bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical, Oncological and Obstetric Outcomes After Radical Abdominal Trachelectomy for Early-Stage Cervical Cancer at a Single Tertiary Center.
Authors: Kranawetter Marlene , Grimm Christoph , Obermair Helena M , Paspalj Valentina , Reinthaller Alexander , Langthaler Eva , Polterauer Stephan 
Published: May 2021

Abstract
Purpose

Radical trachelectomy is a viable option to preserve fertility for young patients with early cervical cancer. The aim of this study was to report surgical, oncological and obstetric outcomes of patients treated with radical abdominal trachelectomy at our institution.
Methods

A retrospective chart analysis and telephone survey for all patients with early stage cervical cancer treated with a radical abdominal trachelectomy and pelvic lymphadenectomy between 2007 and 2019 at the Department of Obstetrics and Gynaecology at the Medical University of Vienna, Austria was performed.
Results

Radical abdominal trachelectomy with pelvic lymph-node dissection was attempted for 22 patients. Four cases required conversion to radical hysterectomy due to positive resection margins and two cases required primary chemo-radiotherapy due to positive lymph nodes. Sixteen successfully abdominal radical trachelectomies preserving fertility were performed with two of these patients treated with neo-adjuvant chemotherapy. With a median follow-up time of 21.5 (6.5- 57.25) months, one patient (4.5%) had disease recurrence and subsequently died from cervical cancer. Six patients attempted to conceive, with a resulting four pregnancies with a live birth rate of 75%.
Conclusion

Abdominal radical trachelectomy is a safe procedure for women with early stage cervical cancer who desire fertility preservation. Surgery should be performed at a high volume gynaeco-oncological center.
Nomogram to Predict an Endometrial Thickness &gt;7.5 mm in the Frozen Embryo Transfer Cycle for Thin Endometrial Women
Authors: Guo Zizhen , Chen Wei , Wang Yuqing , Chu Ran , Xu Xinxin , Zhang Lixia , Yan Lei , Ma Jinlong 
Published: May 2021

Abstract
Background A sufficient endometrial thickness (EMT) is essential for successful pregnancy. For patients with a thin endometrium (EMT ≤7.5 mm on human chorionic gonadotropin [HCG] trigger day) in IVF, some studies have suggested freezing all embryos and preparing the endometrium in the subsequent frozen-thawed cycle, but not all patients can obtain a thicker endometrium during endometrial preparation in the frozen embryo transfer cycle than on HCG trigger day in the fresh embryo transfer cycle. This study aimed to investigate which characteristics of patients with a thin endometrium suggest the possibility of EMT >7.5 mm in the subsequent frozen cycle, and build up a prediction nomogram.Methods Data were collected from the university-based reproductive medical center between January 2013 and September 2019. Multivariable logistic regression was used to generate the final prediction model and construct the nomogram. Model performances were quantified by discrimination and calibration.Results The predictive variables that entered the final model were: hysteroscopic adhesiolysis history, PCOS status, application of clomiphene in the ovarian stimulation process, the ovarian stimulation protocol, and the endometrial preparation protocol. The receiver operating characteristic curve for the final model and validation cohort was 0.76 (95% confidence interval [CI]: 0.722–0.797) and 0.71 (95% CI: 0.66–0.76), respectively. Discrimination performed well in both the modeling and validation cohorts.Conclusion We conclude that in women with a thin endometrium (EMT ≤7.5 mm on HCG trigger day), the absence of a hysteroscopic adhesiolysis history, and the presence of PCOS, the application of clomiphene in the ovarian stimulation process, the application of a GnRH agonist short protocol, mild stimulation protocol, natural cycle protocol, and natural cycle for endometrial preparation are prognostic for an increased possibility of EMT >7.5 mm in the subsequent frozen cycle.
Cellulolytic enzymes produced from ramie stalks feedstock and their synergistic effect on sacchariﬁcation of ramie stalks
Authors: Xie Chunliang , Cao Cha , Xu Chao , Gong Wenbing , Zhu Zuohua , Zhou Yingjun , Yan Li , Hu Zhenxiu , Peng Yuande 
Published: May 2021

Abstract
Background: The high cost of cellulase is one of the main obstacles hindering the large-scale biorefining of lignocellulosic biomass. Screening strains with high cellulase producing capability and improving enzymatic hydrolysis technology are important methods to reduce the cost of enzymes. A powerful strategy to lignocellulose as a feedback combined with different enzymes synergism can reduces the time of designing high-efficient enzyme mixtures and significantly improve saccharification of specific substrates.Results: After optimization, the maximum CMCase and FPA produced by Trichoderma reesei reached to 6.06 IU/mL and 0.085 IU/mL, respectively. The hydrolysis capability of Trichoderma reesei was induced at the presence of ramie stalk not wheat bran. Synergistic effect was observed as enzymes produced by Trichoderma reesei and Aspergillus niger were incubated together, and the highest reducing sugars yield was achieved when enzyme cocktail was prepared at the ratio of 1:1. In particular, reducing sugars yield reached to 417 mg/g dry substrate was achieved after hydrolyzing the substrate by prepared enzyme cocktail, which were 1.36 - 3.35 folds higher than different single enzymes.Conclusion: This study indicated that (1) the carbon source exhibited a directional induction effect on the types of cellulolytic enzymes secreted by microorganisms; (2) cellulolytic enzymes from different sources could synergistically strengthen the enzymatic hydrolysis of lignocellulosic materials, providing a clue for the preparation and compounding of cellulolytic enzymes.
Impact of Binary Triage System and Structural Reorganization of Emergency Department on Health Care Worker Exposed to Suspected Covid-19 Patients – A Single Centre Analysis
Authors: Safaai Sufian , Wahab Mahathar Abd , Saiboon Ismail Mohd 
Published: May 2021

Abstract
Background

A binary triage system based on infectivity and facilitated by departmental restructuring was developed to manage suspected COVID-19 patients with an aim to provide effective infection prevention and control among health care workers (HCWs) in the emergency department. This study analyses the effectiveness of the new triage system and structural reorganization in response to the COVID-19 pandemic.
Methods

Cross-sectional observational study conducted in the Emergency and Trauma Department in Kuala Lumpur Hospital (HKL). The implementation of a binary triage system separates patients with risk of COVID-19 who present with fever and respiratory symptoms from other patients. Data on exposed HCW to COVID-19 patients were captured pre-restructuring and post-restructuring of the emergency department and analysed using descriptive statistics.
Results

A total of 846 HCWs were involved in this study. Pre-restructuring reported 542 HCWs exposed to COVID-19 patients while post-restructuring reported 122. Using the four categorical exposure risks for HCWs which are no identifiable risk, low risk, medium risk, and high risk, the number of HCWs exposed during pre-restructuring were 15(1.8%), 504(59.6%), 15(1.8%), and 8(0.9%) respectively while post-restructuring the numbers were 122(14.4%), 8(0.9%), 109(12.9%), and 5(0.1%) respectively. There was a 77.5% reduction in the number of exposed HCW (542 vs 122).
Conclusion

A binary triage system based on severity and infectivity supported with structural reorganization can be effective in reducing HCWs COVID-19 exposure.
Delineation of Neck Node Levels for Patients with Locally Advanced Supraglottic Cancer Receiving Radical IMRT: A Cross-Sectional Study in Mainland China
Authors: Xu Yi , He Meilin , Liu Yang , Yi Jun-Lin , Zhang Ye 
Published: May 2021

Abstract
Background and purpose: In the era of IMRT for locally advanced supraglottic cancer (LA-SGC), the delineation of lymph node clinical target volumes (LN-CTV) remains controversial. We aim to survey the diversity of LN-CTV for LA-SGC patients undergoing radical radiotherapy in mainland China and to provide a basis for improving delineation consistency.Methods: Radiation oncologists from one provincial cancer hospital, one randomly chosen provincial general hospital and one randomly chosen municipal general hospital from each of the 30 provinces of mainland China participated. The study included four representative cases (T2N1, T3N2b, T4N0, T4N2c) of LA-SGC chosen from the following four different groups: non-T4, low nodal burden (T2-3N0-1); non-T4, high nodal burden (T2-3N2-3); T4, low nodal burden (T4N0-1); and T4, high nodal burden (T4N2-3). Respondents were asked which lymph node levels should be included in high-risk (HR) or low-risk (LR) CTV for nodal prophylactic irradiation. The impact of risk factors was also assessed.Results: Altogether, 164 chief or attending physicians completed valid questionnaires from all 82 hospitals in China. The criteria that HR-CTV included the node levels with positive lymph nodes and the next lower adjacent level (83.8%–90% agreement) were followed by most physicians (n=160, 97.6%). In the N0-1 stage (cases 1 and 3), ipsilateral levels II and III selected as HR-CTV and level IV as LR-CTV reached good agreement. Whether contralateral levels II and III should be included in HR- or LR-CTV remained controversial; more respondents were inclined to choose them as HR-CTV in case 3 (61.3%). Some respondents supported including contralateral level IVa in LR-CTV (61.9%-68.1%). In the N2 stage (cases 2 and 4), bilateral levels II–IVb other than HR-CTV regions were all included in LR-CTV was indicated in most respondents (75%–92.5%). Levels Ib and V were more likely included in CTV when there were multiple positive lymph nodes in the ipsilateral neck, and more respondents selected level V as HR-CTV in case 4. Nearly half of respondents selected ipsilateral level VIb as CTV when the subglottic region was involved (50.6%, 46.2% and 56.2% in cases 2 to 4, respectively). Tumours crossing the midline (141, 86%), extracapsular spread (132, 80.5%), T stage (142, 86.5%) and N stage (154, 93.9%) as risk factors influencing nodal level selection were shown to have good agreement (≥80%).Conclusion: Most physicians selected involved nodal levels and lower adjacent levels as HR-CTVs in mainland China. Whether bilateral levels II–IV are included in CTV reached relative consensus but poor agreement for HR- or LR-CTV. The selection conditions of levels Ib, Va/b and VIb as CTVs require further research.
The Challenge of Ovarian Tissue Culture: 2D Versus 3D Culture
Authors: Pais Ana Sofia , Reis Sandra , Laranjo Mafalda , Caramelo Francisco , Silva Fátima , Botelho Maria Filomena , Almeida-Santos Teresa 
Published: May 2021

Abstract
Background

Cryopreservation of ovarian tissue is a powerful technique for preserving female fertility, as it can restore fertility and endocrine function. To increase the longevity of the transplant and decrease the risk of reimplantation of neoplastic cells, several studies have been carried out with the culture of ovarian tissue. The aim of this study was to compare a conventional (2D) culture with an alginate matrix three-dimensional (3D) model for ovarian tissue culture.
Results

The ovarian tissue culture within the alginate matrix (3D) was similar to 2D culture, regarding follicular density, follicular cell proliferation and cell apoptosis in follicles and stroma. Stromal cells proliferation was kept stable in conventional culture but decreased in 3D culture (p = 0.001). At 24 hours of culture, cytotoxicity was lower in the 3D model (p = 0.006). As culture time increased, cytotoxicity seemed to be similar. Degradation of the tissue was suggested by the histological score analysis of tissue morphology during 72 hours of culture. Tissue injury was greater (p = 0.01) in 3D culture due to higher interstitial oedema (p = 0.017) and tissue necrosis (p = 0.035).
Conclusion

According to our results 3D culture of ovarian tissue has no advantage over 2D culture being more time consuming, difficult to perform and having worse reproducibility.
Inflammatory Cytokines are Associated to Lower Glomerular Filtration Rate in Patients with Hypertensive Emergency
Authors: de Andrade Days Oliveira , Aguiar Franciana Luísa , Mansor Ana Luiza Possebon , Valente Flavia Mariana , Souza Doroteia Rossi Silva , Lopes Valquiria da Silva , Fernandes Leticia Baruffi , de Godoy Moacir Fernandes , Yugar-Toledo Juan Carlos , Cosenso-Martin Luciana Neves , Vilela-Martin Jose Fernando 
Published: May 2021

Abstract
Introduction: Hypertension and kidney function are closely related. However, there are few studies on renal function during acute elevation of blood pressure (BP), denominated hypertensive crisis (HC). Objectives: To evaluate the relationship between renal function and inflammatory cytokines in HC, subdivided into hypertensive urgency (HUrg) and emergency (HEmerg). Methods: 74 normotensive subjects (NT), 74 controlled hypertensive (ContrHT), 50 patients with HUrg and 78 with HEmerg were studied. The glomerular filtration rate (eGFR) was estimated, and cytokine levels were measured. Statistical analysis was performed using the Kruskal-Wallis or Mann-Whitney test and Spearman's correlation, with significant differences p-value <0.05. Results: The eGFR was significantly lower in HEmerg group compared to the NT, ContrHT and HUrg groups. All cytokines were significantly elevated in patients with HC compared to the control groups (NT and ContrHT). In addition, the cytokines interleukin (IL)-1β, IL-6 and IL-10 were higher in the HEmerg group compared to the HUrg groups. There was a negative correlation between eGFR and the cytokines (IL-6, IL-8, IL-10 and TNF-α) in the HEmerg group. Conclusions: Elevated inflammatory cytokines are associated with reduced eGFR in individuals with HEmerg, indicating an involvement of the inflammatory process in the pathogenesis of acute elevations of BP.
Impact of simulation-based education on the performance assessment, knowledge retention and mentality of nursing students: A systematic reviews and meta-analysis
Authors: Xu Yun , Xu Yue , Wang Qing , Du Shizheng , Jiang Xing , Xu Guihua 
Published: May 2021

Abstract
Background: Simulation-based education is a new type of teaching method that is suitable for clinic-related majors. This article aims to determine its impact on clinical skill assessment, performance maintenance, and mentality of nursing students.Methods: After searching PubMed, Embase, Web of Science, The Cochrane Library, MEDLINE, and EBSCO database, we conducted a systematic collection of randomized controlled trials (RCTs) on the impact of simulation-based education on performance evaluation and mentality of nursing students. The retrieval time limit was from the establishment of the database to March 12, 2021. Meta-analysis was performed using RevMan5.4 software, and two researchers used ROB2.0 software to evaluate the risk of bias in the included literature. The quality evaluation of the outcome indicators was performed using GRADEpro. A standardized mean difference (SMD) with a 95% confidence interval (CI) was used in estimating the pooled effects of RCTs. Results: A total of 21 RCTs were performed, including 1683 nursing students. The results of meta-analysis showed that simulation-based education significantly improved the assessment scores of nursing students (SMD = 1.46, 95% CI = 1.02 to 1.90, P < 0.00001), self-confidence (SMD = 1.19, 95% CI = 0.48 to 1.90, P = 0.001), satisfaction (SMD = 0.86, 95% CI = 0.13 to 1.60, P = 0.02), and knowledge retention (SMD = 1.89, 95% CI = 0.76 to 2.87, P = 0.0008), and the difference was statistically significant. The results of subgroup analysis showed that long-term intervention (MD = 1.44, 95% CI = 0.62, 2.26, P = 0.0006) and short-term intervention (MD = 1.46, 95% CI = 0.95, 1.97, P < 0.00001) improved the performance assessment of nursing students, and the difference was statistically significant.Conclusions: Simulation-based education can significantly improve the assessment scores, self-confidence, and satisfaction of the nursing students, and the scores can be effectively retained for a period of time. Limited by the quality of the number of included studies, the above conclusions need to be verified by high-quality studies.
Effects of (Combined) Chinese Medicine on the Risk of Death From COVID-19: A Retrospective Data Analysis Based on 4567 Patients
Authors: Wang Qian , Liu Yuntao , Weng Heng , Yang Yuqi , Li Jun , Zeng Jing , Wang Jinzhong , Peng Zhe , Liangsheng Sun , Pan Zongqi , Yan Fang , Zhou Yuanshen , Ding Banghan , He Zehui , Tao Lanting , Huang Donghui , Liu Yuxiang , Chen Yahui , Zhu Wei , Li Kun , Zou Xu , Zhang Zhongde 
Published: May 2021

Abstract
Background

The coronavirus disease 2019 (COVID-19) epidemic is still ongoing, but the optimal treatment remains unclear. China adopted a series of measures, including widespread screening, strict quarantine and early treatment, combining western medicine with Chinese medicine, leading to rapid control of its spread. Nevertheless, the effects of ( combined ) Chinese medicine in reducing the toll of COVID-19 lack proof from statistics.
Objective

We conducted a retrospective data analysis to determine whether ( combined ) Chinese medicine is able to affect patient outcomes and to decrease the risk of death in COVID-19 patients.
Methods

The data were acquired by outputting the formatting information from the HIS system and then extracting and recording it in the database for complete cases. The demographics, disease onset, treatment, survival/death and all of the clinical classifications, groups and definitions were verified by specialists in the clinic, along with the research methodology and statistics, before conducting the statistical analysis. The characteristics of the cohort and the clinical symptoms and signs, prescriptions and outcomes were described and analyzed by the mean ± SD, median, interquartile range and composition ratio. Analysis of variance was used for comparisons between the measurement data sets; otherwise, the rank sum test was used. Counting data were compared between groups using the chi square test and Fisher’s exact test. Tendency matching was adopted to make the general data balance between groups. A Cox proportional hazard model was used to compare the risk of death among the different groups.
Results

Four centers were included in our study, and a total of 6,076 patients' clinical records were obtained after combining the data. We included 4567 cases for the descriptive statistics, and the crude case fatality rate was 3.0%. Compared with using only western medicine, (combined) Chinese medicine reduced the risk of death from COVID-19 after adjusting for other prognostic risk factors (HR = 0.135, 95% CI (0.088, 0.208)). Multivariate Cox regression also indicated that when applying the clinical classification of severe/critical, age ≥ 65 years old, coronary heart disease or chronic kidney disease and a time from onset to hospital admission of fewer than 14 days, all of these factors increased the risk of death.
Conclusion

(Combined) Chinese medicine can significantly reduce the risk of death from COVID-19, but the specific strategy/solution, effects and amount need further exploration in future studies.
Functionally significant polymorphisms of the MMP-9 gene are associated with peptic ulcer disease in the Caucasian population of Central Russia
Authors: Minyaylo Oksana , Ponomarenko Irina , Reshetnikov Evgeny , Dvornyk Volodymyr , Churnosov Mikhail 
Published: May 2021

Abstract
This study analyzed the association of functionally significant SNPs of matrix metalloproteinase (MMP) genes in the development of peptic ulcer disease (PUD) in Caucasians from Central Russia. Ten SNPs of the MMP-1, MMP-2, MMP-3, MMP-8, and MMP-9 genes were analyzed for association with PUD in a cohort of 798 patients with PUD (including 404 H. pylori-positive and 394 H. pylori-negative) and 347 H. pylori-negative controls using logistic regression and assuming the additive, recessive, and dominant genetic models. Allele G of the rs17576 MMP9 locus conferred a higher risk for PUD (ORadj = 1.31, pperm=0.016), haplotype AACG of loci rs17576-rs3787268-rs2250889-rs17577 of the MMP9 gene decreased risk for PUD (ORadj=0.17, pperm=0.003). Also, allele C of rs3918249, allele G of rs17576 and haplotype CG of rs3918249-rs17576 of the MMP9 gene increased risk for H. pylori-positive PUD (ORadj = 1.82, pperm=0.002; ORadj = 1.53–1.95 pperm=0.001–0.013 and ORadj = 1.49 pperm=0.009 respectively). The above loci and 50 linked to them possess significant regulatory effects and may affect the alternative splicing of four genes and the expression of 17 genes in various organs and tissues related to the PUD pathogenesis.
WITHDRAWN: Inhibitory Effect of ZnO-NPs and NF-CS-ZnO Nano-Hybrid Against Herpes Simplex Virus Type 1 Infection
Authors: Abbasi Mahya , Arab-Bafrani Zahra , Zabihi Erfan , Arabzadeh Ali Mohammad , Babaei Amir , Sedaghat Mohsen , Mousavi Elham 
Published: May 2021

Abstract
Background: Since the viruses are intracellular parasite and their replication depends on the host cells, to develop a medication against the viral infections, some substances should be provided having no damage on the host’s cells and tissue. Although the antiviral effects of zinc ion against the viral pathogens has been conspicuous, undesirably it shows a severe toxicity on the cells in cell culture and host tissues in animal models. Methods: To optimize, zinc oxide nanoparticles with antiviral property at the lowest cell toxicity, nano-fibrillar chitosan-ZnO nano-hybrid was synthesized and then, its inhibitory effect against the HSV replication was investigated in comparison to ZnO nanoparticles using plaque reduction and Real time PCR method. Results: Although the infectivity of HSV-1 was reduced in initial steps of virus entry, the significant reduction of viral titer was observed in post exposure of Nano particles on HSV-1 infected cells. In contrary, no changes of viral load were identified in pre-incubation experiment, co-incubation of virus and nanoparticles prior to virus inoculation. Conclusion: Nano-fibrillar CS could dramatically decrease the cell cytotoxicity of ZnO, even though the antiviral effect of ZnO nanoparticles did not change. Nano hybrids appears to penetrate into the host cells and intracellularly inhibits the virus multiplication.