bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recurrent Renal Tumor Thrombus in Inferior Vena Cava After Surgery: Surgical Management and Clinicopathological Features from a Large Chinese Center
Authors: Liu Zhuo , Li Yuxuan , Zhu Guodong , Ge Liyuan , Tang Shiying , Hong Peng , Zhao Xun , Zhang Shudong , Tian Xiaojun , Wang Shumin , Liu Cheng , Zhang Hongxian , Ma Lulin 
Published: July 2021

Abstract
Background: To summarize the surgical technique and clinicopathological features of recurrent renal tumor thrombus in inferior vena cava (IVC) after surgery.Methods: We retrospectively analyzed the clinicopathological data of nine patients with recurrent renal tumor thrombus in IVC after surgery, who were admitted to Peking University Third Hospital between November 2015 and March 2021. Results: Among the nine patients, six patients (66.7%) developed recurrent tumor thrombus in the IVC after radical nephrectomy; two cases (22.2%) were recurrent tumor thrombus in the IVC after partial nephrectomy. One patient (11.1%) underwent partial nephrectomy first and radical nephrectomy for the second time. The recurrence of tumor thrombus in the IVC occurred after the operation. All the nine patients underwent open surgery for IVC thrombectomy. Eight patients (88.9 %) were operated smoothly. Among these eight patients, six patients (75%) underwent IVC segmental resection, and two patients (25%) underwent IVC thrombectomy. Another patient underwent IVC tumor thrombus exclusion. Median operative time was 380 (IQR: 338.5–540.5) min. Median estimated intraoperative blood loss was 1200 (IQR: 600–2250) ml. According to the modified Clavien classification system, one patient had grade I complications, three patients had grade II complications, and one patient had grade IVa complications. During a 20-months (range, 2-58 months) follow-up, tumor-specific death occurred in three patients and distant metastasis occurred in six patients.Conclusions: The operation of recurrent renal tumor thrombus in IVC after surgery is difficult. For patients with high-risk renal cell carcinoma, more close follow-up should be conducted after operation.
Effect of Problem-based Learning on Agreement of Severity Classification Results of Triage Nurses in the Emergency Department
Authors: Jang Kyeongmin , Jo Eunmi , Song Kyoung Jun 
Published: July 2021

Abstract
BackgroundProblem-based learning is a learner-led learning method that helps improve critical thinking, problem solving skills, and knowledge. It is necessary to confirm whether it can help to agree the severity classification results among nurses through problem-based learning.MethodsThis study had a single-group time series design to investigate the effect of problem-based learning led by triage nurses on the agreement of Korean Triage and Acuity Scale classification results for patients who visited the emergency department. We extracted 300 patients each in May and August 2018 before problem-based learning began and 300 patients each in May and August 2019 after problem-based learning. ResultsAfter problem-based learning, the length of emergency department stay decreased about 30 minutes, although the decrease was not statistically significant (p=.172). However, self-efficacy for the classification of emergency patients in triage nurses and weighted kappa coefficients were improved (p<.001).ConclusionIn this study, problem-based learning led by triage nurses improved the inter-rater agreement of Korean Triage and Acuity Scale classification results and self-efficacy of triage nurses. Therefore, problem-based learning led by triage nurses can contribute to patient safety in the emergency department by enhancing the expertise of triage nurses and increasing the accuracy of triage classification.
Comparison of GnRH Agonist, hCG, and Dual Trigger for Final Oocyte Maturation in ICSI Cycle. A Case Control Study
Authors: Mahmoudinia Malihe , Khadem Nayereh , khazaee Azadeh , sadeghi Tahere , jahanpak Nafiseh , Gholamianm Masoumeh , Mahmoudinia Mahbobeh , Mohammadi Seyed Ali 
Published: July 2021

Abstract
The authors have requested that this preprint be removed from Research Square.
What are the Ethical Approaches Used by Experts When Sharing Health Data? - An Interview Study
Authors: Johansson Jennifer Viberg , Bentzen Heidi Beate , Mascalzoni Deborah 
Published: July 2021

Abstract
Background: Health data driven activities have become central in diverse areas (research, AI development, wearables, etc.), and new ethical challenges have arisen with regard to privacy, integrity, and appropriateness of use. To improve data subjects’ privacy and security, we aim to identify ethically relevant issues experienced by experts in the data intensive exploitation area while collecting, using, or sharing peoples’ health data. Methods: Twelve experts, who were collecting, using, or sharing health data in different contexts in Sweden were interviewed. We used systematic expert interviews to access experts’ specialist knowledge. Thereafter, thematic analysis was used to identify categories and subcategories. The codes targeted ethical issues and approaches reported by the interviewed experts. Results: The main conceptual categories were ‘Consideration of the consequences,’ ‘Respect for rights,’ ‘Procedural compliance,’ and ‘Professional conduct.’ The respondents discussed and balanced different ethical approaches through several examples. They were morally sensitive to the problems involved in sharing health data. Conclusions: These empirical findings suggest a need for practical procedures that make it easier for data collectors and sharers to follow the ethical principles and laws relating to data sharing. We suggest that the time is now ripe to move on from policy discussions to practical technological solutions of the principles.
Clinical and immunological response to checkpoint therapy in renal cell carcinoma is associated with TCF1+ CD8 T-cells in the tumor
Authors: Carlisle Jennifer , Jansen Caroline , Cardenas Maria , Soierajska Ewelina , Moon Adriana Reyes , Greenwald Rachel , delBalzo Luke , Prokhnevska Nataliya , Kucuk Omer , Carthon Bradley , Mullane Patrick , Osunkoya Adeboye , Baumgarten Deborah , Hosseinzadeh Fares , Wilkinson Scott , Lake Ross , Sowalsky Adam , Liu Yuan , Master Viraj , Bilen Mehmet , Kissick Haydn 
Published: July 2021

Abstract
We investigated changes in T cell responses in the peripheral blood of patients with advanced renal cell carcinoma (RCC) after receiving immunotherapy. We found that a small proportion of both CD4 and CD8 cells activate and express the proliferation marker Ki67 and the activation markers HLA-DR and CD38. Patients who had the highest increase in these HLA-DR+CD38+ CD8 T cells after treatment had the best anti-tumor response. We studied these newly activated cells in more detail using flow cytometry and RNAseq and found
that while these cells expanded in most patients, their phenotype did not drastically change during treatment.
However, when we analyzed the TCR repertoire of these HLA-DR+CD38+CD8+ T cells, we found only patients who responded to the treatment had a burst of new clonotypes enter this pool of activated cells. Finally, we investigated how the T-cell response in the resected tumor months or years before receiving checkpoint therapy predicted later response to checkpoint therapy. Together, these data suggest that having a strong pre-existing immune response and immediate T cell response to checkpoint therapy is a predictor of anti-tumor response in patients with RCC.
Low Expression of STING Promoted Endometrial Stromal Cells Invasion and Migration Via STING/IRF3/IFNb1 Pathway in Endometriosis Eutopic Endometrium
Authors: xu zhen , zhao hen , yue caixin , zhang lixia , li muzi , wang yuqing , du yanbo , yan lei 
Published: July 2021

Abstract
Background: Recent studies have confirmed that endometriosis is a chronic inflammatory disease. In our previous work, we found that STING (stimulator of interferon genes) was differentially expressed in eutopic endometrium and controlled endometrium by proteomics.Method: we used the 11 pairs of samples to verify STING expression by WB and IHC experiments. We detected cells proliferation by EdU assays, cells invasion and migration by Transwell assays. The effect of signaling pathway in HESC was detected by WB and Elisa expreriments.Results: STING was significantly lower expressed in eutopic endometrium of endometriosis, while IHC results showed that STING was expressed in both stroma and glandular epithelium of normal endometrium, but in endometriosis, STING was mainly expressed in the stroma of eutopic endometrium, and mainly in glandular epithelium of ectopic endometrium. Further study on the role of STING on endometrial stromal cells showed that low expression of STING could promote the HESC proliferation by EdU experiments, invasion and migration by Transwell experiments. The effect of STING/IRF3/IFNb1 signaling pathway in HESC with low expression of STING was also reduced, mainly showed the decreased expression of phosphorylated IRF3 and TBK1, and the decreased secretion of IFNb1. In order to further study the effect of IFNb1, secreted by STING/ IRF3/IFNb1 signaling pathway, on stromal cells, we added exogenous IFNb1 to the HESC with low expression of STING, and found that IFNb1 could reverse the invasion and migration function of stromal cells, but little effect on cell proliferation.Conclusions: We clarified that STING expressed mainly in stromal tissues and lower in endometriosis eutopic endometrium compared to normal endometrium. Low expressed STING promoted stromal cells invasion and migration via STING/IRF3/IFNb1 signaling pathway.
Transcriptional Regulation of KCS Gene by Bzip29 and MYB70 Transcription Factors in Respond to ABA-Stimulated Wound Suberization of Kiwifruit
Authors: Han Xueyuan , Wei Xiaopeng , Lu Wenjing , Wu Qiong , Mao Linchun 
Published: July 2021

Abstract
Background: Our previous study has demonstrated that the transcription of AchnKCS involved in suberin biosynthesis was up-regulated by exogenous abscisic acid (ABA) during the wound suberization of kiwifruit, but the regulatory mechanism has not been fully elucidated. Results: Through subcellular localization analysis in this work, AchnbZIP29 and AchnMYB70 transcription factors were observed to be localized in the nucleus. Yeast one-hybrid and dual-luciferase assay proved the transcriptional activation of AchnMYB70 and transcriptional suppression of AchnbZIP29 on AchnKCS promoter. Furthermore, the transcription level of AchnMYB70 was enhanced by ABA during wound suberization of kiwifruit, but AchnbZIP29 transcription was reduced by ABA.Conclusions: Therefore, it was believed that ABA enhanced the transcriptional activation of AchnMYB70 on AchnKCS by increasing AchnMYB70 expression. On the contrary, ABA relieved the inhibitory effect of AchnbZIP29 on transcription of AchnKCS by inhibiting AchnbZIP29 expression. These results gave further insight into the molecular regulatory network of ABA in wound suberization of kiwifruit.
NADPH-dependent oxidation of CRMP2 through a MICAL1-Prx1 redox relay controls neurite outgrowth
Authors: Salas Clara Ortegón , Bodnar Yana , Uhlenkamp Dennis , Schneider Katharina , Knaup Lara , Deponte Marcel , Berndt Carsten , Lillig Christopher , Gellert Manuela 
Published: July 2021

Abstract
CRMP2/DPYL2 is an effector protein in the semaphorin signaling pathway that controls cytoskeletal dynamics, linking extracellular signals to the formation of axonal networks.
CRMP2 is regulated by post-translational modifications including a dithiol-disulfide redox switch.
The mechanisms of reduction of this switch were established, the signal-induced oxidation, however, remained unclear. Here, we show that CRMP2 is oxidized through a redox relay involving the flavin-mooxygenase MICAL1 and the peroxidase Prx1 as specific signal transducers.
Using molecular oxygen and electrons provided by NADPH, MICAL produces hydrogen peroxide and specifically oxidizes Prx1 through direct interactions between the proteins. Subsequently, Prx1 oxidizes CRMP2. The lack of any components of this redox relay dysregulates neurite outgrowth. Consequently, both oxidation and reduction of CRMP2 require reducing equivalents in the form of NADPH.
The Effect of Early Rescue ICSI and Split IVF-ICSI in Preventing Low Fertilization Rate During the First ART Cycle: A Real-world Retrospective Cohort Study
Authors: Yang Dongzi , Jiang Linlin , Qian Yifan , Chen Xiaoli , Ji Xiaohui , Ou Songbang , Li Ruiqi , Li Yu 
Published: July 2021

Abstract
BackgroundShort gamete coincubation in in vitro fertilization (IVF-S) combined with early rescue intracytoplasmic sperm injection (R-ICSI) and split IVF-ICSI insemination, are two methods to prevent unpredicted low or failed fertilization. This study aimed to determine the utility of IVF-S combined with R-ICSI and split IVF-ICSI during the first assisted reproductive technology (ART) cycle.Patients and methodsA single-center retrospective cohort study based on real-world data. Couples with a high risk of low IVF fertilization during the first ART cycle underwent IVF-S with R-ICSI (n=191) or split IVF-ICSI (n=775). Fertilization rate, embryo quality, and clinical outcomes were measured.ResultsAfter propensity score matching, we included 188 couples in the IVF-S with R-ICSI group as Group 1 and 720 in the split IVF-ICSI group as Group 2, with low IVF fertilization rates of 4.79% and 9.03%, respectively. Normal fertilization rates were similar in the two groups; however, Group1 had a higher multiple pronuclei rate (10.42% vs. 4.50%, P <0.001). The groups were similar for rates of high-quality embryos, blastocyst formation rate, embryo implantation, clinical pregnancy, miscarriage, loss to follow-up, and live birth. Low fertilization following IVF occurred in nine couples in Group 1 with 47 MII oocytes performed R-ICSI and 65 in Group 2 with 331 MII oocytes performed ICSI. Similar fertilization rate, embryo development, and clinical outcomes were noted in two groups with low fertilization.ConclusionsIVF-S with early R-ICSI and split IVF-ICSI were effective strategies in preventing IVF fertilization failure or low fertilization rate in couples with high-risk factors. IVF-S with early R-ICSI could become the preferred approach because of its advantages-fewer ICSI procedures, similar clinical pregnancy rate and live birth rate.
Amplification, Copy Number Variation, Expression and Association of Non-synonymous SNP of Bovine Beta-defensin 129 Gene With Distinct Fertility of Cattle Bull
Authors: Solanki Subhash Singh , Kashyap Poonam , Vats Ashutosh , Kumar Vijay , Pukhrambam Martina , De Sachinandan , Kumar Rakesh , Datta Tirtha Kumar 
Published: July 2021

Abstract
BackgroundThe male reproductive specific class-A β-defensins are adsorbed on sperm surface and enrich sperm functioning thus considered vital for maintaining male fertility. The primate DEFB129 play role in sperm maturation, motility, and fertilization but its contribution to bovine fertility is still unexplored. MethodRLM-RACE and RT-qPCR approaches were used to characterize and expression analysis of Indian cattle BBD129 gene. The polymorphism analysis of the BBD129 gene was done by PCR, sequencing, and absolute RT-qPCR on sperm gDNA from distinct fertility cattle bulls. Bioinformatic analysis was performed to understand the structural and functional implications of SNP on BBD129 protein. ResultsThe complete coding sequence of the BBD129 gene consists of 582 bp mRNA including UTRs and conserves all beta-defensin-like characteristics. Sequencing results revealed two conserved non-synonymous T169G (rs378737321, S57A) and A329G (rs383285978, N110S) SNPs in the functional protein-coding exon. Based on SNP position and linkage, BBD129 gene haplotypes were categorized into four groups: TA haplotype (169T & 329A), GA haplotype (T169G polymorphism), TG haplotype (A329G polymorphism), and GG haplotype (when T169G & A329G polymorphisms present together). The frequencies distributions of BBD129 haplotypes in the high fertile group (n=105 clones) were: TA (71.42%), GA (1.90%), TG (2.8%), and GG (24.76%), while in the low fertile group of bulls, the frequencies distributions of observed BBD129 haplotypes (n=149 clones) were: TA (36.24%), GA (0%), TG (2.68%), and GG (61.07%). The distributions of TA haplotype were majorly distributed in bulls with a high conception rate (P=0.5256) while double mutated GG haplotype was significantly more abundant in bulls with a lower conception rate (P=0.0001). BBD129 exist as a single-copy gene in the bovine genome and found higher expression in the corpus-epididymis region. Bioinformatic analyses found nsSNPs as neutral and non-deleterious but their structural-distorter could result in altered mRNA secondary structure, protein conformations decreased protein stability, and compromised biological functionalities. The polymorphisms resulted in altered O-glycosylations (deletion S57A and insertion N110S) and an increase in phosphorylations (52T-Threonine and 110S-Serine) post-translational-modifications. ConclusionBBD129 gene polymorphism could be associated with the fertility performance of cattle bulls.
The Contrast Agent Pooling (C.A.P.) Sign and Imminent Cardiac Arrest: A Retrospective Study
Authors: Lee Yu-Husan , Chen Jiashan , Chen Po-An , Sun Jen-Tang , Kang Bo-Hwi , Chu Sheng-En , Fan Chieh-Min , Tsai Kuang-Chau , Sim Shyh-Shyong 
Published: July 2021

Abstract
BackgroundThe sign of contrast agent pooling (C.A.P.) in dependent part of the venous system were reported in some case reports, which happened in the patients before sudden cardiac arrest. Until now, there is no solid evidence enough to address the importance of the sign. This study aimed to assess the accuracy of the C.A.P. sign in predicting imminent cardiac arrest and the association of the C.A.P. sign with patient’s survival.MethodsThis is a retrospective cohort study. The study included 128 patients who visited the emergency department of Far Eastern Memorial Hospital, who received contrast computed tomography (CT) scan and then experienced cardiac arrest at the emergency department (from January 1, 2016 to December 31, 2018). With positive C.A.P. sign, the primary outcome is whether in-hospital cardiac arrest happens within an hour; the secondary outcome is survival to discharge.ResultsIn the study, 8.6% (N=11) patients had positive C.A.P. sign and 91.4% (N=117) patients did not. The accuracy of C.A.P. sign in predicting cardiac arrest within 1 hour is 85.94%. The C.A.P. sign had a positive association with IHCA within 1 hour after the CT scan (adjusted odds ratio 11.60, 95% conﬁdence interval [CI] 1.97 – 68.20). The odd ration of survival to discharge is 0.0081 with positive C.A.P. sign (95% CI 0.00697 – 2.188).ConclusionThe C.A.P. sign can be considered as an alarm for imminent cardiac arrest and poor prognosis. The patients with positive C.A.P. sign were more likely to experience imminent cardiac arrest; in contrast, less likely to survive. Trial registrationThe study was approved by our institutional ethical committee (IRB No.108107-E).
Implementation of Six Sigma Method To Improve Hospital Discharge Process: A Before-And- After Study With The Control Group In A Large Hospital
Authors: Fazaeli Somayeh , Yousefi Mehdi , Dokht Mohadeseh Sabethoseini , Heidarian Hamidreza 
Published: July 2021

Abstract
Background: Delayed hospital discharge is a complex process that can impact hospital and service delivery capacity. The improvement of this process requires structural reforms and coordination with different wards, individuals, and the hospital.The present study aimed to use the Six Sigma method to reduce hospital discharge time. Methods: This pre-post study was conducted based on an experimental design from 2016 to 2020. A series of Six Sigma-driven interventions based on the Define-Measure-Analyze-Improve-Control (DMAIC) cycle was employed in a 1,000 bed tertiary care hospital to decrease discharge waiting time. Two wards in the hospital were allocated to the intervention and control groups. Three months of pre-intervention data were compared with 16 months of post-intervention in each group. The data were analyzed in Stata software (version 14.1). The level of statistical significance was set at 0.000.Results: There was a significant difference (P<0.000) between pre and post-intervention, as well as experimental and control groups. The discharge time points in the intervention and control groups before the intervention were reported as 438 and 411 min, respectively. After the intervention, the discharge time reached 246 min (3.20 h decrease) in the intervention group (P<0.000) and 475 min in the control group (P<0.574). The waiting time in stations 2, 3, and 4 reached zero after the intervention(P<0.000). The trend of discharge time after the intervention from October 2017 to March 2020 demonstrated that the changes were stable (184±25.56 min).Conclusions: As evidenced by the obtained results, the Six Sigma methodology can be an effective change management tool for the improvement of discharge time. The findings suggested that the use of electronic discharge and focusing on physician readiness for writing a discharge order would have the greatest impact.
Postmortem Diagnosis of Pulmonary Tumor Thrombotic Microangiopathy with Rapid Exacerbation in a Patient with Gastric Cancer: A Case Report
Authors: Kamidani Ryo , Kumada Keisuke , Okada Hideshi , Yoshimura Genki , Kanayama Tomohiro , Tomita Hiroyuki , Miura Tomotaka , Oiwa Hideaki , Mizuno Yosuke , Kitagawa Yuichiro , Yasuda Ryu , Miyake Takahito , Doi Tomoaki , Yoshida Takahiro , Yoshida Shozo , Hara Akira , Ogura Shinji 
Published: July 2021

Abstract
Background: Pulmonary tumor thrombotic microangiopathy (PTTM) is a condition involving the development of pulmonary hypertension caused by the presence of microscopic tumor emboli of peripheral pulmonary arteries . Here, we report a case of rapidly exacerbating PTTM associated with gastric cancer, which was identified after the patient’s death through a pathological autopsy.Case presentation: Four days before a 52-year-old Asian woman, whose initial symptom was the occurrence of anterior chest pain while coughing, visited the emergency department of Gifu University Hospital, she had been diagnosed as having multiple osteolytic bone metastases throughout her body; for the detection of a primary lesion, she was scheduled to undergo combined positron emission tomography and computed tomography (CT) at a later date. However, she was unable to stand up, and consequently, she visited the emergency department. At the time of admission, the results of a physical examination revealed that while breathing room air, she had a percutaneous oxygen saturation level of 90% and cyanosis, and she was in a state of hemodynamic shock; laboratory-test data revealed the presence of elevated levels of fibrin degradation products and D-dimer in her blood. The results of chest CT were normal. She was admitted to the hospital’s general ward for follow-up; however, she was soon in a further state of shock and respiratory failure. Electrocardiography revealed findings associated with right heart strain; however, contrast-enhanced CT did not reveal the presence of pulmonary embolism. She was transported to an intensive care unit of the hospital and treated for pulmonary hypertension; however, 45 h after her arrival at the hospital, she died of respiratory failure. A pathological autopsy revealed the presence of gastric cancer, tumor microemboli, and fibrous intimal thickening of the peripheral arteries of both lungs; thus, a diagnosis of PTTM was made. Conclusion: In cases involving patients with carcinoma of unknown primary site and pulmonary hypertension, if CT scan rules out pulmonary embolism, emergency physicians and intensivists must consider the possibility of the patients having PTTM, which represents an oncologic emergency, and initiate the administration of chemotherapy as soon as possible.