bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative pathologic analysis of mediastinal B-cell lymphomas: selective expression of p63 but no GATA3 optimally differentiates primary mediastinal large B-cell lymphoma from classic Hodgkin lymphoma
Authors: Kim Hyun-Jung , Kim Hee Kyung , Park Gyeongsin , Min Soo Kee , Cha Hee Jeong , Lee Hyekyung , Choi Suk Jin , Na Hee Young , Choe Ji-Young , Kim Ji Eun 
Published: December 2019

Abstract
Background
Interpretation of mediastinal biopsy is often challenging even for experienced pathologists especially when a hematolymphoid neoplasm is suspected. Primary mediastinal large B-cell lymphoma (PMLBCL) and classic Hodgkin lymphoma (CHL) represent two major types of mature B-cell lymphomas of the mediastinum. Although PMLBCL and mediastinal CHL share many clinicopathologic characteristics, their treatment strategies and responses are remarkably different. We therefore aimed to find distinctive histologic or protein markers to better differentiate these two lesions.

Methods
Search for primary mediastinal B-cell lymphomas found 52 consecutive cases from 3 university hospitals of Korea during 2005 to 2012. Among them, 32 cases that were available for additional immunohistochemistry (IHC) assessment were enrolled in this study. These cases consisted of the following: CHL (N = 13), PMLBCL (N = 16), and B-cell lymphoma unclassifiable, with features intermediate between diffuse large B-cell lymphoma and CHL (gray zone lymphoma, N = 3). Along with the clinicopathologic findings, the expression of p63, GATA3 and cyclin E was investigated by IHC in the three categorized lesions mentioned above.

Results
Most clinical features overlapped between PMLBCL and CHL except for the increased disease progression and mortality found in PMLBCL. In the pathologic review, the presence of epithelioid granuloma favored a diagnosis of CHL, whereas reticulated or alveolar patterns of fibrosis were characteristic of PMLBCL. For protein markers, p63 was predominantly positive in PMLBCL (15/16) compared with CHL (2/13), which indicates that p63 is a marker of the highest diagnostic accuracy when calculated by the area under the ROC curve. GATA3 was expressed in the majority of CHL cases (10/13) compared with PMLBCL (0/16), while the expression of cyclin E was only rarely present in a minor population of PMLBCL.

Conclusions
P63 expression in tumor cells, even focal expression, and no GATA3 is the most helpful feature in distinguishing PMLBCL from mediastinal CHL.
Changes in traditional ecological knowledge of forage plants in immigrant villages of Ningxia, China
Authors: Ma Ying , Luo Binsheng , Zhu Qiang , Ma Dongxing , Wen Qi , Feng Jinchao , Xue Dayuan 
Published: December 2019

Abstract
Background
Ecological migration serves as an important measure for poverty eradication as well as for the protection, inheritance, and utilization of traditional ecological knowledge. This study investigated and cataloged the traditional forage plant resources and recorded the associated traditional knowledge of immigrant villages in Hongsibu District of Ningxia, China. The diversity of traditional forage plant resources and the changes in associated traditional ecological knowledge were compared among ecological immigrant villages from different emigration areas, with a hope of providing a reference for forage development, the conservation of wild forage plant resources, and the development of regional animal husbandry.

Methods
From March 2018 to May 2019, a field investigation was conducted in six villages in Ningxia. Through the snowball technique, a total of 315 immigrants were interviewed using various methods, including semistructured interviews and key person interviews, which included opportunities for free listing. The changes in the utilization of traditional forage plants were compared between the ecological migrants and the original inhabitants, and the causes underlying the changes were analyzed. In addition, the major forage plant species in the research area were investigated and evaluated.

Results
(1) The six investigated villages reported 224 traditional forage plant species that belong to 42 families and 150 genera. Compared with their original living areas, the number of traditional forage plant species used in the immigrant villages decreased with the increase in the relocation distance. (2) The utilization of traditional forage plants varied among the immigrants who moved to Hongsibu District from forest areas, loess hilly areas, and semiarid desertified areas. The smaller the difference was in ecological environment between the immigration and emigration areas, the more the traditional forage plant knowledge had been retained. (3) The diversity and associated knowledge of traditional forage plants retained by ecological migrants are closely correlated to gender, age, education level, and occupation.

Conclusion
This study revealed that the diversity of traditional forage plants and associated knowledge retained after migration vary among ecological immigrants from different areas; generally, the immigrants that relocated from a closer place retained more ecological knowledge. In the immigrant villages with significantly different natural resources and a long distance from the migrants’ original locations, the diversity of traditional forage plants decreased, and the traditional knowledge about forage plants showed signs of being forgotten and abandoned by the younger generation. Therefore, measures are urgently needed to document and protect the forage plant resources and preserve the traditional knowledge of ecological immigrants.
Opioid use disorder in Germany: healthcare costs of patients in opioid maintenance treatment
Authors: Reimer Jens , Vogelmann Tobias , Trümper Daniel , Scherbaum Norbert 
Published: December 2019

AbstractBackgroundOpioid Use Disorder (OUD) is a substance use disorder with a chronic course associated with comorbid mental and somatic disorders, a high burden of psychosocial problems and opioid maintenance treatment (OMT) as a standard treatment. In the US, OUD imposes a significant economic burden on society, with annual societal costs estimated at over 55 billion dollars. Surprisingly, in Europe and especially in Germany, there is currently no detailed information on the healthcare costs of patients with OUD. The goal of the present research is to gather cost information about OUD patients in OMT with a focus on maintenance medication and relapses.MethodsWe analysed health claims data of four million persons covered by statutory health insurance in Germany, applying a cost-of-illness approach and aimed at examining the direct costs of OMT patients in Germany. Patients with an ICD-10 code F11.2 and at least one claim of an OMT medication were stratified into the treatment groups buprenorphine, methadone or levomethadone, based on the first prescription in each of the follow-up years. Costs were stratified for years with and without relapses. Group comparisons were performed with ANOVA.ResultsWe analysed 3165 patient years, the total annual sickness funds costs were on average 7470 € per year and patient. Comparing costs of levomethadone (8400 €, SD: 11,080 €), methadone (7090 €, SD: 10,900 €) and buprenorphine (6670 €, SD: 7430 €) revealed significant lower costs of buprenorphine compared to levomethadone (p < 0.0001). In years with relapses, costs were higher than in years without relapses (8178 € vs 7409 €; SD: 11,622, resp. 10,378 €). In years with relapses, hospital costs were the major cost driver.ConclusionsThe present study shows the costs of OUD patients in OMT for the first time with a German dataset. Healthcare costs for patients with an OUD in OMT are associated with more than two times the cost of an average German patients. Preventing relapses might have significant impact on costs. Patients in different OMT were dissimilar which may have affected the cost differences.
New hemostatic device for grade IV–V liver injury in porcine model: a proof of concept
Authors: Segura-Sampedro Juan José , Pineño-Flores Cristina , Craus-Miguel Andrea , Morales-Soriano Rafael , González-Argente Francesc Xavier 
Published: December 2019

Abstract
Background
The liver is the most injured organ following abdominal trauma. Uncontrolled bleeding remains the main cause of early liver injury-related death, with a mortality rate of 50–54% in the first 24 h after admission and with 80% of operative deaths. Packing and reoperation account for the increased survival in severe liver trauma, and they are recommended for severe liver injuries (grades IV–V).
Perihepatic packing can lead to several potential complications. An excessive packing can cause complications due to abdominal compartment syndrome, while a soft packing may be ineffective, and thus, bleeding can continue inadvertently with the consequent hypovolemic shock and potentially death.

Methods
We designed a new vacuum-based device to perform perihepatic packing without the negative side-effects of the classic technique. We conducted a prospective pilot feasibility study in a porcine model. We compared the traditional perihepatic packing (PHP) (n = 2) with the new VacBagPack device (VBP) (n = 2).

Results
Both pigs survived with the new device and showed an equivalent outcome to the one that survived in the traditional technique group. Blood tests were similar too. This suggests that VBP could be at least as effective as traditional PHP.

Conclusions
We establish a first step towards the development of a new packing device. A new study with a bigger sample size still in pigs will be conducted. Also, an industrial model of the device is currently in production.
Primary total hip arthroplasty using an uncemented Wagner SL stem in elderly patients with Dorr type C femoral bone
Authors: Zhen Ping , Liu Jun , Li Xusheng , Lu Hao , Zhou Shenghu 
Published: December 2019

AbstractBackgroundThe purpose of this study was to review retrospectively the primary total hip arthroplasties operated upon with the cementless Wagner Self-Locking stem in patients with type C femoral bone.MethodsTwenty-eight total hip arthroplasties were performed in 25 patients aged ≥ 60 years using a cementless Wagner Self-Locking femoral component between 2006 and 2011. According to Dorr’s criteria, all 28 femora were classified as type C bone. All patients were treated with THA using a cementless Wagner cone prosthesis. Clinical and radiologic evaluations were performed on all patients.ResultsMean follow-up period was 125 ± 10.5 months (range 96 to 156 months). Average Harris hip score pre-operatively was 46 ± 9 (range 39 to 62) and at the last follow-up was 90 ± 9 (range 83 to 98). The stem to canal fill is calculated as percentages on the operative side at three distinct levels: just below the lesser trochanter, at midstem, and 1 cm above the tip of the component on anteroposterior radiograph. The mean proximal stem-to-canal fill percentages were 97% ± 2.1%, 95% ± 3.5%, and 88% ± 2.6%, respectively (anteroposterior view) and 92% ± 2.2%, 86% ± 1.9%, and 83% ± 2.5%, respectively (lateral view). Radiographic evaluation demonstrated good osteointegration of the implants in the follow-up.ConclusionsBased on the long-straight cylindrical tapered stem design, the cementless Wagner SL stem can achieve reliable stability by close apposition of the stem and wide stovepipe femoral canal from metaphysis to diaphysis in type C bone.
Design and evaluation of nano-hydroxyapatite/poly(vinyl alcohol) hydrogels coated with poly(lactic-co-glycolic acid)/nano-hydroxyapatite/poly(vinyl alcohol) scaffolds for cartilage repair
Authors: Su Weiping , Hu Yihe , Zeng Min , Li Mingqing , Lin Shaoru , Zhou Yangying , Xie Jie 
Published: December 2019

Abstract
Background
Poly(vinyl alcohol) (PVA) hydrogels have been widely used in synthetic cartilage materials. However, limitations of PVA hydrogels such as poor biomechanics and limited cell ingrowth remain challenges in this field.

Methods
This work aimed to design novel nano-hydroxyapatite (nano-HA)/poly(vinyl alcohol) (PVA) hydrogels coated with a poly(lactic-co-glycolic acid) (PLGA)/nano-HA/PVA scaffold to counter the limitations of PVA hydrogels. The core, comprising nano-HA/PVA hydrogel, had the primary role of bearing the mechanical load. The peripheral structure, composed of PLGA/nano-HA/PVA, was designed to favor interaction with surrounding cartilage.

Results
The double-layer HA/PVA hydrogel coated with PLGA/HA/PVA scaffold was successfully prepared using a two-step molding method, and the mechanical properties and biocompatibility were characterized. The mechanical properties of the novel PLGA/HA/PVA scaffold modified HA/PVA hydrogel were similar to those of native cartilage and showed greater sensitivity to compressive stress than to tensile stress. Rabbit chondrocytes were seeded in the composites to assess the biocompatibility and practicability in vitro. The results showed that the peripheral component comprising 30 wt% PLGA/5 wt% HA/15 wt% PVA was most conducive to rabbit chondrocyte adhesion and proliferation.

Conclusions
The study indicated that the double-layer HA/PVA hydrogel coated with PLGA/HA/PVA scaffold has the potential for cartilage repair.
Correlation analysis between the pulmonary function test and the radiological parameters of the main right thoracic curve in adolescent idiopathic scoliosis
Authors: Wang Yonggang , Yang Fengguang , Wang Dongmin , Zhao Haiyan , Ma Zhanjun , Ma Peifen , Hu Xuchang , Wang Shixiong , Kang Xuewen , Gao Bingren 
Published: December 2019

Abstract
Background
Scoliosis causes thoracic deformities, and it is necessary to assess these changes in pulmonary function test (PFT). To determine how measurements of spinal and thoracic cage deformities are related to pulmonary function.

Methods
Seventy-two patients with main right thoracic curvature in adolescent idiopathic scoliosis (AIS) underwent a PFT and a radiological parameter evaluation of spinal and thoracic cage deformities. Simple and multiple linear regressions were also used to note whether a combination of variables might better predict PFT values. Means were compared using the two-sample t test or one-way ANOVA with Tukey’s multiple comparison methods.

Results
Forced vital capacity (FVC)% predicted had significantly negative correlations with main thoracic curve Cobb (MT-Cobb) (R2 = 0.648, p < 0.001), main thoracic curve-rib hump (MT-RH) (R2 = 0.522, p < 0.001), main thoracic curve apical vertebral body-to-rib ratio (MT-AVB-R) (R2 = 0.536, p < 0.001), and main thoracic curve apical vertebra translation (MT-AVT) (R2 = 0.383, p < 0.001). Multiple regression analysis was performed with FVC% predicted as the dependent variable and MT-Cobb, MT-RH, MT-AVB-R, and MT-AVT as the independent variables. MT-Cobb, MT-RH, MT-AVB-R, and MT-AVT were factors with a significant effect on FVC% predicted (p < 0.001). For 45 patients who had preoperative FVC impairment (FVC% predicted < 80%), their MT-Cobb averaged 76.71°. Twenty-seven patients with normal preoperative FVC (FVC% predicted ≥ 80%) had a smaller mean MT-Cobb of 52.03° (p < 0.001). In other radiological parameters, the impaired FVC group had a MT-AVT of 54.29 mm compared to 38.06 mm for the normal FVC group (p < 0.001). MT-AVB-R averaged 2.92 for the impaired FVC group and 1.78 for the normal FVC group (p < 0.001). MT-RH averaged 28.79 mm for the impaired group and 16.62 mm for the normal group (p < 0.001). Further stratification of preoperative PFT results is divided into three groups. The three groups also showed significant differences in MT-Cobb, MT-RH, MT-AVB-R, and MT-AVT (p < 0.001).

Conclusion
Severe scoliosis leads to an increased degree of thoracic deformity, which increases the risk of lung damage in AIS. Moreover, a more accurate assessment of pulmonary function is achieved through radiological parameters and PFTs.
How can forest management increase biomass accumulation and CO2 sequestration? A case study on beech forests in Hesse, Germany
Authors: Krug Joachim H. A. 
Published: December 2019

Abstract
Background
While the capability of forests to sequester carbon dioxide (CO2) is acknowledged as an important component in fighting climate change, a closer look reveals the difficulties in determining the actual contribution by forest management when indirect and natural impacts are to be factored out. The goal of this study is to determine the direct human-induced impacts on forest growth by cumulative biomass growth and resulting structural changes, exemplified for a dominating forest species Fagus sylvatica L. in central Europe. In 1988, forest reserves with directly adjacent forest management areas (under business as usual management) were established in the federal state of Hesse, Germany. Thereof, 212 ha of forest reserve and 224 ha of management area were selected for this study. Biomass changes were recorded for a time span of 19 to 24 years by methods used in the National Inventory Report (NIR) and structural changes by standard approaches, as well as by a growth-dominance model.

Results
The results indicate a higher rate of cumulative biomass production in the investigated management areas and age classes. The cumulative biomass growth reveals a superior periodic biomass accumulation of about 16%. For beech alone, it is noted to be about 19% higher in management areas than in forest reserves. When harvests are not included, forest reserves provide about 40% more biomass than management areas. The analysis of growth-dominance structures indicates that forest management led to a situation where trees of all sizes contributed to biomass increment more proportionally; a related increase in productivity may be explained by potentially improved resource-use efficiency.

Conclusions
The results allow a conclusion on management-induced structural changes and their impact on carbon sequestration for Fagus sylvatica L., the dominating forest species in central Germany. This affirms a potential superiority of managed forests to forests where the management was abandoned in terms of biomass accumulation and reveal the impact and effect of the respective interventions. Especially the analysis of growth-dominance structures indicates that forest management resulted in more balanced dominance structures, and these in higher individual biomass increment. Forest management obviously led to a situation where trees of all sizes contributed to biomass increment more proportionally.
Oral health-related quality of life in Loeys-Dietz syndrome, a rare connective tissue disorder: an observational cohort study
Authors: Nguyen Quynh C. , Duverger Olivier , Mishra Rashmi , Mitnik Gabriela Lopez , Jani Priyam , Frischmeyer-Guerrerio Pamela A. , Lee Janice S. 
Published: December 2019

Abstract
Background
Loeys-Dietz syndrome (LDS) is a rare connective tissue disorder whose oral manifestations and dental phenotypes have not been well-characterized. The aim of this study was to explore the influence of oral manifestations on oral health-related quality of life (OHRQoL) in LDS patients.

Material and methods
LDS subjects were assessed by the craniofacial team at the National Institutes of Health Clinical Center Dental Clinic between June 2015 and January 2018. Oral Health Impact Profile (OHIP-14) questionnaire, oral health self-care behavior questionnaire and a comprehensive dental examination were completed for each subject. OHRQoL was assessed using the OHIP-14 questionnaire with higher scores corresponding to worse OHRQoL. Regression models were used to determine the relationship between each oral manifestation and the OHIP-14 scores using a level of significance of p ≤ 0.05.

Results
A total of 33 LDS subjects (51.5% female) aged 3–57 years (19.6 ± 15.1 years) were included in the study. The OHIP-14 scores (n = 33) were significantly higher in LDS subjects (6.30 [SD 6.37]) when compared to unaffected family member subjects (1.50 [SD 2.28], p < 0.01), and higher than the previously reported scores of the general U.S. population (2.81 [SD 0.12]). Regarding oral health self-care behavior (n = 32), the majority of LDS subjects reported receiving regular dental care (81%) and maintaining good-to-excellent daily oral hygiene (75%). Using a crude regression model, worse OHRQoL was found to be associated with dental hypersensitivity (β = 5.24; p < 0.05), temporomandibular joints (TMJ) abnormalities (β = 5.92; p < 0.01), self-reported poor-to-fair oral health status (β = 6.77; p < 0.01), and cumulation of four or more oral manifestations (β = 7.23; p < 0.001). Finally, using a parsimonious model, self-reported poor-to-fair oral health status (β = 5.87; p < 0.01) and TMJ abnormalities (β = 4.95; p < 0.01) remained significant.

Conclusions
The dental hypersensitivity, TMJ abnormalities, self-reported poor-to-fair oral health status and cumulation of four-or-more oral manifestations had significant influence on worse OHRQoL. Specific dental treatment guidelines are necessary to ensure optimal quality of life in patients diagnosed with LDS.
Researching violence against women and girls in South Sudan: ethical and safety considerations and strategies
Authors: Contreras-Urbina Manuel , Blackwell Alexandra , Murphy Maureen , Ellsberg Mary 
Published: December 2019

AbstractBackgroundGlobally, it is estimated that at least one out of every three women experiences violence by an intimate partner and/or non-partner throughout their lifetime. Women and girls are at even higher risk of violence in conflict and humanitarian crises. Although effort has expanded to build rigorous evidence and research on violence against women and girls (VAWG) among conflict-affected populations, methodological and ethical challenges remain. Basic ethical research practices are more challenging in conflict-affected populations and therefore require supplementary protections. While it is important to follow international ethical guidelines, in practice it is sometimes difficult depending on the setting. The aim of this paper is to present the main ethical challenges that occur when conducting research on VAWG in conflict and humanitarian settings, as well as potential strategies to address these challenges, based on a recent study carried out in South Sudan in 2016.Case presentationThis paper provides an analysis utilizing the World Health Organization guidelines on doing research on VAWG and in conflict and humanitarian settings. The paper analyses four main components: the first component is a risk-benefit assessment, which includes identifying the research gap and evaluating feasibility with local stakeholders. The second component is a methodological and conceptual approach, which involves both local stakeholders and external experts in order to develop flexible methods that can be used in a volatile conflict setting. The third component is safety considerations, which emphasizes the importance of collaborating with a partner with strong local networks. The last component is analysis and research uptake. This component describes the importance of developing different research products, and disseminating them in a way to ensure they would be relevant and minimize any risks to the participants.ConclusionsThe study in South Sudan provided an excellent opportunity to put into practice the international ethical guidelines to carry out research on VAWG in conflict and humanitarian settings. The study enabled the research team to reflect on the guidelines and develop strategies to cope with new methodological and ethical challenges that arose in this complex setting, adapting the guidelines, as necessary. It demonstrated the necessity of developing a strong yet adaptable methodology with multiple alternative plans to solve any safety or ethical issues that occur throughout the entirety of the study. It also revealed the importance of collaborating with an implementing partner and gathering input from both local and international stakeholders on research design, analysis and uptake. Most importantly, the study in South Sudan emphasized that this type of complex research requires significant planning, in addition to substantial financial and human resources. Donor buy-in and flexibility is therefore essential.