bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary endoscopic bile duct stone removal for severe acute cholangitis: a retrospective study
Authors: Ishii Yu , Nakayama Akihiro , Nakatani Kei , Nishihara Shigetoshi , Oikawa Shu , Usami Tomono , Noguchi Toshihiro , Mitsui Yuta , Yoshida Hitoshi 
Published: September 2021

Introduction: While the Tokyo Guidelines 2018 suggest primary stone removal for mild to moderate cholangitis, a guideline for severe acute cholangitis is not mentioned. We, therefore, investigated the clinical outcomes of patients with severe acute cholangitis to confirm the usefulness and safety of primary stone removal. Method: This study included 104 severe acute cholangitis patients without gallstone pancreatitis diagnosed at our institution between January 2014 and December 2020. Patients with percutaneous transhepatic biliary drainage as the primary drainage, bile duct stenosis, and endoscopically unidentified bile duct stones were excluded from this study. The clinical results of 14 patients with primary stone removal (primary group) and 23 patients with elective stone removal (elective group) were then retrospectively examined (excluding abnormal values due to underlying diseases). Results: Upon comparing the patient characteristics between groups, the elective group had significantly higher cardiovascular dysfunction (57% vs 7%; p = 0.004), septic shock (39% vs 0%; p = 0.006), disseminated intravascular coagulation treatment (57% vs 14%; p = 0.016), and positive blood cultures (91% vs 43%; p = 0.006) than those in the primary group. Endoscopic sphincterotomy for naïve papilla (90% vs 21%; p = 0.01) and endoscopic nasobiliary drainage (50% vs 9%; p = 0.014) were higher in the primary group, while endoscopic biliary stenting (7% vs 87%; p < 0.001) was lower than that in the elective group. Discussion: There were no significant differences in adverse events or complete stone removal rates between the two groups. In the primary group, the period from the first endoscopic retrograde cholangiopancreatography to stone removal (0 days vs 12 days; p < 0.001) and hospitalization period (12 days vs 26 days; p = 0.012) were significantly shorter and the hospitalization cost ($7731 vs $18758; p < 0.001) was significantly lower than those in the elective group. Conclusion: If patients are appropriately selected, bile duct stones may be safely removed for the treatment of severe acute cholangitis.
Spontaneous spinal epidural hematoma: a case report
Authors: Sheng Ooi Chin , Wu Ren-Chieh , Chang I-Hsin 
Published: September 2021

Abstract
Background
Spinal epidural hematomas usually occur under certain conditions; they rarely occur spontaneously. The prevalence of spontaneous spinal epidural hematoma is ~ 0.1 per 100,000, and the male-to-female ratio is approximately 1.4 to 1. Herein, we describe a rare case of spontaneous spinal epidural hematoma.

Case presentation
A 63-year-old Taiwanese woman, with underlying hypertension, anemia, and a history of cardiovascular accident without sequela, was admitted to our emergency department with a chief complaint of sudden bilateral weakness in the lower limbs. Magnetic resonance imaging revealed a spontaneous epidural hematoma. The patient underwent emergency surgery to remove the epidural hematoma and laminectomy for decompression. The bilateral lower limb weakness was alleviated immediately after the surgery.

Conclusion
In patients with no risk factors related to spinal epidural hematoma, symptoms of bilateral lower limb weakness must be investigated carefully because this condition may occur spontaneously.
Prevalence of urinary symptoms and infections among traditional tannery workers in the Fez city of Morocco: case–control study
Authors: Ilham Arhoune , Hasnae Hoummani , Btissam Arhoune , Leila Belaroussi , Samira El Fakir , Sanae Achour 
Published: September 2021

Abstract
Background
Many work activities such as leather tanning include hazards to work. Among these, biological hazards are particularly important and pose a serious problem to human health and environment. The aims of this study were to estimate the prevalence of dysuria and urinary tract infections among tannery workers and to identify their risk factors.

Methods
This observational survey was conducted among 220 tannery workers and 220 age-matched control group from Fez city in Morocco. Reported urinary symptoms, demographic and professional information were obtained by a standardized questionnaire collected from participants and were then compared among the two groups. The logistic regression model was used to explore the interaction between variables with significant association.

Results
The most common symptoms reported by tannery workers and controls were dysuria (36.4% vs. 1.8%, p < 0.001), voiding frequency (15.5% vs. 0.9%, p < 0.001) and incontinence (3.2% vs. 0.5%, p < 0.001). A positive urinary culture was seen in 3.64% of the tannery workers but not in the controls (0%). E-coli was the only species. Multivariate logistic regression showed that exposure to biological hazards increased significantly the odds of dysuria by 6.76 times (CI 1.112–41.78; p = 0.038) but rather, low or normal weight was a protective factor of dysuria (OR 0.53; CI 0.249–0.950; p = 0.035).

Conclusion
Multiple working conditions including exposure to biological hazards may cause an increase in urogenital disorders in the tannery workers. A significantly higher prevalence of urinary symptoms among male workers demand serious attention and further investigation.
Wolbachia-driven selective sweep in a range expanding insect species
Authors: Deng Junchen , Assandri Giacomo , Chauhan Pallavi , Futahashi Ryo , Galimberti Andrea , Hansson Bengt , Lancaster Lesley T. , Takahashi Yuma , Svensson Erik I. , Duplouy Anne 
Published: September 2021

Abstract
Background
Evolutionary processes can cause strong spatial genetic signatures, such as local loss of genetic diversity, or conflicting histories from mitochondrial versus nuclear markers. Investigating these genetic patterns is important, as they may reveal obscured processes and players. The maternally inherited bacterium Wolbachia is among the most widespread symbionts in insects. Wolbachia typically spreads within host species by conferring direct fitness benefits, and/or by manipulating its host reproduction to favour infected over uninfected females. Under sufficient selective advantage, the mitochondrial haplotype associated with the favoured maternally-inherited symbiotic strains will spread (i.e. hitchhike), resulting in low mitochondrial genetic variation across the host species range.

Method
The common bluetail damselfly (Ischnura elegans: van der Linden, 1820) has recently emerged as a model organism for genetics and genomic signatures of range expansion during climate change. Although there is accumulating data on the consequences of such expansion on the genetics of I. elegans, no study has screened for Wolbachia in the damselfly genus Ischnura. Here, we present the biogeographic variation in Wolbachia prevalence and penetrance across Europe and Japan (including samples from 17 populations), and from close relatives in the Mediterranean area (i.e. I. genei: Rambur, 1842; and I. saharensis: Aguesse, 1958).

Results
Our data reveal (a) multiple Wolbachia-strains, (b) potential transfer of the symbiont through hybridization, (c) higher infection rates at higher latitudes, and (d) reduced mitochondrial diversity in the north-west populations, indicative of hitchhiking associated with the selective sweep of the most common strain. We found low mitochondrial haplotype diversity in the Wolbachia-infected north-western European populations (Sweden, Scotland, the Netherlands, Belgium, France and Italy) of I. elegans, and, conversely, higher mitochondrial diversity in populations with low penetrance of Wolbachia (Ukraine, Greece, Montenegro and Cyprus). The timing of the selective sweep associated with infected lineages was estimated between 20,000 and 44,000 years before present, which is consistent with the end of the last glacial period about 20,000 years.

Conclusions
Our findings provide an example of how endosymbiont infections can shape spatial variation in their host evolutionary genetics during postglacial expansion. These results also challenge population genetic studies that do not consider the prevalence of symbionts in many insects, which we show can impact geographic patterns of mitochondrial genetic diversity.
CAMPAREE: a robust and configurable RNA expression simulator
Authors: Lahens Nicholas F. , Brooks Thomas G. , Sarantopoulou Dimitra , Nayak Soumyashant , Lawrence Cris , Mrčela Antonijo , Srinivasan Anand , Schug Jonathan , Hogenesch John B. , Barash Yoseph , Grant Gregory R. 
Published: September 2021

Abstract
Background
The accurate interpretation of RNA-Seq data presents a moving target as scientists continue to introduce new experimental techniques and analysis algorithms. Simulated datasets are an invaluable tool to accurately assess the performance of RNA-Seq analysis methods. However, existing RNA-Seq simulators focus on modeling the technical biases and artifacts of sequencing, rather than on simulating the original RNA samples. A first step in simulating RNA-Seq is to simulate RNA.

Results
To fill this need, we developed the Configurable And Modular Program Allowing RNA Expression Emulation (CAMPAREE), a simulator using empirical data to simulate diploid RNA samples at the level of individual molecules. We demonstrated CAMPAREE’s use for generating idealized coverage plots from real data, and for adding the ability to generate allele-specific data to existing RNA-Seq simulators that do not natively support this feature.

Conclusions
Separating input sample modeling from library preparation/sequencing offers added flexibility for both users and developers to mix-and-match different sample and sequencing simulators to suit their specific needs. Furthermore, the ability to maintain sample and sequencing simulators independently provides greater agility to incorporate new biological findings about transcriptomics and new developments in sequencing technologies. Additionally, by simulating at the level of individual molecules, CAMPAREE has the potential to model molecules transcribed from the same genes as a heterogeneous population of transcripts with different states of degradation and processing (splicing, editing, etc.). CAMPAREE was developed in Python, is open source, and freely available at https://github.com/itmat/CAMPAREE.
Admission white blood cell count predicts post-discharge mortality in patients with acute aortic dissection: data from the MIMIC-III database
Authors: Zhang Chiyuan , Fu Zuli , Bai Hui , Lin Guoqiang , Shi Ruizheng , Chen Xuliang , Xu Qian 
Published: September 2021

Abstract
Background
Inflammation underlies both the pathogenesis and prognosis in patients with acute aortic dissection (AAD). This study aimed to assess the association of ICU admission of white blood cell count (WBCc) with post-discharge mortality in these patients.

Methods
Clinical data were extracted from the MIMIC-III V1.4 database. After adjusted to covariables, Cox regression analysis and Kaplan–Meier survival curve were performed to determine the relationship between WBCc on admission and post-discharge mortality (30-day, 90-day, 1-year and 5-year) in AAD patients. Subgroup analysis and receiver operating characteristic (ROC) curve analysis were used to test the performance of WBCc in predicting mortality in AAD patients.

Results
A total of 325 eligible patients were divided into 2 groups: normal-WBCc group (≤ 11 k/uL) and high-WBCc group (> 11 K/uL). In univariate Cox regression analysis, high WBCc was significant risk predictor of 30-day, 90-day, 1-year and 5-year mortality [hazard ratio (HR), 95% CI, P 2.58 1.36–4.91 0.004; 3.16 1.76–5.70 0.000; 2.74 1.57–4.79 0.000; 2.10 1.23–3.54 0.006]. After adjusting for age and other risks, high WBCc remained a significant predictor of 30-day, 90-day and 1-year mortality in AAD patients (HR, 95% CI, P 1.994 1.058–3.76 0.033; 2.118 1.175–3.819 0.013; 2.37 1.343–4.181 0.003). The area under ROC curve of WBCc for predicting 30-day, 90-day, 1-year and 5-year mortality were 0.69, 0.70, 0.66 and 0.61, respectively. The results from subgroups analysis showed that there was no interaction in most strata and patients who were younger than 69 years of age or had history of respiratory disease with an elevated WBCc had an excess risk of 30-day mortality (HR, 95% CI, P 3.18 1.41–7.14 0.005; 3.84 1.05–14.13 0.043).

Conclusions
Higher than normal WBCc on admission may predict post-discharge mortality in patients with AAD.
Can the adverse childhood experiences (ACEs) checklist be utilized to predict emergency department visits among children and adolescents?
Authors: Bhattarai Asmita , Dimitropoulos Gina , Marriott Brian , Paget Jaime , Bulloch Andrew G. M. , Tough Suzanne C. , Patten Scott B. 
Published: September 2021

Abstract
Background
Extensive literature has shown an association of Adverse Childhood Experiences (ACEs) with adverse health outcomes; however, its ability to predict events or stratify risks is less known. Individuals with mental illness and ACE exposure have been shown to visit emergency departments (ED) more often than those in the general population. This study thus examined the ability of the ACEs checklist to predict ED visits within the subsequent year among children and adolescents presenting to mental health clinics with pre-existing mental health issues.

Methods
The study analyzed linked data (n = 6100) from two databases provided by Alberta Health Services (AHS). The Regional Access and Intake System (RAIS 2016–2018) database provided data on the predictors (ACE items, age, sex, residence, mental health program type, and primary diagnosis) regarding children and adolescents (aged 0–17 years) accessing addiction and mental health services within Calgary Zone, and the National Ambulatory Care Reporting System (NACRS 2016–2019) database provided data on ED visits. A 25% random sample of the data was reserved for validation purposes. Two Least Absolute Shrinkage and Selection Operator (LASSO) logistic regression models, each employing a different method to tune the shrinkage parameter lambda (namely cross-validated and adaptive) and performing 10-fold cross-validation for a set of 100 lambdas in each model were examined.

Results
The adaptive LASSO model had a slightly better fit in the validation dataset than the cross-validated model; however, it still demonstrated poor discrimination (AUC 0.60, sensitivity 37.8%, PPV 49.6%) and poor calibration (over-triaged in low-risk and under-triaged in high-risk subgroups). The model’s poor performance was evident from an out-of-sample deviance ratio of − 0.044.

Conclusion
The ACEs checklist did not perform well in predicting ED visits among children and adolescents with existing mental health concerns. The diverse causes of ED visits may have hindered accurate predictions, requiring more advanced statistical procedures. Future studies exploring other machine learning approaches and including a more extensive set of childhood adversities and other important predictors may produce better predictions. Furthermore, despite highly significant associations being observed, ACEs may not be deterministic in predicting health-related events at the individual level, such as general ED use.
Gender discrepancy in the predictive effect of metabolic syndrome and its components on newly onset cardiovascular disease in elderly from rural China
Authors: Yu Shasha , Guo Xiaofan , Li GuangXiao , Yang Hongmei , Zheng Liqiang , Sun Yingxian 
Published: September 2021

Abstract
Background
This study aimed to estimate whether metabolic syndrome (MetS) and its components could be used to predict cardiovascular disease (CVD) in a longitudinal analysis in a rural elderly Chinese population.

Method
At baseline during 2012–2013, a total of 2486 elderly from rural Chinese were enrolled and were followed up during 2015–2017. Stroke and coronary heart disease (CHD) were included in CVD and were diagnosed by clinicians. The National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) and the International Diabetes Federation (IDF) criteria were used to define MetS separately.

Result
Hazard ratios adjusting for CHD, stroke and CVD in those with MetS using the NCEP ATP III criteria in females were 1.27 (95 % CI 0.73, 2.21), 1.54 (95 % CI 0.99, 2.40) and 1.45 (95 % CI 1.00, 2.10), respectively; 1.33 (95 % CI 0.77, 2.32), 1.44 (95 % CI 0.92, 2.25) and 1.36 (95 % CI 0.94, 1.97), respectively, with the AHA/NHLBI criteria; and 1.10 (95 % CI 0.89,1.36), 1.62 (95 % CI 1.03, 2.55) and 1.36 (95 % CI 0.93, 1.97), respectively, with the IDF criteria. Additionally, abdominal obesity using the AHA/NHLBI criteria was significantly associated with the incidence of stroke (HR: 1.60; 95 % CI 1.01, 2.52). However, among rural elderly males, neither MetS nor its components predicted new-onset CVD.

Conclusions
MetS is correlated with high incidence of CVD among rural elderly female, and only using the NCEP ATP III criteria to define MetS could make the incidence of CVD obvious difference. In order to reduce rural elderly CVD, effective measures to prevent, diagnose, and treat MetS should be enacted in a timely manner, especially among females.
Relationship between Chinese Baijiu consumption and dental caries among 55- to 74-year-old adults in Guangdong, southern China: a cross-sectional survey
Authors: Huang Xiangyu , Liang Yihao , Fan Weihua , Liu Wei , Wu Buling , Li Jianbo 
Published: September 2021

Abstract
Background
Whether an association between alcohol consumption and dental caries exists is still unclear. Chinese Baijiu is the most common alcohol consumed by middle-aged and elderly Chinese individuals. This study aimed to assess the relationship between alcohol consumption (Chinese Baijiu) and dental caries in Guangdong Province, southern China.

Methods
A cross-sectional study was conducted in Guangdong Province using a multistage, stratified, equal-sized, random sampling strategy. In total, 576 individuals aged 55–74 were recruited to fill out a questionnaire through face-to-face and one-on-one interviews and to undergo a series of dental examinations with a Community Periodontal Index (CPI) probe. According to the standard for clinical dentition examination of the WHO 2013 criteria, the presence of dental caries was determined by the DFT/DFRoot (decayed-filled tooth/root) index. The ratios of males to females and urban people to countrymen were both 1:1. Then, the chi-square test and rank-sum tests were used to compare the differences in caries between subgroups, and multivariate logistic regression analyses, as well as negative binomial regression analyses, were executed to identify the potential relationship between alcohol consumption and caries.

Results
The prevalence of crown caries was 79.17% with a DFT index of 3.19, while that of root caries was 61.28% with a DFRoot index of 2.08. The prevalence and mean tooth of crown caries of females were higher than those of males. The prevalence and mean DFRoot of root caries in rural areas were higher than those in urban areas. The results of the multivariate logistic regression analysis and negative binomial regression analysis showed that there was a statistically significant negative correlation between the consumption frequency of Chinese Baijiu and caries (often vs. never/rarely, crown caries: odds ratio (OR) = 0.54, 95% confidence interval (CI): 0.26–1.13, P = 0.103, incidence rate ratio (IRR) = 0.63, 95% CI: 0.44–0.92, P = 0.015; root caries: OR = 0.47, 95% CI: 0.24–0.93, P = 0.030, IRR = 0.52, 95% CI: 0.32–0.54, P = 0.008).

Conclusions
Within the limitations of this study, frequent consumption of Chinese Baijiu was a protective factor for caries in middle-aged and elderly people in Guangdong Province. However, considering the harm of alcohol to one’s general health, it is recommended to drink moderately and avoid alcohol abuse.
Association between frailty and mortality among patients with accidental hypothermia: a nationwide observational study in Japan
Authors: Takauji Shuhei , Hifumi Toru , Saijo Yasuaki , Yokobori Shoji , Kanda Jun , Kondo Yutaka , Hayashida Kei , Shimazaki Junya , Moriya Takashi , Yagi Masaharu , Yamaguchi Junko , Okada Yohei , Okano Yuichi , Kaneko Hitoshi , Kobayashi Tatsuho , Fujita Motoki , Shimizu Keiki , Yokota Hiroyuki , Yaguchi Arino 
Published: September 2021

Abstract
Background
Frailty has been associated with a risk of adverse outcomes, and mortality in patients with various conditions. However, there have been few studies on whether or not frailty is associated with mortality in patients with accidental hypothermia (AH). In this study, we aim to determine this association in patients with AH using Japan’s nationwide registry data.

Methods
The data from the Hypothermia STUDY 2018&19, which included patients of ≥18 years of age with a body temperature of ≤35 °C, were obtained from a multicenter registry for AH conducted at 120 institutions throughout Japan, collected from December 2018 to February 2019 and December 2019 to February 2020. The clinical frailty scale (CFS) score was used to determine the presence and degree of frailty. The primary outcome was the comparison of mortality between the frail and non-frail patient groups.

Results
In total, 1363 patients were included in the study, of which 920 were eligible for the analysis. The 920 patients were divided into the frail patient group (N = 221) and non-frail patient group (N = 699). After 30-days of hospitalization, 32.6% of frail patients and 20.6% of non-frail patients had died (p < 0.001). Frail patients had a significantly higher risk of 90-day mortality (Hazard ratio [HR], 1.64; 95% confidence interval [CI], 1.25–2.17; p < 0.001). Based on the Cox proportional hazards analysis using multiple imputation, after adjustment for age, potassium level, lactate level, pH value, sex, CPK level, heart rate, platelet count, location of hypothermia incidence, and rate of tracheal intubation, the HR was 1.69 (95% CI, 1.25–2.29; p < 0.001).

Conclusions
This study showed that frailty was associated with mortality in patients with AH. Preventive interventions for frailty may help to avoid death caused by AH.