bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management and long-term outcomes of acute right colonic diverticulitis and risk factors of recurrence
Authors: Ma Zhilong , Liu Weiwei , Zhou Jia , Yao Le , Xie Wangcheng , Su Mingqi , Yang Jin , Shao Jun , Chen Ji 
Published: April 2022

Abstract
Background
Acute right-sided colonic diverticulitis (RCD) is a common disease in Asian populations for which the optimal treatment remains controversial. The aim of this study was to investigate management and evaluate long-term outcomes of treatment in patients with acute RCD.

Methods
We retrospectively collected and analyzed clinical data for patients with acute RCD admitted to the Tongren Hospital, Shanghai Jiao Tong University School of Medicine from December 2015 to December 2020. The patients were divided into two groups, according to primary treatment strategy, which was either conservative treatment or surgical treatment.

Results
A total of 162 consecutive patients with acute RCD were enrolled in the study. There was no significant difference in age, sex, history of abdominal surgery, medical co-morbidities, fever, previous history of RCD, treatment success rate and incidence of complications between the conservative and surgery groups. However, the recurrence rate in conservative groups was significantly higher than in surgery groups (16.53% vs 2.44%, P = 0.020). And more frequent bowel movements and previous history of RCD increased the risk of recurrence of acute RCD. Moreover, there was no significant difference in either treatment success rate or the overall recurrence rate between the patients with uncomplicated diverticulitis and patients with complicated diverticulitis.

Conclusions
Surgical treatment is also safe and effective for acute RCD. Surgical treatment should mainly be considered for patients with acute RCD with recurrence risk factors (more frequent bowel movements and previous history of RCD) or with complicated acute RCD.
Risk factors for postoperative ileus after diverting loop ileostomy closure
Authors: Nakao Toshihiro , Shimada Mitsuo , Yoshikawa Kozo , Tokunaga Takuya , Nishi Masaaki , Kashihara Hideya , Takasu Chie , Wada Yuma , Yoshimoto Toshiaki , Yamashita Syoko , Iwakawa Yosuke 
Published: April 2022

Abstract
Background
Postoperative ileus is one of the most common complications after diverting loop ileostomy closure. Some reports have investigated the risk factors for postoperative complications or ileus after ileostomy closure; however, these studies did not evaluate the index surgery sufficiently. In this study, we evaluated the risk factors, including the details of the index surgery, for ileus after diverting ileostomy closure.

Methods
This was a retrospective study of patients who underwent ileostomy closure following index surgery for rectal cancer. Patients who developed postoperative ileus [POI (+)] and patients who did not [POI (−)] after ileostomy closure were compared.

Results
Sixty-eight patients were evaluated and were divided into two groups: POI (+) (n = 11) and POI (−) (n = 57), and the groups were compared. There were no significant differences in the details of the index surgery, operative procedure, transanal total mesorectal excision, lateral lymph node dissection, operating time, or blood loss. The incidence of Clavien–Dindo grade ≥ III complications and adjuvant chemotherapy after index surgery were significantly higher in the POI (+) group.

Conclusions
The incidence of Clavien–Dindo grade ≥ III complications and adjuvant chemotherapy after index surgery may increase the risk of postoperative ileus after ileostomy closure.
Predicting medical graduates’ clinical performance using national competency examination results in Indonesia
Authors: Utomo Prattama Santoso , Randita Amandha Boy Timor , Riskiyana Rilani , Kurniawan Felicia , Aras Irwin , Abrori Cholis , Rahayu Gandes Retno 
Published: April 2022

Abstract
Background
Indonesia has applied a national competency exit-examination for medical graduates since 2014, called The Indonesia Medical Doctor National Competency Examination (IMDNCE). This examination is administered to ensure the competence of medical graduates from at present 83 medical schools in Indonesia. Although many studies reported their evaluation on medical licensing examinations, there are not many studies performed to evaluate the correlation of a national licensing examination to the graduates’ clinical practice.

Aims
This research aimed to evaluate the performance of new medical doctors in Indonesia in their internship period after the IMDNCE completion, and whether it might become a predictive indicator for the new medical doctors’ clinical performance.

Methods
An observational cross-sectional study was performed in November–December 2017 on 209 doctors who were new medical graduates. Thirty-one senior doctors from a range of regions in Indonesia who were recruited and trained previously participated in the observation. The Clinical Performance Instrument (CPI) tool was developed as an evaluation tool of the new doctors’ clinical competence to be observed for three weeks. The obtained data were analysed using descriptive statistics and correlated to the IMDNCE scores.

Results
The mean (95% CI) of the CPI for all participants was 83.0 (80.8–85.2), with no correlation of CPI score with IMDNCE results in domains of communication, professionalism and patient safety (p > 0.05). However, the mean total of the CPI observation scores from doctors who graduated from public medical schools was higher than those graduating from private medical schools. Also, there were differences in scores related to the institution’s accreditation grade (p < 0.05).

Conclusion
There is no difference between CPI and national competency examination results. There was no statistical correlation between the clinical performance of new medical doctors during their internship to CBT and OSCE scores in the national competency examination. New doctors’ performance during internship is affected by more complex factors, not only their level of competencies.
Development and usability of a web-based patient-tailored tool to support adherence to urate-lowering therapy in gout
Authors: te Kampe Ritch , Boonen Annelies , Jansen Tim L. , Elling Jan Mathis , Flendrie Marcel , van Eijk-Hustings Yvonne , Janssen Matthijs , van Durme Caroline , de Vries Hein 
Published: April 2022

Abstract
Background
The aim of this study is to develop and assess usability of a web-based patient-tailored tool to support adherence to urate-lowering therapy (ULT) among gout patients in a clinical setting.

Methods
The content of the tool was based on the Integrated Change (I-Change) model. This model combines various socio-cognitive theories and assumes behavioral change is a result of becoming aware of the necessity of change by integrating pre-motivational, motivational, and post-motivational factors. An expert group (five gout experts, three health services researchers, and one health behavior expert) was assembled that decided in three meetings on the tool’s specific content (assessments and personalized feedback) using information from preparatory qualitative studies and literature reviews. Usability was tested by a think aloud approach and validated usability questionnaires.

Results
The I-Change Gout tool contains three consecutive sessions comprising 80 questions, 66 tailored textual feedback messages, and 40 tailored animated videos. Navigation through the sessions was determined by the patients’ intention to adapt suboptimal ULT adherence. After the sessions, patients receive an overview of the personalized advices and plans to support ULT adherence. Usability testing among 20 gout patients that (ever) used ULT and seven healthcare professionals revealed an overall score for the tool of 8.4 ± 0.9 and 7.7 ± 1.0 (scale 1–10). Furthermore, participants reported a high intention to use and/or recommend the tool to others. Participants identified some issues for further improvement (e.g. redundant questions, technical issues, and text readability). If relevant, these were subsequently implemented in the I-Change Gout tool, to allow further testing among the following participants.

Conclusion
This study provides initial support for the usability by patients and healthcare professionals of the I-Change Gout tool to support ULT adherence behavior.
Sex differences in rumen fermentation and microbiota of Tibetan goat
Authors: Guo Xinyu , Sha Yuzhu , Lv Weibing , Pu Xiaoning , Liu Xiu , Luo Yuzhu , Hu Jiang , Wang Jiqing , Li Shaobin , Zhao Zhidong 
Published: April 2022

Abstract
Background
The gut microbiota play an important role in maintaining host metabolism, the immune system and health, while sex, genotype, diet and health have specific effects on the composition of the gut microbiota. Therefore, to explore the sex differences in the structure and function of rumen microbiota in Tibetan goats, herein we analyzed sex differences in rumen fermentation parameters, rumen microbiota and the expression of genes related to VFA transport in Tibetan goats.

Results
The results showed that the contents of acetic acid and propionic acid in the rumen of TGM (Tibetan goat male) were significantly higher than those in TGFm (Tibetan goat female) (P < 0.05), and total VFAs was significantly higher in TGM than TGFm (P < 0.05). Expression of the VFA transport-related genes DRA, AE2, MCT-1, NHE1, and NHE2 in the rumen epithelium of TGFm was significantly higher than that in TGM. Analysis of the composition and structure of the rumen microbiota revealed significant sex differences. At the phylum level, Firmicutes and Bacteroidetes were the dominant phyla in Tibetan goats. In addition, Fibrobacteres and Spirochaetes had significantly greater relative abundances in TGFm than in TGM (P < 0.05). At the genus level, the relative abundance of Fibrobacter, Ruminococcus_1 and Pyramidobacter was significantly higher in TGFm than in TGM (P < 0.05). The functional prediction results showed that replication, recombination and repair, RNA processing and modification were mainly enriched in TGFm (P < 0.05).

Conclusions
Correlation analysis revealed significant associations of some rumen microbiota with the fermentation product VFAs and VFA transport-related genes. We concluded that yearling TGM and TGFm have distinct fermentation and metabolism abilities when adapting to the plateau environment, which provides a certain sex reference basis for Tibetan goat adaptation to the plateau environment.
A functional role of S100A4/non-muscle myosin IIA axis for pro-tumorigenic vascular functions in glioblastoma
Authors: Inukai Madoca , Yokoi Ako , Ishizuka Yuuki , Hashimura Miki , Matsumoto Toshihide , Oguri Yasuko , Nakagawa Mayu , Ishibashi Yu , Ito Takashi , Kumabe Toshihiro , Saegusa Makoto 
Published: April 2022

Abstract
Background
Glioblastoma (GBM) is the most aggressive form of brain tumor and has vascular-rich features. The S100A4/non-muscle myosin IIA (NMIIA) axis contributes to aggressive phenotypes in a variety of human malignancies, but little is known about its involvement in GBM tumorigenesis. Herein, we examined the role of the S100A4/NMIIA axis during tumor progression and vasculogenesis in GBM.

Methods
We performed immunohistochemistry for S100A4, NMIIA, and two hypoxic markers, hypoxia-inducible factor-1α (HIF-1α) and carbonic anhydrase 9 (CA9), in samples from 94 GBM cases. The functional impact of S100A4 knockdown and hypoxia were also assessed using a GBM cell line.

Results
In clinical GBM samples, overexpression of S100A4 and NMIIA was observed in both non-pseudopalisading (Ps) and Ps (-associated) perinecrotic lesions, consistent with stabilization of HIF-1α and CA9. CD34(+) microvascular densities (MVDs) and the interaction of S100A4 and NMIIA were significantly higher in non-Ps perinecrotic lesions compared to those in Ps perinecrotic areas. In non-Ps perinecrotic lesions, S100A4(+)/HIF-1α(−) GBM cells were recruited to the surface of preexisting host vessels in the vascular-rich areas. Elevated vascular endothelial growth factor A (VEGFA) mRNA expression was found in S100A4(+)/HIF-1α(+) GBM cells adjacent to the vascular-rich areas. In addition, GBM patients with high S100A4 protein expression had significantly worse OS and PFS than did patients with low S100A4 expression. Knockdown of S100A4 in the GBM cell line KS-1 decreased migration capability, concomitant with decreased Slug expression; the opposite effects were elicited by blebbistatin-dependent inhibition of NMIIA.

Conclusion
S100A4(+)/HIF-1α(−) GBM cells are recruited to (and migrate along) preexisting vessels through inhibition of NMIIA activity. This is likely stimulated by extracellular VEGF that is released by S100A4(+)/HIF-1α(+) tumor cells in non-Ps perinecrotic lesions. In turn, these events engender tumor progression via acceleration of pro-tumorigenic vascular functions.
Human infection with a reassortant swine-origin influenza A(H1N2)v virus in Taiwan, 2021
Authors: Yang Ji-Rong , Kuo Chuan-Yi , Yu I.-Ling , Kung Fang-Yen , Wu Fang-Tzy , Lin Jen-Shiou , Liu Ming-Tsan 
Published: April 2022

AbstractBackgroundInfluenza A virus infections occur in different species, causing mild-to-severe symptoms that lead to a heavy disease burden. H1N1, H1N2 and H3N2 are major subtypes of swine influenza A viruses in pigs and occasionally infect humans.MethodsA case infected by novel influenza virus was found through laboratory surveillance system for influenza viruses. Clinical specimens were tested by virus culture and/or real-time RT–PCR. The virus was identified and characterized by gene sequencing and phylogenetic analysis.ResultsIn 2021, for the first time in Taiwan, an influenza A(H1N2)v virus was isolated from a 5-year old girl who was suffering from fever, runny nose and cough. The isolated virus was designated A/Taiwan/1/2021(H1N2)v. Full-genome sequencing and phylogenetic analyses revealed that A/Taiwan/1/2021(H1N2)v is a novel reassortant virus containing hemagglutinin (HA) and neuraminidase (NA) gene segments derived from swine influenza A(H1N2) viruses that may have been circulating in Taiwan for decades, and the other 6 internal genes (PB2, PB2, PA, NP, M and NS) are from human A(H1N1)pdm09 viruses.ConclusionNotably, the HA and NA genes of A/Taiwan/1/2021(H1N2)v separately belong to specific clades that are unique for Taiwanese swine and were proposed to be introduced from humans in different time periods. Bidirectional transmission between humans and swine contributes to influenza virus diversity and poses the next pandemic threat.
Outcomes following balloon tibioplasty versus conventional osteosynthesis techniques for Schatzker type III tibial plateau fractures: a systematic review
Authors: Blankenship Andrew , Singleton Amy , Hiatt Logan , Evanson Kirk W. , Phillips Seth , Miller Richard 
Published: April 2022

Abstract
Introduction
Schatzker type III fractures of the tibial plateau require elevation of the depressed portions to regain articular congruity. Balloon tibioplasty has been used as an alternative to conventional metal instruments for elevation of the lateral tibial plateau. This study compared functional outcomes following balloon tibioplasty or conventional osteosynthesis techniques in patients with type III fractures of the tibial plateau.

Materials and methods
A systematic literature search was performed using PubMed, EMBASE, and Cochrane Library to identify studies published through March 29, 2021, pertaining to balloon tibioplasty or conventional osteosynthesis techniques for type III fractures. Non-human studies, opinion or editorial pieces, systematic reviews, case series (< 5 patients), and articles published in a non-English language were excluded. Primary outcomes were Rasmussen clinical score, range of motion, and Knee Society Score (KSS). A Joanna Briggs Institute (JBI) risk of bias assessment was performed for all studies.

Results
A total of 95 studies were identified, with 10 studies (and 132 total patients) meeting inclusion criteria: 1 study focused on balloon tibioplasty, 8 studies reported outcomes following conventional osteosynthesis, and 1 study compared outcomes of the two techniques. Mean follow-up times varied widely, from 4 to 76.3 months. Where reported, balloon tibioplasty resulted in good to excellent functional outcomes as indicated by Rasmussen clinical scores (mean 28.3 in a case series; mean 28.9 in a randomized controlled trial) and range of motion (≥ 140° in both studies) 1–2 years following surgery. KSS was not reported consistently enough for comparison. Studies ranged from low to high risk of bias according to the JBI assessment.

Conclusions
Balloon tibioplasty can lead to excellent functional outcomes in patients with depression fractures of the lateral tibial plateau. More research is needed to directly compare outcomes following treatment with balloon tibioplasty or conventional osteosynthesis techniques.
Peri-articular administration of tranexamic acid is an alternative route in total knee arthroplasty: a systematic review and meta-analysis
Authors: Fan DingYuan , Ma Jia , Liu XiaoHua , Zhang Lei 
Published: April 2022

AbstractBackgroundAs an antifibrinolytic agent, tranexamic acid (TXA) is increasingly used in total knee arthroplasty (TKA) to reduce blood loss. The administration of intravenous and intra-articular TXA has been well explored, but the most efficient way to administer TXA remains in question. Peri-articular injection (PAI) of TXA is a recently mentioned method. A meta-analysis of the efficacy of PAI TXA in patients after TKA should be performed.MethodsA systematic search was performed within PubMed, Embase, and the Cochrane Library up to November 8, 2021. Two authors independently screened studies for eligibility and extracted data for analysis. The primary outcome was haemoglobin change. The secondary outcomes were haematocrit change, total drainage volume, thromboembolic events, and blood transfusion.ResultsA total of ten studies were included in this meta-analysis. The results indicated that there was a significant decrease in haemoglobin change when using PAI TXA compared with no TXA (mean difference − 1.05; 95% CI − 1.28 to − 0.81;P < 0.00001;I2 = 0%), but it had no significant differences compared with IA and IV (mean difference − 0.01; 95% CI − 0.17 to − 0.14;P = 0.85;I2 = 39%). There were no significant differences between the TXA < 1.5 g subgroup (0.10, 95% CI − 0.27 to 0.46;P = 0.60;I2 = 0%) and the TXA ≥ 1.5 g subgroup (0.18, 95% CI − 0.12 to 0.48;P = 0.24;I2 = 74%). In addition, the combined group (PAI plus IV or IA) was superior to the IV or IA group in terms of haemoglobin change (mean difference − 0.51; 95% CI − 0.76 to − 0.27;P < 0.0001;I2 = 19%). Regarding haematocrit change, the pooled result showed it was significantly less in the PAI group than the non-TXA group. Similarly, comparing it against the IV subgroup, the result revealed a difference in favour of the PAI group, with a mean difference of − 1.89 g/dL (95% CI − 2.82 to − 0.95;P < 0.0001;I2 = 67%). For total drainage volume, the pooled result was in favour of PAI TXA over no TXA (297 ml, 95% CI − 497.26 to − 97.23;P = 0.004;I2 = 87%), but it had no significant difference compared with IA and IV (mean difference − 37.98; 95% CI − 115.68 to 39.71;P = 0.34;I2 = 95%). There was no significant difference in thromboembolic events (OR 0.74; 95% CI 0.25 to 2.21;P = 0.59;I2 = 0%). Blood transfusion was not significantly different between the PAI group and the non-TXA group (OR 0.50; 95% CI 0.23 to 1.06;P = 0.07;I2 = 21%), and there was no significant difference between PAI and the other two TXA injection methods (OR 0.72; 95% CI 0.41 to 1.25;P = 0.24;I2 = 19%).ConclusionPAI has comparable effects to IV and IA injections. PAI is an alternative injection route of TXA for patients who have undergone TKA.
Measurement for gap balancing technique in patients undergoing total knee arthroplasty: a large retrospective observational study
Authors: Xuequan Zhao , Bin Zhao , Shuzhang Yao , Kanduo Cao , Chongxi Ren 
Published: April 2022

Abstract
Background
Many traditional methods are available to prevent unbalance of extension and flexion gap during total knee arthroplasty (TKA), but there are no reports on the use of measurement and positioning method before tibial osteotomy with self-made tools. We designed a self-made tool measuring the location before tibial osteotomy and determined the clinical effect.

Methods
The retrospective study included patients who received TKA at our hospital, between January 1, 2012 and December 31, 2015. A new method, named as the measurement and localization before osteotomy with self-made tools, was developed to measure the osteotomy position of the posterior femoral condyle during TKA. They were divided into two groups, one that received the new method (Group I), and the other that received the traditional method as a control (Group I I). HSS score, Oxford score, VAS score and knee joint activity were evaluated in two groups.

Results
One hundred and eighty-seven of 210 eligible patients were included. The function of knee joint in all patients was improved and the pain was obviously relieved. Significant differences were found in the HSS score, Oxford score, VAS score, knee joint activity between two groups at 5-year follow-up (p < 0.05).

Conclusions
The biomet knee prosthesis was selected for all intraoperative implants. All operations were completed by the same senior surgeon. The use of self-made tools may contribute to improve the balance between flexion and extension gaps as well as the balance between internal and external gaps during TKA, and overcome knee flexion instability.
ZMAT1 acts as a tumor suppressor in pancreatic ductal adenocarcinoma by inducing SIRT3/p53 signaling pathway
Authors: Ma Zuyi , Li Zhenchong , Wang Shujie , Zhou Zixuan , Liu Chunsheng , Zhuang Hongkai , Zhou Qi , Huang Shanzhou , Zhang Chuanzhao , Hou Baohua 
Published: April 2022

Abstract
Background
Pancreatic ductal adenocarcinoma (PDAC) is one of the deadliest cancer due to its highly aggressive phenotype and lack of effective biomarkers or treatment strategies. ZMAT1 belongs to the C2H2 type zinc finger family, but its biological function is rarely investigated, as well as its role in cancer development.

Methods
Multiple bioinformatics analyses were used to evaluate ZMAT1 expression and potential role in PDAC. Intro and vivo studies were performed to assess the effects of ZMAT1 on PDAC cells growth. Furthermore, CHIP-seq and luciferase reporter assay was conducted to identify its specific regulatory mechanism in PDAC.

Results
The current study identified the down-regulation of ZMAT1 and its associations with unfavorable clinicopathological characteristics and poor survival of PDAC. Further, we found overexpression of ZMAT1 inhibited pancreatic cancer cell proliferation by inducing p21, leading to impaired S/G2 cell cycle progression. Besides, over-expression of ZMAT1 led to decreased pancreatic cancer cell apoptosis. Mechanistically, ZMAT1 up-regulated p53 expression and inhibition of p53 abrogated the effect of ZMAT1 over-expression on pancreatic cancer cell, indicating the role of ZMAT1 in PDAC was dependent on p53. By performing CHIP-seq assay, we found ZMAT1 did not bind to P53 but bound to the promoter region of SIRT3, an upstream regulator for p53. Luciferase reporter assay showed transfection of ZMAT1 induced SIRT3 transcription, suggesting ZMAT1 was a transcriptional activator for SIRT3.

Conclusion
Our findings indicated the role of ZMAT1-SIRT3-p53 signaling pathway during tumor growth, highlighting that ZMAT1 is a tumor suppressor and novel biomarker of PDAC.