bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mid-term outcomes of modified valve-sparing aortic root replacement versus the Bentall procedure for middle-aged Chinese patients with acute DeBakey I aortic dissection: a single-center retrospective study
Authors: Wu Qingsong , Wang Zhisheng , Qiu Zhihuang , Shen Yue , Chen Xiaodong , Chen Xingfeng , Chen Liangwan 
Published: April 2021

AbstractBackgroundThe mid-term and long-term efficacies of valve preservation in acute DeBakey I aortic dissection (AD) are controversial. Thus, it is unclear whether middle-aged patients with acute DeBakey I AD should undergo modified valve-sparing procedures or the Bentall procedure in an emergency setting.MethodsThis study included 213 middle-aged Chinese patients (under 60 years old) who were treated for acute DeBakey I AD between January 2009 and June 2015. The treatments involved modified valve-sparing aortic root replacement (VSARR) (117 patients) or the Bentall procedure (96 patients). Preoperative, intraoperative, postoperative, and follow-up data were analyzed. Echocardiography and thoracoabdominal computed tomography angiography (CTA) findings were reviewed at 3 months, 1 year, and then annually after surgery.ResultsNo significant differences were observed in terms of the preoperative, intraoperative, in-hospital mortality, and postoperative parameters. There were also no significant differences in aortic regurgitation (AR). However, follow-up examinations using CTA revealed that 6 patients had endoleakage at the distal end of the triple-branched stent (0/110 patients [0.0%] vs. 6/90 patients [6.7%],P = 0.022). The anticoagulation-related thromboembolism/bleeding events was significantly lower in group A than in group B (0/110 patients [0.0%] vs. 11/90 patients [11.1%],P = 0.001). And postoperative aortic valve re-operation rate was significantly lower in group A (1/110 patients [0.9%] vs. 8/90 patients [8.9%],P = 0.020). There was no significant difference in survival during the follow-up period (log-rankP > 0.05).ConclusionFor middle-aged patients with acute DeBakey I AD, VSARR were associated with a lower rate of endoleakage at the distal end of the triple-branched stent, thromboembolism/bleeding events and aortic valve re-operation (vs. the Bentall procedure).
Endothelial glycocalyx degradation is associated with early organ impairment in polytrauma patients
Authors: Qi Feng , Zhou Hao , Gu Peng , Tang Zhi-He , Zhu Bao-Feng , Chen Jian-Rong , Zhang Jin-Song , Li Feng 
Published: April 2021

Abstract
Background
Endothelial glycocalyx (EG) abnormal degradation were widely found in critical illness. However, data of EG degradation in multiple traumas is limited. We performed a study to assess the EG degradation and the correlation between the degradation and organ functions in polytrauma patients.

Methods
A prospective observational study was conducted to enroll health participants (control group) and polytrauma patients (trauma group) at a University affiliated hospital between Feb 2020 and Oct 2020. Syndecan1 (SDC1) and heparin sulfate (HS) were detected in serum sample of both groups. In trauma group, injury severity scores (ISS) and sequential organ failure assessments (SOFA) were calculated. Occurrences of acute kidney injury (AKI), trauma-induced coagulopathy (TIC) within 48 h and 28-day all-cause mortality in trauma group were recorded. Serum SDC1 and HS levels were compared between two groups. Correlations between SDC1/HS and the indicators of organ systems in the trauma group were analyzed. ROC analyses were performed to assess the predictive value of SDC1 and HS for AKI, TIC within 48 h, and 28-day mortality in trauma group.

Results
There were 45 polytrauma patients and 15 healthy participants were collected, totally. SDC1 and HS were significantly higher in trauma group than in control group (69.39 [54.18–130.80] vs. 24.15 [13.89–32.36], 38.92 [30.47–67.96] vs. 15.55 [11.89–23.24], P <  0.001, respectively). Trauma group was divided into high degradation group and low degradation group according to SDC1 median. High degradation group had more severe ISS, SOFA scores, worse organ functions (respiratory, kidney, coagulation and metabolic system), and higher incidence of hypothermia, acidosis and shock. The area under the receiver operator characteristic curves (AUC) of SDC1 to predict AKI, TIC occurrence within 48 h and 28-day mortality were 0.838 (95%CI: 0.720–0.957), 0.700 (95%CI: 0.514–0.885) and 0.764 (95%CI: 0.543–0.984), respectively.

Conclusions
EG degradation was elevated significantly in polytrauma patients, and the degradation was correlated with impaired respiratory, kidney, coagulation and metabolic systems in early stage. Serum SDC1 is a valuable predictive indicator of early onset of AKI, TIC, and 28-day mortality in polytrauma patients.
Evaluating the prevalence and severity of NAFLD in primary care: the EPSONIP study protocol
Authors: Nasr Patrik , Iredahl Fredrik , Dahlström Nils , Rådholm Karin , Henriksson Pontus , Cedersund Gunnar , Dahlqvist Leinhard Olof , Ebbers Tino , Alfredsson Joakim , Carlhäll Carl-Johan , Lundberg Peter , Kechagias Stergios , Ekstedt Mattias 
Published: April 2021

AbstractBackgroundNon-alcoholic fatty liver disease (NAFLD) affects 20–30% of the general adult population. NAFLD patients with type 2 diabetes mellitus (T2DM) are at an increased risk of advanced fibrosis, which puts them at risk of cardiovascular complications, hepatocellular carcinoma, or liver failure. Liver biopsy is the gold standard for assessing hepatic fibrosis. However, its utility is inherently limited. Consequently, the prevalence and characteristics of T2DM patients with advanced fibrosis are unknown. Therefore, the purpose of the current study is to evaluate the prevalence and severity of NAFLD in patients with T2DM by recruiting participants from primary care, using the latest imaging modalities, to collect a cohort of well phenotyped patients.MethodsWe will prospectively recruit 400 patients with T2DM using biomarkers to assess their status. Specifically, we will evaluate liver fat content using magnetic resonance imaging (MRI); hepatic fibrosis using MR elastography and vibration-controlled transient elastography; muscle composition and body fat distribution using water-fat separated whole body MRI; and cardiac function, structure, and tissue characteristics, using cardiovascular MRI.DiscussionWe expect that the study will uncover potential mechanisms of advanced hepatic fibrosis in NAFLD and T2DM and equip the clinician with better diagnostic tools for the care of T2DM patients with NAFLD.Trial registration:Clinicaltrials.gov, identifier NCT03864510. Registered 6 March 2019,https://clinicaltrials.gov/ct2/show/NCT03864510.
Sequential transarterial chemoembolization and early radiofrequency ablation improves clinical outcomes for early-intermediate hepatocellular carcinoma in a 10-year single-center comparative study
Authors: Yan Liangliang , Ren Yanqiao , Qian Kun , Kan Xuefeng , Zhang Hongsen , Chen Lei , Liang Bin , Zheng Chuansheng 
Published: April 2021

Abstract
Background
Transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) are effective treatment methods for unresectable hepatocellular carcinoma (HCC). However, there is still a lack of clinical research on whether early sequential RFA, compared with late combination therapy, can improve the long-term efficacy of initial TACE treatment.

Methods
This retrospective study investigated a cohort of patients who underwent combination therapy using TACE and RFA (TACE followed by RFA) from January 2010 to January 2020 at our medical centre. A total of 96 patients underwent TACE combined with early RFA (usually during the first hospitalization), which was called TACE + eRFA. Thirty-four patients received 1–2 palliative TACE treatments first and then underwent TACE treatment combined with late RFA (TACE + lRFA). All patients continued to receive palliative TACE treatments after intrahepatic lesion progression until reaching intolerance. The overall survival (OS) rate, time to tumour progression (TTP), tumour response rate and major complication rates were compared between the two groups.

Results
There were significant differences in the median OS (46 months vs 33 months; P = 0.013), median TTP (28 months vs 14 months; P < 0.00), objective response rate (ORR) (89.6% vs 61.8%, P = 0.000) and disease control rate (DCR) (94.8% vs 73.5% P = 0.002) between the two groups. Multivariable analysis revealed that the Barcelona Clinic Liver Cancer stage was an independent risk factor for OS. Meanwhile, multivariable analysis revealed that TACE + eRFA was associated with an enhanced TTP.

Conclusion
Early sequential RFA treatment in patients with early-intermediate HCC can improve local tumour control and clinical outcomes while reducing the frequency of TACE treatment. In clinical practice, in HCC patients initially treated with TACE, it is recommended to combine RFA as soon as possible to obtain long-term survival.
Reduction in circulating vitamin D binding protein in patients with multiple sclerosis
Authors: Maghbooli Zhila , Omidifar Abolfazl , Varzandi Tarlan , Salehnezhad Tayebeh , Sahraian Mohammad Ali 
Published: April 2021

Abstract
Background
In this study, we aimed to determine the risk association between vitamin D binding protein (VDBP) polymorphism in patients with multiple sclerosis (MS) in a MS biobank and the difference in VDBP serum levels in MS patients who were recently diagnosed.

Method
The current case-control study was performed on 296 MS patients and 313 controls. Thereafter, two common missense VDBP polymorphisms, named rs7041and rs4588, were evaluated in all the participants. Serum levels of vitamin D and vitamin D binding protein were assessed in 77 MS patients who were diagnosed since one year ago and in 67 healthy people who were matched in terms of age and sex.

Result
The frequency distributions of VDBP genotypes and alleles of SNP rs7041 and rs4588 were observed to be similar in both the MS and control groups (p > 0.05). The VDBP haplotypes, as Gc2/Gc2, Gc1/Gc1, and Gc1/Gc2, were found to be similar in the MS and control groups (p > 0.05).
In subgroup analysis, circulating VDBP was lower in MS patients (Ln-VDBP (μgr/ml): 3.64 ± 0.91 vs. 5.31 ± 0.77, p = 0.0001) even after adjusting for vitamin D levels, body mass index, and taking vitamin D supplement. There was no significant association between VDBP haplotypes and vitamin D levels in the two groups.

Conclusion
The present study suggested an association between lower levels of circulating VDBP and multiple sclerosis in newly diagnosed patients. However, the VDBP causative role in the development of MS is still unclear, so it needs more studies.
Internet-based behavioural activation to improve depressive symptoms and prevent child abuse in postnatal women (SmartMama): a protocol for a pragmatic randomized controlled trial
Authors: Obikane Erika , Baba Toshiaki , Shinozaki Tomohiro , Obata Soichiro , Nakanishi Sayuri , Murata Chie , Ushio Emiko , Suzuki Yukio , Shirakawa Norihito , Honda Mari , Sasaki Natsu , Nishi Daisuke , O’Mahen Heather , Kawakami Norito 
Published: April 2021

Abstract
Background
Child abuse and postnatal depression are two public health problems that often co-occur, with rates of childhood maltreatment highest during the first year of life. Internet-based behavioural activation (iBA) therapy has demonstrated its efficacy for improving postnatal depression. No study has examined whether the iBA program is also effective at preventing child abuse. This study aims to investigate whether iBA improves depressive symptoms among mothers and prevents abusive behaviours towards children in postpartum mothers in a randomized controlled trial, stratifying on depressive mood status. The study also evaluates the implementation aspects of the program, including how users, medical providers, and managers perceive the program in terms of acceptability, appropriateness, feasibility, and harm done.

Methods
The study is a non-blinded, stratified randomized controlled trial. Based on cut-off scores validated on Japanese mothers, participants will be stratified to either a low Edinburgh Postnatal Depression Scale (EPDS) group, (EPDS 0–8 points) or a high EPDS group (EPDS ≥9 points). A total of 390 postnatal women, 20 years or older, who have given birth within 10 weeks and have regular internet-access will be recruited at two hospitals. Participants will be randomly assigned to either treatment, with treatment as usual (TAU) or through intervention groups. The TAU group receives 12 weekly iBA sessions with online assignments and feedback from trained therapists. Co-primary outcomes are maternal depressive symptoms (EPDS) and psychological aggression toward children (Conflict Tactic Scale 1) at the 24-week follow-up survey. Secondary outcomes include maternal depressive symptoms, parental stress, bonding relationship, quality of life, maternal health care use, and paediatric outcomes such as physical development, preventive care attendance, and health care use. The study will also investigate the implementation outcomes of the program.

Discussion
The study investigates the effectiveness of the iBA program for maternal depressive symptoms and psychological aggression toward children, as well as implementation outcomes, in a randomized-controlled trial. The iBA may be a potential strategy for improving maternal postnatal depression and preventing child abuse.

Trial registration
The study protocol (issue date: 2019-Mar-01, original version 2019005NI-00) was registered at the UMIN Clinical Trial Registry (UMIN-CTR: ID UMIN 000036864).
Oral cancer knowledge and screening behavior among smokers and non-smokers in rural communities
Authors: Wong Tzu-Jung , Li Qian , Dodd Virginia , Wang Wei , Bian Jiang , Guo Yi 
Published: April 2021

Abstract
Background
Research suggests having an oral and pharyngeal cancer (OPC) examination for early diagnosis can increase survival rate. However, the OPC screening rate is low in certain populations. To improve OPC screening rate, this study identified factors that are associated with having an OPC examination.

Methods
Participants with landlines and aged 25 years and older were recruited from six northern Florida counties. Bivariate and logistic regressions were used to predict the outcome of whether the participants had ever had an OPC examination as well as whether participants had ever heard of an OPC examination.

Results
Of 2260 participants with a mean age of 55.9 ± 15.0 years, the majority of participants never smoked (53.4%), self-identified as Whites (70.6%), and had some college or 2-year degree education (30.3%). Smokers were significantly less likely to have ever heard of an OPC examination than those who never smoked. Significant interaction between smoking status and race, and smoking status and social support interaction were found. Whites who never smoked were more likely to have had an OPC examination than non-Whites who never smoked. Former and current smokers with greater social support were more likely to have had an OPC examination than those with lower social support.

Conclusion
The findings from this study inform the need to enhance the awareness of having an OPC examination among smokers and to reduce barriers for racial minority populations to receive an OPC examination. Future research is warranted to develop interventions to target certain populations to improve the rate of OPC examination.
Influence of weight status on bone mineral content measured by DXA in children
Authors: Ferrer Francisco Sánchez , Castell Ernesto Cortes , Marco Francisco Carratalá , Ruiz Mercedes Juste , Rico José Antonio Quesada , Roca Ana Pilar Nso 
Published: April 2021

Abstract
Introduction
Childhood obesity is a public health problem with repercussions in later life. As tissue formation peaks in childhood we determined how weight status influences bone mineral content.

Material and methods
We studied 553 children aged 4–18 years over 10 years (46.8% girls). We measured age, weight, height and through bone densitometry (DXA), bone mineral content (BMC), bone mineral density (BMD), and waist, arm and hip circumferences. The patients were divided into groups using the body mass index z-score: underweight, normal weight, overweight, obese and very obese.

Results
BMC and BMD values were highest in the normal-weight and overweight groups. Logistic regression showed bone mineralization was inversely associated with waist circumference, the association being positive for weight and age. No differences were found according to sex.

Discussion
Studies of the relationship between weight and bone mineralization report contradictory results, often because of different study designs. Moreover, studies in children are either few or with small samples. Our findings in a large sample show the importance of weight status in bone mineralization given the risk of bone fractures or osteoporosis.

Conclusions
Weight status influenced bone mineralization. BMC and BMD decreased in children with a higher degree of obesity. Waist circumference correlated negatively with bone mineralization.
The polymorphisms of FGFR2 and MGAT5 affect the susceptibility to COPD in the Chinese people
Authors: Li Xiaobo , Zhou Guangyu , Tian Xiaobo , Chen Fei , Li Guoyao , Ding Yipeng 
Published: April 2021

Abstract
Background
Chronic obstructive pulmonary disease (COPD) is characterized by incomplete reversible airflow limitation and chronic inflammatory response lesions. This study mainly explored whether FGFR2 and MGAT5 polymorphisms affected the risk of COPD in the Chinese people.

Methods
Five variants in FGFR2 and MGAT5 were chosen and genotyped using Agena MassARRAY platform from 315 COPD patients and 314 healthy controls. The correlation of FGFR2 and MGAT5 with COPD susceptibility was evaluated with odds ratio (OR) and 95% confidence interval (CI) via logistic regression.

Results
We found rs2420915 enhanced the risk of COPD, while rs6430491, rs2593704 reduced the susceptibility of COPD (p < 0.05). Rs2420915 could promote the incidence of COPD in the elderly and nonsmokers. Rs1907240 and rs2257129 also increased the susceptibility to COPD in nonsmokers (p < 0.05). MGAT5-rs2593704 played a protective role in COPD development in different subgroups (age ≤ 70, male, smokers, and individuals with BMI ≤ 24 kg/m2). Meanwhile, rs6430491 was linked with a lower risk of COPD in nonsmoking and BMI ≤ 24 kg/m2 subgroups.

Conclusions
We concluded that FGFR2 and MGAT5 genetic polymorphisms are correlated with the risk of COPD in the Chinese people. These data underscored the important role of FGFR2 and MGAT5 gene in the occurrence of COPD and provided new biomarkers for COPD treatment.
Trial registration: NA.
Association between syndesmophyte and metabolic syndrome in patients with psoriatic arthritis or ankylosing spondylitis: a cross-sectional study
Authors: Petcharat Chonachan , Srinonprasert Varalak , Chiowchanwisawakit Praveena 
Published: April 2021

Abstract
Objective
To investigate the prevalence of and factors associated with metabolic syndrome (MetS) in patients with psoriatic arthritis (PsA) or ankylosing spondylitis (AS).

Methods
This cross-sectional study included PsA or AS patients who attended Siriraj Hospital (Bangkok, Thailand) during March 2014 to October 2017. The Harmonized MetS definition was used to diagnose MetS. Demographic, clinical, and spinal radiographic data were collected. Logistic regression was used to identify factors associated with MetS.

Results
Among 319 patients, 153 had AS and 166 had PsA. MetS was present in 43% of PsA and 19% of AS (p < 0.001). Multiple regression analysis identified body mass index (BMI) > 23 (odds ratio [OR]: 3.7), female gender (OR range: 3.8–3.9), and the number of syndesmophytes or ankylosis [SynAnk] (OR: 1.1) were associated with MetS among PsA patients. For AS patients, BMI > 23 (OR: 9.1) and age > 40 (OR: 4.3) were associated with MetS. Disease activity index was not associated with MetS.

Conclusions
MetS was significantly more prevalent in PsA than in AS. Structural change of the spine was associated with MetS in PsA. PsA patients with being female, BMI > 23 or evidence of spinal change should be informed to screen for MetS. AS patients with age > 40 or BMI > 23 should be informed to screen for MetS.
Mutations in ALK and TSC1 in a gastrointestinal stromal tumor: a case report
Authors: Song Qingzhi , Li Guan , Li Zhuofei , Ao Sheng , Hou Jianing , Lv Guoqing 
Published: April 2021

Abstract
Background
Gastrointestinal stromal tumors rarely occur in children, but when they do, their biological behavior and histopathological patterns differ from those of adults.

Case presentation
A 13-year-old boy with a gastrointestinal stromal tumor was characterized by a rare genetic mutation. The patient complained of “fatigue with intermittent abdominal pain for 1 month”. According to the preoperative imaging examination, gastroscopy, and gastroscopic biopsy, the patient was diagnosed with a gastric stromal tumor. Postoperative pathology showed that the tumor cells were fusiform and ovoid, and mitotic figures were easily seen. Immunohistochemistry revealed that the tumor was S-100(+), SOX10(−), CD34(+), SMA(partially+), DOG-1(+), CD117(+), KI-67 (positive for 20% + of the subjects and 40% + of the hotspots), and SDHB(−). Genetic tests showed missense mutations in ALK and TSC1. With surgical treatment, the tumor was completely removed. The patient recovered well and was discharged on the ninth day after the operation. He is currently under follow-up.

Conclusions
In this case involving a patient with a gastrointestinal stromal tumor, immunohistochemistry indicated that the tumor was an "SDH-deficient type", and gene detection showed no KIT or PDGFRA mutation but rare ALK and TSC1 mutations, which adds to the knowledge of the types of gene mutations in children with gastrointestinal stromal tumors.
Anxiety and facial self-contacts: possible impact on COVID-19 transmission in dental practice
Authors: Carrillo-Diaz María , Lacomba-Trejo Laura , del Valle-González Antonio , Romero-Maroto Martín , González-Olmo María José 
Published: April 2021

Abstract
Background
The purpose was to analyse the associations between dental and trait anxiety, fear of COVID-19 and the duration and frequency of spontaneous hand-to-face contact (self-contact).

Methods
A cross-sectional design was carried out with 128 adult patients from four dental clinics in Madrid, during the confinement, from March 15 to May 15. The patients’ movements in the waiting room were monitored with Microsoft Kinect Software, also completed the Trait anxiety subscale of the STAI, the COVID-19 Fear and the S-DAI questionnaire.

Results
Associations were observed between the duration and frequency of facial, mask and eye contact with trait anxiety and dental fear was determined only by the frequency of this self-contact. Trait anxiety is associated with dental anxiety and with fear of COVID-19. Although facial self-contact is higher in women, it also rises in men as dental fear increases. Moreover, dental anxiety is a good predictor of trait anxiety and the incidence of facial self-contact.

Conclusions
Understanding the possible associations between biopsychosocial factors, such as trait anxiety, dental anxiety and self-contact is important. It may help to prevent the spread of COVID-19 in the population as well as enabling the formulation of effective interventions to improve oral health care through the implementation of dental care programmes.