bluuebunny/crossref_metadata_2025_split huggingface dataset:
Therapeutic Endoscopic Retrograde Cholangiopancreatography for Pediatric Hepato-Pancreato-Biliary diseases: A Systematic Review and Meta-analysis
Authors: Sun Rongjuan , Xu Xiaodan , Zheng Qipeng , Zhan Jianghua 
Published: March 2022

Abstract
Background: Hepato-pancreato-biliary (HPB) disease has different causes and types between children and adults, which have been diagnosed increasingly in the pediatric group. Endoscopic retrograde cholangiopancreatography (ERCP) has been gradually considered as a therapeutic method in adults, while in pediatric patients, there are not many reports of its usage. This systematic review and meta-analysis aims to assess the use condition of therapeutic ERCP in the management of pediatric HPB diseases.Methods: This systematic literature search was conducted in the PubMed、Embase、Web of Science and the Cochrane library databases to identify all relevant articles published from inception to February 2022 that evaluated therapeutic ERCP in pediatric patients with Hepato-Pancreato-Biliary diseases. The researchers included studies that patients were less than 18 years old and underwent therapeutic ERCP procedures. A random-effects model was used to analyze the usage rate of therapeutic ERCP-procedures, procedural success rates, adverse events rates, and the rate of different therapeutic procedures. Subgroup analysis, sensitivity analysis, and meta-regression were conducted to analyze the source of heterogeneity.Results: A total of 33 articles were included. After homogenization, the overall usage of therapeutic interventions accounts for 77% (95%CI74%-81%) in all ERCP procedures. After excluding outlier studies, the estimation of therapeutic procedure success rate is 74% (95% CI 69 %-79%), adverse events rate is 8% ( 95% CI 6 %-10%). In our study, stent placement is the most common procedure which makes up 75% (95%CI 65%-86%) of all therapeutic procedures. In addition, the usage proportion of sphincterotomy (ST), stone extraction/removal, bougienage/Balloon dilation is respectively 46% (95% CI 39 %-53%), 34% (95% CI 31%-38%), and 26% (95% CI 22%-29%).Conclusions: ERCP procedure is gradually considered as a therapeutic technique in pediatric patients, the proportion of therapeutic ERCP is 77% of total usage, which is increasing by the year. Meanwhile, its success rate is relatively high. It reflects that this operation modality is promising in the treatment of Hepato-pancreato-biliary disorders and is gradually expanded as more branch technologies are being used. A variety of operations can be achieved through ERCP procedures, and more functions should be developed in the future.
Metastatic extraocular sebaceous carcinoma: a case report and review of literature
Authors: TAOUFIK Hind , BOUJGUENNA Imane , BENLAASSEL Oumnia AIT , BELBACHIR Anass , RAIS Hanane , BENCHAMKHA Yassine , HOCAR Ouafa , AMAL Said 
Published: March 2022

Abstract
Background: Sebaceous carcinomas are rare, aggressive, malignant tumors that arise from sebaceous glands. They can be ocular or extraocular. They exhibit a variety of histologic growth patterns and diverse clinical presentations. Metastases are rarely reported.Observation: A 79 year old woman presented to our department with a quickly enlarging nodule involving the mid part of her forehead 2 weeks before admission. Histological examination found a sebaceous carcinoma. The patient underwent a total excision of the lesion, and was scheduled for Radiotherapy. She was lost to follow and returned 6 months later with a right latero cervical mass related to lymph node metastasis.Conclusion: Extraocular sebaceous carcinomas represent about 25% of all sebaceous carcinomas. The available literature on treatment recommends wide surgical excision with tumor-free margins with removal of regional lymph nodes, followed sometimes by adjuvant radiotherapy. Unlike our case where the evolution was quickly aggressive, these tumors were classically considered to be a less offensive neoplasm than their ocular equivalent.
Image Segmentation with Boundary-to-Pixel Direction and Magnitude Based on Watershed and Attention Mechanism
Authors: Xu Hongyang , Xing Yuanxiu , Wang Wenbo 
Published: March 2022

Abstract
An improved image segmentation algorithm with boundary-to-pixel direction and magnitude (IS-BPDM) is proposed to deal with small regions segmentation while keeping the accuracy of edge segmentation. First, we develop a BPDM network embedded with watershed and attention module and use an adaptive loss function to achieve each pixel’s robust and accurate BPDM which is defined as a two-dimensional vector, including direction and magnitude, and pointing from its nearest boundary pixel to itself. Then, we use the leaned BPDMs to obtain the refined initial segmented regions by considering the pixels near boundary have shorter magnitude and near root pixels have longer magnitude, meanwhile adjacent pixels in different regions or nearby pixels on both sides of root pixel in same region have opposite directions and nearby pixels in same region have similar directions. Last, we utilize a fast grouping method according to direction similarity to combine these initial segmented regions into final segmentation. The experimental results show that compared with the state-of-art methods in image segmentation, the IS-BPDM approach proposed in this paper achieves better segmentation accuracy and high computational efficiency, and outperforms in small regions segmentation on public datasets.
Influence of public health and infection control interventions during the severe acute respiratory syndrome coronavirus 2 pandemic on the in-hospital epidemiology of pathogens: In hospital versus community circulating pathogens
Authors: Dapper Laura , Dick Aline , Nonnenmacher-Winter Claudia , Günther Frank 
Published: March 2022

Abstract
Background: The first detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Germany was reported in early February 2020. In addition, extensive control measures on the coronavirus disease 2019 (COVID-19) pandemic have been placed in Germany since March 2020. These include contact and travel restrictions, distance rules, mandatory wearing of face masks and respirators, cancellation of mass events, closures of day-care centers, schools, restaurants and shops, isolation measures, and intensified infection control measures in medical and long-term care facilities. Changes in demand or access to health care services and intensified control measures can lead to changes in transmission dynamics and imply effects on the overall occurrence of infectious diseases in hospitals.Methods: To analyze the impact of infection control measures implemented in public on infectious diseases in hospitals, surveillance data from Marburg University Hospital were analyzed retrospectively. The analysis was conducted from January 2019 to June 2021, referred to hospital occupancy and mobility data in the county of Marburg-Biedenkopf, and correlated to control measures in hospitals and the general population.Results: The COVID-19 pandemic and associated measures immediately impacted the occurrence of infectious diseases at the Marburg University Hospital. Significant changes were detected for virus-associated respiratory and gastrointestinal diseases. The massive drop in norovirus infections was significantly affected by the onset of the pandemic (P = 0.028). Similar effects were observed for rotavirus (up to -89%), respiratory syncytial virus (up to -98%), and adenovirus infections (up to -90%). The decrease in gastrointestinal and respiratory virus detection rates was significantly affected by the decline in mobility (P < 0.05). Of note, since April 2020, there have been no detected influenza cases. Furthermore, Clostridioides difficile-related infections declined after late 2020 (- 44%). In contrast, no significant changes were detected in the prevalence of susceptible and drug-resistant bacterial pathogens. In particular, the detection rates of methicillin-resistant Staphylococcus aureus isolates or multidrug resistant (MDR) and extended drug resistant (XDR) bacteria remained constant, although the consumption of hand disinfectants and protective equipment increased.Conclusions: The COVID-19 pandemic and associated public health measures had a significant impact on infectious diseases and the detection of pathogens at the Marburg University Hospital. Significant changes were observed for community transmissible infections, while no such effects on pathogens primarily associated with nosocomial transmission could be detected.
Numerical analysis on long-term shifts of mixing regime and nutrient status in Lake Biwa under climate change
Authors: Zhou Jinxin , Yoshida Takero , Kitazawa Daisuke 
Published: March 2022

Abstract
As global awareness of the climate-related freshwater quality heightens, research on lakes, as sentinels of climate change, has been and will continue to be valuable. The effects on lakes include mixing regime and nutrient status. Although the effects on mixing regime are investigated worldwide, a research gap exists for nutrient status. Lake Biwa, the largest lake in Japan, experienced multiple environmental problems over the last 60 years with a well-recorded monitoring dataset. By validating the numerical model with monitoring data, a holistic understanding has been obtained. The mixing regime was represented by the overturn, and there exists an approximate one-month difference in the onset of overturn over the simulation period. The phosphorus nutrient is the limiting one and has been successfully controlled based on simulation results. Moreover, regarding the freshwater quality issue of hypoxia problem, a linear relationship exists between the concentration of dissolved oxygen (DO) and the concentration of dissolved inorganic phosphorus (DIP), indicating that further limiting the DIP loads is an effective and practicable solution proposal to alleviate hypoxia. Because climate change induces slow onset events, continuous works are necessary to serve a better management strategy of Lake Biwa and lakes elsewhere.
Clinical outcomes and safety of PD-1 inhibitors therapy in elderly patients with advanced gastric cancer
Authors: Zhou Juanjuan , Cai Yunlong , Chen Zhen , Zhang Xiaomei , Xiang Xiaojun 
Published: March 2022

Abstract
Background
Immunotherapy is currently the standard regimen for the first-line treatment of gastric cancer. Nonetheless, the efficacy and safety of PD-1 inhibitors in the treatment of elderly patients with advanced gastric cancer remain uncertain.
Methods
A retrospective analysis was performed on 51 patients aged ≥ 65 years subjected to anti-PD-1 antibody therapy in the First Affiliated Hospital of Nanchang University between January 2018 and May 2021. We analyzed related factors of the patients.
Result
Only 15.7% of all patients experienced immune-related events. Objective response rate (ORR) and disease control rate (DCR) of patients were 31.4% and 78.4%, respectively. First-line treatment was associated with a better ORR. In univariate analysis, two or more distant metastatic organs, high LDH group, and non-excellent LIPI score group were associated with low MPFS and MOS ([HR, 3.745; CI, (1.667–7.244); P < 0.05], [HR, 2.304; CI, (1.137–4.670); P < 0.05], [HR, 2.822; CI, (1.314–6.059); P < 0.01], [HR, 3.024; CI, (1.191–7.677); p < 0.05], [HR, 3.050; CI, (1.302–7.147); p < 0.05], [HR, 2.607; CI, (1.060–6.407); P < 0.05]. First-line therapy was associated with better MOS (P < 0.05). Additionally, the number of distant metastatic organs was an independent prognostic risk factor for PFS.
Conclusions
In summary, treatment with PD-1 inhibitors on elderly patients with advanced gastric cancer yield satisfactory curative effect and manageable safety. Thus, elderly individuals with gastric cancer could greatly benefit from the first-line treatment use of PD-1 inhibitors.
Temporal Trends of Medical Cost and Cost-Effectiveness in Sepsis Patients -A Japanese Nationwide Medical Claims Database-the Japan Sepsis Alliance (JaSA) Study Group
Authors: Oami Takehiko , Imaeda Taro , Nakada Taka‑aki , Takahashi Nozomi , Yamao Yasuo , Nakagawa Satoshi , Ogura Hiroshi , Shime Nobuaki , Umemura Yutaka , Matsushima Asako , Fushimi Kiyohide 
Published: March 2022

Abstract
Background:Sepsis is the leading cause of death worldwide. Although the mortality of sepsis patients has been decreasing over the past decade, the trend of medical costs and cost-effectiveness for sepsis treatment remains insufficiently determined.Methods:We conducted a retrospective study using the nationwide medical claims database of sepsis patients in Japan between 2010 and 2017. After selecting sepsis patients with a combined diagnosis of presumed serious infection and organ failure, patients over the age of 20 were included in this study. The primary outcome was the annual trend of the effective cost per survivor, calculated from the gross medical cost and number of survivors per year. Subsequently, we performed subgroup and multiple regression analyses to determine the significant predictors contributing to an increase in medical cost.Results:Among 50,490,128 adult patients with claims, a total of 1,276,678 patients with sepsis were selected from the database. Yearly gross medical costs to treat sepsis gradually increased over the decade from $3.04 billion in 2010 to $4.38 billion in 2017 (rate = + $0.2 billion/year, p < 0.0001), whereas the total medical cost per hospitalization declined (rate = - $1,001/year, p < 0.0001). While the survival rate of sepsis patients improved during the study period, the effective cost per survivor significantly decreased (rate = - $1,723/year, p = 0.001). In the subgroup analysis, the gross medical cost of the late elderly (75 ≤ age) showed the highest coefficient throughout the time period, despite the lowest medical cost per person. While gender (male), number of chronic diseases, intensive care unit (ICU) admission, length of hospital stay, and site of infection (blood, heart, and meninges/brain/spinal cord) contributed to an increase in medical costs, an increase in age, admission year, and other types of infection (abdominal, bone and soft tissue, respiratory, and urogenital) were significant predictors of reduced medical costs.Conclusions:We demonstrated an increase in annual gross medical costs with an improvement in annual cost-effectiveness in patients with sepsis between 2010 and 2017. Among the various factors altering medical costs, gender (male), number of chronic diseases, ICU admission, length of hospital stay, and specific types of infection were associated with increased medical expenses.
Genome mining reveals polysaccharide-degrading potential and new antimicrobial gene clusters of novel intestinal bacterium Paenibacillus jilinensis sp. nov
Authors: Ma Ke , Chen Wei , Yan Shi-Qing , Lin Xiao-Qi , Liu Zhen-Zhen , Zhang Jia-Bao , Gao Yu , Yang Yong-Jun 
Published: March 2022

Abstract
BackgroundDrug-resistant bacteria has posed a great threat to animal breeding and human health, it is obviously urgent to develop new antibiotics that can effectively combat drug-resistant bacteria. The commensal flora inhabited in the intestines become potential candidates owing to the production of a wide range of antimicrobial substances. In addition, host genomes do not encode most enzymes needed to degrade dietary structural polysaccharides, the decomposition of these polysaccharides mainly depends on gut commensals-derived CAZymes.Resultswe report a novel species isolated from the chicken intestine, designated as Paenibacillus jilinensis sp. nov. and with YPG26T (=CCTCC M2020899T) as type strain. The complete genome of P. jilinensis YPG26T consists of a single circular chromosome of 3.97 Mb in length, with a G+C content of 49.34% (mol %). It carries 33 rRNA genes, 89 tRNA genes, and 3871 protein-coding genes among which abundant carbohydrate degrading enzymes (CAZymes) are encoded. Moreover, this strain has capability to antagonize multiple pathogens in vitro, we identified putative 6 BGCs encoding bacteriocin, NRPs, PKs, terpenes and protcusin by genome mining. In addition, antibiotic susceptibility testing showed sensitivity to all antibiotics tested.ConclusionsThis study highlights the varieties of CAZymes genes and BGCs in the genome of Paenibacillus jilinensis. These findings confirm the beneficial function of gut microbiota, and also provide a promising candidate for the development of new carbohydrate degrading enzymes and antibacterial agents.
Clinical Effectiveness of Perioperative EPO combine with Iron sucrose Treatment in Total Knee Arthroplasty Surgery：Not blinded， prospective randomized clinical trial of efficacy and safety
Authors: Yusufu Yalikun , Ren Ke , Li Yong gang , Wang Chen , Lu Jun 
Published: March 2022

Abstract
Trial design:
The purpose of this study was prospectively analyzing the effect of EPO combined with Iron sucrose on postoperative anemia prevention and prognosis of patients with TKA.
Methods
Participants in this study will be randomly assigned to treatment group or control group. Patients in the treatment group will perioperatively receive EPO for 10 days combined with iron sucrose injection for 3 days preoperative. The general data, hematological indexes, transfusion rate, total blood loss and knee joint function score will be analyzed.
Results
92 patients met the inclusion criteria, including 46 patients in the treatment group and 46 patients in the control group. There were no significant statistical differences in descriptive characteristics of the population between two groups. The results indicated that the anemic rate of the treatment group was significantly lower than control group after treatment (67.4%vs93.5%, P = 0.001). The hematological index also has significantly difference in two group. Such as Postoperative Hb, RBC count, Hct. The treatment group perioperative blood loss was significantly lower than control group (587.69 ± 340.81ml vs. 812.72 ± 329.7ml, P = 0.002). The treatment group shows better in HSS score and WOMAC score (HSS score: P = 0.007; WOMAC score: P = 0.001), HSS score improved 3.37 points and WOMAC score improved 12.08 points after operation than control group. No postoperative blood transfusion and postoperative complications occurred in the study period.
Conclusions
According to our study, we found that perioperative treatment of erythrocyte mobilization in patients with TKA can improve postoperative hemoglobin level, reduce postoperative total blood loss, and reduce postoperative anemic rate without increased drug cost on the hospitalization expenses. Patients received erythrocyte mobilization treatment can significantly accelerate the erythropoiesis after surgery, promote the hemoglobin level return to normal more quickly. The patiens after treatment shows advantage at HSS score and WOMAC score.
Pulmonary artery banding as adjunct therapy for ventricular recovery after ALCAPA-repair: a case report
Authors: Mets Gilles , Bové Thierry , François Katrien , Vandekerckhove Kristof , Panzer Joseph 
Published: March 2022

Abstract
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital coronary anomaly commonly associated with severe but reversible left ventricular (LV) dysfunction. We present an ALCAPA case of persisting left ventricular failure with inability to wean off the ventilator and inotropes after successful coronary reimplantation, in whom pulmonary artery banding enabled bridging to myocardial recovery. Pulmonary artery banding may be considered as a bridge-to-recovery in selected cases of severe left ventricular dysfunction after ALCAPA-repair.
An Objective System for Quantitative Assessment of Television Viewing Among Children (Family Level Assessment of Screen Use in the Home-Television): System Development Study
Authors: Vadathya Anil Kumar , Musaad Salma , Beltran Alicia , Perez Oriana , Meister Leo , Baranowski Tom , Hughes Sheryl O , Mendoza Jason A , Sabharwal Ashutosh , Veeraraghavan Ashok , O'Connor Teresia 
Published: March 2022

Background
Television viewing among children is associated with developmental and health outcomes, yet measurement techniques for television viewing are prone to errors, biases, or both.

Objective
This study aims to develop a system to objectively and passively measure children’s television viewing time.

Methods
The Family Level Assessment of Screen Use in the Home-Television (FLASH-TV) system includes three sequential algorithms applied to video data collected in front of a television screen: face detection, face verification, and gaze estimation. A total of 21 families of diverse race and ethnicity were enrolled in 1 of 4 design studies to train the algorithms and provide proof of concept testing for the integrated FLASH-TV system. Video data were collected from each family in a laboratory mimicking a living room or in the child’s home. Staff coded the video data for the target child as the gold standard. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were calculated for each algorithm, as compared with the gold standard. Prevalence and biased adjusted κ scores and an intraclass correlation using a generalized linear mixed model compared FLASH-TV’s estimation of television viewing duration to the gold standard.

Results
FLASH-TV demonstrated high sensitivity for detecting faces (95.5%-97.9%) and performed well on face verification when the child’s gaze was on the television. Each of the metrics for estimating the child’s gaze on the screen was moderate to good (range: 55.1% negative predictive value to 91.2% specificity). When combining the 3 sequential steps, FLASH-TV estimation of the child’s screen viewing was overall good, with an intraclass correlation for an overall time watching television of 0.725 across conditions.

Conclusions
FLASH-TV offers a critical step forward in improving the assessment of children’s television viewing.