bluuebunny/crossref_metadata_2025_split huggingface dataset:
Loco-regional N staging in Rectal Cancer with Magnetic Resonance Imaging: A Study of Inter- and Intra-Observer Variability
Authors: Stoppino Luca Pio , Francavilla Alessia , Petrera Miriana Rosaria , Manco Maria Grazia Rita , Gravina Matteo , Milillo Paola , Macarini Luca , Vinci Roberta 
Published: August 2021

Abstract
Background: Colorectal cancer is one of the most common tumors for both men and women: in the United States, it represents the third leading cause of new cancer cases and cancer-related deaths. The prognosis is directly related to tumor infiltration in the mesorectum and lymph node metastases. In particular, it’s important to define the distance between lymphadenopathy and mesorectal fascia, as this has repercussions on surgical planning. This study aimed to evaluate the agreement among observers with different abdominal MRI expertise and intra-observer reliability in lymph nodes size and feature definition. Methods: In this retrospective study, MRI examinations were performed in 88 patients with rectal adenocarcinoma treated with primary surgery. Four observers, two senior physicians, and two junior physicians, analyzed MRI scans in two sessions 30 days apart and determined the size and morphological pattern of regional lymph nodes. Statistical analysis included the determination of Fleiss kappa (k) coefficient, Cohen's Kappa coefficient, and confidence intervals (CI). Results: The inter-observer reproducibility for MRI N-staging was good among the four physicians (kappa = 0.65; CI 0.45–0.77). Reproducibility between the two senior physicians had a kappa of 0.68 (CI 0.62–1.00), while between the two junior physicians had a kappa of 0.61 (CI 0.33–0.89). Inter-observer reproducibility was excellent for mesorectal, inferior mesenteric, and internal iliac lymph nodes (kappa values of 0.89, 0.82, and 0.80 respectively). For the other two nodal stations (superior and middle rectal lymph nodes, sacral lymph nodes), there was a good interobserver reproducibility (kappa between 0.70 and 0.77).The intra-observer reproducibility of interpretations of the MRI overall N staging progressively decreased among observer B (kappa= 0.85), observer C (kappa= 0.59), and the other two physicians. There was a significant difference in lymph nodes measurements between the first and second sessions in observer A (p ≥ 0.05). Excellent intraobserver reproducibility was found for mesorectal lymph nodes; the lowest intraobserver reproducibility values were found for presacral and lateral sacral lymph nodes.Conclusions: Although the low accuracy of MRI in assessing the involvement of metastatic lymph nodes in rectal cancer, this study demonstrates good interobserver reliability among physicians with different abdominal MRI experiences.
Prospect of Managing Invasive Plants by Native Insect Herbivores: A Case Study of Kashmir Himalaya
Authors: Ahmad Tariq , Rashid Irfan , Ahmad Rayees , Mehraj Maajid , Ahmad Naieem 
Published: August 2021

Abstract
Biological invasions are considered a massive threat to native biodiversity engulfing both terrestrial and aquatic ecosystems worldwide while having cascading ecological and economic effects on the invaded regions. Kashmir Himalaya, an important constituent of the biodiversity hotspot, is heavily invaded by invasive alien plants. An inventory of species diversity of invasive plants and native insect herbivores was carried out in different terrestrial habitats of Kashmir Himalaya in the years 2018-19 and 2019-20. The results showed maximum value (3.39) of Shannon’s diversity index at district Kupwara with minimum value (2.967) at district Srinagar. Margalef Index attained maximum value (5.966) at district Bandipora and a minimum value (4.724) at district Srinagar. Our data revealed maximum value of evenness (0.732) in district Baramulla with minimum value (0.650) at district Pulwama. Similarly, district Baramulla of North Kashmir showed highest Simpson value (0.957) while district Srinagar with minimum value (0.934). Plantago major belonging to the family Plantaginaceae was found to be the most dominant invasive plant species followed by Taraxacum officinale of family Asteraceae. Altica himensis was the most abundant native insect herbivore feeding on almost all invasive plant species with maximum damage on Rumex hastatus of Polygonaceae family. A total of 42 invasive plant species were recorded during the entire study period, of which 12 are worst invaders namely Plantago major, Taraxacum officinale, Trifolium rapens, Trifolium pratense, Plantago lanceolata, Cyanodon dactylon, Anthemis cotula, Clinopodium umbrosum, Ranunculus arvensis, Veronica persica, Dactylis glomerata and Vulpia myuros. A total of 14 native insect herbivores species were identified on these invasive alien plants, of which the prospect of 06 insect herbivore species as potential biocontrol agents is promising. Among the collected insect herbivores, a few namely Chrysolina herbacea, Melanoplus differentialis, Pieris brassicae and Altica himensis are being reared on native and invasive plant species under laboratory conditions. Preliminary results of these native insect herbivors as potential biocontrol agents against invasive alien plants are encouraging. These novel, non-coevolved insect herbivores can not only be exploited to control the spread of invasive plants but could also thwart huge economic losses associated with the management of invasive plants worldwide.
The Impact of Sex Differences on Renal Function Outcomes After Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma: A Retrospective Study
Authors: Chien Tsu-Ming , Li Ching-Chia , Lu Yen-Man , Chang Hsueh-Wei , Chou Yii-Her , Wu Wen-Jeng 
Published: August 2021

Abstract
Background: Upper tract urothelial carcinoma (UTUC) is a relatively rare type of urothelial carcinoma. Additionally, only few reports have examined the sex differences in patients with UTUC. Therefore, the present study aimed to identify the sex factors affecting renal function in patients with UTUC.Methods: Patients who underwent radical nephroureterectomy for non-metastatic UTUC between 2000 and 2013 were retrospectively reviewed and divided into two groups by sex. The Kaplan–Meier method was applied to evaluate the effects of sex on survival, whereas for the other clinicopathological parameters, hazard ratios were evaluated using the Cox regression model. The analyses were also performed in patients with different chronic kidney disease (CKD) stages.Results: A total of 368 patients were included, 147 men and 221 women. Female patients had a higher rate of anemia, advanced CKD stage, and dialysis. Male patients predominantly had a higher rate of smoking. The Kaplan–Meier analysis revealed no differences between sexes on metastasis-free survival (MFS) and cancer-specific survival. Multivariate analysis confirmed that ureteral tumors, advanced pathological tumor stage, and adjuvant chemotherapy indicated significantly worse survival outcomes in both sexes. However, only female patients with advanced CKD showed poorer MFS. After adjusting for renal function, the analysis found men had worse MFS.Conclusions: The female sex is significantly associated with a higher prevalence of advanced CKD among patients with UTUC in Taiwan. The impact of sex differences on renal function needs to be considered when evaluating survival.
Diagnostic Accuracy of Anthropometric Indices for Discriminating Elevated Blood Pressure in Pediatric Population: A Systematic Review and a Meta-Analysis
Authors: Tao Jun-Min , Wei Wei , Ma Xiao-Yang , Huo Ying-Xiang , Hu Meng-Die , Li Xiao-Feng , Chen Xin 
Published: August 2021

Abstract
Background: Childhood obesity is more likely to increase the chance of many adult health problems. Numerous studies have shown obese children to be more prone to elevated blood pressure (BP) and hypertension. It is important to identify an obesity anthropometric index with good discriminatory power for them in pediatric population.Methods: MEDLINE/PubMed, Web of Science, and Cochrane databases were retrieved comprehensively for eligible studies on childhood obesity and hypertension/elevated BP through June 2021. The systematic review and meta-analysis of studies used receiver operating characteristics (ROC) curves for evaluating the discriminatory power of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) in distinguishing children with elevated BP and hypertension. Results: 21 cross-sectional studies involving 177,943 children and 3–19 years of age were included in our study. Meta-analysis showed that the pooled area under the reporting receiver-operating characteristic curves (AUC) and 95% confidence intervals (CIs) for BMI, WC, and WHtR to detect hypertension of boys were 0.68 (0.64, 0.72), 0.69 (0.64, 0.74), 0.67 (0.63, 0.71), for elevated BP, the pooled AUCs and 95% CIs were 0.67 (0.61, 0.73), 0.65 (0.58, 0.73), 0.65 (0.61, 0.71). The pooled AUCs and 95% CIs for BMI, WC and WHtR of predicting hypertension were 0.70 (0.66, 0.75), 0.69 (0.64, 0.75), 0.67 (0.63, 0.72) in girls, the pooled AUCs and 95% CIs of predicting elevated BP were 0.63 (0.61, 0.65), 0.62 (0.60, 0.65), 0.62 (0.60, 0.64) respectively. There was no anthropometric index was statistically superior in identifying hypertension and elevated BP, however, the accuracy of BMI predicting hypertension was significantly higher than elevated BP in girls (P< 0.05). The subgroup analysis for the comparison of BMI, WC and WHtR was performed, no significant difference in predicting hypertension and elevated BP in pediatric population. Conclusions: This systematic review showed that no anthropometric index was superior in identifying hypertension and elevated BP in pediatric population. while compared with predicting elevated BP, all the indicators showed superiority in predicting hypertension in children, the difference was especially obvious in girls. A better anthropometric index should be explored to predict children’s early blood pressure abnormalities.
Whole Exome Sequencing Revealed Three Novel Variants in TSPAN12 and LRP5 Genes for Two Families with Familial Exudative Vitreoretinopathy
Authors: Dan Handong , Wang Dongdong , Huang Zixu , Shi Qianqian , Zheng Miao , Xiao Yuanyuan , Song Zongming 
Published: August 2021

Abstract
Background: Familial exudative vitreoretinopathy (FEVR) is a complex form of blindness-causing retinal degeneration. This study investigated the potential disease-causing variant and molecular basis in two Chinese families with FEVR. Methods: All family members underwent detailed ophthalmological examinations, including best-corrected visual acuity, fundus examination, and fluorescein fundus angiography. Whole exome sequencing, bioinformatics analysis, and Sanger sequencing of available family members were used to confirm the disease-causing gene variant. Results: The proband F1-II:1, his mother, and proband F2-II:1 were diagnosed with FEVR based on clinical symptoms, fundus manifestation, and fundus fluorescein angiography. Whole exome sequencing showed that the proband F1-II:1 had a novel heterozygous variant in the TSPAN12 gene, c.236T>G p. (Met79Arg), which may disturb the transmembrane domain of the TSPAN12 protein. The variant was cosegregated with the phenotypes of FEVR in the family. The proband F2-II:1 carried novel compound heterozygous variants, c.1210G>A p. (Gly404Arg) and c.1612C>T p. (Arg538Trp), in the LRP5 gene, which may disturb the second β-propeller motif of the LRP5 protein. These three variants were classified as likely pathogenic variants. The variants were predicted to be damaging or deleterious using multiple lines of prediction algorithms; they were not frequently found in multiple population databases. The residues affected by these variants are highly conserved among different species. The three novel variants may be potential disease-causing variants in the two families. Conclusions: These results expand the spectrum of variants in TSPAN12 and LRP5 genes and enrich the understanding of the molecular etiology of FEVR.
Long-term Differences in K Balance Under Rice–wheat Cultivation Alter Potassium Supplying Ability of Soils
Authors: Zhang Zhiyi , Liu Dongbi , Wu Maoqian , Xia Ying , Zhang Fulin , Fan Xianpeng 
Published: August 2021

Abstract
The aims of the present study were to provide scientific bases for rational use of crop straw to substitute chemical potassium (K) input and to protect the ecological environment. The effects of potassium fertilization and straw incorporation on soil K balance and K supplying in a long-term (14 years) field experiment. Five treatments were examined: no fertilization and straw (CK); fertilization with no straw return (NPK); only straw return at 6000 kg hm-2 per season (RS); fertilization with straw return at 3000 kg hm-2 per season (NPKS); and fertilization with straw return at 6000 kg hm-2 per season (NPK2S). K composition, K balance and quantity-intensity (Q/I) relationship were studied. Under no fertilization or low straw returned conditions, soil K was unbalance and deficiency seriously. Straw return at 6000 kg hm-2 per season with fertilization improved the soil potassium supply and K balance. Long-term K surplus (4 or 5 years), Compared with NPK, the NPK2S significantly increased non-special adsorption K (Knsa) and non-exchangeable K (Kne) by 5.7 to 11.2 mg kg-1 and 65.7 to 128.1 mg kg-1, respectively. Q/I relationship showed cropping without straw K or without fertilizer K resulted in lower quantity (nonspecifically and specifically held K i.e. –∆K0 and Kx) and intensity (equilibrium activity ratio i.e. CR0K) of K in tested soils. K-fertilization with straw maintain higher exchangeable K (EK0) and a higher difference between EK0 and minimum exchangeable K(EKmin), and would help to prevent depletion in non-exchangeable pool of soil K under intensive cropping. Additionally, The straw return mainly decreased potential buffering capacity for exchangeable pool (PBCKn), 43.92% to 48.22% of added K in soil might be converted to exchangeable pool while it was 25.67% to 29.19% be converted to non-exchangeable pool. The contribution of exchangeable K towards plant K uptake would be higher in the soil with straw than the soil without straw and the non-exchangeable K would be the long-term fixed K as a supplement to the potassium pool. K fertilizer with 6000 kg hm-2 straw return in each crop season increased soil available K and slowly available K. The contribution of exchangeable K towards plant K uptake was higher in the soil with straw than without straw and the non-exchangeable K would be the long-term fixed K as a supplement to the potassium pool. The findings underlined important of the straw return and contribution for sustain K supplying ability of soils.
Serum sodium trajectory during AKI and mortality risk
Authors: Chavez-Iñiguez Jonathan Samuel , Maggiani-Aguilera Pablo , Rondon-Berrios Helbert , Kashani Kianoush , Pérez-Flores Christian , Michel-González Jorge , Torre-Quiroga Andrés De la , Luna-Ramos Andrea , Navarro-Blackaller Guillermo , Medina-González Ramón , Garcia-Garcia Guillermo 
Published: August 2021

Abstract
Introduction: Kidneys play a primary role in electrolyte homeostasis. The association between serum sodium level and mortality or the need for kidney replacement therapy during acute kidney injury has not been adequately explored. Methods: In this prospective cohort study, we enrolled patients admitted to the Civil Hospital of Guadalajara from August 2017 to March 2020. We divided patients into five groups based on the serum sodium level trajectories up to ten days following hospitalization, 1) stable normonatremia (serum sodium 135 and 145 mEq/L), 2) fluctuating serum sodium levels (increased/decreased in and out of normonatremia), 3) uncorrected hyponatremia, 4) corrected hyponatremia, and 5) uncorrected hypernatremia. We assessed the association of serum sodium trajectories with mortality and the need for kidney replacement therapy (secondary objective). Results: A total of 288 patients were included. The mean age was 55±18 years, and 175 (60.7%) were male. Acute kidney injury stage 3 was present in 145 (51%). Kidney replacement therapy started in 72 (25%) patients, and 45 (15.6%) died. After adjusting for confounders, 10-day hospital mortality was significantly higher in group 5 (HR, 3.12; 95% CI, 1.05 to 9.24, p = 0.03), and kidney replacement therapy initiation was higher in group 3 (HR, 2.44; 95% CI, 1.04 to 5.70, p = 0.03) compared with group 1. Conclusion: In our prospective cohort, most patients with acute kidney injury had alterations in serum sodium. Uncorrected hypernatremia was associated with death, and uncorrected hyponatremia was correlated with the need for kidney replacement therapy.
Essential Role of Reliable Reduction Quality in Internal Fixation of Femoral Neck Fractures in the Non-elderly Patients—A Propensity Score Matching Analysis
Authors: Qiu Longhai , Huang Yuliang , Li Guowen , Wu Hongbo , Zhang Zhiwen , Zhang Yu 
Published: August 2021

Abstract
Background: The rate of failure of internal fixation for femoral neck fractures has remained largely unchanged over the past 30 years. The current study attempted to identify the controllable variables influencing the failure of internal fixation of femoral neck fractures. Methods:The study included 190 patients aged from 20 to 65 with femoral neck fracture caused by low energy violent injuries, who were treated with multiple cannulated screws over the period 2005-2019 at a single centre. Kaplan-Meier (KM) survival analysis was firstly utilized to evaluate the potential interaction between each variable and cumulative rates of reoperation. If P < 0.1 in KM survival analysis, the variables would be included in subsequent Cox survival analysis to explore the influencing need for reoperation of a femoral neck fracture. Next, all of the 190 patients were divided into perfect reduction group (Garden Alignment Index Ⅰ) and imperfect reduction group (Garden Alignment Index Ⅱ, Ⅲ, Ⅳ). Propensity score matching (PSM) analysis resulted in 39 pairs. After the baseline variables were balanced between the two groups, Cox survival analysis was utilized again to explore the variables influencing the need of reoperation of a femoral neck fracture. Finally, KM survival analysis was utilized to compare the cumulative rate of reoperation between perfect reduction (Group PR) and imperfect reduction（Group IR）as a subgroup analysis. Results: Before PSM analysis, the mean age was 49.96±12.02 years and the total reoperation rate was 17.40%. Cox survival analysis showed that only reduction quality was interrelated with the need for reoperation before PSM analysis and after PSM analysis. Kaplan–Meier cumulative reoperation rate was higher in Group IR than in Group PR after PSM analysis. Conclusion: To prolong the service life of the original femoral head, it is essential to achieve a completely anatomical reduction and maintain the reduction quality until the patient fully recovers.
Molecular Mechanism of Gleditsiae Spina for the Treatment of High-grade Serous Ovarian Cancer Based on Network Pharmacology and Experimental Verification
Authors: Zhang Boran , Dan Wenchao , Chen Xing , Dai Cunfang , Li Guangda , Ma Tingting , Chen Xinjie , Yin Xiaohui , Zhang Ganlin , Wang Xiaomin 
Published: August 2021

Abstract
Background

In this study, we aimed to analyze the pharmacological mechanism of Gleditsiae Spina in the treatment of high-grade serous ovarian cancer (HGSC) based on network pharmacology and in vitro experiments.
Methods

The main active ingredients of Gleditsiae Spina were identified by high performance liquid chromatography and mass spectrometry, and ADME screening was performed. The component targets of Gleditsiae Spina were screened using the pharmMapper platform, and differentially expressed genes in normal and HGSC tissues were identified through GEO database. Thereafter, Cytoscape 3.7.2 software was used to construct the network of "active ingredient-targets," and the BioGenet database was used for protein-protein interaction analysis. Furthermore, the protein-protein interaction network was established, and the potential protein function module was mined. Biological processes and pathways were analyzed through gene ontology and Kyoto Encyclopedia of Genes and Genomes analysis.
Results

The core active ingredients of Gleditsiae Spina for regulating HGSC included luteolin, genistein, D-(+)-tryptophan, ursolic acid, and berberine. The ideal targets were HPSE, PI3KCA, AKT1, and CTNNB1. The prediction results were verified by molecular docking, molecular dynamics simulation, and western blot analysis.
Conclusions

This study revealed the mechanism of Gleditsiae Spina for the treatment of HGSC based on multi-components, multi-targets, and multi-channels. It also provides a theoretical basis for the prevention of ovarian cancer and its treatment using traditional Chinese medicine in the future.
The Effect of Acetate Ringer's Solution Versus lactate Ringer's Solution on Acid Base Physiology in Infants with Biliary Atresia
Authors: Liu Xiang , Cao Hongyan , Tan Xiaona , Shi Jing , Qiao Li , Zhang Qi , Shi Lei 
Published: August 2021

Abstract
Backgroud: The choice of the perioperative crystalloid is a key component of the fluid management and must take into account the liver function and the appearing metabolic disorders to avoid increase the liver extra metabolism. The aim of this study is to analyze the effect of acetate Ringer's solution or lactate Ringer's solution in biliary atresia patients.Methods: We included 68 infant patients aged between 21~65 d, ASA physical status II or Ⅲ, who underwent elective Kasai hepatoportoenterostomy, received either AR and LR for intravenous fluid resuscitation according to their group allocation. Lactate concentration, serum electrolytes and pH were noteded before skin incision (T1), end of surgery (T2) and postoperative 12 h. We also recorded the time of operation, stay of hospital, loss of blood and urinary, total volume of infusion of crystalloid.Results: Lactate level was significantly higher in Group LR than in Group AR patients at T2 ( 0.76 ± 0.13 versus 0.57 ± 0.22, P=0.03 ). Compared with T3, sodium and chlorine were significantly higher in two groups at T2 ( 145.2 ± 3.1 versus 143.4 ± 3.4 and 104.6 ± 3.7 versus 105.2 ± 2.1 ). No significant differences were noted in potassium, HCO3- and calcium. There was no statistically significant difference in pH. No glycopenia was recorded in two groups. No significant difference was noted in administration of vasoactive drug (0.7% versus 1% ).Conclusions: Resuscitation with AR and LR is associated with similar clinical improvement in infants with biliary atresia. Use of AR reduced the level of lactate in comparison with LR.