bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anastomotic leakage following resection of the esophagus—introduction of an endoscopic grading system
Authors: Bachmann Jeannine , Feith Marcus , Schlag Christoph , Abdelhafez Mohamed , Martignoni Marc E. , Friess Helmut 
Published: March 2022

Abstract
Background
Malignant tumors of the esophagus are the sixth leading cause of cancer-related deaths worldwide. Postoperative leakage of the esophago-gastrostomy leads to mediastinal sepsis, which is still associated with a high morbidity and mortality rate. The aim of this study was to describe the endoscopic view of the different severity grades of an anastomotic leakage.

Methods
Patients
Between June 2016 and September 2018, 144 patients were operated upon in the Department of Surgery, University of Munich, Germany.
Among these patients, 34 (23.6%) presented with a leakage of the anastomosis.
Endoscopy
In this retrospective analysis, the focus is to describe different patterns of leakage of the anastomosis.

Results
We studied 34 patients in whom post-esophagectomy leakage of the anastomosis was detected and treated with an endoluminal vacuum sponge system. The leakage healed in 26 of 29 patients (success rate 89.7%).
With the increasing severity of leakage, the treatment time and the in-hospital mortality correspondingly increased. Furthermore, the incidence of the development of a fistula to the tracheobronchial system increased with higher grades of leakage.

Conclusions
Exact descriptions of leakage are necessary to compare the cases and to prove post-treatment improvement. This is, to our knowledge, the first publication to present a leakage grading score in patients after esophagectomy including reconstruction with a gastric tube.
This new grading system needs to be tested in further analyses, with a special focus on prospective analysis.
Impact of the COVID-19 pandemic on subcutaneous venous port-related complications in patients with cancer: a retrospective case–control study
Authors: Dahlin Linnea , Taxbro Knut , Hammarskjöld Fredrik 
Published: March 2022

Abstract
Background
Vascular access in cancer patients is of great importance in order to deliver tumour-specific therapy and continues to be so during exceptional conditions. This study aimed to examine the impact of the coronavirus disease 2019 pandemic on the care and complication rates associated with subcutaneous venous port (PORT) insertion in cancer treatment.

Methods
We retrospectively studied all adult cancer patients that received a PORT in 2020 at a Swedish county hospital, including insertion characteristics and in-dwell complication rates for up to 6 months after implantation; these estimates were compared with historic data.

Results
Data from 257 patients, of which 56 were haematological patients, were included and compared with those of 168 patients in the control group. The group characteristics were similar, except for the inclusion of haematological patients in the study group. Insertion characteristics showed a shorter waiting time and higher rates of antibiotic and sedative use during the pandemic. The rates of postoperative haematoma and catheter occlusion during the study period were higher than otherwise. The rates of adverse events related to the PORT in the solid tumour group were comparable to those in the control group (18.4% vs. 14.9%). Patients with haematological malignancies were more likely to experience adverse events (37.5% vs. 18.4%) and deep venous thrombosis (7.1% vs. 1.0%) than those with solid tumours.

Conclusion
In conclusion, the present findings suggest that PORTs remain a safe venous access system even during a pandemic, indicating a robust vascular access service.
The technical efficiency of maternal and child health hospitals in China: a case study of Hubei Province
Authors: Jiang Dongdong , Liu Xinliang , Chen Yan , Hao Jinwei , Huang Hao , Huang Qian , Chen Qinghua , Wang Quan , Li Hao 
Published: March 2022

Abstract
Background
Maternal and child health (MCH) hospitals play an essential role in providing MCH services in China, while the supply has become increasingly challenging in the past decade, especially among secondary MCH hospitals. In this study we aimed to evaluate the technical efficiency (TE) of secondary MCH hospitals in Hubei province (China) to generate evidence-based decision-making for efficiency improvement.

Methods
The data were collected from the Department of Maternal and Child Health of Health Commission of Hubei Province in 2019. A total of 59 out of 74 secondary MCH hospitals were included as our study sample. Four input indicators (number of health professionals, number of beds, number of equipment with value greater than 10,000 RMB Yuan, building area for hospital operations) and three output indicators (number of total diagnostic patients, number of discharged patients, and number of birth deliveries) were selected based on previous literature. TE scores of the sample hospitals were estimated by using Bootstrap-Data Envelopment Analysis (Bootstrap-DEA).

Results
After bias-correction with Bootstrap-DEA model, the average TE score of the MCH hospitals was 0.673. 20 (33.89%) MCH hospitals had TE scores below the average. No MCH hospitals achieved excellent efficiency; 16 (27.11%) MCH hospitals reached good efficiency; and 26 (44.06%) MCH hospitals fell into poor and failing efficiency. Besides, 17 MCH hospitals had TE scores of 1 before bias-corrections, while none of them reached 1 after bias correction.

Conclusions
Significant capacity variations existed among the secondary MCH hospitals in terms of input and output indicators and their overall TE was low in Hubei of China. For better improvement, the secondary MCH hospitals in Hubei need to improve their internal management and strengthen the construction of their information systems. A series of policy supports are needed from the health and insurance administrations to optimize health resources. Third-party performance evaluation can be piloted to improve efficiency and overall performance of the MCH hospitals. The policy recommendations we raise for MCH hospitals in Hubei can be worth learning for some low- and middle- income countries.
Nutritional practice of pregnant women in Buno Bedele zone, Ethiopia: a community based cross-sectional study
Authors: Yismaw Worke Sisay , Teklu Tigist Shayi 
Published: March 2022

AbstractBackgroundWorthy health and welfare is part of the goals set by united nation. Dietary practice is visible activities or conducts of eating habit performed by a person. Poor maternal nutrition during pregnancy were associated with higher risk of having a preterm labour, low birth-weight, Intrauterine growth restrictions and facing threats to their own wellbeing and survival.ObjectiveTo assess the nutritional practice of pregnant women in Buno Bedele zone.MethodsA community-based cross-sectional study design was deployed to conduct this study from November 1–30, 2019 in the Buno Bedele zone, Ethiopia. The study included 592 pregnant women and a proportional sample of the size of the population was allocated to each 32 kebeles. A structured interviewer administered pretested tool was utilized for data collection. Data entry was conducted using EPI-data version 3.4 and cleaned, edited and analyzed using the SPSS version 24.0. The data were presented in the form of text, frequencies, tables and figures while logistic regression was used to discover the association between dependent and independent variables.ResultThis study found that about 185 (31.2%) pregnant mothers had good dietary practice. The mothers’ educational status (AOR = 1.33, 95% CI 0.34, 2.08), income (AOR = 5.7, 95% CI, 5.1, 6.65), dietary knowledge (AOR = 3.03, 95% CI 1.98, 4.18) and pregnancy intervals (AOR = 4.16 95% CI 2.74, 6.49) were factors found to be affecting the nutritional practices of pregnant women.Conclusion and recommendationOnly 31.2% of pregnant women had good dietary practice. This indicated that the majority of study participants had a poor dietary practice, which is a concern because having poor dietary practice contributes to maternal and neonatal mortality and morbidity. To increase their nutrition practices to have a healthy pregnancy. We need to focus on; nutrition education on basic nutrients, community mobilization on dietary practices using media, work on barriers, and advocating nutrition practice activities.
The association between sPD-1 levels versus liver biochemistry and viral markers in chronic hepatitis B patients: a comparative study of different sPD-1 assays
Authors: Jeng Wen-Juei , Chen Chien-Hung , Wang Yi-Wen , Pan Mei-Hung , Lin Chia-Wei , Lin Chun-Yen , Yang Hwai-I 
Published: March 2022

Abstract
Background
Soluble programmed death-1 (sPD-1) is a novel immune markers and possibly predictive of chronic hepatitis B (CHB) outcome. However, results were inconsistent by different ELISA kits. This study aims to compare the characteristics and correlations with other markers for sPD-1 measured by MyBioSource (MB) and R&D (RD) kits.

Methods
A total of 254 untreated CHB patients from three sites were assayed with sPD-1 by MB and RD kits at the same time. Spearman’s correlations between the kits, and those with viral markers and ALT levels were calculated. Multivariate linear regression analysis was applied for independent factors associated with the sPD-1 levels.

Results
There’s no correlation between sPD-1 level using MB and RD assays. sPD-1 by MB correlated profoundly with HBsAg (r = 0.8311, P < 0.0001), HBV DNA (r = 0.3896, P < 0.0001), and ALT levels (r = 0.1604, P = 0.0105) while an opposite trend by RD kit (r = − 0.0644, P = 0.3109; r = 0.2554, P < 0.0001; r = 0.4417, P < 0.0001, respectively for the 3 markers). In the multivariate linear regression analysis, HBsAg and ALT levels was the major factor associated with sPD-1 levels by MB and RD, respectively.

Conclusions
The characteristics and correlations with host/viral markers of sPD-1 by the two kits are different and leading to different associations on clinical outcomes of CHB.
An efficient chromatin immunoprecipitation (ChIP) protocol for studying histone modifications in peach reproductive tissues
Authors: Canton Monica , Farinati Silvia , Forestan Cristian , Joseph Justin , Bonghi Claudio , Varotto Serena 
Published: March 2022

AbstractBackgroundPerennial fruit trees display a growth behaviour characterized by annual cycling between growth and dormancy, with complex physiological features. Rosaceae fruit trees represent excellent models for studying not only the fruit growth/patterning but also the progression of the reproductive cycle depending upon the impact of climate conditions. Additionally, current developments in high‐throughput technologies have impacted Rosaceae tree research while investigating genome structure and function as well as (epi)genetic mechanisms involved in important developmental and environmental response processes during fruit tree growth. Among epigenetic mechanisms, chromatin remodelling mediated by histone modifications and other chromatin-related processes play a crucial role in gene modulation, controlling gene expression. Chromatin immunoprecipitation is an effective technique to investigate chromatin dynamics in plants. This technique is generally applied for studies on chromatin states and enrichment of post-transcriptional modifications (PTMs) in histone proteins.ResultsPeach is considered a model organism among climacteric fruits in the Rosaceae family for studies on bud formation, dormancy, and organ differentiation. In our work, we have primarily established specific protocols for chromatin extraction and immunoprecipitation in reproductive tissues of peach (Prunus persica). Subsequently, we focused our investigations on the role of two chromatin marks, namely the trimethylation of histone H3 at lysine in position 4 (H3K4me3) and trimethylation of histone H3 at lysine 27 (H3K27me3) in modulating specific gene expression. Bud dormancy and fruit growth were investigated in a nectarine genotype called Fantasia as our model system.ConclusionsWe present general strategies to optimize ChIP protocols for buds and mesocarp tissues of peach and analyze the correlation between gene expression and chromatin mark enrichment/depletion. The procedures proposed may be useful to evaluate any involvement of histone modifications in the regulation of gene expression during bud dormancy progression and core ripening in fruits.
CAR race to cancer immunotherapy: from CAR T, CAR NK to CAR macrophage therapy
Authors: Pan Kevin , Farrukh Hizra , Chittepu Veera Chandra Sekhar Reddy , Xu Huihong , Pan Chong-xian , Zhu Zheng 
Published: March 2022

AbstractAdoptive cell therapy with chimeric antigen receptor (CAR) immunotherapy has made tremendous progress with five CAR T therapies approved by the US Food and Drug Administration for hematological malignancies. However, CAR immunotherapy in solid tumors lags significantly behind. Some of the major hurdles for CAR immunotherapy in solid tumors include CAR T cell manufacturing, lack of tumor-specific antigens, inefficient CAR T cell trafficking and infiltration into tumor sites, immunosuppressive tumor microenvironment (TME), therapy-associated toxicity, and antigen escape. CAR Natural Killer (NK) cells have several advantages over CAR T cells as the NK cells can be manufactured from pre-existing cell lines or allogeneic NK cells with unmatched major histocompatibility complex (MHC); can kill cancer cells through both CAR-dependent and CAR-independent pathways; and have less toxicity, especially cytokine-release syndrome and neurotoxicity. At least one clinical trial showed the efficacy and tolerability of CAR NK cell therapy. Macrophages can efficiently infiltrate into tumors, are major immune regulators and abundantly present in TME. The immunosuppressive M2 macrophages are at least as efficient as the proinflammatory M1 macrophages in phagocytosis of target cells; and M2 macrophages can be induced to differentiate to the M1 phenotype. Consequently, there is significant interest in developing CAR macrophages for cancer immunotherapy to overcome some major hurdles associated with CAR T/NK therapy, especially in solid tumors. Nevertheless, both CAR NK and CAR macrophages have their own limitations. This comprehensive review article will discuss the current status and the major hurdles associated with CAR T and CAR NK therapy, followed by the structure and cutting-edge research of developing CAR macrophages as cancer-specific phagocytes, antigen presenters, immunostimulators, and TME modifiers.
Emerging rodent-associated Bartonella: a threat for human health?
Authors: Krügel Maria , Król Nina , Kempf Volkhard A. J. , Pfeffer Martin , Obiegala Anna 
Published: March 2022

AbstractBackgroundSpecies of the genusBartonellaare facultative intracellular alphaproteobacteria with zoonotic potential.Bartonellainfections in humans range from mild with unspecific symptoms to life threatening, and can be transmitted via arthropod vectors or through direct contact with infected hosts, although the latter mode of transmission is rare. Among the small mammals that harbourBartonellaspp., rodents are the most speciose group and harbour the highest diversity of these parasites. Human–rodent interactions are not unlikely as many rodent species live in proximity to humans. However, a surprisingly low number of clinical cases of bartonellosis related to rodent-associatedBartonellaspp. have thus far been recorded in humans.MethodsThe main purpose of this review is to determine explanatory factors for this unexpected finding, by taking a closer look at published clinical cases of bartonellosis connected with rodent-associatedBartonellaspecies, some of which have been newly described in recent years. Thus, another focus of this review are these recently proposed species.ConclusionsWorldwide, only 24 cases of bartonellosis caused by rodent-associated bartonellae have been reported in humans. Possible reasons for this low number of cases in comparison to the high prevalences ofBartonellain small mammal species are (i) a lack of awareness amongst physicians ofBartonellainfections in humans in general, and especially those caused by rodent-associated bartonellae; and (ii) a frequent lack of the sophisticated equipment required for the confirmation ofBartonellainfections in laboratories that undertake routine diagnostic testing. As regards recently describedBartonellaspp., there are presently 14 rodent-associatedCandidatustaxa. In contrast to species which have been taxonomically classified, there is no official process for the review of proposedCandidatusspecies and their names before they are published. This had led to the use of malformed names that are not based on the International Code of Nomenclature of Prokaryotes. Researchers are thus encouraged to proposeCandidatusnames to the International Committee on Systematics of Prokaryotes for approval before publishing them, and only to propose new species ofBartonellawhen the relevant datasets allow them to be clearly differentiated from known species and subspecies.Graphical Abstract
Regulation of oxytocin receptor gene expression in obsessive–compulsive disorder: a possible role for the microbiota-host epigenetic axis
Authors: D’Addario Claudio , Pucci Mariangela , Bellia Fabio , Girella Antonio , Sabatucci Annalaura , Fanti Federico , Vismara Matteo , Benatti Beatrice , Ferrara Luca , Fasciana Federica , Celebre Laura , Viganò Caterina , Elli Luca , Sergi Manuel , Maccarrone Mauro , Buzzelli Valeria , Trezza Viviana , Dell’Osso Bernardo 
Published: March 2022

Abstract
Background
Obsessive–compulsive disorder (OCD) is a prevalent and severe clinical condition. Robust evidence suggests a gene-environment interplay in its etiopathogenesis, yet the underlying molecular clues remain only partially understood. In order to further deepen our understanding of OCD, it is essential to ascertain how genes interact with environmental risk factors, a cross-talk that is thought to be mediated by epigenetic mechanisms. The human microbiota may be a key player, because bacterial metabolites can act as epigenetic modulators. We analyzed, in the blood and saliva of OCD subjects and healthy controls, the transcriptional regulation of the oxytocin receptor gene and, in saliva, also the different levels of major phyla. We also investigated the same molecular mechanisms in specific brain regions of socially isolated rats showing stereotyped behaviors reminiscent of OCD as well as short chain fatty acid levels in the feces of rats.

Results
Higher levels of oxytocin receptor gene DNA methylation, inversely correlated with gene expression, were observed in the blood as well as saliva of OCD subjects when compared to controls. Moreover, Actinobacteria also resulted higher in OCD and directly correlated with oxytocin receptor gene epigenetic alterations. The same pattern of changes was present in the prefrontal cortex of socially-isolated rats, where also altered levels of fecal butyrate were observed at the beginning of the isolation procedure.

Conclusions
This is the first demonstration of an interplay between microbiota modulation and epigenetic regulation of gene expression in OCD, opening new avenues for the understanding of disease trajectories and for the development of new therapeutic strategies.
Rare missense mutations in ABCA7 might increase Alzheimer’s disease risk by plasma membrane exclusion
Authors: Bossaerts Liene , Hendrickx Van de Craen Elisabeth , Cacace Rita , Asselbergh Bob , Van Broeckhoven Christine 
Published: March 2022

AbstractThe adenosine triphosphate–binding cassette subfamily A member 7 gene (ABCA7) is associated with Alzheimer’s disease (AD) in large genome-wide association studies. Targeted sequencing of ABCA7 suggests a role for rare premature termination codon (PTC) mutations in AD, with haploinsufficiency through nonsense-mediated mRNA decay as a plausible pathogenic mechanism. Since other classes of rare variants in ABCA7 are poorly understood, we investigated the contribution and pathogenicity of rare missense, indel and splice variants in ABCA7 in Belgian AD patient and control cohorts. We identified 8.36% rare variants in the patient cohort versus 6.05% in the control cohort. For 10 missense mutations identified in the Belgian cohort we analyzed the pathogenetic effect on protein localization in vitro using immunocytochemistry. Our results demonstrate that rare ABCA7 missense mutations can contribute to AD by inducing protein mislocalization, resulting in a lack of functional protein at the plasma membrane. In one pedigree, a mislocalization-inducing missense mutation in ABCA7 (p.G1820S) co-segregated with AD in an autosomal dominant inheritance pattern. Brain autopsy of six patient missense mutation carriers showed typical AD neuropathological characteristics including cerebral amyloid angiopathy type 1. Also, among the rare ABCA7 missense mutations, we observed mutations that affect amino acid residues that are conserved in ABCA1 and ABCA4, of which some correspond to established ABCA1 or ABCA4 disease-causing mutations involved in Tangier or Stargardt disease.
Anal fistula metastasis of rectal cancer after neoadjuvant therapy: a case report
Authors: Fukai Shota , Tsujinaka Shingo , Miyakura Yasuyuki , Matsuzawa Natsumi , Hatsuzawa Yuuri , Maemoto Ryo , Kakizawa Nao , Rikiyama Toshiki 
Published: March 2022

Abstract
Background
Anal metastasis of colorectal cancer is very rare and may present synchronously or metachronously, regardless of pre-existing anal diseases. We report a case of anal fistula metastasis after completion of neoadjuvant therapy for rectal cancer, followed by surgical resection of the primary tumor and metastatic lesion.

Case presentation
A 50-year-old man was diagnosed with rectal cancer located 5 cm from the anal verge, with a clinical stage of cT3N0M0. He denied any medical or surgical history, and physical examination revealed no perianal disease. He underwent preoperative chemoradiation therapy (CRT) consisting of a tegafur/gimeracil/oteracil potassium (S-1)-based regimen with 45 Gy of radiation. After completion of CRT, computed tomography (CT) revealed the primary tumor’s partial response, but a liver mass highly suggestive of metastasis was detected. This mass was later diagnosed as cavernous hemangioma 3 months after CRT initiation. He then underwent and completed six cycles of consolidation chemotherapy with a capecitabine-based regimen. Subsequent colonoscopy revealed the complete response of the primary tumor, but CT showed thickening of the edematous rectal wall. Therefore, we planned to perform low anterior resection as a radical surgery. However, he presented with persistent anal pain after the last chemotherapy, and magnetic resonance imaging revealed a high-intensity mass behind the anus, suggestive of an anal fistula. We considered the differential diagnosis of a benign anal fistula or implantation metastasis into the anal fistula. Fistulectomy was performed, and a pathological diagnosis of tubular adenocarcinoma, suggestive of implantation metastasis, was made. Thereafter, we performed laparoscopic abdominoperineal resection. Histopathological examination revealed well-differentiated adenocarcinoma, ypT2N0, with a grade 2 therapeutic effect. Subsequent immunohistochemistry of the resected anal fistula showed a CDX-2-positive, CK20-positive, CK7-negative, and GCDFP-15 negative tumor, with implantation metastasis. There was no cancer recurrence 21 months after the radical surgery.

Conclusions
This is the first report of anal fistula metastasis after neoadjuvant therapy for rectal cancer in a patient without a previous history of anal disease. If an anal fistula is suspected during or after neoadjuvant therapy, physical and radiological assessment, differential diagnosis, and surgical intervention timing for fistula must be carefully discussed.