bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of bowel preparation on elective colectomies for diverticulitis: analysis of the NSQIP database
Authors: Zhuo Haoran , Liu Zheng , Resio Benjamin J. , Liu Jialiang , Wang Xishan , Pei Kevin Y. , Zhang Yawei 
Published: June 2022

Abstract
Background:Recent data based on large databases show that bowel preparation (BP) is associated with improved outcomes in patients undergoing elective colorectal surgery. However, it remains unclear whether BP in elective colectomies would lead to similar results in patients with diverticulitis. The purpose of this study was to investigate whether bowel preparation influences surgical site infections (SSI) and anastomotic leakage (AL) in patients with diverticulitis undergoing elective colectomies. Study design:We identified 16,380 diverticulitis patients who underwent elective colectomies from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) colectomy targeted database (2012-2017). Multivariate logistic regression models were employed to assess the impact of different bowel preparation strategies on postoperative complications, including SSI and AL.Results:In the identified population, a total of 2,524 patients (15.4%) received no preparation (NP), 4,715 (28.8%) mechanical bowel preparation (MBP) alone, 739 (4.5%) antibiotic bowel preparation (ABP) alone, and 8,402 (51.3%) MBP + ABP. Compared to NP, patients who received any type of bowel preparations showed a significant decrease in rates of SSI and AL after adjustment for potential confounders (SSI: MBP [OR=0.82, 95%CI: 0.70-0.96], ABP [0.69, 95%CI: 0.52-0.92]; AL: MBP [OR=0.66, 95%CI: 0.51-0.86], ABP [0.56, 95%CI: 0.34-0.93]), where the combination type of MBP+ABP had the strongest association with a decreased risk (SSI:OR=0.58, 95%CI:0.50-0.67; AL:OR=0.46, 95%CI:0.36-0.59). The significantly decreased risk of 30-day mortality was observed in the bowel preparation of MBP + ABP only (OR=0.32, 95%CI: 0.13-0.79). After further stratification by surgery procedure, patients who received MBP + ABP showed consistently lower risk for both SSI and AL when undergoing open and laparoscopic surgeries (Open: SSI [OR=0.51, 95%CI: 0.37-0.69], AL[OR=0.47, 95%CI: 0.25-0.91]; Laparoscopic: SSI[OR=0.58, 95%CI: 0.47-0.72, AL[OR=0.49, 95%CI: 0.35-0.68]).Conclusions:MBP + ABP for diverticulitis patients undergoing elective open or laparoscopic colectomies is associated with decreased rates of SSI and AL and 30-day mortality. Benefits of MBP + ABP for diverticulitis patients undergoing robotic surgeries warrant further investigation.
The combined utilization of predictors: a better approach to diagnose and predict rotator cuff tears than using a single predictor
Authors: Ma Qi , Sun Changjiao , Gao Hong , Cai Xu 
Published: June 2022

Abstract
ObjectivesTo explore whether the combined utilization of two predictors is more efficient to predict and diagnose rotator cuff tears (RCTs) than using a single predictor, and to find out which combination is the best screening approach for RCTs.MethodsThis was a retrospective study and patients who visited our hospital and were diagnosed with or without RCTs via magnetic resonance imaging from January 2018 to April 2022 were enrolled and classified into two groups respectively. Four predictors, the critical shoulder angle (CSA), the acromion index (AI), the greater tuberosity angle (GTA) and the double-circle radius ratio (DRR) were picked to participate in the present study. Quantitative variables were compared by independent samples t tests and qualitative variables were compared by chi-square tests to find significant differences between groups. Binary logistic regression analysis was used to distinguish independent risk factors and calculate the increased odds of having a RCT, and construct discriminating combined models to further diagnose and predict RCTs. Receiver operating characteristic (ROC) curves were pictured and areas under the curve (AUC) were calculated to determine the overall diagnostic performance of the involved predictors and the combined models. For all tests a p value of < 0.05 was considered statistically significant.ResultsOne hundred and thirty-nine shoulders with RCTs and 57 shoulders without RCTs were included. The mean values of CSA (35.36 ± 4.57 versus 31.41 ± 4.09°, P = 0.000), AI (0.69 ± 0.08 versus 0.63 ± 0.08, P = 0.000), DRR (1.43 ± 0.10 versus 1.31 ± 0.08, P = 0.000) and GTA (70.15 ± 7.38 versus 64.75 ± 7.91°, P = 0.000) were significantly larger in the RCT group than for controls. Via ROC curves, we found the combined model always showed a better diagnostic performance than either of its contributors, improving the AUC from 0.668–0.823 to 0.751–0.883, and extending the upper boundary of diagnostic sensitivity from 71.9–81.3%, and the diagnostic specificity from 82.5–86.0%. Via logistic regression analysis, we found the values of both predictors over their cutoff values resulted in a dramatical and enormous increasement (20.169–161.214 folds) in the risk of having a RCT, which is far beyond that by using a single predictor only (2.815–11.191 folds).ConclusionThe combined utilization of predictors is a better approach to diagnose and predict RCTs than using a single predictor. With a comprehensive consideration on the diagnostic and predictive performance of the combined models, we conclude the CSA together with the DRR present the strongest detectability for a presence of RCTs.
TGF-β regulates m 6 A RNA methylation after PM 2.5 exposure
Authors: Xue Kaibing , Li Zhigang , Zhang Yuanxun , Tang Ning , Wei Yongjie 
Published: June 2022

Abstract
Atmospheric particulate matter exposure has adverse effects on human health, but its molecular mechanism is complex and need to be explored in depth over time. m6A RNA methylation is an important epigenetic modification that regulates gene expression at the post-transcriptional level. Our previous animal exposure studies found that PM2.5 exposure up-regulated m6A RNA methylation in lung, but the regulatory pathway is currently unclear. PM2.5 can activate transforming growth factor-β (TGF-β), and Smad2/3, a downstream factor of TGF-β, can affect m6A RNA methylation by binding to the RNA methyltransferase complex. Based on the above evidences, the current study aimed to investigate the role of TGF-β signal pathway in PM2.5-induced m6A RNA methylation through animal and A549 cell exposure model. Our results showed that PM2.5 could induce upregulation of m6A RNA methylation, accompanied by increased expression of TGF-β, Smad3, methyltransferase-like 3 (METTL3), methyltransferase-like 14 (METTL14) in both lungs of mice and A549 cell line. Furthermore, the TGF-β inhibition cellular experiments determined that PM2.5 exposure altered the level of m6A RNA methylation, expression of TGF-β, Smad3. Accordingly, it is clear that TGF-β plays an indispensable role in m6A RNA methylation after PM2.5 exposure. Our study demonstrates that PM2.5 exposure influence RNA m6A methylation through the TGF-β signal pathway.
Non-targeted metabolomics analysis reveals changes in plasma and skin metabolic profiles after capsaicin gavage in mice
Authors: Xiao Zhen , Yu Simin , Yang Xiaoliang OU , Wang Xiuping , Zhang Deng , Zhao Yongwei , Li Chunming 
Published: June 2022

Abstract
Background
As an essential spice, chili pepper has essential physiological functions for humans. Capsaicin is the main compound found in chili pepper and has complex pharmacologic effects. Capsaicin has been observed to play an important role in obesity, cardiovascular and gastrointestinal diseases, various cancers and dermatologic conditions. Although possessing a broad spectrum of bioactivities, changes in the metabolic profile of the organism are inadequately unknown after oral gavage with capsaicin.
Methods
Therefore, an untargeted metabolomics approach coupled with multivariate statistical analyses was first applied to study the plasma and skin metabolic differences between mouse groups with and without capsaicin treatment by gavage. And we discussed these differential metabolites in the context of the physiological functions of capsaicin.
Results
The results showed that 38 plasma metabolites and 7 skin metabolites were associated with capsaicin intake, mainly associated with energy metabolism, lipid metabolism, and oxidative stress. KEGG pathway enrichment analysis revealed that these differential metabolites are primarily involved in some crucial pathways, such as Central carbon metabolism in cancer, Pyruvate metabolism, and ABC transporters in plasma; sphingolipid metabolism in the skin.
Conclusions
Plasma and skin metabolome showed significant alterations in response to the capsaicin supplementation, and these findings contribute to a better understanding of the potential effects of a capsaicin-rich diet on organisms.
Malting quality and preharvest sprouting traits are genetically correlated in spring malting barley
Authors: Rooney Travis E. , Sweeney Daniel W. , Kunze Karl H. , Sorrells Mark E. , Walling Jason 
Published: June 2022

Abstract
Expansion of malting barley production into non-traditional growing regions and erratic weather has increased the demand for preharvest sprouting (PHS) resistant, high quality malting barley cultivars. This is hindered by the relatively unknown relationships between PHS resistance and malting quality. Here we present a three-year study of malting quality and germination at different after-ripening durations post physiological maturity. Malting quality traits alpha amylase (AA) and free amino nitrogen (FAN) and germination rate at six days post PM shared a common association with a SNP in HvMKK3 on chromosome 5H in the Seed Dormancy 2 (SD2) region responsible for PHS susceptibility. Soluble protein (SP) and soluble over total protein (S/T) both shared a common association with a marker in the SD2 region, but the most significant association was not well correlated with the causative mutation in HvMKK3. Significant genetic correlations between PHS resistance and the malting quality traits AA, FAN, SP, S/T were detected across and within HvMKK3 allele groups. High adjunct malt quality was related to PHS susceptibility. Selection for PHS resistance led to a correlated response in malting quality traits. Results strongly suggest pleiotropy of HvMKK3 on malting quality traits and that the classic “Canadian-style” malt is caused by a PHS susceptible allele of HvMKK3. PHS susceptibility appears to benefit the production of malt intended for adjunct brewing, while PHS resistance is compatible with all-malt brewing specifications. Correlations of germination rate to malting quality traits indicate its potential for use as a secondary trait in selection.
The effect of oral zinc supplementation on bone biomarkers in rats in the experimental model of space exploration (simulated weightlessness)
Authors: Eslami Reza , Khoshvaghti Amir , Swann Jennifer , Hosseiniara Reza 
Published: June 2022

Abstract
Background: Zinc as a cofactor is effective in the function of many enzymes and is also essential for collagen synthesis and bone mineralization. Objectives: The current study aims to survey the effect of oral zinc supplementation on bone biomarkers (alkaline phosphatase and osteocalcin) in rats in the experimental model of space exploration (simulated weightlessness). Methods: This was an experimental study. A laboratory model of space exploration for inducing weightlessness in rats was done by the Hindlimb suspension technic. Rats were randomly divided into 2 groups; group A (n=7) received daily zinc sulfate and group B (n=7) received daily placebo. Rats received the supplement or placebo for 30 days. The alkaline phosphatase and osteocalcin were assessed in both groups at baseline and 30 days. Results: The microgravity simulation model of space exploration increased significantly alkaline phosphatase and decreased significantly osteocalcin in rats. Adding zinc sulfate to the diet has been effective in increasing the amount of alkaline phosphatase but has not shown a significant effect on the amount of osteocalcin reduction.Conclusion: According to current findings, it seems that Zinc administration did not have an effect on osteocalcin improvement but led to more rising of alkaline phosphatase in rats.
Long-standing Diabetes Mellitus Increases Concomitant Pancreatic Cancer Risk in Intraductal Papillary Mucinous Neoplasms
Authors: Yamaguchi Atsushi , Tazuma Susumu , Tamaru Yuzuru , Kusunoki Ryusaku , Kuwai Toshio , Kouno Hirotaka , Toyota Naoyuki , Sudo Takeshi , Kuraoka Kazuya , Kohno Hiroshi 
Published: June 2022

Abstract
Background: When monitoring patients with an intraductal mucinous neoplasm (IPMN), it is important to consider both IPMN-derived carcinoma and concomitant ductal adenocarcinoma (PDAC). The latter is thought to have a poorer prognosis. We retrospectively analyzed risk factors for concomitant PDAC in IPMN.Methods: In total, 547 patients with pancreatic cysts, including IPMN inappropriate for surgery on initial diagnosis, encountered from April 2005 to June 2019, were reviewed. We performed surveillance via imaging examination once or twice a year. Results: There were five intraductal papillary mucinous adenocarcinoma encountered. In comparison, there were 14 concomitant PDAC encountered. The prognosis was very poor in concomitant PDAC. All 14 PDAC patients had IPMN. In patients with IPMN, long-standing diabetes mellitus was the only significant risk factor for concomitant PDAC in both univariate and multivariate analysis ( P < 0.001 and P < 0.01, respectively). Further, patients with IPMN and diabetes mellitus had high frequency of concomitant PDAC (9.5%, 9/95) in a median 48-month surveillance period.Conclusions: When monitoring IPMN, concomitant PDAC should be considered, rather than IPMN-derived carcinoma. During this period, it may be prudent to concentrate on patients with other risk factors for PDAC, such as long-standing diabetes mellitus.
Long term evaluation of a multidisciplinary trigeminal neuralgia service
Authors: Singhota Sanjeet , Tchantchaleishvili Nana , Wu Jianhua , Zrinzo Ludvic , Thorne Lewis , Akram Harith , Zakrzewska Joanna 
Published: June 2022

Abstract
Background: Trigeminal neuralgia is an episodic severe neuralgic pain and can be managed both medically and surgically. If possible, this should be directed by a Multidisciplinary Team (MDT) of specialised surgeons, physicians, dentists, psychologists and specialist nurses with access to all treatment modalities, which enables patients to make an informed decision about their future management.Objective: The aim of this study was to review the outcomes of patients managed by an MDT clinic, in a single institute over an eleven-year period.Methods: A prospective database was used to identify patients with trigeminal neuralgia or its variants who had attended a joint MDT clinic. The electronic notes were examined for demographics, onset and duration of trigeminal neuralgia, medications history, pain scores and details of surgical procedures if any by two independent assessors. Results: 334 patients attended the MDT between 2008-2019. Forty-nine of them had surgery before being referred to the service and were included but analysed as a subgroup. Of the remaining patients, 54% opted to have surgery following the MDT either immediately or at a later date. At the last reported visit 55% of patients who opted to have surgery were pain free and off medications, compared to 15.5% of medically managed patients. Surgical complications were mostly attributable to numbness and in the majority of cases this was temporary. All patients who were not pain free, had complications after surgery or opted to remain on medical therapy were followed up in a facial pain clinic which has access to pain physicians, clinical nurse specialists and a tailored pain management program. Regular patient related outcome measures are collected to evaluate outcomes.Conclusion: An MDT clinic offers an opportunity for shared decision making with patients deciding on their personal care pathway which is valued by patients. Not all patients opt for surgery, and some continue to attend a multidisciplinary follow up program. Providing a full range of services including psychological support, improves outcomes.
Preoperative prediction of intrahepatic cholangiocarcinoma lymph node metastasis by means of machine learning: a multicenter study in China
Authors: Huang Tingfeng , Liu Hongzhi , Lin Zhaowang , Kong Jie , Lin Kongying , Lin Zhipeng , Chen Yifan , Lin Qizhu , Zhou Weiping , Li Jingdong , Li Jiang-Tao , Zeng Yongyi 
Published: June 2022

Abstract
Background: Hepatectomy is currently the most effective modality for the treatment of intrahepatic cholangiocarcinoma (ICC). The status of lymph node affects the choice of surgical method and the formulation of postoperative treatment plan. Therefore, preoperative judgment of lymph node status is of great significance. Previous prediction models mostly adopted logistic regression modeling, and few studies applied random forests in the prediction of ICC lymph node metastasis(LNM).Methods: A total of 149 ICC patients who met clinical conditions were enrolled in the training group. Taking into account preoperative clinical data and imaging features, 21 indicators were included for analysis and modeling. Logistic regression was used to filter variables through multivariate analysis, and random forest was used to rank the importance of variables through algorithm. The prediction accuracy of the model was assessed by the C-index and calibration curve and validated with external data. Result: Multivariate analysis shows that CEA, CA199, and lymphadenopathy on imaging are independent risk factors for lymph node metastasis. The random forest algorithm identifies the top four risk factors as CEA, CA199, lymphadenopathy on imaging and AST. The predictive power of random forest is significantly better than the nomogram established by logistic regression in both the validation group and the training group (AUC reached 0.758 in the validation group) Conclusions: We construct a random forest model for predicting lymph node metastasis. Compared with the traditional nomogram, it has higher prediction accuracy, and at the same time, it has an auxiliary role in imaging examinations.
Ventilatory ratio and pre-ICU management delay as early predictors of mortality in invasively ventilated COVID-19-related ARDS patients. A retrospective observational cohort study.
Authors: Toumi Radhouane , Meddeb Khaoula , Bedhiafi Emir , Ennouri Emna , Bouguezzi Nabil , Hamdi Dhouha , Saida Imen Ben , Boussarsar Mohamed 
Published: June 2022

Abstract
Purpose: Coronavirus disease 2019 (COVID-19) caused by the novel SARS-CoV-2 has been a burden on healthcare systems with numerous hospital and intensive care unit (ICU) admissions, the most severe of which requiring invasive mechanical ventilation (IMV).The aim of this study is to analyze characteristics of COVID-19-related ARDS patients requiring IMV in order to determine early clinical and physiological predictors of mortality.Methods: This is a retrospective observational cohort study carried out in the medical ICU of Farhat Hached University hospital in Sousse, Tunisia, between March 3rd 2020 and December 31st 2021. All consecutive patients with confirmed SARS-CoV-2 infection admitted to the ICU and requiring IMV were included. Demographic, clinical, physiological and ventilator data were collected. Univariate and multivariate cox regression models and Kaplan–Meier overall survival curves were used to identify risk factors of mortality.Results: 732 patients were admitted to the ICU, 465(63.5%) had a confirmed COVID-19 infection, 247(53.1%) required IMV. Median [IQR] age was 67[59-74] years; and pre-ICU management delay, 4[3-7] days. 149(60.3%) were on standard oxygenation; High-Flow Nasal Oxygen, 20(8.1%); Non-Invasive Positive Pressure Ventilation, 56(22.7%) and already on IMV, 15(6.1%). SAPS II, 31[27-37]; P/F ratio, 96[76.3-139.8]. At day1 of IMV, tidal volume, 6.5[6-7] ml; PEEP, plateau and driving pressures, respectively, 10[8-10], 27[24-28] and 16[14-19] cmH2O; P/F ratio, 126.3[90.3-170.8]; ventilatory ratio, 2.36±0.89 and mechanical power, 36.0[29.3-45.2] J/min. Median length of stay, 12[7-17] days and median IMV duration, 8[5-12] days. Mortality rate, 84.6%. Early independent factors predicting mortality were age, pre-ICU management delay and ventilatory ratio at day1 of IMV.Conclusion: In invasively ventilated COVID-19-related ARDS patients, older age, longer pre-ICU management delay and higher ventilatory ratio at day1 of invasive mechanical ventilation, were independent risk factors of mortality.
Intramural cancer recurrence in the rectum after curative surgery for proximal sigmoid colon cancer: a case report
Authors: Asada Yusuke , Chinen Katsuya , Yamataka Ken , Tokuyama Jo , Kurihara Naoto , Iida Shuhei 
Published: June 2022

Abstract
Background:Intramural metastasis distant from the primary tumor is rare in colorectal cancer. Here, we present a notably rare case of asynchronous intramural recurrence in the rectum after curative surgery for proximal sigmoid colon cancer. To the best of our knowledge, our paper is the first case report of this type of recurrence.Case presentation:A 44-year-old man underwent curative sigmoidectomy for proximal sigmoid colon cancer with tubular adenocarcinomas. The pathological diagnosis was T3N0M0, Stage IIA, according to the 8th Union for International Cancer Control classification. Moderate venous invasion was observed, and all resection margins were negative, including sufficient proximal and distal margins from the tumor.After 15 months, the tumor marker level had increased, and positron emission tomography-computed tomography (PET-CT) revealed abnormal fluorodeoxyglucose uptake in the rectum. Colonoscopy revealed a submucosal tumor (SMT)-like lesion in the upper rectum, and biopsy revealed a tubular adenocarcinoma. We performed curative low anterior resection based on a diagnosis of an atypical primary cancer or a rare case of intramural recurrence. We chose tumor-specific mesorectal excision (TSME) with a distal margin of 3 cm from the tumor. The SMT-like tumor was located approximately 20 cm from the initial sigmoid colon anastomosis (i.e., at least 20 cm distal to the initial sigmoid colon cancer), and pathological findings revealed cancer cells with the same features as the initial sigmoid colon cancer, only in the intestinal wall but not in the mucosa. Therefore, the recurrence was determined to be intramural. Severe venous invasion was also observed, and all resection margins were negative.After 24 months, lung recurrence and local recurrence, which may have involved the lymph nodes in the preserved mesorectum after TSME at the bottom of the pelvis, was detected on PET-CT. We started systemic chemotherapy and stable disease was achieved.Conclusions:This report presented a rare case of asynchronous intramural recurrence in the rectum after curative surgery for proximal sigmoid colon cancer. The discussion regarding the etiology, diagnosis, and optimal surgical procedure to achieve local control for rare intramural recurrence in colorectal cancer should provide valuable information in the clinical setting.