bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diabetes Mellitus and Incidence of Bladder and Kidney Cancer: An Exposure-Control Matched Study
Authors: Park Jae Won , Kim Dong Kyun , Bang Sung Eun , Lim Hyunsun 
Published: August 2020

Abstract
Background: Diabetes mellitus (DM), one of the most common metabolic diseases worldwide, is associated with malignancies at many sites. The relationship between DM and bladder or kidney cancer is still controversial. We investigated the associations between DM and bladder or kidney cancer in a population-based exposure-control matched study.Method: Using the Korean National Health Insurance System sample cohort database, we identified patients who were diagnosed as having DM between January 2006 and December 2010. A control group was also selected from the database using propensity score matching to adjust for age and sex. An exposure-control matched study was conducted until December 2015. The two groups were compared for baseline characteristics and bladder or kidney cancer incidence. Cox’s proportional hazard regression analyses were performed to investigate associations between bladder or kidney cancer and each clinical variable.Results: In total, 132,570 patients with DM were identified. In addition, 132,570 patients without DM matched by age and sex (control group) were selected. The mean age was 54 years, and the male-to-female ratio was 1:1. During the follow-up period, 619 patients in the DM group and 511 in the control group were diagnosed as having bladder cancer. Of those diagnosed as having kidney cancer, 419 patients were in the DM group and 285 were in the control group. Adjusted Cox’s proportional hazard regression analysis revealed that DM is associated with bladder and kidney cancer.Conclusions: DM is associated with bladder and kidney cancer. Older men are at an increased risk for both cancers.
Mid-term Results of an Anterior Plating Via Combined Anterior Approach for complex Acetabular Fractures: A Retrospective Cohort Study
Authors: Meng Weikun , Ou Yi , Wu Zhaoxiang , Yang Hongchang , Chen Ge , Bi Xin , Gao Liang , Chen Zhong 
Published: August 2020

Abstract
Background: Solely anterior plating via the modified Stoppa approach might yield satisfactory outcomes for selected cases of complex acetabular fractures, however, its indications are not practically clear. Methods: Patients with complex acetabular fractures treated with solely anterior plating via the modified Stoppa approach with or without a lateral window at our trauma center between January 2013 and December 2019 were retrospectively reviewed. Fracture type was identified according the newly established three-column classification of acetabular fracture. Perioperative information was recorded, and fracture reduction was evaluated radiographically at 3 days postoperatively. Postoperative hip function was assessed at least 1 year postoperatively. Results: Twenty patients were included with an average 17 months (range, 13-28) follow-up. According to the three-column classification, 2 cases were classified as type B2.2, 8 cases as type B2.3, 3 cases as type C1, and 7 cases as type C3. The mean time from injury and surgery was 7.0 days (range, 3-13 days), operative time was 2.0 hours (range, 1.4-3.2 hours), and intraoperative blood loss was 320 ml (range, 220-450 ml). Fracture reduction was excellent in 15 cases (75%), good in 3 cases (15%), fair in 1 case (5%), and poor in 1 case (5%). Final hip function was excellent in 13 cases (68%), good in 3 cases (16%), fair in 2 cases (11%), and poor in 1 case (5%). Bony healing was achieved in all cases and few complications were reported including recoverable obturator nerve injuries in 2 patients (10%) and controllable osteoarthritis in 1 patient (5%). Conclusions: Solely anterior plating via the combined anterior approach achieved satisfactory mid-term outcomes for complex acetabular fractures with posterior column detachments. Based on the newly established three-column classification of complex acetabular fracture, the type B, C1, and C3 fractures are possibly the appropriate indications for such a simplified procedure.Trial registration informationThe trial was retrospectively registered in https://www.researchregistry.com (No. Researchregistry4862) on July 04, 2019. The first participant was enrolled on March 06, 2017.
Morphometric Study of The Ventricular Indexes in Healthy Ovine Brain Using MRI
Authors: Trovatelli Marco , Spediacci Carlotta , Castellano Antonella , Bernardini Andrea , Dini Daniele , Malfassi Luca , Pieri Valentina , Falini Andrea , Ravasio Giuliano , Riva Marco , Bello Lorenzo , Brizzola Stefano , Zani Davide Danilo 
Published: August 2020

Abstract
BackgroundSheep (Ovis aries) have been largely used as animal models in a multitude of specialties in biomedical research. The similarity to human brain anatomy in terms of brain size, skull features, and gyrification index, gives to ovine as a large animal model a better translational value than small animal models in neuroscience. Despite this evidence and the availability of advanced imaging techniques, morphometric brain studies are lacking. We herein present the morphometric ovine brain indexes and anatomical measures developed by two observers in a double-blinded study and validated via an intra- and inter-observer analysis. ResultsFor this retrospective study, T1-weighted Magnetic Resonance Imaging (MRI) scans were performed at 1.5T on 15 sheep, under general anaesthesia. The animals were female Ovis aries, in the age of 18-24 months. Two observers assessed the scans, twice time each. The statistical analysis of intra-observer and inter-observer agreement was obtained via the Bland-Altman plot and Spearman rank correlation test.The results are as follows (mean±Standard deviation): Indexes: Bifrontal 0,338 ± 0,032 cm; Bicaudate 0,080 ± 0,012 cm; Evans’ 0,218 ± 0,035 cm; Ventricular 0,241 ± 0,039 cm; Huckman 1,693 ± 0,174 cm; Cella Media 0,096 ± 0,037 cm; Third ventricle ratio 0,040 ± 0,007 cm. Anatomical measures: Fourth ventricle length 0,295 ± 0,073 cm; Fourth ventricle width 0,344 ± 0,074 cm; Left lateral ventricle 4,175 ± 0,275 cm; Right lateral ventricle 4,182 ± 0,269 cm; Frontal horn length 1,795 ± 0,303 cm; Interventricular foramen left 1,794 ± 0,301cm; Interventricular foramen right 1,78 ± 0,317 cm.ConclusionsThe present study provides baseline values of linear indexes of the ventricles in the ovine models. The acquisition of these data contributes to filling the knowledge void on important anatomical and morphological features of the sheep brain.
Resilience and vulnerability of maternity services in Zimbabwe: a comparative analysis of the effect of Covid-19 and lockdown control measures on maternal and perinatal outcomes at Mpilo Central Hospital.
Authors: Shakespeare Clare , Dube H , Moyo S , Ngwenya S 
Published: August 2020

Abstract
Background: On 27th March the Zimbabwean government declared the Covid-19 pandemic a ‘national disaster’. Travel restrictions and emergency regulations have had significant impacts on maternity services, including staff shortages, resource stock-outs, and closure of antenatal clinics. Estimates of the indirect impact of Covid-19 on maternal and perinatal mortality expect it to be considerable, but little data is yet available.This study aims to examine the impact of Covid-19 and lockdown control measures on non-Covid outcomes in a government tertiary level maternity unit in Bulawayo, Zimbabwe, by comparing maternal and perinatal morbidity and mortality before and after lockdown was implemented.Methods: This is a retrospective, observational study, using a cross-sectional design to compare routine monthly maternal and perinatal statistics three months before and after Covid-19 emergency measures at Mpilo Central Hospital.Results: Between January-March and April-June 2020, average monthly deliveries fell from 747 to 681 and Caesarean section rates from 29.8% to 26.6%. Women with unbooked pregnancies presenting in labour almost doubled from 4.4% to 8%. There was no substantial change, however, in maternal mortality or severe maternal morbidity (post-partum haemorrhage (PPH), uterine rupture, severe preeclampsia/eclampsia), stillbirth rate or special care baby unit (SCBU) admission. There was a small increase in early neonatal death (ENND) from an average of 18.7 to 24.0 deaths per month.Conclusion: Maternal and perinatal outcomes must continue to be monitored to assess the impact of Covid-19 and lockdown measures as the epidemic in Zimbabwe unfolds. Despite the vulnerability of the healthcare system, the resilience and commitment of maternity units and healthcare workers to providing care in the most difficult circumstances should not be underestimated.
Degradome Sequencing-based Identification of PhasiRNAs Biogenesis Pathways in Oryza Sativa
Authors: Yu Lan , Guo Rongkai , Jiang Yeqin , Ye Xinghuo , Yang Zhihong , Meng Yijun , Shao Chaogang 
Published: August 2020

Abstract
Background: The miRNA-derived secondary phased small interfering RNAs (phasiRNAs) participate in post-transcriptional gene silencing and play important roles in various bio-processes in plants. In rice, two miRNAs, miR2118 and miR2275, were mainly responsible for the triggering of 21-nt and 24-nt phasiRNAs biogenesis, respectively. However, compare to other plant species, relative fewer phasiRNA biogenesis pathways have been discovered in rice, which limits the comprehensive understanding of the mechanism of phasiRNA biogenesis and the miRNA derived regulatory network. Results: In this study, we performed a systematical searching for phasiRNA biogenesis pathways in rice. As a result, five novel 21-nt phasiRNA biogenesis pathways and five novel 24-nt phasiRNA biogenesis pathways were identified. Further exploration of the regulatory function of phasiRNAs revealed eleven novel phasiRNAs with 21-nt length targeting forty-one genes, most of which involving in the growth and development of rice. In addition, five novel phasiRNAs with 24-nt length were found targeting the promoter of an OsCKI1 gene and causing higher methylation status in panicle, implying their regulatory function of the transcription of OsCKI1, and subsequently affect the development of rice. Conclusions: These results substantially extended the information of phasiRNA biogenesis pathways and their regulatory function in rice.
Accessing the Syndemic of COVID-19 and Malaria Intervention in Africa
Authors: Shi Benyun , Zheng Jinxin , Xia Shang , Lin Shan , Wang Xinyi , Liu Yang , Zhou Xiao-Nong , Liu Jiming 
Published: August 2020

Abstract
Background: The COVID-19 pandemic has caused substantial disruptions to health services in the low and middle-income countries with a high burden of other diseases, such as malaria in sub-Saharan Africa. As the COVID-19 pandemic spread to Africa, there is an urgent need to assess the impact of COVID-19 pandemic on malaria transmission potential in malaria-endemic countries in Africa.Methods: We present a data-driven method to quantify the extent to which the COVID-19 pandemic, as well as various non-pharmaceutical interventions (NPIs), could lead to the change of malaria transmission potential in 2020. First, we adopt a particle Markov Chain Monte Carlo method to estimate epidemiological parameters in each country by fitting the time series of the cumulative number of COVID-19 cases. Then, we simulate the epidemic dynamics of COVID-19 under two groups of NPIs: (i) contact restriction and social distancing, and (ii) early identification and isolation of cases. Based on the simulated epidemic curves, we quantify the impact of COVID-19 epidemic and NPIs on the distribution of insecticide-treated nets (ITNs). Finally, by treating the total number of ITNs available in each country in 2020, we evaluate the negative effects of COVID-19 pandemic on malaria transmission potential based on the notion of vectorial capacity.Results: We conduct case studies in four malaria-endemic countries, Ethiopia, Nigeria, Tanzania, and Zambia, in Africa. The epidemiological parameters (i.e., the basic reproduction number R0 and the duration of infection DI ) of COVID-19 in each country are estimated as follows: Ethiopia (R0 = 1:57, DI = 5:32), Nigeria (R0 = 2:18, DI = 6:58), Tanzania (R0 = 2:47, DI = 6:01), and Zambia (R0 = 2:12, DI = 6:96). Based on the estimated epidemiological parameters, the epidemic curves simulated under various NPIs indicated that the earlier the interventions are implemented, the better the epidemic is controlled. Moreover, the effect of combined NPIs is better than contact restriction and social distancing only. By treating the total number of ITNs available in each country in 2020 as a baseline, our results show that even with stringent NPIs, malaria transmission potential will remain higher than expected in the second half of 2020.Conclusions: By quantifying the impact of various NPI response to the COVID-19 pandemic on malaria transmission potential, this study provides a way to jointly address the syndemic between COVID-19 and malaria in malaria-endemic countries in Africa. The results suggest that the early intervention of COVID-19 can effectively reduce the scale of the epidemic and mitigate its impact on malaria transmission potential.
Reference letters for subspecialty medicine residency positions: Are they valuable for decision-making? Results from a Canadian mixed method study.
Authors: Chopra Deepti , Joneja Mala , Sandhu Gurjit , Smith Christopher A. , Spagnuolo Catherine M. , Hookey Lawrence 
Published: August 2020

Abstract
Background
The letter of recommendation is currently an integral part of applicant selection for residency programs. Internal medicine residents will spend much time and expense completing sub-specialty away electives to obtain a letter of recommendation. The purpose of this study was 1) to examine a large sample of reference letters in order to define essential components of a high-quality letter, and 2) to elucidate the relationship between quality of reference letter and the letter writer.
Methods
We conducted a two-phase mixed methods study. In phase one, a large sample of letters of recommendation was examined using an audit tool as a coding framework. A 5-point composite endpoint of high-quality letter components was subsequently developed. In phase two, program director letters were compared to non-program director home institution and elective letters based on inclusion of components of the 5-point composite endpoint using Chi square testing.
Results
715 letters were examined (398 non-program director home institution letters, 201 program director letters, and 116 elective letters). High-quality letter components were: nature of relationship, duration of relationship, In Training Evaluation Report information, research involvement and comments on areas for improvement. Program director letters had a significantly higher proportion (10.4%) of all 5 high-quality components, compared to 0% in both non-program director home institution letters and elective letters (p < 0.001). A significantly higher proportion of program director letters had 4–5 high-quality components (62.5%) compared to 2% of non-program director home institution letters and 0% of elective letters (p < 0.0001).
Conclusions
Letters of recommendation from elective rotations are of the poorest quality and such rotations should not be pursued for the sole purpose of obtaining a letter. The low quality of elective letters leads to the recommendation that writers should decline to write them, programs should not require them and trainees should not request them. Program directors write the highest quality letters and should be a resource for faculty development. Clinical supervisors can use the 5-point composite endpoint as a guide when writing letters for applicants.
AKR1B10 promotes breast cancer cell proliferation and migration via the PI3K/AKT/NF-κB signaling pathway
Authors: Qu Jiayao , Li Jia , He Rongzhang , Liu Xiangting , Gong Ke , Duan Lili , Luo Weihao , Hu Zheng , luo dixian 
Published: August 2020

Abstract
BackgroudAberrant expression of Aldo-Keto reductase family 1 member B10 (AKR1B10) has been observed during the progression of some human carcinomas. However, the expression pattern and clinical relevance of AKR1B10 in breast cancer (BC) need clarification.MethodsThe relationship between the high expression of AKR1B10 and the overall prognosis and disease-free survival of breast cancer patients was analyzed by Kaplan-Meier Plotter database. Breast cancer cell lines MCF-7/AKR1B10 stably overexpressing AKR1B10 and breast cancer cell lines BT-20/shAKR1B10 that knock down AKR1B10 were constructed, respectively. RT-qPCR, Western blot and immunohistochemistry were used to detect the expression of AKR1B10 in breast cancer and its normal tissues. CCK8 cell proliferation assay and cell scratch test were used to detect the proliferation and migration of breast cancer cells. Western blot was used to detect the expression of proliferation-related proteins cyclinD1, c-myc, survivin and EMT-related proteins twist, snail, slug, ZEB1, E-cadherin, PI3K, p-PI3K, AKT, p-AKT, IKBα, p-IKBα, NF-κB p65, and p-NF-κB p65 proteins in breast cancer cells. The PI3K inhibitor LY94002 was used to treat MCF-7 cells to detect PI3K/AKT/NF-κB signal cascade protein Expression, and expression of NF-κB p65 in nucleoproteins and plasma proteins.ResultsIn this study, we found that AKR1B10 expression was higher in BC tissue compared to paired non-cancerous tissue. The expression of AKR1B10 positively correlated with lymph node metastasis, tumor size, Ki67 expression, and p53 expression, but inversely correlated with overall and disease-free survival rates. Gene Ontology (GO) analysis showed that AKR1B10 was closely related to cell proliferation. Overexpression of AKR1B10 facilitated proliferation and migration of BC cells in vitro in association with induction of epithelial-mesenchymal transition. Conversely, knockdown of AKR1B10 inhibited these effects. Mechanistically, silencing AKR1B10 reduced the phosphorylation of PI3K, AKT, and NF-κB p65, whereas AKR1B10 overexpression activated these signaling molecules. Indeed, PI3K inhibition attenuated NF-κB p65 nuclear localization.ConclusionsOur results demonstrate that AKR1B10 promotes proliferation and migration of BC cells and represents a novel prognostic indicator as well as a potential therapeutic target in BC.
Using the WHO Safe Childbirth Checklist to Improve Essential Care Delivery as Part of the District -Wide Maternal and Newborn Health Quality Improvement Initiative, a Time Series Study
Authors: Bitewulign Befikadu , Abdissa Dereje , Mulissa Zewdie , Kiflie Abiyou , Abate Mehiret , Biadgo Abera , Alemu Haregeweyni , Zelalem Meseret , Kassa Munir , Parry Gareth , Magge Hema 
Published: August 2020

Abstract
Background: Care bundles are a set of three to five evidence-informed practices which, when performed collectively and reliably, may improve health system performance and patient care. To date, many studies conducted to improve the quality of essential birth care practices (EBPs) have focused primarily on provider- level and have fallen short of the predicted impact on care quality, indicating that a systems approach is needed to improve the delivery of reliable quality care. This study evaluates the effectiveness of integrating the use of the World Health Organization Safe Childbirth Checklist (WHO-SCC) into a district-wide system improvement collaborative program designed to improve and sustain the delivery of EBPs as measured by "clinical bundle" adherence over-time.Methods: The WHO-SCC was introduced in the context of a district-wide Maternal and Newborn Health (MNH) collaborative quality of care improvement program in four agrarian Ethiopia regions. Three "clinical bundles" were created from the WHO-SCC: On Admission, Before Pushing, and Soon After Birth bundles. The outcome of each bundle was measured using all- or- none adherence. Adherence was assessed monthly by reviewing charts of live births.A time-series analysis was employed to assess the effectiveness of system-level interventions on clinical bundle adherence. STATA version 13.1 was used to analyze the trend of each bundle adherence overtime. Autocorrelation was checked to assess if the assumption of independence in observations collected overtime was valid. Prais-Winsten was used to minimize the effect of autocorrelation.Findings: Quality improvement interventions targeting the three clinical bundles resulted in improved adherence over time across the four regions. In Tigray region, adherence to “On Admission” bundle was increased monthly on average by B =1.39 (95% CI; 0.47 - 2.32; P<0.005).Similarly, adherence to the “Before Pushing” bundle in Southern Nations, Nationalities and People’s (SNNP) region increased monthly on average by B = 2.3 (95% CI; 0.89 - 3.74; P<0.005). Conclusion: Use of the WHO-SCC paired with a system-wide quality improvement approach improved and sustained quality of EBPs delivery. Further studies should be conducted to evaluate the impact on patient-level outcomes.
A Novel Nomogram for Predicting Liver Metastasis in Patients with Gastrointestinal Stromal Tumor: A SEER-based Study
Authors: Zhou Guowei , Xiao Keshuai , Gong Guanwen , Wu Jiabao , Zhang Ya , Liu Xinxin , Jiang Zhiwei , Ma Chaoqun 
Published: August 2020

Abstract
Background: Liver metastasis (LIM) of gastrointestinal stromal tumor (GIST) is associated with poor prognosis. The present study aimed at developing and validating nomogram to predict LIM in patients with GIST, thus helping clinical diagnosis and treatment.Methods: The data of GIST patients derived from Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2016, which were then screened by univariate and multivariate logistic regression for the construction of LIM nomogram. The model discrimination of LIM nomogram was evaluated by concordance index (C-index) and calibration plots, while the predictive accuracy and clinical values were measured by decision curve analysis (DCA) and clinical impact plot. Furthermore, we validated predictive nomogram in the internal testing set.Results: A total of 3797 patients were enrolled and divided randomly into training and validating groups in a 3-to-1 ratio. After logistic regression, the significant variables were sex, tumor location, tumor size, N stage and mitotic rate. The calibration curves showed the perfect agreement between nomogram predictions and actual observations, while the DCA and clinical impact plot showed the clinical utility of LIM nomogram. C-index of the nomogram was 0.812. What’s more, receiver operating characteristic curves (ROC) also showed good discrimination and calibration in the training set (AUC=0.794, 95% CI: 0.778 to 0.808) and the testing set (AUC=0.775, 95% CI: 0.748 to 0.802).Conclusion: The nomogram for patients with GIST can effectively predict the individualized risk of liver metastasis and provide insightful information to clinicians to optimize therapeutic regimens.