bluuebunny/crossref_metadata_2025_split huggingface dataset:
The interrelationship between ventilatory inefficiency and left ventricular ejection fraction in terms of cardiovascular outcomes in heart failure outpatients
Authors: Chen Shyh-Ming , Wang Lin-Yi , Wu Po-Jui , Liaw Mei-Yun , Chen Yung-Lung , Chen An-Ni , Tsai Tzu-Hsien , Hang Chi-Ling , Lin Meng-Chih 
Published: June 2020

Abstract

BackgroundThe relationship between left ventricular ejection fraction (LVEF) and cardiovascular (CV) outcome is well documented in patients with low LVEF. Ventilatory inefficiency is an important prognostic predictor in all spectrums of heart failure (HF). In stable HF outpatients, whether the relationship between LVEF and CV outcome is affected by ventilatory inefficiency remains unknown. We hypothesized that the presence of ventilatory inefficiency influences the prognostic predictability of LVEF in chronic HF outpatients.Materials and MethodsIn total, 169 HF outpatients underwent the cardiopulmonary exercise test (CPET) and were followed up for a median of 9.25 years. Subjects were divided into five groups of similar size according to baseline LVEF (£39%, 40-58%, 59-68%, 69-74%, and ³75%). The primary endpoints were CV mortality and first HF hospitalization. The Cox proportional hazard model was used for simple and multiple regression analyses to evaluate the interrelationship between LVEF and ventilatory inefficiency (ventilatory equivalent for carbon dioxide [VE/VCO2] at anaerobic threshold [AT] >34.3, optimized cut-point).ResultsOnly LVEF and VE/VCO2 at AT were significant predictors of major CV events. The lower LVEF subgroup (LVEF £39%) was associated with an increased risk of CV mortality or HF hospitalization relative to the LVEF ³75% subgroup except for patients with ventilatory inefficiency (p=0.400). The interaction effect between LVEF and ventilatory inefficiency was not significant (p=0.579).ConclusionsVentilatory inefficiency influenced the prognostic predictability of LVEF in reduced LVEF outpatients. Ventilatory inefficiency can be used as the therapeutic target in HF management.Trial registrationClinicalTrials.gov (identifier: NCT04141345), 10/24/2019, retrospectively registered
Risk factors for esophagojejunal anastomotic leakage in curative total gastrectomy combined with D2 lymph node dissection for gastric cancer: A retrospective cohort study
Authors: Xing Jiadi , Liu Maoxing , Qi Xinyu , Yu Jianhong , Fan Yingcong , Xu Kai , Gao Pin , Tan Fei , Yao Zhendan , Zhang Nan , Yang Hong , Zhang Chenghai , Cui Ming , Su Xiangqian 
Published: June 2020

Abstract
Background: This study aimed to explore the risk factors associated with esophagojejunal anastomotic leakage (EJAL) in curative total gastrectomy combined with D2 lymph node dissection for gastric cancer.Methods: 390 consecutive patients receiving Roux-en-Y esophagojejunostomy reconstruction after surgery were reviewed. Multivariate analysis was performed using a logistic regression model to identify independent risk factors for EJAL.Results: Of the 390 patients enrolled in this study, EJAL occurred in 10 patients (2.6%). One patient (1/10) with EJAL died. Univariate analysis identified age (P = 0.025), alcohol consumption (P = 0.019), pulmonary insufficiency (P = 0.049), and intraoperative blood loss (P = 0.015) as risk factors for EJAL. Of these four risk factors, age (P = 0.043) and alcohol consumption (P = 0.043) were retained as independent risk factors by multivariate analysis.Conclusions: Surgeons should be very careful about anastomotic leakage during the perioperative period, especially in patients with advanced age and a history of alcohol consumption. Pulmonary insufficiency and intraoperative blood loss, although not being identified as independent risk factors, should also be considered.
First-Trimester Fasting Hyperglycemia without Gestational Diabetes Mellitus is not Associated with Adverse Pregnancy Outcomes:A Prospective Cohort Study in China
Authors: Guo Zhiheng , Shan Yanhong , Xiu Caifeng , Yang Yi , Zheng Shu , Peng Min 
Published: June 2020

Abstract
Background Gestational diabetes mellitus (GDM) is a common pregnancy-induced metabolic complication worldwide. At present, a variety of strategies for diagnosis and management of GDM have been recommended. Our aim is to investigate the clinical features and pregnancy outcomes among women in whom a first-trimester fasting glucose value (≥ 5.10 mmol/L but < 7.0 mmol/L) was detected and a 2-h 75-g oral glucose tolerance test (OGTT) between 24–28 weeks was negative.Methods This is a prospective cohort study of women who registered and delivered between June 2016 and November 2019 at First Hospital, Jilin University. Pregnant women who met the inclusion criteria were categorized as normal first-trimester fasting plasma glucose(FPG)(< 5.10 mmol/L) and first-trimester fasting hyperglycemia (≥ 5.10 mmol/L but < 7 mmol/L).Outcomes included weeks at time of delivery, neonatal birth weight, Apgar score at 1 min, Apgar score at 5 min, prevalence of macrosomia, hypertensive disorders of pregnancy ,primary cesarean delivery, preterm delivery ,premature rupture of membranes and sillbirth or neonatal death were compared after women who developed gestational diabetes mellitus (GDM) were excluded.Results In our population of 2124 eligible subjects, pregnant women with first-trimester fasting hyperglycemia (≥ 5.10 mmol/L but < 7 mmol/L) constituted 20.8% of the total study population and accounted for 27.6% of subsequent GDM diagnosis. The other 1683 had a normal first-trimester FPG (< 5.1 mmol/L), accounting for 11.6% of all subsequent GDM diagnosis (p < 0.01).After excluding women with a diagnosis of GDM between 24 and 28 weeks of gestation, we observed no significant difference between groups for adverse maternal and prenatal outcomes.Conclusion More than two thirds of first-trimester fasting hyperglycemia pregnant women will have a normal OGTT performed at 24–28 week and of these women whom in no increased risk of adverse pregnancy outcomes have been identified.
Sulfur intermediates as new biogeochemical hubs in an aquatic model microbial ecosystem
Authors: Vigneron Adrien , Cruaud Perrine , Culley Alexander I. , Couture Raoul-Marie , Lovejoy Connie , Vincent Warwick F. 
Published: June 2020

Abstract
BackgroundThe sulfur cycle encompasses a series of complex aerobic and anaerobic transformations of S-containing molecules, and plays a fundamental role in cellular and ecosystems level-processes, influencing biological carbon transfers and other biogeochemical cycles. Despite their importance, the microbial communities and metabolic pathways involved in these transformations remain poorly understood, notably for inorganic sulfur compounds of intermediate oxidation states (thiosulfate, tetrathionate, sulfite, polysulfides). Isolated and highly stratified, the extreme geochemical and environmental contexts of the meromictic ice-capped Lake A, in the Canadian High Arctic, provides an outstanding model ecosystem to resolve the distribution and metabolism of aquatic sulfur cycling microorganisms along redox and salinity gradients. ResultsApplying complementary molecular approaches, we identified sharply contrasting microbial communities and metabolic potentials among the distinct water layers of the Lake A, with homologies to diverse fresh, brackish and saline water microbiomes. Sulfur cycling genes were abundant at all depths, with oxidative processes in the oxic freshwater layers, reductive reactions in the anoxic and sulfidic bottom waters and genes for both transformations at the chemocline, and co-varied with bacterial abundance. Up to 154 different genomic bins with potential for sulfur transformation were recovered, revealing a panoply of taxonomically diverse microorganisms with complex metabolic pathways for biogeochemical sulfur reactions. Metabolism of sulfur cycle intermediates was widespread throughout the water column, co-occurring with sulfate reduction or sulfide oxidation pathways. The genomic bin composition suggested that in addition to chemical oxidation, these intermediate sulfur compounds were likely produced by the predominant sulfur chemo- and photo-oxidizers at the chemocline and by diverse microbial organic sulfur molecule degraders. ConclusionsThe Lake A microbial ecosystem provided an ideal opportunity to identify new features of the biogeochemical sulfur cycle. Our detailed metagenomic analyses across the broad physico-chemical gradients of this highly stratified lake extend the known diversity of microorganisms and metabolic pathways involved in sulfur transformations over a wide range of environmental conditions. The results identify the importance of sulfur cycle intermediates and organic sulfur molecules as major sources of electron donors and acceptors for aquatic and sedimentary microbial communities in association with the classical sulfur cycle.
Verrucous carcinoma of the esophagus with complete response after chemoradiotherapy
Authors: Hashimoto Masashi , Shirakawa Yasuhiro , Tanabe Shunsuke , Tanaka Takehiro , Kobayashi Teruki , Maeda Naoaki , Noma Kazuhiro , Sakurama Kazufumi , Fujiwara Toshiyoshi 
Published: June 2020

Abstract
Background Verrucous carcinoma of the esophagus (VCE) is a rare tumor that is difficult to diagnose. In most cases, biopsies show nonspeciﬁc inﬂammatory and hyperkeratotic changes and do not show malignant findings. Most VCEs are slowly growing, locally advanced tumors with few metastases. Treatments for VCE are the same as for normal esophageal cancer, involving combined chemotherapy, surgical resection, and radiation therapy. However, it has been reported that VCE has a poor response to radiation or chemoradiotherapy (CRT). A case of VCE with complete response (CR) after CRT is presented. Case presentation A 70-year-old man was found to have white, irregular esophageal mucosa four years earlier. He had been followed-up as an outpatient as having candidal esophagitis. However, his tumor grew gradually, and biopsy was performed by endoscopic mucosal resection. He was finally diagnosed with VCE. He had no metastases to distant organs, but some lymph node metastases were suspected. The tumor invaded his left bronchus. First, the esophagostomy and gastrostomy were constructed. The patient then underwent definitive CRT. Four weeks after the end of CRT, two-stage esophagectomy was performed. First, he underwent esophagectomy with thoracic lymph node dissection. A latissimus dorsi flap was patched to the bronchus after primary suture of the hole. Six weeks later, reconstruction of the gastric tube was performed through the antethoracic route. The pathological findings showed complete response to CRT, with no proliferative cancer cells in the specimen. Six months after the first-stage operation, no recurrence has been observed. Conclusions A case of locally advanced VCE that achieved a complete response to CRT was presented. In cases in which local resection would be difficult, CRT might be an appropriate neoadjuvant treatment for VCE.
Sedentary Behaviors Of A School Population In Brazil And Related Factors Descriptive Research With Questionnaire
Authors: Ponce-Blandón José Antonio , Deitos-Vasquez María Eduarda , Romero-Castillo Rocío , Rosa-Viana Diogo da , Robles-Romero José Miguel , Mendes-Lipinski Jussara 
Published: June 2020

Abstract
Background Overweight and obesity arise from a complex range of genetic, environmental, behavioural, educational, and socioeconomic factors. Poor eating habits and poor physical activity increase the probability that children will become obese adolescents. The sedentary lifestyle, encouraged by the rapid evolution of technology, has been accentuated in recent years. Strategies to accelerate obesity prevention include modifying the child's environment for healthy eating and physical activity. For this, it is essential to analyze the characteristics and life habits of children population. This study tries to know the sedentary practices and some life habits related to health among children from the school population of Uruguaiana (RS, Brazil), identifying the sociodemographic factors that can influence it.Methods The sample was composed of 470 school boys and girls, aged between 9 and 10 years. In order to obtain the sample, a random plampling was performed by clusters of the 24 urban public schools of the city. Sociodemographic variables and sedentary habits were measured.Results As regards the variables linked to habits, 24% of the boys and girls answered they had not had breakfast the day they completed the questionnaire. 51.8% stated they did not have breakfast any given day of the week. Regarding to sedentary habits, 25.3% of children watched TV or played video games 5 or more hours a day and 9% rarely played sports with their parents or caregivers. Statistical significance was recorded between “number of hours watching TV and playing video games” and “playing sports with parents or caregivers” (p < 0.05).Conclusions Association between the times spent watching TV or playing video games and the practice of physical exercise in the family, proves once again the importance of the family in education for the health of children. The school provides direct Access to schoolchildren and their parents to launch numerous health education programs.
Performance and Emissions of a Premixed Combustion Engine Fueled by Methanol–Gasoline Blends
Authors: Wang Jibai , Zhang Peng , Zhang Chunhua , Jing Zheng 
Published: June 2020

Abstract
Background: Methanol is abundant, safe, and environmentally friendly and has physicochemical properties similar to those of gasoline. It is a promising alternative fuel in China because it can be directly used in both spark- and compression-ignition internal combustion engines. The current development of spark-ignition engines focuses on the reduction of the fuel volume and increase in the compression ratio (CR), which would benefit the engine’s thermal efficiency. However, increasing the CR may deteriorate particulate matter (PM) due to the high temperature.Methods: Herein, an experimental study was conducted on methanol–gasoline blends in a spark-ignition engine. We examined the performance and formaldehyde emissions of methanol–gasoline blends by using three volume fractions (M0, M15, and M100). In addition, the effects of the CR on PM emissions were investigated.Results: The following relationships were observed: (1) When methanol was blended with gasoline, the formaldehyde emissions increased significantly. The formaldehyde emissions of 100% methanol were higher than those of the methanol–gasoline blend with a methanol volume fraction of 15%; both of these emissions were higher than those of pure gasoline; (2) Increasing the CR resulted in increased PM emissions; (3) For a given blending ratio, the PM emissions were positively correlated with the CR; and (4) The PM emissions were negatively correlated with the methanol volume fraction.Conclusions: Methanol reduces the heat loss at the wall surface. As the ratio of methanol in gasoline increases, the PM emissions decrease. On the other hand, the PM emissions are positively correlated with the CR. The addition of lower alcohols dilutes the concentrations of soot precursors, thereby reducing the soot emissions.
Prostate-Specific Antigen Dynamics After Carbon Ion Radiotherapy for Prostate Cancer
Authors: Takakusagi Yosuke , Oike Takahiro , Kano Kio , Anno Wataru , Tsuchida Keisuke , Mizoguchi Nobutaka , Serizawa Itsuko , Yoshida Daisaku , Kamada Tadashi , Katoh Hiroyuki 
Published: June 2020

Abstract
Background This study aimed to explain the dynamics of prostate-specific antigen (PSA) levels in patients with prostate cancer who were treated with carbon ion radiotherapy (CIRT) and neoadjuvant androgen-deprivation therapy (ADT). Methods Eighty-five patients with intermediate-risk prostate cancer who received CIRT and neoadjuvant ADT from December 2015 to December 2017 were analyzed in the present study. The total dose of CIRT was set at 51.6 Gy (relative biological effectiveness) delivered in 12 fractions over 3 weeks. The PSA bounce was defined as a ≥0.4 ng/ml increase of PSA levels from the nadir, followed by any decrease. PSA failure was defined using the Phoenix criteria.Results The median patient age was 68 (range, 48–81) years. The median follow-up duration was 33 (range, 20–48) months. The clinical T stage was T1c, T2a, and T2b in 26, 44, and 14 patients, respectively. The Gleason score was 6 in 3 patients and 7 in 82 patients. The median pretreatment PSA level was 7.37 (range, 3.33–19.0) ng/ml. All patients received neoadjuvant ADT for a median of 6 (range, 2–116) months. PSA bounces were observed in 39 patients (45.9%), occurring a median of 12 (range, 6–30) months after CIRT. PSA failure was observed in eight patients (9.4%), occurring a median of 21 (range, 15–33) months after CIRT. The 3-year PSA failure-free survival rate was 88.5%. No clinical recurrence was observed during the follow-up period. Younger age was a significant predictor of PSA bounces and PSA failure. Conclusions The dynamics of PSA levels after CIRT was investigated in the present study. Further follow-up is needed to reveal the clinical significance of PSA dynamics.
A Pilot Randomized Study of Atorvastatin As Adjunct Therapy in Patients with Acute Venous Thromboembolism
Authors: Wang Tzu-Fei , Waller Amanda P. , Lin Ella , Wei Lai , Bartosic Abigail , Riedl Ken , Kerlin Bryce A. 
Published: June 2020

Abstract
Background: Venous thromboembolism (VTE) is a considerable public health threat. Improving the management of VTE may achieve better long-term outcomes. In this single-center pilot study, we sought to investigate the effects of statins in addition to anticoagulation in patients with acute VTE.Methods: We enrolled patients over the age of 18 presenting with an acute proximal lower extremity deep vein thrombosis with or without pulmonary embolism. Patients were randomized to anticoagulation alone (with either warfarin or rivaroxaban) or anticoagulation plus atorvastatin 40 mg daily and followed for 9 months. The primary objective was to determine if adjunct atorvastatin reduced thrombin generation, estimated by endogenous thrombin potential and/or peak thrombin concentration. Secondary endpoints included recurrent VTE, arterial thrombosis, bleeding events, and more.Results: A total of 21 patients (11 randomized to anticoagulation only and 10 to anticoagulation plus atorvastatin) were enrolled over 3.5 years. The addition of atorvastatin significantly reduced the mean low-density lipoproteins at 3 months, but did not reduce either endogenous thrombin potential, peak thrombin, D-dimer, or high sensitivity-C reactive protein. Given the low recruitment rate, continuation of the study was deemed futile and the study was terminated early. Barriers to enrollment and completion of study included the many ineligible patients due to the exclusion criteria (e.g. pre-existing statin use, active malignancy, etc) and high rate of lost follow-up.Conclusions: The pilot study did not enroll sufficient number of patients, but was able to inform obstacles for future similar studies investigating the effects of statins in the management of patients with VTE.Trial registration: The study was registered with ClinicalTrials.gov (NCT02331095), January 6, 2015. https://clinicaltrials.gov/ct2/show/NCT02331095
Malnutrition Precipitated Measles Outbreak in Gewane District, Afar Regional State, Northeastern Ethiopia, 2016
Authors: Ayele Wolde Melese 
Published: June 2020

Abstract
Background: Measles is a contagious viral and vaccine-preventable disease that is continuing a public health problem. It is occurring as an outbreak not only in developing but also in developed countries.Methods: A 1:2 ratios, unmatched case-control study was conducted from September 19/2016- October 08/2016 in Undufo Kebele, Gewane district, Northeastern Ethiopia. Both confirmed by laboratory and epidemiologically linked measles cases were involved. Controls were those who had no clinical signs of measles during the data collection period and residents of the same community where cases were identified. An interviewer-administered questionnaire was used to collect data. Nutritional status was measured using MUAC and the result decided based on the world health organization's nutritional categorization of children by MUAC. Data were entered into Epi-info 7 and analyzed using SPSS-21. Binary logistic regression was done to identify risk factors for measles infection with 95% confident level of Odds ratio.Result: Fifty cases and 100 controls have participated in this investigation. Four out of five samples collected were positive for measles IgM antibody. There were three deaths reported. There was no vaccination history of cases and controls. The majority of cases were female and between 6–15 years of age. In multivariable analysis, malnutrition (AOR = 3.21; 95%CI 1.871,6.334), and contact history (AOR = 12.24; 95%CI 6.992,28.121) increased the risk of contracting measles infection.Conclusion: children under 15-year age were more affected groups. The absence of vaccination in the area precipitated by a high rate of malnutrition was the main cause that aggravates the number of new infections. Contact history and malnutrition were the identified risk factors for measles infection. Therefore, increasing immunization coverage of more than 80%, and securing food security decrease the susceptibility of outbreak occurrence.
Norcantharin ameliorates the development of murine lupus via limiting STAT3-mediated IL-17-producing cell accumulation
Authors: Du Lijun , Feng Yuxiang , He Zhixing , Huang Lin , Li HaiChang , Wen Chengping , Zhang Yun 
Published: June 2020

Abstract
Background: Systemic lupus erythematosus (SLE), a devastating autoimmune disorder, results from the aberrant T cell and B cell activation. Norcantharin(NCTD), a derivative of Cantharidin, is an efficacious anti-cancer drug, whereas the role of NCTD in SLE remains unknown. As a result, we aimed to investigate the therapeutic effect of NCTD on the development of murine lupus.Methods: MRL/MpJ and MRL/ lpr female mice were randomly divided into three groups and administered with vehicle control or NCTD at 1 mg/kg or 2 mg/kg. The mortality rate, auto-antibodies, kidney damage, immune complex deposition and lupus-related inflammation level were tested. Furthermore, the proportion of T/B cells or T cell subsets in splenocytes from each group was monitored using flow cytometry. Finally, double-negative (CD3+CD4-CD8-, DN) T cell proliferation and T helper 17 (Th17) cell differentiation in vitro as well as regulatory pathways were analyzed for NCTD treatment.Results: NCTD decreased mortality, the accumulation of anti-dsDNA, splenomegaly and inflammation level of lupus mice. In addition, NCTD-treated MRL/ lpr mice showed notably ameliorated renal involvement. Moreover, we found that NCTD reduced DN T cell proliferation and Th17 differentiation via mediating the activation of signal transducer and activator of transcription 3 (STAT3). Conclusions: NCTD effectively suppressed DN T cell proliferation and Th17 cell polarization, thus ultimately contributing to the attenuated the SLE development. Our results revealed that NCTD may be a promising therapeutic agent for SLE.