bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety and efficacy of inferoposterior access approach to the renal pedicle during transperitoneal laparoscopic radical nephrectomy: A retrospective comparative analysis at a single institution
Authors: Cheng Xiao-Bao , Lam Wayne , Lu Zhen-Quan , Lo Richard 
Published: September 2020

Purpose To assess the safety and efficacy of transperitoneal laparoscopic radical nephrectomy using an inferoposterior approach to the renal pedicle. Materials and methods A retrospective review of 89 patients who underwent transperitoneal laparoscopic radical nephrectomy by a single surgeon between June 2014 and December 2019 at a single urological unit was carried out. Access to the renal pedicle was via the inferoposterior approach in 48 cases (study group) and 41 were approached via the conventional anterior approach (control group). Patient demographics, intra-operative anatomical findings, and procedural details including operative time on renal pedicles and post-operative outcomes were recorded. Post-operative complications were recorded and classified according to the Clavien-Dindo classification. A comparative analysis between the two groups was performed using Chi-square test and t-test. Results The inferoposterior approach group had a shorter operative time (132.85±26.65 min vs 153.46±39.94 min; p<0.01), which could be attributed to the shorter time spent operating on the renal vasculature (46.31±6.16 min vs 64.46±7.64 min; p<0.01). Lower average blood loss was also observed in the inferoposterior approach group (42 ml vs 62 ml; p<0.05). No significant difference was identified concerning the mean patient age, body mass index, tumor size, number of renal vessels identified, and post-operative length of stay between the two groups. None of the patients required conversion to open. Conclusion Inferoposterior approach to access the renal pedicle during transperitoneal laparoscopic radical nephrectomy is a safe and effective technique, which shortens the operative time when compared to the conventional anterior approach. Level of evidence: Level 3b.
Admiral Nursing—A Model of Specialist Dementia Care in Acute Hospitals
Authors: Aldridge Zena , Oliver Emily , Gardener Hannah , Dening Karen Harrison 
Published: September 2020

Introduction The rising prevalence of dementia has led to increased numbers of people with dementia being admitted to acute hospitals. This demand is set to continue due to an increasingly older population who are likely to have higher levels of dependency, dementia, and comorbidity. If admitted to the hospital, people with dementia are at higher risk of poor outcomes during and following a hospital admission. Yet, there remains a significant lack of specialist support within acute hospitals to support people with dementia, their families and hospital staff. Methods Admiral Nurses are specialists that work with families affected by dementia and provide consultancy and support to health and social care colleagues to improve the delivery of evidenced based dementia care. Historically, Admiral Nurses have predominantly been based in community settings. In response to the increasing fragmentation of services across the dementia trajectory, the Admiral Nurse model is evolving and adapting to meet the complex needs of families impacted upon by dementia inclusive of acute hospital care. Results The Admiral Nurse acute hospital model provides specialist interventions which improve staff confidence and competence and enables positive change by improving skills and knowledge in the provision of person-centred dementia care. The role has the capacity to address some of the barriers to delivering person centred dementia care in the acute hospital and contribute to improvements across the hospital both as a result of direct interventions or influencing the practice of others. Conclusion Improving services for people with dementia and their families requires a whole system approach to enable care coordination and service integration, this must include acute hospital care. The increasing numbers of people with dementia in hospitals, and the detrimental effects of admission, make providing equitable, consistent, safe, quality care and support to people with dementia and their families a national priority requiring immediate investment. The inclusion of Admiral Nursing within acute hospital services supports service and quality improvement which positively impacts upon the experience and outcomes for families affected by dementia.
Comparison of Lower Extremity EMG Muscle Testing With Hands-Free Single Crutch vs Standard Axillary Crutches
Authors: Dewar Cuyler , Martin Kevin D. 
Published: September 2020

Background: In order to maintain nonweightbearing restrictions of the lower extremity, an assistive device must be utilized. Currently most devices require the restricted limb to be held in a static position while the contralateral extremity provides forward propulsion. Atrophy and disuse conditions ensue rapidly, slowing healing and prolonging recovery. A hands-free single crutch (HFSC) utilizes both lower extremities, potentially reducing atrophy. The purpose of this study was to examine the electromyographic (EMG) differences between an HFSC and standard axillary crutches (SAC). Methods: A prospective, crossover study was performed using 21 healthy volunteers from an active duty foot and ankle clinic. Demographic data were obtained and then subjects were fitted with an HFSC and SAC. Wireless surface EMG sensors were applied to the belly of the rectus femoris (RF), vastus lateralis (VL), lateral gastrocnemius (LG), and the gluteus maximus (GM) by a board-certified orthopedic surgeon. Subjects then ambulated at a self-selected velocity for 30 m while 15 seconds of the gait cycle were recorded for each device. Mean muscle activity and the maximum voluntary isometric contraction (MVIC) were recorded. Results: The RF, GM, and LG showed significantly increased levels of muscle activity while using the HFSC compared to SAC (respectively P = .05, P = .03, P = .03). The VL did not show significantly higher muscle activity while using the HFSC ( P = .051). The RF, GM, and VL showed statistically significant higher MVIC percentages while using the HFSC compared with SAC (respectively P = .005, P = .005, P = .013). The LG did not show significantly higher MVIC percentage while using the HFSC ( P = .076). Conclusion: The HFSC subjects demonstrated increased muscle recruitment and intensity while maintaining cyclic contractions consistent with bipedal gait pattern. SAC demonstrated less recruitment and intensity with an isometric pattern regardless of the phase of gait. Clinical Relevance: Muscle atrophy following lower extremity immobilization.
Recombinant VWF fragments improve bioavailability of subcutaneous factor VIII in hemophilia A mice
Authors: Vollack-Hesse Nadine , Oleshko Olga , Werwitzke Sonja , Solecka-Witulska Barbara , Kannicht Christoph , Tiede Andreas 
Published: September 2020

Abstract
Conventional treatment of hemophilia A (HA) requires repetitive IV injection of coagulation factor VIII (FVIII). Subcutaneous administration of FVIII is inefficient because of binding to the extravascular matrix, in particular to phospholipids (PLs), and subsequent proteolysis. To overcome this, recombinant dimeric fragments of von Willebrand factor (VWF) containing the FVIII-stabilizing D3 domain were engineered. Two fragments, called VWF-12 and VWF-13, demonstrated high binding affinity to recombinant human FVIII (rhFVIII) and suppressed PL binding in a dose-dependent manner. High concentrations of VWF fragments did not interfere with the functional properties of full-length VWF in vitro. The HA mouse model was used to study the effects of VWF-12 or VWF-13 on the in vivo pharmacokinetics of rhFVIII, demonstrating (1) no significant impact on rhFVIII recovery or half-life after a single IV administration; (2) enhanced bioavailability (up to 18.5%) of rhFVIII after subcutaneous administration; and (3) slow absorption (peak concentration, 6 hours) and prolonged half-life (up to 2.5-fold) of rhFVIII after subcutaneous administration. Formation of anti-FVIII antibodies was not increased after administration of rhFVIII/VWF-12 subcutaneously compared with rhFVIII IV. A single subcutaneous dose of rhFVIII/VWF-12 provided protection in the HA tail-bleeding model for up to 24 hours. In summary, recombinant VWF fragments support FVIII delivery through the subcutaneous space into vascular circulation without interfering with VWF or FVIII function. Slow resorption and excretion of FVIII after subcutaneous administration highlight the potential application of VWF fragments for subcutaneous FVIII prophylaxis in HA.
Direct activation of the alternative complement pathway by SARS-CoV-2 spike proteins is blocked by factor D inhibition
Authors: Yu Jia , Yuan Xuan , Chen Hang , Chaturvedi Shruti , Braunstein Evan M. , Brodsky Robert A. 
Published: September 2020

AbstractSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly contagious respiratory virus that can lead to venous/arterial thrombosis, stroke, renal failure, myocardial infarction, thrombocytopenia, and other end-organ damage. Animal models demonstrating end-organ protection in C3-deficient mice and evidence of complement activation in humans have led to the hypothesis that SARS-CoV-2 triggers complement-mediated endothelial damage, but the mechanism is unclear. Here, we demonstrate that the SARS-CoV-2 spike protein (subunit 1 and 2), but not the N protein, directly activates the alternative pathway of complement (APC). Complement-dependent killing using the modified Ham test is blocked by either C5 or factor D inhibition. C3 fragments and C5b-9 are deposited on TF1PIGAnull target cells, and complement factor Bb is increased in the supernatant from spike protein–treated cells. C5 inhibition prevents the accumulation of C5b-9 on cells, but not C3c; however, factor D inhibition prevents both C3c and C5b-9 accumulation. Addition of factor H mitigates the complement attack. In conclusion, SARS-CoV-2 spike proteins convert nonactivator surfaces to activator surfaces by preventing the inactivation of the cell-surface APC convertase. APC activation may explain many of the clinical manifestations (microangiopathy, thrombocytopenia, renal injury, and thrombophilia) of COVID-19 that are also observed in other complement-driven diseases such as atypical hemolytic uremic syndrome and catastrophic antiphospholipid antibody syndrome. C5 inhibition prevents accumulation of C5b-9 in vitro but does not prevent upstream complement activation in response to SARS-CoV-2 spike proteins.
A comparison of ice wrap and subacromial injection for postoperative pain and edema control following arthroscopic rotator cuff repair
Authors: Kara Yavuz Selim , Hapa Onur , Işın Yağmur , Kılıç Ali İhsan , Havitçioğlu Hasan 
Published: September 2020

AbstractBackgroundPostoperative pain and edema are the most common problems associated with arthroscopic rotator cuff repair. The purpose of the present study was to compare ice wrap and subacromial injection (SI) as treatments for early postop pain and edema control and to contrast them with a control group.Materials and methods59 patients treated with arthroscopic rotator cuff repair were randomized into three groups: 23 patients who received an ice wrap, 20 patients who received a SI, and a control group of 16 patients.ResultsPatient demographics, comorbidities, tear retraction, degree of fatty muscle degeneration, surgical procedures, and amount of irrigation fluid were similar for the three groups, which also showed similar results regarding postoperative pain and edema control as well as analgesic consumption.ConclusionsThe present study failed to show any difference in effectiveness between the two most common pain management modalities, or between those modalities and the control group.Level of evidenceIV, prospective observational study.
Genomic, microbial and environmental standardization in animal experimentation limiting immunological discovery
Authors: Enriquez Josue , Mims Brianyell Mc Daniel , Trasti Scott , Furr Kathryn L. , Grisham Matthew B. 
Published: September 2020

AbstractBackgroundThe use of inbred mice housed under standardized environmental conditions has been critical in identifying immuno-pathological mechanisms in different infectious and inflammatory diseases as well as revealing new therapeutic targets for clinical trials. Unfortunately, only a small percentage of preclinical intervention studies using well-defined mouse models of disease have progressed to clinically-effective treatments in patients. The reasons for this lack of bench-to-bedside transition are not completely understood; however, emerging data suggest that genetic diversity and housing environment may greatly influence muring immunity and inflammation.ResultsAccumulating evidence suggests that certain immune responses and/or disease phenotypes observed in inbred mice may be quite different than those observed in their outbred counterparts. These differences have been thought to contribute to differing immune responses to foreign and/or auto-antigens in mice vs. humans. There is also a growing literature demonstrating that mice housed under specific pathogen free conditions possess an immature immune system that remarkably affects their ability to respond to pathogens and/or inflammation when compared with mice exposed to a more diverse spectrum of microorganisms. Furthermore, recent studies demonstrate that mice develop chronic cold stress when housed at standard animal care facility temperatures (i.e. 22–24 °C). These temperatures have been shown alter immune responses to foreign and auto-antigens when compared with mice housed at their thermo-neutral body temperature of 30–32 °C.ConclusionsExposure of genetically diverse mice to a spectrum of environmentally-relevant microorganisms at housing temperatures that approximate their thermo-neutral zone may improve the chances of identifying new and more potent therapeutics to treat infectious and inflammatory diseases.
The role of the globular heads of the C1q receptor in TcdA-induced human colonic epithelial cell apoptosis via a mitochondria-dependent pathway
Authors: Liang Jinhua , Ning Yongzhong , Dong Li , Ma Xiufeng , Li Shu , Yang Heran , Li Qi , Chen Ling , Gao Lingjuan , Xu Yanmin 
Published: September 2020

Abstract
Background
Clostridioides (formerly Clostridium) difficile infection is the leading cause of antibiotic-associated colitis. Studies have demonstrated that C. difficile toxin A (TcdA) can cause apoptosis of many human cell types. The purpose of this study was to investigate the relationships among exposure to TcdA, the role of the receptor for the globular heads of C1q (gC1qR) gene and the underlying intracellular apoptotic mechanism in human colonic epithelial cells (NCM 460). In this study, gC1qR expression was examined using real-time polymerase chain reaction (PCR), western blotting and immunohistochemical staining. Cell viability was assessed by the water-soluble tetrazolium salt (WST-1) assay, and cell apoptosis was assessed by flow cytometry and the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling (TUNEL) assay. Mitochondrial function was assessed based on reactive oxygen species (ROS) generation, changes in the mitochondrial membrane potential (ΔΨm) and the content of ATP.

Results
Our study demonstrated that increasing the concentration of TcdA from 10 ng/ml to 20 ng/ml inhibited cell viability and induced cell apoptosis (p < 0.01). Moreover, the TcdA-induced gC1qR expression and enhanced expression of gC1qR caused mitochondrial dysfunction (including production of ROS and decreases in the ΔΨm and the content of ATP) and cell apoptosis. However, silencing of the gC1qR gene reversed TcdA-induced cell apoptosis and mitochondrial dysfunction.

Conclusion
These data support a mechanism by which gC1qR plays a crucial role in TcdA-induced apoptosis of human colonic epithelial cells in a mitochondria-dependent manner.
Comparative chloroplast genome analyses of Avena: insights into evolutionary dynamics and phylogeny
Authors: Liu Qing , Li Xiaoyu , Li Mingzhi , Xu Wenkui , Schwarzacher Trude , Heslop-Harrison John Seymour 
Published: September 2020

Abstract
Background
Oat (Avena sativa L.) is a recognized health-food, and the contributions of its different candidate A-genome progenitor species remain inconclusive. Here, we report chloroplast genome sequences of eleven Avena species, to examine the plastome evolutionary dynamics and analyze phylogenetic relationships between oat and its congeneric wild related species.

Results
The chloroplast genomes of eleven Avena species (size range of 135,889–135,998 bp) share quadripartite structure, comprising of a large single copy (LSC; 80,014–80,132 bp), a small single copy (SSC; 12,575–12,679 bp) and a pair of inverted repeats (IRs; 21,603–21,614 bp). The plastomes contain 131 genes including 84 protein-coding genes, eight ribosomal RNAs and 39 transfer RNAs. The nucleotide sequence diversities (Pi values) range from 0.0036 (rps19) to 0.0093 (rpl32) for ten most polymorphic genes and from 0.0084 (psbH-petB) to 0.0240 (petG-trnW-CCA) for ten most polymorphic intergenic regions. Gene selective pressure analysis shows that all protein-coding genes have been under purifying selection. The adjacent position relationships between tandem repeats, insertions/deletions and single nucleotide polymorphisms support the evolutionary importance of tandem repeats in causing plastome mutations in Avena. Phylogenomic analyses, based on the complete plastome sequences and the LSC intermolecular recombination sequences, support the monophyly of Avena with two clades in the genus.

Conclusions
Diversification of Avena plastomes is explained by the presence of highly diverse genes and intergenic regions, LSC intermolecular recombination, and the co-occurrence of tandem repeat and indels or single nucleotide polymorphisms. The study demonstrates that the A-genome diploid-polyploid lineage maintains two subclades derived from different maternal ancestors, with A. longiglumis as the first diverging species in clade I. These genome resources will be helpful in elucidating the chloroplast genome structure, understanding the evolutionary dynamics at genus Avena and family Poaceae levels, and are potentially useful to exploit plastome variation in making hybrids for plant breeding.
Asymmetrical cortical vein sign predicts early neurological deterioration in acute ischemic stroke patients with severe intracranial arterial stenosis or occlusion
Authors: Li Wei , Xiao Wei-Min , Luo Gen-Pei , Liu Yong-Lin , Qu Jian-Feng , Fang Xue-Wen , Wang Fang , Chen Yang-Kun 
Published: September 2020

Abstract
Background
Susceptibility weighted imaging (SWI) provides an approximate assessment of tissue perfusion and shows prominent hypointense cortical veins in the ischemic territory because of the increased concentration of deoxyhemoglobin. We aimed to evaluate whether asymmetrical prominent cortical vein sign (APCVS) on SWI can predict early neurological deterioration (END) in acute ischemic stroke patients with severe intracranial arterial stenosis or occlusion (SIASO).

Methods
One hundred and nine acute ischemic stroke patients with SIASO who underwent SWI were retrospectively recruited. END was defined as an increase in the National Institutes of Health Stroke Scale score ≧2 points despite standard treatment in the first 72 h after admission. The APCVS was defined as more and/or large vessels with greater signal loss than those in the opposite hemisphere on SWI.

Results
Thirty out of the 109 (27.5%) patients developed END. Sixty (55.0%) patients presented with APCVS on SWI. APCVS occurred in 24 (80%) patients with END, whereas it only occurred in 36 (45.6%) patients without END (P = 0.001). Patients with APCVS were more likely to have END (40.0%, vs. 12.2%, P = 0.001) than those without END. Multivariate logistic regression indicated that APCVS (OR = 4.349, 95% C.I. = 1.580–11.970, P = 0.004) was a significant predictor of END in acute ischemic stroke patients with SIASO, adjusted for previous stroke history and acute infarct volume.

Conclusions
In acute ischemic stroke patients with SIASO, the APCVS might be a useful neuroimaging marker for predicting END, which suggests the importance of evaluation of perfusion status.
Alteration of plasma metabolites associated with chemoradiosensitivity in esophageal squamous cell carcinoma via untargeted metabolomics approach
Authors: Zhang Yaowen , Wang Jianpo , Dai Ningtao , Han Peng , Li Jian , Zhao Jiangman , Yuan Weilan , Zhou Jiahuan , Zhou Fuyou 
Published: September 2020

Abstract
Background
To investigate the differences in plasma metabolomic characteristics between pathological complete response (pCR) and non-pCR patients and identify biomarker candidates for predicting the response to neoadjuvant chemoradiotherapy (nCRT) in esophageal squamous cell carcinoma (ESCC).

Methods
A total of 46 ESCC patients were included in this study. Gas chromatography time-of- flight mass spectrometry (GC-TOF/MS) technology was applied to detect the plasma samples collected before nCRT via untargeted metabolomics analysis.

Results
Five differentially expressed metabolites (out of 109) was found in plasma between pCR and non-pCR groups. Compared with non-pCR group, isocitric acid (p = 0.0129), linoleic acid (p = 0.0137), citric acid (p = 0.0473) were upregulated, while L-histidine (p = 0.0155), 3′4 dihydroxyhydrocinnamic acid (p = 0.0339) were downregulated in the pCR plasma samples. Pathway analyses unveiled that citrate cycle (TCA cycle), glyoxylate and dicarboxylate metabolic pathway were associated with ESCC chemoradiosensitivity.

Conclusion
The present study provided supporting evidence that GC-TOF/MS based metabolomics approach allowed identification of metabolite differences between pCR and non-pCR patients in plasma levels, and the systemic metabolic status of patients may reflect the response of ESCC patient to neoadjuvant chemoradiotherapy.
Changes in ocular biometric measurements after vitrectomy with silicone oil tamponade for rhegmatogenous retinal detachment repair
Authors: Liu Rui , Li Qingchen 
Published: September 2020

Abstract
Background
To observe the changes in ocular biometric measurements after vitrectomy with silicone oil tamponade for rhegmatogenous retinal detachment (RRD) repair.

Methods
Sixty-three phakic, macula-off RRD eyes underwent vitrectomy with silicone oil tamponade but not lens extraction were included in this retrospective study. Measurements of axial length (AL), anterior chamber depth (ACD), lens thickness (LT) using the new Zeiss IOLMaster 700 and derivative lens position (LP), relative lens position (RLP) and lens-retina distance (LRD) were compared and analyzed between preoperative and postoperative in phakic, macula-off eyes with RRD.

Results
Preoperative AL, ACD, LT, LP, RLP and LRD were 24.94 ± 1.82 mm, 3.45 ± 0.42 mm, 4.34 ± 0.16 mm, 5.55 ± 0.41 mm, 0.22 ± 0.01 and 19.52 ± 1.82 mm. After a mean 4.85-month duration of silicone oil tamponade, postoperative AL, ACD, LT, LP, RLP and LRD were 25.42 ± 2.20 mm, 3.30 ± 0.41 mm, 4.43 ± 0.21 mm, 5.46 ± 0.40 mm, 0.22 ± 0.02 and 20.17 ± 2.36 mm, respectively. The differences in all measurements are significant (all P < 0.05). Preoperative AL and LRD are positively while RLP is negatively correlated with change in LRD. Change in AL but not in LT or LP is correlated with change in LRD. Biometric measurements except LT between preoperative and postoperative were in close agreement.

Conclusion
The underestimation of AL and anterior shifting of lens in phakic, macula-off eyes with RRD after vitrectomy with silicone oil tamponade.