bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cruciate retaining and posterior stabilized total knee arthroplasty in severe varus osteoarthritis knee: A match-pair comparative study in an Asian population
Authors: Soong Junwei , Ou Yang Youheng , Ling Zhixing Marcus , Chia Shi-Lu , Lo Ngai Nung , Yeo Seng Jin 
Published: December 2021

Background Posterior stabilized (PS) total knee arthroplasty (TKA) is advocated in severe varus osteoarthritic (OA) knees as the posterior cruciate ligament posed challenges in gap balancing. However, there is scarcity in the literature to illustrate the superiority of PS TKA over cruciate retaining (CR) TKA. Our study aims to compare the outcomes between CR and PS TKAs in patients with severe varus OA knees. Methods: A retrospective review was conducted on patients who underwent primary TKA for OA knee from 2003 to 2013. Patients with OA knees of varus tibiofemoral angle ≥15 were matched into two groups (Group CR and PS) according to age, gender, and body mass index and compared in terms of clinical (tibiofemoral alignment, range of motion, and revision rate) and functional outcome (Knee Society Scoring, Oxford Knee Score, Short Form-36 Health Survey). Results: Both Group CR ( n = 56) and PS ( n = 56) had similar pre-operative scores. Both groups achieved correction of tibiofemoral alignment from median pre-operative varus of 17.6/17.0 (CR/PS) ( p = .279) to median post-operative valgus of 4.9/4.0 (CR/PS) ( p = .408). Over 24 months, both groups were comparable in achieving significant improvement in clinical and functional outcomes. No case of revision surgery was reported (median follow-up months; CR: 65, PS: 74, p = .549). Conclusion: Both CR and PS TKAs perform similarly well in severe varus OA knee up to 2 years post-operation. Further studies are warranted to assess the long-term outcome between the two implant designs.
Association Between Fetal Thymus Size and Intrauterine Growth Restriction
Authors: Keshavarz Elham , Rustazade Sheikhyusefi Marjan , Khalili Pouya Ensi , Mirzamoradi Masoumeh , Khazaei Mehdi , Moharamzad Yashar , Sanei Taheri Morteza 
Published: December 2021

Objective: The objective of this study was to evaluate the association between reduced fetal thymus size and intrauterine growth restriction (IUGR). This study was devised to determine the association between thymus size and any abnormal Doppler indices within the fetal umbilical artery (UA), as well as the middle cerebral artery (MCA). Materials and Methods: Forty-six pregnancies between 20 and 38 weeks of gestation with IUGR and 46 normal pregnancies within similar gestational age (GA) range were included. The transverse diameter of fetal thymus was measured. In the IUGR group, the fetal umbilical artery (UA) and middle cerebral artery (MCA) Doppler flow velocities were recorded. Results: The mean GA of fetuses with IUGR (33.5 weeks) was higher than control group (30.3 weeks). To adjust for the effect of GA, analysis of covariance (ANCOVA) was performed. The adjusted mean thymus diameters were 19.02 mm in IUGR and 21.25 within the control group (mean difference = 2.23 mm; P = .02). The mean (±SD) thymus size in 16 fetuses, with abnormal Doppler findings, was significantly lower than in the group with normal Doppler findings, 17.45 (±2.50) vs 22.02 (±5.39) mm; P < .001. Conclusion: IUGR may be associated with reduced fetal thymus size, especially when coupled with abnormal Doppler findings. The thymus size in a group of IUGR fetuses, with abnormal Doppler findings, was smaller than IUGR fetuses, with normal Doppler findings.
TRAP1 suppresses oral squamous cell carcinoma progression by reducing oxidative phosphorylation metabolism of Cancer-associated fibroblasts
Authors: Xiao Li , Hu Qiannan , Peng Yanshuang , Zheng Kaiyue , Zhang Ting , Yang Lianjie , Wang Zhi , Tang Wanrong , Yu Jie , Xiao Qian , Zhang Dandan , Zhang Weifang , He Chanjuan , Wu Dengxun , Zheng Yanyan , Liu Ying 
Published: December 2021

AbstractBackgroundGlucose metabolism in cancer associated fibroblasts (CAFs) within the tumor microenvironment is a material and energy source for tumorigenesis and tumor development. However, the characteristics and important regulatory mechanisms of glucose metabolism in fibroblasts associated with oral squamous cell carcinoma (OSCC) are still unknown.MethodsWe successfully isolated, cultured, purified and identified CAFs and normal fibroblasts (NFs). Cell culture, immunohistochemistry (IHC) and CCK8, flow cytometry, Seahorse XF Analyzer, MitoTracker assay, western blotting (WB), transmission electron microscope, Quantitative real-time PCR (qPCR), immunofluorescence (IF), and Label-free quantitative proteomics assay, animal xenograft model studies and statistical analysis were applied in this study.ResultsWe demonstrated that the proliferation activity of CAFs was significantly enhanced as compared to NFs, while the apoptosis rate was significantly decreased. CAFs in OSCC preferentially use oxidative phosphorylation (OXPHOS) rather than glycolysis. Moreover, CAFs showed stronger maximal respiration, a larger substantial mitochondrial spare respiratory capacity (SRC) and higher adenosine triphosphate (ATP) production capacity than NFs. The results of mitotracker green fluorescence staining showed that compared with NFs, CAFs exhibited stronger green fluorescence. The results of WB showed the expression level of Peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α) obviously increased in CAFs compared to NFs. These results confirmed that CAFs have greater mitochondrial activity and function than NFs. Furthermore, Label-free quantitative proteomics assays showed that both ATP synthase subunit O (ATP5O) and tumor necrosis factor receptor-associated protein 1 (TRAP1) are important differentially expressed proteins in the mitochondria of CAFs/NFs. Overexpression of TRAP1 in CAFs increased basal oxygen consumption rate (OCR), maximal respiration, ATP production and SRC. In vivo, overexpression TRAP1 expression in CAFs suppress tumor growth.ConclusionTaken together, the results indicated that TRAP1 is an important regulatory molecule of CAFs glucose metabolism and promotes OSCC progression by regulating the OXPHOS of CAFs.
Evaluation of a 55-gene classifier as a prognostic biomarker for adjuvant chemotherapy in stage III colon cancer patients
Authors: Oki Eiji , Shinto Eiji , Shimokawa Mototsugu , Yamaguchi Shigeki , Ishiguro Megumi , Hasegawa Seiji , Takii Yasumasa , Ishida Hideyuki , Kusumoto Tetsuya , Morita Masaru , Tomita Naohiro , Shiozawa Manabu , Tanaka Masafumi , Ozawa Heita , Hashiguchi Yojiro , Ohnuma Shinobu , Tada Sachiyo , Matsushima Tomoko , Hase Kazuo 
Published: December 2021

Abstract
Background
Adjuvant chemotherapy reduces the risk of recurrence of stage III colon cancer (CC). However, more effective prognostic and predictive biomarkers are needed for better treatment stratification of affected patients. Here, we constructed a 55-gene classifier (55GC) and investigated its utility for classifying patients with stage III CC.

Methods
We retrospectively identified patients aged 20–79 years, with stage III CC, who received adjuvant chemotherapy with or without oxaliplatin, between the years 2009 and 2012.

Results
Among 938 eligible patients, 203 and 201 patients who received adjuvant chemotherapy with and without oxaliplatin, respectively, were selected by propensity score matching. Of these, 95 patients from each group were analyzed, and their 5-year relapse-free survival (RFS) rates with and without oxaliplatin were 73.7 and 77.1%, respectively. The hazard ratios for 5-year RFS following adjuvant chemotherapy (fluoropyrimidine), with and without oxaliplatin, were 1.241 (95% CI, 0.465–3.308; P = 0.67) and 0.791 (95% CI, 0.329–1.901; P = 0.60), respectively. Stratification using the 55GC revealed that 52 (27.3%), 78 (41.1%), and 60 (31.6%) patients had microsatellite instability (MSI)-like, chromosomal instability (CIN)-like, and stromal subtypes, respectively. The 5-year RFS rates were 84.3 and 72.0% in patients treated with and without oxaliplatin, respectively, for the MSI-like subtype (HR, 0.495; 95% CI, 0.145–1.692; P = 0.25). No differences in RFS rates were noted in the CIN-like or stromal subtypes. Stratification by cancer sidedness for each subtype showed improved RFS only in patients with left-sided primary cancer treated with oxaliplatin for the MSI-like subtype (P = 0.007). The 5-year RFS rates of the MSI-like subtype in left-sided cancer patients were 100 and 53.9% with and without oxaliplatin, respectively.

Conclusions
Subclassification using 55GC and tumor sidedness revealed increased RFS in patients within the MSI-like subtype with stage III left-sided CC treated with fluoropyrimidine and oxaliplatin compared to those treated without oxaliplatin. However, the predictive power of 55GC subtyping alone did not reach statistical significance in this cohort, warranting larger prospective studies.

Trial registration
The study protocol was registered in the University Hospital Medical Education Network (UMIN) clinical trial registry (UMIN study ID: 000023879).
Exploratory study on classification of chronic obstructive pulmonary disease combining multi-stage feature fusion and machine learning
Authors: Peng Junfeng , Zhou Mi , Zou Kaiqiang , Zhu Xiongyong , Xu Jun , Teng Yi , Zhang Feifei , Chen Guoming 
Published: December 2021

Abstract
Background
Due to the complexity and high heterogeneity of the acute exacerbation of chronic obstructive pulmonary disease (AECOPD), the guidelines (global initiative for chronic obstructive, GOLD) is unable to fully guide the treatment of AECOPD.

Objectives
To provide a rapid treatment in line with the development of the AECOPD after admission. In this paper, we propose a multi-stage feature fusion (MSFF) framework combining machine learning to track the diseases deterioration risk of the AECOPD.

Methods
First, we identify 408 AECOPD patients as the study population. Then, feature segment and fusion methods are applied to generate the phased data set. Finally, human studies are designed to evaluate the performance of the MSFF framework.

Results
The experimental results show that the proposed framework is potential to obtain the full-process tracking of deterioration risk for the AECOPD patients. The proposed MSFF framework achieves a higher overall accuracy average and F1 scores than the four physician groups i.e., IM, Surgery, Emergency, and ICU.

Conclusions
The proposed MSFF model may serve as a useful disease tracking tool to estimate the deterioration risk at each stage, and finally achieve the disease monitoring and management for AECOPD patients.
A nomogram to predict the risk of prolonged length of stay following primary total hip arthroplasty with an enhanced recovery after surgery program
Authors: Wang Haosheng , Fan Tingting , Li Wenle , Yang Bo , Lin Qiang , Yang Mingyu 
Published: December 2021

Abstract
Background
The aim of this study was to identify the risk factors associated with prolonged length of stay (LOS) in patients undergoing primary total hip arthroplasty (THA) managed with an enhanced recovery after surgery (ERAS) program and develop a prediction model for improving the perioperative management of THA.

Methods
In this single-center retrospective study, patients who underwent primary THA in accordance with ERAS from May 2018 to December 2019 were enrolled in this study. The primary outcome was prolonged LOS (> 48 h) beyond the first postoperative day. We collected the clinical patient’s clinical characteristics, surgery-related parameters, and laboratory tests. A logistic regression analysis explored the independent risk factors for prolonged LOS. According to published literature and clinical experience, a series of variables were selected to develop a nomogram prediction model to predict the risk of prolonged LOS following primary THA with an ERAS program. Evaluation indicators of the prediction model, including the concordance index (C-index), the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis, were reported to assess the performance of the prediction model. The bootstrap method was conducted to validate the performance of the designed nomogram.

Results
A total of 392 patients were included in the study, of whom 189 (48.21%) had prolonged LOS. The logistics regression analysis demonstrated that age, sex, hip deformities, intraoperative blood loss, operation time, postoperative Day 1 (POD) hemoglobin (Hb), POD albumin (ALB), and POD interleukin-6 (IL-6) were independent risk factors for prolonged LOS. The C-index was 0.863 (95% CI 0.808 to 0.918) and 0.845 in the bootstrapping validation, respectively. According to the results of the calibration, ROC curve, and decision curve analyses, we found that the nomogram showed satisfactory performance for prolonged LOS in this study.

Conclusions
We explored the risk factors for prolonged LOS following primary THA with an ERAS program and developed a prediction model. The designed nomogram was expected to be a precise and personalized tool for predicting the risk and prognosis for prolonged LOS following primary THA with an ERAS program.
Effect of workshops for coaches on the motor ability of balance in children practicing sports in late childhood
Authors: Wilczyńska D. , Łysak-Radomska A. , Podczarska-Głowacka M. , Krasowska K. , Perzanowska E. , Walentukiewicz A. , Lipowski M. , Skrobot W. 
Published: December 2021

Abstract
Background
The coach attitude impacts the whole mind and body system of a child athlete from emotional and motivational aspects to motor skills like motor coordination. It translates into the ability to control and stabilize posture. The vestibular system plays an important role in this regulation. This system, next to the visual system and mechanoreceptors, is responsible for balance and control during posture transition. Moreover, the vestibular system is influenced by emotional factors. Therefore the authors of this study focused on the changes in the balance stability of children practicing sport after the implementation of the psychological workshops for coaches.

Methods
Fifty-nine children at the age of 9–12 practicing soccer, art gymnastic and sport gymnastic were divided into two groups. The experimental group consisted of 31 participants and 28 in the control group. Experimental group children were under the influence of the 3 coaches who attended three workshops over 12 weeks period. Control group children were coached by 5 coaches who attended no workshops. Postural stability tests were performed on children before and after the workshops.

Results
The statistically significant changes were observed in selected parameters of children’s balance stability after the experiment. The significant difference between the experimental and control group in Overall Stability Index (OSI) (p < 0.0002), Anterior–Posterior Stability Index (AP) (p < 0.01), Medial–Lateral Stability Index (ML) (p < 0.01) with eyes open were observed after the experiment. The results show a significant deterioration in control group contrary to the experimental group where the improvement trend was observed. Moreover, the difference between the groups was observed in OSI parameter (p < 0.005) with eyes closed after the experiment.

Conclusion
The results obtained by the authors of the current study may support the thesis that educating coaches allows for better results in postural stability of child’s athletes. Nevertheless, this thesis requires further research, with particular emphasis on the age and gender of young athletes.
GC–MS of essential oil, metal profile and physicochemical properties of fruits of Citrus macrophylla Wester from Sudan
Authors: Mohammed Abdelhafeez M. A. , Alrayeh Alrayeh S. , Mohamed Moawia E. , Abdel-Rahman Nawal A. 
Published: December 2021

Abstract
Background
The study investigated the essential oil composition, metal profile and physiochemical properties of Citrus macrophylla Wester fruits collected from Agricultural Research Corporation, Shambat area, Khartoum North, Sudan. The species was introduced by one of the authors Dr. Moawia E. Mohamed from the National Repository of Citrus and Dates of Riverside, California, USA. This species is known as universal rootstock.

Results
The graphite furnace–atomic absorption spectrometry determined the presence of sodium (6.38 ppm), potassium (701.93 ppm), calcium (371.28 ppm), magnesium (54.78 ppm), cadmium (0.013 ppm), zinc (0.256 ppm) and lead (0.200 ppm). The content of peel, moisture and ash of C. macrophylla was measured as 18.35%, 23.75% and 2.04%, respectively. Among thirty compounds identified using gas chromatography–mass spectrometry, limonene is the major compound (72.85%). The vitamin C (ascorbic acid) content of C. macrophylla juice was determined as 55.0 mg/100 g. The fruit diameter, fruit weight and percentages of juice, peel and seed were determined as 91.4 mm, 276.5 g, 47.92%, 26.37% and 19.20%, respectively. The pH value, total soluble solids (TSS), titratable acidity (TA) and ripening index (RI) of C. macrophylla are found to be 3.50, 8.00%, 7.44% and 10.81, respectively.

Conclusion
The results in this study suggested that C. macrophylla could be beneficial in food as healthy juice.
CFD investigation of flow through a centrifugal compressor diffuser with splitter blades
Authors: Khalafallah M. G. , Saleh H. S. , Ali S. M. , Abdelkhalek H. M. 
Published: December 2021

AbstractThe aerodynamic losses in centrifugal compressors are mainly associated with the separated flow on the suction sides of impeller and diffuser vanes. The overall performance of such compressors can be improved by adding splitter vanes. The present work examines the effect of varying the geometrical location of the splitter vanes in the diffuser on the overall performance of a high-speed centrifugal compressor stage of a small gas turbine. To increase the pressure recovery through the diffuser, two radial sets of vanes are used. The first set of vanes (diffuser-1) is equipped with splitter vanes, placed mid-distance between the main vanes, while the vanes of the second set (diffuser-2) are conventional vanes. Flow through the compressor was simulated using the ANSYS 19 workbench program. Flow characteristics and compressor performance were obtained and analyzed for different circumferential positions of the splitting vanes relative to the main vanes of diffuser-1. The study covered seven positions of the splitter vanes including the original design of the diffuser where the splitter vanes were located at mid-distance between the main vanes. The analysis shows that, at design conditions, selecting the position of the splitter vanes to be nearer to the pressure side of the main vanes improves the stage performance. In the present study, locating the splitters at 33% of the angular distance between the main vanes leads to the best performance, and a significant improvement in the overall stage performance is recorded. The pressure recovery coefficient is raised by about 17%, the pressure ratio is increased by about 1.13%, and the stage efficiency is increased by about 2.01%, compared to the original splitter position. Performance improvement is related to the suppression of the flow separation and the more uniformity of flow. On the contrary, further moving the splitter closer to the main blade, the pressure recovery coefficient is decreased by about 2% than the position of 33% of the angular distance, but still higher than the original position by about 15% and a limited improvement in the compressor performance is noticed. Moving the splitter far out the main blade annihilates the static pressure recovery of the diffuser by about 2:7% compared with the original position. So, for the investigated compressor, the best position of the splitter blade in the circumferential direction, which provides the best stage performance in our parametric analysis, is not necessary to be at the mid-angular distance between the diffuser’s main blades, but it is achieved by moving the splitter to about 33% of the angular distance where the diminished loss from the suppressed flow separation is more prevailing and the instigated friction losses from splitter surfaces are less critical.
Life-threatening complications of streptococcal sepsis: a PICU contemporary series
Authors: Piastra M. , Ferrari V. , Picconi E. , Morena T. C. , Pezza L. , De Rosa G. , Fedele M. C. , Genovese O. , Onesimo R. , Tempera A. , Valentini P. , Buonsenso D. , Visconti F. , Zito G. , Benassi C. , Conti G. 
Published: December 2021

Abstract
Background
Life-threatening streptococcal sepsis nowadays represents an uncommon event in previously healthy infants and children. Critically ill patients suffering from severe streptococcal sepsis complications may present with pre-antibiotic era clinical pictures and require a timely clinical approach to achieve restitutio ad integrum.

Results
We report a series of four patient groups affected by an uncommon life-threatening streptococcal sepsis, each of them exhibiting some distinct features. Streptococcus Agalactiae sepsis was associated with cerebral thrombotic/ischaemic lesions, whereas severe cardiogenic shock was prominent in the Streptococcus Viridans group; Streptococcus Faecalis and β-hemolytic group A Streptococcus patients mostly reported lung complications.

Conclusions
Previous antibiotic treatments should not delay aggressive treatment in the intensive care setting. Early diagnostic suspicion, as well as appropriate and aggressive treatment provided within an intensive care setting are crucial for the clinical outcome.