bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison between anterolateral thigh free flap and jejunal flap for tissue reconstruction in patients underwent resection of pharyngoesophageal squamous cell carcinoma after radiotherapy failure: a retrospective study
Authors: Sun Si-Lu , Zhong Bing , Zhou Sui-zi , Liu Jun , Liu Ya-Feng , Liu Shi-Xi , Chen Fei 
Published: November 2021

Abstract
Background
Anterolateral thigh (ALT) free flap and jejunal flap (JF) were commonly used in tissue reconstruction for pharyngoesophageal squamous cell carcinoma (PESCC) with worsening tissue adhesion and necrosis after radiotherapy failure. However, the results of tissue reconstruction and postoperative complications of these two flaps are controversial. The purpose of this study was to compare outcomes between group ALT free flap and group JF in PESCC after radiotherapy failure.

Methods
Intraoperative information and postoperative outcomes of patients with PESCC after radiotherapy failure who underwent ALT and JF reconstruction from January 2005 to December 2019 were compared and analyzed.

Results
The defect size of ALT (Numbers, 34) and JF (Numbers, 31) was 36.19 ± 11.35 cm2 and 35.58 ± 14.32 cm2 (p = 0.884), respectively. ALT and JF showed no significant difference in operation time (p = 0.683) and blood loss (p = 0.198). For postoperative outcomes within 30 days both in recipient site and donor site including wound bleeding, wound dehiscence, wound infection, and pharyngocutaneous fistula, ALT free flap and JF showed similar results. Flap compromise (Numbers, 2 VS.3, p = 0.663), flap take backs (Numbers, 1 VS.1, p = 1.000), partial flap failures (Numbers, 4 VS.2, p = 0.674), and total flap failures (Numbers, 0 VS.0, p = 1.000) showed no difference between the two groups. In addition, no significance was found in hypoproteinemia between the two groups (Numbers, 4 VS.2, p = 0.674). ALT free flap was not statistically different from JF in the incidence of dysphagia at the postoperative 6 months (Numbers of liquid diet, 5VS.5; Numbers of partial tube feeding, 6VS.7; Numbers of total tube feeding, 3VS.1, p = 0.790) and 12 months (Numbers of liquid diet, 8VS.7; Numbers of partial tube feeding, 8VS.7; Numbers of total tube feeding, 5VS.5, p = 0.998). The cause of dysphagia not found to differ between the two groups both in postoperative 6 months (p = 0.814) and 12 months (p = 0.845).

Conclusion
Compared with JF, ALT free flap for PESCC patients after radiotherapy failure showed similar results in postoperative outcomes. ALT free flap may serve as a safe and feasible alternative for PESCC patients after radiotherapy failure.
Is diabetic ketoacidosis a good predictor of 5-year metabolic control in children with newly diagnosed type 1 diabetes?
Authors: Emilia Kowalczyk , Aneta Stypułkowska , Barbara Majewska , Małgorzata Jarzębowska , Aleksandra Hoffmann , Paulina Buła , Agnieszka Szypowska 
Published: November 2021

Abstract
Background
The study aimed to evaluate whether the presence of DKA at diabetes diagnosis was associated with poorer metabolic control during a 5-year follow-up.

Methods
The study included children treated due to newly diagnosed T1D complicated with DKA between 2010 and 2014 with a complete 5-year follow-up. In every case we performed individual matching for age, gender and BMI with a person without DKA (nDKA) on recognition. We collected data regarding treatment modality, HbA1C, total daily insulin dose, basal insulin and BMI-SDS.

Results
85 children at the median age of 7.93 years had DKA at diabetes diagnosis. The median pH was 7.19.Continuous subcutaneous insulin infusion (CSII) was used in 87% of participants in each group. No differences in HbA1C level (7,3%vs7,2%;p = .413) were noted after 5 years of disease duration. The severity of ketoacidosis exerted no significant effect on HbA1C. The method of insulin delivery at baseline was significantly associated with HbA1C levels after 5 years of observation, βCSII = − 1.46,95%CI[− 2.01 to − 0.92],p < .001.

Conclusions
The presence of DKA at diabetes diagnosis is not associated with deteriorated long-term metabolic control in children using modern technologies. The early implementation of CSII into diabetes treatment may change the effect of DKA and lead to a long-term HbA1C improvement.
Total productivity change of Health Centers in Greece in 2016–2018: a Malmquist index data envelopment analysis application for the primary health system of Greece
Authors: Trakakis Anastasios , Nektarios Miltiadis , Tziaferi Styliani , Prezerakos Panagiotis 
Published: November 2021

AbstractBackgroundThis paper attempts to evaluate the primary health care system by evaluating health centres in Greece.MethodsMalmquist Index Data Envelopment Analysis is applied to study the total productivity of 155 health centres in Greece during 2016–2018. The data were collected from the Ministry of Health and submitted to quality tests to ensure validity and avoid bias.ResultsThis paper measures the productivity of each of the 155 health centres in Greece and how it shifted during 2016–2018. In addition, the overall productivity change of the 155 health centres over time is calculated and analysed as being due to technical efficiency or technological efficiency. The analysis of the mean values showed a decrease of 0.9% in the overall productivity factor from 2016 to 2017 and a decrease of 5.2% from 2017 to 2018. The overall decrease in the productivity of the 155 health centres was 3.1%. From 2016 to 2018, 59 health centres changed their productivity mainly due to technological change and 91 changed mainly due to technical efficiency change. One health centre showed regression to its total productivity due to equal regression of its technical efficiency and technology.ConclusionsThe method used is nonparametric data envelopment analysis along with the Malmquist index to include panel data in the analysis. Meaningful results were extracted by indicating the number of health centres that improved their productivity, regressed in productivity, or remained constant through the period 2016–2018. This paper may contribute to improving health centres’ efficiency and productivity. Furthermore, valuable results can be extracted for the National Health Care System to match available resources that correspond to each health centre’s needs, as well as for manager planners and stakeholders in primary health care.
Reconstruction and repair, using mini-plate and bone graft for persons living with HIV with giant cell tumor of long bone: retrospective analysis of a single-center experience
Authors: Xu Biao , Ma Rui , Zhang Wen-sheng , Zhang Qiang , Zhao Chang-song , Wang Jie 
Published: November 2021

Abstract
Background
To evaluate the effect of reconstruction and repair, using a mini-plate and bone graft for HIV -positive patients with giant cell tumor of long bone.

Methods
We conducted a retrospective analysis of 12 HIV positive patients with giant cell tumor of long bone. A non-HIV-positive cohort of patients, matched for age, sex, and disease type, was selected as the control group. From June 2012 to August 2020, curettage by ultrasonic scalpel was performed in all patients, combined with min- plate and bone graft treatment. All patients were followed- up for 18 to 60 months. Limb function was evaluated, using the MSTS93 scoring system, and any examples of postoperative recurrence, distant metastasis, complications, MSTS93 score, and fracture prognosis were recorded.

Results
The mean age of HIV group was 43.5 years. The ratio of men to women was 11: 1. In all cases the histopathological diagnosis was clear, except the patients with primary malignant giant cell tumor of bone, including five, three, two, and two cases in the proximal tibia, distal femur, distal tibia, and talus, respectively. Following their surgery, all patients were followed up with an average of 31.24 ± 11.84 months. No local recurrence or pulmonary metastases were observed. Post-surgery, all the 12 patients showed good bone morphologic repair and reconstruction, good bone healing, good joint function, and no pathological fractures around their lesion. In the HIV group, one case of giant cell tumor in the proximal tibia showed mild articular surface collapse and mild valgus deformity of the knee joint but retained good joint function. The MSTS scores of excellent or good in the two groups comprised 83.3%, thus, there was no significant difference between them (P > 0.05). Compared with preoperatively, the MSTS scores in the HIV group were significantly improved, ranging from 7 to 11 points preoperatively to 24 to 27 points postoperatively; this difference was statistically significant (P < 0.05).

Conclusion
Reconstruction and repair, using a mini-plate and bone graft for HIV -positive patients with giant cell tumor of long bone can achieve satisfactory results. The mini- plate requires little space and is flexible during reconstruction and fixation, significantly reducing complications such as surgical site infection, as well as preserving joint function and avoiding amputation; therefore, it is a safe and effective treatment method.
Assessment of sagittal spinopelvic alignment in asymptomatic Chinese juveniles and adolescents: a large cohort study and comparative meta-analysis
Authors: Hou Canglong , Chen Kai , Chen Yu , Zhou Tianjunke , Yang Mingyuan , Li Ming 
Published: November 2021

Abstract
Study design
Retrospective study and comparative meta-analysis.

Objective
To document the sagittal spinopelvic alignment in a large cohort study in asymptomatic Chinese juveniles and adolescents, and to explore whether these parameters were different from various regions using meta-analysis.

Methods
Medical records of 656 asymptomatic Chinese juveniles and adolescents were reviewed, whose mean age was 13.14 ± 3.41 years old, including 254 male and 402 female volunteers. Demographic and lateral radiological parameters were evaluated. Furthermore, a systematic online search was performed to identify eligible studies. Weight mean difference (WMD) with 95% confidence interval (CI) were used to evaluate whether these sagittal parameters were different from various regions.

Results
The mean value of sagittal spinopelvic alignment in this study was calculated and analyzed respectively. Significant differences of PI (34.20 ± 4.00 vs. 43.18 ± 7.12, P < 0.001) and PT (3.99 ± 6.04 vs. 8.42 ± 7.08, P < 0.001) were found between juveniles and adolescents. A total of 17 studies were recruited for meta-analysis. For juvenile populations, TK, PI and SS of Caucasians were significantly larger than those of our study (all P < 0.001). As for adolescent populations, PI (P = 0.017), TK (P = 0.017) and SS (P < 0.001) of Caucasians was found to be greater when compared with that of our study. All in all, TK, PI and SS in Chinese pre-adult populations were significantly smaller than those populations in Caucasian regions (all P < 0.001).

Conclusion
Our study was the first large-scale study that reported the mean values of sagittal parameters in asymptomatic Chinese juveniles and adolescents. There were significant differences in TK, PI and SS between our study and other previous reported populations, which reminded us for using specific mean values in different populations when restoring a relatively normal sagittal spinopelvic balance in spinal deformity.
Allometric equations for selected Acacia species (Vachellia and Senegalia genera) of Ethiopia
Authors: Aneseyee Abreham Berta , Soromessa Teshome , Elias Eyasu , Feyisa Gudina Legese 
Published: November 2021

AbstractBackgroundAllometric equations are used to estimate biomass and carbon stock of forests. In Ethiopia, despite the presence of large floral diversity, only a few site-specific allometric equations have been developed so far. This study was conducted in the Omo-Gibe woodland of south-western Ethiopia to develop an allometric equation to estimate the Above-ground Biomass (AGB) of the fourAcaciaspecies (Senegalia polyacantha,Vachellia seyal, Vachellia etbaicaandVachellia tortilis).Fifty-four (54)Acaciatrees were sampled and measured within 35 temporarily established square plots. In each plot, dendrometric variables were measured to derive the models based on combinations of Diameter at Breast Height (DBH), height, and wood density as predictor variables. Model performance was evaluated using goodness-of-fit statistics. The biomass was compared using four allometric biomass models that have been widely used in the tropics.ResultsThe model containing DBH alone was more accurate to estimate AGB compared to the use of multiple predictor variables. This study, therefore, substantiated the importance of site-specific allometric equations in estimating the AGB ofAcaciawoodlands. This is because a site-specific allometric equation recognizes the environmental factors, vegetation types and management practices.ConclusionsThe results of this study contribute to a better understanding of allometric equations and an accurate estimate of AGB ofAcaciawoodlands in Ethiopia and similar ecosystems elsewhere.
Inequity and benefit incidence analysis in healthcare use among Syrian refugees in Egypt
Authors: Fares Hani , Puig-Junoy Jaume 
Published: November 2021

AbstractBackgroundThe Syrian conflict has created the worst humanitarian refugee crisis of our time, with the largest number of people displaced. Many have sought refuge in Egypt, where they are provided with the same access to healthcare services as Egyptian citizens. Nevertheless, in addition to the existing shortcomings of the Egyptian health system, many obstacles specifically limit refugees’ access to healthcare. This study looks to assess equity across levels of care after observing services utilization among the Syrian refugees, and look at the humanitarian dilemma when facing resource allocation and the protection of the most vulnerable.MethodsA cross‐sectional survey was used and collected information related to access and utilization of outpatient and inpatient health services by Syrian refugees living in Egypt. We used concentration index (CI), horizontal inequity (HI) and benefit incidence analysis (BIA) to measure the inequity in the use of healthcare services and distribution of funding. We decomposed inequalities in utilization, using a linear approximation of a probit model to measure the contribution of need, non-need and consumption influential factors.ResultsWe found pro-rich inequality and horizontal inequity in the probability of refugees’ outpatient and inpatient health services utilization. Overall, poorer population groups have greater healthcare needs, while richer groups use the services more extensively. Decomposition analysis showed that the main contributor to inequality is socioeconomic status, with other elements such as large families, the presence of chronic disease and duration of asylum in Egypt further contributing to inequality. Benefit incidence analysis showed that the net benefit distribution of subsidies of UNHCR for outpatient and inpatient care is also pro-rich, after accounting for out-of-pocket expenditures.ConclusionOur results show that without equitable subsidies, poor refugees cannot afford healthcare services. To tackle health inequities, UNHCR and organisations will need to adapt programmes to address the social determinants of health, through interventions within many sectors. Our findings contribute to assessments of different levels of accessibility to healthcare services and uncover related sources of inequities that require further attention and advocacy by policymakers.
Simulation studies, 3D QSAR and molecular docking on a point mutation of protein kinase B with flavonoids targeting ovarian Cancer
Authors: Ajjarapu Suchitra Maheswari , Tiwari Apoorv , Taj Gohar , Singh Dev Bukhsh , Singh Sakshi , Kumar Sundip 
Published: November 2021

Abstract
Background
Ovarian cancer is the world’s dreaded disease and its prevalence is expanding globally. The study of integrated molecular networks is crucial for the basic mechanism of cancer cells and their progression. During the present investigation, we have examined different flavonoids that target protein kinases B (AKT1) protein which exerts their anticancer efficiency intriguing the role in cross-talk cell signalling, by metabolic processes through in-silico approaches.

Method
Molecular dynamics simulation (MDS) was performed to analyze and evaluate the stability of the complexes under physiological conditions and the results were congruent with molecular docking. This investigation revealed the effect of a point mutation (W80R), considered based on their frequency of occurrence, with AKT1 protein.

Results
The ligand with high docking scores and favourable behaviour on dynamic simulations are proposed as potential W80R inhibitors. A virtual screening analysis was performed with 12,000 flavonoids satisfying Lipinski’s rule of five according to which drug-likeness is predicted based on its pharmacological and biological properties to be active and taken orally. The pharmacokinetic ADME (adsorption, digestion, metabolism, and excretion) studies featured drug-likeness. Subsequently, a statistically significant 3D-QSAR model of high correlation coefficient (R2) with 0.822 and cross-validation coefficient (Q2) with 0.6132 at 4 component PLS (partial least square) were used to verify the accuracy of the models. Taxifolin holds good interactions with the binding domain of W80R, highest Glide score of − 9.63 kcal/mol with OH of GLU234 and H bond ASP274 and LEU156 amino acid residues and one pi-cation interaction and one hydrophobic bond with LYS276.

Conclusion
Natural compounds have always been a richest source of active compounds with a wide variety of structures, therefore, these compounds showed a special inspiration for medical chemists. The present study has aimed molecular docking and molecular dynamics simulation studies on taxifolin targeting W80R mutant protein of protein kinase B/serine- threonine kinase/AKT1 (EC:2.7.11.1) protein of ovarian cancer for designing therapeutic intervention. The expected result supported the molecular cause in a mutant form which resulted in a gain of ovarian cancer. Here we discussed validations computationally and yet experimental evaluation or in vivo studies are endorsed for further study. Several of these compounds should become the next marvels for early detection of ovarian cancer.
Numerical evaluation on steep soil-nailed slope using finite element method
Authors: Kaothon Panyabot , Chhun Kean Thai , Yune Chan-Young 
Published: November 2021

AbstractIn conventional design of soil-nailed slope, the nail parameters such as nail spacing (1–2 m), and nail inclination (10º–20º) have been recommended without considering any specific slope angle. Henceforth, this paper presents a numerical evaluation on the soil-nailed slope with flexible facing based on the finite element method in order to investigate the range of those two parameters with any size of nail head in various slope angles (45º, 55º, 65º, and 75º). Based on a minimum factor of safety (FSmin  =  1.5), the analysis results indicated that the suggested range of those parameters in the conventional specification was applicable in the slope angle of 45º and 55º with any sizes of nail head. Nevertheless, it was not practical for slope angle of 65º and 75º, which required the size of nail head at least 400  ×  400  ×  250 mm, with nail spacing less than or equal to 1.5 m, and nail inclination from 5º to 10º.
Assessment the effect of vitamin D supplementation on plasma vitamin D levels, inflammation, and oxidative stress biomarkers based on vitamin D receptor genetic variation in breast cancer survivors: a protocol for clinical trial
Authors: kazemian Elham , Akbari Mohammad Esmaeil , Moradi Nariman , Gharibzadeh Safoora , Amouzegar Atieh , Rozek Laura S. , Mondul Alison M. , Khademolmele Maryam , Zarins Katie R. , Ghodoosi Nasim , Shateri Zahra , Fallah Soudabeh , Davoodi Sayed Hossein 
Published: November 2021

Abstract
Background
Both human genes and environmental exposures, due to complex interplay, play important role in the cancer etiology. Vitamin D is associated with a reduced risk of incidence and mortality of several human cancers. This study will aim to investigate the possible effects of individual polymorphisms in vitamin D receptor (VDR) as well as effects of VDR haplotypes on response to vitamin D supplementation in breast cancer survivors.

Methods
This is an interventional study in which the effects of vitamin D supplementation on plasma vitamin D levels, inflammatory and antioxidant biomarkers and factors associated with cell proliferation, differentiation, damage, and apoptosis will be investigated stratified by variations in VDR genotype. The present study will be conducted on breast cancer survivors referred to the Shohadaye Tajrish hospital and its associated clinics. One hundred ninety-eight breast cancer survivors will receive 4000 IU of vitamin D3 daily for 12 weeks. VDR Fok1, ApaI, TaqI, BsmI, and Cdx-2 genotype will be determined at the end of the study and responses to vitamin D supplements (inflammatory, antioxidant, cell proliferation, differentiation, damage, and apoptosis biomarkers) will be compared between the three subgroups of each VDR polymorphism as well as different VDR haplotype categories.

Discussion
Genetic variation is a fundamental factor influencing individuals’ divergent responses to diet, nutritional status, metabolic response, and diet-related health disorders. Furthermore, studies of gene and environment interactions will provide a precise and accurate assessments of individuals’ dietary requirements by considering both the genetic and environmental aspects simultaneously. The results of the current study, to some extent, will highlight the discrepancies existing in the findings of different studies regarding vitamin D, VDR, and cancer by considering both the genetic and environmental aspects simultaneously. If responses to vitamin D supplementation could be modified by VDR SNPs, determining the distribution of VDR polymorphisms in both breast cancer survivors and healthy populations will provide a new insight into the vitamin D requirements of individuals to prevent cancer and its related mortality based on their genotypes.
Trial registration This trial has been registered on Iranian Registry of Clinical Trials (IRCT) under the identification code: IRCT2017091736244N1, registration date: 2017-11-10, http://www.irct.ir/trial/27153