bluuebunny/crossref_metadata_2025_split huggingface dataset:
Salvage Robotic-Assisted Thoracoscopic Esophagectomy after Definitive Chemoradiotherapy for Clinical T4b Esophageal Cancer: A Case Report
Authors: Sasamori Ryohei , Motoyama Satoru , Sato Yusuke , Wakita Akiyuki , Nagaki Yushi , Fujita Hiromu , Kemuriyama Kohei , Sasaki Yoshihiro , Imai Kazuhiro , Minamiya Yoshihiro 
Published: March 2021

Abstract
BackgroundAlthough twenty years have passed since the start of robot-assisted thoracoscopic esophagectomy, salvage esophagectomy by robotic-assisted surgery has not yet been introduced by almost surgeons. Theoretically, robot-assisted thoracoscopic esophagectomy (RATE) increases operative precision and maneuverability within the narrow space of the mediastinum. However, surgeons have doubted that RATE is indicated for patients with tumor invasion of adjacent vital organs clinically (cT4b) or patients with scar tissue from definitive chemoradiotherapy. Herein, we report our case of salvage RATE for cT4b thoracic esophageal cancer which invaded to the left main bronchus before definitive chemoradiotherapy.Case presentationA man in his 60’s with middle thoracic esophageal cancer [cT4b (left main bronchus) N1 M0 cStage IIIC] received definitive chemoradiotherapy (fluorouracil and cisplatin, total radiation dose of 60 Gy). After the chemoradiotherapy, upper gastrointestinal endoscopy revealed a residual primary tumor, and we performed robotic-assisted thoracoscopic subtotal esophagectomy and gastric tube reconstruction via a retrosternal route with three-field lymphadenectomy. Although it was difficult to dissect the tumor from adjacent organs, especially in the left main bronchus and pericardium, due to the scarring after definitive chemoradiotherapy, R0 surgery was achieved. With RATE, the high-resolution three-dimensional images, stable surgical field and stable motion are considerable advantages for salvage esophagectomy for cT4b tumors. At present (30 months after surgery), the patient’s performance status is 0 and he is alive without a recurrence. ConclusionsRobot-assisted thoracoscopic esophagectomy provided considerable advantages for salvage esophagectomy after definitive chemoradiotherapy for a cT4b tumor.
Good Operative Effects of Patellofemoral Arthroplasty Combined With the Tibial Tubercle Transfer for Isolated Patellofemoral Arthritis Patients With an Increased Tibial Tuberosity-Trochlear Groove Distance
Authors: Dong Conglei , Zhao Chao , Li Ming , Kang Huijun , Piao Kang , Hao Kuo , Xu Chenyue , Wei Maozheng , Wang Fei 
Published: March 2021

Abstract
BackgroundThe objective of present study was to investigate the operative effect of patellofemoral arthroplasty combined with the tibial tubercle transfer for isolated patellofemoral arthritis patients with an increased tibial tuberosity-trochlear groove distance (>20mm). MethodsA prospective study was performed between November 2012 and December 2017. Finally, thirty-six cases, with a mean age of 61.1 ± 7.3 years, were admitted to our study. A total of 17 patients underwent patellofemoral arthroplasty combined with tibial tubercle transfer, and 19 patients underwent patellofemoral arthroplasty only. All eligible patients had CT scans preoperatively and at 12 months follow-up, to assess the stability of the patellofemoral joint on axial slices. In addition, the demographic and clinical features of all the patients were asked. Knee balance was assessed with the single leg stance test and timed get up and go, and functionality was evaluated with stair climbing test and the Western Ontario and McMaster Universities Osteoarthritis Index score. (P>0.05) ResultsPreoperatively, the data regarding the knee balance and functionality were not significantly different between the two Groups (P>0.05). Many measurements showed significant differences between the two groups at the last follow-up. Significant differences were seen in well-known measurements such as the SLST (Group I, 28.9 s (SD 7.5); Group II, 20.3 s (SD 5.9); p < 0.001), TGUG (Group I, 13.4 s (SD 3.2); Group II, 16.8 s (SD 3.1); p < 0.001), and SCT (Group I, 18.6 s (SD 6.8); Group II, 24.5 s (SD 8.7); p < 0.001). Additionally, the median WOMAC score was improved from 62.7 (SD 11.2) preoperatively to 25.7 (SD 8.2) one year postoperatively in Group I and from 64.1 (SD 10.7) to 36.2 (SD 9.7) in Group II, which were also significantly different between the groups. ConclusionsFor such special IPA patients with an increased TT-TG (>20mm), the combined operation of PFA combined with TTT can better restore the involutional relationship of patellofemoral joint and further improve the balance and function of knee joint.
The Prevalence of Insufficient Iodine Intake in Pregnancy in Africa: a Systematic Review and Meta-analysis
Authors: Businge Charles Bitamazire , Musarurwa Hannibal Tafadzwa , Longo-Mbenza Benjamin , Kengne Andre Pascal 
Published: March 2021

Abstract
BackgroundFortification of foodstuffs with iodine, mainly through iodisation of salt, which commenced in several African countries after 1995 is the main method for mitigating iodine deficiency in Africa. We assessed the degree of iodine nutrition in pregnancy across Africa before and after the implementation of national iodine fortification programs (CRD42018099434).MethodsElectronic databases and grey literature were searched for baseline data before implementation of population-based iodine supplementation and for follow-up data up to September 2020. R-metamedian and metamean packages were used to pool country-specific median UIC estimates and derived mean UIC from studies with similar features. ResultsOf 54 African countries, 23 had data on iodine nutrition in pregnancy mostly from subnational samples. Data before 1995 showed that severe iodine deficiency was prevalent in pregnancy with a pooled pregnancy median UIC of 28.6 µg/L (95% CI 7.6 – 49.5). By 2005, five studies revealed a trend towards improvement in iodine nutrition state in pregnancy with a pooled pregnancy median UIC of 174.1 µg/L (95% CI 90.4 – 257.7). Between 2005 and 2020 increased numbers of national and subnational studies revealed that few African countries had sufficient, while most had mildly inadequate, and some severely inadequate iodine nutrition in pregnancy. The pooled pregnancy median UIC was 145 μg/L (95% CI 126 – 172). Conclusion Improvement in iodine nutrition status in pregnancy following the introduction of fortification of foodstuffs with iodine in Africa is sub-optimal, exposing a large proportion of pregnant women to the risk of iodine deficiency and associated disorders.
The Association Between Serum Uric Acid and the Cardiometabolic Phenotype Among Healthcare Workers in Azar Cohort Study
Authors: Somi Mohammad hossein , Frounchi Negin , Ostadrahimi Alireza , Zakavi Seyed Sina , Gilani Neda , Faramarzi Elnaz 
Published: March 2021

Abstract
Background: As of now, it is unknown whether hyperuricemia can be considered as an independent risk factor or just as a marker to represent the correlation between uric acid and other metabolic syndrome (MetS) risk factors. To the best of the authors’ knowledge, no other work has been reported to study this relationship between serum uric acid (SUA) and cardiometabolic phenotypes. In this work, we intend to study the correlation between SUA and the cardiometabolic phenotype among healthcare workers in Azar cohort study. Method: In this cross-sectional study, anthropometric measurements, serum fasting blood sugar (FBS), triglyceride (TG), cholesterol, high lipoprotein density (HDL), liver enzymes, blood urea nitrogen (BUN), SUA, creatinine (Cr), and blood pressures of 1458 healthcare workers were evaluated. MetS was diagnosed based on ATP III. We classified the participants into four cardiometabolic phenotypes, i.e., metabolically-healthy lean (MHL), metabolically-unhealthy lean (MUHL), metabolically-healthy obese (MHO), and metabolically-unhealthy obese (MUHO).Results: MHL (32.6%) and MHO (66%) have the highest prevalence rate in the first and second SUA tertiles, respectively, which are statistically significant (P-value ≤0.001). We observed an ascending trend in the mean values of WC, TG, cholesterol, low HDL, FBS, BUN, Cr, SBP, DBP, BMI, and liver enzymes from the first SUA tertile to the third SUA tertile (P-value <0.05). Compared to the lowest SUA tertile, the odds of MHO and MUHO increased by 2.29 (95% CI 1.46-3.59) and 5.38 (95%CI 3.45-9.39), respectively. In contrast, no similar trend was observed regarding the association between MUHL and the SUA tertile.Conclusion: We proposed the use of the easily-measured SUA level as a marker for early diagnosis of at-risk MUHL and MHO individuals to administer proper interventions. Further prospective works are needed to identify the effects of SUA on the progression of MetS in various body size subgroups.
Livestock Movement Informs the Risk of Disease Spread in Traditional Production Systems in East Africa
Authors: Ekwem Divine , Morrison Thomas A. , Reeve Richard , Enright Jessica , Buza Joram , Shirima Gabriel , Mwajombe James K. , Lembo Tiziana , Hopcraft J. Grant C. 
Published: March 2021

Abstract
In Africa, livestock are important to local and national economies, but their productivity is constrained by infectious diseases. Comprehensive information on livestock movements and contacts is required to devise appropriate disease control strategies; yet, understanding contact risk in systems where herds mix extensively, and where different pathogens can be transmitted at different spatial and temporal scales, remains a major challenge. We deployed Global Positioning System collars on cattle in 52 herds in a traditional agropastoral system in western Serengeti, Tanzania, to understand fine-scale movements and between-herd contacts, and to identify locations of greatest interaction between herds. We examined contact across spatiotemporal scales relevant to different disease transmission scenarios. Daily cattle movements increased with herd size and rainfall. Generally, contact was greatest away from households, during periods with low rainfall and in locations close to dipping points. We demonstrate how movements and contacts affect the risk of disease spread. For example, contact rate was relatively sensitive to the survival time of different pathogens in the environment, and less sensitive to transmission distance, at least over the range of values that we explored. We identify times and locations of greatest disease transmission potential and that could be targeted through tailored control strategies.
Benefit of Replanning in MR-guided Online Adaptive Radiation Therapy in the Treatment of Liver Metastasis
Authors: Mayinger Michael , Ludwig Roman , Christ Sebastian M. , Bello Riccardo Dal , Ryu Alex , Weitkamp Nienke , Pavic Matea , Schüler Helena Garcia , Wilke Lotte , Guckenberger Matthias , Unkelbach Jan , Tanadini-Lang Stephanie , Andratschke Nicolaus 
Published: March 2021

Abstract
Purpose: To assess the effects of daily adaptive MR-guided replanning in stereotactic body radiation therapy (SBRT) of liver metastases based on a patient individual longitudinal dosimetric analysis. Methods: Fifteen patients assigned to SBRT for oligometastatic liver metastases underwent daily MR-guided target localization and on-table treatment plan re-optimization. Gross tumor volume (GTV) and organs at risk (OARs) were adapted to the anatomy-of-the-day. A reoptimized plan (RP) and a rigidly shifted baseline plan (sBP) without re-optimization were generated for each fraction. After extraction of DVH parameters for GTV, planning target volume (PTV), and OARs (stomach, duodenum, bowel, liver, heart) plans were compared on a per-patient basis.Results: Median pre-treatment GTV and PTV were 14.9 cc (interquartile range (IQR): 7.7 – 32.85) and 62.7 cc (IQR: 42.4 – 105.5) respectively. SBRT with RP improved PTV coverage (V100%) for 47/75 of the fractions and reduced doses to the most proximal OARs (D1cc, Dmean) in 33/75 fractions compared to sBP. RP significantly improved PTV coverage (V100%) for metastases within close proximity to an OAR by 4.0 % (≤ 0.2 cm distance; n = 7; p = 0.01), but only by 0.2% for metastases farther away from OAR (> 2 cm distance; n = 7; p = 0.37). No acute grade 3 treatment-related toxicities were observed.Conclusion: MR-guided online replanning SBRT improved target coverage and OAR sparing for liver metastases with a distance of more < 2 cm to the nearest luminal OAR. Only marginal improvements in target coverage were observed for target distant to critical OARs, indicating that these patients do not benefit from daily adaptive replanning.
Impacts of English Language Proficiency on Healthcare Access, use, and Outcomes among Immigrants: A Qualitative Study
Authors: Pandey Mamata , Maina Geoffrey , Amoyaw Jonathan , Li Yiyan , Kamrul Rejina , Michaels Clara Rocha , Maroof Razawa 
Published: March 2021

Abstract
Background: Immigrants from culturally, ethnically, and linguistically diverse countries face many challenges during the resettlement phase, which influences their access to healthcare services and health outcomes. Healthy immigrant effect or the health advantage that immigrants arrive with is observed to deteriorate with increased length of stay in the host country. Methods: An exploratory qualitative design, following community based research approach was followed. The research team consisted of health researchers, clinicians, and community members. The objective was to explore the barriers to healthcare access among immigrants with limited English language proficiency. Three focus groups were carried out with 29 women and nine men attending English language classes at a settlement agency in a mid-sized city. Additionally, 17 individual interviews were carried out with healthcare providers caring for immigrants and refugees. Results: Thematic analysis was carried out with transcribed focus groups and healthcare provider interview data. Both the healthcare providers and the immigrants indicated that limited language proficiency often delayed access to already available healthcare services and interfered with the development of a therapeutic relationship between the client and the healthcare provider. Language barriers also impeded effective communication between healthcare providers and clients, leading to suboptimal care and dissatisfaction with the care received. Language limitations interfered with treatment adherence and the use of preventative and screening services, further delaying access to timely care, causing poor chronic disease management, and ultimately resulting in poor health outcomes. Involving untrained interpreters, family members, or others from the ethnic community was problematic due to misinterpretation and confidentiality issues. Conclusions: The study emphasises the need to provide language assistance during medical consultations to address language barriers among immigrants. The development of guidelines for recruitment, training, and effective engagement of language interpreters during medical consultation is recommended to ensure high quality, equitable and client-centered care.
A computationally designed Rituximab/CD3 T cell engager targeting CD20+ cancers with multiple mechanisms of action
Authors: Cai Wenyan , Dong Jianbo , Kankanamalage Sachith Gallolu , Titong Allison , Shi Jiadong , Jia Zhejun , Wang Bo , Huang Cai , Zhang Jing , Lin Jun , Kan Steven Z. , Zhou Joe , Liu Yue 
Published: March 2021

Abstract
Bispecific T cell engaging antibodies (TEAs) with one arm targeting a cancer antigen and another arm binding to CD3 have demonstrated impressive efficacy in multiple clinical studies. However, establishing a safety/efficacy balance remains challenging. For instance, some TEAs have severe safety issues. Additionally, not all patients or all cancer cells of one patient respond equally to TEAs. Here, we developed a next-generation bispecific TEA with better safety/efficacy balance and expanded mechanisms of action. Using the computer aided antibody design strategy, we replaced heavy chain complementarity-determining regions (HCDRs) in one Rituximab arm with HCDRs from a CD3 antibody and generated a novel CD20/CD3 bispecific antibody. After series of computer aided sequence optimization, the lead molecule, GB261, showed great safety/efficacy balance both in vitro and in animal studies. GB261 exhibited high affinity to CD20 and ultra-low affinity to CD3. It showed comparable T cell activation and reduced cytokine secretion compared to a benchmark antibody (BM). GB261-induced ADCC and CDC only killed CD20+ cells but not CD3+ cells. It exhibited better RRCL cell killing than the BM in a PBMC engrafted, therapeutic treatment mouse model and good safety in cynomolgus monkeys. Thus, GB261 is a promising novel TEA against CD20+ cancers.
Qtl Mapping of Clavibacter Michiganensis Subsp. Michiganensis (cmm) Resistance Originating from Solanum Pimpinellifolium g1.1554
Authors: Sen Yusuf , Manrique Mary Jane , Kabaş Aylin , Visser Richard G.F. , Heusden A.W.(Sjaak van 
Published: March 2021

Abstract
Bacterial canker of tomato, caused by Clavibacter michiganensis subsp. michiganensis (Cmm), is considered the most serious bacterial threat in tomato and causes large damages in production areas. Worldwide, Cmm is subjected to quarantine regulations. There is no cultivar on the market containing Cmm resistance. A mapping study was done in order to identify Quantitative Trait Loci (QTL) for resistance in a cross between Solanum lycopersicum and S. pimpinellifolium GI.1554, a wild relative of tomato. Besides wilting, symptoms like stem discoloration and bacterial titer were considered. Using single trait and multi-trait approaches, we have identified five QTL regions that are associated with wilting, stem discoloration and bacterial titer in three different environments. These QTLs can be used in breeding programs to develop cultivars with higher levels of resistance.
The Diversity Analysis and Functional Prediction of Endophytic Fungi Community of Gymnadenia Conopsea from Different Altitudes in Tibet
Authors: Yin Xiu , Zhang Erhao , Lu Yazhou , Quan Hong , Li Lianqiang , Yuan Lei , Yuan Fang , Lan Xiaozhong 
Published: March 2021

Abstract
Gymnadenia conopsea has high economic value, and can be used as a medicinal and ornamental plant. Due to its low natural reproduction rate and overexploitation, the extinction of this plant is gradually accelerating. Understanding the composition and diversity of endophytic fungi is of great significance in promoting its propagation and the utilization of beneficial fungal strains. In this study, the diversity of fungal communities from roots, stems, leaves, fruits, and soils at four different elevations was studied with Illumina MiSeq sequencing. A total of 3,707,871 sequences were detected from all samples, and the number of clustering OTUs was 14,800. The OTUs were assigned to 4 phyla, 17 classes, 41 orders, 73 families, and 99 genera. The predominant fungal groups included Ascomycota and Basidiomycota, accounting for 33.71%-86.38% and 6.98%-58.30% of the total species, respectively. According to the alpha diversity index analysis, the diversity and richness of endophytic fungal communities in plant tissues at low altitudes were higher than those at high altitudes, while the diversity and richness of soil fungi were the opposite. In addition, principal coordinate analysis (PCoA) not only showed that the fungal community structure was correlated with altitude but also indicated tissue specificity of the community structure. Our study explored the composition of the endophytic fungal community among different tissues from different altitudes and included functional analysis, which might provide new ideas for saving the endangered species G. conopsea.
Permanent His-Bundle Pacing in the Right Atrium in a Patient With a Mobitz II Atrioventricular Block: A Case Presentation
Authors: Zhang Zaiqiang , Ding Jiawang 
Published: March 2021

Abstract
Background: This case report presents a patient diagnosed with sick sinus syndrome who was successfully treated with permanent His-bundle pacing (PHBP).Case presentation: A 36-year-old man was transferred to our hospital due to recurrent syncope. He was diagnosed with sick sinus syndrome based on the 24-hour Holter and a history of syncope. He was admitted to hospital and successfully treated with PHBP. The postoperative examination showed that the pacing rhythm, pacemaker pacing and perception function were normal. He was discharged without any complications after a successful pacemaker implantation. Conclusions: We described a case in which PHBP may become an optimal approach to the management of patients with sick sinus syndrome. Right ventricular pacing has been attempted with inconsistent efficacy outcomes. HBP provides a promising alternative pacing option that might provide symptom resolution to patients with sick sinus syndrome.
Fully-Automated Synthesis of 177Lu Labelled FAPI Derivatives On The Module Modular Lab-Eazy
Authors: Eryilmaz Kurtulus , KILBAS Benan 
Published: March 2021

Abstract
Backround:
To the best of our knowledge, manually production of [177Lu]Lu-FAPI radiopharmaceutical derivatives has been only described in literature. In this work, a fully-automated [177Lu]Lu-FAPI synthesis has been well designed for the first time using commercially available synthesis module. In addition to the development of an automated system with disposable cassette, quality control (QC) and stability studies were comprehensively employed.
Results
A fully automated synthesis of [177Lu]Lu-FAPI derivatives was achieved on the Modular Lab Eazy (ML Eazy) with high radiochemical yield (85–90%). Chromatographic analysis indicated the formation of radiosynthesis with an absolute radiochemical purity (99%). Stability experiments clarified the durability of the products within 4 days. All obtained specifications are consistent to European Pharmacopoeia.
Conclusion
A fully automated synthesis of [177Lu]Lu-FAPI radiopharmaceuticals were accomplished regarding quality control standards and quality assurance by using commercially available a modular approach namely ML Eazy with disposable customized cassette and template.
Enhanced Biodegradation of Anthracene by Multi-Substrate Progressive Domestication of a Mixed Microbial Consortium With Pseudomonas_Aeruginosa DM3
Authors: Li Wei , Liu Yanzehua , Li Dan , Wang Liping , Mao Zhen , Wang Qi 
Published: March 2021

Abstract
The degradation of polycyclic aromatic hydrocarbons has attracted much attention. Based on toluene-catechol-anthracene multi-substrate progressive domestication, a mixed microbial consortium with synergistic metabolic activity was screened from the activated sludge of coking wastewater. High-throughput sequencing showed that the consortium was dominated by Flavobacteriia at the class level, with the proportion increasing from 8.88% to 56.41% after domestication, and that Myroides and Brevundimonas dominated at the genus level, increasing from less than 1% to 55.53% and 12.28%, respectively. Under temperature conditions of 30 °C, a pH of 7, and an initial anthracene concentration of 40 mg L-1, the degradation ratio reached 85.7% just 16 days after inoculation. Degradation ratio of Anthracene (40 mg L-1) via the consortium plus an indigenous strain Pseudomonas_aeruginosa DM3 on the sixth day (83%) equated to that in the control group without DM3 on the 12th day. The first-order rate constant (k=0.240 and 0.159 d-1) was calculated for the anthracene degradation within 10 days, with a corresponding half-life by the consortium of 2.9 days with DM3 and 4.4 days without DM3. The metabolites 1-naphthol, dibutyl phthalate, and 1,2-benzene dicarboxylic acid, mono (2-ethylhexyl) ester were presented in the reaction, inferring the metabolic pathway of phthalic acid. Our work revealed that inoculating the mixed microbial consortium with indigenous Pseudomonas aeruginosa DM3 has the potential for removing polycyclic aromatic hydrocarbons.