bluuebunny/crossref_metadata_2025_split huggingface dataset:
Study on the strength of glued laminated timber beams with round holes: difference in structural performance between homogeneous-grade and heterogeneous-grade timber
Authors: Okamoto Shigefumi , Akiyama Nobuhiko , Araki Yasuhiro , Aoki Kenji , Inayama Masahiro 
Published: January 2021

AbstractVarious design codes and design proposals have been proposed for glued laminated timber beams with round holes, assuming that the entire beam is composed of homogeneous-grade timber. However, in Japan, glued laminated timber composed of homogeneous-grade timber is rarely used for beams. In this study, the difference in the load-bearing capacity of glued laminated beams composed of homogeneous-grade timber and heterogeneous-grade timber with round holes when fractured by cracking was investigated experimentally and analytically. The materials used in the tests were glued laminated beams composed of homogeneous-grade Scots pine timber with a strength grade of E105-F345 and heterogeneous-grade Scots pine timber with a strength grade of E105-F300. Experiments confirmed that although the glued laminated beams composed of heterogeneous-grade timber have a lower material strength in the lamina with holes, its resistance to fracturing due to cracks associated with the holes is almost the same as that of the glued laminated beams composed of homogeneous-grade timber. The stresses acting on the holes in the laminated timber with holes of less than half the beam height were lower in the glued laminated beams composed of heterogeneous-grade timber than in the glued laminated beams composed of homogeneous-grade timber. The ratio of the stresses was found to be approximately equal to the ratio of the maximum bending stress or the maximum shear stress acting on the inner layer lamina, as determined by Bernoulli–Euler theory.
Role of liver enzymes in patients with blunt abdominal trauma to diagnose liver injury
Authors: Shrestha Anup , Neupane Harish Chandra , Tamrakar Kishor Kumar , Bhattarai Abhishek , Katwal Gaurav 
Published: January 2021

Abstract
Background
The liver is the second most injured organ following blunt abdominal trauma (BAT) after the spleen. Although the computed tomography (CT) scan is considered as the gold standard for diagnosing liver injury in BAT, it may not readily available in all the hospitals. This study was performed to evaluate the role of aspartate transaminase (AST) and alanine transaminase (ALT) in patients with BAT and its significance in predicting the diagnosis and severity of the liver injury.

Method
The study was conducted in Chitwan Medical College Teaching Hospital (CMCTH) from February 2019 to May 2020. It was a prospective observational study. All the patients with BAT were received by on-duty surgical residents in the emergency department. Based on the imaging and operative finding, patients with liver injury and without liver injury were noted with the associated injury. For comparisons of clinical and grading characteristics between the two groups (liver injury and no liver injury), the chi-squared test was used for categorical variables as appropriate, and the Mann-Whitney U test used for quantitative variables (AST and ALT). The comparisons between more than two groups (grade of injury) were performed using the Kruskal-Wallis test. The receiver operating characteristic (ROC) was used to calculate the optimal cut-off value of AST and ALT.

Results
Among the 96 patients admitted with BAT, 38 patients had liver injury and 58 patients had no liver injury. The median length of the intensive care unit (ICU) stay of patients with liver injury was higher than without liver injury. There was a significant difference in the median level of AST and ALT (< 0.001) between patients with liver injury and no liver injury. The area under the ROC curve of AST was 0.89 (95% confidence interval 0.86–0.98) and of ALT was 0.92 (95% confidence interval 0.83–0.97). The area under the curve demonstrated that the test was a good predictor for the identification of liver injury and also the severity of liver enzymes. The cut-off values for the liver injury were 106 U/l and 80 U/l for AST and ALT, respectively. Based on these values, AST ≥ 106 U/l had a sensitivity of 71.7%, a specificity of 90%, a positive predictive value of 86.8%, and a negative predictive value of 77.6%. The corresponding values for ALT ≥ 80 U/l were 77.8%, 94.1%, 92.1%, and 82.8%, respectively.

Conclusion
In conclusion, we report the optimal cut-off value of AST and ALT for liver injury in BAT as ≥ 106 U/l and 80 U/l, respectively. The elevated level of AST and ALT might assist the emergency physicians and surgeons to timely refer the suspected patients with the liver injury to a tertiary center.
The association of age with decline in renal function after low anterior resection and loop ileostomy for rectal cancer: a retrospective cohort prognostic factor study
Authors: Rhemouga Amal , Buettner Stefan , Bechstein Wolf O. , Woeste Guido , Schreckenbach Teresa 
Published: January 2021

Abstract
Background
Low anterior resection (LAR) is often performed with diverting loop ileostomy (DLI) for anastomotic protection in patients with rectal cancer. We aim to analyze, if older patients are more prone to a decline in kidney function following creation and closure of DLI after LAR for rectal carcinoma versus younger patients.

Methods
A retrospective cohort study from a database including 151 patients undergoing LAR for rectal carcinoma with DLI was used. Patients were divided in two age groups (Group A: <65 years, n = 79; Group B: ≥65 years, n = 72). For 123 patients undergoing DLI reversal prognostic factors for an impairment of serum creatinine (SCr) and estimated glomerular filtration rate (eGFR) 3 months after DLI reversal was analyzed using a multivariate linear regression analysis.

Results
SCr before LAR(T0) was significant higher in Group B (P = 0.04). Accordingly, the eGFR at T0 in group B was significantly lower (P < 0.001). No patients need to undergo hemodialysis after LAR or DLI reversal.
Age and SCr at T0were able to statistically significant predict an increase in SCr (P<0.001) and eGFR (P=0.001) three months after DLI reversal (The R² for the overall model was .82 (adjusted R² = .68).

Conclusion
DLI creation may result in a reduction of eGFR in older patients 3 months after DLI closure. Apart from this, patients do not have a higher morbidity after creation and closure of DLI resulting from LAR regardless of their age.
Tertiary lymphoid tissue in early‐stage IgG4-related tubulointerstitial nephritis incidentally detected with a tumor lesion of the ureteropelvic junction: a case report
Authors: Miyanaga Tatsuhito , Mizuguchi Keishi , Hara Satoshi , Zoshima Takeshi , Inoue Dai , Nishioka Ryo , Mizushima Ichiro , Ito Kiyoaki , Fuji Hiroshi , Yamada Kazunori , Sato Yuki , Yanagita Motoko , Kawano Mitsuhiro 
Published: January 2021

Abstract
Background
IgG4-related kidney disease causes renal impairment of unknown pathogenesis that may progress to kidney failure. Although ectopic germinal centers contribute to the pathogenesis of the head and neck lesions of IgG4-related disease, the presence of tertiary lymphoid tissue (TLT) containing germinal centers in IgG4-RKD has rarely been reported.

Case presentation
We report a 72-year-old Japanese man who had IgG4-related tubulointerstitial nephritis (TIN) with TLT formation incidentally detected in a resected kidney with mass lesion of IgG4-related ureteritis in the ureteropelvic junction. During follow-up for past surgical resection of a bladder tumor, renal dysfunction developed and a ureter mass was found in the right ureteropelvic junction, which was treated by nephroureterectomy after chemotherapy. Pathology revealed no malignancy but abundant IgG4-positive cell infiltration, obliterative phlebitis and storiform fibrosis, confirming the diagnosis of IgG4-related ureteritis. In the resected right kidney, lymphoplasmacytes infiltrated the interstitium with focal distribution in the renal subcapsule and around medium vessels without storiform fibrosis, suggesting the very early stage of IgG4-TIN. Lymphocyte aggregates were also detected at these sites and consisted of B, T, and follicular dendritic cells, indicating TLT formation. IgG4-positive cells infiltrated around TLTs.

Conclusions
Our case suggests that TLT formation is related with the development of IgG4-TIN and our analysis of distribution of TLT have possibility to elucidate IgG4-TIN pathophysiology.
Neurocritical care complications and interventions influence the outcome in aneurysmal subarachnoid hemorrhage
Authors: Hammer Alexander , Erbguth Frank , Hohenhaus Matthias , Hammer Christian M. , Lücking Hannes , Gesslein Markus , Killer-Oberpfalzer Monika , Steiner Hans-Herbert , Janssen Hendrik 
Published: January 2021

Abstract
Background
This observational study was performed to show the impact of complications and interventions during neurocritical care on the outcome after aneurysmal subarachnoid hemorrhage (SAH).

Methods
We analyzed 203 cases treated for ruptured intracranial aneurysms, which were classified regarding clinical outcome after one year according to the modified Rankin Scale (mRS). We reviewed the data with reference to the occurrence of typical complications and interventions in neurocritical care units.

Results
Decompressive craniectomy (odds ratio 21.77 / 6.17 ; p < 0.0001 / p = 0.013), sepsis (odds ratio 14.67 / 6.08 ; p = 0.037 / 0.033) and hydrocephalus (odds ratio 3.71 / 6.46 ; p = 0.010 / 0.00095) were significant predictors for poor outcome and death after one year beside “World Federation of Neurosurgical Societies” (WFNS) grade (odds ratio 3.86 / 4.67 ; p < 0.0001 / p < 0.0001) and age (odds ratio 1.06 / 1.10 ; p = 0.0030 / p < 0.0001) in our multivariate analysis (binary logistic regression model).

Conclusions
In summary, decompressive craniectomy, sepsis and hydrocephalus significantly influence the outcome and occurrence of death after aneurysmal SAH.
Clinical features associated with the efficacy of chemotherapy in patients with glioblastoma (GBM): a surveillance, epidemiology, and end results (SEER) analysis
Authors: Wen Jieqiong , Chen Wanbin , Zhu Yayun , Zhang Pengbo 
Published: January 2021

Abstract
Background
Glioblastoma (GBM) is a highly malignant brain tumor with poor survival and prognosis. Randomized trials have demonstrated that chemotherapy improves survival in patients with GBM. This study aims to examine the clinical characteristics that are potentially associated with the efficacy of chemotherapy and the risk factors of GBM.

Methods
A total of 25,698 patients diagnosed with GBM were identified between 2004 and 2015 from the Surveillance, Epidemiology, and End Results (SEER). The clinical and demographic variables between groups were examined by Student’s t-test and Pearson’s chi-square test. GBM-specific survival (GBMSS) and overall survival (OS) were evaluated using the Kaplan-Meier method with the log-rank test. Univariable and multivariable analyses were also performed using the Cox proportional hazards model to identify statistically significant prognostic factors.

Results
Patients who received chemotherapy had better overall survival (median OS 13 vs. Three months, HR = 1.9224, 95%CI 1.8571–1.9900, p < 0.0001) and better GBMSS (median GBMSS of 12 vs. Three months, HR = 1.9379, 95%CI 1.8632–2.0156, p < 0.0001), compared to patients who did not. Further subgroup analysis revealed that among patients who underwent chemotherapy, those who were younger, with a supratentorial tumor, received surgery, or radiotherapy had both improved OS and GBMSS. Age, race, tumor location, tumor size, and treatments were identified as independent prognostic factors by multivariable analyses for patients with glioblastoma.

Conclusion
Patients with GBM who were younger (< 65 years), underwent surgery, or radiotherapy can benefit more from chemotherapeutic regimens. Age, race, tumor size, tumor location, surgery, radiotherapy, and chemotherapy were factors associated with the prognosis of patients with GBM.
Analysis of cranial type characteristics in term infants: a multi-center study
Authors: Yang Wang , Hu Bin , Chen Jianping , Shen Wenzhi , Wang Chengju , Chang Qin , Li Wenzao , Qu Fuxiang , Pan Qiuming , Zhang Yuping 
Published: January 2021

Abstract
Background
Positional head deformity (PHD) is defined as a change in the shape of an infant’s skull due to an external force. In certain cases, it can lead to cosmetic deformities or even neurological issues due to its impact on the developing nervous system. Therefore, we conducted this study to investigate the incidence and characteristics of PHD in term infants in China and preliminarily establish a localized diagnostic reference standard.

Methods
Overall, 4456 term infants from three medical institutions in Chongqing were and divided and analyzed according to their age. Cranial vault asymmetry (CVA) and cephalic index (CI) were calculated in all infants. The current international diagnostic criteria were used to understand PHD incidence and analyze the CVA and CI distribution.

Results
According to the current international standards, the total detection rate of PHD in Chongqing’s term infants was 81.5%, with brachycephaly alone being the most frequent (39.4%), followed by brachycephaly with plagiocephaly (34.8%) and plagiocephaly alone (6.2%). The detection rates of dolichocephaly were low: alone, 0.9% and combined with plagiocephaly, 0.2%. According to age, plagiocephaly (44.5%) and brachycephaly (82.0%) were the most frequent in the 2-3-month group. The 75th/90th/97th and 3rd/10th/25th/75th/90th/97th percentiles of CVA and CIs were 0.4/0.7/1.0 and 76.4/78.8/82.3/91.1/94.6/99.2%, respectively.

Conclusions
According to the current international standards, the PHD detection rate among term infants in Chongqing was high. Therefore, a new diagnostic standard for Chinese infants was proposed where CVA ≥ 0.4 cm indicates plagiocephaly, CI ≥ 91% indicates brachycephaly, and CI ≤ 82% indicates dolichocephaly.
Prevalence, distribution and risk factors for brucellosis infection in goat farms in Ningxiang, China
Authors: Li Yin , Tan Dan , Xue Shuang , Shen Chaojian , Ning Huajie , Cai Chang , Liu Zengzai 
Published: January 2021

Abstract
Background
In south China, goats are the major source of Brucellosis for human infection. However, there are few studies on the prevalence of and risk factors for goat brucellosis in south China. In this study, we conducted a cross-sectional study to investigate the herd prevalence, spatial distribution and relevant risk factors for goat brucellosis in Ningxiang county, south China. Commercial goat farms (n = 457) were randomly selected, and their disease status was ascertained by testing serum samples of chosen individuals using the Rose Bengal Test (screening test) and the Serum Agglutination Test (confirmatory test) in series. A farm with at least two positive individuals was defined as a case farm. Standardized questionnaires were used to collect information on management and hygiene practices in farms. A logistic model with a binomial outcome was built to identify risk factors for being seropositive.

Results
The true herd prevalence in commercial goat farms was 4.5% (95%CI: 0.2%-12.2%) and the townships in the centre of the county had higher herd prevalence. The risk factors associated with seropositive on local goat farms include “Introduction in the past 12 months” (OR= 61, 95%CI: 16-333), “Improperly disposal of the sick or dead goats” (OR= 33, 95%CI: 5-341) and “Poor hygiene in lambing pen” (OR= 25, 95%CI: 5-192).

Conclusions
These findings will aid in the development of control strategies of Brucellosis in south China and risk factors identified in this study should be taken into consideration when designing a control strategy.
Correlation analysis of IL-11 polymorphisms and Hirschsprung disease subtype susceptibility in Southern Chinese Children
Authors: Zhang Hong , Zhao Jing-Lu , Zheng Yi , Xie Xiao-Li , Huang Li-Hua , Li Le , Zhu Yun , Lu Li-Feng , Hu Tu-Qun , Zhong Wei , He Qiu-Ming 
Published: January 2021

Abstract
Background
Hirschsprung disease (HSCR) is a hereditary defect, which is characterized by the absence of enteric ganglia and is frequently concurrent with Hirschsprung-associated enterocolitis (HAEC). However, the pathogenesis for HSCR is complicated and remains unclear. Recent studies have shown that pro-inflammatory cytokines such as interleukin-11 (IL-11) are involved in the enteric nervous system's progress. It was found that IL-11 SNPs (rs8104023 and rs4252546) are associated with HSCR in the Korean population waiting for replication in an independent cohort. This study evaluated the relationship between IL-11 and the susceptibility of patients to HSCR by performing subphenotype interaction examination, HAEC pre-/post-surgical patient-only association analysis, and independence testing.

Methods
In this study, a cohort consisting of children from Southern China, comprising 1470 cases and 1473 controls, was chosen to examine the relationship between two polymorphisms (rs8104023 and rs4252546 in IL-11) and susceptibility to HSCR by replication research, subphenotype association analysis, and independence testing.

Results
The results showed that IL-11 gene polymorphisms (rs8104023 and rs4252546) are not associated with the risk of HSCR in the Chinese population. The results of both short-segment and long-segment (S-HSCR and L-HSCR) surgery (3.34 ≤ OR ≤ 4.05, 0.02 ≤ P ≤ 0.04) showed that single nucleotide polymorphisms (SNP) rs8104023 is associated with susceptibility to HAEC.

Conclusions
This study explored the relationship between genetic polymorphisms and susceptibility to HAEC in HSCR subtypes for the first time. These findings should be replicated in a larger and multicentre study.
Impact of a transition education program on health-related quality of life in pediatric patients with congenital heart disease: study design for a randomised controlled trial
Authors: Werner Oscar , Bredy Charlene , Lavastre Kathleen , Guillaumont Sophie , De La Villeon Gregoire , Vincenti Marie , Gerl Cristelle , Dulac Yves , Souletie Nathalie , Acar Philippe , Pages Laurence , Picot Marie-Christine , Bourrel Gerard , Oude Engberink Agnes , Million Elodie , Abassi Hamouda , Amedro Pascal 
Published: January 2021

AbstractBackgroundRecent advances in the field of congenital heart disease (CHD) led to an improved prognosis of the patients and in consequence the growth of a new population: the grown up with congenital heart disease. Until recently, more than 50% of these patients were lost to follow up because of the lack of specialized structures. The critical moment is the transition between paediatric and adult unit. Therapeutic education is crucial to solve this issue by helping patients to become independent and responsible. The TRANSITION-CHD randomized trial aims to assess the impact of a transition education program on health-related quality of life (HRQoL) of adolescents and young adults with CHD.MethodsMulticentre, randomised, controlled, parallel arm study in CHD patients aged from 13 to 25 years old. Patients will be randomised into 2 groups (education program vs. no intervention). The primary outcome is the change in self-reported HRQoL between baseline and 12-month follow-up. A total of 100 patients in each group is required to observe a significant increase of the overall HRQoL score of 7 ± 13.5 points (on 100) with a power of 80% and an alpha risk of 5%. The secondary outcomes are: clinical outcomes, cardiopulmonary exercise test parameters (peak VO2, VAT, VE/VCO2 slope), level of knowledge of the disease using the Leuven knowledge questionnaire for CHD, physical and psychological status.DiscussionAs the current research is opening on patient related outcomes, and as the level of proof in therapeutic education is still low, we sought to assess the efficacy of a therapeutic education program on HRQoL of CHD patients with a randomized trial.Trial registrationThis study was approved by the National Ethics Committee (South-Mediterranean IV 2016-A01681-50) and was registered on Clinicaltrials.gov (NCT03005626).
Comparison of the overall survival of proximal and distal gastric cancer after gastrectomy: a systematic review and meta-analysis
Authors: Xue Jiaming , Yang Huiliang , Huang Shanshan , Zhou Tingting , Zhang Xiangwen , Zu Guo 
Published: January 2021

AbstractBackgroundThe aim of this study was to investigate the overall survival (OS) between proximal gastric cancer (PG) and distal gastric cancer (DG) patients after gastrectomy.MethodsArticles on the prognostic study of PG and DG patients after gastrectomy were collected from the PubMed, EMBASE, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang, and VIP databases from the date of establishment until December 2020. The data were statistically analyzed by Stata software (version 11.0, StataCorp).ResultsA total of 10 articles met the inclusion criteria. Meta-analysis showed that the 1-, 3- and 5-year OS rates of PG patients were significantly lower than those of DG patients (RR = 0.898, 95% CI: 0.825 to 0.977,P= 0.013; RR = 0.802, 95% CI: 0.708 to 0.909,P= 0.001; RR = 0.736, 95% CI: 0.642 to 0.844,P= 0.000). After subgroup analysis according to different countries, the combined RR values of were as follows: 1-year OS: eastern countries: RR = 0.966, 95% CI: 0.944 to 0.988,P= 0.003, western countries: RR = 0.687, 95% CI: 0.622 to 0.759,P= 0.000; 3-year OS: eastern countries: RR = 0.846, 95% CI: 0.771 to 0.929,P= 0.000, western countries: RR = 0.742, 95% CI: 0.399 to 1.382,P= 0.348; and 5-year OS: eastern countries: RR = 0.798, 95% CI: 0.716 to 0.889,P= 0.000, western countries: RR = 0.646, 95% CI: 0.414 to 1.008,P= 0.054.ConclusionIn terms of 1-, 3-, and 5-year OS, PG patients had lower rates than DG patients and the eastern countries/western countries subgroup, but there were no significant differences in 3- and 5-year OS for the western countries. These results merit further clinical validation in future studies.(Registration ID: UMIN000040393; Date of registration: 2020/05/13)