bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is Removal of the Internal Fixation After Successful Intervertebral Fusion Necessary? A Case–control Study Based on Patient-reported Quality of Life
Authors: Niu Shangbo , Yang Dehong , Ma Yangyang , Lin Shengliang , Xu Xuhao 
Published: October 2021

Abstract
BackgroundIntervertebral fusion and internal fixation are often applied to patients with lumbar spinal disease. Whether to remove the internal fixation after successful fusion remains uncertain, but such a question needs to be explored in light of concerns regarding patients’ quality of life and health insurance. We sought to probe if the removal of internal fixation after successful lumbar intervertebral fusion affects patients’ quality of life.MethodsThis was a real-world retrospective case–control study. Data of 102 patients who had undergone posterior lumbar fusion with cage and internal fixation to treat lumbar degenerative diseases were extracted from a single center from 2012 to 2020. Fifty-one patients had undergone internal fixation removal surgery, and 51 controls who retained internal fixations were matched according to demographic and medical characteristics. The quality of life of patients based on the Medical Outcomes Study Short Form 36 (SF-36) scale and their self-assessment were surveyed.ResultsThere was no statistical difference in the overall score of the SF-36 questionnaire between the two groups, but the general health (GH) subscore was lower in the case group than in the control group (P = 0.0284). Among those patients who underwent internal fixation removal, the quality of life was improved after instrument removal as indicated by an increased overall score (P = 0.0040), physical functioning (PF) (P = 0.0045), and bodily pain (BP) (P = 0.0008). Among patients with pre-surgery discomfort, instrument removal generated better outcomes in 25% and poor outcomes in 4.2%. Among patients without pre-surgery discomfort, instrument removal generated better outcomes in 7.4% and poor outcomes in 11.1%.Conclusion﻿Among patients who achieved successful posterior lumbar internal fixation, whether or not to remove the fixation instruments should be evaluated carefully. In patients experiencing discomfort, instrument removal could improve their quality of life, but the benefits and risks should be comprehensively explained to these patients. Instrument removal should not be routinely performed due to its limited or even negative effect in patients who do not report discomfort before surgery.
Tapered wedge stems decrease early postoperative subsidence following cementless total hip arthroplasty in Dorr type C femurs compared to fit-and-fill stems
Authors: Ikemura Satoshi , Motomura Goro , Hamai Satoshi , Fujii Masanori , Kawahara Shinya , Sato Taishi , Hara Daisuke , Shiomoto Kyohei , Nakashima Yasuharu 
Published: October 2021

Abstract
Background: To compare the degree of stem subsidence between two different femoral component designs and to determine the risk factors associated with stem subsidence after cementless total hip arthroplasty (THA) in Dorr type C femurs. Methods: We retrospectively reviewed 91 consecutive hips in 87 patients with Dorr type C proximal femoral morphology who underwent primary cementless THA using a fit-and-fill stem or a tapered wedge femoral stem at our institution between January 2013 and June 2020. A fit-and-fill stem was used in 48 hips and a tapered wedge stem was used in 43 hips. Radiologically, the distance between the apex of the major trochanter and the stem shoulder were measured at three different time points (immediately [0W], one week [1W], and six weeks [6W] after surgery) and the degrees of stem subsidence were assessed by comparing the distance between 0W and 1W, 1W and 6W, and 0W and 6W, respectively. Results: The mean degree of stem subsidence (0W vs. 1W) was 0.25 mm (standard deviation [SD] 0.58) in the fit-and-fill stem group, and 0.24 mm (SD 0.43) in the tapered wedge stem group. There was no significant difference between the two groups (P = 0.4493). However, the mean degrees of subsidence were significantly higher in the fit-and-fill stem group (1W vs. 6W, 0.38 mm [SD 0.81]; 0W vs. 6W, 0.64 mm [SD 1.17]) than in the tapered wedge stem group (1W vs. 6W, 0.17 mm [SD 0.29]; 0W vs. 6W, 0.25 mm [SD 0.35]) (P < 0.05 for both). In addition, the rates of >3 mm subsidence (in which instability can be observed) were 16.7% (8 of 48 hips) and 2.3% (1 of 43 hips), respectively. There was also a significant difference between the two stems (P = 0.0324). Multivariate analysis demonstrated that higher age and fit-and-fill stem were risk factors for >3 mm subsidence after THA in Dorr type C femurs (P = 0.0396 and 0.0227, respectively). Conclusion: Our findings suggest that the tapered wedge stem is more suitable for Dorr type C femurs than the fit-and-fill stem to avoid early postoperative subsidence in cementless THA.
Plasma Levels of Bactericidal/Permeability-Increasing Protein Correlate with Systemic Inflammation in Acute Coronary Syndrome
Authors: Yu Shicheng , Li Zheng , Li Miaonan , Xu Pan , Zhang Nana , Tian Yuan , Qian Fudong , Wang Hongju 
Published: October 2021

Abstract

Background: Neutrophils play important roles in atherosclerosis and atherothrombosis. Bactericidal/permeability-increasing protein (BPI) is mainly expressed in the granules of human neutrophils in response to inflammatory stress. This observational, cross-sectional study investigated the plasma level of BPI in patients with acute coronary syndrome (ACS) and its correlation with blood neutrophil counts and circulating inflammatory biomarkers.Methods: A total of 367 patients who had acute chest pain and who were admitted to our hospital for coronary angiography (CAG) and/or percutaneous coronary intervention (PCI) from May 1, 2020 to August 31, 2020 were recruited. Among them, 256 had a cardiac troponin value above the 99th percentile upper reference limit and were diagnosed with ACS. The remaining patients (n = 111) were classified as non-ACS. The TIMI and GRACE scores were calculated at admission. The Gensini score based on CAG was used to determine atherosclerotic burden. Plasma levels of interleukin (IL)-1β, myeloperoxidase-DNA (MPO-DNA), high sensitivity C-reactive protein (hs-CRP), S100A8/A9, and BPI were measured using enzyme-linked immunosorbent assays. Correlations of plasma BPI levels with examination scores and levels of circulating inflammatory biomarkers were explored. Receiver operating characteristic (ROC) curve analysis was used to determine the diagnostic efficacy of BPI for ACS and myocardial infarction. Results: Patients in the ACS group showed significantly higher plasma BPI levels compared to the non-ACS group (46.42 ± 16.61 vs. 16.23 ± 13.19 ng/mL, p < 0.05). Plasma levels of IL-1β, MPO-DNA, hs-CRP, and S100A8/A9 in the ACS group were also significantly higher than those in the non-ACS group (all p < 0.05). In addition, plasma BPI levels were positively correlated with the TIMI, GRACE, and Gensini scores (r = 0.176, p = 0.003; r = 0.320, p < 0.001; r = 0.263, p < 0.001, respectively) in patients with ACS. Plasma BPI levels were also positively correlated with blood neutrophil counts (r = 0.266, p < 0.001) and levels of circulating inflammatory biomarkers (IL-1β, r = 0.512; MPO-DNA, r = 0.452; hs-CRP, r = 0.554; S100A8/A9, r = 0.434; all p < 0.001) in patients with ACS. ROC curve analysis revealed that the diagnostic efficacy of BPI for ACS was not inferior to that of IL-1β, MPO-DNA, hs-CRP, S100A8/A9, or blood neutrophil counts. ROC analysis also showed that the diagnostic efficacy of BPI for myocardial infarction was not inferior to that of creatine kinase (CK)-MB or cardiac troponin I.Conclusion: BPI is associated with systemic inflammation in ACS and may be involved in the process of atherosclerosis and atherothrombosis. The potential of BPI as a prognostic and diagnostic biomarker for ACS should be investigated in clinical settings.
Soil Quality Indicators in Conventional and Conservation Tillage Systems in the Brazilian Cerrado
Authors: Pinto Luiz Alberto da Silva Rodrigues , de Lima Sandra Santana , Silva Cristiane Figueira da , Gonçalves Rafael Gomes da Mota , Morais Igor de Sousa , Ferreira Robert , Junior Wanderson Farias da Silva , Torres José Luiz Rodrigues , Pereira Marcos Gervasio 
Published: October 2021

Abstract
Conventional and conservation tillage systems can alter soil aggregation and total and labile soil organic matter (SOM) contents. This study aimed to determine the degree of soil aggregation, quantify total carbon (TC), permanganate oxidizable carbon (POXC), light organic matter (LOM), and potentially mineralizable carbon (CO2-C) contents in soils aggregates, and assess soil quality indices at sites under conventional and conservation tillage in the Cerrado region of Minas Gerais State, Brazil. Four experimental areas were analyzed: a area under conventional tillage for 20 years, a area under no-till for 6 years, a area under no-till for 18 years, and a reference area of undisturbed Cerrado vegetation. Soil aggregates retained on 8.0 to 4.0 mm sieves were evaluated for size class distribution and mean weight diameter. TC, POXC, LOM, daily and total CO2-C emissions were also analyzed. These data were used to calculate the C/N ratio and sensitivity, carbon pool, and lability indices. The results of SOM compartments were in agreement with those obtained for the soil aggregation status. Environmental conditions at no-till areas promoted macroaggregate formation and preserved TC and LOM contents, resulting in a high degree of aggregate stability. Soil quality indices were sensitive to identify changes between the reference area and managed areas. Soil aggregates from no-till areas had higher CO2-C emissions and accumulations than those from the conventional tillage area.
Risk Factors and Prognostic Significance of Lateral Pelvic Lymph Node Dissection After Neoadjuvant Chemoradiotherapy for Rectal Patients with Clinically Suspected Lateral Lymph Node Metastasis
Authors: Zhou Sicheng , Jiang Yujuan , Pei Wei , Liang Jianwei , Zhou Zhixiang 
Published: October 2021

Abstract
Aim It is still controversial whether the addition of lateral pelvic lymph node (LPN) dissection (LPND) to total mesorectal excision (TME) can provide a survival benefit after neoadjuvant chemoradiotherapy (nCRT) in rectal cancer patients with pathological lateral lymph node metastasis (LPNM).Methods Patients with clinically suspected LPNM who underwent nCRT followed by TME+LPND were systematically reviewed and divided into the positive LPN group (n=15) and the negative LPN group (n=58). Baseline characteristics, clinicopathological data and survival outcomes were collected and analysed.Results Of the 73 patients undergoing TME+LPND after nCRT, the pathological LPNM rate was 20.5% (15/73). Multivariate analysis showed that a post-nCRT LPN size ≥7 mm (OR: 55.43; 95% CI, 4.24-724.42; P=0.002) and lymphatic invasion (OR: 11.81; 95% CI, 1.75-79.59; P=0.011) were independent risk factors for pathological LPNM. The overall recurrence rate of patients with LPNM was significantly higher than that of patients without LPNM (60.0% vs 27.6%, P=0.018). Multivariate regression analysis identified that LPNM was an independent risk factor not only for overall survival (OS) (HR: 3.82; 95% CI, 1.19-12.25; P=0.024) but also for disease-free survival (DFS) (HR: 2.50; 95% CI, 1.05-5.92; P=0.038). Moreover, N1-N2 stage was another independent risk factor for OS (HR: 7.41; 95% CI, 1.63-33.75; P=0.010).Conclusions Post-nCRT LPN size ≥7 mm and lymphatic invasion were risk factors for pathological LPNM after nCRT. Furthermore, even if TME+LPND is performed after nCRT, patients with pathological LPNM still show an elevated overall recurrence rate and poor prognosis.Statement：For patients with pathological LPNM, whether the employment of nCRT can reduce the local recurrence rate and improve survival is still not clear. The aim of this study was to identify risk factors for LPNM and investigate the oncological outcomes and prognostic values.
Spatio-temporal patterns of malaria in Nepal from 2005 to 2018: a country progressing towards malaria elimination
Authors: Bhattarai Shreejana , Blackburn Jason K. , McKune Sarah L. , Ryan Sadie Jane 
Published: October 2021

Abstract

Background

Nepal is attempting to eliminate malaria by 2026. Despite decreased malaria burden in Nepal between 2004 and 2018, studies have shown that some malaria indicators are increasing in certain parts of the country and that malaria has shifted to previously non-endemic areas. The objective of this study is to analyze the spatio-temporal patterns of malaria in Nepal from 2005 to 2018, following the introduction of Long-Lasting Insecticidal Nets (LLINs) as vector control intervention.

Methods

Data describing five different malaria indicators were obtained from annual reports of the Department of Health Services of the Government of Nepal: incidence of Indigenous Malaria, Imported Malaria, PV ( Plasmodium vivax) Malaria, PF ( Plasmodium falciparum) Malaria, and Total Malaria. Spatial variation in temporal trend method was employed in SaTScan software to detect the unusually high or low temporal trends of malaria indicators, and to generate their spatio-temporal clusters.

Results

All five indicators revealed spatiotemporal clusters of increasing malaria. Indigenous Malaria increased by 113.71% in a cluster of three mountainous districts where malaria was previously non-endemic. Most clusters of Imported Malaria had an increasing trend. The most prominent cluster included Kathmandu, the capital, where Imported Malaria increased by 156.22%. PV and PF Malaria also had clusters with an increasing trend. There were two clusters of Total Malaria with an increasing trend. Even though some clusters had decreasing trends in malaria indicators, the rate of decrease incidence in the clusters was lower than that outside the clusters.

Conclusion

The overall malaria burden is decreasing in Nepal as the country progresses closer to the elimination deadline. However, several spatiotemporal clusters showed increasing trends of malaria incidence. Furthermore, in clusters where a decreasing incidence trend was observed, the rate of decrease was far lower than the rate outside the cluster. Thus, it is necessary to focus vector control interventions in all these clusters. This information can help public health officials to make decisions for implementing vector control interventions to successfully eliminate malaria form the country.
Six-Week Actual Use Study to Evaluate the Impact of Oral Tobacco-Derived Nicotine Pouches on Cigarette Smoking and Smokeless Tobacco Product Use Behaviors
Authors: McCaffrey Stacey , Lewis Jennifer , Becker Elizabeth , Vansickel Andrea , Larson Elsa , Sarkar Mohamadi 
Published: October 2021

Abstract
Background Oral tobacco-derived nicotine (OTDN) products are a rapidly emerging, innovative category of noncombustible tobacco products. These products are tobacco-leaf free and do not contain or generate many of the harmful and potentially harmful constituents (HPHCs) found in combustible cigarettes or smokeless tobacco (ST) products. OTDN products may therefore offer adult tobacco consumers a potentially reduced harm alternative. However, little is known about OTDN product use patterns or their ability to substitute for more harmful tobacco products.Methods We conducted an open-label, 2-phase, actual use study designed to characterize OTDN pouch product (on!® nicotine pouches - NP) use patterns, including impact on other tobacco use behaviors among adult tobacco consumers interested in using NP. Adult current cigarette smokers (AS) and/or adult ST users (ASTU) (n = 1,147 complete) who were not planning to quit were offered free choice of a portfolio of NP (seven flavors at five nicotine levels) to use at-home, ad-libitum, for 6-weeks following an initial 5-day trial. Participants responded to daily electronic surveys that captured the amount, frequency, and topography (e.g., time in mouth, placement in mouth) of NP and other tobacco product use. Results The majority (99 to 100%) of study participants used NP throughout the 6-week period. Participants used ~5-6 pouches/day of a variety of flavors and nicotine levels. At the end of 6 weeks, a modest proportion of AS (27%) and a substantial proportion of ASTU (71%) reported no use of cigarettes or ST respectively, while reporting continued use of NPs. Additionally, 39% of AS and 14% of ASTU reduced daily consumption of cigarettes or ST products, respectively by 50-99%. Conclusions Participants found NPs acceptable with a sizeable proportion completely switching away from or substantially reducing (50-99%) their cigarette or ST consumption by week 6. Availability of a variety of flavors and nicotine levels appeared to facilitate the conversion to NP. These data suggest that, under the conditions of the study, NP can be a potential substitute for cigarettes or ST products and may offer harm reduction potential for adult smokers and smokeless tobacco users not interested in quitting.Trial Registration Note: This study is an observational study with tobacco products currently available in the marketplace for adult tobacco consumers. Since there is no intervention per se and we did not collect any biosamples this is not a “clinical study” and there is no appropriate registry for such behavioral observational studies, we do not believe that this requirement is applicable.
Research on a Classification Method of Crop Planting Structures Based on Indexes and an Improved U-Net Network
Authors: Li Weidong , Meng Fanqian 
Published: October 2021

Abstract
This paper proposes a method for extracting crop planting structures based on indexes, image fusions and an improved U-Net deep semantic segmentation network; this method can automatically and accurately extract multiple types of information regarding crop planting structures. Taking the Landsat 8 commercial multispectral satellite dataset as an example, three indexes are used to highlight the characteristics of vegetation, water and soil. The GS method is used to combine the indexes to fuse panchromatic bands and obtain 15-m high-resolution fused images, and the images are sliced to obtain training sets and test sets of images. When using different combinations of index-fused images and the improved U-Net network to classify the test set data, the overall accuracy rate reaches more than 92.4%, and the accuracy rate of the crop planting structure (wheat, cotton, and woodland) reaches up to 94.2%. The results showed that the participation of AWEI in the image synthesis process can significantly improve the classification effect of the crop planting structure by more than 1.2%, and the kappa coefficient of the NDVI-AWEI method reaches 0.886; thus, this method is the most stable and suitable for actual production. This method can assist relevant enterprises in adjusting and optimizing their regional planting structures, in the intelligent allocation of irrigation water and in other related decisions.
Who Is Using Take-home Naloxone a Lot? An Examination of Super-savers
Authors: Eide Desiree , Lobmaier Philipp , Clausen Thomas 
Published: October 2021

Abstract
BackgroundAs the opioid overdose crisis persists and take-home naloxone (THN) programmes expand, it is important that the intervention is targeted towards those most likely to use it. We examined THN program participants to 1) describe those that return for refills, specifically those that reported multiple use (super-savers) and 2) to determine what rescuer characteristics were associated with higher rates of THN use. MethodsThis study included a cohort of consenting THN recipients from June 2014- June 2021 who completed initial and refill questionnaires from a widespread program in Norway. Adjusted logistic regression was used to explore associations with higher rates of THN use. ‘Super-savers’ reported three or more THN uses.ResultsA total of 1054 participants returned for a THN refill during the study period. Of these, 558 reported their last THN to have been used on an overdose. In the adjusted model, the only significant predictor for being a super-saver was previously witnessing 11-20 overdoses at baseline [AOR, 3.27 (1.18-9.07)]. Overall, those who returned for a refill were comparable, regardless of if their last THN had been used on an overdose. Conclusions﻿Witnessing a high number of overdoses was subsequently associated with higher reports of THN use. THN programs should continue to emphasize and prioritize THN for people actively using drugs, particularly those who have witnessed overdoses previously.
Macamide B Pretreatment Attenuates Neonatal Hypoxic-Ischemic Brain Damage of Mice Induced Apoptosis by Regulates Autophagy Via The PI3K/AKT Signaling Pathway
Authors: Yang Xiaoxia , Wang Mengxia , Zhou Qian , Bai Yanxian , Liu Jing , Yang Junhua , Li Lixia , Li Guoying , Luo Li 
Published: October 2021

Abstract
Lepidium meyenii (Maca) is an annual or biennial herb from South America that is a member of the genus Lepidium L. in the family Cruciferae. This herb has antioxidant, anti-apoptotic, and enhances autophagy functions and can prevent cell death, and protect neurons from ischemic damage. Macamide B, an effective active ingredient of maca, has a neuroprotective role in neonatal hypoxic-ischemic brain damage (HIBD), and the underlying mechanism of its neuroprotective effect is not yet known. The purpose of this study is to explore the impact of macamide B on HIBD-induced autophagy and apoptosis and its potential mechanism for neuroprotection. The modified Rice-Vannucci method was used to induce HIBD on 7-day-old (P7) macamide B and vehicle-pretreated pups. TTC staining was used to evaluate the cerebral infarct volume of pups, brain water content was measured to evaluate the neurological function of pups, neurobehavioral testing was used to assess functional recovery after HIBD, TUNEL and FJC staining was used to detect cell autophagy and apoptosis, and western blot analysis was used to detect the expression levels of the pro-survival signaling pathway phosphatidylinositol-3-kinase/protein kinase B (PI3K/AKT) and autophagy and the apoptosis-related proteins. The results show that macamide B pretreatment can significantly decrease brain damage, improve the recovery of neural function after HIBD. At the same time, macamide B pretreatment can induce the activation of PI3K/AKT signaling pathway after HIBD, enhance autophagy, and reduce hypoxic-ischemic (HI)-induced apoptosis. In addition, 3-methyladenine (3-MA), an inhibitor of PI3K/AKT signaling pathway, significantly inhibits the increase in autophagy levels, aggravates HI-induced apoptosis, and reverses the neuroprotective effect of macamide B on HIBD. Our data indicate that macamide B pretreatment might regulate autophagy through PI3K/AKT signaling pathway, thereby reducing HIBD-induced apoptosis and exerting neuroprotective effects on neonatal HIBD. Macamide B may become a new drug for the prevention and treatment of HIBD.