bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Sydney Triage to Admission Risk Tool (START) to improve patient flow in an Emergency Department: A model of care implementation pilot study
Authors: Ebker-White Anja , Bein Kendall , Russell Saartje Berendsen , Dinh Michael 
Published: October 2019

Abstract
Background

The Sydney Triage to Admission Risk Tool (START) is a validated clinical analytics tool designed to estimate the probability of in-patient admission based on Emergency Department triage characteristics.

Methods

This was a single centre pilot implementation study using a matched case control sample of patients assessed at ED triage. Patients in the intervention group were identified at triage by the START tool as likely requiring in-patient admission and briefly assessed by an ED Consultant. Bed management were notified of these patients and their likely admitting team based on senior early assessment. Matched controls were identified on the same day of presentation if they were admitted to the same in-patient teams as patients in the intervention group and same START score category. Outcomes were ED length of stay and proportion of patients correctly classified as an in-patient admission by the START tool.

Results

One hundred and thirteen patients were assessed using the START-based model of care. When compared with matched control patients, this intervention model of care was associated with a significant reduction in ED length of stay [301 minutes (IQR 225-397) versus 423 minutes (IQR 297-587) p<0.001] and proportion of patients meeting four hour length of stay thresholds increased from 24% to 45% (p<0.001).

Conclusion

In this small pilot implementation study, the START tool, when used in conjunction with senior early assessment was associated with a reduction in ED length of stay. Further controlled studies are now underway to further examine its utility across other ED settings.
Δ133p53/FLp53 predicts poor clinical outcome in esophageal squamous cell carcinoma
Authors: Tu qimin , Gong Hongjian , Yuan Chunhui , Liu Gao , Huang Jinqi , Li Zhichao , Luo Jianfei 
Published: October 2019

Abstract
Background

p53 isoform Δ133p53 is directly transactivated by p53 and antagonizes p53 activities in cancer progression. However, its correlation with prognosis and cancer recurrence in esophageal squamous cell carcinoma (ESCC) is still unclear.Methods

Expression of Δ133p53 and Δ133p53/full-length p53 (FLp53) in tissues and serums of 180 ESCC patients was evaluated using qRT-PCR.Results

Tissue Δ133p53 expression and Δ133p53/FLp53 ratio were significantly increased in ESCC tissue compared with adjacent normal tissue. Pre-operative Δ133p53 expression and Δ133p53/FLp53 ratio in tissue or serum samples were positively associated with TNM stage and post-operative recurrence. Kaplan-Meier curve and multivariate cox regression analyses revealed that the tissue and serum Δ133p53/FLp53 ratio (cutoff value: 2.9160) were independent prognostic factors for overall survival (OS) and progression-free survival (PFS) in ESCC patients, and showed no statistical difference in receiver-operating characteristic (ROC) curve analysis, while serum Δ133p53 showed no significant prognostic value. More importantly, the serum Δ133p53/FLp53 ratio in ESCC patients was significantly decreased within 72 h post tumor resection and patients with a consistently high serum Δ133p53/FLp53 ratio (≥ 2.9160) had higher recurrence rates than those with consistently low ratio values. In addition, dynamic detection in each follow-up timepoint showed that serum Δ133p53/FLp53 ratios were higher than 2.9160 upon recurrence, and they even increased prior to radiologic progression.Conclusion

the serum Δ133p53/FLp53 ratio can be a novel predictor for survival outcome and may serve as a real-time parameter for monitoring recurrence in ESCC patients after surgery.
Clinical significance and prognostic role of tumor-associated macrophages infiltration according to histologic location in canine mammary carcinomas
Authors: Monteiro Lidianne Narducci , Reis Diego Carlos dos , Salgado Breno Souza , Cassali Geovanni 
Published: October 2019

Abstract
Background: Tumor-associated macrophages (TAMs) have been involved in growth and metastases of human and canine mammary tumors. However, the prognostic importance of TAM specific location in canine mammary tumors (CMT) was not evaluated. In this study we evaluated the potential role of TAMs in specific histologic locations – intratumoral (iTAM) and stromal (sTAM), as well as total macrophage (tTAM) counts – as prognostic indicators in CMT. Results: Clinico-pathologic data from 66 animals with mammary carcinoma and their tumors were used in this study. Samples were stained with anti-macrophage antibody for subsequent TAM count. High levels of iTAM, sTAM, and tTAM were related with clinical stage and vascular invasion. Additionally, tTAM alone revealed a relation with tumor size, while high levels of sTAM and tTAM also were correlated with node metastasis and a poor prognosis based on survival analysis. Conclusions: CMT with aggressive features can reveal higher TAM counts. TAMs are associated with vascular invasion and nodal metastasis, and sTAM and tTAM counts are correlated with overall survival, consequently leading to the conclusion that sTAM and/or tTAM counts could be used as prognostic indicators in canine mammary invasive carcinomas.
Resection of retrohepatic inferior vena cava without reconstruction in ex vivo liver resection and autotransplantation: a retrospective study
Authors: Yang Xianwei , Wang Tao , Kong Junjie , Huang Bin , Wang Wentao 
Published: October 2019

Abstract
Background: Retrohepatic inferior vena cava (RIVC) resection without reconstruction in ex vivo liver resection and autotransplantation (ERAT) for advanced alveolar echinococcosis (HAE) is unclear. Methods: Depending on the presence of a rich collateral circulation and stable blood volume in ERAT, we chose not to rebuild the RIVC. Then, we chose an appropriate revascularization technique for the hepatic and renal veins. Finally, all ERAT procedures were completed, and short- and long-term outcomes were observed. Results: Between February 2014 and August 2018, 5 advanced HAE patients who underwent ERAT required the described technique. One patient died of circulatory failure 1 day after surgery. Another four patients, with a median follow-up duration of 18 months (range, 10-25 months), demonstrated normal liver and kidney function, no thrombosis and no HAE recurrence. Conclusions: Through the long-term results of ERAT, the pros and cons of not reconstructing the RIVC need to be re-examined. In cases with a rich collateral circulation, the RIVC can be reconstructed. However, in cases requiring the resection of multiple organs, RIVC reconstruction is prudential.
Feasibility of combining two individualized lung recruitment maneuvers at birth for very low gestational age infants: a retrospective cohort study
Authors: Kanaan Zalfa , Bloch-Queyrat Coralie , Boubaya Marouane , Lévy Vincent , Bolot Pascal , Waszak Paul 
Published: October 2019

Abstract
BACKGROUND Lung recruitment at birth has been advocated as an effective method of improving the respiratory transition at birth. Sustained inflations (SI) and dynamic positive end-expiratory pressure (PEEP) were assessed in clinical and animal studies to define the optimal level. Our working hypothesis was that very low gestational age infants (VLGAI) < 32 weeks’ gestation require an individualized lung recruitment based on combining both manoeuvers. METHODS Between 2014 and 2016, 100 and 102 inborn VLGAI were enrolled before and after introducing these manoeuvers based on progressive increase in SI up to 15 seconds, with simultaneous gradual increase in PEEP up to 15 cmH2O, according to the cardiorespiratory response. Retrospective comparisons of the rate of mechanical ventilation (MV) < 72h of life, short- and mid-term morbidity were then performed. RESULTS Among extremely low gestational age infants (ELGAI) < 29 weeks’ gestation, MV and its mean duration < 72h of life, consumption of a 2 nd dose of surfactant, and postnatal corticosteroids decreased significantly from 92 to 71%, 42 to 12h, 35 to 12%, and 49 to 24%, respectively. Among VLGAI, most of these results, and the rate of bronchopulmonary dysplasia (decreasing from 14 to 6%), were significant after a multivariate analysis. Neonatal mortality and morbidity were not different. CONCLUSIONS In our setting, combining two individualized lung recruitment maneuvers at birth was feasible and may be beneficial on short- and mid-term pulmonary outcomes, especially in ELGAI < 29 weeks’ gestation. A randomized controlled trial is needed to confirm these results.
Association among biofilm formation, virulence gene expression, and antibiotic resistance in Proteus mirabilis isolates from diarrhetic animals in northeast China
Authors: Sun Yadong , Wen Shanshan , Zhao Lili , Xia Qiqi , Pan Yue , Liu Hanghang , Wei Chengwei , Chen Hongyan , Ge Junwei , Wang Hongbin 
Published: October 2019

Abstract
Background The aim of this study was to investigate the association among biofilm formation, virulence gene expression, and antibiotic resistance in P. mirabilis isolates collected from diarrhetic animals (n = 176) in northeast China between September 2014 and October 2016. Results Approximately 92.05% of the isolates were biofilm producers, whereas 7.95% of the isolates were non-producers. The prevalence of virulence genes in biofilm producers was significantly higher than that in non-producers. Biofilm production was significantly associated with the expression of ureC , zapA , rsmA , hmpA , mrpA , atfA , and pmfA ( P < 0.05). Drug susceptibility tests revealed that approximately 76.7% of the isolates were multidrug-resistant (MDR) and extensively drug-resistant (XDR). Biofilm production was significantly associated with resistance to doxycycline, tetracycline, sulfamethoxazole, kanamycin, and cephalothin ( P < 0.05). Although the pathogenicity of the biofilm producers was stronger than that of the non-producers, the biofilm-forming ability of the isolates was not significantly associated with morbidity and mortality in mice ( P > 0.05). Conclusion Our findings suggested that a high level of multidrug resistance in diarrhetic animals infected with P. mirabilis in northeast China.The results of this study indicated that the positive rates of the genes expressed by biofilm-producing P. mirabilis isolates were significantly higher than those expressed by non-producing isolates.
Different effects of cortisol on pro-inflammatory gene expressions of LPS-, heat-killed E.coli-, or live E.coli-stimulated bovine endometrial epithelial cells
Authors: Cui Luying , Wang Yali , Wang Heng , Dong Junsheng , Li Zixiang , Li Jun , Qian Chen , Li Jianji 
Published: October 2019

Abstract
Background: Bacterial infections are common in postpartum dairy cows. Cortisol level has been observed to increase in dairy cows during peripartum period, and is associated with the endometrial innate immunity against pathogen like E.coli . However, the mechanism underlying how cortisol regulates E.coli -induced inflammatory response in bovine endometrial epithelial cells (BEEC) remains elusive. Results: Cortisol decreased the expressions of IL1β, IL6, TNF-α, IL8, and TLR4 mRNA in BEEC treated with LPS or heat-killed E.coli , but up-regulated the these gene expressions in BEEC stimulated by live E.coli . Conclusion: Cortisol exerted the anti-inflammation action on LPS- or heat-killed E.coli -stimulated BEEC, but the pro-inflammation action on live E.coli -induced BEEC.
Formulation of Improved Traditional Drugs against virulent species of Salmonella spp in Benin: assessment of the properties from Uvaria chamae, Lantana camara and Phyllantus amarus in Benin, West Africa
Authors: LEGBA Boris , DOUGNON Victorien , GBAGUIDI Carène , ANIAMBOSSOU Alidah , DEGUENON Esther , DOUGNON Jacques , BABA-MOUSSA Lamine 
Published: October 2019

Abstract
Background Uvaria chamae (Annonaceae), Phyllantus amarus (Phyllantaceae) and Lantana camara (Verbenaceae) are empirically alleged to be used as Beninese medicinal plants in the treatment of salmonellosis. This study aimed to produce scientific data on in vitro and in vivo efficacy of Uvaria chamae, Lantana camara and Phyllantus amarus on multiresistant Salmonella spp isolated in Benin.Results After in vitro tests on aqueous and ethanolic extracts of Uvaria chamae, Lantana camara and Phyllantus amarus , only the aqueous extract of Uvaria chamae (leaves) showed the best anti- Salmonella ’s activity. It has been used for the following experiments. The induction of salmonellosis revealed 9.0 10 8 CFU/ml was optimal concentration for triggering and maintaining the symptoms in chicks. This infective concentration has been used for in vivo assessment. 24 hours post inoculation later, the symptoms of salmonellosis (wet cloaca, diarrhea stool and somnolence) were observed in infected groups. After seven days of treatment, the rate of reduction of bacterial load at 100 mg / L, 200 mg / L, 400 mg / L of this extract was 85%, 52.38% and 98% respectively in the chicks groups infected with Salmonella Typhimurium ATCC 14028. About the groups infected with Salmonella spp (virulent strain), the rate of reduction of bacterial load at 100 mg / L, 200 mg / L, 400 mg / L of this extract was 0%, 98.66% and 99.33%. The toxicity tests did not show any significant effect of the Uvaria chamae ’s extract on the biochemical and hematological parameters of the chicks.Conclusion The aqueous extract of Uvaria chamae is active in vitro and in vivo on multiresistant strains of Salmonella spp . This plant is a good candidate for the development of an improved traditional medicine for the management of salmonellosis.
Organ/space infection is a common cause of high output stoma and outlet obstruction
Authors: Hara Yutaro , Miura Takuya , Sakamoto Yoshiyuki , Morohashi Hajime , Nagase Hayato , Hakamada Kenichi 
Published: October 2019

Abstract
Aim: The objectives of this study are to identify causes of high-output stoma (HOS) and outlet obstruction (OO), which are major complications of diverting ileostomy. Methods: A retrospective analysis was performed in 103 patients who underwent colorectal surgery and diverting ileostomy between December 2015 and November 2018. Results: HOS was found in 32 patients (31.1%) and OO in 19 (18.4%). Organ/space surgical site infection (SSI), anastomotic leakage and OO were independent HOS-related factors in univariate analysis, and OO (odds ratio [OR] 3.82, p=0.022) was a independent HOS-related factor in multivariate analysis. Organ/space SSI and HOS were independent OO-related factors in univariate analysis, and organ/space SSI (OR 3.69, p=0.02) was a independent OO-related factor in multivariate analysis. The white blood cell (WBC) count on postoperative day (POD) 3 was significantly higher in the HOS group compared to the non-HOS group (9765 vs. 8130 /mL, p<0.05), and the WBC count (9400 vs. 7475 /mL, p<0.05) and C-reactive protein level (6.01 vs. 2.92 mg/L, p<0.05) on POD 6 were significantly higher in the OO group compared to the non-OO group. Conclusion: Organ/space infection is involved in the common pathology of HOS and OO. Decreased intestinal absorption due to intestinal edema caused by organ/space SSI and relative stenosis at the abdominal wall-penetrating site are major causes of HOS and OO
The "slide technique" - a novel free-hand method of subaxial cervical pedicle screw placement
Authors: Liu Bin , Liu Xiangyang , Shen Xiongjie , Wang Guoping , Chen Yixin 
Published: October 2019

Abstract
Background : Cervical Pedicle Screw(CPS) placement is a challenging work due to high risk of neurovascular complications. Although there have been a number of different free-hand or navigation assisted techniques for CPS placement, perforations always occur during screw insertion, especially lateral perforation. The objective of this research is to describe a novel free-hand technique for subaxial CPS placement (C3–C7) for improving security and decreasing the chances of perforation. Methods : Thirty-two patients undergoing surgery with CPS instrumentation (C3–C7) at our institute between June 2017 and December 2018 were included in the study. All the patients had cervical trauma, and pedicle screw insertion was made according to the free-hand “slide technique”. Lamina, lateral mass and facet joint of the target area were clearly exposed and the optimal entry point was found on the lateral mass posterior surface. A pedicular probe was then inserted and gently advanced. During the pedicle probe insertion, the cortex of the medial margin of the pedicle acted as a “slide” to permit safe insertion of the screw. If the pedicle screw pathway was intact, screw of appropriate size was carefully placed. Three-dimensional (3D) CT imaging reconstruction was performed in all the patients after surgery, and screw perforations were graded with the Gertzbein-Robbins classification. Results : A total of 257 CPSs (C3-7) were inserted, of which 41 CPSs in C3, 61 CPSs in C4, 55 CPSs in C5, 53 CPSs in C6, and 47 CPSs in C7. The diameter and length of CPSs were 3.5 mm and 22-26 mm respectively. According to the Gertzbein-Robbins classification, grade 0, 231 screws; grade 1, 19 screws; and grade 2, 7 screws. No neurovascular complications occurred stemming from malpositioning of pedicle screws. In perforated screws (26 screws), lateral perforations were 16, medical perforations were 5, and inferior perforations were 4. Conclusions : The initial usage result show the “slide technique” is a safe, effective and cost-effective technique for pedicle screw placement in the cervical spine. This is the first report of such technique, we recommend it to wide practical application though further studies are needed.
M1 Macrophage Infiltrations Exacerbate Muscle and Bone Atrophy after Peripheral Nerve Injury
Authors: Shimada Nobuhiro , Sakata Asuka , Igarashi Takashi , Takeuchi Mamoru , Nishimura Satoshi 
Published: October 2019

Abstract
Background: Peripheral nerve injury causes limb muscle/bone atrophy, leading to chronic pain. We hypothesized that M1 macrophages, which focused on neurogenic inflammation, are important in muscle/bone atrophy after nerve injury. We investigated M1 macrophages’ influence on such atrophy after nerve injury in mice to prevent muscle/bone atrophy by suppressing M1 macrophages. Methods: Hind limb muscle weight and total bone density were measured in chronic constriction injury (CCI) model mice. Immunohistochemistry and intravital microscopy were performed to visualize the hind limb muscle and bone, and the cells were quantitated using flow cytometry. We compared M1 macrophages’ infiltration and muscle/bone atrophy in macrophage depletion and untreated groups, and investigated these changes using administration models of anti-inflammatory drugs and drugs for neuropathic pain. Results: Muscle weight was significantly lower 1 week after CCI compared to control groups, and total bone density significantly decreased in 5 weeks. Osteoclasts were significantly higher 1 week after CCI, compared to the control groups. M1 macrophage muscle infiltration was observed from 2 h, via intravital microscopy, and 1 week after CCI, and was significantly higher 1 week after CCI compared to the control groups. In the macrophage depletion, dexamethasone, pregabalin, and loxoprofen administration groups, M1 macrophage infiltration into muscle and bone was significantly lower, and muscle weight and bone density were significantly higher than the untreated group. Conclusions: M1 macrophage infiltration exacerbates muscle/bone atrophy after peripheral nerve injury. By suppressing M1 macrophages at the neural injury local site, muscle/bone atrophy could be avoided.
Decision Tree Analysis on the Factors Influencing the COI of Infantile Bronchopneumonia Inpatients in a Northern Hospital of China
Authors: pei dongmei , YUE YANGYANG , guo jiakai , guo qiyong 
Published: October 2019

Abstract
Background:
Bronchopneumonia is a disease with a high death rate for children in developing countries. It not only affects the healthy growth of children, but also puts economic pressure and additional burdens on their families and society. Social development and advancement may change the factors influencing the hospitalization costs. This study aimed to explore reasonable cost control approaches by analyzing the factors related to unreasonable increases in medical costs, so as to standardize the diagnosis and treatment behaviors and determine management methods for scientific medical costs.
Methods:
Using the decision tree analysis method combined with the characteristic variables of inpatients, data mining and analysis were performed on the assortment of charges for15,980infantile bronchopneumonia inpatients in a northern hospital of China during January 2013 to December 2017.
Results:
The medical costs of infantile bronchopneumonia inpatients tended to decrease year by year. Various factors influencing the hospitalization costs were sequenced in order of decreasing importance: salvage, complications, admission condition, discharge condition, hospital stay, age and medical payment mode. The hospitalization cost of 623(78.5%) patients with salvage during hospitalization was >RMB 10,000. Hospitalization cost of
Prognosis Evaluation of Universal Coronary Heart Disease: The Interplay between SYNTAX Score and ApoB/ApoA1
Authors: Wang Xiaotong , Wang Zhongyu , Li Bing , Yang Ping 
Published: October 2019

Abstract
Object：To assess the prognosis value of different kinds of SYNTAX score together with apoB/apoA1 in universal coronary heart disease (Regardless of coronary lesion). Method：396 patients undergoing percutaneous coronary intervention（PCI）and coronary stenting from 2013 to 2014 were chosen and recorded the major adverse cardiovascular events (MACE) and quality of life during the next 5 years. According to SYNTAX and SYNTAX II score, the patients were divided into low-risk, medium-risk and high-risk groups, and the clinical features, MACE incidence and EQ-5D score at each time points were compared. And the predictive factors of MACE incidence were analyzed. Results：①Compared with SYNTAX low-risk group, MACE incidence in 1 year significantly increased in medium-high risk group（p=0.011）. Compared with SYNTAX II low-risk group, MACE incidence in 5 years significantly increased in medium and high-risk group（p=0.032）.② Compared with SYNTAX II low-risk group，cardiovascular mortality in 3 and 5 years significantly elevated in high-risk group（p=0.001，p＜0.001 respectively）. ③ Compared with SYNTAX II low and medium-risk group, EQ-5D score in 5 years significantly decreased in high-risk group（p=0.001）. ④ ApoB/ApoA1 was more likely to be classified as high risk in SYNTAX/SYNTAX II medium and high-risk group（p=0.023，p=0.044 respectively）. ⑤Logistic regression analysis showed that apoB/apoA1 was an independent predictor of MACE events in hospital and 5 years（p=0.032，p=0.016 respectively），SYNTAX score was an independent predictor of MACE events in 1 year（medium-risk group：p=0.02；high-risk group：p=0.015）SYNTAX II score was an independent predictor of MACE events in 5 yeasrs(p=0.003). Conclusions：①SYNTAX score has a high predictive value for short-term prognosis while SYNTAX II score is more predictive of long-term prognosis. ② SYNTAX II score is superior to SYNTAX score in predicting cardiovascular death. ③ The combination of apoB/apoA1 high-risk and SYNTAX II medium and high-risk group is the focus of clinical treatment and long-term follow-up observation.