bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Tourniquet During Total Knee Arthroplasty when Tranexamic Acid was used: A Meta-analysis of Randomized Controlled Trials
Authors: Sun Changjiao , Zhang Xiaofei , Ma Qi , Tu Yan , Cai Xu , Zhou Yonggang 
Published: November 2021

Abstract
Introduction：The efficacy of tourniquet use during primary total knee arthroplasty (TKA) is thought to reduce intraoperative blood loss, improve surgical exposure, and optimize cement fixation. Tranexamic acid（TXA）use can decrease postsurgical blood loss and transfusion requirements. This review aimed to appraise the effects of tourniquet use in TKA for patients with tranexamic acid use.Methods：A meta-analysis was conducted to identify relevant randomized controlled trials involving TXA plus a tourniquet（TXA-T group）and use of TXA plus no tourniquet（TXA-NT group） in TKA. Web of Science，PubMed, Embase，Cochrane Controlled Trials Register,、Cochrane Library、Highwire、CNKI, and Wanfang database were searched from 2010 through October 2021.Results: We identified 1720 TKAs (1690 patients) assessed in 14 randomized controlled trials. Compared with the TXA-NT group, the TXA-T group resulted in less intra-operative blood loss (P＜0.00001) and decreased duration of surgery (P＜0.00001), however more hidden blood loss(P=0.0004) and less knee range of motion (P＜0.00001). No significant differences were found between two groups in terms of decrease in hemoglobin (P=0.84), total blood loss (P=0.79), transfusion rate( P=0.18) ,drainage volume(P=0.06) , Visual Analogue Scale(VAS) at either the day of surgery (P=0.2)、1 day(P=0.25)、2 day(P=0.39)、3 day(P=0.21)、5 day(P=0.21)、7day (P=0.06)or 1 month after surgery(P=0.16), Hospital for Special Surgery (HSS) score at either 7 day （P=0.10)、 1month（P=0.08)、 3 month（P=0.22) or 6 month after the surgery（P=0.92), Knee circumference（P=0.28）,length of hospital(P=0.12), and complications such as intramuscular venous thrombosis(P=0.81), deep venous thrombosis(P=0.10), superficial infection(P=0.45), deep wound infection(P=0.64) and delayed wound healing(P=0.65).Conclusion: No big differences could be found by using or not tourniquet when use the TXA, though some benefits are related to operation time and less intra-operative blood loss by using tourniquet and TXA, Using the tourniquet was related to more hidden blood loss and less knee range of motion. More adequately powered and better-designed randomized controlled trials （RCTs）studies with long-term follow-up are required to validate this study.
First Description of a Multisystemic and Lethal SARS-CoV-2 Variant of Concern P.1 (Gamma) Infection in a FeLV-Positive Cat: New Concerns Regarding Viral Re-emergence and Adaption to Pets
Authors: Carneiro Rodrigo Lima , Farias Jessica Pires , Pinheiro Josilene Ramos , Farias Jackson , Vielmo Andre Carloto , Birbrair Alexander , Belmok Aline , Melo Fernando Lucas , Ribeiro Bergmann Moraes , Chaves Gepoliano , Vidal Paloma Oliveira , Luiz Wilson Barros , Amorim Jaime Henrique 
Published: November 2021

Abstract
Background: Coronaviruses are recognized for their ability to cross the species barrier and infect new hosts. The coronavirus disease 2019 (COVID-19) is caused by the new coronavirus SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2). It remains unclear whether other animals, including pets, are crucial in the spread and maintenance of COVID-19 worldwide. Methods: In this study, we analysed the first fatal case of a SARS-CoV-2 and FeLV (Feline leukemia virus) co-infection of an eight-year-old male cat. We carried out a clinical evaluation, pathological analysis, and viral genomic analysis. Results: As main results, we observed an animal presenting severe acute respiratory syndrome and lesions in several organs, which led to animal’s death. The causative agent was confirmed to be SARS-CoV-2, variant of concern P.1 (Gamma). The virus presented a pattern of mutations potentially associated with feline infection. In addition, the virus was detected by RT-qPCR in the spleen, liver, heart, lungs, trachea, intestines and kidneys, indicating a multisystemic viral infection. The virus was found in a high load in the trachea, suggesting a capacity of transmitting the virus. Conclusion: Our data show that felines, such as FeLV-positive cats, are susceptible to SARS-CoV-2 infection, and may be intermediate hosts in this pandemic.
WITHDRAWN: Implementing Health Related Social Needs Screening in an Outpatient Clinic: A Cross-Sectional Study
Authors: Nohria Raman , Xiao Nan , Guardado Rubeen , Drainoni Mari-Lynn , Smith Cara , Nokes Keith , Byhoff Elena 
Published: November 2021

Abstract
BackgroundTo date, health-related social needs (HRSN) screening implementation efforts have reported high rates of identified social needs. However, little is known about how screening processes may fail to leverage implementation strategies to optimize reach, and thereby unintentionally target non-representative groups for screening and referral programs. MethodsElectronic medical data were abstracted from 2016-2020 for 4,731 screened patients from 7 affiliated clinics of a federally-qualified health center (FQHC). Unscreened patients were pulled first as a random sample from the study period, then matched based on clinic site and clinic visit frequency. Sociodemographic traits, comorbid conditions, and outpatient encounter type and frequency were compared between the screened and unscreened patient cohorts using descriptive statistics.ResultsScreened patients (n-4731) had a median of 3.3 (+/- 2.5) unmet HRSN. Compared to a random sample of unscreened FQHC patients, screened patients had significantly more clinic visits (26.8 vs 16.3; p<0.05) and carried a higher comorbid disease burden (3+ conditions: 8% vs 2%; p<0.05). When the unscreened cohort was matched to the screened cohort for clinic site, these findings remained constant. Due to high visit frequency in the screened cohort, our analysis was matched for clinic visit frequency. Screened patients continued to demonstrate a higher comorbid disease burden (3+ conditions, 8% vs 3%; p<0.05), but only had a higher prevalence of 4 chronic conditions (diabetes, hypertension, chronic kidney disease, and anxiety/depression). ConclusionsWithout an a priori plan for implementation, we have found a predisposition to screen patients who visit outpatient services more often and have a higher comorbid disease burden. HRSN screening processes will benefit from implementation strategies to improve reach and to ensure maximal uptake of screening.
Forest Malaria and Prospects for Antimalarial Chemoprophylaxis Among Forest Goers: Findings From a Qualitative Study in Lao PDR
Authors: Jongdeepaisal Monnaphat , Inthasone Soulixay , Khonputsa Panarasri , Malaphone Vilayvone , Pongsoipetch Kulchada , Pongvongsa Tiengkham , Mayxay Mayfong , Chindavongsa Keobouphaphone , Pell Christopher , Maude Richard James 
Published: November 2021

Abstract
Background Despite significant decline in malarial incidence and mortality in countries across the Greater Mekong Subregion, the disease remains a public health challenge. Transmission continues mainly among people who visit forests in remote areas, often along international borders, where access to primary healthcare is limited. In the absence of effective vector-control measures and limited periods of exposure, malaria chemoprophylaxis has been proposed as a strategy to protect forest goers. As a rarely used approach for indigenous populations, questions remain about its feasibility and acceptability. Drawing on in-depth interviews with forest goers and stakeholders, this article examines opportunities and challenges for implementation of antimalarial chemoprophylaxis for forest goers in Lao PDR.Methods In-depth interviews were conducted with 16 forest goers and 15 stakeholders in Savannakhet province, Lao PDR. Interview topics included experience of malaria prevention and health services, and perceptions of prophylaxis as a potential component of malaria elimination strategy. The interviews were transcribed and coded using inductive and deductive approaches for qualitative thematic analysis.Results In ethnically and geographically diverse villages, awareness of malaria risk prompts forest goers to protect themselves, albeit suboptimality using available preventive measures. Stakeholders highlighted challenges for targeting at-risk populations and approaches to address forest malaria in southern Laos. Among policymakers, choice and cost of antimalarials, particularly their efficacy and source of funding, were key considerations for the feasibility of malaria prophylaxis. Acceptability of prophylaxis among forest goers was also influenced by the complexity of the regimen, including the number of tablets and timing of doses. Implementation of prophylaxis may be affected by a lack of transportation and communication barriers in remote communities. Conclusion Adding prophylaxis to existing malaria control activities requires strengthening the capacity of local health workers in Lao PDR. Ideally, this would be part of an integrated approach that includes strategies to address the other febrile illnesses that forest goers describe as priority health concerns. The prophylactic regimen also requires careful consideration in terms of effectiveness and simplicity of dosing.
Immortalization-Upregulated Protein Promotes Pancreatic Cancer Progression By Regulating NPM1/FHL1-Mediated Cell-Cycle-Checkpoint Protein Activity
Authors: Luo Qiankun , Pan Yanfeng , Fu Qiang , Zhang Xu , Zhou Shuai , Yu Pengfei , Tian Huiyuan , Liu Pan , Chen Song , Zhang Hongwei , Qin Tao 
Published: November 2021

Abstract
Immortalization-upregulated protein (IMUP) plays a vital role in cell proliferation and tumor progression. However, its role in pancreatic ductal adenocarcinoma (PDAC) remains unclear. Here, we select IMUP as an alternative gene based on GeneChip analysis of clinical PDAC tissues and transcriptome data from The Cancer Genome Atlas. IMUP expression is upregulated in PDAC tumor tissues. Moreover, high IMUP expression correlates with poor prognosis, while IMUP depletion inhibits PDAC cell proliferation and colony formation capacity in vitro, and decreases xenograft tumor growth in vivo. IMUP downregulation leads to cell-cycle arrest in the S phase. IMUP Knockdown increases the expression of four-and-a-half LIM domain protein 1 (FHL1), which regulates the phosphorylation of cell division cycle 25A (CDC25A) by cycle checkpoint kinase 1 (CHK1) and promotes cytoplasmic distribution of CDC25A by interaction with 14-3-3ξ. Furthermore, FHL1 knockdown restores the effects induced by IMUP depletion. liquid chromatography tandem mass spectrometry and immunoprecipitation analysis further show that IMUP interacts directly with nucleophosmin (NPM1) and enhances its stability. DNA methylation sequencing shows that FHL1 promoter methylation decreases when IMUP is downregulated. Overexpression of NPM1 can increase the methylation level of FHL1, thereby decreasing its expression. Our study provides a novel perspective on IMUP/NPM1/FHL1-mediated cell-cycle arrest by regulating CDC25A phosphorylation in PDAC. These findings may provide a new therapeutic target for PDAC.
Seismic Performance of Pre-Fabricated Segmental Bridges With An Innovative Layered-UHPC Connection
Authors: WANG Ruilong , MA Biao , CHEN Xu 
Published: November 2021

Abstract
Ultra-high-performance concrete (UHPC) has been regarded as promising alternative to provide reliable connections between difference segments (e.g., columns and pier footing/cap) during accelerated bridge construction (ABC) procedures. This paper proposes an innovative layered-UHPC connection for the pre-fabricated segmental (PFS) pier, whose seismic performance was validated through quasi-static experiment. The corresponding design procedure for PFS pier with this type of connections is presented based on the test results. The layered-UHPC connection ensures the emulative performance of pre-fabricated bridge as cast-in-place (CIP) ones, as well as provides greater economic efficiency than traditional UHPC connections. Based on experimental results, key issues concerning this connection, including the tensile behavior of UHPC, height of connection region, thickness of UHPC layer and steel bars in grouting bed, are presented and discussed. Then a seismic design procedure is proposed utilizing the capacity protection philosophy widely adopted in design specifications. The layered-UHPC connection is expected as capacity-protected component without damage, since it provides anchorage for steels extended from columns and pier cap/footing. While the pre-fabricated region is designed as ductile component undergoing nonlinearity during strong earthquakes. Following the detailed elaborations about the design philosophy, requirement and implementation steps, this procedure is further presented through illustration examples using PFS piers with various heights. The results show that PFS piers designed according to this procedure could meet the requirement under both frequent and rare earthquakes. Note that the PFS piers with this layered-UHPC connections could be designed similar to and emulative as CIP ones, which is believed friendly to designers in engineering practice.
The Long-term Outcome of CyberKnife-Based Stereotactic Radiotherapy for Intra/ Extracranial Non-Vestibular Schwannomas: A Single-Center Experience
Authors: Hong Sukwoo , Kagawa Kenji , Sato Kengo , Nomura Ryutaro , Ichi Shunsuke 
Published: November 2021

Abstract
Background

The long-term outcomes of CyberKnife-based hypofractionated stereotactic radiotherapy (SRT) for intra/ extracranial non-vestibular schwannomas (nVS) need to be accumulated.
Method

Patients who received SRT by CyberKnife for nVS from 2010 to 2019 were retrospectively reviewed.
Results

A total of 45 patients with nVS were identified. The mean age was 53 (± 18) years old, and 23 patients (51%) were female. Twenty-nine patients (64%) had previous procedures. As for the tumor extension, 22 (49%) nVS were classified as primary intracranial, five (11%) were classified as intra/ extracranial (dumbbell shape), and 18 (40%) were classified as primary extracranial. The median prescribed dose, covering 95% of the planning target volume, was 21 (IQR 21 – 25) Gy, and the median target volume was 7 (IQR 3.6-13.1) cm3. The local control rate of nVS for patients without neurofibromatosis type 2 (NF2) was 100%. Old age (OR 0.92, p-value 0.03) and previous surgery (OR 0.02, p-value 0.02) were significant risk factors for no symptomatic improvement. The progression-free survival was 74 (±33) months clinically and 69 (IQR 36 – 94) months radiologically. During follow-up, two cases (4%) with NF2 resulted in treatment failure, 13 cases (41%) resulted in transient tumor expansion (TTE), 10 (22%) suffered from transient adverse radiation effect (ARE), and two (4%) resulted in permanent ARE.
Conclusions

Hypofractionated SRT for head, neck, and spine nVS was an effective treatment regardless of tumor extension relative to the cranium. Although the risk of permanent ARE was low, some patients experienced transient clinical worsening due to TTE.
Techno-Economic Analysis for Fertilizer House Using Hybrid Power Stations
Authors: Bihari Shiv Prakash , Sadhu Pradip Kumar 
Published: November 2021

Abstract
Renewable energy sources are not necessarily declining carbon sources. A hybrid generation network may be used in the power market to maximize the usage of renewable energy sources. The aim is to model hybrid power station and to determine the most effective system design through cost estimation. The power consumption of an agricultural device illustrates fertilizer house electricity needs and agricultural land irrigated pumps providing an average of 165.44 kWh / h of electricity per hour, an overall energy use of 7.12 kW and a total load of operation of 19.57 kW. The standard radiation intensity is 5.35 kWh per m2 per day, the luminosity amount is an around 0.534, and the maximum wind velocity is 4.60 m/s. Electricity generation is $323,659.25 and the gross electricity expense (Co2) is $1,325 and reflects an annual monthly power consumption of 21,264 kWh (47.1 %) and 12,756 kWh/yr (36.8 %).
Biochemical and Cytological Interactions Between Callose Synthase and Microtubules in the Tobacco Pollen Tube
Authors: PARROTTA LUIGI , Faleri Claudia , Casino Cecilia Del , Mareri Lavinia , Aloisi Iris , Guerriero Gea , Hausman Jean-Francois , Duca Stefano Del , Cai Giampiero 
Published: November 2021

Abstract
Callose is a cell wall polysaccharide involved in several fundamental biological processes, ranging from plant development to response to abiotic and biotic stresses. To understand how callose deposition is regulated, it is important to know how its synthesizing enzyme, i.e., callose synthase, is regulated and if it interacts with vesicular-cytoskeletal system of plant cells. Actin filaments are thought to determine the long-range distribution of callose synthase through transport vesicles. Unlike other enzymes (such as cellulose synthase) that synthesize cell wall polysaccharides, the spatial and biochemical relationships between callose synthase and microtubules are poorly understood. Some experimental evidence already support the association between callose synthase and tubulin, however, despite its importance in maintaining plant integrity, knowledge about regulation of callose biosynthesis is still limited. Here we investigated the association between callose synthase and cytoskeleton by biochemical and ultrastructural analyses in a model system, pollen tube, where callose is an essential cell wall component. Native 2-D electrophoresis and isolation of the callose synthase complex confirmed that callose synthase is associated with tubulin and can interface with cortical microtubules. In contrast, actin and sucrose synthase (which supplies UDP-glucose to callose synthase) are not permanently associated with callose synthase. Immunogold labeling showed strong colocalization of the enzyme and microtubules; this association is occasionally mediated by vesicles. The association between callose synthase and vesicles was also demonstrated by co-distribution between the enzyme and Rab11b; in addition, the not homogeneous distribution of callose synthase in cell membranes is also shown by analysis of membrane microdomains.
IFT20 confers paclitaxel resistance by triggering β-arrestin-1 to modulate ASK1 signaling in breast cancer
Authors: Qiu Ni , Jin Huan , Cui Lulu , Zhan Yong-tao , Xia Hao-ming , Jiang Ming , Zhou Jie , Liang Hong-ling , Ao Xiang , He Zhi-min , Li Hong-sheng 
Published: November 2021

Abstract
Background: System paclitaxel-based chemotherapy is the first-line treatment regimen of defense against breast cancer, but inherent or acquired chemotherapy resistance remains a major obstacle in breast cancer therapy. Elucidating the molecular mechanism of chemoresistance is essential to improve the outcome of patients with breast cancer.
Methods: Paclitaxel sensitivity was first evaluated using models of IFT20 deletion and overexpression of breast cancer cells in vitro and in vivo studies to identify the effect of IFT20 on paclitaxel chemoresistance. To delineate the molecular mechanism of IFT20 contributions to paclitaxel chemoresistance, changes in ASK signaling and its downstream JNK cascades expression were quantified using western blots, and the potential involvement of β-arrestin-1 was investigated using co-IP studies.
Results: IFT20 is positively associated with shorter relapse-free survival in patients with system paclitaxel-based chemotherapy. High expressed IFT20 in breast cancer cells increases resistance to cell death upon paclitaxel treatment; in contrast, IFT20 knockdown enhances apoptosis in breast cancer cells in response to paclitaxel. Mechanistically, IFT20 triggers β-arrestin-1 to bind with ASK1 and promotes the ubiquitination of ASK1 degradation, leading to attenuating ASK1 signaling and its downstream JNK cascades, which helped cells to escape from cell death during paclitaxel treatment.
Conclusion: IFT20 confers to paclitaxel chemoresistance. It interacts with β-arrestin-1 to mediate ubiquitination of ASK1 for feedback inhibition of ASK1/JNK signaling and restrains paclitaxel-induced apoptosis. These findings identify IFT20 as a promising novel target for overcoming paclitaxel resistance in breast cancer.
Effectiveness of a Prerequisite Histological Course for Eight-year Programme Students in China: A Randomized Controlled Study
Authors: Ruan Yan , Zhang Junlei , Cai Qiyan , Wang Jiali , Liu Gaoke , Liu Yunlai , Mei Feng , Niu Jianqin , Xiao Lan , Li Hongli , Tian Yanping 
Published: November 2021

Abstract
Background: Due to their lack of basic medical knowledge and learning strategies different from that of high school, it is more difficult for students of 8-year medical programme to adapt to study in the initial stage of basic medicine. This study was to determine whether a prerequisite course can provide an opportunity to adjust learning strategies and improve basic medicine learning performance in order to adapt to study in medical college earlier for achieving the goals of 8-year programme. Methods: A prerequisite course of histology was conducted by a two-round modified Delphi study. 74 students of 8-year medical programmeme were subjected randomized to two groups: the prerequisite course group (PC group) and non-prerequisite course group (NPC group). The PC group take part in the prerequisite course by student-centred blended learning approach. The NPC group, taught by the same teachers, underwent requisite histology teaching activities directly with no prerequisite course. Examination of the prerequisite course and requisite histology course were carried out. Effect of the prerequisite course was evaluated by an empirical method using a questionnaire-based approach. Results: No significant difference was found in baseline admission characteristics between the two groups (P>0.05). Students' scores of the PC group were significantly higher than those of students of NPC group in both prerequisite course and requisite histology examinations (P < 0.05). The results of questionnaires showed that the PC students reported positive effects of the blended learning (P<0.05). Students were satisfied with the prerequisite course, which was beneficial for the adaptation in learning strategies, the uptake in medical knowledge and cultivation of scientific research ability (P<0.01). Furthermore, our prerequisite course is conducive to the study of subsequent courses, especially for pathology.Conclusion: Our prerequisite course for students of the long-term medical education model could effectively adapt their learning strategies, enhance their knowledge of basic medicine, and improve their scientific research capacity. These findings suggest that the prerequisite course is useful and should be incorporated into the initial stage of basic medicine in future medicine curriculum reform for Chinese students.