bluuebunny/crossref_metadata_2025 huggingface dataset:
Nimodipine reduces delayed cerebral vasospasm after intracranial tumor surgery: a retrospective study
Authors: Yu Ying , Li Yunqian , Jin Zheng , Chen Fan
Published: August 2020

Background：Cerebral vasospasm (CVS) is a serious neurosurgical complication. This retrospective study was performed to analyze if nimodipine can improve prognosis and reduces ischemia secondary to delayed CVS after intracranial tumor surgery.Methods：Retrospective analysis of 94 patients with an anterior cranial fossa tumor and underwent intracranial tumor surgery was performed, with 42 cases treated with normal saline and 52 cases treated with nimodipine solution. Transcranial Doppler ultrasonography was used to measure velocity in the middle cerebral artery (MCA) and the distal extracranial internal carotid artery (eICA). An examination was conducted 1 day before surgery and 1, 3, 5, 7, and 14 days after surgery. Follow-up was performed using the Glasgow Outcome Scale (GOS) 3 months after discharge.Results：We showed that in the nimodipine group, CVS occurred in 13 (25%) patients who did not have CVS in the first three days after operation; nine patients had CVS between 4 and 7 days, and 4 had CVS between 8 and 14 days. In the normal saline group, nineteen (45%) patients had CVS, 3 presented with CVS within 3 days, 11 between 4-7 days and 5 between 8-14 days. A significant difference in the occurrence of CVS was observed between the two groups. Preoperative and postoperative the MCA velocities were compared, revealing a significant change in the normal saline group (P < 0.05) but not in the nimodipine group. Furthermore, significant differences in the outcome were observed between the two groups at the 3-month follow-up (P < 0.05).Conclusions：Nimodipine markedly improves prognosis and significantly reduces ischemia secondary to delayed CVS after intracranial tumor surgery, as well as the risks of mortality and morbidity.
Mixed Method Synthesis of Cognitive interviews with Kenyan peripartum adolescents: Testing EPDS and PHQ questionnaires in Nairobi primary care settings
Authors: Kumar Manasi , Huang Keng-Yen , Othieno Caleb , Kagoya Martha , Nyongesa Vincent , Unutzer Jurgen , Saxena Shekhar , McKay Mary
Published: August 2020

Background: Cognitive interviewing is a well-recognized methodology to identify clinical and commonsensical relevance of mental health questionnaire items by our research participants. Depression is amongst the most common condition impacting pregnant and parenting adolescents in sub-Saharan Africa (SSA). In Kenya, studies have reported depression prevalence estimates of 12-50% in peripartum adolescents. While young people prefer using English, there has not been enough data to point to how well they respond to Kiswahili translations of the commonly used tools.Method: Thirty-two participants between ages 14-18 years were approached and through informed consent for them to participate. We used Edinburgh Postnatal Depression Scale (EPDS) and Patient Health Questionnaire-9 (PHQ-9) in English and Kiswahili versions to carry out the interviews and were coded along four domains of comprehension, retrieval, judgement and patient response. Scores were tabulated for all participants and simple reliability analyses were offered. The interviews were discussed within the team and tables were shared between three raters for further consensus. The interview transcripts were analyzed manually using thematic analysis.Discussion: We found that adolescents had challenges in fully understanding items in both set of tools however, EPDS was better received than PHQ-9. Psychometrically, EPDS English version and Kiswahili versions fared better than the PHQ-9 English and Kiswahili versions. PHQ-9 presented considerable issues with regards to semantic clarity however had simpler response options in comparison to EPDS which was more experientially appropriate, but response options were not simple. On our thematic analysis we felt that the adolescents were significantly challenged by the new, unanticipated pregnancy or motherhood experience. Poverty, poor partner support, discord with parents and distress in the family, and traumatic end of supportive and helpful relationships were the notable problems.Conclusion: While sensitive cross-cultural translations for the commonly used open access depression tools is critical, it is also pertinent to understand whether these are developmentally appropriate. Our participants had multiple psychosocial and material challenges that necessitate measures sensitive to their age, social context and health experiences. Additionally, we felt that both the tools may not be suitable for self-administration and may need involvement of a case worker or community health worker.
Examination of Cerebral Aneurysm by Scanning Acoustic Microscopy
Authors: Tanoren Bukem
Published: August 2020

Background: Asymptomatic intracranial aneurysms rupture without any warning, therefore, use of high-resolution imaging techniques for the rupture risk assessment is essential. Methods: This study’s goal is to assess the feasibility of scanning acoustic microscopy (SAM) in the characterization of cerebral aneurysm. The aneurysm’s dome samples were obtained from 12 different patients with and without subarachnoid hemorrhage. Results: The acoustic impedance values are found statistically higher in samples from female patients than in samples from male patients. On the other hand, sample from a male patient without subarachnoid hemorrhage has higher acoustic impedance value when compared with samples from male patients with subarachnoid hemorrhage, however, this discrepancy is not observed in female patients. Conclusion: In summary, the success of SAM in monitoring the altering acoustic impedance values in male and female patients with and without subarachnoid hemorrhage indicates the potential of SAM for the diagnosis of instability of cerebral aneurysms.
Impact of Variant-level Batch Effects on Identification of Genetic Risk Factors in Large Sequencing Studies
Authors: Wickland Daniel P , Ren Yingxue , Sinnwell Jason P , Reddy Joseph S , Pottier Cyril , Sarangi Vivekananda , Carrasquillo Minerva M , Ross Owen A , Younkin Steven G , Ertekin-Taner Nilüfer , Rademakers Rosa , Hudson Matthew E , Mainzer Liudmila Sergeevna , Biernacka Joanna M , Asmann Yan
Published: August 2020

Background: Genetic studies have shifted to sequencing-based rare variants discovery after decades of success in identifying common disease variants by Genome-Wide Association Studies using Single Nucleotide Polymorphism chips. Sequencing-based studies require large sample sizes for statistical power but often inadvertently introduce batch effects because samples are typically collected, processed, and sequenced at multiple centers. Conventionally, batch effects are first detected and visualized using Principal Components Analysis and then controlled by including batch covariates in the disease association models. For sequencing-based genetic studies, because all variants included in the association analyses have passed quality control measures, this conventional approach treats every variant as equal and ignores the substantial differences still remaining in variant qualities and characteristics such as genotype quality scores, alternative allele fractions (fraction of reads supporting alternative allele at a variant position) and sequencing depths.

Results: In the Alzheimer’s Disease Sequencing Project (ADSP) exome dataset of 9,904 cases and controls, we discovered hidden variant-level differences between sample batches of three sequencing centers and two exome capture kits. Although sequencing centers were included as a covariate in our association models, we observed differences at the variant level in genotype quality and alternative allele fraction between samples processed by different exome capture kits that significantly impacted both the confidence of variant detection and the identification of disease-associated variants. Furthermore, we found that the association signals of a subset of top disease risk variants came exclusively from samples processed by one exome capture kit that was more effective at capturing the alternative alleles compared to the other kit.

Conclusions: Our findings highlight the importance of additional variant-level quality control for large sequencing-based genetic studies. More importantly, we demonstrate that automatically filtering out variants with batch differences may lead to false negatives if the batch discordance came largely from quality differences and if the variants from one batch had better quality scores.
Machine learning models for predicting lymph node and distant metastases in colorectal cancer
Authors: Dai Xiaoyu , Dai Siqi , Yang Xi , Zhuang Jing , Liu Jin , Han Shuwen
Published: August 2020

Background: Colorectal cancer (CRC) is the third most common malignancy in the world and metastasis is responsible for a major proportion of the cancer-related deaths in CRC patients.Aims: To construct machine learning models for predicting lymph node and distant metastases in colorectal cancer and analyze biological functions features of metastasis-related genes.Methods: RNA-seq and miRNA-seq data as well as corresponding clinical data from colon adenocarcinoma (COAD) and rectum adenocarcinoma (READ) were obtained from The Cancer Genome Atlas (TCGA) database. The differentially expressed RNAs (DE-RNAs) in non-LNM (N0) and LNM (N1/N2) as well as non-distant metastases (M0) and distant metastases (M1) were analyzed. Six machine learning models including logistic regression (LR), random forest (RF), support vector machine (SVM), Catboost, gradient boosting decision tree (GBDT), and artificial neural network (NN) were constructed to predict cancer metastasis and the feature genes of the optimal model were further analyzed by functional enrichment, protein-protein interaction (PPI) network, and drug-target analyses.Results: Differential RNA expression profiles of LNM and non-LNM as well as M0 vs. M1 were observed in both COAD and READ samples. NN model was determined to be the optimal model for predicting distant metastases, while Catboost and LR models were the optimal models for predicting LNM in COAD and READ samples, respectively. PPI analysis indicated that KIR2DL4, chemokine-related genes CXCL9/10/11/13 and CCL25, and gamma-aminobutyric acid (GABA) receptor genes (GABRR1, GABRB2 and GABRA3) were key genes in metastasis. In addition, atorvastatin and eszopiclone were identified as potential therapeutic agents as they target these genes.Conclusions: We constructed six machine learning models for predicting colorectal cancer metastases and identify the optimal model. We analyzed biological functions features of metastasis-related RNAs in colorectal cancer.
Nestin+ Cells Isolated From The Peritoneum Attenuate Peritoneal Fibrosis Via Suppressing IL-33 /ST2 Signaling
Authors: Zhou Ying , Shentu Yangping , Ma Shuqing , Ye Simin , Jiang Nan , Zhao Zongyuan , Bai Yongheng , Liu Xiaoyuan , Chen Hao , Yang Dicheng , Jiang Huanchang , Zheng Chenfei , Chen Chaosheng
Published: August 2020

Background

The intermediate filament protein Nestin, a specific marker for multifunctional, multilineage progenitor cells, is regulated during the progression of reparative and reactive fibrosis in the liver, heart and kidney. However, whether Nestin regulates peritoneal fibrosis via suppressing IL-33/ST-2 signaling is unclear.
Methods

High-glucose peritoneal dialysis solution (PDS) or TGF-β1 was administered to a mouse peritoneal dialysis (PD) model to induce peritoneal fibrosis (PF) in vivo and to human peritoneal mesothelial cells (HPMCs) in vitro to stimulate accumulation of extracellular matrix (ECM). Nestin+ cells isolated from the peritoneum of Nestin-green fluorescent protein (GFP) transgenic mice were transplanted in vivo, and adeno-associated virus (AAV)-RNAi was used to silence IL-33 in vitro.
Results

Notably, Nestin was found in both the mouse peritoneum and HPMCs derived from PD effluent (PDE) and HMrSV5. These Nestin+ PMCs showed extensive proliferation for more than 20 passages. The mice that received chronic PDS infusions showed typical features of PF, including substantially increased peritoneal thickness, excessive matrix deposition, increased peritoneal permeability, and increased expression levels of α-smooth muscle actin (α-SMA) and collagen I (Col I). Nestin+ cells isolated from the peritoneum could significantly ameliorate these pathological changes. A parallel decrease in interleukin-33 (IL-33) and ST-2 accumulation in the peritoneum of Nestin+ cell-transplanted mice was observed. In addition, downregulation of IL-33 expression increased TGF-β1-induced ECM in the HPMCs.
Conclusion

Nestin+ cells isolated from the peritoneum had a clear protective effect on high-glucose PDS-induced PF by suppressing IL-33/ST-2 signaling.
Public Utilization of Face Masks in Brazil During COVID-19 Pandemic Outbreak: Temporal Trend Analysis
Authors: Pereira-Ávila Fernanda Maria Vieira , Botelho Eliã Pinheiro , Góes Fernanda Garcia Bezerra , Gir Elucir , Sousa Laelson Rochelle Milanês , Caldeira Natália Maria Vieira Pereira , Silva Ana Cristina de Oliveira e , Lam Simon Ching
Published: August 2020

Background: The coronavirus disease 2019 (COVID-19) has recorded approximately 8.6 million confirmed cases and more than 450.000 deaths worldwide. As of today, Brazil remains the second most affected country, with more than 1 million confirmed cases and more than 50,000 related deaths. This study aimed to evaluate the temporal trend of the frequency of face mask use among Brazil’s general population.Method: A cross-sectional survey method was adopted in this study. Online survey regarding sociodemographic and protective personal measures against COVID-19 was used to collect data. Data were collected from April 17 to May 15, 2020. The frequency of face mask use was divided into five categories: “never,” “rarely,” “sometimes,” “frequently,” and “always.” Joinpoint regression model was employed to analyze the daily percentage change (DPC) of each category. Ethics aspects were considered.Results: A total of 14,756 volunteers comprised the study sample. The “frequently” and “always” categories represented 71% of the sample, with the former being superior to the latter (39.4% vs. 31.6%, respectively). Temporal trend analysis showed two trend periods for all categories. The “never,” “rarely,” and “sometimes” categories decreased in the first period and stabilized in the second period. Conversely, the “frequently” and “always” categories showed an upward trend. Like other categories, the “frequently” category had stabilized in the second period. However, the “always” category still showed an increasing trend in the second period. The association analysis results showed a decrease in the use of face masks in women, postgraduate people, those aged above 35 years, and those earning more than seven times the federal monthly income minimal wage. However, the use of masks increased among young people and those with elementary to graduate degrees. The “always” use of face masks increased in the south and decreased in the southeast of Brazil. Conclusion: The preponderance of the “frequently” category and the slow DPC in the second trend period of the “always” category suggest the necessity of further enforcement of the use of face masks in Brazil. The adaptation of this new habit among Brazilians is time demanding, and thus strategies must be implemented in a more natural way.
The Effects of Caregiving on Leisure Time Physical Activity in a Cohort of Manufacturing Workers: A Cross-Sectional Study.
Authors: Garza Jennifer , Cavallari Jennifer , Dugan Alicia , Namazi Sara , Fortinsky Richard , Cherniack Martin
Published: August 2020

Background

While leisure time physical activity (LTPA) has been linked to a myriad of health benefits, many individuals do not get enough LTPA. In this study, we investigated how caregiving responsibilities (for children, adults under age 65, and adults over age 65) affected components of LTPA including exercise, walking, gardening, and housework in a population of manufacturing workers.
Methods

A cross-sectional study was performed among 857 manufacturing workers who completed a survey assessing caregiving responsibility and LTPA. Linear regression analyses were used to test for associations between caregiving and LTPA.
Results

We observed that caregivers for children reported significantly (p < 0.05) fewer hours of exercise and walking, but more hours of housework, than non-caregivers. We observed no association between caregiving for adults under age 65 or adults aged 65 and older and exercise or walking. Caring for adults under age 65 was associated with a significant (p < 0.05) increase in hours spent gardening, and caring for adults aged 65 and older was associated with a significant increase in hours spent performing housework.
Conclusions

We identified associations between caregiving and physical activity in a population of manufacturing workers. Our results support the development of targeted interventions to promote health in working caregiver populations.
How to Identify White Coat Hypertension at The First Diagnosis: Establishment of A Scoring Model for The Differential Diagnosis of White Coat Hypertension and Sustained Hypertension
Authors: Cai Peng , Peng Yan , Chen YuXi , Wang Yan , Wang Xukai
Published: August 2020

Background: To establish a scoring model for the differential diagnosis of white coat hypertension (WCH) and sustained hypertension (SHT). Methods: 553 adults with elevated office blood pressure, normal renal function and no antihypertensive drugs were included in this study. 17 parameters, such as gender and age, were obtained by questionnaire investigation and biochemical index detection. WCH and SHT were distinguished by 24-hour ambulatory blood pressure monitoring. Participants were randomly divided into a training set (445 cases) and a verification set (108 cases). In the training set, the above parameters were screened by LASSO regression and univariate logistic regression analysis, then, the scoring model was constructed through multivariate logistic regression analysis. ROC curve and calibration curve were used to discuss the discrimination and calibration of this scoring model respectivelyResults: 6 parameters were finally selected, namely isolated systolic hypertension, systolic blood pressure, diastolic blood pressure, triglyceride, serum creatinine, and cardiovascular and cerebrovascular diseases. Multivariate logistic regression was used to establish the scoring model. The R2 and AUC of the scoring model in the training set were 0.163 and 0.705, respectively. In the verification set, the R2 of the scoring model was 0.206, and AUC was 0.718. The calibration test results showed that the scoring model had good stability in both training set and verification set (MSE=0. 001, MAE=0. 014; MSE=0. 001, MAE=0. 025, respectively).Conclusion: A stable scoring model for distinguishing WCH can be established, which can assist clinical medical workers to identify WCH at the first diagnosis.
Sex-specific recombination predicts parent of origin for recurrent genomic disorders
Authors: Mosley Trenell , Johnston H. Richard , Cutler David J , Zwick Michael E , Mulle Jennifer G
Published: August 2020

Genomic disorders are caused by structural rearrangements of the genome that generally occur during meiosis. Often the rearrangements result in large-scale (> 1 kb) copy number variants (CNV; deletions or duplications ≥ 1 kb). Recurrent pathogenic CNVs harbor similar breakpoints in multiple unrelated individuals and are primarily formed via non-allelic homologous recombination (NAHR). Several pathogenic NAHR-mediated recurrent CNV loci demonstrate biases for parental origin of de novo CNVs. However, the mechanism underlying these biases is not well understood. Here we have curated parent of origin data for multiple pathogenic CNV loci and demonstrate a significant association between sex-specific differences in meiotic recombination and parental origin biases at these loci. Our results suggest that parental-origin of CNVs is largely controlled by sex-specific recombination rates, and highlight the need to consider these differences when investigating mechanisms that cause structural variation.
Identification of Key Genes and miRNA-mRNA Regulatory Pathways in Bronchopulmonary Dysplasia in Preterm Infants by Bioinformatics Methods
Authors: Sun Tong , Yu Haiyang , Fu Jianhua
Published: August 2020

Background: Bronchopulmonary dysplasia (BPD) remains a severe respiratory complication of preterm infants in neonatal intensive care units (NICUs). However, its pathogenesis has been unclear. Bioinformatics analysis, which can help us explore genetic alternations and recognize latent diagnostic biomarkers, has recently promoted the comprehension of the molecular mechanisms underlying disease occurrence and development. Methods: In this study, we identified key genes and miRNA-mRNA regulatory networks in BPD in preterm infants to elucidate the pathogenesis of BPD. We downloaded and analyzed miRNA and gene expression microarray datasets from the Gene Expression Omnibus database (GEO). Differentially expressed miRNA (DEMs) and differentially expressed genes (DEGs) were obtained through NetworkAnalyst. We performed pathway enrichment analysis using the Database for Annotation, Visualization and Integrated Discovery program (DAVID), Gene Ontology (GO), and Kyoto Encyclopedia of Genes and Genomes (KEGG). Then we used the STRING to establish protein–protein interactions and the Cytoscape tool to establish miRNA–mRNA regulatory networks. Results: We identified 19 significant DEMs and 140 and 33 significantly upregulated and downregulated DEGs, respectively. Functional enrichment analysis indicated that significant DEGs were associated with the antigen processing and presentation, and B-cell receptor signaling pathways in BPD. Key DEGs, such as CD19, CD79B, MS4A1, and FCGR2B were selected as hub genes in PPI networks. Conclusions: In this study, we screened out 19 DEMs that might play important roles in the regulatory networks of BPD. Higher expression of miRNAs such as miR-15b-5p, hsa-miR-32-5p, miR-3613-3p, and miR-33a-5p and lower expression of miRNAs such as miR-3960, miR-425-5p, and miR-3202 might be correlated with the process of BPD.
Analysis of MDR1 Polymorphisms Among HIV-Infected Individuals on ARV Therapy from Western India
Authors: Singh HariOm , Samani Dharmesh , Chauware Vijay , Dhole T.N
Published: August 2020

Background: MDR1 is involved in the transport of numerous drugs. Polymorphism of MDR1 is linked with the treatment outcome. ARV regimen is being used to manage the progression of HIV infection. Ethnic disparities have been observed in the distribution of MDR1 genotypes. Methods: MDR1 polymorphism (1236 C/T, 3435 C/T) was genotyped in 34 individuals with ARV-associated hepatotoxicity, 131 HIV-infected, and one-fifty-five healthy by utilization of PCR-RFLP. Results: Haplotype TC exposed the greater risk for hepatotoxicity severity when compared between individuals with hepatotoxicity and HIV infected (OR=1.96, P=0.06). While haplotypes TT and CC bared a reduce risk for hepatotoxicity severity (OR= 0.16, P=0.006; OR= 0.46, P=0.06). Haplotype TT and CC displayed a decrease risk of hepatotoxicity severity while compared between individuals with hepatotoxicity and healthy (OR=0.09, P=0.003; OR=0.34, P=0.03). A higher occurrence of MDR1 1236TT genotype was seen among patients with hepatotoxicity who consumed alcohol (28.6% versus 14.8%, OR=1.50). In patients with hepatotoxicity taking nevirapine, there was an increased incidence of MDR1 1236TT genotype in contrast with efavirenz (21.7% versus 9.1%, OR=2.11). In HIV-infected people taking nevirapine, MDR1 1236CT, 1236TT genotypes found to be increased compared with efavirenz (43.7% versus 33.3%, OR=1.66; 12.6% versus 8.3%, OR=1.96). A higher occurrence of MDR1 1236TT genotype has happened in hepatotoxicity cases having both alcohol and nevirapine (40.0% versus 16.67%, OR=2.21). Conclusion: MDR1 haplotypes may have an influence on the severity of hepatotoxicity. Individual utilizing nevirapine and alcohol with MDR1 1236TT and 3435CT genotypes may have combined effect on vulnerability of severity of hepatotoxicity and progression of HIV infection
Student Attendance at Pharmacology Lectures and Its Relation to Exam Performance in the Era of Lecture Capture: A Two-Year Analysis.
Authors: Powers Claud A , Carroll Mairead A.
Published: August 2020

Background: Students can now often choose to attend live lectures or review recordings of the lectures made using lecture-capture technology. However, data on lecture attendance in such cases is scarce, and there are few comparisons of the learning outcomes of the different learning approaches. This study reports data relevant to this issue. Methods: Attendance data was collected at 13 of 40 voluntary lecture sessions in the Medical Pharmacology course in Fall 2013 (192 students) and Fall 2014 (207 students) by use of an audience-response system. All 40 lectures were recorded using lecture-capture, and students could attend lectures or review the online recordings and PowerPoint files as desired. The data illuminated the features of student lecture attendance and its relation to exam performance. Results: Only 25-31% of students attended any given monitored lecture, and only 12-14% exhibited high attendance (>80%); 41-52% of students did not attend any monitored sessions. On average, exam scores of students with high lecture attendance were significantly higher than those of other students with a significant shift in scores to higher ranks. Exam scores of students with intermediate to low attendance (77-8%) did not differ from those of non-attending students. The exam scoring advantage associated with high attendance remained evident 20 weeks after the Fall semester when students took a comprehensive NBME exam in pharmacology. Conclusions: Only a small fraction of students had high attendance at live voluntary lectures providing foundational material. On average, students with high attendance had higher exam scores even though all students had unlimited access to the identical material on-line. The exam scoring advantage associated with high attendance appeared to be long-lasting. The data indicate that high attendance at live lectures was part of a very successful learning approach for some students.
The Effects of Protective Ventilation on the Production of Endogenous Melatonin and Prognosis in Patients Undergoing Esophageal Cancer Surgery: A Prospective Randomized Double-Blind Controlled Study
Authors: Wang Lixia , Li Jun , Huang Yuting , Zhu Yan , Shen Qiying , Zou Hongyun , Liu Xuesheng
Published: August 2020

Background: Exogenous melatonin exerts a similar effect to protective ventilation on attenuating ventilator-induced lung injury (VILI) by inhibiting NLRP3 inflammasome activation in mouse model. However, the effect of protective ventilation on the production of endogenous melatonin and prognosis in patients undergoing esophageal cancer surgery remains unknown. In this study, we aimed to reveal the effects of protective ventilation on the production of endogenous melatonin, interleukin (IL)-1β, IL-18 and major complications in patients undergoing esophageal cancer surgery. Methods: Eight-eight patients were randomized to receive “conventional” ventilation (Vt=10 mL/kg) or lung protective ventilation [Vt=5 mL/kg along with 5 cm of H2O positive end-expiratory pressure (PEEP)]. IL-1β, IL-18 and melatonin levels in bronchoalveolar lavage fluid (BALF) and serum were measured. Respiratory variables and outcomes were evaluated.Results: Lung protective ventilation decreased the peak airway pressure (Ppeak), plateau airway pressure (Pplat) and driving pressure (ΔP) compared with the “conventional” ventilation group. Lung protective ventilation inhibited polymorphonuclear (PMN) cells invasion into the BALF (P=0.000). Likewise, lung protective ventilation suppressed alveolar and serum IL-1β and IL-18 secretion after mechanical ventilation. Furthermore, lung protective ventilation resulted in a decrease in the inhibition of endogenous MT production compared to “conventional” ventilation (P=0.000). In addition, lung protective ventilation reduced the incidence of postoperative pulmonary complications (P=0.04) and the rate of major postoperative complications (P=0.023).Conclusions: Taken together, lung protective ventilation for esophageal cancer surgery suppressed the secretion of IL-1β, IL-18 and restored the endogenous melatonin level. Meanwhile, lung protective ventilation improved postoperative outcomes after esophageal cancer surgery.Trial registration: The Chinese Clinical Trial Registry, ChiCTR1900026190. Registered 25 September 2019, http://www.chictr.org.cn/edit.aspx?pid=34677&htm=4
Increase in Salivary Oxytocin Levels in Mothers After Tactile Contact Between Adiaper-like Nonwoven Sheet With Large Projectionsand the Palm: A Pilot Study
Authors: Sakamoto Takashi , Izumori Sayaka , Tomita Mina , Fukuda Yuko , Okuda Yasuyuki , Saito Naoko , Nakamura Junji
Published: August 2020

ObjectiveThe aim of this pilot study was to investigate whether or not tactile contact between a diaper-like nonwoven sheet with specific physical characteristics and the palm of the hand would increase the maternal level ofoxytocinwhich is one of the neuropeptides promoting formation of the mother-infant bond.ResultsTen healthy non-breastfeeding Japanese mothers were enrolled in this pilot study. We prepared diaper-like nonwoven sheets with large or small projections. Physical indices related to softness and fluffiness were higher in the sheet with large projections than in the sheet with small projections. Salivary oxytocin levels in the motherswere increasedafter tactile contact with thesheet with large projections, but not after contact with the sheet with small projections. This pilot study suggests that maternal oxytocin levels are increased by tactile contact between a soft and fluffy diaper sheet and the palm.
PHOENIX: A new framework for applying psychological theories to the adoption of innovations by healthcare professionals
Authors: Fahy Nick , Greenhalgh Trish , Shaw Sara
Published: August 2020

Background Although implementation science has borrowed concepts from psychology to explain how individuals think and act in relation to innovation adoption, the use of psychology has been limited and not well adapted to the aims and obligations of professionals. We aimed to enrich implementation science with a broader set of psychological theories relevant for professional behaviour, drawing particularly on the diffusion of innovations and stages of change models. Methods The study had two parallel components. The first was a hermeneutic review of how psychological theory has and could be used to understand innovation adoption by health professionals. The second component was an empirical case study of the implementation of guidance on routine HIV screening in three sites across two London hospitals. Primary data sources were synthesised and combined with emerging secondary research findings, each feeding into the other. Analysis focused empirically on how the stages of the diffusion of innovations adoption model (prior conditions, knowledge, persuasion, decision, implementation, confirmation) could be enriched by psychological theories. Results The hermeneutic review identified at least 20 relevant psychological theories from social, organisational, developmental and sports psychology; many of these were not single theories but contributions from domains of evolving research, making this an underestimate of potentially relevant theory. We developed a model (PHOENIX) to encapsulate how psychological theory can help illuminate each stage of adoption from diffusion of innovations theory: Person and History (prior conditions stage) – individuals’ characteristics and past experiences; Overload avoidance (knowledge stage) – filtering strategies when faced with overwhelming amounts of new knowledge; Evolving attitudes (persuasion stage) – a social process of collectively emerging views within a team; Networked decisions (decision stage) – decisions at two levels of the department combined with individual judgements; Implementation support (implementation stage) to turn an intention to act into actual action, with external supports valuable to reduce the cognitive effort required; uneXceptional (confirmation stage) – sustained effort to turn the new behaviour from a conscious innovation to a habit. Conclusions The PHOENIX model, if affirmed in further studies, has potential to enrich the study of innovation adoption by healthcare staff in organisational and professional contexts.
Rapid Response Team Activation After Major Hip Surgery: Patient Characteristics and Outcomes
Authors: Pritchard Angus , Jones Daryl , Bellomo Rinaldo , Hardidge Andrew , Harley Ian , Tan Chong Oon , Nazareth Justin , Guha Ranj , Ellard Louise , Hu Raymond , Churilov Leonid , Weinberg Laurence
Published: August 2020

Background: Rapid Response Teams (RRT) are a critical care resource that reviews deteriorating patients within the hospital. Whilst contemporary literature has focused on outcomes of RRTs, little is known about the detailed perioperative course and characteristics of patients who require RRT activation after major hip surgery. We aimed to describe demographic, preoperative, surgical, anesthetic and postoperative characteristics of patients who required RRT activation after major hip surgery. We also sought to assess if these characteristics affected mortality during the index hospital admission. Methods: We reviewed a RRT database of adult patients undergoing orthopedic surgery at a university teaching hospital. We then retrospectively reviewed the medical records to extract a priori defined patient, preoperative, surgical, anesthetic and postoperative data of major hip surgery admissions between September 2014 and December 2017. Patients who survived the index hospital stay were compared to those who died.Results: Overall, 187 patients had a postoperative RRT activations. Mean (SD) age was 82.1 (11.6) years; 125 (67%) were female and most patients had at least one significant comorbidity: mean (SD) Charlson Comorbidity Index (CCI) of 5.6 (2.1). The majority of patients (68%) were frail, ASA class 3 or greater (91%) and underwent non-elective surgery (88%). Median (IQR) time from surgery to RRT activation was 29.4 hours (11.3:75.0), and 25 (13%) patients had unplanned admissions to ICU/HDU. Compared to patients who survived RRT activation, those who died displayed higher CCI [6.5 (1.8) vs. 5.5 (2.1); p=0.02], were more frail (80.1% vs. 56.5%; odds ratio 3.2; 95%CI: 1.2 to 8.1; p=0.03) and received less intraoperative opioids [median (IQR) intravenous morphine equi-analgesia 5.8 (0.1:8.2) mg vs. 11.7 (3.7:19.0) mg; p=0.03]. They were also more likely to receive an urgent medical review prior to RRT activation (62% vs 40%; odds ratio 2.4; 95%CI: 1.1 to 5.6; p=0.05).Conclusions: Death after RRT activation occurred in 1 out of 7 patients undergoing major hip surgery. Common patient characteristics included advanced age (>82 years), frailty, high CCI and emergency surgery. Further studies investigating perioperative surveillance teams in the identification of the high-risk patients before surgery, and deteriorating patients after major hip surgery, are warranted.
Identification of Protein Phosphatase 1 Regulatory Subunit 3 as a Prognostic Biomarker in Patients with Gastric Cancer
Authors: Zhu Ya-Zhen , Liao Xi-Wen , Liu Yi , Mo Xian-Wei , Tang Wei-Zhong , Lin Yuan , Luo Shanshan
Published: August 2020

Background: The study aimed to determine: (1) The potential application of the protein phosphatase 1 regulatory subunit 3 (PPP1R3B) gene as a prognostic marker in gastric cancer (GC) and (2) The possible role of PPP1R3B in biological processes and pathways.Methods: The complete RNA-sequencing (RNA-seq) data and other relevant clinical and survival information was acquired from The Cancer Genome Atlas (TCGA). The univariate survival analysis with Cox regression model and Kaplan‐Meier analysis was used to investigate the association between clinical pathologic features and PPP1R3B gene expression. A genome-wide gene set enrichment analysis (GSEA) was also conducted to define the underlying molecular mechanism of the PPP1R3B gene in GC development.Results: The Log rank test and Cox regression identified the prognostic application of PPP1R3B expression in GC patients. Comprehensive survival analysis suggested that PPP1R3B might be an independent predictive factor for the survival time in patients with GC. The prognostic relationship between PPP1R3B and GC was also verified by the Kaplan–Meier plotter (KM plotter). Patients with a high expression of PPP1R3B were associated with a shorter clinical survival time. Additionally, GSEA demonstrated that PPP1R3B might be involved in multiple biological processes and pathways.Conclusions: Our findings demonstrated that the PPP1R3B gene could be used as a potential molecular marker for GC prognosis.
Effect of posterior cruciate ligament recession on knee joint pressure and joint space measured by an electronic pressure sensor during total knee arthroplasty
Authors: Zhao Ran , Liu Yanqing , Tian Hua
Published: August 2020

Purpose: The purpose of this study was to evaluate the change in posterior cruciate ligament (PCL) tension by directly measuring the pressure changes in the knee joint when the ligament was released or resected during total knee arthroplasty (TKA).Methods: We prospectively analysed 22 patients who underwent primary TKA (28 knees) between October 2019 and January 2020. The pressure changes in the medial and lateral compartment were measured with an electronic pressure sensor with PCL retention (at 0°, 45°, 90° and 120° of flexion), tibial recession and PCL resection, and changes in the knee joint space were measured.Results: At 0°, 45°, 90° and 120° of flexion, the total pressure in the knee joint after tibial recession of the PCL was significantly higher than with PCL resection, and higher than PCL recession, but only at 120°. Recession or resection of the PCL affected knee joint extension, and the medial/lateral pressure in the knee joint decreased. Pressure in the lateral compartment showed no significant change, while pressure in the medial compartment decreased significantly during knee flexion, which also led to a change in the ratios of the medial and lateral pressures in the knee joint. After resecting the PCL, the mean flexion and extension gaps increased by 0.64 mm and 0.46 mm, respectively.Conclusion: Tibial recession of the PCL can release the PCL while retaining some PCL function. PCL release affects both the flexion and extension gaps, and more cases will increase the flexion gap.
Effect and Safety of Naomaili Granules (脑脉利颗粒) for the Treatment of Acute Ischemic Stroke: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial
Authors: Li Xiaogang , Song Dongjing , Zhou Peiyang , Wang Huagang , Zhou Chengfang , Hu Bo , Li Wentao , Yang Dongdong
Published: August 2020

Background: It is of vital importance for the treatment and prognosis of Acute Stroke to find effective Chinese medicine that can be combined with western medicine in the acute stage. The purpose of this study is to investigate the effect and safety of Naomaili Granules (脑脉利颗粒, NML) for the treatment of acute stroke, hoping to provide a new idea and drug choice for the integrated treatment of Chinese and Western medicine in the acute stage of ischemic stroke, and at the same time to improve the treatment plan in the acute stage of ischemic stroke from the perspective of TCM syndromes. Methods: A total of 187 patients with acute ischemic stroke were randomly divided into the NML group (93 cases) and the placebo group (94 NML mimics), 1 bag (10g/bag), thrice daily for 20 days. Basic medications during the trial: Aspirin enteric-coated tablets, 1 tablet (0.1g/tablet), once a day. After treatment, the modified Rankin scale, the incidence of cardiovascular events and TCM Syndrome effect were the main efficacy indicators. Meanwhile, adverse events (AEs) were evaluated during the whole clinical trial. Results: In the FAS 90 days after the onset, the experimental group was 70.00%, and the control group was 45.24%. There was a statistically significant difference between the two groups. The incidence of acute cardio-cerebrovascular events was 1 case (1.08%) in the experimental group and 0 in the control group after 20 days of FAS treatment. Conclusion: The combined application of NML in the acute stage of ischemic stroke can effectively improve the prognosis of patients, and improve the independent survival ability of patients, and its safety is reliable, providing a new way of thinking and medication choice for the treatment of acute ischemic stroke with integrated traditional Chinese and western medicine.Trial registration: ChiCTR, ChiCTR2000033619. Registered 7 June 2020 - Retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=54619
A Central Nervous System Focused Treatment Program for People with Frozen Shoulder: A Feasibility Study.
Authors: Horno Silvia Mena-del , Moscardó Lirios Dueñas , Lluch Enrique , Louw Adriaan , Luque-Suárez Alejandro , Navarro-Ledesma Santiago , Bernat Mercè Balasch i
Published: August 2020

Background: Frozen shoulder (FS) is a highly disabling pathology of poorly understood etiology, which is characterized by the presence of intense pain and progressive loss of range of motion (ROM). The aim of this study was to evaluate the feasibility and clinical impact of a CNS-focused treatment program for people with frozen shoulder (FS).Methods: 10 subjects with primary FS received a 10 weeks CNS-focused intervention including sensory discrimination training and graded motor imagery techniques delivered as clinic sessions (60 minutes) and home therapy (30 minutes five times per week). Measurements were taken at baseline, after a 2-weeks washout period, after treatment and at three months follow-up. The Shoulder Pain and Disability Index (SPADI) was the primary outcome. Secondary measures were: feasibility-related outcomes, self-reported shoulder pain, active and passive range of motion, two-point discrimination threshold (TPDT), left/right judgement task (LRJT), fear-avoidance (Tampa Scale for Kinesiophobia), pain catastrophization (Pain Catastrophizing Scale) and pain sensitization (Central Sensitization Inventory).Results: 70% of participants completed the treatment. No significant changes were found after washout period except for TPDT (p=0.02) and SPADI (p=0.025). Improvements in self-reported shoulder pain (p=0.028) and active shoulder flexion (p=0.016) were shown after treatment (p=0.028) and follow-up (p=0.001) and in SPADI at follow-up (p=0.008). No significant changes were observed in TPDT, LRJT, fear-avoidance, pain catastrophization and pain sensitization. Conclusions: a CNS-focused treatment program might be a suitable approach to improve pain and disability in FS but further research is needed to draw firm conclusions.Trial registration: Clinical Trials. NCT03320200. Registered 25 October 25 2017, https://clinicaltrials.gov/ct2/show/NCT03320200?term=NCT03320200&draw=2&rank=1
Spatial-temporal patterns and trends of homicide in socioeconomically deprived settings: violence surveillance in Alagoas, Brazil, 2006‒2015
Authors: Barbosa Kevan Guilherme Nóbrega , Walker Blake Byron , Silva Alessandra Vieira da , Gonzaga Géssyca Luise Procópio , Brum Evanisa Helena Maio de , Ribeiro Mara Cristina
Published: August 2020

Background

Homicide rates in the state of Alagoas (Brazil) have been high for a long time over the last decade. In this study, we quantified the violence rates and mapping the cities in higher risk for homicide.
Method:

A surveillance of homicide rates over ten years in the state of Alagoas, located in North-Eastern of Brazil was carried out through spatial-temporal analysis. First, the male/female ratio was calculated later the top violent cities and the relative risk for males and females were mapped.
Results

A total of 19,560 homicides were investigated in two large regions of the state called Metro Region and Inner Cities. A pattern of violence by homicide involving mostly men throughout all state was observed and highest rates for the metropolitan region of the state capital. Homicide has been spreading from the capital to other inner cities, and distinct pattern was observed when mapping the risk according to sex.
Conclusions

Homicide has remained as a serious local problem in the state over ten years, and our results suggest that inner areas in the state have experienced an increase of homicide rates, requiring strong investment in combat and prevention.
Effectiveness of personal letters to healthcare professionals in changing clinical practice behaviours: A Systematic Review protocol
Authors: Grimani Aikaterini , Goffe Louis , Tang Mei Yee , Beyer Fiona , Sniehotta Falko F. , Vlaev Ivo
Published: August 2020

Background: Letters are regularly sent by healthcare organisations to healthcare professionals to encourage them to take action, change practice or implement guidance. However, whether letters are an effective tool in delivering a change in clinical practice behaviour is currently uncertain. In addition, there are currently no evidence-based guidelines to support providers and health authorities with advice on how to formulate the communication, what information and behaviour change techniques to include in order to optimise the potential effect on the behaviour of the receivers. To address this research gap, we aim to inform such guidance through this systematic review.Methods/ Design: A systematic literature search of published and unpublished studies (the grey literature) in electronic databases will be conducted to identify studies that meet our inclusion criteria. The search will be conducted in five electronic databases: MEDLINE, EMBASE, PsycINFO, the Cochrane Library and CINAHL. We will also conduct supplementary searches in Google Scholar, hand search relevant journals, and conduct backward and forward citation searching for included studies and relevant reviews. A systematic approach to searching, screening, reviewing and data extraction will be applied based on Preferred Reporting Items for Systematic reviews and Meta-Analysis. Titles, abstracts, full-texts for eligibility will be examined independently by researchers. The quality of the included studies will be assessed using quality assessment tool for studies with diverse design and Cochrane risk of bias tool. Disagreements will be resolved by a consensus procedure.Discussion: This review aims to provide comprehensive evidence of the effectiveness of personal letters to healthcare professionals in changing clinical practice behaviours. Health policy makers across government will benefit from being able to increase compliance in clinical settings by applying theories of behaviour to design of policy communications. The synthesized findings will be disseminated through peer-reviewed publication.Systematic review registration: PROSPERO CRD42020167674