlled, assessor-statistician-blinded, positive medicine clinical trial will include 70 participants with PMOP recruited from 2 traditional Chinese Medicine hospitals. These participants will be randomly allocated to a treatment group (Group Embedding) and a control group (Group Medication) in a 1:1 ratio. Participants in the treatment group will receive acupoint thread embedding treatment once 2 weeks in the following predefined acupoints: Shenshu (BL23), Sanyinjiao (SP6), Guanyuan (RN4), Ganshu (BL18), Dazhu (BL11), Xuanzhong (GB39), Zusanli (ST36), and Pishu (BL20). Meanwhile, the participants in the control group will take 0.3 mg Climen tablet orally, 1 tablet/day; every month has a schedule of the 21-day-continuous-taking-medicine period, and 7-day tablet-free period. There is a study period of 3 months and a follow-up period of 1 month for each group. The primary outcomes will be the following therapeutic indexed: Short-Form of McGill Pain Questionnaire (SF-MPQ), Osteoporosis Symptom Score during the observation period and follow-up period. The secondary outcomes will be Osteoporosis Quality of Life Scale (OQOLS), 16-item Assessment of Health-Related Quality of Life in Osteoporosis. In addition, functional magnetic resonance imaging (fMRI) scans and bone density test will be done before and after the observation period to show cranial neuroimaging changes. All the outcomes will be evaluated before and after treatment. The safety of interventions will be assessed at every visit.

Discussion:
We present study design and rationale to explore the effectiveness and neural mechanism of acupoint thread embedding for PMOP through these outcomes.

Trial registration:
Chinese Clinical Trial Registry, ChiCTR-INR-17011491.