bluuebunny/crossref_metadata_2025_split huggingface dataset:
Application of Treatment Simulation Software for War Injury in Emergency Treatment Training on the Battlefield based on Chinese Visible Human Datasets
Authors: Hu Xin , Liu Li , Xu Zhou , Yang JingYi , Guo HongFeng , Zhu Ling , Wu Yi 
Published: January 2021

Abstract
Background: Proficiency in self-help and mutual aid skills is correlated with the prognosis of injured patients, and this study aims to create treatment simulation software for war injuries that reflect the physical constitution of Chinese people and study its application in first aid training on the battlefield. Methods: Based on thin-sectional, highly precise Chinese Visible Human (CVH) data with high resolution, combined with self-help and mutual medical aid measures such as digital pressure hemostasis, cricothyroid membrane puncture, pneumothorax puncture and bone marrow puncture for battlefield first aid, useing Amira and other softwares to building the simulation software for the technical training of military medical students and basic medical officers was constructed. Eighty medical service students were trained on battlefield first aid technology, and a new training mode for the treatment of war injuries was developed and optimized. Results: Simulation software of hemostasis and puncture for battlefield first aid that was suitable for the technical training of military medical students and its supporting teaching materials 3D-PDF were established. The software included modules of hemostasis of the vertex, face, head-shoulder, shoulder-arm, forearm, upper forearm, lower limb and foot and puncture of the cricothyroid membrane , pneumothorax, and bone marrow cavity. Collaborating with interactive 3D-PDF, it was successfully used for on-site first aid training of military medical students. The questionnaire results showed that the trainees had a high recognition of the human-computer interactive performance of the software with a clear interface and easy operation. The accuracy and richness of the three-dimensional model structure, knowledge of hemostasis and puncture and applied anatomy contained in this software were high, helping trainees to quickly master the knowledge points and operation techniques related to hemostasis and puncture. Conclusion: The system can effectively mobilize the learning enthusiasm of students and fully improve the learning efficiency of the basic materials and applied anatomy of battlefield first aid, as well as the teaching efficiency of teachers. The training simulation of battlefield first aid, comprising a combination of various modes, effectively complemented each other, met many training needs, and achieved satisfactory training results. Additionally, this software could be used in the emergency training of traffic accident injuries and disaster-related injuries.
Laparoscopic High Anterior Resection with Transrectal Natural Orifice Specimen Extraction Has Better Short-Term Recovery and Psychological Wellness Outcomes Compared to Conventional Laparoscopy
Authors: Wang Kaijing , Zhang Yuanyuan , Gao Wei , Liu Jie , Liu Meng-Cheng , Zhuang Huiren , Gu Dong-Di , Xiao Lizhen , Jiang Dandi , Liu Yan , Ji Zhonghua , Li Dan 
Published: January 2021

Abstract
Background: Transrectal natural orifice specimen extraction (NOSE) is less invasive compare to traditional laparoscopic-assisted anterior resection (LAR). However, psychological evaluation of patients after transrectal LAR-NOSE is needed to evaluate its clinical feasibility. This study aimed to compare patient outcomes between LAR and LAR-NOSE.Methods: We studied 215 patients with colorectal cancer who underwent surgery between June 2015 and April 2018; they were randomized into two groups: LAR-NOSE (n=109) and LAR (n=106). Data on pain, anxiety, and depression were collected and compared. Pain was assessed by a visual analogue scale (VAS) and anxiety and depression by the self-rating anxiety scale (SAS), self-rating depression scale (SDS), and state-trait anxiety inventory. The overall survival and 5-year disease-free survival (DFS) rates were noted.Results: The extraction success rate in the LAR-NOSE group was 87.1% (95/109 cases). The LAR-NOSE SAS (44.21 ± 8.46) and SDS (37.29 ± 8.98) scores were significantly lower than the LAR scores (51.04 ± 9.12 and 44.65 ± 9.27, respectively; P<0.05) 1 week postoperatively. The LAR VAS scores were significantly higher on postoperative days 1–3 (P<0.05). LAR-NOSE was associated with faster operational and intestinal recovery times, less blood loss, and shorter postoperative hospitalization (P<0.05). However, 5-year DFS between the groups was the same.Conclusion: patients in the LAR-NOSE group showed better outcomes related to postoperative anxiety and depression, postoperative complications, and short-term postoperative recovery. Our results suggest transrectal NOSE as a feasible and potentially preferable method for treatment in selected patients.Registration No: SHDFYY2015-098 Date:2015.02.01
CYSTM1: A Novel Biomarker for&nbsp;Hepatocellular Carcinoma Prognosis
Authors: Du Jun , Wang Jinguo 
Published: January 2021

Abstract
Background: The expression and molecular mechanism of cysteine rich transmembrane module containing 1 (CYSTM1) in human tumor cells remains unclear. The aim of this study was to determine whether CYSTM1 could be used as a potential prognostic biomarker for hepatocellular carcinoma (HCC).Methods: We first demonstrated the relationship between CYSTM1 expression and HCC in various public databases. Secondly, Kaplan–Meier analysis and Cox proportional hazard regression model were performed to evaluate the relationship between the expression of CYSTM1 and the survival of HCC patients which data was downloaded in the cancer genome atlas (TCGA) database. Finally, we used the expression data of CYSTM1 in TCGA database to predict CYSTM1-related signaling pathways through bioinformatics analysis.Results: The expression level of CYSTM1 in HCC tissues was significantly correlated with T stage (p = 0.039). In addition, Kaplan–Meier analysis showed that the expression of CYSTM1 was significantly associated with poor prognosis in patients with early-stage HCC (p = 0.003). Multivariate analysis indicated that CYSTM1 is a potential predictor of poor prognosis in HCC patients (p = 0.036). The results of biosynthesis analysis demonstrated that the data set of CYSTM1 high expression was mainly enriched in neurodegeneration and oxidative phosphorylation pathways.Conclusion: CYSTM1 is an effective biomarker for the prognosis of patients with early-stage HCC and may play a key role in the occurrence and progression of HCC.
Gastric-Type Mucinous Adenocarcinoma of the Cervix in A Woman With Peutz-Jeghers Syndrome
Authors: tong tong , Fan Qiong , Shi Shu , Li Yuhong , Wang Yudong 
Published: January 2021

Abstract
Background: Peutz-Jeghers syndrome(PJS) is a very rare autosomal dominant disorder with predisposition to multiple neoplasms. Gastric-type adenocarcinoma (GAS) is a less common carcinoma of the cervix than squamous cell carcinoma, which is more aggressive and has lower 5 year survival rate than usual type endocervical adenocarcinoma (ECA), and unrelated to human papilloma virus(HPV) infection as well. We present a 32 year-old patient with Peutz-Jeghers syndrome who was found to have gastric-type adenocarcinoma of the cervix. Case presentation: A 32-year-old woman without sexual life ever who was diagnosed Peutz-Jeghers syndrome when she was two years old presented with watery discharge for more than 6 months. A tumor around 6cm was found on the cervix and she was diagnosed gastric-type mucinous adenocarcinoma of the cervix clinical stage IB3. She was treated with artery intervention chemotherapy for one course followed by radical surgery and then systematic chemotherapy.Conclusions: The case suggests more thorough cancer screening for patients with PJS as the disorder is rare and has high risk of malignancies. Young patients with Peutz-Jeghers syndrome, including those without sexual life, who have watery discharge or bleeding should be screened for cervical carcinoma even if cytologic results or human papilloma virus (HPV) is negative.
Outcome Prediction after Neoadjuvant Chemotherapy (NAC) for Breast Cancer, using Tumor-Infiltrating Lymphocytes within Fibrotic Foci of Tumor Stroma (FF-TILs)
Authors: Asano Yuka , Kashiwagi Shinichiro , Kouhashi Rika , Yabumoto Akimichi , Takada Koji , Ishihara Sae , Goto Wataru , Morisaki Tamami , Shibutani Masatsune , Tanaka Hiroaki , Hirakawa Kosei , Ohira Masaichi 
Published: January 2021

Abstract
Background: Tumor-infiltrating lymphocytes (TILs), which are indicators for monitoring an immune response, are generally mononuclear immunocytes that aggregate with tumors and are thought to have a close relationship with cancer cells. On the other hand, a fibrotic focus (FF) within the stroma of a tumor is a histological formation that plays an important role in the cancer microenvironment with regard to proliferation and development. Here, we focus on TILs that exist within the FF and we have performed pathological evaluations.Methods: Of the 320 patients were treated with neoadjuvant chemotherapy (NAC), 239 subjects who were able to evaluate FF-TILs were targeted. Lymphocytes that infiltrate the FF are FF-TILs.Results: The disease-free survival (DFS) period after NAC for the high-FF-TIL group was found to be significantly longer than that for the low-FF-TIL group for all cases (p < 0.001) and for all subtypes of triple-negative breast cancer (TNBC) (p = 0.001), human epidermal growth factor receptor 2-enriched breast cancer (HER2BC) (p = 0.010), and hormone receptor-positive breast cancer (HRBC) (p = 0.003). In multivariable analysis as well, high-FF-TIL group classification was an independent factor for recurrence after NAC for all cases (p < 0.001, hazard ratio (HR) = 0.198) and all subtypes of TNBC (p = 0.006, HR = 0.172), HER2BC (p = 0.025, HR = 0.135), and HRBC (p = 0.007, HR = 0.228).Conclusions: It is suggested that FF-TILs are a useful factor for predicting recurrence of breast cancer after NAC.Article headings: NAC for breast cancer by evaluation of FF-TILs
SUVmax Reduction Predicts Long-Term Survival in Patients of Non-pCR Both in the Tumor and Lymph Nodes after Neoadjuvant Chemoradiotherapy in Esophageal Squamous Cell Carcinoma
Authors: Nagaki Yushi , Motoyama Satoru , Sato Yusuke , Wakita Akiyuki , Fujita Hiromu , Sasaki Yoshihiro , Imai Kazuhiro , Minamiya Yoshihiro 
Published: January 2021

Abstract
Background: A pathological complete response (pCR) after neoadjuvant chemoradiotherapy (NACRT) ensures long-term survival in esophageal squamous cell carcinoma (ESCC) patients following esophagectomy, but pCR patients are a minority. The aim here was to identify prognostic factors in patients with non-pCR ESCC after NACRT. Methods: This is a retrospective study. Investigated were 5-year overall survival (OS), disease-specific survival (DSS), and relapse-free survival (RFS) among non-pCR ESCC patients divided into pT0N0, primary site pCR (pT0N+), lymph node pCR (pT+N0), and non-pCR in both the tumor and lymph nodes (pT+N+) subgroups after NACRT and esophagectomy. Focusing on the SUVmax reduction rate in the primary tumor in 88 patients who underwent FDG-PET before and after NACRT, we used univariate and multivariate Cox proportional hazard models to identify prognostic factors.Results: Although there were no significant survival differences among non-pCR ESCC patients with pT0N+, pT+N0, or pT+N+, and survival rate among pT+N+ patients was the poorest. After setting a 60% cutoff for the SUVmax reduction rate in the tumor, RFS curves for non-pCR patients significantly differed between patients above the cutoff and those below it. For pT+N+ patients, the SUVmax reduction rate (<60% vs ≥60%) was an independent prognostic factor of OS, DSS, and RFS.Conclusion: Because ESCC patients with SUVmax reduction rates of <60% in the tumor after NACRT and categorized as pT+N+ after NACRT had significantly poorer prognoses, even after esophagectomy, a change in treatment strategy may be an option to improve survival.
MRI Volumetric Changes in Hippocampal Subfields in Psychosis: a Protocol for a Systematic Review and Meta-analysis
Authors: Nasa Anurag , Mosley Olivia , Roman Elena , Kelliher Allison , Gaughan Caoimhe , Levins Kirk J. , Coppinger David , O’Hanlon Erik , Roddy Darren William , Cannon Mary 
Published: January 2021

Abstract
Background: The hippocampus has for long been known for its abilities to form new, declarative memory. However, emerging findings across conditions in the psychosis spectrum also implicate its role in emotional regulation. Systematic reviews have demonstrated consistent volume atrophic changes in the hippocampus. The aim of the systematic review and metanalysis which will follow from this protocol will be to investigate the volume-based neuroimaging findings across each of the subfields of the hippocampus in psychosis independent of diagnosis.Methods: Volume changes across subfields of the hippocampus in psychotic illnesses will be assessed by systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). MRI neuroimaging studies of patients with a definitive diagnosis of psychosis (including brief pre diagnostic states) will be included. Studies lacking adequate controls, illicit drug use, medical psychosis, history of other significant psychiatric comorbidities or emphasis on age groups above 65 or below 16 will be excluded. Subfields investigated will include the CA1, CA2/3, CA4, subiculum, presubiculum, dentate gyrus, stratum, molecular layer, granular cell layer, entorhinal cortex and fimbria. Two researchers will independently conduct the search and selection procedures to gather suitable studies. One reviewer will independently perform all the data extraction, and another reviewer will then systemically check all the extracted information using the original articles to ensure accuracy. Statistical analysis will be performed using the metafor and meta packages in R Studio with application of the random effects model.Discussion: This study will provide insight into the volumetric changes in psychosis of the subfields of the hippocampus, independent of diagnosis. This may shed light on the intricate neural pathology which encompasses psychosis and will open avenues for further exploration of the structures identified as potential drivers of volume change.Systematic review registration: PROSPERO CRD42020199558
Gut Microbiota Changes After Metabolic Surgery in Adult Diabetic Patients With Mild Obesity: a Randomised Controlled Trial
Authors: Lau Eva , Belda Eugeni , Picq Paul , Carvalho Davide , Ferreira-Magalhães Manuel , Silva Maria Manuel , Barroso Isaac , Correia Flora , Vaz Cidalia Pina , Miranda Isabel , Barbosa Adelino , Klement Karine , Dore Joel , Freitas Paula , Prifti Edi 
Published: January 2021

Abstract
Background: Roux-en-Y gastric bypass (RYGB) surgery is one of the most efficient procedures for the treatment of obesity, also improving metabolic and inflammatory status, in patients with mild obesity. The underlying mechanisms have not been fully understood, but gut microbiota is hypothesized to play a key role. Our aim was to evaluate the association between gut microbiota changes and anthropometric, metabolic and inflammatory profiles after metabolic surgery compared with medical therapy, in type 2 diabetic (T2DM) adults with mild obesity (BMI 30-35 Kg/m2).Methods: DM2 was an open-label, randomised controlled clinical trial (RCT: ISRCTN53984585) with 2 arms: (i) surgical, and (ii) medical. The main outcome was gut microbiota changes after: metabolic surgery (Roux-en-Y gastric bypass - RYGB) versus standard medical therapy. Secondary outcomes included anthropometric, metabolic and inflammatory profiles. Clinical visits, blood workup, and stool samples were collected at baseline and months (M)1, 3, 6, 12. Gut microbiota was profiled using 16S rRNA targeted sequencing.Results: Twenty patients were included: 10 in surgical and 10 in medical arm. Anthropometric and metabolic comparative analysis favoured RYGB over medical arm. At M12, the percentage of weight loss was 25.5% vs. 4.9% (p<0.001) and HbA1c was 6.2% vs. 7.7% (p<0.001) respectively.We observed a continuous increase of genus richness after RYGB up until M12. In the medical arm, genus richness ended-up being significantly lower at M12. Composition analysis indicated significant changes of the overall microbial ecosystem (permanova p=0.004, [R2=0.17]) during the follow-up period after RYGB. There was a strong association between improvement of anthropometric/metabolic/inflammatory biomarkers and increase in microbial richness and Proteobacterial lineages.Conclusions: This was the first RCT studying composite clinical, analytic, and microbiome changes in T2DM patients with class 1 obesity after RYGB versus standard medical therapy. The remarkable phenotypic improvement after surgery occurred concomitantly with changes in the gut microbiome, but at a lower level.Trial registration: ISRCTN53984585 (http://www.isrctn.com/ISRCTN53984585)
Clinical Outcomes and Independent Risk Factors for 90-day Mortality in Critically-ill Patients Infected With SARS CoV-2: a Multicenter Study in Turkish Intensive Care Units
Authors: Gundogan Kursat , Akbudak Ismail Hakki , Hanci Pervin , Halacli Burcin , Temel Sahin , Gullu Zuhal , Inci Kamil , Bilir Yeliz , Bozkurt Firdevs Tugba , Yildirim Fatma , Simsek Meltem , Yuksel Recep Civan , Eren Esma , Altintas Neriman Defne , Talan Leyla , Elay Gulseren , Guven Goksel , Kara Iskender , Aydin Emre , Yilmaz Seda , Mengi Tugce , Sari Sema , Akbas Turkay , Cinleti Burcu Acar , Ayhan Nazire Ates , Ozbek Deniz Aral , Sahin Taha Koray , Acikgoz Asli , Esbah Ali Umit , Firat Ahmet , Aydemir Ferhan , Gurkok Mehmet Cagatay , Zerman Avsar , Gumus Ayca , Turkoglu Melda , Aydogdu Muge , Ulu Ramazan , Celik Jale Bengi , Balci Canan , Kirakli Cenk , Karakoc Emre , Ozyilmaz Ezgi , Ersoy Ebru Ortac , Ocal Serpil , Sen Irem Akin , Tor Ibrahim Hakki , Comert Bilgin , Ergan Begum , Saracoglu Kemal Tolga , Ergil Julide , Yuksel Ummu Gulsum , Tutar Nuri , Sungur Murat , Topeli Arzu 
Published: January 2021

Abstract
Background: There are limited data on long-term outcome and mortality predictors of COVID-19 from different parts of the world. The aim of this study was to determine risk factors of 90-day mortality in critically-ill patients infected with SARS-CoV-2 in Turkish ICUs. Methods: This multicenter, retrospective study was performed in 26 ICUs in Turkey. All patients with confirmed SARS-CoV2 infection, requiring more than 24 hours of ICU follow-up were included in the study. Demographics, clinical characteristics, laboratory variables, respiratory support, treatment types, and survival data were recorded. Results: A total of 421 patients were included in the study. The median age was 67 (IQR: 57-76) years, and 251 patients (59.6%) were men. 90-day mortality rate was 55.1%. Factors independently associated with 90-day mortality were receiving invasive mechanical ventilation (HR 4.09 [95% CI: 2.20-7.63]), admission lactate level > 2 mmol/L (2.78 [1.93-4.01]), age ≥ 60 years (2.45 [1.48-4.06)]), having cardiac arrhythmia during ICU stay (2.01 [1.27-3.20]), receiving vasopressor treatment (1.94 [1.32-2.84]), positive fluid balance of ≥ 600 ml/per day during ICU follow-up (1.68 [1.21-2.34]), admission PaO2/FiO2 ratio of ≤ 150 mmHg (1.66 [1.18-2.32], and baseline ECOG score ≥ 1 (1.42 [1.00-2.02]. Conclusion: This study has shown that long-term mortality was high in critically-ill COVID-19 patients in Turkish ICUs. Invasive mechanical ventilation, high lactate level, older age, presence of cardiac arrhythmia, need for vasopressor treatment, positive fluid balance, severe hypoxemia and not having fully-active performance were related with mortality.
Trends and Socioeconomic Factors in Smoking and Alcohol Consumption Among Chinese Adults: Evidence From National Health Service Surveys
Authors: Liu Kehui , Ding Yan , Lu Xiang , Wang Zhonghua 
Published: January 2021

Abstract
Background: Smoking and excessive drinking are risk factors for many diseases. With the rapid economic development in China, it is important to identify trends in smoking and alcohol consumption and factors that contribute to these behaviors to ensure the health of the population.Methods: we analyzed pooled cross-sectional data from the fourth, fifth, and sixth National Health Service Surveys conducted in Jiangsu Province in 2008, 2013, and 2018, respectively. Trends in smoking and alcohol use were analyzed with descriptive statistics, and bivariate and multivariate logistic regression was used to identify contributing factors.Results: Among total sample, smoking rate was 23.95%, in which the incidence of mild, moderate and severe smoking was 5.75%, 4.63% and 13.56%, respectively; drinking rate was 23.29%, in which non-excessive drinking and excessive drinking were 19.80% and 3.49%, respectively. From 2008–2018, overall and light-to-moderate smoking rates first increased and then decreased while heavy smoking rate declined; and alcohol consumption increased while excessive drinking increased before decreasing. The varying tendency of smoking and drinking rates in urban area was similar to rural area, however there was a significant gap in incidence between urban and rural area. Socioeconomic factors, demographic, health-related and year variables were significant associated with smoking and drinking. Conclusion: Preventive measures such as education and support services along with stricter regulations for tobacco and alcohol use are needed to improve public health in China.
A Strategy That Improves the Culture of Information Use at Primary Health Care Units in Ethiopia
Authors: Abera Wondwosen Shiferaw , Halallo Brook Abate , Beshir Ismael Ali , Desta Binyam Fekadu , Argaw Mesele Damte 
Published: January 2021

Abstract
Background: Health systems require high-quality data production for health service delivery and program improvement. Ethiopia’s health sector was challenged with lack of quality data from its routine health information system which is an essential element of evidence-based decision making. To overcome this, the Ethiopian Ministry of Health introduced a health information system (HIS) performance monitoring tool named the connected woreda strategy (CWS). This study aims to assess the effectiveness of the CWS to improve culture of information use at primary health care entities. Methods: The study employed a repeated cross-sectional study design through pre and post testing of district health offices using connected woreda assessment tools. A total of 78 districts were enrolled in this study to assess their performance on the implementation of the CWS. The CWS assessment checklist is comprised of 54 questions, all of which were assigned numeric number response types and categorized into HIS capacity (30%), data quality (30%), and administrative data use (40%) and further categorized as districts that meet the highest standards, (>90% of common set of criteria) i.e. ‘model woredas’, districts that meet medium standards, (between 65% to 90% score of common set criteria) i.e. ‘candidate woredas’ and districts that meet lowest standards (<65 of common set of criteria) i.e. ‘emerging woredas’. Finally, the data were analyzed using the SPSS-version 25 software. Results: A total of 78 districts were employed and described and a paired sample t-test was used to measure the performance of districts on CWS implementation. Due to CWS implementation, 10% of districts were ‘models’ in HIS performance; ‘candidate’ districts increased from 40% to 73%; and ‘emerging’ districts decreased from 60% to 17%. Finally, overall CWS scores showed significant improvements after the intervention with 73.4 ± 10.48 SD compared to before intervention 60.4±13.69 SD, with t (77) =-7.18 and p=0.001. Conclusions: This study has revealed that the CWS implementation has a positive effect towards cultural transformation of use of data for decision making at primary health care entities. Thus, scaling up the connected woreda implementation is recommended at the national level to improve the performance of primary health care entities.