bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transversus Abdominis Release (TAR) Procedure: Experience of An Abdominal Wall Reconstruction Group.
Authors: Ricaurte Alberto , Rey Carlos , Giron Felipe , Conde Danny , Rodriguez Lina , Venegas David , Vanegas Marco , Pardo Manuel , Vargas Felipe , Navarro Jorge 
Published: August 2021

Abstract
BackgroundComplex abdominal wall defects are important conditions with a high morbidity, leading to impairment of patients physical condition and quality of life. In the last decade, the abdominal wall reconstruction paradigm has changed due to formation of experienced and excellence groups, improving clinical outcomes after surgery. Therefore, our study shows the perspective and outcomes of an abdominal wall reconstruction group (AWRG) in Colombia, focused on transverse abdominis release (TAR) procedure.MethodsA retrospective review of a prospectively collected database was conducted. All the patients older than 18 years old that underwent TAR procedure between January 2014 – December 2020 were included. Analysis and description of postoperative outcomes (recurrence, surgical site infection (SSI), seroma, hematoma, and re-intervention) was performed.Results50 patients underwent TAR procedure. 62% of patients were male. Mean age was 55 ± 13.4 years. Mean BMI was 27.8 ± 4.5 Kg/m2. Abdominal wall defects were classified with EHS ventral Hernia classification having a W3 hernia in 72% of all defects (Mean gap size of 11.49 cm ± 4.03 cm). Mean CeDAR preoperative risk score was 20.5 % ± 14.5%. Protective association was established for SSI if the procedure was performed by the AWRG OR 0.7 (IC 95% 0.05-0.93 ). Higher risk of SSI was found in cases not performed by the abdominal wall reconstruction group OR 13.6 (CI 95% 9.12 - 15.5 ). ConclusionsTAR procedure for complex abdominal wall defects under specific clinical conditions including emergency scenarios is viable. Specialized and experienced groups lessen surgical site infection.
Anterolateral Approach Might Be Superior to Posterolateral Approach in Controlling Lower Limb Discrepancy for Special Total Hip Arthroplasty Patients
Authors: Xiong Ao , Li Guoqing , Liu Su , Xu Chang , Wang Deli , Zeng Hui 
Published: August 2021

Abstract
Objectives: Variable approaches for total hip arthroplasty (THA) are promoted but investigations of associations between the approaches and the postoperative lower limb discrepancy (LLD) are limited. We intended to compare the efficacy between the anterolateral approach (ALA) and posterolateral approach (PLA) in controlling of postoperative LLD. Methods: Two retrospective cohorts were established including patients undergone unilateral primary THA. Preoperative and latest follow-up radiographs were compared and evaluated. Two hundred and sixty patients (140 females and 126 males; aged 46.70 ± 13.62 years) were recruited with around 20 months follow-up postoperatively. Results: Univariate analysis identified lower postoperative LLD, lower postoperative acetabular offset and lower hospital costs in the ALA group than in the PLA group (p＜0.01), however, the femoral and global offset and length of stay (LOS) are comparable between (p > 0.05). Multivariable liner regression revealed that PLA, preoperative LLD, developmental dysplasia of the hip and aseptic avascular necrosis are major contributors to the postoperative LLD (p<0.05). Conclusions: This study illustrates that the ALA might be superior to the PLA in controlling the postoperative LLD among some of the THA patients. Both ALA and PLA are comparable in regard to femoral and offset and LOS.
Arthrospira Platensis Mediated Green Biosynthesis of Silver Nanoparticlesas Breast Cancer Controlling Agent: In-vitro and In-vivo Safety Approach.
Authors: Deeb Nehal El , Abo-Eleneen Mai A. , Awad Omyma A. , Abo-Shady Atef M. 
Published: August 2021

Abstract
Biogenic Silver Nanoparticle (bio-AgNPs) is one of the most fascinating nanomaterials used in the biomedical purposes. In the current study, we biosynthesized AgNPs (bio-AgNPs) using Arthrospira platensis(A-bio-AgNPs), Microcystis aeruginosa(M-bio-AgNPs)and Chlorella vulgaris(C-bio-AgNPs) active metabolites and evaluated their anticancer efficacy against breast cancer. The recovered bio-AgNPs were characterized using Scanning and Transmission Electron Microscopy (SEM and TEM) and their safety profiles were monitoring in-vitro on PBMCs cells and in-vivo on Albino mice. The obtained results indicated the safety usage of bio-AgNPs at concentration of 0.1 mg/ml on PBMCs cells and 1.5mg/ml on the Albino mice. The bio-AgNPs displayed dose-dependent cytotoxic effects against HepG-2, CaCO-2 and MCF-7 cell lines by inducing ROS and arresting the treated cells in G0/G1 and sub G0 phases. In addition, A-bio-AgNPs induced breast cancer cellular apoptosis by down regulating the expression of survivin, MMP7, TGF and Bcl2 genes. Upon A-bio-AgNPs treatment, a significant reduction in tumor growth and prolonged survival rates were recorded in breast cancer BALB/c model. Furthermore, A-bio-AgNPs treatment significant decreased theKi 67 protein marker from 60% (in the untreated group) to 20% and increased Caspase 3 protein levels to 65% (in treated groups) comparing with 45% (in Doxorubicin treated groups).
Non-Linear Relationship of Gamma-Glutamyl Transpeptidase To Lymphocyte Count Ratio With The Recurrence of Hepatocellular Carcinoma with Staging I-II: A Retrospective Cohort Study
Authors: Li Zeping , Liang Lili , Duan Wen , Zhou Chengmao , Yang Jianjun 
Published: August 2021

Abstract
Background
high recurrence rate was a major factor for poor postoperative prognosis of hepatocellular carcinoma (HCC) patients. The present study was intended to evaluate the association of gamma-glutamyl transpeptidase to lymphocyte count ratio (GLR) and the recurrence of HCC with staging I-II in Chinese.
Methods
the retrospective cohort data was derived from the First Affiliated Hospital of Zhengzhou University from January 2014 to December 2018 on 496 patients who underwent radical resection of HCC with staging I-II. Multivariable Cox regression models were used to determine hazard ratios (HR) and 95% confidence intervals (CIs) for the recurrence of HCC with staging I-II of each GLR tertile category. The restricted cubic spline model was used to find out the threshold effect.
Results
with the low tertile of GLR as the reference, multivariable-adjusted HRs and 95% CIs of the middle and high tertile categories were 1.748 (1.170, 2.612) and 2.078 (1.339, 3.227). In addition, there was a positive correlation (1.002 (1.001, 1.004)) and a non-liner relationship was found, whose point was 27.5. When the GLR was less than 27.5, the risk of recurrence increased, obviously with the increase in GLR levels (1.041 (1.014, 1.068)).
Conclusions
the GLR was independently associated with the recurrence of HCC patients with staging I-II. Furthermore, the relationship was positive and no-linear.
The Design and Realization of the Evaluation Model for Enhancing the "Second Classroom" Education by Using the Multimedia Interface
Authors: Xie Faguo , Zhou Min , Xia Qing , Xie Long 
Published: August 2021

Abstract
The increasing challenges in improving the educational system such as innovation,are gaining much greater attention in the media in classrooms. Technological innovations have a significant potential to improve the learning and teaching process.The standard online learning method cannot effectively recommend the required learning content, which leads to poor learning and no visible improvement of student performance after learning. In this paper, online multimedia learning-based teaching performance analysis(OML-TPA) has been proposed based on the virtual network function structureto improve the teaching effect appropriately. The first is to develop a classifier for online educational tool learning, build on the student's capabilities and then develop a multimedia online education dataset.This indicates that the design of network-based virtualization features interactive multimedia educational management method can enhance students' learning effect.According to student data, the teaching management system can automatically analyze student learning capacity such that students can be graded by the level of attention they are required to receive.Finally, the interactive multimedia education control system is designed to realize online multimedia education management based on virtualization architecture in the network.The OML-TPA is evaluated using simulation analysis and observed the highest accuracy ratio(93.7 %), performance ratio(92.6 %), learning rate(95.1 %), feedback ratio(91.8 %), the efficiency ratio(96.7 %), precision ratio(94.3%)and learning outcome ratio(97. 6 %) compared to other methods.
Escherichia Coli From Urine Samples of Pregnant Women as an Indicator for Antimicrobial Resistance in the Community: a Field Study From Rural Burkina Faso.
Authors: Post A.S. , Guiraud I. , Peeters M. , Lompo P. , Ombelet S. , Karama I. , Yougbaré S. , Garba Z. , Rouamba E. , Tinto H. , Jacobs J. 
Published: August 2021

Abstract
Introduction: In low- and middle-income countries, surveillance of antimicrobial resistance (AMR) is mostly hospital-based and, in view of poor access to clinical microbiology, biased to more resistant pathogens. We assessed AMR among Escherichia coli isolates obtained from urine cultures of pregnant women as an indicator for community AMR and compared the AMR results with those from E. coli isolates obtained from febrile patients in previously published clinical surveillance studies conducted within the same population in Nanoro, rural Burkina Faso.Results: Between October 2016 – September 2018, midstream urine samples collected as part of routine antenatal in Nanoro district were cultured by a dipslide method and screened for antibiotic residues. Among 6018 consenting women (median (IQR) age 25 (20 - 30)), 84 (1.4%) were excluded because of symptoms of urinary tract infection and 96 (1.6%) screened positive for antibiotic residues. Significant growth - defined as a monoculture of Enterobacterales at counts of ≥ 104 colony forming units/ml – was observed in 202 (3.4%) cultures; E. coli represented 155 (76.7%) of isolates. Among these E. coli isolates, resistance rates to ampicillin, cotrimoxazole and ciprofloxacin were respectively 65.8%, 64.4% 16.2%, compared to 89.5%, 89.5% and 62.5% among E. coli from historical clinical isolates (n = 48 of which 45 from blood cultures). Proportions of extended spectrum beta-lactamase producers and multidrug resistance were 3.2% and 5.2% among E. coli isolates from urine in pregnant women versus 35.4%, and 60.4% respectively among clinical isolates. Adding urine culture to the routine urine analysis (protein and glucose) of antenatal was feasible. The dipslide culture method was affordable and user-friendly and allowed on-site inoculation and easy transport; challenges were contamination (midstream urine sampling) and the semi-quantitative reading. Conclusions: The E. coli isolates obtained from healthy pregnant women had significantly lower AMR rates compared to clinical E. coli isolates, probably reflecting the lower antibiotic pressure in the pregnant women population. Provided confirmation of the present findings in other settings, E. coli from urine samples in pregnant women may be a potential indicator for benchmarking, comparing, and monitoring community AMR rates across populations over different countries and regions.
Amygdala Abnormalities Are Related to Anxiety in Patients With Sporadic Amyotrophic Lateral Sclerosis
Authors: Liu Shuangwu , zhao yuying , ren qingguo , gong gaolang , zhang dong , shao kai , lin pengfei , yuan ying , dai tingjun , zhang yogqing , li ling , li wei , shan peiyan , meng xiangshui , wang qian , Yan Chuanzhu 
Published: August 2021

Abstract
To explore selective atrophy patterns and resting-state functional connection (FC) alterations in the amygdala at different stages of amyotrophic lateral sclerosis (ALS), and to determine any correlations between amygdala abnormalities and neuropsychiatric symptoms. We used the King’s clinical staging system for ALS to divide 83 consecutive patients with ALS into comparable subgroups at different disease stages. We investigated the pattern of selective amygdala subnucleus atrophy and analysed amygdala-based whole-brain FC analysis in the patients and 94 healthy controls (HCs). Cognitive and emotional functions were also evaluated using a neuropsychological test battery. There were no significant differences between King’s stage 1 ALS patients and HCs for any amygdala subnucleus volumes. Compared with HCs, King’s stage 2 patients had significantly lower left accessory basal nucleus and cortico-amygdaloid transition volumes after Bonferroni correction. Furthermore, after Bonferroni correction, King’s stage 3 patients demonstrated significant reductions in most subnucleus volumes as well as global amygdala volume compared with HCs. Notably, amygdala-based resting-state FC was unaltered in ALS patients until King’s stage 3. Specific subnucleus volumes were significantly associated with Mini-Mental State Examination scores and Hamilton Anxiety Rating Scale scores in ALS patients. In conclusions, our study provides a comprehensive profile of amygdala abnormalities in ALS patients. The pattern of amygdala abnormalities in ALS patients differed across King’s clinical disease stages, and our findings suggest that amygdala abnormalities are an important feature of patients with ALS. Moreover, amygdala volume may play an important role in anxiety and cognitive dysfunction in ALS patients.
Effects of Early, Non-Excisional Debridement in the Operating Theatre on Paediatric Burn Wound Re-Epithelialisation Time and Skin-Graft Requirement: A Retrospective Cohort Study.
Authors: Griffin Bronwyn , Bairagi Anjana , Jones Lee , Dettrick Zoe , Holbert Maleea , Kimble Roy 
Published: August 2021

Abstract
Background: Reported advantages of early excision and grafting for larger burn injuries include reduced morbidity, mortality, and hospital length of stay for adult burn patients. Evidence to support this has strengthened over the last 50 years. However, a paucity of evidence supports the best option for paediatric burns and, less still, the advantages of non-excisional (mechanical) debridement. Ketamine procedural sedation and analgesia in the emergency department is a popular alternative to debridement in operating theatres under general anaesthesia. This study aims to evaluate the association between early (<24hours post injury) non-excisional debridement under general anaesthesia in the operating theatre with burn wound re-epithelialisation time and skin graft requirements. Methods: Children younger than 17 years who presented with burns of five percent total body surface area or greater were included in a retrospective cohort study. Data between January 2013 to December 2019 were extracted from a state-wide paediatric burns’ registry for analysis. Time to re-epithelialisation was tested using survival analysis, and binary logistic regression for odds of skin graft requirement. A propensity matched dataset based on depth and size of burn wound, was used to analyse effects of early non-excisional debridement in the operating theatre compared to control. Results: Overall, 392 children met eligibility for the study with a male over-representation of 58.2%. When propensity matched, non-excisional debridement under general anaesthesia in the operating theatre, within 24hours of injury, significantly reduced the time to re-epithelialisation (15.0 (CI: 11.00-20.00) versus 20.0 (CI:13.5 – 31.00) days) and the odds of requiring a skin graft (OR:0.319 (0.125 – 0.812).Conclusion: This study is the first to demonstrate that early, initial, non-incisional debridement under general anaesthesia in the operating theatre significantly reduces wound re-epithelialisation time and subsequent need for a skin graft in paediatric burn patients. Analysis suggests that ketamine procedural sedation in the emergency department used for burn wound debridement is not an effective substitute for debridement in the operating theatre.
New traveling wave structures for two higher dimensional nonlinear evolution equations with time-dependent coefficients: Horseshoe-like solitons and multiwave interaction solutions
Authors: Qin Yuxin , Liu Yinping , Xu Guiqiong 
Published: August 2021

Abstract
In this paper, by introducing new traveling wave transformations in specific nonlinear forms, a variety of new multiwave interaction solutions for two higher dimensional nonlinear evolution equations with time-dependent coefficients are investigated. These new kinds of multiwave solutions can enrich solutions of nonlinear evolution equations with variable coefficients.
Inverting Sediment Bedforms for Exploring the Hazard of Volcanic Density Currents Directly in the Field
Authors: Dellino Pierfrancesco , Dioguardi Fabio , Sulpizio Roberto , Mele Daniela 
Published: August 2021

Abstract
Pyroclastic density currents are ground hugging gas-particle flows moving at high speed down the volcano slope. They are among the most hazardous events of explosive volcanism, causing devastation and deaths1,2. Because of the hostile nature they cannot be analyzed directly and most of their fluid dynamic behavior is reconstructed by the deposits left in the geological record, which frequently show peculiar structures such as bedforms of the types of ripples and dunes3,4. In this paper, we simplify a set of equations that link flow behavior to particle motion and deposition. This allows, for the first time, the build up of a phase diagram by which the hazard of dilute pyroclastic density currents can be explored easily and quickly by inverting bedforms wavelength and grain size.
Fine Mapping of Intracranial Aneurysm Susceptibility Based on a Genome-wide Association Study
Authors: Hong Eun Pyo , Youn Dong Hyuk , Kim Bong Jun , Ahn Jun Hyong , Park Jeong Jin , Rhim Jong Kook , Jeon Jin Pyeong 
Published: August 2021

Abstract
In addition to conventional genome-wide association studies (GWAS), a fine-mapping is increasingly used to identify the genetic function of variants associated with disease susceptibilities. Here, we used a fine-mapping approach to evaluate the casual variants based on a previous GWAS involving patients with intracranial aneurysm (IA). Fine-mapping analysis was conducted based on the chromosomal data provided by GWAS consisting 250 patients diagnosed with IA and 296 controls using posterior inclusion probability (PIP) and log10 transformed Bayes factor (log10BF). The narrow sense of heritability (h2) explained by each casual variant was estimated. Subsequent gene expression and functional network analyses were used to calculate the transcripts per million (TPM) values. Twenty causal candidate single nucleotide polymorphisms (SNPs) surpassed a genome-wide significance threshold for creditable evidence (log10BF > 6.1). Four SNPs including rs75822236 (R535H, GBA; log10BF = 15.06), rs112859779 (G141S, TCF24; log10BF = 12.12), rs79134766 (A208T, OLFML2A; log10BF = 14.92), and rs371331393 (Q1932X, ARHGAP32; log10BF = 20.88) showed a completed PIP value in each chromosomal region, suggesting a high probability of variant causality associated with IA. Expression in GBA was highly enriched in the whole blood (TPM = 33.13), while TCF24 were rarely expressed in all tissues and cells. No direct interaction was observed between the four casual genes; however, PSAP appeared to be particularly important via indirect correlation between other genes. Our results suggested that four mutations of GBA, TCF24, OLFML2A, and ARHGAP32 were linked to IA susceptibility and pathogenesis. Our approach may promise more informative mutations in the following GWAS.
Cementation of a Dual Mobility Cup in a Well-fixed Acetabular Component- A Reliable Option in Revision Total Hip Arthroplasty?
Authors: Bellova Petri , Koch Fiona , Stiehler Maik , Hartmann Albrecht , Fritzsche Hagen , Günther Klaus-Peter , Gorornzy Jens 
Published: August 2021

Abstract
Background:The “cup-in-cup” technique allows for revision of failed total hip arthroplasty (THA) when the cementless cup is well fixed. Furthermore, it can be used for liner wear or mechanical failure where liner replacement may be impossible or impractical. Recently, the “cup-in-cup” technique in combination with dual mobility cups (DMC) has drawn increased attention. Our aim was to report on the clinical and radiographic outcomes following this surgery.Methods:From 2015 to 2020, 33 patients treated with the DMC- “cup in cup” technique were retrospectively reviewed. Fourteen patients had died while 19 were available for the final follow-up (FU), of which 15 underwent both a radiograph and a FU visit, 2 underwent a radiograph only and 2 underwent a telephone interview only. Patient-related outcome measures included the HHS and the WOMAC. Radiographs were assessed for implant loosening and positioning. Primary endpoint was revision of any cause and secondary endpoint was loosening of the DMC at the latest FU. The survival analysis was conducted using the Kaplan-Meier method. Results:The mean age at surgery was 78.6±7.1 (63-93) years and the mean surgery duration was 124.4±52.0 (60-245) minutes. Recurrent dislocation (42.4%), periprosthetic fracture (39.4%) and polyethylene wear (6.1%) were the most frequent reasons for surgery. The mean FU duration (n=19) was 28.5±17.3 (3-64) months. The mean HHS score at FU was 59.4±22.2 (29-91) and the mean WOMAC score was 59.7±25.6 (15.6-93.8). Two cups were revised due to instability and one revision was performed due to periprosthetic joint infection, accounting for an overall cup survival rate of 86.8% after a mean FU of 22.9±18.0 (1.5-64.6) months. The survival rate free of loosening was 90.9% after a mean FU of 22.3±18.5 (1.5-64.7) months.Conclusions:We found that the cementation of a DMC in a well-fixed cup is a promising short- to mid-term treatment addressing THA instability especially in elderly and frail patients, who benefit from a reduced operation time. Proper cementation technique, adequate cup positioning as well as selection of a sufficiently large DMC are crucial for treatment success. Longer FUs will be needed in the future in order to further prove the benefit of this technique.
Obesity and adverse pregnancy outcomes in older patients with decreased ovarian reserve: a retrospective single-centre study
Authors: Lin Fangxu , Shi Hao , Shi Qiongyao , Su Yingchun , Dai Shanjun , Yang Qingling , Guo Yihong 
Published: August 2021

Abstract
BackgroundIn recent years, infertility has increased in older women with decreased ovarian reserve (DOR). Studies have shown that women with DOR have fewer oocytes, which are poorer in quality, and have an increased risk of adverse pregnancy outcomes. Pre-pregnancy BMI is significantly correlated with many adverse pregnancy outcomes. Therefore, we conducted this study to explore the correlation between body mass index (BMI) and abortion and live birth in older patients with DOR. MethodsThe clinical data of 2052 older women with infertility and DOR admitted to the Reproductive Medicine Center of the First Affiliated Hospital of Zhengzhou University from August 2009 to May 2018 were analysed retrospectively. Patients were divided into underweight (BMI < 18.5 kg/m 2 ; n = 56), normal weight (18.5 kg/m 2 ≤ BMI < 24 kg/m 2 ; n = 1389), overweight (24 kg/m 2 ≤ BMI < 28 kg/m 2 ; n = 527) and obese (BMI ≥ 28 kg/m 2 ; n = 80). We compared the pregnancy outcomes of patients in each group. ResultsLogistic regression analysis showed that being overweight or obese were independent risk factors for miscarriage (P < 0.05) and protection factors for live births (P<0.05). Being underweight was a protective factor for live births (P < 0.05). ConclusionsThe abortion and live birth rates in older infertile women with DOR are correlated with BMI. Higher BMI was associated with higher abortion rates and lower live birth rates. Being underweight also correlated with the live birth rate. Therefore, to improve pregnancy outcomes, we suggest that older patients with DOR may benefit from maintaining a normal weight before seeking fertility treatments.