bluuebunny/crossref_metadata_2025 huggingface dataset:
HIV-Tat and Cocaine Impact Brain Energy Metabolism: Redox Modification and Mitochondrial Biogenesis Influence NRF-Transcriptional Mediated Neurodegeneration
Authors: Sivalingam Kalaiselvi , Cirino Thomas J. , McLaughlin Jay P. , THANGAVEL SAMIKKANNU
Published: July 2020

HIV infection and drugs of abuse induce oxidative stress and redox imbalance, which cause neurodegeneration. The mechanisms by which HIV infection and cocaine consumption affect astrocytes energy metabolism lead neurodegenerative dysfunction remain poorly understood. We investigated how oxidative injury cause energy resource and depletion of glutathione synthetase (GSS), activating energy sensor AMPK-mediated glycolytic enzymes, and mitochondrial biogenesis lead to NRF transcription factors in astrocytes. Both human primary astrocytes in vitro (HIV-1Tat/cocaine) and HIV-inducible Tat (iTat) mice exposed to cocaine inhibit the GSS and altered superoxide dismutase (SOD) level. This, in turn, significantly activated AMPK and raised the several glycolytic enzymes, oxidative phosphorylation, mitochondrial biogenesis of PGC-1α and TFAM, Nrf1 and Nrf2 gene transcription, and protein expression. These results suggest that redox inhibition of GSS altered AMPK activation and mitochondrial biogenesis influence Nrf transcriptions, which are important resource of astrocytes signaling network in brain energy metabolism in HIV-positive cocaine users. In conclusion, HIV-1 Tat altered redox inhibition, thus raising glycolytic metabolic profiles and mitochondrial biogenesis led to Nrf transcription, which impact astrocyte-energy resource and metabolism. Further cocaine comorbidity exacerbation of these effects led to worse in neurodegeneration.
Haemodynamic Activity Characterization of Resting State Networks by Fractal Analysis and Thalamocorticalmorpho functional Integrity in Chronic Migraine
Authors: Porcaro Camillo , Renzo Antonio Di , Tinelli Emanuele , Lorenzo Giorgio Di , Parisi Vincenzo , Caramia Francesca , Fiorelli Marco , Piero Vittorio Di , Pierelli Francesco , Coppola Gianluca
Published: July 2020

Background - Chronic migraine (CM)can be associated with aberrant long-range connectivity of MRI-derived resting-state networks (RSNs). Here, we investigated how the fractal dimension (FD) of blood oxygenation level dependent (BOLD) activity maybe used to estimatethe complexity of RSNs, reflecting flexibility and/or efficiency in information processing in CM patients respect to healthy controls (HC).Methods -Resting-state MRI data were collected from 20 untreated CM without history of medication overuse and 20 HC. On both groups, we estimated the Higuchi’sFD. On the same subjects,fractional anisotropy (FA) and mean diffusivity (MD)values of bilateral thalami were retrieved from diffusion tensor imaging andcorrelated with the FD values.Results - CM showed higher FD values within dorsal attention system (DAS) and the anterior part of default-mode network (DMN), and lower FD values within the posterior DMN compared to HC.Although FA and MD were within the range of normality, both correlated with the FD values of DAS.Conclusions - FDof DAS and DMN may reflect disruption of cognitive control of pain in CM.Normal microstructure of the thalamus and its positive connectivity with the cortical networking may be yet another evidence in supporting CM as a never-ending migraine attack.
Development of a Managed Clinical Network for Children’s Palliative Care – A Qualitative Evaluation
Authors: Papworth Andrew , Fraser Lorna , Taylor Jo
Published: July 2020

Background Consistent evidence suggests that children’s palliative care is not equitable and managed clinical networks have been recommended as a solution. This study explored the development of a managed clinical network for children’s palliative care in England, with an aim to identify barriers and enablers of successful implementation. Methods Thematic analysis of semi-structured interviews and focus groups with 45 healthcare staff with a role in developing the Network or in the delivery of children’s palliative care (September 2019-March 2020). Results The study identified Network features that helped to formalise governance processes, establish training and networking opportunities, standardise practice, and improve collaboration between organisations. These include the funded Network co-ordinator, committed individuals who lead the Network, and a governance structure that fosters collaboration. However, the Network’s development was impeded by cross-cutting barriers including limited funding for the Network and children’s palliative care more generally, no shared technology, lack of standards and evidence-base for children’s palliative care, and shortage of palliative care staff. These barriers impacted on the Network’s ability to improve and evaluate palliative care provision and affected member engagement. Competing organisational priorities and differences between NHS and non-NHS members also impeded progress. Training provision was well received, although barriers to access were identified. Conclusions Key features of children’s palliative care can act as barriers to developing a managed clinical network. Managing expectations and raising awareness, providing accessible and relevant training, and sharing early achievements through ongoing evaluation can help to sustain member engagement, which is crucial to a network’s success.
Anaphylatoxin Receptor C3AR1 Promotesoptic Nerve Degeneration in DBA/2J Mice
Authors: Harder Jeffrey M , Williams Pete , Braine Catherine , Yang Hongtian , Thomas Jocelyn , Foxworth Nicole , John Simon , Howell Gareth
Published: July 2020

BackgroundThe risk of glaucoma increases significantly with age and exposure to elevated intraocular pressure, two factors linked with neuroinflammation. The complement cascade is a complex immune process with many bioactive end-products, including mediators of inflammation called anaphylatoxins. Complement cascade activation has been shown in glaucoma patients and models of glaucoma. However, the function of anaphylatoxin signaling in glaucoma is largely untested. Here,theC3AR1 anaphylatoxin receptor was genetically disrupted in DBA/2J mice, an ocular hypertensive model of glaucoma, to test its contribution to neurodegeneration. Methods A null allele of C3ar1 was backcrossed into DBA/2J mice. Development of iris disease, ocular hypertension, optic nerve degeneration, retinal ganglion cell activity, loss of RGCs, and myeloid cell infiltrationin C3ar1 deficient andsufficient DBA/2J mice were compared across multiple ages. RNA sequencing was performed on microglia from primary culture to determine global effects of C3ar1 on microglia gene expression. ResultsDeficiency in C3ar1 lowered the risk ofdegeneration in ocular hypertensive mice without affectingintraocular pressure elevation at 10.5 months of age. Differences were found in the percentage of mice affected, but not in individual characteristics of disease progression.The protective effect of C3ar1 deficiency was then overcome by additional aging and ocular hypertensive injury. Microglia and other myeloid derived cells were the primary cells identified that express C3ar1.In the absence of C3ar1, microglial expression of genes associated with neuroinflammation and other immune functions were differentially expressed compared to WT. A network analysis of these data suggested that the IL10 signaling pathway is a major interaction partner of C3AR1 signaling in microglia.ConclusionsC3AR1 was identified as a damaging neuroinflammatory factor. These datahelp suggest complement activation causesglaucomatous neurodegeneration through multiple mechanisms, including inflammation. Microglia and infiltrating myeloid cells expressed high levels ofC3ar1 and are the primary candidates to mediate its effects. C3AR1 appeared to be a major regulator ofmicrogliareactivity and neuroinflammatory function due to its interaction with IL10 signaling and other immune related pathways.Targeting myeloid-derived cells and anaphylatoxin signaling with therapiesis expected to improveneuroprotective therapeutic strategies.
Potential Using of Molecular Characterization and Structure of The Gut Bacterial Community for Postmortem Interval Estimation in Sprague Dawley Rats
Authors: Li Huan , Zhang Siruo , Liu Ruina , Yuan Lu , Wu Di , Yang E , Yang Han , Ullah Shakir , Ishaq Hafiz Muhammad , Liu Hailong , Wang Zhenyuan , Xu Jiru
Published: July 2020

Once the body dies, the inherent microbes of the host begin to break down from the inside and play a key role thereafter. It is hypothesized that after the death certain rectal microbes would change during the decomposition course in the body. This study aimed to investigate the probable shift in the composition of the rectal flora at different time intervals up to 15 days after death and to explore bacterial taxa important for estimating the time of death. At the phylum level, Proteobacteria and Firmicutes showed major shifts, when checked at 11 different intervals, and emerged at most of the postmortem intervals. At the species level, Enterococcus faecalis and Proteus mirabilis existed at most postmortem intervals; the former showed a downward trend after day 5 postmortem, while the latter showed an upward trend. There were obvious differences in bacterial community structure and richness at the phylum, genus, and species levels during the decomposition of the corpse of rats. The phylum, genus, and species taxa richness decreased initially and then increased significantly. The turning point came on day 9 when genus, rather than phylum or species, contained the most information for estimating the time of death. We constructed a prediction model using genus taxon data from high-throughput sequencing, which explained 87.2% of the time since the first sampling within 1 h. Seven bacteria, namely Enterococcus, Proteus, Lactobacillus, unidentified Clostridiales, Vagococcus, unidentified Corynebacteriaceae, and unidentified Enterobacteriaceae, were included in this model. The above-mentioned bacteria showed a promising future for estimating the shortest time of death and results of current study were agreeing with the proposed hypothesis.
Association Between Air Pollution in Lima and the High Incidence of COVID-19: Findings from a Post Hoc Analysis
Authors: Vasquez-Apestegui Vanessa , Parras-Garrido Enrique , Tapia Vilma , Paz-Aparicio Valeria M. , Rojas Jhojan P. , Sánchez-Ccoyllo Odón R. , Gonzales Gustavo F.
Published: July 2020

Background
Corona virus disease (COVID-19) originated in China in December 2019. Thereafter, a global logarithmic expansion of the cases has occurred. Some countries have a higher rate of infections despite of early implementation of quarantine. Air pollution could be related to the high susceptibility to SARS-CoV-2 and the associated case-fatality rates (deaths/cases*100). Lima, Peru has the second highest incidence of COVID-19 in Latin America and it is also one of the cities with highest levels of air pollution in the Region.
Methods
This study investigated the association of the levels of PM2.5 exposure in the previous years (2010–2016) in 24 districts of Lima with the cases, deaths and case-fatality rates of COVID-19.
Results
Until June 12, 2020, there were 6,308 deaths and 220,749 SARS-CoV-2 positive cases in Peru. In Lima, the total number of COVID-19 deaths in all metropolitan areas was 2,382. The case-fatality rate at the national level was 2.58% and 1.93% in Lima. Higher PM2.5 levels are associated with higher number of cases and deaths of COVID-19. The case-fatality rate (Deaths/cases*100) did not increase with the increase in PM2.5 levels. A higher number of food markets was associated with higher incidence and mortality of COVID-19 (p < 0.01 for both); these associations persisted when cases (r = 0.49; p < 0.01) and deaths (r = 0.58; p < 0.01) were adjusted by the population density. The association of PM2.5 with cases of COVID-19 was maintained after controlling analysis by age, sex and number of food markers.
Conclusions
the higher rates of COVID-19 in Metropolitan Lima is attributable, among others, to the increased PM2.5 exposure in the previous years after adjusting for age, sex and number of food markets. Reduction of air pollution since a long term perspective, and social distancing are needed to prevent spreads of virus outbreak.
Effects of Oral Contraceptives and Metformin on The Concentrations of Anti-Müllerian Hormone in Women with Polycystic Ovary Syndrome
Authors: Wang Liping , Hua Ke , Cai Wenwei , Fu Weiping , Zhang Hongxia , Fang Chunxia
Published: July 2020

Background: Whether treatment with oral contraceptives (OC) and metformin can reduce anti-Müllerian hormone (AMH) levels in PCOS remains controversial. This study aims to investigate the effects of OC and metformin on serum AMH concentrations in women with polycystic ovary syndrome (PCOS). Methods: This prospective study included 120 women with PCOS. Patients were treated with OC (35 μg of ethinyl estradiol plus 2 mg of cyproterone acetate), metformin, or OC plus metformin for 3 months according to their different endocrine/metabolic disturbances. Forty-eight patients with hyperandrogenism (HA) were treated with OC, 32 patients with insulin resistance (IR) were treated with metformin, and 40 patients with HA and IR were treated with a combination of OC and metformin. Serum AMH levels were compared before and after treatment within each group.Results: AMH levels decreased significantly in both OC groups (from 12.54 ± 5.59 ng/mL before treatment to 9.03 ± 4.49 ng/mL after treatment, P < 0.01) as well as in the OC + metformin group (from 10.62 ± 4.57 ng/mL to 7.74 ± 3.19 ng/mL, P < 0.01). However, AMH concentrations remained unchanged in the metformin group, although insulin sensitivity was improved. Conclusion: Treatment with OC alone or OC plus metformin led to a significant reduction of serum AMH in PCOS patients with HA, while metformin treatment alone did not affect AMH levels in patients with IR.
Designing and Evaluation of E-Health Educational Intervention on Students' Physical Activity: An Application of Pender's Health Promotion Model
Authors: Sabooteh Sahar , Feizi Awat , Shekarchizadeh Parivash , Shahnazi Hossein , Mostafavi Firoozeh
Published: July 2020

Background: The purpose of this study was to design and evaluate the software and web-based curriculum based on Pender Model to promote students' physical activity.Methods: This is a quasi-experimental study that was conducted on 225 eligible students who were randomly divided into 2 groups of Web and software-based intervention and control. The sample size of the study was selected from the students using stratified sampling method. Evaluation was done by pre-test and post-test and follow-up was performed immediately, 2 and 6 months after the intervention. The data were analyzed by statistical software SPSS using descriptive statistics, chi-square, one way ANOVA and repeated measures ANOVA.Results: The study results showed that the level of physical activity after the intervention in the web and software groups was significantly increased compared to the control group (p <0.001). Also, the mean score of Pender model constructs, immediately, 2 and 6 months after the intervention was significantly different in the web and software groups (p <0.001). Conclusion: It seems that designing and implementing educational program based on Pender model and its presentation in the form of educational software and web has a positive effect on promoting physical activity of students.
CogTale: An Online Platform for the Evaluation, Synthesis and Dissemination of Evidence From Cognitive Interventions Studies
Authors: Sabates Julieta , Belleville Sylvie , Castellani Mary , Dwolatsky Tzvi , Hampstead Benjamin M. , Lampit Amit , Simon Sharon , Anstey Kaarin J. , Goodenough Belinda , Mancuso Serafino , Marques Davis , Sinnott Richard , Bahar-Fuchs Alex
Published: July 2020

Systematic reviews and meta-analyses are critical in health-related decision making, and are considered the gold standard in research synthesis methods. However, with new trials being regularly published and with the development of increasingly rigorous standards of data synthesis, systematic reviews often require much expertise and long periods of time to be completed. Automation of some of the steps of evidence synthesis productions is a promising improvement in the field, capable of reducing the time and costs associated with the process.This article describes the development and main characteristics of a novel online repository of cognitive intervention studies entitled Cognitive Treatments Article Library and Evaluation (CogTale). The platform is currently in a Beta Release phase, as it is still under development. However, it already contains over 70 studies, and the CogTale team is continuously coding and uploading new studies into the repository. Key features include several automatically-calculated methodological quality indices and effect sizes, carrying out meta-analyses, and the generation of evidence reports including certainty ratings.
Intra-Articular Pressure in Osteoarthritis of the Knee
Authors: niu kai , Pan le hai
Published: July 2020

Background: IAP （intra-articular pressure）of the knee has been extensively studied in the knee of rheumatoid arthritis1.3 . the relationship between IAP and osteoarthrosis of knee rarely mentioned in the literature. The purpose of the study was to discover the pressure profiles observed in OA(Osteoarthritis ）. The characteristics of osteoarthritis are multiple osteophytes, unstable chondral flaps ,joint-space narrowing，sclerosis. Whether these factors effect of osteoarthritis intra-articular pressure.Methods: Fifty three research subjects were studied. They were divided into two subgroups, group 1: Forty osteoarthritis (OA). group 2: Thirteen control knee of healthy volunteer. IAP was measured using the hand held portable water manometer. before operation of arthroscopic procedures in OAgroup . Research data were analyzed to identify IAP between the two groups. Results: The main findingwasthat Resting IAP was positive pressure in all Osteoarthritis joints, otherwise subatmospheric or weakly atmospheric in normal subjects. Conclusions: The IAP rising is a feature of all patients with OAgroup. Therefore, These observations we recognize that significantly increased resting IAP is major influences by multiple osteophytes, joint-space narrowing，sclerosis , loose bodies and definite deformity of bony ends.
Improving Structure Based Models for Predicting Chemical Functions and Weight Fractions in Cosmetic Products using Ensemble Support Vector Machine
Authors: Vojinovic Tanja B , Kascelan Ljiljana , Potpara Zorica , Radonjic Natasa , Kascelan Zorka
Published: July 2020

Through usage of a large number of cosmetic products, consumers are very often exposed to toxic chemicals. This paper is aimed at proposing a model for the prediction of chemical functions and weight fractions in these products based on the structural and physical-chemical properties of the chemicals. Due to the imbalance of classes we used Support Vector Machine (SVM) method, which can complement a smaller class with the examples that are most similar to it and identify the examples that are most different. The generality of the SVM method was additionally enhanced by combining it with ensemble Bootstrap Aggregation (Bagging). The research results show that the proposed bagging SVM method can overcome the disadvantages of previously applied methods. Further, it can help address the lack of information needed to assess exposure to risk from the use of cosmetic products containing toxic chemicals in their composition. The proposed models can be applied to predict whether a certain chemical may be a substitute for a function performed by another possibly toxic chemical in a cosmetic product, as well as well as to determine the quantity proportion of a certain dangerous chemical on the basis of its chemical structure and physical-chemical properties.
Interobserver Variability in Organ at Risk Delineation in Head and Neck Cancer.
Authors: Veen Julie van der , Gulyban Akos , Willems Siri , Maes Frederik , Nuyts Sandra
Published: July 2020

Background: In radiotherapy inaccuracy in organ at risk (OAR) delineation can impact treatment plan optimisation and treatment plan evaluation. Brouwer et al. showed significant interobserver variability (IOV) in OAR delineation in head and neck cancer (HNC) and published international consensus guidelines (ICG) for OAR delineation in 2015. The aim of our study was to evaluate IOV in the presence of these guidelines. Methods: HNC radiation oncologists (RO) from each Belgian radiotherapy centre were invited to complete a survey and submit contours for 5 HNC cases. Reference contours (OARref) were obtained by a clinically validated artificial intelligence-tool trained using ICG. Dice similarity coefficients (DSC), mean surface distance (MSD) and 95% Hausdorff distances (HD95) were used for comparison.Results: Fourteen of twenty-two RO (64%) completed the survey and submitted delineations. Thirteen (93%) confirmed the use of delineation guidelines, of which six (43%) used the ICG. The OARs whose delineations agreed best with the OARref were mandible (median DSC 0.9, range [0.8-0.9]; median MSD 1.1mm, range [0.8-8.3], median HD95 3.4mm, range [1.5-38.7]), brainstem (median DSC 0.9 [0.6-0.9]; median MSD 1.5mm [1.1-4.0], median HD95 4.0mm [2.3-15.0]), submandibular glands (median DSC 0.8 [0.5-0.9]; median MSD 1.2mm [0.9-2.5], median HD95 3.1mm [1.8-12.2]) and parotids (median DSC 0.9 [0.6-0.9]; median MSD 1.9mm [1.2-4.2], median HD95 5.1mm [3.1-19.2]). Oral cavity, cochleas, PCMs, supraglottic larynx and glottic area showed more variation. RO who used the consensus guidelines showed significantly less IOV (p=0.008).Conclusion: Although ICG for delineation of OARs in HNC exist, they are only implemented by about half of RO participating in this study, which partly explains the delineation variability. However, this study highlights that guidelines alone do not suffice to eliminate IOV and that more effort needs to be done to accomplish further treatment standardisation, for example with artificial intelligence.
Characterization of the Metrnl Serum Levels in Patients with Inflammatory Bowel Disease and its Association with Inflammatory Cytokines
Authors: Gholamrezayi Afsane , Mohamadinarab Maryam , Rahbarinejad Pegah , Fallah Soudabeh , Barez Shekufe Rezghi , Setayesh Leila , Moradi Nariman , Fadaei Reza , Chamani Elham , Tavakoli Tahmine
Published: July 2020

Background
Meteorin-like (Metrnl) is a newly discovered adipokine with the anti-inflammatory and insulin sensitizing properties. Accordingly, Metrnl regulates glucose tolerance, enhances metabolism in body tissues, and induces thermogenesis in white adipose tissue. However, the correlation among Metrnl, IBD, and obesity still remains unexplored.
Methods
The present study was conducted on 54 healthy control, 42 Ulcerative Colitis (UC), and 43 Crohn's disease (CD) patients who were diagnosed by pathological examination. In these patients, serum levels of adiponectin, Metrnl, IL-6, and TNF-α were measured using ELISA kits.
Results
Metrnl concentration significantly decreased in both of the UC (85.25 ± 36.55 pg/mL) and CD (76.93 ± 27.92 pg/mL) patients compared to control group (107.52 ± 35.33 pg/mL). Similarly, adiponectin has also decreased in these two patient groups compared to the controls. However, IL-6 and TNF-α significantly increased in both of the patient groups. Moreover, Metrnl indicated an inverse relationship with BMI in the controls and both of the patient groups. In addition, there was an inverse correlation among Metrnl, IL-6, and TNF-α in both of the patient groups.
Conclusions
The current study is the first one reporting the decreased Metrnl serum level in the patients with IBD, which is inversely related to BMI, TNF-α, and IL-6. These results suggested a possible role for Metrnl in the pathogenesis of IBD, particularly through inflammation modulating.
The Impact of Propofol- and Inhalant-Based Anesthesia on Acute Kidney Injury After Major Abdominal Surgery: A Retrospective Observational Study
Authors: Kim Bo Rim , Yoon Susie , Song Gyu Young , Lee Seohee , Bahk Jae-Hyon , Nam Karam
Published: July 2020

Background: The optimal anesthetic for preventing postoperative acute kidney injury (AKI) remains unclear, and few studies on this topic have been conducted in the context of non-cardiac surgery. The purpose of this retrospective study was to compare propofol- and inhalant-based anesthesia in terms of the risk of AKI after open major abdominal surgery (MAS).Methods: Adult patients who underwent open MAS (gastrectomy, hepatectomy, colectomy, or pancreatectomy) at our institute from January 2016 to December 2018 were included. Using multivariable logistic regression, the risk of postoperative AKI was compared between patients who underwent propofol-based anesthesia (propofol group) and those who received inhalant-based anesthesia (inhalant group). Additional logistic regression analyses were performed after propensity score matching and inverse probability of treatment weighting (IPTW).Results: In total, 3,616 patients were analyzed. The incidence of postoperative AKI was 5.0% (77/1546) and 7.8% (161/2070) in the propofol and inhalant groups, respectively. The risk of AKI was significantly higher in the inhalant group (adjusted odds ratio [aOR], 1.69; 95% confidence interval [CI], 1.23–2.30; P= 0.001) than the propofol group. In the propensity score-matched cohort, the inhalant group had a higher risk of AKI than the propofol group (aOR, 1.68; 95% CI, 1.21–2.34; P= 0.002), and the logistic regression with IPTW showed similar results (OR, 1.74; 95% CI 1.14–1.66; P< 0.001).Conclusion: The risk of AKI after open MAS may differ significantly according to the anesthetic used. Patients receiving inhalant-based anesthesia may have a greater risk of postoperative AKI than those anaesthetized with propofol.
Arm and finger measurements in pregnant Asian parturients and their implications on blood pressure measurement: a prospective cohort study
Authors: Lim Ming Jian , Tan Chin Wen , Tan Hon Sen , Sultana Rehena , Eley Victoria , SNG Ban Leong
Published: July 2020

Background
Accurate blood pressure (BP) measurement depends on appropriate cuff size and shape in relation to the arm. Arm dimensions outside the recommended range of cuff sizes or trunco-conical arms may result in inaccurate BP measurements. Measuring BP using finger cuffs is a potential solution. Arm cuff size is based on mid-arm circumference (MAC), and trunco-conicity is quantified by conicity index. We aimed to determine the correlation of MAC, body mass index (BMI), and weight with conicity index.
Methods
A prospective cohort study was conducted in the KK Women’s and Children’s hospital where third trimester parturients scheduled for cesarean delivery were recruited after obtaining informed consent. Parturients were asked to rate their experience with time taken to obtain BP readings, cuff popping off during measurement, need to move the cuff from the upper arm to lower arm or leg, and need to change to a different cuff. Our primary outcome was the correlation between MAC and conicity index, calculated using Pearson’s correlation. The correlation between BMI and weight with conicity index was also determined.
Results
We enrolled 300 parturients. Moderate correlation was found between left MAC and left conicity index (r = 0.41, 95% CI 0.32 to 0.51), and right MAC and right conicity index (r = 0.39, 95% CI 0.29 to 0.48). Weight (r = 0.35 to 0.39) and BMI (r = 0.41 to 0.43) correlated with conicity index in this study. MAC of 1 parturient fell outside the recommended range for arm cuffs, but all parturients fit into available finger cuffs. Obese parturients had increased problems with arm cuffs popping off and needing a change of cuff.
Conclusions
BMI better correlated with conicity index compared to MAC or weight. Standard finger cuffs were suitable for all parturients studied and may be a suitable alternative.
Trial registration:
Clinicaltrials.gov NCT04012151. Registered 9 Jul 2019 https://clinicaltrials.gov/ct2/show/NCT04012151
Developing EU environmental standards for the food, drink and milk industries: key environmental issues and data collection
Authors: Santonja German Giner , Karlis Panagiotis
Published: July 2020

Background
The European Commission organised the review of the best available techniques reference document for the food, drink and milk industries according to the provisions of the Industrial Emissions Directive (Directive 2010/75/EU). Under this policy, an exchange of information between Member States, industrial organisations, non-governmental organisations promoting the protection of the environment and the European Commission took place.
Results
A crucial part for developing these EU environmental standards was the determination of the key environmental issues of the food, drink and milk sector. Key environmental issues were defined for emissions to air and water, and for energy and water consumption. The key environmental issues were determined by using four criteria proposed by the European Commission. Moreover, a data collection procedure was designed and real-plant emissions and consumption data were obtained from a variety of food, drink and milk installations across the European Union.
Conclusions
The development of the EU environmental standards for the food, drink and milk sector will be the reference for the operation of around 2 800 installations in Europe until these standards are reviewed again.
Repair of an Isolated Right Partial Anomalous Pulmonary Venous Connection by Rerouting Blood Flow Through an Interatrial Septum Flap in a 68-Year-Old-Woman: A Case Report
Authors: Morishtia Atsushi , Hagino Ikuo , Tomioka Hideyuki , Katahira Seiichiro , Hoshino Takeshi , Hanzawa Kazuhiko
Published: July 2020

Background: Partial anomalous pulmonary venous connection draining into the right atrium with an intact atrial septum is a very rare clinical entity in the adult population. Partial anomalous pulmonary venous connection must be suspected as a differential diagnosis when the cause of right heart enlargement and pulmonary artery hypertension is unknown.Case presentation: This study describes the surgical case of an isolated right partial anomalous pulmonary venous connection to the right atrium in a 68-year-old woman, who underwent tricuspid ring annuloplasty and right-sided maze procedure simultaneously. She had complaints of gradually progressing dyspnea on exertion. However, a diagnosis could not be established despite consultations at multiple hospitals for over a year. Right heart catheterization revealed severe pulmonary artery hypertension with a mean pulmonary artery pressure of 46 mmHg, step-up phenomenon of oxygen saturation at the mid-level of the right atrium with a pulmonary-to-systemic blood flow ratio of 2.4, and a pulmonary vascular resistance of 3.1 Wood Units. In addition, it was mandatory to comprehensively utilize valuable imaging modalities, such as transthoracic echocardiography, transesophageal echocardiography, and multidetector computed tomography angiography for the accurate diagnosis and efficient surgical planning of this partial anomalous pulmonary venous connection. As medical treatment with pulmonary artery vasodilator therapy did not improve her symptoms, she underwent surgical repair. An atrial septal defect was created surgically with a curvilinear tongue-shaped cut. The right anomalous pulmonary veins were rerouted through the surgically created atrial septal defect into the left atrium with a baffle comprised of the interatrial septum flap, kept in continuity with the anterior margin and sutured while mobilizing the enlarged right atrium. The patient had an uneventful postoperative course and remains asymptomatic. Conclusions: The described surgical technique could be considered an effective alternative for patients undergoing surgical repair for a partial anomalous pulmonary venous connection isolated to the right atrium. The indication for surgery must be judged on a case-by-case basis in these patients with prevalent systemic-to-pulmonary shunting.
The Impact of Diabetes Mellitus on Acute Kidney Injury after Coronary Artery Bypass Grafting
Authors: Wang Rui , Zhang Hang , Zhu Yifan , Chen Wen , Chen Xin
Published: July 2020

Background: Diabetes mellitus(DM) is an indicator affects postoperative mortality and morbidity after coronary artery bypass grafting (CABG). Acute kidney injury (AKI) is one of the frequent postoperative complications after CABG. This multi-centre register study designed to investigate the impact of DM on postoperative AKI in primary isolated CABG patients. Methods: We included all patients (n =4325) from Jiangsu Province CABG register who underwent primary isolated CABG from September 2017 to August 2019. The patients were divided into 3 groups: A group(non-DM, n=3067), B group(DM with oral hypoglycemic agents, n=706) and C group(DM with insulin treatment, n=552). The development and severity of AKI were based on Acute Kidney Injury Network (AKIN) criteria. Results: There were totally 338, 108 and 145 patients developed AKI in A,B and C group respectively. Comparing with A group , B group had a higher rate of AKI(c2=10.071, p=0.002), C group had a higher rate(c2=94.042, p＜0.001) and severity of AKI(c2=10.649, p=0.005). The adjusted odds ratio for AKI was 1.26 (95% CI 1.03-1.57) in B group and 3.92 (95% CI 3.27-5.16) in C group, in comparison with A group. Conclusions: Independent of baseline renal function or cardiac function, DM was associated with an increased risk of AKI after CABG, especially in patients with insulin treatment, who also had a higher severity of AKI.
FABP5 enhances malignancies of lower-grade gliomas via canonical activation of NF-κB signaling
Authors: Wang Jia , Alafate Wahafu , Wang Yichang , Wu Wei , Xiang Jianyang , Ma Xudong , Wang Ning , Liu Hao , Bai Xiaobin , Huo Longwei , Xu Dongze , Wang Maode , Xie Wanfu
Published: July 2020

Background
Lower-grade gliomas (LGGs) are grade II/III gliomas based on the WHO classification with significant genetic heterogeneity and clinical properties. Traditional histological classification of gliomas has been challenged by the improvement of molecular stratification, however, the reproducibility and diagnostic accuracy of LGGs classification remain poor.
Methods
In this study, we derived all relevant data of LGGs including TCGA and CGGA databases from official websites. Bioinformatic analyses unveiled the clinical significance of FABP5 and its potential downstream targets. IHC, qRT-PCR and western blot assays were further conducted to validate those bioinformatic findings. Moreover, lentiviral transduction assays were performed to evaluate the function of FABP5 in patient-derived cell lines.
Results
We identified fatty acid binding protein 5 (FABP5) as one of the most enriched genes in malignant LGGs and elevated FABP5 revealed severe outcomes in LGGs. Functionally, lentiviral suppression of FABP5 reduced malignant characters including proliferation, cloning formation, migration, invasion and TMZ resistance, contrarily, the malignancies of LGGs were enhanced by exogenous overexpression of FABP5. Mechanistically, epithelial-mesenchymal transition (EMT) was correlated to FABP5 expression in LGGs and tumor necrosis factor α (TNFα)-dependent NF-κB signaling was involved in this process. Furthermore, FABP5 induced phosphorylation of inhibitor of nuclear factor kappa-B kinase α (IKKα) thus activated nuclear factor kappa-B (NF-κB) signaling.
Conclusion
Taken together, our study indicated that FABP5 enhances malignancies of LGGs through canonical activation of NF-κB signaling, which could be used as individualized prognostic biomarker and potential therapeutic target of LGGs.
CTCF, a novel fusion partner of ETO2 in a post-transplant relapsed acute myeloid leukemia patient
Authors: Li Jiao , Shen Zhen , wang zheng , Xu Yi , Zeng Zhao , Bian Xiaosen , Zhang Jun , Pan Jinlan , Wu Wenzhong , Yao Li , Chen Suning , Wen Lijun
Published: July 2020

Background

ETO2 is a nuclear co-repressor, which plays a critical role in the regulation of the cell cycle, self-renewal capacity, and differentiation of hematopoietic progenitor cells.
Methods

We identified novel fusion transcripts involving ETO2 and CTCF by RNA-seq in a post-transplant relapsed case.
Results

The CTCF-ETO2 and ETO2-CTCF chimeric genes were validated by RT-PCR and Sanger sequencing. In addition, both transcripts apparently promoted cell proliferation which is beneficial to tumorigenesis.
Conclusion

The novel fusions may have prognostic value and pathogenic mechanisms in acute myeloid leukemia.
Simultaneous Targeting Tumor Cells and Cancer-Associated Fibroblasts with a Paclitaxel-Hyaluronan Bioconjugate: in vitro Evaluation in Non-Melanoma Skin Cancer
Authors: Bellei Barbara , Caputo Silvia , Migliano Emilia , Lopez Gianluca , Marcaccini Valeria , Cota Carlo , Picardo Mauro
Published: July 2020

Background: Cancers are complex organs which encompass not only the tumor cells but also cells within the surrounding stroma. Such cells, mainly cancer associated fibroblasts (CAFs) and immune infiltrating cells, facilitate many aspects of cancer development providing a structural and supportive framework rich of bioactive compounds. So far, there are emerging studies proposing the combination of conventional anti-cancer therapy, directed against neoplastic cells, to molecules targeting tumor microenviroment. Methods: The study was designed to evaluated the pharmacological properties of the anti-tumor agent paclitaxel conjugated to hyaluronic acid (HA) on non-melanoma skin cancer (NMSC) and on the surronding dermal fibroblasts. This molecule, named Oncofid-P20 (Onco-P20), targets preferentially cells expressing high level of CD44, the natural ligand of HA.Results: Consistent with paclitaxel’s mechanism of action involving interferences with the normal breackdown of microtubules during cell division, highly sensible carcinoma cells underwent rapidly to apoptotic cell death. Interestingly, less sensible cells such as dermal fibroblasts resisted to the Onco-P20 treatment and experirenced a senescent-like status characterized by morphological change, decreaded proliferation, and significant modification of the gene espression profile. Onco-P20-treated fibroblasts lowered growth factors production, down-modulate Wnt signal pathway and acquired a pro-inflammatory profile. Independently to the direct exposure to taxol, in presence of Onco-P20-treated fibroblasts or their conditioned medium, carcinoma cells reduced the proliferation rate. Similar to NHF, fibroblasts isolated from skin cancer tumor lesion or from tissue adjacent to the tumor acquired an anti-neoplastic activity under Oncofid-P20 treatment.Conclusion: Collectively, our data demonstrated that Onco-P20, exerting both a direct and a NHF-mediated indirect paracrine effect on carcinoma cells, is a good candidate for an innovative therapy alternative to surgery for treatment of NMSC.
lncRNA APOC1P1-3 promoting anoikis-resistance of breast cancer cells
Authors: Lu Qi , Wang Li , Zhu Ping , Li Luying , Wang Xue , Jin Youping , Zhi Xiuling , Yu Jerry , Li Xin , Qin Xingjun , Zhou Ping
Published: July 2020

Background

Anoikis resistance plays a critical role in the tumor metastasis by allowing survival of cancer cells in the systemic circulation. We previously showed that long non-coding RNAs APOC1P1-3 (lncRNA APOC1P1-3) inhibits breast cancer cell apoptosis. However, its role in the anoikis resistance remains unclear.
Methods

We induced anoikis resistance in two breast cancer cell lines (MCF-7 and MDA-MB-231) under anchorage-independent culture condition and studied the effects of lncRNA APOC1P1-3 on the apoptosis. The Dual-Luciferase activity assay were used to whether miRNA-188-3P can specifically bind to lncRNA APOC1P1-3. We further explored the role of APOC1P1-3 in the lung metastasis by injecting MDA-MB-231 and MDA-MB-231-APOC1P1-3-knock-down cells in the female BALB/c nude mice.
Results

We found that it suppressed early apoptosis of these cells by gain or loss of their function, respectively. We further explored its mechanism related to anoikis resistance, and found this molecule promoted the resistance via activating Caspase 3, 8, 9 and PARP. Moreover, it was specifically binding to the target miRNA-188-3p to block its inhibition of Bcl-2 (an anti-apoptosis protein). These findings suggest that lncRNA APOC1P1-3 plays an important role in the development of breast cancer metastasis via anoikis resistance.
Conclusions

This study demonstrates that lncRNA APOC1P1-3 can promote the anoikis resistance of breast cancer cells and specifically bind to miRNA-188-3p acting as a “sponge” to block the inhibition of anti-apoptotic protein Bcl-2.
Did the COVID-19 Pandemic Have Immediate Impacts on the Socio-Emotional and Digital Skills of Japanese Children
Authors: Moriguchi Yusuke , Sakata Chifumi , Meng Xianwei , Todo Naoya
Published: July 2020

Background: A novel coronavirus, SARS-CoV-2, has spread widely throughout the world. To reduce the spread of infection, children are prevented from going to school and have fewer opportunities for in-person communication. Although the pandemic has impacted the everyday lives of children, its impact on their development is unknown. This cross-sectional study compared Japanese children’s socio-emotional behaviors and skills for operating digital devices before and during the pandemic.Methods: Parents completed a web-based questionnaire before and during the pandemic for children ages 0-9. Children’s socio-emotional development in an everyday context was assessed using the Strengths and Difficulties Questionnaire (SDQ). Children’s basic touch interaction skills to operate digital devices and skills to use functions of digital devices were also measured.Results: The results indicated that during the pandemic, children were more prosocial, experienced more problems in their peer relationships, and had better digital skills, but no differences were found in emotional symptoms, conduct problems, hyperactivity between before and during the pandemic. The differences in digital skills was explained by the duration of children’s media use.Conclusions: Overall, our results suggest the pandemic may have immediate impact on children’s socio-emotional behaviors and digital skills. Trial registration: We pre-registered our hypotheses, method, primary analyses, and sample size (https://osf.io/c7p6b)
Preoperative False-Negative Transthoracic Echocardiographic Results in Native Valve Infective Endocarditis Patients: A Retrospective Study from 2001 To 2018
Authors: Ren Zuning , Zhang Jian , Chen Hongjie , Mo Xichao , Cai Shaohang , Peng Jie
Published: July 2020

Background: Infective endocarditis (IE) is a lethal disease that is difficult to diagnosis early. Although echocardiography is one of the most widely used diagnostic technique, it has limited sensitivity. This study surveyed the clinical features of IE patients who underwent surgery and compared transthoracic echocardiography and histological findings to explore the factors related to false-negative echocardiographic results.Methods: Medical records were extracted from IE patients consecutively hospitalized between June 2001 and June 2018. Results: A total of 182 patients with native valve IE who underwent surgery were included. Compared to the non-surgery group, the surgery group was more likely to have pre-existing valvular lesions and more serious cardiac conditions and a relative lack of signs of infection and cerebrovascular events, leading to a lower proportion of “definite cases” before surgery. The false-negative rate of echocardiography was 14.5%. Echocardiography has significant disadvantages in diagnosing perivalvular abscesses, valve perforations, and left-sided endocarditis, especially for subjects with both aortic and mitral valve infections. The multivariate analysis identified congenital heart disease and small vegetations (<10 mm) as independent predictors of false-negative echocardiography results. Conversely, fever and heart murmurs on admission served as protective factors. Conclusions: Under some circumstances, echocardiography provides inconsistent results compared with surgical findings, and negative echocardiography results do not rule out IE. The diagnosis of IE depends on comprehensive evaluations using multiple methods.
Predicting adverse events in patients who are anxious about dental procedures
Authors: Oike Yasunobu , Takamura Norito , Tokunaga Jin , Ogata Kenji , Setoguchi Nao , Nakamura Mariko
Published: July 2020

Background

Dental extractions can cause significant anxiety making patients feel sick. In serious cases, extractions can cause unconsciousness and even death. Therefore, systemic adverse events must be completely avoided. We herein developed a method to predict dental extraction-related adverse events in patients.
Methods

The State-Trait Anxiety Inventory (STAIY-1) was administered before calculus removal and extraction, and STAIY-2 was administered before calculus removal in 93 patients (men, 44; women, 49). These patients were at a dental clinic for outpatient treatment. The vital signs like blood pressure, pulse rate, and arterial oxygen saturation and salivary amylase activity were measured at 2- and 4-min intervals before calculus removal as well as before extraction.
Results

Of the 93 patients, one man and one woman suffered from an adverse event. Maximum points for raw STAIY-1 scores were measured before extraction for both men and women, suggesting that performing the STAIY-1 survey prior to extraction is effective in predicting extraction-related adverse events. We also investigated rate changes (rate change = mean value during extraction − mean value during calculus removal/mean value during calculus removal) and mean pre-extraction pulse rates in patients who suffered from an adverse event. Adverse events occurred in men when there was a rate change of ≥ 0.225 and mean pre-extraction pulse rate was ≥ 90.0 bpm and in women when there was a rate change of ≥ 0.200 and the mean pre-extraction pulse rate was ≥ 95.0 bpm. We used these pulse rates as cutoff values.
Conclusions

Thus, the combined use of pre-extraction STAIY-1 results and pulse rate cutoff values could increase the success of predicting adverse events in such patients.
Zadek osteotomy for the treatment of Haglund’s Syndrome
Authors: Zheng Weixin , Du Junhua , Liang Jingqi , Zhang Yan , Liang Xiaojun , Zhao Hongmou
Published: July 2020

Background: Although several treatment options described in paper, Haglund’s Syndrome (HS) is a challenging common lower extremity disorder. This study reported the clinical outcomes of Zadek osteotomy (ZO) for the treatment of HS.Methods: This retrospective study included 19 patients who underwent ZO from January 2016 to June 2018. Patients were evaluated using the American Orthopedic Foot Ankle Society ankle-hindfoot scale (AOFAS), Visual Analogue Scale (VAS), ankle range of motion (AROM), and Chauveaux-Liet (CL) angle preoperatively and at final follow-up visit (16.3±4.2) months. Postoperative complications of patients were also recorded.Results: The ZO exhibited a significant improvement (P＜0.05) in preoperative to postoperative AOFAS (from 53.2±5.4 to 86.4±6.5), VAS ( from 6.3±2.1 to 0.9±1.2 ) scores and CL angle (from 18.2±1.3 to 9.4±2.1 ) degrees, the dorsiflexion of AROM (DAROM) (from 23.4±2.3 to 29.4±1.2) degrees. The planter flexion of AROM (PAROM) (from 32.5±3.5 to 33.2±3.4) degrees (P＞0.05). One postoperative complication was observed: a case of hardware pain in healthy patient. The overall rate of satisfaction after surgery was (94.7%).Conclusions: ZO is effective and safe procedure for the treatment of HS. This method can be a good option for those patients of HS.