bluuebunny/crossref_metadata_2025 huggingface dataset:
Scar Quality Examination Comparing Titanium Coated Suture Material and Non-Coated Suture Material on Flap Donor sites in Reconstructive Surgery
Authors: Berninghausen Laura Katharina , Osterhoff Georg , Langer Stefan , Kohler Lukas Herbert
Published: August 2020

OBJECTIVES Wound healing and scar quality after trauma are subject to impairment through excessive wound healing, chronic wound or even surgical site infections. Optimizing the process of scar formation and skin healing is crucial in virtually all fields of medicine. In this regard, we tested the possible usage and advantages of titanium coated suture material. METHODS We performed a prospective observational cohort study including 30 patients who underwent soft tissue reconstruction. One half of the donor flap site was sutured with titanium coated suture material, while the other half was closed with non-coated sutures . Scar quality of the donor flap site was assessed by photographs and POSAS scores on days 2-5, 14, 42, 72 and 180 postoperatively. RESULTS No difference between the titanium coated sutures and non-coated sutures was seen in the POSAS assessment, neither for the patient scale at 14, 42, 72 and 180 days, nor for the observer scale on the same dates. Comorbidities like diabetes, chronic renal failure and smoking as well as the BMI of each patient affected the wound healing process to an equal degree on both sides of the suture. CONCLUSION No difference between titanium coated and non-titanium-coated suture material was seen in the POSAS assessment in regard to scar quality and wound healing. The titanium-coated suture material can be considered to be equally as effective and safe in all qualities as the non-titanium-coated suture material, even in patients with comorbidities.
Endovascular Treatment of Vertebral and Basilar Artery Aneurysms with Low-Profile Visualized Intraluminal Support Device
Authors: Hong Quanlong , Li Wenqiang , Ma Jing , Jiang Peng , Zhang Yisen
Published: August 2020

Background: The Low-profile Visualized Intraluminal Support (LVIS) device is a self-expanding, nitinol, single-braid, closed-cell device that was recently developed for endovascular embolization of intracranial aneurysms. However, current knowledge regarding the use of LVIS devices to treat vertebral and basilar artery aneurysms is limited. We aimed to evaluate the feasibility, efficacy, and safety of the LVIS device for treating vertebral and basilar artery aneurysms.Methods: Between January 2015 and December 2017, patients with vertebral and basilar artery aneurysms treated using LVIS stents were enrolled in this study. We analyzed patients’ demographic, clinical and aneurysmal characteristics, procedural details, complications, and angiographic and clinical follow-up results.Results: We identified 63 patients with 64 vertebral and basilar artery aneurysms who underwent treatment with (n=59) or without (n=5) LVIS stenting, including 10 patients with ruptured aneurysms. Forty-one aneurysms were located at the vertebral artery, and 23 at the basilar artery. Intraprocedural-related complications developed in three (4.8%) patients, while none of these patients developed morbidities or died during follow-up. Three patients developed post-procedural complications (4.8%). Two patients experienced ischemic events immediately post-procedure. A minor permanent morbidity developed in one of the two patients (1.6%). The mortality rate was 1.6%, for that the patient died of brainstem hemorrhage after 1 month of follow-up. At a mean follow-up of 12.5 months, 39/43 (90.7%) patients had stable or improved aneurysms, and four (9.3%) had recanalized.Conclusions: Endovascular treatment of vertebral and basilar artery aneurysms with the LVIS device is feasible, safe, and effective in the short-term. Long-term and larger cohort studies are necessary to validate our results.
Exploring the Roles of 5-HTTLPR, STin2, 5-HT2A, and TPH2 Variants in Heroin Dependence
Authors: Chiang Hung , Wu Hung-Chi , Tsai Jui-Kang , Kao Wei-Tsung
Published: August 2020

Background: Substance abuse is a major worldwide public health and social problem. The serotonergic system, specifically the serotonin transporter (5-HTT) and postsynaptic activation of the serotonin 2A receptor (5-HT2A), may play a relevant role in substance dependence. This study investigated the association of 5-HTTLPR, serotonin transporter intron 2 (STin2), 5-HT2A, and tryptophan hydroxylase 2 (TPH2) variants with heroin dependence and determined genetic predispositions to heroin dependence and heroin co-occurring disorders.Methods: This study comprised 36 case and 24 control subjects. All participants completed self-reported questionnaires which included items regarding demographic information, the Chinese Health Questionnaire (CHQ), Eysenck Personality Inventory, Parental Bonding Instrument, and the Taiwanese version of the Toronto Alexithymia Scale-20. Heroin-dependent subjects underwent further examinations including hepatitis B virus, hepatitis C virus, and venereal disease research laboratory tests. Genomic DNA was extracted from 3.5 mL of peripheral blood in all participants for genotyping of 5-HTTLPR, STin2, 5-HT2A, and TPH2. Results: The heroin-dependent subjects were older than the control subjects (t=19.091, p<0.001). Statistically significant differences in education level (t=83.66, p<0.001), sex distribution (χ2=32.642, p<0.001), marriage status (χ2=6.705, p=0.035), and smoking status (χ2=60.00, p<0.001) were observed between heroin-dependent and control subjects. The CHQ score in the heroin-dependent subjects was higher than that in the control group (t=20.944, p<0.001). Statistically significant differences in father care (t=5.031, p=0.029) and father protection (t=4.170, p=0.046) distributions were observed between heroin-dependent and control subjects. Conclusions: Older males, divorced subjects, and smokers had higher risks of heroin dependence, while subjects who received more education had a lower risk of heroin dependence. Heroin-dependent subjects had higher CHQ scores and lower father care and higher father protection.
Preparing Lifelong Learners for Delivering Pharmaceutical Care in an Ever-Changing World: A Study of Pharmacy Students
Authors: Khamis Sarah , Abdi Abdikarim Mohamed , Basgut Bilgen
Published: August 2020

Background Continuing professional development (CPD) continues to gain acceptance as a model for health care professionals to engage in lifelong learning (LLL). Whilst many pharmacy schools have not adopted yet specific programs targeting the development of LLL skills though it’s widely accepted as an essential competence. This paper examines the effectiveness and utility of a longitudinal CPD training program introduced to last year master of pharmacy students.Methods A CPD simulation course was introduced to a cohort of fifth year students in Northern Cyprus in the 2018–2019 academic year. The program was delivered as an interactive orientation course in one semester; meanwhile, in the second semester, the students applied the CPD cycle and filled their portfolios during their final experiential practice. A mixed-methods approach was used to evaluate the outcomes using students’ preparedness for lifelong learning (SPLLL) self-administered questionnaire delivered pre-post program, focus group sessions for students to reflect on the course experience, and instructors’ evaluations of portfolios.Results Following the implementation of the course, students’ assessment scores were significantly higher overall (166.2 ± 15.2 vs 212.78 ± 27.1) and for all scale domains, including “knowledge (40.85 ± 6.55 vs 60.8 ± 8.89), skills (44.2 ± 6.53 vs 51 ± 6.04), attitude (49.44 ± 6 vs 54.4 ± 6.7) and practice (31.67 ± 4.87 vs 46.56 ± 8.69)”, compared to the baseline assessment. Additionally, compared to fifth year students who responded to the second SPLLL questionnaire, the intervention group students’ assessment was significantly higher in knowledge, skills, and practice. The qualitative analysis reported high student satisfaction and achievement of the course objectives. Nineteen of the students scored high on their portfolios.Conclusion The CPD simulation course provided students with opportunities to practice and develop self-assessment and self-management skills that are all desirable for lifelong learning and prepared them for CPD.
Alcohol use and its associated factors during pregnancy in Ethiopia: a population-based survey
Authors: Addis Nitsu , Azage Muluken , Nigatu Dabere , Kirksey Kristen
Published: August 2020

Background: Alcohol use during pregnancy is a modifiable health behavior that causes a range of health problems in infants, including impaired growth, stillbirth, and fetal alcohol spectrum disorder. However, there is lack of comprehensive information on alcohol use and associated factors during pregnancy using a population-based dataset in Ethiopia. Therefore, this study aimed to assess the prevalence of alcohol use during pregnancy and associated factors using a national, population-based survey.Methods: The study utilized data from the 2011 and 2016 Ethiopian Demographic and Health Survey, a cross-sectional survey conducted on a nationally representative sample. The survey employed a multistage cluster sampling method to generate representative national and sub-national health and health related indicators. A total of 2,341 pregnant women were included in the analysis. Factors associated with alcohol use were identified using multivariable logistic regression model. Adjusted odds ratios (AOR) with 95% confidence interval (CI) were computed to quantify the degree of association between independent variables and alcohol use.Results: In Ethiopia, the prevalence of alcohol use among pregnant women was 30.2% (95% CI: 28.4%-32.2%). The study identified that being employed (AOR: 2.07; 95%CI: 1.55-2.77), ever attempted termination of pregnancy (AOR: 2.21; 95% CI: 1.60-3.05), having two (AOR: 2.56; 95% CI: 1.76-3.72), or three (AOR: 2.98; 95% CI: 1.40-6.35) sexual partners in lifetime and chat chewing (AOR: 8.91; 95% CI: 4.61-17.23) had increased the odds of alcohol use during pregnancy.Conclusion: In this study, the prevalence of alcohol use during pregnancy among Ethiopian mothers was high. Working status, ever used something to terminate the pregnancy, more than one lifetime partner, and chat chewing were factors associated with alcohol use during pregnancy. Thus, prevention interventions and strategies can draw on the identified modifiable health behaviors.
Mid-and Long-term Clinical Efficacy Analysis of Carotid Artery Stenosis Treated With Carotid Endarterectomy
Authors: Wan Yanhua , Li Yiran , Xu Jiasheng , Wan Shasha , Wang Riwei , Zhang Kaihua , Zeng Qingfu
Published: August 2020

Objective: To explore the mid-and long-term clinical efficacy analysis of carotid artery stenosis treated with carotid endarterectomy.Methods: Retrospective analysis of 89 cases of patients with carotid artery stenosisundergoing carotid endarterectomy from our center from Jan,2013 to June,2017. To gather the hospitalization data of patients including the general information, the past medical history, preoperative conditions, the situation during surgery, postoperative situations. All the patients were followed up from 16 months to 63 months, and to make survival analysis on the follow-up status.Results：Among the 89 cases, 22cases of mild stenosis ,67cases of severe stenosis. 5 cases had postoperation wound hemorrhage or hematoma, 2 cases of cranial nerve injury, 2cases of cerebral stroke. Among the 62 cases of symptomatic carotid artery stenosis,48cases have been improved in term of their clinical symptoms with improvement rate of 77.4%. The Nonparametric test of mRS scores before and after surgery showed that there was significant difference in the preoperative and postoperative scores（P<0.05）.Conclusion: The mid-and long-term clinical efficacy of carotid artery stenosis treated with carotid endarterectomy is good. The previous history of coronary heart disease and peripheral vascular diseases are the influence factors for the mid- and long-term adverse outcomes after carotid endarterectomy.
Prediction of risk factors of bronchial mucus plugs in children with Mycoplasma pneumoniae pneumonia
Authors: zhang Jiahui , Wang Ting , Ji Wei , Yan Yongdong , Sun Zhichao , Tan Jiahong , Wu Jinfeng , Huang Li , Chen Zhengrong
Published: August 2020

Background
Recently, many cases of pneumonia with Mycoplasma pneumoniae (M. pneumoniae) infection have been shown to have varying degrees of intrabronchial mucus plug formation. The clinical, laboratory, radiological characteristics, and treatment of patients with Mycoplasma infection are analyzed in this study. The risk factors for M. pneumoniae pneumonia (MPP) mucus plug formation are explored, and a risk factor scoring system is established.
Methods
MPP patients treated with bronchoscopy were retrospectively enrolled in the study from February 2015 to December 2019. The children were divided into a mucus plug group and a control group according to the presence or absence of mucus plug formation. The clinical, laboratory, radiological characteristics, and treatment of the two groups of children were compared. The receiver operating characteristic (ROC) curve was drawn to evaluate the regression model and establish the MPP mucous plug risk factor scoring system.
Results
A univariate analysis showed that the children in the mucous group were older and had a longer fever duration, longer hospital stay, higher fever peak, more cases of wheezing symptoms and allergies, and azithromycin or corticosteroids were administered later. In addition, neutrophil, C-reactive protein (CRP), lactate dehydrogenase (LDH), D-dimer (DD), sputum MP-DNA copy number, and total immunoglobulin A (IgA) levels were higher, while prealbumin (PA) levels were lower. The ROC curve analysis showed that children with MPP had PA ≤ 144.5 mg/L, had used corticosteroids during the course of the illness of ≥ 4.5 days, CRP ≥ 12.27 mg/L, an LDH ≥ 462.65 U/L, and there was a possibility of intra-airway mucus formation. The independent risk factors were scored according to their odds ratio (OR) value. Among the 255 children with MPP, the high-risk group had 44 (83.02%) mucus plugs out of 53; the middle-risk group had 35 (34.3%) mucus plugs out of 102; and the low-risk group had 11 (11%) mucus plugs out of 100.
Conclusions
PA levels, timing of corticosteroid use (use in the first few days), CRP levels, and LDH levels were independent risk factors for MPP mucus plug formation. This provides a basis for the early identification of MPP combined with mucus plug formation.
Differences in Inflammation, Apoptosis and Tissue Hypo-perfusion Indicators Caused by Using Two Different Gauges in Cecal Ligation and Puncture-induced Rat Models of Sepsis
Authors: Didari Tina , Baeeri Maryam , Rahimifard Mahban , Mozaffari Shilan , Haghi-Aminjan Hamed , Mojtahedzadeh Mojtaba , Najafi Atabak
Published: August 2020

Background: Rodent Cecal Ligation and Puncture (CLP) models, which mimic sepsis in humans. Gauges needle size during CLP related to cytokine storm, inflammation and organ failure.This study focus on precise and low cost various biochemical markers to trace sepsis severity in cardiopulmonary system and blood after CLP with gauge needle size -18 (G-18) and -21 (G-21) in rats.Results: For the purpose of this study, 18 male Wistar rats were assigned into three groups: CLP procedure with G-18 needle, CLP procedure with G-21 and sham. Following the procedure, oxidative stress markers, blood markers, apoptosis indicators, gene expression of autophagy and cellular hypoxia and histopathological assessments were carried out in the cardiopulmonary tissue and blood 24 hours after CLP. All measured factors were increased in both G-18 and G-21 gauge groups in comparison with the sham. Moreover, 24 hours after CLP, inflammatory markers, blood profile, lactate level, pro-inflammatory cytokines, caspases, gene expression of cellular homeostasis and autophagy in samples were more pronouncedly increased in the G-18 group in comparison with the G-21. Conclusions: This experiment provides a significant association of inflammation and cytokine storm with anti-oxidant property, apoptotic condition and gene expression of tissue and blood infection related to severity organ damage were increased with G-18 compare to G-21. Our study has identified cost-effective indicators to evaluate organ failure during sepsis. This should be considered by all investigators using G-18 in comparison with G-21 to induce severe sepsis.
Early Assessment Window for Predicting Breast Cancer Neoadjuvant Therapy Using Biomarkers, Ultrasound, and Diffuse Optical Tomography
Authors: Zhu Quing , Ademuyiwa Foluso O , Young Catherine , Appleton Catherine , Covington Matthew F , Ma Cynthia , Sanati Souzan , Hagemann Ian S , Mostafa Atahar , Uddin K. M. Shihab , Grigsby Isabella , Frith Ashley E , Aya Leonel Hernandez , Poplack Steven P
Published: August 2020

Background: Neoadjuvant Therapy (NAT) permits less aggressive breast and axillary surgery and better assessment of systemic response. Establishing accurate and early predictors of NAT response would help limit morbidity of ineffective regimens through modification of treatment regimens and thereby optimize clinical outcomes. The purpose of the study was to assess the utility of tumor biomarkers, ultrasound (US) and US-guided diffuse optical tomography (DOT) in early prediction of breast cancer response to NAT.MethodsThis prospective HIPAA compliant study was approved by the institutional review board. Forty one patients were imaged with US and US-guided DOT prior to NAT, at completion of the first three treatment cycles, and prior to definitive surgery from February 2017 to January 2020. Miller-Payne grading was used to assess pathologic response. Receiver operating characteristic curves (ROCs) were derived from logistic regression using independent variables, including: tumor biomarkers, US maximum diameter, percentage reduction of the diameter (%US), pretreatment maximum total hemoglobin concentration (HbT) and percentage reduction in HbT (%HbT) at different treatment time points. Resulting ROCs were compared using area under the curve (AUC). Statistical significance was tested using two-sided two-sample student t-test with P<0.05 considered statistically significant. ResultsThirty-eight patients (mean age =47, range 24-71 years) successfully completed the study, including 15 HER2+ of which 11 were ER+; 12 ER+ or PR+/HER2-, and 11 triple negative. The combination of HER2 and ER biomarkers, %HbT at the end of cycle 1 (EOC1) and %US (EOC1) provided the best early prediction, AUC = 0.941 (95% CI: 0.869­–1.0). Similarly an AUC of 0.910 (95% CI: 0.810–1.0) with %US (EOC1) and %HbT (EOC1) can be achieved independent of HER2 and ER status. The most accurate prediction, AUC = 0.974 (95% CI: 0.933–1.0), was achieved with %US at EOC1 and %HbT (EOC3) independent of biomarker status. ConclusionThe combined use of tumor HER2 and ER status, US, and US-guided DOT may provide accurate prediction of NAT response as early as the completion of the first treatment cycle. Clinical Trial Registration number: NCT02891681Registration time: September 7, 2016https://clinicaltrials.gov/ct2/show/NCT02891681
CD9 Defines Acute Myeloid Leukemia Stem Cells and is Regulated by Alpha-2-Macroglobulin
Authors: Liu Yongliang , Wang Guiqin , Zhang Jiasi , Chen Xue , Xu Huailong , Heng Gang , Chen Jun , Zhao Yongchun , Li Jiatao , Ni Yuanli , Zhang Yingzi , Liu Limei , Shan Juanjuan , Qian Cheng
Published: August 2020

Background: Leukemia stem cells (LSCs) are responsible for the initiation, progress and relapse of acute myeloid leukemia (AML). Therefore, the therapy strategy of targeting LSCs is hopeful to eradicate AML. In this study, we aim to identify LSC-specific surface markers and uncover the underlying mechanism of AML LSCs.Methods: Microarray gene expression data were used to investigate the candidate AML-LSC specific markers. CD9 expression was evaluated by flow cytometry in AML cell lines, patients with AML and normal donors. The biological characteristics of CD9-positive (CD9+) cells were analyzed by in vitro proliferation, chemotherapeutic drug resistance, migration and in vivo xenotransplantation assays. The molecular mechanism involved in CD9+ cell function was investigated by gene expression profiling. Effect of alpha-2-macroglobulin (A2M) on CD9+ cells was analyzed by proliferation, drug resistance and migration assays.Results: CD9 as a cell surface protein was specifically expressed on AML LSCs, but almost not expressed on normal hematopoietic stem cells (HSCs). CD9+ cells exhibited more resistance to chemotherapy drugs and higher migration potential than CD9-negative (CD9-) cells. More importantly, CD9+ cells possess the ability to reconstitute human AML in immunocompromised mice and promote tumor growth, suggesting CD9+ cells define the LSC population. Furthermore, we identified A2M plays a crucial role in CD9+ LSCs stemness maintenance. Down-regulation of A2M impairs drug-resistance and migration of CD9+ cells.Conclusion: Our findings suggest that CD9 is a new biomarker of AML LSCs and may serve as a promising therapeutic target.
Famine Exposure During Early Life Increased the Risk of Ascending Aorta Dilatation in Adults
Authors: HUANG Yu-qing , LIU Lin , Lo Kenneth , YU Yu-ling , CHEN Chao-lei , HUANG Jia-yi , ZHANG Bin , FENG Ying-qing
Published: August 2020

Background: The relationship between malnutrition and ascending aorta dilatation (AAD) is still unclear. Therefore, the aim of this study was to examine the association of exposure to the Chinese famine during early life with AAD in adulthood. Methods: We investigated data of 2598 adults born between 1952 and 1964 from Guangdong, China. All enrolled subjects were divided into five groups: no exposed, fetal exposed, early, mid and late childhood exposed. AAD was assessed by cardiac ultrasound. Multivariate logistic regression and interaction tests were used to estimate the odds ratio (OR) and confidence interval (CI) between famine exposure and AAD. Results: There were 2598 (943 male, mean age 59.1 ± 3.65 years) participants were enrolled, among them consist of 270 (10.4%) subjects with AAD. We found that famine exposure (OR=2.266, 95% CI: 1.477, 3.477, P=0.013), age, smoking, hypertension, elevated SBP, elevated BMI was an independent risk factor for AAD. In addition, compared with no exposed group, the adjusted ORs for AAD widening from fetal-exposed, early, mid to late childhood exposed were 1.374 (95% CI: 0.794, 2.364, P=0.251), 1.976 (95% CI: 1.243, 3.181, P=0.004), 1.929 (95% CI: 1.237, 3.058, P=0.004) and 2.227 (95% CI: 1.433, 3.524, P<0.001), respectively. Stratified analysis showed that the effect of famine exposure on AAD was more pronounced in female, smokers, BMI ≥24 kg/m2 and hypertensive patients. Conclusions: We observed that exposure to famine during early life was an independent risk factor for AAD in adulthood; this effect was not modified by gender, BMI, smoking, hypertension and diabetes.
Serum Metabolomic Patterns in Young Patients with Ischemic Stroke: A Case Control Study
Authors: Liu Jia , Yuan Junliang , Zhao Jingwei , Zhang Lin , Wang Qiu , Wang Guang
Published: August 2020

Background: Ischemic stroke is one of the leading causes of death and adult disability. The incidence of ischemic stroke continues to rise in young adults. This study aimed to provide a comprehensive evaluation of metabolic changes and explore possible mechanisms in young ischemic stroke patients without common risk factors. Methods: This study investigated serum metabolomics in 50 young patients with newly suffered ischemic stroke and 50 age-, sex-, and body mass index–matched healthy controls. The metabolomic data were analyzed by performing a multivariate statistical analysis.Results: The 197 metabolites, including amino acids, bile acids, free fatty acids, and lipids, were identified in all participants. Multivariate models showed significant differences in serum metabolomic patterns between young patients with ischemic stroke and healthy controls. The stroke patients had increased L-methionine, homocysteine, glutamine, uric acid, GCDCA, and PE (18:0/20:4, 16:0/22:5), and decreased levels of L-citrulline, taurine, PC (16:2/22:6, 16:2/20:5, 15:0/18:2), and SM (d18:1/23:0, d20:0/19:1, d18:1/22:0, d16:0/26:1, d16:0/18:0, d16:0/22:1, d18:1/19:1, d16:0/17:1, d16:1/24:1, d18:1/19:0). Based on the identified metabolites, the metabolic pathways of arginine biosynthesis, glycerophospholipid metabolism, and taurine and hypotaurine metabolism were significantly enriched in the young patients with ischemic stroke. Conclusions: Serum metabolomic patterns were significantly different between young patients with ischemic stroke and healthy controls.
Fuelwood Use and Carbon Emission Reduction of Improved Biomass Cook Stoves; Evidence From Kitchen Performance Test in Tigray, Ethiopia
Authors: Manaye Ashenafi , Amaha Selemawit , Gufi Yirga , Tesfamariam Berihu , Worku Adefires , Abrha Haftu
Published: August 2020

Background In Ethiopia, biomass is the main form of fuel approximately for 92% of the population. Currently, several strategies were designed to reduce fuelwood consumption and greenhouse gases (GHG) emission by implementing improved cooking stoves (ICS). Nevertheless, the adoption of ICSs has been very slow. Therefore, these studies were conducted to assess the performance of ICS (“Mirt” and Tikikil”) on fuelwood consumption and greenhouse gas emission (GHG) in the kitchens of real households.Methods To select the study households (HH), both cross-sectional and longitudinal study designs were used. We used Kitchen Performance Test (KPT), based on three days of repeated fuel wood use measurements to compare the wood-saving performance of ICS and the traditional cook stoves (TCS). The carbon emission in the study area was calculated based on the clean development mechanism and United Nation’s Framework of Convention on Climate change.Result The study indicated that there were significant differences (p < 0.05) between the use of improved and traditional cooking stoves in total and per capita wood consumption. The use of “Mirt” and “Tikikil” than the traditional stove reduced the household wood consumption by 35 % (438 kg/ year) and 18% (185 kg/ year), respectively. Likewise, use of these ICS stoves lead to decrease of 0.65 and 0.27 tons of carbon dioxide equivalents (CO2 e) per stove per year. ConclusionAdopting of ICS reduced the amount of fuelwood used and carbon emission at household level significantly as compared to the use of TCS. This finding have implication on adoption of ICS technology is important on reducing CO2 emission, forest degradation and household workloads.
Discrepant End-Tidal Concentrations of Sevoflurane at the Same A-Line Autoregressive Index Level During Induction of General Anaesthesia: An Observational Study
Authors: Hsu Che-Hao , Ho Shung-Tai , Lu Chih-Cherng , Wang Ju-O , Yeh Te-Chun , Lin Tso-Chou
Published: August 2020

Background: The A-Line Autoregressive Index (AAI), which is derived from auditory evoked potentials, has been used for determining anaesthetic depth. This study verified the correlation between AAI values and the corresponding end-tidal concentrations of sevoflurane during general anaesthesia induction.Methods: Thirty young male adults undergoing elective minor orthopaedic surgery were sequentially allocated to receive inspiratory 3%, 5%, or 6% sevoflurane for mask induction, followed by mechanical ventilation after tracheal intubation. The inspiratory, end-tidal, and estimated jugular bulb concentrations of sevoflurane were recorded at three target AAI values: below 20, below 10 and at the start of burst suppression.Results: The mean time to loss of consciousness in the 6% sevoflurane group was shorter than that in the 5% and 3% groups; however, the groups had comparable AAI values (range: 16–45). The 6% group had a higher end-tidal concentration (4.5% ± 0.2% vs. 3.8% ± 0.2%, P < 0.05) than did the 5% group, despite having the same target anaesthetic levels by AAI score ≤ 10, whereas the estimated jugular bulb concentrations were comparable (1.9% vs. 1.9%) in both groups. Conclusions: Following mechanical ventilation with inspiratory 3%, 5%, or 6% sevoflurane, the end-tidal concentrations were discrepant at the same end points of AAI levels, despite similar estimated jugular bulb concentrations of sevoflurane. Thus, conventional alveolar concentration may overestimate anaesthesia depth during rapid wash-in of sevoflurane.
Comparison of Two Intravenous Fluid Management Strategies in COVID-19 Patients in Hubei, China: A Retrospective Multicenter Study
Authors: Yuan Yaping , Wu Jionghe , Wang Runsheng , Wu Zhanling , Pan Lei , Cheng Jing , Que Yifan , Deng Jing , Chang Christopher , Xu Guogang , Li Hongxia
Published: August 2020

Background

Optimal fluid management in patients with COVID-19 has not been reported. This retrospective, multicenter study investigated the impact of intravenous infusion volume in the early stage of COVID-19 on clinical outcomes.
Methods

127 patients from two tertiary hospitals were separated into the “conservative” and “liberal” groups based on average daily intravenous infusion volume within the first seven days after admission. Basic information, demographic and epidemiological characteristics, laboratory findings, treatments, and outcome measures were retrieved from medical records. The disease progression and prognosis were analyzed and compared.
Results

The average daily intravenous infusion volume within 7 days was 500 (150–700) ml/day in the conservative-strategy group (n = 87), and 1100 (1000–1288) ml/day in the liberal-strategy group (n = 40) (p < 0.001). There were no statistical differences in median age, male-to-female ratio, epidemiology, laboratory findings on admission, comorbidities, and average daily urine output within the seven days (p > 0.05). The final K+ in the liberal group was slightly higher than that at admission, and the final hematocrit level in the conservative group had a significant difference than that at admission (p < 0.05). The mean (± SD) duration of hospitalization was 22.41 ± 11.99 days in the conservative group and 25.28 ± 12.08 days in the liberal group (p = 0.120). However, compared to the liberal group, conservative group had statistically lower rates of disease progression (9.3% vs 37.5%, p < 0.001), mechanical ventilation (2.3% vs 27.5%, p < 0.001) and in-hospital mortality (2.3% vs 15.0%, p = 0.012).
Conclusions

Although there appeared to be no significant difference in the duration of hospitalization between using conservative and liberal fluid management strategies, the former was associated with lower rates of disease progression, mechanical ventilation and in-hospital mortality without increased nonpulmonary-organ dysfunction. These results support the importance of implementing conservative intravenous fluid infusion in the early stage of COVID-19.
Decitabine bioproduction using a biocatalyst with improved stability by adding nanocomposites
Authors: Méndez Mariana B. , Trelles Jorge A. , Rivero Cintia W
Published: August 2020

A novel IDA-LaNDT derivative was able to reach the highest productivity in the biosynthesis of a well-known antitumoral agent called decitabine. However, the combination of two simple and inexpensive techniques such as ionic absorption and gel entrapment with the incorporation of a bionanocomposite such as bentonite significantly improved the stability of this biocatalyst. These modifications allowed the enhancement of storage stability (for at least 18 months), reusability (400 h of successive batches without significant loss of its initial activity), and thermal and solvent stability with respect to the non-entrapped derivative. Moreover, reaction conditions were optimized by increasing the solubility of 5-aza by dilution with dimethylsulfoxide. Therefore, a scale-up of the bioprocess was assayed using the developed biocatalyst, obtaining 221 mg/L.h of DAC. Finally, green parameters were calculated using the nanostabilized biocatalyst, whose results indicated that it was able to biosynthesize DAC by a smooth, cheap, and environmentally friendly methodology.
Does TB Vaccination Reduce COVID-19 Infection?: No Evidence from a Regression Discontinuity and Difference-in-Differences Analysis
Authors: Matsuura Hiroaki , Fukui Masao , Kawaguchi Kohei
Published: August 2020

In the middle of the global COVID-19 pandemic, the BCG hypothesis, the prevalence and severity of the COVID-19 outbreak seems to be negatively correlated with whether a country has a universal coverage of pediatric Bacillus Calmette–Guérin (BCG) vaccination, has emerged and attracted the attention of scientiﬁc community and media outlets. However, all existing claims are based on cross-country correlations that do not exclude the possibility of spurious correlation. By merging country-age-level confirmed case statistics of COVID-19 from 17 countries with the start/termination years of pediatric universal BCG vaccination policy and age-specific BCG vaccination coverage, this paper examines the role of BCG vaccination in COVID-19 infection. Despite the cross-country evidence from the previous literature, the results of both regression discontinuity design and difference-in-differences approaches do not support the BCG hypothesis.The results of these previous studies are likely to suffer from spurious correlations.
Predicting Prevention of Cigarette Smoking in Youth: Using Multi-Theory Model (MTM)
Authors: Abasi Hamid , Asadi Zahra Sadat , Mezerji Naser Mohammad gholi
Published: August 2020

Background: Cigarette smoking (CS) is the most important cause of death and disability in the world and is a complex behavior that is affected by various factors. This study was aimed to test the ability of MTM to predict preventing CS in youth.Methods: In this cross-sectional study, 230 youth who were volunteer to do military services as a soldier were selected by simple random sampling in 2019, western Iran. Data collection were performed by using questionnaire demographic characteristics and MTM constructs of CS. The obtained data were analyzed using descriptive statistics, logistic regression, and Hosmer–Lemeshow test in SPSS 20 software.Results: In this study, the Mean (± SD) age of the participants was 21.13 (±0.89). The prevalence of current cigarette smoking (CCS) and ever cigarette smoking (ECS) was 12.2% and 23%, respectively. The results of the logistic regression test showed that ECS (p< 0.001) and having a family member smoker (p=0.026) were predictor factors for CCS. Sustenance of preventing CS behavior was predicted by constructs of emotional transformation (p=0/006), practice for change (p=0=022), and changes in the social environment (p< 0.001).Conclusions: MTM shows that it is a reliable and useful theory in the sustenance of preventing CS behavior in youth who volunteer to do military services as soldiers. Therefore, this robust theory should be tested in designing, implementing, and evaluating of CS prevention interventions.
Effects of Medical Insurance System and Nursing Care on the Hospitalization Cost Effectiveness of Acute Myocardial Infarction Patients
Authors: Chu Ying-hong , Jiang Gui-hua , Zhang Hong , Luan Xiao-rong
Published: August 2020

Background Acute myocardial infarction is still a burden on Chinese patients. Whether different medical insurance system have any influence on the hospitalization cost and therapeutic effect of acute myocardial infarction patient needs further investigation. Methods In this study, 600 patients were stratified by health insurance status to investigate the cost effectiveness. Results Compared with free medical care, patients with other health insurance status have a significantly lower age (P ˂ 0.05~0.001), the youngest of which is new rural cooperative medical system. The hospital expense, nursing fee, length of stay, daily hospitalization cost, daily drug cost, daily nursing cost and percent of nursing cost of different health insurance status were statistically significant. ANCOVA analyses controlling for age showed that the differences of hospital expenses, nursing fee, length of stay and daily hospitalization cost were still statistically significant. Further studies found that health insurance status was the leading factors influencing length of stay (β =-0.305, P=0.0000001), nursing costs (β =-0.319, P=0.004), daily hospitalization costs (β =0.296, P=0.0001) and occurrence of clinical events (β =-0.186, OR=0.830, 95%CI 0.694-0.993, P=0.041). Conclusions The hospitalization cost, length of stay, nursing work and therapeutic effect of acute myocardial infarction patients are affected by different health insurance status and age.
A physical activity coaching intervention can increase and maintain physical activity and health-related outcomes in adult ambulatory care patients in a regional hospital: the Healthy4U-2 randomised controlled trial
Authors: Barrett Stephen , Begg Steve , O'Halloran Paul , Kingsley Michael
Published: August 2020

Background: The Healthy 4U-2 study sought to evaluate the effect of a twelve-week, physical activity (PA) coaching intervention for changes and maintenance in PA, anthropometrics and health-related outcomes in adults presenting to an ambulatory hospital clinic.Methods: One hundred and twenty insufficiently active adults were recruited from an ambulatory hospital clinic and randomised to an intervention group that received an education session and five 20-minute telephone sessions of PA coaching, or to a control group that received the education session only. ActiGraph GT3X accelerometers were used to measure moderate-to-vigorous physical activity (MVPA) at baseline, post-intervention (3 months) and follow-up (9 months). Secondary outcome measures (anthropometrics, PA self-efficacy, health-related and quality of life) were also assessed at the three time points.Results: At baseline, the mean age and body mass index of participants were 53 ± 8 years and 31 ± 4 kg/m2, respectively. Relative to control, the intervention group increased objectively measured MVPA at post-intervention (p<0.001) and 9 months follow-up (p<0.001). At the 9-month follow-up the intervention group completed 22 min/day of MVPA (95% CI: 20 to 25 min/day), which is sufficient to meet the recommended PA guidelines. The intervention group exhibited beneficial changes in body mass (p<0.001), waist circumference (p<0.001), body mass index (p<0.001), PA self-efficacy (p<0.001), and health-related quality of life (p<0.001) at the 9-month follow-up.Conclusions: This study demonstrates that a low contact PA coaching intervention results in beneficial changes in PA, anthropometrics and health-related outcomes in insufficiently active adults presenting to an ambulatory care clinic. The significant beneficial changes were measured at post-intervention and the 9-month follow-up, demonstrating a maintenance effect of the intervention. Trial registration: Prospectively registered on the Australian and New Zealand Clinical Trials Registry (ANZCTR). Trial registration number: ACTRN12619000036112. http://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=376318
Development of a Complex Exercise Rehabilitation Intervention for People with Pulmonary Hypertension: The Supervised Pulmonary Hypertension Exercise Rehabilitation (SPHERe) Trial
Authors: Ennis Stuart , Sandhu Harbinder , Bruce Julie , Seers Kate , Pincus Tamar , Mason James , Lall Ranjit , Ji Chen , Banerjee Prithwish , Canaway Alastair , Booth Katie , Taylor Stephanie J. C. , Robertson Elizabeth , Singh Sally , Fitzmaurice David , Bowater Sarah , Clift Paul , Underwood Martin , McGregor Gordon
Published: August 2020

Background: People with pulmonary hypertension (PH) are not routinely referred for exercise rehabilitation despite the potential for reducing breathlessness and improving quality of life. We describe the development of a supervised exercise-based rehabilitation programme for this group. The intervention will be tested in a randomised controlled trial (Supervised Pulmonary Hypertension Exercise Rehabilitation trial: SPHERe).Methods: Work was completed in three phases; 1) systematic review, 2) stakeholder engagement with consensus from expert opinion, and 3) intervention piloting and acceptability testing. Our systematic reviews identified exercise interventions for pulmonary hypertension. The draft intervention was ratified through discussions with representatives from medicine, exercise physiology, psychology, and patients. We subsequently assessed the SPHERe intervention in a pre-pilot. Results: Systematic reviews report that exercise might be safe and effective in this population. We found that other exercise interventions were within existing international cardiopulmonary rehabilitation guidelines. Stakeholder opinion and consensus shaped components of the SPHERe intervention, including addition of individual behavioural education sessions to promote adherence to exercise. Our pre-pilot investigation identified a number of condition-specific issues relating to safety and fear avoidance. We addressed these by adding two familiarisation sessions. The development of comprehensive intervention training manuals for participants and practitioners will ensure standardised delivery.Discussion: The SPHERe intervention incorporates three main components: supervised gym exercise, behavioural strategies to encourage adherence, and a home exercise plan for people with pulmonary hypertension. We will evaluate the clinical and cost-effectiveness of the SPHERe intervention in a multicentre randomised controlled trial for people with pulmonary hypertension (ISCRTN no.:10608766)
Mapping Trends and Identifying Hotspots in Research on Mesenchymal Stem Cells in Cardiovascular Disease
Authors: Chen Chan , Lou Yang , Li Xin-Yi , Lv Zheng-Tian , Zhang Lu-Qiu , Mao Wei
Published: August 2020

Background: Mesenchymal stem cells (MSCs) have important research value and broad application prospects in the cardiovascular disease. This study in order to provide information on the latest progress, evolutionary path, frontier research hotspots and future research developmental trends in this field. Methods: A knowledge map was generated by CiteSpace and VOSviewer analysis software based on data obtained from the literature on MSCs in the cardiovascular field.Results: The USA and China ranked at the top in terms of the percentage of articles, accounting for 34.306% and 28.550%, respectively. The institution with the highest number of research publications in this field was the University of Miami, followed by the Chinese Academy of Medical Sciences and Harvard University. The research institution with the highest ACI value was Harvard University, followed by the Mayo Clinic and the University of Cincinnati.The top three subjects in terms of the number of published articles were cell biology, cardiovascular system cardiology and research experimental medicine. The journal with the most publications in this field was Circulation Research, followed by Scientific Reports and Biomaterials. The direction of research on MSCs in the cardiovascular system was divided into four parts: (1) tissue engineering and gene and material research, (2) cell transplantation and signal transduction pathway research, (3) assessment of the efficacy of the use of stem cells from different sources in the treatment of acute myocardial infarction, and (4) myocardial hypertrophy, heart failure and myocardial infarction regeneration and repair research. Tissue research is the hotspot and frontier in this field.Conclusion: MSC research has presented a gradual upward trend in the cardiovascular field. Multidisciplinary intersection is a characteristic of this field. Engineering and materials disciplines are particularly valued and have received attention from researchers. The progress in multidisciplinary research will provide motivation and technical support for the development of this field.
Identification of key biomarkers and functional pathways in osteosarcomas with lung metastasis: Evidence from bioinformatics analysis
Authors: Liu Denghua , Zhou Rui , Zhou Aiguo
Published: August 2020

Background: In osteosarcoma, the lung is the most common metastatic organ. Intensive work has been made to illuminate the pathogeny, but the specific metastatic mechanism remains unclear. Thus, we conducted the study to seek to find the key genes and critical functional pathways associated with progression and treatment in osteosarcoma with lung metastasis.Methods: Two independent datasets (GSE14359 and GSE85537) were screened out from the Gene Expression Omnibus (GEO) database and the overlapping differentially expressed genes (DEGs) were identified using GEO2R online platform. Subsequently, the Gene Ontology (GO) annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways enrichment analysis of DEGs were conducted using DAVID. Meanwhile, the protein-protein interaction (PPI) network constructed by STRING was visualized using Cytoscape. Afterwards, the key module and hub genes were extracted from the PPI network using the MCODE and cytoHubba plugin. Moreover, the raw data obtained from GSE73166 and GSE21257 was applied to verify the expression differences and conduct the survival analyses of hub genes, respectively. Finally, the interaction network of miRNAs and hub genes constructed by ENCORI was visualized using Cytoscape.Results: A total of 364 DEGs were identified, comprising 96 downregulated genes and 268 upregulated genes, which were mainly involved in cancer-associated pathways, adherens junction, ECM-receptor interaction, focal adhesion, MAPK signaling pathway. Subsequently, 10 hub genes were obtained and survival analysis demonstrated SKP2 and ASPM were closely related to poor prognosis of patients with osteosarcoma. Finally, hsa-miR-340-5p were found to be most closely associated with these hub genes according to the interaction network of miRNAs and hub genes.Conclusion: The key genes and functional pathways identified in the study may contribute to understanding the molecular mechanisms involved in the carcinogenesis and progression of osteosarcoma with lung metastasis, and provide potential diagnostic and therapeutic targets.
Research on Investment Portfolio Model Based on Neural Network and Genetic Algorithm
Authors: Zhou Wei , Zhao Yuanjun , Chen Weiwei , Liu Yanghui , Yang Rongjun , Liu Zheng
Published: August 2020

With the maturity of neural network theory, it provides new ideas and methods for the prediction and analysis of stock market investment. The purpose of this paper is to improve the accuracy of stock market investment prediction, we build neural network model and genetic algorithm model, study the law of stock market operation, and improve the effectiveness of neural network and genetic algorithm. Through the empirical research, it is found that the neural network model can make up for the shortcomings of the traditional algorithm through the optimization of genetic algorithm.