bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of chemotherapy with survival in stage II colon cancer patients who received radical surgery: a retrospective cohort study
Authors: Lv Zhihao , Liang Yuqi , Liu Huaxi , Mo Delong 
Published: March 2021

Abstract
Background
It remains controversial whether patients with Stage II colon cancer would benefit from chemotherapy after radical surgery. This study aims to assess the real effectiveness of chemotherapy in patients with stage II colon cancer undergoing radical surgery and to construct survival prediction models to predict the survival benefits of chemotherapy.

Methods
Data for stage II colon cancer patients with radical surgery were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (1:1) was performed according to receive or not receive chemotherapy. Competitive risk regression models were used to assess colon cancer cause-specific death (CSD) and non-colon cancer cause-specific death (NCSD). Survival prediction nomograms were constructed to predict overall survival (OS) and colon cancer cause-specific survival (CSS). The predictive abilities of the constructed models were evaluated by the concordance indexes (C-indexes) and calibration curves.

Results
A total of 25,110 patients were identified, 21.7% received chemotherapy, and 78.3% were without chemotherapy. A total of 10,916 patients were extracted after propensity score matching. The estimated 3-year overall survival rates of chemotherapy were 0.7% higher than non- chemotherapy. The estimated 5-year and 10-year overall survival rates of non-chemotherapy were 1.3 and 2.1% higher than chemotherapy, respectively. Survival prediction models showed good discrimination (the C-indexes between 0.582 and 0.757) and excellent calibration.

Conclusions
Chemotherapy improves the short-term (43 months) survival benefit of stage II colon cancer patients who received radical surgery. Survival prediction models can be used to predict OS and CSS of patients receiving chemotherapy as well as OS and CSS of patients not receiving chemotherapy and to make individualized treatment recommendations for stage II colon cancer patients who received radical surgery.
Visual assessment of commercial drivers in the South West Region of Cameroon
Authors: Vofo Brice Nguedia , Ayuk Doris Ako , Pe’er Jacob , Chichom-Mefire Alain , Tendongfor Nicholas , Nche Eleanor Ngwe 
Published: March 2021

AbstractBackgroundDriving is a visually intensive task. In Cameroon, where the burden of road traffic deaths is high, visual assessment is not universally performed before the issuance of driver licenses. This study aims to assess the visual status of commercial drivers (CDs) in the southwestern region of Cameroon, and to find its relation to road traffic crashes (RTCs).MethodsThis work was a cross-sectional community-based study on CDs in Limbe and Buea. Questionnaires were used to assess sociodemographic parameters, the incidence of RTCs, and self-reported visual status. Visual acuity (VA) was measured using a standard Snellen chart at 6 m. Statistical analysis was performed using descriptive methods: frequencies, the paired Student’s t-test, and the chi-square test.ResultsTwo hundred seven CDs were enrolled in this study, all of which were male, with a mean age of 41.8 ± 12.1 years. A total of 15.0% had undergone an eye exam prior to licensure, and 3.4% had undergone an eye exam within the past 10 years. The VA in the better-seeing eye of participants was less than 6/9 and 6/12 in 14.1 and 10.6% of CDs, respectively. Seventy-five percent of CDs with self-reported poor vision and 95% of CDs with VA < 0.5 had a history of RTCs compared to 55.8% of CDs with self-reported good vision and 55.7% of CDs with VA ≥ 0.5 (p < 0.05). Injuries from RTCs were more common in CDs with self-reported poor vision (81.1%) and in those with VA < 0.5 (90.5%) compared to CDs who self-reported good vision (55.8%) and those with VA ≥ 0.5 (55.7%) (p < 0.05).ConclusionsA large proportion of CDs did not undergo a visual assessment before the issuance or renewal of their driver licenses. A substantial number of CDs had poor vision in their better-seeing eye and suffered from RTCs and related injuries, which suggests that the visual status of CDs in Cameroon is related to the gruesome number of road traffic crashes and deaths in the country. Therefore, concerned authorities should consider making vision tests a necessary requirement for the obtention of driver licenses.
Influence of Patella thickness on Patellofemoral pressure in total knee Arthroplasty
Authors: Tanikawa Hidenori , Tada Mitsunori , Ogawa Ryo , Harato Kengo , Niki Yasuo , Kobayashi Shu , Nagura Takeo 
Published: March 2021

Abstract
Background
Patellofemoral complications are one of the major issues after total knee arthroplasty (TKA). Excessive patellofemoral joint pressure is associated with complications after TKA surgery, and the amount of patellar osteotomy has a direct effect on patellofemoral joint pressure. The purpose of this study was to evaluate the influence of patella thickness on patellofemoral pressure in TKA.

Methods
Five freshly frozen cadavers were operated with a custom-made Stryker posterior stabilizing type knee joint prosthesis. Patellofemoral joint pressure was measured using a pressure sensor, with the knee joint flexed from 90 to 110 degrees, and with patellar thickness of − 2 mm to + 4 mm.

Results
Increasing or decreasing patellar thickness significantly increased or decreased patellofemoral pressure. Regarding knee flexion angle, patellofemoral pressure increased with increasing patellar thickness at all flexion angles, but the pressure increase was greatest at 90 degrees of knee flexion and smallest at 110 degrees.

Conclusions
The amount of patellar osteotomy influences the patellofemoral pressure. Surgeons should avoid increasing patella thickness, since the resulting increased patellofemoral pressure may reduce knee joint function.
A modified method to treat severe asymptomatic pre‐existing degeneration of adjacent segment: a retrospective case‐control study
Authors: Zhang Xinliang , Zhu Jinwen , Li Yibing , Hao Dingjun , Gao Wenjie 
Published: March 2021

Abstract
Background
Pre-existing degeneration of adjacent segment is an important risk factor for adjacent-segment degeneration (ASD), but only limited and controversial studies have addressed its management.

Methods

We retrospectively analyzed patients with symptomatic degeneration of the L5/S1 segment warranting surgical interference and severe asymptomatic degeneration of the L4/5 segment. Of these patients, those who underwent interbody fusion of the causative (L5/S1) segment and distraction of the intervertebral space and facet fusion of the adjacent L4/5 segment were included in Group A (n = 103), while those who underwent interbody fusion of both the L5/S1 and L4/5 segments were included in Group B (n = 81). Clinical and radiographic outcomes were evaluated.

Results
Mean follow-up time was 58.5 months (range, 48–75 months). We found no significant difference in clinical outcomes or incidence of ASD in the L3/4 segment between Groups A and B. Compared with Group B, Group A experienced less bleeding (315 ± 84 ml vs. 532 ± 105 ml), shorter operation time (107 ± 34 min vs. 158 ± 55 min) and lower costs (US $13,830 ± $2640 vs. US $16,020 ± $3380; P < 0.05). In Group A, the disc height ratio (DHR) of the L4/5 segment was significantly increased from a preoperative value of 0.40 ± 0.13 to a last–follow-up value of 0.53 ± 0.18 (P < 0.05), while the degree of canal stenosis (DCS) was decreased from a preoperative value of 34.3 ± 11.2% to a last–follow-up value of 15.9 ± 9.3 % (P < 0.05).

Conclusions
This modified method could be effective in treating severe asymptomatic pre-existing degeneration of adjacent segment in the lumbar spine.
Glide path enlargement of curved molar canals using HyFlex EDM glide path file versus PathFile: a comparative study of preparation time and postoperative pain
Authors: Han Yi , Hou Xiao-Mei 
Published: March 2021

AbstractBackgroundThis randomized clinical trial aimed to compare the preparation time and severity of postoperative pain between HyFlex Electric Discharge Machine (EDM) glide path file (GPF) and PathFile.MethodsEighty patients whose molar teeth had at least one severely curved canal were treated by the same specialist. After access cavity preparation, the patients were randomly assigned to receive glide path enlargement with either HyFlex EDM GPF or PathFile. ProTaper Next X1 and X2 files were used to prepare the canals. The time of preparation was assessed and the severity of postoperative pain over the next 7 days was recorded. The preparation time and the postoperative pain scores were compared using the Linear Mixed Models (P ≤ 0.05).ResultsGlide path enlargement time was significantly shorter with HyFlex EDM GPF (27.828 ± 2.345 s) than with PathFile (48.942 ± 2.864 s) (P < 0.001). The highest postoperative pain score was recorded on the first day and the pain decreased over time in both groups. HyFlex EDM GPF group patients reported significantly less postoperative pain than PathFile group patients overall (P < 0.001).ConclusionsPostoperative pain and glide path preparation time could be reduced by using HyFlex EDM GPF system.Trial registrationPKUSSNCT, PKUSSNCT-17B12, Registered 24 October 2017.
The HER Salt Lake media campaign: comparing characteristics and outcomes of clients who make appointments online versus standard scheduling
Authors: Myers Kyl , Sanders Jessica N. , Dalessandro Cristen , Sexsmith Corinne D. , Geist Claudia , Turok David K. 
Published: March 2021

Abstract
Background
Little research has examined how media outreach strategies affect the outcomes of contraceptive initiatives. Thus, this paper assesses the potential impact of an online media campaign introduced during the last six months of a contraceptive initiative study based in Salt Lake City, UT (USA).

Methods
During the last six months of the HER Salt Lake Contraceptive Initiative (September 2016-March 2017), we introduced an online media campaign designed to connect potential clients to information about the initiative and a brief (9-item) appointment request form (via HERsaltlake.org). Using linked data from the online form and electronic medical records, we examine differences in demographics, appointment show rates, and contraceptive choices between “online requester” clients who made clinical appointments through the online form (n = 356) and “standard requester” clients who made appointments using standard scheduling (n = 3,051). We used summary statistics and multivariable regression to compare groups.

Results
The campaign logged 1.7 million impressions and 15,765 clicks on advertisements leading to the campaign website (HERSaltLake.org). Compared to standard requesters, online requesters less frequently reported a past pregnancy and were more likely to be younger, white, and to enroll in the survey arm of the study. Relative to standard requesters and holding covariates constant, online requesters were more likely to select copper IUDs (RRR: 8.14), hormonal IUDs (RRR: 12.36), and implants (RRR: 10.75) over combined hormonal contraceptives (the contraceptive pill, patch, and ring). Uptake of the contraceptive injectable, condoms, and emergency contraception did not differ between groups.

Conclusion
Clients demonstrating engagement with the media campaign had different demographic characteristics and outcomes than those using standard scheduling to arrange care. Online media campaigns can be useful for connecting clients with advertised contraceptive methods and initiatives. However, depending on design strategy, the use of media campaigns might shift the demographics and characteristics of clients who participate in contraceptive initiatives.

Trial Registration
Clinicaltrials.gov identifier NCT02734199, Registered 12 April 2016—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02734199.
Comparison of ‘Mental training’ and physical practice in the mediation of a structured facial examination: a quasi randomized, blinded and controlled study
Authors: Nelskamp Arne , Schnurr Benedikt , Germanyuk Alexandra , Sterz Jasmina , Lorenz Jonas , Sader Robert , Rüsseler Miriam , Seifert Lukas B. 
Published: March 2021

Abstract
Background
The correct performance of a structured facial examination presents a fundamental clinical skill to detect facial pathologies. However, many students are not adequately prepared in this basic clinical skill. Many argue that the traditional ‘See One, Do One’ approach is not sufficient to fully master a clinical skill. ‘Mental Training’ has successfully been used to train psychomotor and technical skills in sports and other surgical fields, but its use in Oral and Maxillofacial Surgery is not described. We conducted a quasi-experimental to determine if ‘Mental Training’ was effective in teaching a structured facial examination.

Methods
Sixty-seven students were randomly assigned to a ‘Mental Training’ and ‘See One, Do One’ group. Both groups received standardized video instruction on how to perform a structured facial examination. The ‘See One, Do One’ group then received 60 min of guided physical practice while the ‘Mental Training’ group actively developed a detailed, stepwise sequence of the performance of a structured facial examination and visualized this sequence subvocally before practicing the skill. Student performance was measured shortly after (T1) and five to 10 weeks (T2) after the training by two blinded examiners (E1 and E2) using a validated checklist.

Results
Groups did not differ in gender, age or in experience. The ‘Mental Training’ group averaged significantly more points in T1 (pE1 = 0.00012; pE2 = 0.004; dE1 = 0.86; dE2 = 0.66) and T2 (pE1 = 0.04; pE2 = 0.008, dE1 = 0.37; dE2 = 0.64) than the ‘See One, Do One’ group. The intragroup comparison showed a significant (pE1 = 0.0002; pE2 = 0.06, dE1 = 1.07; dE2 = 0.50) increase in clinical examination skills in the ‘See One, Do One’ group, while the ‘Mental Training’ group maintained an already high level of clinical examination skills between T1 and T2.

Discussion
‘Mental Training’ is an efficient tool to teach and maintain basic clinical skills. In this study ‘Mental Training’ was shown to be superior to the commonly used ‘See One, Do One’ approach in learning how to perform a structured facial examination and should therefore be considered more often to teach physical examination skills.
Large-scale transcriptomics to dissect 2 years of the life of a fungal phytopathogen interacting with its host plant
Authors: Gay Elise J. , Soyer Jessica L. , Lapalu Nicolas , Linglin Juliette , Fudal Isabelle , Da Silva Corinne , Wincker Patrick , Aury Jean-Marc , Cruaud Corinne , Levrel Anne , Lemoine Jocelyne , Delourme Regine , Rouxel Thierry , Balesdent Marie-Hélène 
Published: March 2021

Abstract
Background
The fungus Leptosphaeria maculans has an exceptionally long and complex relationship with its host plant, Brassica napus, during which it switches between different lifestyles, including asymptomatic, biotrophic, necrotrophic, and saprotrophic stages. The fungus is also exemplary of “two-speed” genome organisms in the genome of which gene-rich and repeat-rich regions alternate. Except for a few stages of plant infection under controlled conditions, nothing is known about the genes mobilized by the fungus throughout its life cycle, which may last several years in the field.

Results
We performed RNA-seq on samples corresponding to all stages of the interaction of L. maculans with its host plant, either alive or dead (stem residues after harvest) in controlled conditions or in field experiments under natural inoculum pressure, over periods of time ranging from a few days to months or years. A total of 102 biological samples corresponding to 37 sets of conditions were analyzed. We show here that about 9% of the genes of this fungus are highly expressed during its interactions with its host plant. These genes are distributed into eight well-defined expression clusters, corresponding to specific infection lifestyles or to tissue-specific genes. All expression clusters are enriched in effector genes, and one cluster is specific to the saprophytic lifestyle on plant residues. One cluster, including genes known to be involved in the first phase of asymptomatic fungal growth in leaves, is re-used at each asymptomatic growth stage, regardless of the type of organ infected. The expression of the genes of this cluster is repeatedly turned on and off during infection. Whatever their expression profile, the genes of these clusters are enriched in heterochromatin regions associated with H3K9me3 or H3K27me3 repressive marks. These findings provide support for the hypothesis that part of the fungal genes involved in niche adaptation is located in heterochromatic regions of the genome, conferring an extreme plasticity of expression.

Conclusion
This work opens up new avenues for plant disease control, by identifying stage-specific effectors that could be used as targets for the identification of novel durable disease resistance genes, or for the in-depth analysis of chromatin remodeling during plant infection, which could be manipulated to interfere with the global expression of effector genes at crucial stages of plant infection.
Artesunate ameliorates cigarette smoke-induced airway remodelling via PPAR-γ/TGF-β1/Smad2/3 signalling pathway
Authors: Pan Kunming , Lu Juanjuan , Song Yun 
Published: March 2021

AbstractBackgroundAirway remodelling is the major pathological feature of chronic obstructive pulmonary disease (COPD), and leads to poorly reversible airway obstruction. Current pharmacological interventions are ineffective in controlling airway remodelling. In the present study, we investigated the potential role of artesunate in preventing and treating airway remodelling and the underlying molecular mechanisms in vitro and in vivo.MethodsA COPD rat model was established by cigarette smoke (CS) exposure. After 12 weeks of artesunate treatment, pathological changes in the lung tissues of COPD rats were examined by ELISA and histochemical and immunohistochemical staining. A lung functional experiment was also carried out to elucidate the effects of artesunate. Human bronchial smooth muscle (HBSM) cells were used to clarify the underlying molecular mechanisms.ResultsArtesunate treatment inhibited CS-induced airway inflammation and oxidative stress in a dose-dependent manner and significantly reduced airway remodelling by inhibiting α-smooth muscle actin (α-SMA) and cyclin D1 expression. PPAR-γ was upregulated and TGF-β1/Smad2/3 signalling was inactivated by artesunate treatment in vivo and in vitro. Furthermore, PPAR-γ knockdown by siRNA transfection abolished artesunate-mediated inhibition of HBSM cell proliferation by activiting the TGF-β1/Smad2/3 signalling pathway and downregulating the expression of α-SMA and cyclin D1 in HBSM cells.ConclusionsThese findings suggest that artesunate could be used to treat airway remodelling by regulating PPAR-γ/TGF-β1/Smad signalling in the context of COPD.
Comparison of non-intubated and intubated video-assisted thoracoscopic surgeries of major pulmonary resections for lung cancer—a meta-analysis
Authors: Xue Wenfei , Duan Guochen , Zhang Xiaopeng , Zhang Hua , Zhao Qingtao , Xin Zhifei , He Jie 
Published: March 2021

Abstract
Objective
The aim of this study was to compare the safety feasibility and safety feasibility of non-intubated (NIVATS) and intubated video-assisted thoracoscopic surgeries (IVATS) during major pulmonary resections.

Methods
A meta-analysis of eight studies was conducted to compare the real effects of two lobectomy or segmentectomy approaches during major pulmonary resections.

Results
Results showed that the patients using NIVATS had a greatly shorter hospital stay and chest-tube placement time (weighted mean difference (WMD): − 1.04 days; 95% CI − 1.50 to − 0.58; P < 0.01) WMD − 0.71 days; 95% confidence interval (CI), − 1.08 to − 0.34; P < 0.01, respectively) while compared to those with IVATS. There were no significant differences in postoperative complication rate, surgical duration, and the number of dissected lymph nodes. However, through the analysis of highly selected patients with lung cancer in early stage, the rate of postoperative complication in the NIVATS group was lower than that in the IVATS group [odds ratio (OR) 0.44; 95% CI 0.21–0.92; P = 0.03, I2 = 0%].

Conclusions
Although the comparable postoperative complication rate was observed for major thoracic surgery in two surgical procedures, the NIVATS method could significantly shorten the hospitalized stay and chest-tube placement time compared with IVATS. Therefore, for highly selected patients, NIVATS is regarded as a safe and technically feasible procedure for major thoracic surgery. The assessment of the safety and feasibility for patients undergoing NIVATS needs further multi-center prospective clinical trials.
Alpha‐actinin‐4 is essential for maintaining normal trophoblast proliferation and differentiation during early pregnancy
Authors: Peng Wei , Liu Ying , Qi Hongbo , Li Qingshu 
Published: March 2021

Abstract
Background
Proper differentiation of trophoblasts in the human placenta is essential for a successful pregnancy, whereas abnormal regulation of this process may lead to adverse pregnancy outcomes, especially preeclampsia (PE). However, the underlying mechanism of trophoblast differentiation remains unclear. Previous studies have reported the involvement of alpha-actinin-4 (ACTN4) in the actin cytoskeleton dynamics and motility. Hence, we hypothesized that ACTN4 may act as an important regulator in the normal proliferation and differentiation of trophoblasts during early pregnancy.

Method:
To test this hypothesis, we collected villous tissues from women undergoing a legal pregnancy termination during 6–10 weeks of gestation and explanted them for cell culture and siRNA transfection. We also obtained placental tissues from PE patients and healthy pregnant women and isolated the primary cytotrophoblast (CTB) cells. The expression of ACTN4 in the CTBs of placental villi and during the differentiation of CTBs into STBs was detected by immunofluorescence, immunohistochemistry (IHC), and EdU proliferation assays. Besides, villous explant, Matrigel invasion, transwell migration assay, and Wound-healing assay were performed to identify the possible role of ACTN4 in the outgrowth of explants and the invasion, migration, and proliferation of cell column trophoblasts (CCTs). Western blot analysis was carried out to compare the protein expression level of AKT, Snail activities, and epithelial-to-mesenchymal transition (EMT) in the villi or HTR8/SVneo cells with ACTN4 knockdown.

Results
ACTN4 was highly expressed in CTB cells and interstitial extravillous trophoblast (iEVT) cells but not found in the syncytiotrophoblast (STB) cells in the first trimester villi. Downregulation of ACTN4 led to reduced trophoblast proliferation and explant outgrowth ex vivo, as well as iEVT invasion and migration in vitro due to disrupt of actin filaments organization. Such ACTN4 inhibition also decreased AKT and Snail activities and further impeded the EMT process. In addition, ACTN4 expression was found to be downregulated in the iEVTs from preeclamptic placentas.

Conclusions
Our findings suggest that ACTN4 may act as an important regulator of trophoblast proliferation and differentiation during early pregnancy, and dysregulation of this protein may contribute to preeclampsia pathogenesis.