bluuebunny/crossref_metadata_2025_split huggingface dataset:
Traumatic displacement of laser in situ keratomileusis flaps: an integrated clinical case presentation
Authors: Shih Lu-Yang , Peng Kai-Ling , Chen Jiunn-Liang 
Published: April 2021

AbstractBackgroundTraumatic dislocation of laser-assisted in situ keratomileusis (LASIK) corneal flaps is an uncommon postoperative complication that could occur any time after LASIK, and could be visually devastating. We evaluated the visual outcomes, corneal sensation, tear function, and dry eye questionnaire results of patients with traumatic dislocation of LASIK flaps, including one LASIK flap amputation.MethodsThis is a retrospective case series. Seven patients who were diagnosed with traumatic displacement of the LASIK flap and underwent flap replacement surgery between August 2014 and January 2019 were included.Patient’s visual acuity, refraction, corneal sensitivity, non-invasive tear breakup time (NIBUT), tear meniscus height (TMH), and ocular surface disease index (OSDI) results were evaluated.ResultsThe patients’ mean age was 35.86 ± 5.84 years, and 42.9 % (3/7) were male. The mean duration from LASIK to trauma was 8.86 ± 2.48 years.The mean preoperative and postoperative six-month corrected distance visual acuity (CDVA) were 0.55 ± 0.34 and 0.02 ± 0.03, respectively. The mean spherical equivalent and astigmatism at six months postoperatively was − 1.0 ± 0.95 D and − 0.5 ± 0.25 D, respectively. The corneal flap was clear and well-positioned at the final follow-up (mean: 28.57 ± 6.9 months). 85.71 % (6/7) of the patients showed worse corneal sensation in the injured eye. Interocular OSDI discrepancy was less in those whose last visit was more than 30 months after the trauma.ConclusionsPostoperative CDVAat six months was improved, and the refractive data also showed some improvement. The corneal nerve and tear function recovery peaked before 30 months, while the OSDI continued to show a strong trend of improvement beyond 30 months.
Fasting serum potassium and long-term mortality in healthy men
Authors: Falk Ragnhild S. , Robsahm Trude Eid , Paulsen Jan Erik , Stocks Tanja , Drake Isabel , Heir Trond 
Published: April 2021

Abstract
Background
Serum potassium levels have been positively associated with cardiovascular mortality, but little is known about the association with cancer mortality and death due to other causes. We examined whether serum levels of potassium were associated with long-term mortality in a healthy cohort.

Methods
Oslo Ischemia Study invited 2341 initially healthy men aged 40–59 years with no use of medication to a comprehensive health survey in 1972. Fasting serum level of potassium (mmol/L) was ascertained at baseline for 1989 men. We have complete follow-up for death throughout 2017. Cox proportional hazard models were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) and adjusted for multiple confounders.

Results
After a median follow-up of 30 years (interquartile range 21.2–38.7), 1736 deaths were observed, of which 494 were cancer deaths, 688 cardiovascular deaths, and 536 deaths related to other causes. Restricted cubic spline analysis showed that potassium level was linearly and positively associated with long-term cancer mortality; HR per mmol/L 1.8, 95% CI 1.4–2.4. Compared with low levels of potassium (≤ 4.0 mmol/L), men with high levels (≥4.6 mmol/L) showed a significantly 78% higher risk of cancer death. A positive linear association was found for all-cause mortality (HR per mmol/L 1.6, 95% CI 1.4–1.8), and for cardiovascular (HR per mmol/L 1.4, 95% CI 1.1–1.7) and other cause mortality (HR per mmol/L 1.7, 95% CI 1.3–2.2).

Conclusions
These findings suggest that serum potassium level appears to predict long-term mortality in healthy middle-aged men, and it might imply future surveillance strategies for individuals with high serum potassium levels.
Incidence and prognostic factors of primary thyroid lymphoma and construction of prognostic models for post-chemotherapy and postoperative patients: a population-based study
Authors: Xiang Nan , Dong Fangyuan , Zhan Xuebing , Wang Shuhan , Wang Junjie , Sun Entao , Chen Bing 
Published: April 2021

Abstract
Background
Primary thyroid lymphoma (PTL) is a rare thyroid malignancy, there are few large sample studies on PTL and no standardized treatment regimen has been established due to the rarity. The aims of this study were to explore the incidence and prognostic factors of PTL and construct visual prognostic prediction models for post-chemotherapy and postoperative patients.

Methods
The incidence of PTL in 1975–2017 was extracted from the US Surveillance, Epidemiology, and End Results (SEER) database, then assessed using joinpoint regression software. A total of 1616 eligible PTL patients diagnosed in 1998–2016 were brought into prognostic analysis. Multivariate Cox regression analyses were carried out to reveal independent prognostic elements for overall survival (OS) and cancer-specific survival (CSS).

Results
PTL incidence showed a relatively steady increase in 1975–1994, which annual percent change (APC) was 4.0%, and steady decreasing in 1994–2017(APC − 2.4%). Age, marital status, lymphoma Ann Arbor stage, histological subtypes, surgery, chemotherapy, and radiation were significantly correlated to OS and CSS. Nomograms were constructed to predict OS and CSS in post-chemotherapy and postoperative PTL patients separately, and were verified to have good reliability.

Conclusions
The incidence of PTL increased and subsequently decreased. We revealed the prognostic implications and constructed reliable nomograms for post-chemotherapy and postoperative PTL patients.
Continuity in palliative care – analysis of intersectoral palliative care based on routine data of a statutory health insurance
Authors: Rehner Laura , Moon Kilson , Hoffmann Wolfgang , van den Berg Neeltje 
Published: April 2021

Abstract
Background
The goal of palliative care is to prevent and alleviate a suffering of incurable ill patients. A continuous intersectoral palliative care is important. The aim of this study is to analyse the continuity of palliative care, particularly the time gaps between hospital discharge and subsequent palliative care as well as the timing of the last palliative care before the patient’s death.

Methods
The analysis was based on claims data from a large statutory health insurance. Patients who received their first palliative care in 2015 were included. The course of palliative care was followed for 12 months. Time intervals between discharge from hospital and first subsequent palliative care as well as between last palliative care and death were analysed. The continuity in palliative care was defined as an interval of less than 14 days between palliative care. Data were analysed using descriptive statistics and Chi-Square.

Results
In 2015, 4177 patients with first palliative care were identified in the catchment area of the statutory health insurance. After general inpatient palliative care, 415 patients were transferred to subsequent palliative care, of these 67.7% (n = 281) received subsequent care within 14 days. After a stay in a palliative care ward, 124 patients received subsequent palliative care, of these 75.0% (n = 93) within 14 days. Altogether, 147 discharges did not receive subsequent palliative care. During the 12-months follow-up period, 2866 (68.7%) patients died, of these 78.7% (n = 2256) received palliative care within the last 2 weeks of life. Of these, 1223 patients received general ambulatory palliative care, 631 patients received specialised ambulatory palliative care, 313 patients received their last palliative care at a hospital and 89 patients received it in a hospice.

Conclusions
The majority of the palliative care patients received continuous palliative care. However, there are some patients who did not receive continuous palliative care. After inpatient palliative care, each patient should receive a discharge management for a continuation of palliative care. Readmissions of patients after discharge from inpatients palliative care can be an indication for a lack of support in the ambulatory health care setting and for an insufficient discharge management. Palliative care training and possibilities for palliative care consultations by specialists should strengthen the GPs in palliative care.
In vitro antibacterial activity of Loxostylis alata extracts and isolated compounds against Salmonella species
Authors: Gado Dorcas A. , Abdalla Muna Ali , Ahmed Aroke S. , Madikizela Balungile , Nkadimeng Sanah M. , Ehlers Marthie M. , McGaw Lyndy J. 
Published: April 2021

Abstract
Background
Owing to antibiotic resistance, alternative antimicrobials from medicinal plants are receiving attention as leads for anti-infective agents. This study aimed to investigate selected tree species and their constituents for activity against bacterial foodborne pathogens, particularly Salmonella serovars.

Methods
Antibacterial activity of ten plant species was determined by serial microdilution against bacteria implicated in causing gastrointestinal ailments. Active compounds were isolated from Loxostylis alata using bioassay-guided fractionation. Antioxidant activity was determined using free-radical scavenging assays. Cytotoxicity and genotoxicity of the extracts was ascertained on Vero cells, and using the Ames assay respectively.

Results
Extracts had low to moderate MIC values from 0.04 to 2.5 mg/mL. Protorhus longifolia and Loxostylis alata were most active and L. alata had the highest selectivity index value (2.51) against Salmonella Typhimurium, as well as high antioxidant activity. Cytotoxicity values ranged from 0.02 to 0.47 mg/mL, while tested extracts were not genotoxic. Bioactive compounds isolated from L. alata included delicaflavone and a polymethoxyflavone.

Conclusions
The Loxostylis alata leaf extract had strong activity against Salmonella serovars but isolated compounds were less active, indicating likely synergistic effects. Extracts of L. alata are promising candidates for development of antimicrobial preparations or food additives against microbial contamination.
Evaluating the influence of music at different sound pressure levels on medical students’ performance of standardized laparoscopic box training exercises
Authors: Nees Lisa Katharina , Grozinger Philipp , Orthmann Natalie , Deutsch Thomas Maximilian , Hennigs André , Domschke Christoph , Wallwiener Markus , Rom Joachim , Riedel Fabian 
Published: April 2021

Abstract
Background
The influence of music on the performance of surgical procedures such as laparoscopy is controversial and methodologically difficult to quantify. Here, outcome measurements using laparoscopic box training tools under standardized conditions might offer a feasible approach. To date, the effect of music exposure at different sound pressure levels (SPL) on outcome has not been evaluated systematically for laparoscopic novices.

Methods
Between May 2017 and October 2018, n = 87 students (49 males, 38 females) from Heidelberg University Medical School performed three different laparoscopy exercises using the “Luebecker Toolbox” that were repeated twice under standardized conditions. Time was recorded for each run. All students were randomly assigned to four groups exposed to the same music compilation but at different SPLs (50–80 dB), an acoustically shielded (earplug) group, or a control group (no intervention).

Results
Best absolute performance was shown under exposure to 70 dB in all three exercises (a, b, c) with mean performance time of 121, 142, and 115 s (p < 0.05 for a and c). For the control group mean performance times were 157, 144, and 150 s, respectively. In the earplug group, no significant difference in performance was found compared to the control group (p > 0.05) except for exercise (a) (p = 0.011).

Conclusion
Music exposure seems to have beneficial effects on training performance. In comparison to the control group, significantly better results were reached at 70 dB SPL, while exposure to lower (50 or 60 dB) or higher (80 dB) SPL as well as under acoustic shielding did not influence performance.
Learning from imbalanced fetal outcomes of systemic lupus erythematosus in artificial neural networks
Authors: Ma Jing-Hang , Feng Zhen , Wu Jia-Yue , Zhang Yu , Di Wen 
Published: April 2021

Abstract
Objective
To explore an effective algorithm based on artificial neural network to pick correctly the minority of pregnant women with SLE suffering fetal loss outcomes from the majority with live birth and train a well behaved model as a clinical decision assistant.

Methods
We integrated the thoughts of comparative and focused study into the artificial neural network and presented an effective algorithm aiming at imbalanced learning in small dataset.

Results
We collected 469 non-trivial pregnant patients with SLE, where 420 had live-birth outcomes and the other 49 patients ended in fetal loss. A well trained imbalanced-learning model had a high sensitivity of 19/21 ($$90.8\%$$

90.8
%

) for the identification of patients with fetal loss outcomes.

Discussion
The misprediction of the two patients was explainable. Algorithm improvements in artificial neural network framework enhanced the identification in imbalanced learning problems and the external validation increased the reliability of algorithm.

Conclusion
The well-trained model was fully qualified to assist healthcare providers to make timely and accurate decisions.
Transportation as a barrier to colorectal cancer care
Authors: Jazowski Shelley A. , Sico Isabelle P. , Lindquist Jennifer H. , Smith Valerie A. , Bosworth Hayden B. , Danus Susanne , Provenzale Dawn , Kelley Michael J. , Zullig Leah L. 
Published: April 2021

Abstract
Background
Transportation barriers limit access to cancer care services and contribute to suboptimal clinical outcomes. Our objectives were to describe the frequency of Veterans reporting and the factors associated with transportation barriers to or from colorectal cancer (CRC) care visits.

Methods
Between November 2015 and September 2016, Veterans with incident stage I, II, or III CRC completed a mailed survey to assess perceived barriers to recommended care. Participants who reported difficulty with transportation to or from CRC care appointments were categorized as experiencing transportation barriers. We assessed pairwise correlations between transportation barriers, transportation-related factors (e.g., mode of travel), and chaotic lifestyle (e.g., predictability of schedules), and used logistic regression to examine the association between the reporting of transportation difficulties, distance traveled to the nearest Veterans Affairs (VA) facility, and life chaos.

Results
Of the 115 Veterans included in this analysis, 18% reported experiencing transportation barriers. Distance to the VA was not strongly correlated with the reporting of transportation barriers (Spearman’s ρ = 0.12, p = 0.19), but chaotic lifestyle was both positively and significantly correlated with experiencing transportation barriers (Spearman’s ρ = 0.22, p = 0.02). Results from the logistic regression model modestly supported the findings from the pairwise correlations, but were not statistically significant.

Conclusions
Transportation is an important barrier to or from CRC care visits, especially among Veterans who experience greater life chaos. Identifying Veterans who experience chaotic lifestyles would allow for timely engagement in behavioral interventions (e.g., organizational skills training) and with support services (e.g., patient navigation).
Behaviour change practices in exercise referral schemes: developing realist programme theory of implementation
Authors: Downey John , Shearn Katie , Brown Nicola , Wadey Ross , Breckon Jeff 
Published: April 2021

Abstract
Background
Exercise Referral Schemes have been delivered worldwide in developed countries to augment physical activity levels in sedentary patients with a range of health issues, despite their utility being questioned. Understanding the implementation mechanisms of behaviour change practices is important to avoid inappropriate decommissioning and support future service planning. The aim of this study was to develop initial theories to understand what influences the behaviour change practices of Exercise Referral practitioners within the United Kingdom.

Methods
An eight-month focused ethnography was undertaken, to carry out the first phase of a realist evaluation, which included participant observation, interviews, document analysis, and reflexive journaling. A comprehensive implementation framework (Consolidated Framework for Implementation Research) was adopted providing an extensive menu of determinants. Mechanisms were categorised based on the Theoretical Domains Framework (within the Capability, Opportunity, Motivation, Behaviour model) providing an explanatory tool linking the levels of the framework.

Results
Three programme theories are proposed. Firstly, motivation and capability are influenced when behaviour change oriented planning and training are in place. Secondly, motivation is influenced if leadership is supportive of behaviour change practice. Lastly, integration between health professionals and practitioners will influence motivation and capability. The conditions necessary to influence motivation and capability include a person-centred climate, cognizant practitioners, and established communities of practice.

Conclusions
The findings are the first to articulate the necessary elements for the implementation of behaviour change practices in Exercise Referral services. These results outline emerging theories about the conditions, resources, and explanations of behaviour change implementation that can inform service development.
Plasma membrane integrity: implications for health and disease
Authors: Ammendolia Dustin A. , Bement William M. , Brumell John H. 
Published: April 2021

AbstractPlasma membrane integrity is essential for cellular homeostasis. In vivo, cells experience plasma membrane damage from a multitude of stressors in the extra- and intra-cellular environment. To avoid lethal consequences, cells are equipped with repair pathways to restore membrane integrity. Here, we assess plasma membrane damage and repair from a whole-body perspective. We highlight the role of tissue-specific stressors in health and disease and examine membrane repair pathways across diverse cell types. Furthermore, we outline the impact of genetic and environmental factors on plasma membrane integrity and how these contribute to disease pathogenesis in different tissues.
New aspects of microbial vitamin K2 production by expanding the product spectrum
Authors: Zhang Zimeng , Liu Linxia , Liu Chuan , Sun Yumei , Zhang Dawei 
Published: April 2021

AbstractVitamin K2 (menaquinone, MK) is an essential lipid-soluble vitamin with critical roles in blood coagulation and bone metabolism. Chemically, the term vitamin K2 encompasses a group of small molecules that contain a common naphthoquinone head group and a polyisoprenyl side chain of variable length. Among them, menaquinone-7 (MK-7) is the most potent form. Here, the biosynthetic pathways of vitamin K2 and different types of MK produced by microorganisms are briefly introduced. Further, we provide a new aspect of MK-7 production, which shares a common naphthoquinone ring and polyisoprene biosynthesis pathway, by analyzing strategies for expanding the product spectrum. We review the findings of metabolic engineering strategies targeting the shikimate pathway, polyisoprene pathway, and menaquinone pathway, as well as membrane engineering, which provide comprehensive insights for enhancing the yield of MK-7. Finally, the current limitations and perspectives of microbial menaquinone production are also discussed. This article provides in-depth information on metabolic engineering strategies for vitamin K2 production by expanding the product spectrum.
Morphological and molecular characteristics of spheroid formation in HT-29 and Caco-2 colorectal cancer cell lines
Authors: Gheytanchi Elmira , Naseri Marzieh , Karimi-Busheri Feridoun , Atyabi Fatemeh , Mirsharif Ensie Sadat , Bozorgmehr Mahmood , Ghods Roya , Madjd Zahra 
Published: April 2021

AbstractBackgroundRelapse and metastasis in colorectal cancer (CRC) are often attributed to cancer stem-like cells (CSCs), as small sub-population of tumor cells with ability of drug resistance. Accordingly, development of appropriate models to investigate CSCs biology and establishment of effective therapeutic strategies is warranted. Hence, we aimed to assess the capability of two widely used and important colorectal cancer cell lines, HT-29 and Caco-2, in generating spheroids and their detailed morphological and molecular characteristics.MethodsCRC spheroids were developed using hanging drop and forced floating in serum-free and non-attachment conditions and their morphological features were evaluated by scanning electron microscopy (SEM). Then, the potential of CSCs enrichment in spheroids was compared to their adherent counterparts by analysis of serial sphere formation capacity, real-time PCR of key stemness genes (KLF4,OCT4,SOX2,NANOG,C-MYC) and the expression of potential CRC-CSCs surface markers (CD166, CD44, and CD133) by flow cytometry. Finally, the expression level of some EMT-related (Vimentin,SNAIL1,TWIST1,N-cadherin,E-cadherin,ZEB1) and multi-drug resistant (ABCB1,ABCC1,ABCG2) genes was evaluated.ResultsAlthough with different morphological features, both cell lines were formed CSCs-enriched spheroids, indicated by ability to serial sphere formation, significant up-regulation of stemness genes,SOX2,C-MYC, NANOGandOCT4in HT-29 andSOX2,C-MYCandKLF4in Caco-2 spheroids (p-value < 0.05) and increased expression of CRC-CSC markers compared to parental cells (p-value < 0.05). Additionally, HT-29 spheroids exhibited a significant higher expression of bothABCB1andABCG2(p-value = 0.02). The significant up-regulation of promoting EMT genes,ZEB1,TWIST1,E-cadherinandSNAIL1in HT-29 spheroids (p-value = 0.03),SNAIL1andVimentinin Caco-2 spheroids (p-value < 0.05) andN-cadherindown-regulation in both spheroids were observed.ConclusionEnrichment of CSC-related features in HT-29 and Caco-2 (for the first time without applying special scaffold/biochemical) spheroids, suggests spheroid culture as robust, reproducible, simple and cost-effective model to imitate the complexity of in vivo tumors including self-renewal, drug resistance and invasion for in vitro research of CRC-CSCs.
Role of LncRNAs in regulating cancer amino acid metabolism
Authors: Guo Yuhong , Lv Bin , Liu Renfeng , Dai Zhengzai , Zhang Feifei , Liang Yiping , Yu Bo , Zeng Duo , Lv Xiao-Bin , Zhang Zhiping 
Published: April 2021

AbstractThe metabolic change of tumor cells is an extremely complicated process that involves the intersection and integration of various signal pathways. Compared with normal tissues, cancer cells show distinguished metabolic characteristics called metabolic reprogramming, which has been considered as a sign of cancer occurrence. With the deepening of tumor research in recent years, people gradually found that amino acid metabolism played crucial roles in cancer progression. Long non-coding RNAs (lncRNAs), which are implicated in many important biological processes, were firstly discovered dysregulating in cancer tissues and participating in extensive regulation of tumorigenesis. This review focuses on the reprogramming of amino acid metabolism in cancers and how lncRNAs participate in the regulatory network by interacting with other macromolecular substances. Understanding the functions of lncRNA in amino acid reprogramming in tumors might provide a new vision on the mechanisms of tumorigenesis and the development of new approaches for cancer therapy.