bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multifocal Papillary Thyroid Carcinoma，Hashimoto's Thyroiditis and Lymph Node Metastasis：A Retrospective Cohort Study
Authors: Wang Denghui , Zhu Jiang , Deng Chang , Yang Zhixin , Hu Daixing , Shu Xiujie , Yu Ping , Su Xinliang 
Published: February 2021

Abstract
Objective: Few studies have evaluated the influence of HT and Multifocality on central lymph node metastases(CLNM) and lateral lymph node metastases(LLNM) of PTC. The present study focused on risk factors for lymph node metastasis in PTC according to the presence of HT or multifocality. Materials and methods:1413 patients were identified.The relationship between HT or multifocality and lymph nodemetastasis was analyzed by univariate and multivariate logistic regression, ROC curves were constructed to show the predictive effect of each variable on the target outcome.Results: The PTCs with HT were more likely to be multifocal.(40.0% versus 17.5%,P ＜0.001). Compared to MPTC without HT, MPTC with HT showed a lower number of metastatic CLNs and LLNs (P < 0.05). HT was identifified as an independent protective factor for CLNM in all PTC patients (OR, 0.480; 95% CI, 0.359-0.643; P< .001) and in MPTC patients (OR, 0.094; 95% CI, 0.044-0.204; P < 0.001), the multicocality was independent risk factors for CLNM(OR, 2.316; 95% CI, 1.667-3.217; P< 0.001) and LLNM(OR, 2.004; 95% CI, 1.469-2.733; P< 0.001).The variables concluded HT or MPTC were screened to predict CLNM in all patients, CLNM in patients with MPTC and LLNM in all patients (AUCs: 0.731, 0.843 and 0.696, respectively, P < 0.0001). The two type of diseases existed concurrently may result in the decrease of CLNM and LLNM, AUCs of ROC to predict CLNM and LLNM are 0.696 and 0.63(P<0.0001). Conclusions: Our study identified multifocality as an independent risk factor predicting CLNM and LLNM in PTC patients. HT was proven to be a protective factor that reduced the CLNM risk in all patients and in patients with MPTC. The existence of both type of diseases can result in the reduction of CLNM and LLNM.
Environmental Protection and Energy Efficiency Improvement by using Marine Alternative fuels in Maritime Transportation
Authors: Elkafas Ahmed Gamal , Khalil Mohamed , Shouman Mohamed R. , Elgohary Mohamed M. 
Published: February 2021

Abstract
Emissions from vessels are a major environmental concern because of their impacts on the deterioration of the environment, especially global warming of the atmosphere. Therefore, the International Maritime Organization (IMO) concern significant care to environmental protection through the reduction of exhaust emission and improvement of energy efficiency through technical and operational measures. Among the suggested measures from IMO, the alternative fuel such as Liquefied Natural Gas (LNG) has the priority to be used instead of fossil fuels. The present paper calculates the effect of using LNG in a dual fuel engine from Environmental and Energy efficiency perspectives. As a case study, a Container Ship has been investigated. The results of the analysis show that percent of CO2, NOx and SOx emissions reduction corresponding to using a dual-fuel engine operating by LNG instead of a diesel engine operating by Heavy Fuel Oil is about 30.1%,81.44%, and 96.94%, respectively. Also, the attained Energy Efficiency Index Value in the case of using the dual-fuel engine is lower than its value by using diesel engine by about 30% and this value will be 77.18%, 86.84%, and 99.27% of the required value of the first, second and third phases, respectively as recommended by IMO.
Heparin Induced Thrombocytopenia in Patients with COVID-19
Authors: Warrior Surbhi , Behrens Elizabeth , Gezer Sefer , Venugopal Parameswaran , Jain Shivi 
Published: February 2021

Abstract
Background
Acute respiratory and renal failure as well as systemic coagulopathy are critical aspects of the morbidity and mortality in patients with COVID-19. Heparin Induced Thrombocytopenia (HIT) occurs when IgG antibodies form against platelet factor 4-Heparin complex, resulting in platelet activation and removal, leading to a prothrombotic state. Studies have shown that only 6% who are investigated serologically for HIT actually have the diagnosis.
Methods
A retrospective analysis was performed on all COVID-19 positive patients hospitalized between March and June 2020. Patients with suspicion for HIT were tested for HIT antibodies with IgG-specific platelet factor 4(PF4)-dependent enzyme immunoassay (EIA). Confirmatory testing with serotonin release assay (SRA) and heparin-induced platelet aggregation were used in cases with intermediate or low optical density (OD) with EIA positivity (EIA+). Due to rarity of disease, a through literature review on HIT in COVID-19 patients was also analyzed.
Results
Incidence of EIA + in COVID-19 patients was 0.6%, significantly higher than in the general population 0.2% (p < 0.0001). The incidence of thromboembolic events in EIA + patients was 87.5%, significantly higher than the rate of 10.90% in all COVID-19 patients (p < 0.0001). The mortality rate in EIA + patients was 50%, significantly greater than the mortality rate of 12% in all hospitalized COVID-19 patients (p = 0.0011). Serological confirmation of HIT diagnosis was 37.5% which is significantly higher than confirmation of HIT in nonCOVID-19 patients 6% (p < 0.0001). Of 39 HIT antibody positive patients in the literature, 23.07% had positive confirmatory testing (6 SRA, 3 HIPAA) which is significantly higher than 5.6% in the general population (p = 0.00001). The incidence of thrombosis in EIA + COVID-19 patients in the literature was 56.4% which is significantly higher than reported rates of thrombotic events in in all COVID-19 patients in the literature at 4.8%1 (p = 0.00001).
Conclusion
Our study indicates incidence of HIT is higher in the COVID-19 population. This can be attributed to the cytokine storm and severe sepsis seen in critically ill COVID-19 patients. Our study also suggests that development of HIT can contribute to increased risk for thromboembolic events as well as mortality of COVID-19 patients, however, our study is limited due to small sample size.
Transvaginal Natural Orifice Transluminal Endoscopic Surgery for Uterosacral Ligament Suspension: a Pilot Study of 35 Caseswith Severe Pelvic Organ Prolapse
Authors: Lu Zhiying , Chen Yisong , Wang Xiaojuan , Li Junwei , Hua Keqin , Hu Changdong 
Published: February 2021

Abstract
Background To describe the short-term outcomes of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) for uterosacral ligament suspension (USLS) in patients with severe prolapse.Methods This is a retrospective study conducted for patients with severe prolapsed (≥stage 3) who underwent vNOTES USLS between May 2019 and July 2020. The Pelvic Organ Prolapse Quantification (POP-Q) score, Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire short form (PISQ-12) and Pelvic Floor Inventory-20 (PFDI-20) were used to evaluate physical prolapse and quality of life before and after vNOTES USLS.Results A total of 35 patients were included. The mean operative time was 111.7±39.4 minutes. The mean blood loss was 67.9±35.8 ml. Statistically significant differences were observed before and after vNOTES USLS in regard to Aa (+0.6±1.7 versus −2.9±0.2), Ba (+1.9±2.2 versus −2.9±0.3), C (+1.5±2.2 versus -6.9±0.9), Ap (-1.4±1.0 versus −3.0±0.1) and Bp (-1.1±1.4 versus −2.9±0.1) (P < 0.05 for all). The mean pre- and post-operative PFDI-20 score was 19.9±6.7 versus 3.2±5.4, and the PISQ-12 score was 24.8±2.3 versus 38.3±4.1 (P < 0.05 for both). During 1–13 months of follow-up, no severe complications or recurrence.Conclusions vNOTES USLS may be a feasible technique to manage severe prolapse, with promising short-term efficacy and safety data. However, a study with a larger number of patients and a longer follow-up period should be conducted.
A retrospective Cohort Study to Predict Acute Kidney Injury Based on the Coagulation and Inflammation in ICU Patients with Sepsis
Authors: Lai Kunmei , Zou Zhenhuan , Xiao Xiongjian , Xu Yueteng , Zhang Chen , Chen Caiming , Wang Yujia , Li Yinshuang , Lin Jiandong , Xu Yanfang 
Published: February 2021

Abstract
Background. Sepsis is a major cause of morbidity and mortality worldwide. Sepsis with acute kidney injury (AKI) is associated with higher mortality risk when compared with those with sepsis and without AKI. Therefore, it is necessary to detect the predictors of sepsis-associated acute kidney injury (SA-AKI) in order to timely prevent, diagnose and treat this complication. Methods. From July 2016 to December 2019, 419 patients with sepsis admitted to the intensive care unit (ICU) were randomly divided into two groups: training group (n= 302) and validation group (n = 117). A least absolute shrinkage and selection operator (LASSO) regression was constructed to select variables within 24 h of admission, and then were included in a logistic regression model to find the independent risk factors of AKI. Hence, a nomogram for predicting SA-AKI with statistically significant covariates was constructed. Discrimination, calibration, and clinical utility of the nomogram performance were assessed and then validated.Results. The risk factors yielded by logistic regression were hypertension(HT), diabetes mellitus(DM), C-reactive protein(CRP), procalcitonin(PCT), activated partial thromboplastin time(APTT), platelet(PLT), and then were incorporated into the nomogram. The areas under the ROC curve of the nomogram in the training and validation groups were 0.856 and 0.885, respectively. The calibration curves demonstrated favorable consistency between the predictions of nomogram and the actual observations in both training as well as validation groups. Decision curve analysis (DCA) showed clinical usefulness of the proposed nomogram model.Conclusions. A risk prediction model by integrating variables can assist in identifying patients who are at high risk of developing SA-AKI. The nomogram had excellent predictive ability and might have significant clinical implications for early detection of AKI in patients undergoing sepsis.
Effects of Peritoneal Dialysis on QT Interval in ESRD Patients
Authors: Zhang Wenjing , Liang Yu , Lv Jia , Li Yan , Sun Jiping 
Published: February 2021

Abstract
Background: Patients with chronic kidney disease (CKD) had a high risk of fatal arrhythmias. The extended corrected QT (QTc) interval is a hallmark of ventricular arrhythmias and sudden cardiac death. Studies have shown that QT interval and QTc were prolonged with the declination in renal function. Notably, QTc prolongation is significantly increased in patients undergoing hemodialysis. However, there were no results available in patients with peritoneal dialysis (PD). This study aimed to report the changes in QT interval and QTc in PD patients.Methods: A total of 66 PD patients were enrolled. The duration of follow-up was 1 year. The demographics, and the etiology of patients were recorded. QTc of ECG and clinical biochemical indexes before dialysis and at 6 months after PD and 1year after PD were determined and analyzed. Dialysis adequacy and peritoneal transport function were assessed in each patient.Results: (1) A total of 66 PD incident patients, including 50 males and 16 females, with an average age of 43.56±15.15 years (males: 43.74±15.53 years; females: 43.00 ± 15.92 years) were enrolled. In terms of etiology, 37 patients (56.06%) had chronic nephritis, followed by diabetic nephropathy in 11 patients (16.67%), IgA nephropathy with 8 patients (12.12%). The peritoneal transport test showed that the most of the peritoneal transport function was low average transport( 25, 37.88%), the least was high transport(2, 3.03%).(2) During the follow-up period, all patients reached the standard of PD. Compared with baseline before dialysis, anemia, low albumin, blood pressure, blood urea nitrogen, creatinine, uric acid, potassium, calcium, phosphorus and parathyroid hormone were improved after PD at 6 months and 1year. The residual renal function was gradually decreases during the follow-up. There were no significant differences in clinical indexes between 6 months and 1 year after PD.(3) The mean QTc of all patients were stable during 1-year follow-up period (pre-PD: 413.49±29.95ms; 6 months: 423.05±51.96ms; 1 year: 409.29±32.32ms, P>0.05). According to gender, the QTc in male patients and in female patients had the same results (P>0.05, respectively).(4) Before PD, diastolic blood pressure (r=-0.261,P=0.039), calcium concentration (r=-0.360,P=0.004) and hemoglobin level (r=-0.432,P=0.000) were found to be the risk factors of QTc prolongation. They were negatively correlated with QTc in end-stage renal disease patients. After patients starting PD, the observed clinical indicators showed no relevance to QTc anymore.Conclusion: Different from hemodialysis induced QTc prolongation, PD did not increase the patient's QT interval and QTc interval. This phenomenon was reported for the first time, suggesting that myocardial electrical activity might be more stable in PD patients.
Efficacy of Tripterygium Glycosides for Diabetic Nephropathy: A Meta-Analysis of Randomized Controlled Trials
Authors: Guo Huabin Guo Huabin , Guo Hua-Bin , Peng Jia-Qing , Zhang Ke-Kai , Zhong Guang-Zhi , Chen Wei-Hong , Shi Gui-Xin 
Published: February 2021

Abstract
Backgrounds: Diabetic nephropathy (DN) is one of the most important clinical complications of diabetes mellitus (DM) and is the most common cause of end-stage renal disease. Currently, there is no highly effective medicine that can prevent, halt, or reverse the progressive course of DN. Initial clinical data showed that Tripterygium glycosides (TGs), a traditional Chinese medicine, can decrease proteinuria in patients with DN.Objectives: The objective of the present study is to investigate the efficacy and safety of TGs for the treatment of DN by meta-analysis of randomized controlled trials (RCTs). Methods: All RCTs of TGs for DN were collected from The China National Knowledge Infrastructure (CNKI), Web of Science, Wanfang Data, Chinese Biomedical Literature Database (CBM), China Science and Technology Journal Database (VIP ) by setting the study inclusion and elimination standards. Two reviewers evaluated the quality of the trials and extracted the data independently. RevMan 5.4 software was used for meta-analyses. The primary outcome was a change in 24-hours urinary total protein (24h TUP). Results: 26 RCTs with 1824 participants were collected for detailed evaluation. The meta-analysis results indicated that TGs was compared with the controls, TGs showed signiﬁcant effects in reducing 24h TUP [WMD = -0.84, 95%CI (-1.09, -0.59)], elevating serum albumin [WMD = 2.88, 95% CI (1.87, 3.90)], and the total efﬁciency [OR =4.08, 95% CI (2.37, 7.04)]. This effect was consistent across the subgroups of period of intervention. Conclusions: The present research showed that TGs was significantly associated with improvement of renal function in patients with DN. TGs offers a novel way in treating DN, more high quality RCTs are needed for better understanding of the role of TGs in DN therapy.
In-plane Dynamic Crushing of a Novel Bio-inspired Re-entrant Honeycomb With Negative Poisson's Ratio&nbsp;
Authors: Wang Yonghui , He Qiang , Chen Yu , Gu Hang , Zhou Honggen 
Published: February 2021

Abstract
In order to seek higher crashworthiness and energy absorption capacity, based on biological inspiration, a novel bio-inspired re-entrant honeycomb (BRH) structure with negative Poisson's ratio is designed by selecting lotus leaf vein as biological prototype. The numerical simulation model is established by the nonlinear dynamics software ABAQUS and further compared with the available reference results to verify the feasibility. The dynamic compression behavior and energy absorption capacity of two types of BRH (BRH-Ⅰ and BRH-Ⅱ) are firstly compared with conventional re-entrant honeycomb (RH). The simulation results show that BRH have better mechanical properties and energy absorption characteristics. Then, the crushing behavior of BRH-Ⅱ under different impact velocities are systematically studied. Three typical deformation modes of BRH-Ⅱ are observed through the analysis of deformation profile. The quasi-static plateau stress is closely related to the cellular structure. Based on one-dimensional shock theory, the empirical equations of dynamic plateau stress for BRH-Ⅱ with different relative densities are given by using least-square fitting. In addition, the effects of impact velocity and relative density on plateau stress and energy absorption behavior are also studied. The results show that the energy absorption capacity of BRH-Ⅱ is increased nearly six times compared with RH at the same impact velocity.
DC Electrical Resistivity and Magnetic Properties of Co Substituted NiCuZn&nbsp;Nano Ferrite
Authors: Jayadev Kanta , Raju M. K. , MURALI N , D Parajuli , Samatha K. 
Published: February 2021

Abstract
Co substituted Ni0.3-xCoxCu25Zn0.45Fe2O4 (x = 0, 0.05, 0.1, 0.15 and 0.2) samples is synthesized using the sol-gel auto-combustion process. X-ray diffraction shows its cubic spinel structure. The lattice constant decreases as the Co content increases. The sizes of the crystallites are in the range of 20.18–26.24 nm. The wavenumbers of tetrahedral and octahedral sites sighted in the FTIR spectra are similar to that of the precursor. The increment on the Co content increases the DC conductivity. The electrical resistivity decrease with increase in the temperature, i.e. it has a negative temperature coefficient with resistance similar to semiconductors. The remnant ratios R obtained from VSM show their isotropic nature forming single domain ferrimagnetic particles. The resultant material is widely significant, as indicated by its result.
Effects of Unhealthy Lifestyle Factors on Healthcare-seeking Behavior in China
Authors: Li Changle , Sun Jing 
Published: February 2021

Abstract
Background: People with unhealthy lifestyles may experience omitted or delayed healthcare, leading to severe sickness and higher healthcare expenditures in the future. Hence, the current study aims to ascertain the effects of current smoking, regular drinking, and physical inactivity on healthcare-seeking behavior among the sick in China.Methods: The data used in this study was obtained from the China Family Panel Studies (CFPS). The final sample consisted of 44,362 individuals in all five waves of data collection. Logistic regression models were used for the analysis.Results: Based on the tests, the fixed effects estimation was the preferred method for panel data in this study. The current study found that sick adults who currently smoked cigarettes were 0.73 times less likely to seek healthcare than those who never smoked or stopped smoking. Compared to non-drinkers, sick adults who regularly drank alcohol decreased the likelihood of seeking healthcare. Sick adults who never participated in physical exercise decreased the odds of seeking healthcare by 24% compared to those who participated in physical exercise. Conclusions: Current smoking, regular drinking, and physical inactivity decreased the probability of seeking healthcare among sick adults. Therefore, screening and brief advice programs should be delivered by primary level care and pay more attention to those who have unhealthy lifestyles, reducing the burden of diseases.
Current status and future of delivery systems for prevention and treatment of infections in the oral cavity
Authors: Şenel Sevda , Özdoğan Ayben Işılay , Akca Gülçin 
Published: February 2021

Abstract
Oral health reflects the general health and it is fundamental to well-being and quality of life. An infection in the oral cavity can be associated with serious complications in human health. Local therapy of these infections offers many advantages over systemic drug administration, targeting directly to the diseased area while minimizing systemic side effects. Specialized drug delivery systems into the oral cavity have to be designed in such a fashion that they resist to the aqueous environment that is constantly bathed in saliva and subject to mechanical forces. Additionally, a prolonged release of drug should also be provided, which would enhance the efficacy and also decrease the repeated dosing. This review is aimed to summarize the current most relevant findings related to local drug delivery of various drug groups for prevention and treatment of infections (viral, bacterial, fungal) and infection related manifestations in the oral cavity. Current therapeutic challenges in regard to effective local drug delivery systems will be discussed and the recent approaches to overcome these obstacles will be reviewed. Finally, future prospects will be overviewed to promote novel strategies that can be implemented in clinical management for prevention and treatment of oral infections.
Nontuberculous Mycobacteria in China-incidence and Antimicrobial Resistance Spectrum From a Nationwide Survey
Authors: Liu Chunfa , Song Yimeng , He Wencong , Liu Dongxin , He Ping , Bao Jingjing , Wang Xinyang , Li Yanming , Zhao Yanlin 
Published: February 2021

Abstract
Background: Information on prevalence and resistance spectrum of nontuberculous mycobacteria (NTM) in China is mainly based on regional or local data. A national survey of NTM pulmonary disease was carried out based on acid-fast positive sputum samples collected in 2013.Methods: Sputum samples collected from enrolled presumptive cases were cultured using L-J medium in 72 nationwide tuberculosis surveillance sites from the 31 Chinese mainland provinces and isolates were sent to national tuberculosis reference laboratory (NTRL). The species of re-cultured strains were identified by MALDI-TOF MS and minimal inhibitory concentrations (MICs) were determined to evaluate the drug susceptibility of NTM isolates.Results: Of 4917 mycobacterial isolates cultured, 317 (6.4%, 95% CI, 5.8% to 7.2%) were confirmed as NTM, among which 287 (7.7%, 95% CI, 6.9% to 8.6%) were from the southern region. In inland and coastal China, 87.7% (95% CI, 78.7% to 93.2%) and 50.0% (95% CI, 43.7% to 56.3%) of isolates, respectively, were slow growing mycobacteria (SGM), with the remaining rapid growing mycobacteria (RGM). A total of 29 species were detected, M. abscessus had higher clarithromycin-inducible resistance rates than M. massiliense (65.67% vs 2.22%). M. kansasii was present lower resistance rates in linezolid and moxifloxacin than Mycobacterium avium-intracellulare complex and other SGM.Conclusions: More NTM pulmonary disease was observed in southern and coastal China (p<0.01). SGM was widely distributed, and more RGM are present in southern and coastal China (p<0.01). The antimicrobial resistance spectrum of different NTM species was significant different, accurate species identification would be facilitated to NTM pulmonary disease treatment.