bluuebunny/crossref_metadata_2025_split huggingface dataset:
Robot-assisted sleeve gastrectomy in patients with obesity with a novel Chinese domestic MicroHand SII surgical system
Authors: Li Weizheng , Kong Kang , Li Pengzhou , Wang Guohui , Cui Beibei , Zhu Liyong , Zhu Shaihong 
Published: May 2021

AbstractBackgroundA new device has been added to the Chinese MicroHand surgical robot family, developed based on the successful application of control algorithms. As a benefit of using these specialized control algorithms, the motion mapping relation can be accommodated into the system without the help of a built-in image system, resulting in a novel Chinese domestic surgical robot with two arms called MicroHand SII, which is different from the former MicroHand S and da Vinci systems. In this study, we investigate the performance of a novel MicroHand SII robotic platform in patients with obesity.MethodsFrom March 2018 to April 2019, a total of 7 patients whose BMI ranged from 29.9 to 49.8 kg/m2were operated on with the robot-assisted technique using the MicroHand SII surgical system. Data regarding demography, surgical procedure and the 3-month outcome postoperation were collected.ResultsThere were 2 female and 5 male patients with a median age (range) of 35 (20–51) years. The median operative time was 160 (149–195) minutes. None were converted to open surgery. All anthropometry indices improved significantly (p < 0.05) at 3 months postoperatively. There were no cases of surgical site infection, gastrointestinal/abdominal bleeding, or conversion to an open operation.ConclusionsThe initial experience showed that the Chinese domestic robot surgical system MicroHand SII could be feasibly and safely applied in sleeve gastrectomy in patients with obesity. Because of the unique design of this system such as a two-hand robot, an array of master–slave motion strategies, and a roll joint at the end of the instruments that allows 7 degrees of freedom, this robotic platform has presented its own obvious advantages.
Therapeutic effect of various ginsenosides on rheumatoid arthritis
Authors: Zhang Meng , Ren Hongwei , Li Kun , Xie Shengsheng , Zhang Ru , Zhang Longlong , Xia Jiaxuan , Chen Xing , Li Xilin , Wang Jianxin 
Published: May 2021

Abstract
Background
Rheumatoid arthritis (RA) is an autoimmune disease which causes disability and threatens the health of humans. Therefore, it is of great significance to seek novel effective drugs for RA. It has been reported that various ginsenoside monomers are able to treat RA. However, it is still unclear which ginsenoside is the most effective and has the potential to be developed into an anti-RA drug.

Methods
The ginsenosides, including Rg1, Rg3, Rg5, Rb1, Rh2 and CK, were evaluated and compared for their therapeutic effect on RA. In in vitro cell studies, methotrexate (MTX) and 0.05% dimethyl sulfoxide (DMSO) was set as a positive control group and a negative control group, respectively. LPS-induced RAW264.7 cells and TNF-α-induced HUVEC cells were cultured with MTX, DMSO and six ginsenosides, respectively. Cell proliferation was analyzed by MTT assay and cell apoptosis was carried out by flow cytometry. CIA mice model was developed to evaluate the therapeutic efficacy of ginsenosides. The analysis of histology, immunohistochemistry, flow cytometry and cytokine detections of the joint tissues were performed to elucidate the action mechanisms of ginsenosides.

Results
All six ginsenosides showed good therapeutic effect on acute arthritis compared with the negative control group, Ginsenoside CK provided the most effective treatment ability. It could significantly inhibit the proliferation and promote the apoptosis of RAW 264.7 and HUVEC cells, and substantially reduce the swelling, redness, functional impairment of joints and the pathological changes of CIA mice. Meanwhile, CK could increase CD8 + T cell to down-regulate the immune response, decrease the number of activated CD4 + T cell and proinflammatory M1-macrophages, thus resulting in the inhibition of the secretion of proinflammatory cytokine such as TNF-α and IL-6.

Conclusion
Ginsenoside CK was proved to be a most potential candidate among the tested ginsenosides for the treatment of RA, with a strong anti-inflammation and immune modulating capabilities.
Homogeneous polyporus polysaccharide inhibits bladder cancer by polarizing macrophages to M1 subtype in tumor microenvironment
Authors: Jia Wenyu , Luo Siwan , Lai Gena , Li Shiqi , Huo Shuai , Li Meifang , Zeng Xing 
Published: May 2021

Abstract
Background
Polyporus polysaccharide (PPS), an active ingredient of traditional Chinese medicinal Polyporus umbellatus, has multiple biological functions, such as anti-cancer, immune-regulating and hepatoprotective activities. The purpose of this study was to investigate the mechanism of homogeneous polyporus polysaccharide (HPP) activated macrophages in the treatment of bladder cancer.

Methods
100 ng/mL Phorbol myristate acetate (PMA) was used to induce THP-1 human leukemic cells as a macrophage model. Then macrophages derived from THP-1 were treated with different concentrations of HPP (1, 10 and 100 μg/mL). Flow cytometry and RT-PCR were used to detected the expression of CD16, CD23, CD86, CD40 and interleukin (IL)-Iβ, iNOS mRNA. ELISA was used to test the change of IL-1β and TNF-α in macrophage after the treatment with HPP. The conditioned medium from HPP-polarized macrophages was used to detect the effect of activated macrophages on bladder cancer. MTT assay, 5-ethynyl-2′-deoxyuridine assay, flow cytometry, Transwell assay, and Western blot analysis were used to detect the effects of polarized macrophages on the viability, proliferation, apoptosis, and migration of bladder cancer cells. Western blot was also used to analysis the change of JAK2/NF-κB pathway protein.

Results
HPP promoted the expression of pro-inflammatory factors, such as IL-Iβ, TNF-α and iNOS, and surface molecules CD86, CD16, CD23, and CD40 in macrophages and then polarized macrophages to M1 type. Results demonstrated that activated macrophages inhibited the proliferation of bladder cancer cells, regulated their apoptosis, and inhibited migration and epithelial–mesenchymal transformation (EMT). JAK2/NF-κB pathways were downregulated in the anti-bladder cancer process of activated macrophages.

Conclusion
The findings indicated that HPP inhibited the proliferation and progression of bladder cancer by the polarization of macrophages to M1 type, and JAK2/NF-κB pathway was downregulated in the process of anti-bladder cancer.
Work empowerment among cancer care professionals: a cross-sectional study
Authors: Siekkinen Mervi , Kuokkanen Liisa , Kuusisto Hannele , Leino-Kilpi Helena , Rautava Päivi , Rekunen Maijastiina , Seppänen Laura , Stolt Minna , Walta Leena , Sulosaari Virpi 
Published: May 2021

Abstract
Background
There is a growing understanding that empowerment of interprofessional personnel is linked to job satisfaction levels and quality of care, but little is known about empowerment in the context of cancer care. This study describes how interprofessional cancer care personnel perceive their performance and factors that promote work empowerment.

Methods
This cross-sectional study enrolled 475 (45.2%) of the 1050 employees who work at a regional cancer centre. The participants used two self-administered questionnaires – the Performance of an Empowered Personnel (PEN) questionnaire and Work Empowerment Promoting Factors (WEP) questionnaire – to report perceptions of work empowerment. Both questionnaires’ categories comprise moral principles, personal integrity, expertise, future orientation, and sociality. The data were analyzed using IBM SPSS Statistics, Versions 24 and 25.

Results
Overall, the performance of work empowerment was evaluated as being rather high (overall sum score mean: 4.05; range: 3.51–4.41; scale: 1–5). The category that rated highest was moral principles (4.41), and the one rated lowest was the social category (3.51). The factors that promoted work empowerment also ranked high (3.93; range: 3.55–4.08; scale: 1–5), with personal integrity (4.08) the highest and future orientation (3.55) the lowest. Performance and factors that promoted work empowerment correlated positively, moderately, and highly statistically significantly (r = 0.531; p < 0.001). Statistically significant associations also were found between empowered performance of personnel and empowerment promoting factors (sex, education, leadership position, belonging to an interprofessional team, and time elapsed since training in interprofessional cooperation).

Conclusion
The personnel rated their performance and the factors perceived to promote work empowerment rather highly. Personal empowerment can be promoted through teamwork training and supportive management in interprofessional cancer care.
Stepwise metabolic engineering of Candida tropicalis for efficient xylitol production from xylose mother liquor
Authors: Zhang Lihua , Chen Zhen , Wang Junhua , Shen Wei , Li Qi , Chen Xianzhong 
Published: May 2021

Abstract
Background
Commercial xylose purification produces xylose mother liquor (XML) as a major byproduct, which has become an inexpensive and abundant carbon source. A portion of this XML has been used to produce low-value-added products such as caramel but the remainder often ends up as an organic pollutant. This has become an issue of industrial concern. In this study, a uracil-deficient Candida tropicalis strain was engineered to efficiently convert XML to the commercially useful product xylitol.

Results
The xylitol dehydrogenase gene was deleted to block the conversion of xylitol to xylulose. Then, an NADPH regeneration system was added through heterologous expression of the Yarrowia lipolytica genes encoding 6-phosphate-gluconic acid dehydrogenase and 6-phosphate-glucose dehydrogenase. After process optimization, the engineered strain, C. tropicalis XZX-B4ZG, produced 97.10 g L− 1 xylitol in 120 h from 300 g L− 1 XML in a 5-L fermenter. The xylitol production rate was 0.82 g L− 1 h− 1 and the conversion rate was 92.40 %.

Conclusions
In conclusion, this study performed a combination of metabolic engineering and process optimizing in C. tropicalis to enhance xylitol production from XML. The use of C. tropicalis XZX-B4ZG, therefore, provided a convenient method to transform the industrial by-product XML into the useful material xylitol.
Nutritional screening based on objective indices at admission predicts in-hospital mortality in patients with COVID-19
Authors: Song Feier , Ma Huan , Wang Shouhong , Qin Tiehe , Xu Qing , Yuan Huiqing , Li Fei , Wang Zhonghua , Liao Youwan , Tan Xiaoping , Song Xiuchan , Zhang Qing , Huang Daozheng 
Published: May 2021

Abstract
Background
Could nutritional status serve as prognostic factors for coronavirus disease 2019 (COVID-19)? The present study evaluated the clinical and nutritional characteristics of COVID-19 patients and explored the relationship between risk for malnutrition at admission and in-hospital mortality.

Methods
A retrospective, observational study was conducted in two hospitals in Hubei, China. Confirmed cases of COVID-19 were typed as mild/moderate, severe, or critically ill. Clinical data and in-hospital death were collected. The risk for malnutrition was assessed using the geriatric nutritional risk index (GNRI), the prognostic nutritional index (PNI), and the Controlling Nutritional Status (CONUT) via objective parameters at admission.

Results
Two hundred ninety-five patients were enrolled, including 66 severe patients and 41 critically ill patients. Twenty-five deaths were observed, making 8.47% in the whole population and 37.88% in the critically ill subgroup. Patients had significant differences in nutrition-related parameters and inflammatory biomarkers among three types of disease severity. Patients with lower GNRI and PNI, as well as higher CONUT scores, had a higher risk of in-hospital mortality. The receiver operating characteristic curves demonstrated the good prognostic implication of GNRI and CONUT score. The multivariate logistic regression showed that baseline nutritional status, assessed by GNRI, PNI, or CONUT score, was a prognostic indicator for in-hospital mortality.

Conclusions
Despite variant screening tools, poor nutritional status was associated with in-hospital death in patients infected with COVID-19. This study highlighted the importance of nutritional screening at admission and the new insight of nutritional monitoring or therapy.
A cross-country qualitative study on contraceptive method mix: contraceptive decisionmaking among youth
Authors: Ouma Lynette , Bozkurt Burcu , Chanley Jill , Power Christine , Kakonge Ronald , Adeyemi Oluwatosin C. , Kudekallu Ramya Jawahar , Leahy Madsen Elizabeth 
Published: May 2021

Abstract
Background
Youth ages 15 to 24, who comprise a large portion of sub-Saharan Africa, face a higher burden of unmet contraceptive need than adults. Despite increased international and national commitments to improving young people’s access to contraception, significant barriers impede their access to a full range of methods. To further explore these barriers among youth in Kenya, Nigeria, and Uganda, we conducted a qualitative study to capture the challenges that affect contraceptive method decisionmaking and complicate youth access to the full method mix.

Methods
To understand factors that impact young people’s contraceptive decisionmaking process across all three countries, we conducted a total of 35 focus group discussions with 171 youth ages 15 to 24 and 130 in-depth interviews with key stakeholders working in youth family planning. Questionnaires aligned with the High Impact Practices in Family Planning’s elements of adolescent-friendly contraceptive services. Data were coded with MAXQDA and analyzed using a framework for contraceptive decisionmaking to identify relevant patterns and themes.

Results
In all three countries, youth reported that condoms are the most commonly sought contraceptive method because they are easiest to access and because youth have limited knowledge of other methods. Youth from diverse settings shared uncertainty and concern about the safety and side effects of many methods other than condoms, complicating their ability to take full advantage of other available methods. While most youth in Kenya, Nigeria, and Uganda reported at least moderate confidence in obtaining the information needed to help choose a method, and only a few youth reported that they are completely unable to access contraceptives, other barriers still present a major deterrent for youth, including cost, inconvenient facility hours and long wait times, and stigma from family, community members, and providers.

Conclusions
Young people’s ability to fully exercise their method choice remains limited despite availability of services, leading them to take the path of least resistance. Program implementers and policymakers should consider the diverse and often interconnected barriers that youth face in attempting to enjoy the benefits of a full spectrum of contraceptive methods and design multi-level interventions to mitigate such barriers.
Contraceptive use among sexually active female adolescents in Ethiopia: trends and determinants from national demographic and health surveys
Authors: Olika Alemi Kebede , Kitila Sena Belina , Terfa Yonas Biratu , Olika Ayantu Kebede 
Published: May 2021

AbstractBackgroundSexual and reproductive health and right of adolescents is a global priority as the reproductive choices made by them have a massive impact on their health, wellbeing, education, and economy. Teenage pregnancy is a public health issue and a demographic challenge in Ethiopia. Increasing access to contraceptive services for sexually active adolescents will prevent pregnancies and related complications. However, little is known about the trends in contraceptive use and its determinants among adolescent girls in Ethiopia. Therefore, this study was designed to examine the trends and factors associated with contraceptive use among sexually active girls aged 15–19 years in Ethiopia by using Ethiopian demographic and health survey data.MethodsFour Ethiopian demographic and health survey data were used to examine trends of contraceptive methods use. To identify factors associated with contraceptive use, the 2016 Ethiopian demographic and health survey data were used. The data was downloaded from the demographic and health survey program database and extracted for sexually active adolescent girls. Data were weighted for analysis and analyzed using SPSS version 21. Descriptive analysis was used to describe the independent variables of the study. A multivariable logistic regression model was used to identify factors associated with contraceptive use and adjusted odds ratios with 95% confidence interval were presented for significant variables. Variables with ap-value less than 0.05 were considered as significantly associated with contraceptive use.ResultsContraceptive method use had increased significantly from 6.9% in 2000 to 39.6% in 2016 among sexually active adolescent girls in Ethiopia. The odds of contraceptive use were lower among female adolescents who had no formal education (AOR 0.044; 95% CI 0.008–0.231) and attended primary education (AOR 0.101; 95% CI 0.024–0.414). But the odds were higher among adolescents from a wealthy background (AOR 3.662; 95% CI 1.353–9.913) and those who have visited health facilities and were informed about family planning (AOR 3.115; 95% CI 1.385–7.007).ConclusionThere is an increment in the trend of contraceptive use among sexually active female adolescents in Ethiopia between 2000 and 2016. Significant variations in the use of modern contraception by wealth status, educational level and visited a health facility, and being informed about family planning were observed. Improving the economic and educational status of young women, and provision of information may help in improving contraceptive use in Ethiopia.
Benefits of treatment with favipiravir in hospitalized patients for COVID-19: a retrospective observational case–control study
Authors: Ucan Anıl , Cerci Pamir , Efe Serdar , Akgun Hakan , Ozmen Ahmet , Yagmuroglu Aysel , Bilgin Muzaffer , Avci Deniz 
Published: May 2021

Abstract
Background
Although more than a year past since COVID-19 was defined, there is no specific treatment yet. Since COVID-19 management differs over time, it is hard to determine which therapy is more efficacious. In this study, we aimed to evaluate the efficacy of the regimen with Favipiravir (FPV) and determine if the timing of FPV addition offers any improvement.

Methods
A retrospective observational case-controlled cohort study was performed between March and September 2020, including adults with COVID-19 in a single-center in Turkey. We categorized patients into age-sex matched three groups, group 1 (n = 48) and group 2 (n = 48) included patients treated with the combination of FPV plus Hydroxychloroquine (HQ) early and late, respectively. Group 3 (n = 48) consisted of patients on HQ monotherapy. In Group 2, if the respiratory or clinic condition had not improved sufficiently, FPV was added on or after day 3.

Results
We found that starting FPV early had an impact on PCR negativity and the progression of the disease. 'No progression' was defined as the absence of a new finding in the control radiological examination and the absence of accompanying clinical deterioration. Also, the decrease in C-reactive protein (CRP) was greater in Group 1 than Group 3 (p < 0.001). However, we found that early initiation of FPV treatment did not have a positive effect on the estimated survival time.

Conclusions
According to this retrospective study results, we believe that for better clinical outcomes, FPV treatment should be started promptly to enhance antiviral effects and improve clinical outcomes.
Age at surgery is correlated with pain scores following trochlear osteotomy in lateral patellar instability: a cross-sectional study of 113 cases
Authors: van Sambeeck Jordy D. P. , Verdonschot Nico , Van Kampen Albert , van de Groes Sebastiaan A. W. 
Published: May 2021

Abstract
Background
A trochlear osteotomy aims to restore patellar stability in patients with recurrent patellar instability and trochlear dysplasia. The age of patients at time of surgery could be a relevant factor which influences outcome. We hypothesized that lower age at time of surgery is associated with better patient-reported outcomes.

Methods
A retrospective study was conducted on patients with patellar instability and trochlear dysplasia. Patients were contacted by phone for informed consent and were then asked to complete online patient-reported outcome measurements (PROMs). The PROMs consisted of the Kujala Knee Score (KKS) (Kujala et al., Arthroscopy 9(2):159-63, 1993; Kievit et al. Knee Surg Sports Traumatol Arthrosc. 21(11):2647-53, 2013), the Short Form 36-item health survey (SF-36v1) (Ware, Med Care 73-83, 1992; Aaronson et al., J Clin Epidemiol. 51(11):1055-68, 1998), and visual analog scale (VAS) scoring pain, instability, disability, and satisfaction on a 0–100 scale. Multivariable linear regression models were used to study the effect of age on the PROM scores.

Results
For this study, 125 surgical procedures in 113 patients were included. Mean VAS pain at rest was 19 and at activity 38; mean Kujala score was 73. Multivariable regression analysis revealed that age at the time of surgery was correlated with VAS pain at rest, with a 0.95 increase of VAS score (scale 0–100) for every year of age. Recurrence of instability was observed in 13 (10%) knees.

Conclusion
In this cross-sectional study, pain scores of 113 patients who have undergone a lateral facet elevating trochlear osteotomy for patellar instability were reported. Age at time of surgery was correlated with an increased pain score at rest with an average of 9.5 points (scale 0–100) for every 10 years of age. Age at time of surgery was not correlated with overall satisfaction.
Influences of temperature and moisture on abiotic and biotic soil CO2 emission from a subtropical forest
Authors: Chen Xiaomei , Liu Muying , Xu Zhanying , Wei Hui 
Published: May 2021

AbstractBackgroundSoil CO2efflux is considered to mainly derive from biotic activities, while potential contribution of abiotic processes has been mostly neglected especially in productive ecosystems with highly active soil biota. We collected a subtropical forest soil to sterilize for incubation under different temperature (20 and 30 °C) and moisture regimes (30%, 60 and 90% of water holding capacity), aiming to quantify contribution of abiotic and biotic soil CO2emission under changing environment scenarios.Main findings:Results showed that abiotic processes accounted for a considerable proportion (15.6−60.0%) of CO2emission in such a biologically active soil under different temperature and moisture conditions, and the abiotic soil CO2emission was very likely to derive from degradation of soil organic carbon via thermal degradation and oxidation of reactive oxygen species. Furthermore, compared with biotically driving decomposition processes, abiotic soil CO2emission was less sensitive to changes in temperature and moisture, causing reductions in proportion of the abiotic to total soil CO2emission as temperature and moisture increased.ConclusionsThese observations highlight that abiotic soil CO2emission is unneglectable even in productive ecosystems with high biological activities, and different responses of the abiotic and biotic processes to environmental changes could increase the uncertainty in predicting carbon cycling.