bluuebunny/crossref_metadata_2025 huggingface dataset:
High incidence of surgical site infection may be related to suboptimal case selection of non-selective arterioembolisation during resuscitation of patients with pelvic fractures
Authors: Lai Chih-Yang , Tseng I-Chuan , Su Chun-Yi , Hsu Yung-Heng , Chou Ying-Chao , Chen Huan-Wu , Yu Yi-Hsun
Published: January 2020

Background In most institutions, arterioembolisation (AE) remains a standard procedure to achieve haemostasis in the resuscitation of patients with pelvic fractures. However, the actual benefits from AE are controversial. Methods We retrospectively reviewed data from patients with closed pelvic fractures between 2014 and 2017 in a single institute. The details of AE and clinical parameters were recorded and analysed to determine whether poor outcomes could be predicted. Results During the study period, 545 patients with closed pelvic fractures were enrolled. Angiography was performed in 131 patients, and 129 patients underwent AE. The patients who underwent AE had higher injury severity score, more numbers of shock status on arrival, and higher incidence of unstable fracture patterns when compared to non-AE group. A higher number of patients who underwent AE required osteosynthesis and experienced surgical site infection (SSI) after osteosynthesis than those who did not receive AE. Nonselective bilateral internal iliac artery embolisation (nBIIAE) was the major approach for AE (74%). Overall, 11 patients experienced SSI in the AE group, 9 of whom had received nBIIAE. The positive predictive value of contrast extravasation (CE) on computed tomography (CT) was 29.6%, with a negative predictive value of 91.3%. Mortality was higher in patients without CE on CT than patients with identifiable CE (30.0% vs. 11.0%, p = 0.03). Conclusion Using the finding of CE on CT examination as a decision for AE is not a reliable indicator because of its low positive predictive value. Considering the high incidence of SSI following nBIIAE, candidates should be carefully selected for this procedure. Other haemostasis procedures such as preperitoneal pelvic packing might be considered for select cases, given the high mortality rate among patients without CE during image studies, relative to patients with identifiable CE.
Novel Biallelic Loss-of-Function Variants in CEP290 Cause Joubert Syndrome in Two Siblings
Authors: Wang Xiang , Zhang Zhu , Zhang Xueguang , Shen Ying , Liu Hongqian
Published: January 2020

BackgroundJoubert Syndrome (JS) is a rare genetic disorder, which can be defined by brainstem malformation, cerebellar vermis hypoplasia and consequent “molar tooth sign” (MTS). JS always shares variety of phenotypes in development defects. With the development of next-generation sequencing, dozens of causative genes have been identified to JS so far. Here we investigated a JS case in two male siblings aged 4 and 10 years old and uncovered a novel pathogenesis through combined methods.Results The siblings shared similar features of nystagmus, delayed intellectual development. typical MTS, and abnormal morphology in fourth ventricle. Whole exome sequencing (WES) and chromosome comparative genomic hybridization (CGH) were then performed on the proband. Strikingly, a maternal inherited nonsense mutation (NM_025114.3: c.5953G>T [p.E1985*]) in CEP290 gene and a paternal inherited deletion in 12q21.32 including exon 1 to 10 of CEP290 gene were identified in the two affected siblings. We further confirmed the two variants by in vitro experiments: qPCR, and PCR-sequencing.Conclusions In this study, we first reported a novel causative mechanism of Joubert Syndrome: a copy number variation (CNV) compounding with a point mutation in CEP290 gene, which can be helpful in the genetic diagnosis of this disease.
Comparison of tendency and accuracy in predicted post-operative refraction and recommended IOL power between IOL Master and VERION before and after optimizing IOL-constant in the VERION
Authors: Teshigawara Takeshi , Meguro Akira , Mizuki Nobuhisa
Published: January 2020

Background: We assessed the accuracy and tendency of the VERION image-guided system (Alcon) and the intra-ocular lens (IOL) Master 700 (Zeiss), by comparing mean refractive shift (MRS) of predicted post-operative refraction (PPR), mean absolute error (MAE) of PPR, recommended IOL power (RIP) and K-value before and after optimizing the IOL-constant in VERION, to show the importance of optimization.Methods: This retrospective study involved 72 eyes. K-value was measured with both biometers. Axial length (AL) and anterior chamber depth (ACD) measured by the IOL Master were applied to the VERION because it cannot measure these variables. The User group for Laser Interference Biometry (ULIB) IOL-constant for the IOL Master was applied to the VERION before optimizing the IOL constant, since no such official measure was established for it. MRS of PPR, MAE of PPR, RIP and K-value as measured by both biometers were compared before and after optimizing the IOL-constant in the VERION. Finally, correlations between the MRS, MAE, RIP, and K-value were analyzed in the VERION. The Wilcoxon signed-rank test was used for analysis.Results: Compared to the IOL Master, K-value was significantly higher in the VERION. Prior to optimization, MRS of PPR showed a significant myopic shift in the VERION, and MAE of PPR was significantly higher. Additionally, RIP in the VERION was significantly lower. After optimization, there were no significant differences in the MRS of PPR and RIP between the VERION and IOL Master. MAE of PPR in the IOL Master was significantly higher than in the VERION. No significant correlations were found between MRS and MAE of PPR and RIP with K-value in the VERION. Conclusions: Before optimization, the VERION was less reliable in MRS, MAE and RIP than the IOL Master. However, after optimization, the difference in MRS and RIP between the two devices became insignificant. This study indicates that optimization of IOL-constant in the VERION is vital. After optimization, the VERION is more accurate in PPR than the IOL Master.
Age-related changes of the corneal endothelium in a Hispanic elderly population.
Authors: Valdez-Garcia J , Ortiz-Morales Gustavo , Morales-Mancillas Nallely , Domene-Hickman Jorge Luis , Hernandez-Camarena Julio , Loya-Garcia Denise , Zavala Judith , Rodriguez-Garcia Alejandro
Published: January 2020

Purpose: To assess the corneal endothelial morphometry in healthy elderly Hispanic eyes.Methods: A retrospective, cross-sectional, observational, descriptive, and analytical study was designed to assess by specular microscopy the central region of the corneal endothelium. In a 4-year period, a total of 75 eyes from 42 patients were studied. All eyes included were from patients 65 or older (mean: 73.87±6.86), without ocular disease or surgeries.Results: The mean cell density (MCD) was 2268±597.0 cells/mm2. 44% of patients had polymegethism, with an average coefficient of variation (CV) of 42.04 ± 10.1%. 76% of patients had low pleomorphism, with an average of 42.3 ± 8.9% hexagonal cells. The mean corneal thickness was 537±38.2 μm. There was no statistically significant difference between age groups for MCD, CV, hexagonality and pachymetry (p=>.05). 27% of patients had corneal guttata.Conclusion: This study suggests that the elderly Hispanic population has a high prevalence of polymegethism, pleomorphism and guttata. Surprisingly, the oldest age group (>85) had an above average MCD, low polymegethism and good pleomorphism.
A pioneer usage of nanogold sandwich ELISA in the detection of hydatid antigen in humans as a tool for improvement of serodiagnostic testing.
Authors: Elawamy Waleed E , Rashed Samia M , Nassr Mona E , Shalash Ibrahim R A , Ali Nagwa S , Elghanam Amera S , Nageeb Marwa M
Published: January 2020

Background: Human cystic echinococcosis is a zoonosis occurring due to dogs handling and exposure to Echinococcus granulosus ova in their stools being an accidental intermediate host. Serology remains the only sure and important tool to diagnose this disease. Our objectives in this research are to improve the serodiagnostic abilities of sandwich ELISA through its binding to gold nanoparticle and proving the role of minute nanoparticles in serodiagnosis. Methods: gold nanoparticles (AuNPs) were employed for the capture of the antigens of protoscolices (pAg) in the patient’s serum by sandwich ELISA. Cross-reactivity for antigens from Hymenolepis nana , Entrobius vermicularis , and Fasciola gigantica was ruled out by using anti-protoscolices polyclonal antibodies (ppAb). (pAg) of sonicated protoscolices which were removed from camel lung cysts, was purified by diethyl aminoethyl Sephadex (DEAE-Sephadex) and injected to a New zealand white rabbit giving ppAb which then conjugated to horseradish peroxidase (HRP) and loaded on AuNPs being used as a diagnostic indicator for circulating pAg by both sandwich ELISA and nanogold sandwich ELISA techniques. Results: Nanogold sandwich ELISA was able to give positive results with 96.3% of hydatid patients and 5% of non-hydatid patients while sandwich ELISA showed 81.4% and 20% positive cases of the same groups respectively. The sensitivity and specificity of nanogold sandwich ELISA were 96.3% & 95% against 81.5% & 80% for those of sandwich ELISA respectively. Conclusion: The conjugation of AuNPs to anti- Echinococcus IgG antibodies seems to be beneficial to maximize the sensitivity of sandwich ELISA, reduce the overall cost of the assay as less antibody was needed, solve harsh buffering conditions and achieve greater stability which provides a reliable quantitation of analytes.
Prevalence and associated factors of chlamydial infection among patients seeking clinic-based STI services in Shenzhen, China
Authors: Wang Hong-Lin , Cai Yu-Mao , Chen Xiang-Sheng , Yu Wei-Ye , Hong Fu-Chang , Feng Tie-Jian , Liu Jin-Hong , Zhang Chun-Lai , Wen Li-Zhang , Wang Feng , Ye Jian-Bin , Weng Rong-Xing , Tang Fen
Published: January 2020

Objectives Prevalence assessment is one of the core components of WHO-recommended STI surveillance programming. This study aimed to provide prevalence and associated factors data for estimating the disease burden of CT, developing intervention programmes, and planning for resource allocations.Methods We carried out a cross-sectional survey among patients attending clinics for STI services. We collected background information from patients (aged 18-49) and determined positivity of CT by nucleic acid amplification test (NAAT) with self-collected urine specimens. Associated factors identified through logistic regression.Results Among the 8324 participants, 751 were detected to be positive for CT, giving an overall prevalence of 9.0% with 10.7% for male and 8.3% for female respectively. Aged older than 24 (OR=0.78, 95%CI=0.62-0.98), married (OR=0.61, 95%CI=0.50-0.75), college or higher education (OR=0.66, 95%CI=0.51-0.86), having no access to health insurance (OR=1.28, 95%CI=1.07-1.51), and positive for NG (OR=4.45, 95%CI=3.22-6.15) were factors found to be significantly associated with CT infection.Conclusions We found that CT infection is prevalent among patients seeking clinic-based STI services in Shenzhen, China. A comprehensive CT screening, surveillance, and treatment programme targeting this population are warranted. And the CT integrated prevention and control projects could be considered as routine public health services by the government.
Prevalence of gastrointestinal bleeding and frequency of selected predictors of mortality on the Medical Emergency Ward at Mulago Hospital
Authors: KISUULE IVAN , Seremba Emmanuel , Kagimu Magid
Published: January 2020

Background Gastroenterologists of Mulago hospital noted that many patients with gastrointestinal bleeding are transferred to their ward from the emergency ward without adequate resuscitation. They recommended that blood should be ring fenced for patients with gastrointestinal bleeding (GI) on the emergency ward so that urgent resuscitation can be done. There was however no current data on the prevalence of GI bleeding in the emergency ward to provide a guide of how much blood should be ring fenced. This was partly because the medical records are not adequately completed as designed. We thus undertook a study to estimate the prevalence of GI bleeding on the emergency ward by incorporating quality improvement methods in the process of data collection to improve the documentation practice on the Casualty assessment form (CAF).Methods This was a cross sectional study incorporating quality improvement methods in the process of data collection from the CAF for patients attending the emergency ward. Focus group discussions and key informant interviews were conducted to ascertain the root causes of inadequate completion of this form. The health care team was educated on documentation of GI bleeding while being assessed weekly for knowledge and practice of completion of the CAF. The filled CAF were assessed for adequate completion while looking out for a documented diagnosis of GI bleeding and selected predictors of mortality.Results Of the 1881 CAF assessed, 278 had a documented diagnosis of GI bleeding, resulting in a prevalence of 6.8%. Of the patients with GI bleeding, 14.1% of them had age greater than 60 years old, 24.0% had a systolic blood pressure less than 100mmHg and 44.5% had a heart rate greater than 100 beats per minute.Conclusion The prevalence of GI bleeding on the medical emergency ward of Mulago hospital is high, with 1 in every 15 patients having this condition. This calls for strategies for resuscitative management of this potentially life threatening condition. Among the selected predictors of mortality, tachycardia was most frequent followed by hypotension. These should always be assessed in a patient with GI bleeding and resuscitative measures with blood transfusion and intravenous fluids undertaken to correct them.
NAFLD progression is related with plasma pro-oxidative biomarkers rather than liver tissue-measured nitrogen metabolism biomarkers in population with obesity and metabolic syndrome
Authors: Suárez-Cuenca Juan Antonio , Domínguez-Pérez Gabriela Alexandra , Hernández-Muñóz Rolando Efraín , Hernández-Patricio Alejandro , Vera-Gómez Eduardo , Gutiérrez-Buendía Juan Ariel , Cázares-García Ollin , Salamanca-García Moisés , Ortíz-Fernández Moisés , Montoya-Ramírez Jesús , Gaytán-Fuentes Omar Felipe , Blas-Azotla Ricardo , Melchor-López Alberto , Vaca Rebeca Pérez-Cabeza de , Mondragón-Terán Paul
Published: January 2020

Background. The metabolic syndrome (MS) is associated with an increased production of nitrogen metabolites and elevated oxidative stress, which favor the development and progression of non-alcoholic fatty liver disease (NAFLD). Subjects with the phenotype known as metabolically unhealthy obese (MUO) meet most of the MS cardiometabolic risk criteria and show a higher prevalence of NAFLD and fibrosis progression risk, compared to the so-known as metabolically healthy obese (MHO). The present study aimed to explore whether liver-specific biomarkers of nitrogen metabolism and oxidative stress, measured in both plasma and in liver tissue, may relate to NAFLD severity and/or metabolic phenotype. Methods. This observational, cross-sectional study included candidates for bariatric surgery with biopsy-proven NAFLD diagnosis and staging. For comparison, the study population was divided according to NAFLD progression (steatohepatitis F0-F1 vs F2-F4) and metabolic phenotype (MHO vs MUO, based on the MS criteria). Hepatic and plasma concentrations of nitrogen metabolites and oxidative stress biomarkers were determined by enzymatic kinetics assays, ELISA and Griess reaction. Results. The study population consisted of 28 patients with obesity and higher prevalence of dyslipidemia, diabetes mellitus and hypertension. NAFLD progression was related with the metabolic phenotype. According to plasma biomarkers, MUO phenotype was related to higher cardiometabolic risk; while NAFLD severity progression was related to higher Hb A1c and triglycerides. Elevated hepatic concentrations of ammonium, nitrites, arginine and citrulline were found in MUO phenotype, but only higher plasma concentration of MDA was found as specifically related to NAFLD progression. Conclusions. Circulating biomarkers of redox state were selectively related with NAFLD progression, supporting prognostic and therapeutic potential target. Hepatic concentrations of nitrogen metabolism biomarkers may be more related to cardiometabolic risk.
Developing a roadmap to improve trial delivery for underserved groups: results from a UK multi-stakeholder process
Authors: Witham Miles D , Anderson Eleanor , Carroll Camille , Dark Paul M , Down Kim , Hall Alistair S , Knee Joanna , Maier Rebecca H , Mountain Gail A , Nestor Gary , Oliva Laurie , Prowse Sarah R , Tortice Amanda , Wason James , Rochester Lynn
Published: January 2020

Background Participants in clinical research studies often do not reflect the populations for which healthcare interventions are needed or will be used. Enhancing representation of underserved groups in clinical research is important to ensure that research findings are widely applicable. We describe a multicomponent workstream project to improve representation of underserved groups in clinical trials.Methods The project comprised three main strands: 1) a targeted scoping review of literature to identify previous work characterising underserved groups and barriers to inclusion; 2) surveys of professional stakeholders and participant representative groups involved in research delivery to refine these initial findings and identify examples of innovation and good practice; 3) a series of workshops bringing together key stakeholders from funding, design, delivery and participant groups to reach consensus on definitions, barriers and a strategic roadmap for future work. The work was commissioned by the UK National Institute for Health Research Clinical Research Network. Output from these strands was integrated by a steering committee to generate a series of goals, workstream plans, and a strategic roadmap for future development work in this area.Results ‘Underserved groups’ was identified and agreed by the stakeholder group as the preferred term. Three-quarters of stakeholders felt that a clear definition of underserved groups did not currently exist; definition was challenging and context-specific but exemplar groups were identified as underserved. Barriers to successful inclusion of underserved groups could be clustered into: communication between research teams and participant groups; how trials are designed and delivered, differing agendas of research teams and participant groups; and lack of trust in the research process. Four key goals for future work were identified: building long-term relationships with underserved groups; developing training resources to improve design and delivery of trials for underserved groups; developing infrastructure and systems to support this work, and working with funders, regulators and other stakeholders to remove barriers to inclusion.Conclusions The work of the INCLUDE group over the next 12 months will build on these findings by generating resources customised for different underserved groups to improve the representativeness of trial populations.
Fertility outcomes of deep infiltrating endometriosis with fertility desire—a meta analysis
Authors: shen yue , Feng Ziyi , Jiang Lili , Li Yue , Liu Kuiran
Published: January 2020

Background: The morbidity of endometriosis has been ascending in recent years. Deep infiltrating endometriosis is the most advanced type of endometriosis. The treatments for patients with DIE and fertility desire are controversial. Materials and Methods: We had search Pubmed, OVID Medline, Cochrane Library published before 2019-10-31, According to the inclusion criteria and exclusion criteria, a total of 17 articles were selected. A 95% confidence interval (CI) was used for clinical pregnancy data, and a random-effect model was used for meta-analysis. Subgroup analysis and sensitivity analysis were performed using Review manager 5.3. Results: Among patients with fertility desire, 370/1142 (32.40%) conceived spontaneously after surgery, compared with 306/1108(27.62%) got pregnant after surgery and assisted reproductive technology（P=0.36,I2=82%）.There is no significant statistical significance in this comparison and the heterogeneity is high. Then，we performed subgroup analysis and found that the heterogeneity was not caused by fertility status ,surgical methods or study characteristics. Conclusion: Through this meta-analysis, we think that surgery combined ART or not doesn’t effect on pregnancy rate in patients with DIE. But further investigations are required to determine fertility outcomes according to age, endometrioma, adenomyosis, ASRM scores and so on.
A Dual-Model of Posttraumatic Stress and Posttraumatic Growth in a Community Sample of Female Conflict-Related Sexual Violence Survivors from Bosnia & Herzegovina
Authors: Anderson Kimberley , Komproe Ivan , Delić Amra , Avdibegović Esmina , Ee Elisa van , Glaesmer Heide
Published: January 2020

Background Posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) are increasingly acknowledged as psychological outcomes that can co-occur in the aftermath of a traumatic event. Less clear however, is how these outcomes interact – particularly for female survivors of conflict-related sexual violence (CRSV) – and to what extent intermediary factors such as coping play a role in this relationship.Methods In a sample of 192 survivors of the 1990s conflict in Bosnia & Herzegovina; of whom 104 experienced CRSV, and 88 who did not, a structural equation model was tested using LISREL 8.8 that included CRSV as a traumatic event, ‘positive reinterpretation’ (as a strategy of approach coping) and ‘behavioural disengagement’ (as a strategy of avoidance coping), and PTSD and PTG as psychosocial outcomes. It was hypothesised that there would be differences in the mechanisms by which PTG and PTSD interact in the two subgroups, given the differences in the nature of the trauma they experienced.Results Through multiple indirect relationships, results showed that CRSV survivors respond to their trauma with both PTSD and PTG, substantiating a dual PTSD-PTG mechanism, as opposed to a single spectrum with these outcomes at the poles. With regard to coping strategies, positive reinterpretation predicted greater PTG, and behavioural disengagement predicted greater PTSD. In the sample of non-sexual violence survivors, positive reinterpretation also remained a significant predictor of PTG.Conclusions Findings suggest that positive reinterpretation as a coping strategy appears to be a stable characteristic that independently predicts PTG, irrespective of trauma type. Mental health care professionals should take into account this specific mechanism when addressing the needs of CRSV survivors, but also war survivors more generally. Reframing traumatic events and post-trauma sequalae during treatment could lead to greater PTG and enhance recovery.
The rs1058587 of growth differentiation factor 15 increased the development and mortality risk of end-stage renal disease
Authors: Li Guisen , SHEN Yajun , CHEN Sipei , WU Changwei , ZHONG Xiang , HONG Daqing
Published: January 2020

Background Growth differentiation factor 15 (GDF-15) is a member of transforming growth factor β (TGF- β). Recent studies have shown that the serum level of GDF-15 increased and was associated with the occurrence and progression of the many diseases. However, the effect of GDF15 variants on end-stage renal disease (ESRD) is still unclear. The study was to explore the effect of GDF15 rs 1058587 on the susceptibility to ESRD and mortality risk of ESRD. Methods A total of 296 ESRD patients and 300 healthy individuals were enrolled. All the patients were followed-up for 3 years. The genotype of GDF-15 rs 1058587 was determined PCR amplification and Sanger sequencing. The baseline serum GDF-15 level was measured by enzyme-linked immunosorbent assay (ELISA). Results The frequency of G gene in ESRD patients was higher in ESRD patients than in controls (30.14% vs. 25.17%, P =0.027). The patients with CG/GG genotype had higher mortality risk in the dominant model (CG+GG vs. CC, OR= 1.708, 95% CI: 1.288 - 2.461, P = 1.00×10 -3 ). Multivariate analysis showed that age > 60 years, total cholesterol > 6 mmol/L, and genotype GG were independent risk factors for mortality in patients with ESRD (P <0.05), and survival analysis informed us that the three-year overall survival of patients with GG genotype was significantly lower than other genotype patients. Conclusions The G allele or CG/GG genotype of GDF15 was associated with higher susceptible risk of ESRD and the genotype GG was an independent risk factor for overall mortality in patients with ESRD.
How to measure professional discrimination in healthcare settings?
Authors: Jaberi Azita , ZareKhafri Fatemeh , Torabizadeh Camellia
Published: January 2020

Professional discrimination is one of the most important challenges of inter-professional interaction. To understand and describe this concept from the viewpoints of health team members, a scientific tool is required to measure professional discrimination based on which planning and decision-making will be possible. Materials and Methods : The present methodological study was conducted in qualitative and quantitative phases. In the first phase, the main aspects of the concept of professional discrimination were defined through extensive literature review and viewpoints of experts and nurses. In the quantitative phase, after designing and extracting the tool items, validity (face, content, and construct) and reliability (internal consistency and stability) of the tool were assessed. Results : Professional discrimination included some concepts, such as discrimination in employment promotion and access to educational opportunities, disparities in welfare compared to other careers such as physicians, disparities in superiors’ behaviors towards inferiors like nurses in different situations, gender and ethnic discrimination, and the consequences of discrimination. In exploratory factor analysis, scree plot and factor load less than 0.4 showed that the questionnaire included five factors, namely “horizontal and vertical discrimination”, “discrimination consequences”, “inequality due to differences in employment, education, and ethnicity”, and “ethnic and gender discrimination”. Conclusion : The results showed that the 33-item questionnaire had appropriate validity and reliability. Indeed, an overview of the existing tools showed that the questionnaire represented better than similar ones both in terms of the specificity of measuring the concept and evaluation of psychometric properties. Measurement of professional discrimination could provide health managers and decision-makers with highly accurate and documented information.
Enhanced rhamnolipids production using a novel bioreactor system based on integrated foam-control and repeated fed-batch fermentation strategy
Authors: Xu Ning , Liu Shixun , Xu Lijie , Zhou Jie , Xin Fengxue , Zhang Wenming , Qian Xiujuan , Dong Weiliang , Jiang Min
Published: January 2020

Background
Rhamnolipid is the best known microbial-derived biosurfactants, which has attracted great interest as potential ‘‘green” alternative for synthetic surfactants. However, rhamnolipid is major contributor to severe foam problems, which greatly inhibits the economics of industrial-scale production. In this study, a novel foam-control system was established for ex situ dealing with the massive overﬂowing foam. Based on the designed facility, foam reduction efficiency, rhamnolipid production by batch and repeated fed-batch fermentation were comprehensively investigated.
Results
An ex situ foam-control system was developed to control the massive overﬂowing foam and improve rhamnolipid production. It was found that the size of individual bubble in the early stage was much larger than that of late fermentation stage and the foam liquefaction efficiency decreased from 54.37% at the beginning to only 9.23 % at the end of the fermentation. This difference of bubble stability directly resulted higher foam reduction efficiency of 67.46 % in the early stage, whereas the small uniform bubbles can only be reduced by 57.53 % at the later fermentation stage. Moreover, reduction of secondary foam is very important for foam controlling. Two improved design of the device in this study got about 20% improvement of foam reduction efﬁciency, respectively. The batch fermentation result showed that the average volume of the overflowing foam was reduced from 58~640 mL/min to 19~216 mL/min during fermentation process, presenting presented a notable reduction efficiency ranging from 51.92% to 73.47%. Meanwhile, rhamnolipid production of batch fermentation reached to 45.63g/L, and the yield 0.76g/g was signiﬁcantly better than ever reported. Further, Moreover, a repeated fed-batch fermentation based on the overall optimization was carried out, total rhamnolipids concentration of 48.67 g/L was reached with yield around of 0.67-0.83 g/g, which presented an improvement of 62% and 49% compared with conventional batch fermentation by using various kinds of defoam, respectively.
Conclusions
The ex situ foam-control system presented a notable reduction efficiency, which helped a lot to easily solve the severe foaming problem without any defoamer addition. Moreover, rhamnolipid production and yield by repeated fed-batch fermentation got prominent improvement compared to conventional batch cultivation, which can further facilitate economical production of rhamnolipids at large scales.
Comparison of postoperative analgesic efficacy of preemptive USG-guided TAP block, USG-guided local infiltration and intravenous dexketoprofen in inguinal hernia repair
Authors: Salık Fikret , Bıçak Mustafa , Akelma Hakan
Published: January 2020

Background Although regional techniques have been suggested more in order to provide postoperative analgesia in inguinal hernia repairs, the ideal method is still controversial. The aim of this study was to evaluate the effect of preemptive transversus abdominis plane (TAP) block, local anesthetic infiltration (LAI) and intravenous dexketoprofen (IVD) on postoperative pain in inguinal hernia repairs. Methods This prospective study included 120 patients with American Society of Anesthesiologists status 1-3 between 18-75 years of age who undergoing elective inguinal hernia surgery under spinal anesthesia. The patients were allocated into three groups: USG-guided TAP block (Group 1, n = 40), USG-guided LAI (Group 2, n = 40) and IVD (Group 3, n = 40) before surgical incision. The mean of tramadol consumption, number of patients in requiring rescue analgesics, duration of postoperative analgesia and complications were recorded for 24 hours postoperatively. VAS scores were evaluated at the 30 minute, 1, 2, 4, 8, 12, 16 and 24th hours. Results There was no significant difference between the postoperative mean tramadol consumption [Group 1: 22.5 mg; Group 2: 20 mg; Group 3: 27.5 (p 0.833)]. The number of patients requiring rescue analgesics was statistically similar (p 0.787). VAS scores at 30. min, 1, 2, 4, 8 and 12 hours were statistically lower in Group 1 than in the other groups (p 0.003, 007, 0013, 0049, 0015, 0021). VAS scores at 30. min and 2. h were lower in Group 1 than Group 2 (p 0.049, 0.037). İn addition, VAS scores at 30 min, 1, 2, 8 and 12 hours were lower in Group 1 than in Group 3 (p 0.003, 0.006, 0.021, 0.017, 0.016). VAS scores at all hours were statistically similar between Group 2 and Group 3. Conclusion This study demonsrated that preemptive transversus abdominis plane block, local anesthetic infiltration or iv dexketoprofen for postoperative analgesia in inguinal hernia repairs had similar effects on postoperative tramadol consumption and number of requiring rescue analgesic patients. However, TAP block provides lower VAS values and excellent analgesia in more patients in the first 24 hours postoperatively.
Sedative Use of Dexmedetomidine vs. Propofol after Cardiac Surgery A Critical Review and Meta-Analysis.
Authors: Abowali Hesham A. , Paganini Matteo , Enten Garrett , Elbadawi Ayman , Camporesi Enrico
Published: January 2020

Background The efficacy and safety of dexmedetomidine in sedation for postoperative cardiac surgeries are controversial when compared to propofol. Methods A computerized search on Medline, EMBASE, Web of Science, and Agency for Healthcare Research and Quality databases was performed through July 2019. Trials evaluating the efficacy of dexmedetomidine versus propofol in the sedation of postoperative cardiac surgery patients were selected. The primary study outcomes were divided into time-dependent (mechanical ventilation time; time to extubation; length of stay in the intensive care unit and the hospital) and non-time dependent (delirium, bradycardia, and hypotension). Results Our final analysis included 11 RCTs published between 2003 and 2019 and involved a total of 1184 patients. Time to extubation was significantly reduced in the dexmedetomidine group (Standardized Mean Difference (SMD) = -0.61, 95% Confidence Interval (CI): -1.06 to -0.16, p=0.008), however no difference in mechanical ventilation time was observed (SMD= -0.72, 95% CI: -1.60 to 0.15, N.S.). Moreover, the dexmedetomidine group showed a significant reduction in Intensive Care Unit length of stay (SMD= -0.70, 95% CI: -0.98 to -0.42, p=0.0005) this did not translate into a reduced hospital length of stay (SMD= -1.13, 95% CI: -2.43 to 0.16, N.S). For non-time dependent factors: incidence of delirium was unaffected between groups (OR: 0.68, 95% CI: 0.43 to 1.06, N.S.), while the propofol group of patients had higher rates of bradycardia (OR: 3.39, 95% CI: 1.20 to 9.55, p=0.020) and hypotension (OR: 1.68, 95% CI: 1.09 to 2.58, p=0.017). Conclusion Despite the ICU time advantages afforded by dexmedetomidine over propofol, the former does not contribute to an overall reduction in hospital length of stay or an overall improvement in postoperative outcomes of heart valve surgery and CABG patients. Additionally, time-dependent outcomes are affected by several confounding factors, and more efforts are needed to analyze factors that could affect sedation in post-cardiac surgery patients and choose unbiased outcomes.
Marathoners’ breathing pattern protects against lung injury by mechanical ventilation: a pilot study
Authors: Oshima Yoshiaki , Okazaki Naoto , Otsuki Akihiro , Takahashi Shunsaku , Harada Tomomi , Inagaki Yoshimi
Published: January 2020

Background: Marathoners use the 2:2 breathing pattern. We hypothesized that this ventilation method may protect against ventilator-induced lung injury.Methods: We studied the 2:2 breathing pattern as a mechanical ventilation mode, by assessing the gas exchange in intact rabbits and the pulmonary protective effects in isolated rabbit lungs. The typical setting of this breathing method was 30 cycles/min of respiratory frequency. The time allocation for one cycle was as follows: 1st inspiratory period, 2nd inspiratory period, 1st expiratory period, and 2nd expiratory period (all 0.3 s long) with intermittent resting periods (all 0.2 s).Results: The 2:2 breathing pattern caused no problems regarding the efficiency of oxygen uptake and carbon dioxide elimination. The wet-to-dry weight ratio of the lung was lower for the proposed 2:2 breathing pattern than with the inversed ratio ventilation (both inspiratory:expiratory ratio 1:1).Conclusions: The marathoners’ breathing pattern may be a novel method to provide protection against ventilator-induced lung injury in clinical settings.
Sevoflurane inhibits Human umbilical vein endothelial cells migration by up-regulating VE-cadherin expression
Authors: Sun Yuanqing , Xu Zifeng , Xu Tao , Xu Hui
Published: January 2020

Background Sevoflurane is a commonly used inhalation anesthesia and is famous for rapid onset of action, less metabolism in vivo and fast recovery. The aim of this study is to elaborate whether sevoflurane inhibits Human umbilical vein endothelial cells (HUVECs) migration function.Methods In vitro experiments, the HUVECs were divided into four groups randomly, and were exposed to 2% sevoflurane, refer to 1.6 minimal alveolar concentration (MAC), respectively for 0.5h, 1h, 2h and the first group was the control group which exposed to the same gas environment with other three groups but only without sevoflurane. After sevoflurane exposure, HUVECs were conducted the scratch assay.Results The results suggested that the HUVECs exposed to 2% sevoflurane for 2 h were more obviously inhibited on the migration distance during 12 h after scratched than the control group. Quantitative PCR results suggested that the HUVECs exposed to 2% sevoflurane for 2 h expressed more vascular endothelial cadherin (VE-cadherin) than the control group, with statistic difference. However, other scratch assay and quantitative trials suggested that the HUVECs which were transfected with VE-cadherin siRNA and exposed to 2% sevoflurane for 2 h had no significant difference with the control group on the migration distance and the expression of VE-cadherin.Conclusion These results suggested that sevoflurane inhibited the HUVECs migration function by up-regulating VE-cadherin expression, and may have an adverse effect on the normal functions of vascular endothelial cells.
Identification and localization of proteins associated with the formation of Streptococcus gordonii and Fusobacterium nucleatum biofilms
Authors: Millones-Gómez pablo alejandro A , Bacilio-Amaranto Reyma Evelyn , Torres Dora Maurtua , Cortavarría Patricia Sheen , Orocollo Yudith Cauna , Choque Jaeson Santos Calla , Mendizabal Margarita Fe Requena , Poma Roger Damaso Calla
Published: January 2020

Background:To successfully colonize the oral cavity, bacteria must adhere directly or indirectly to the oral surfaces available. Fusobacterium nucleatum plays an important role in the development of the oral biofilm community due to its broad adhesion capabilities, serving as a bridge between the members of the oral biofilm community that cannot be directly joined together. The purpose of this study was to identify and localize the proteins associated with the formation of biofilms of Streptococcus gordonii and F. nucleatum. Methods: Multispecies biofilms were identified by amplification of the srtA and radD genes by real-time PCR. Biofilm cells cultured with sucrose were counted. The protein concentrations in the membrane and cytoplasmic fractions were quantified by western blot. Results: The proteins HSP40 and GAPDH were detected in the cytoplasmic fraction of biofilm and F. nucleatum, respectively. The available anti-GAPDH antibody is specific for GAPDH produced by F. nucleatum, which indicated the coaggregation of F. nucleatum on S. gordonii. Conclusions: HSP40 was only detected in the cytoplasmic fraction of the biofilms, making it one of the essential proteins for adherence. This complex set of interactions could have critical implications for the formation and maturation of oral biofilms in vivo and could provide clues to the mechanism behind the distribution of organisms within the human oral cavity.
The problem of “difficult airways” — multicenter studies of Federation of anaesthesiologists and reanimatologists to analyze current clinical practice and review the training system in the Russian Federation. Review
Authors: Andreenko Aleksander A. , Dolbneva E. L. , Stamov V. I.
Published: January 2020

“Difficult airways” situations continue to be one of the main causes of anesthetic mortality and morbidity. Current requirements of patient safety during anesthesia determine the need for the necessary equipment and compliance with existing clinical guidelines. The situation with the equipment of hospitals in the Russian Federation with different airway devices and medical equipment, as well as the approaches used by anesthesiologists are regularly reviewed by the FAR Committee of Difficult Airways by distributing a questionnaire. During the last 10 years there has been a positive trend in the level of hospital equipment with supraglottic airways, there has been an increase in the awareness of specialists about the existing clinical guidelines. An updated version of the survey was developed to examine the current situation in the Russian Federation, to analyze the effectiveness of the approaches used to solve the problem of “difficult airways” and to evaluate the role of the existing recommendations of the FAR.
The role of the human factor is decisive in the development of a significant part of critical situations during anesthesia. A modern training program for clinical residents in anesthesiology should include training in upper airways assessment, performing basic maneuvers of airways management, working out techniques for using various devices, as well as using existing algorithms of actions during “difficult airways” situations. The ability to apply theoretical knowledge and act requires training in a high-fidelity simulation and subsequent analysis of residentʹs performance. The newly developed survey is devoted to the analysis of the situation with airways management training in the clinical residency. Based on the results of the survey, it is planned to develop a draft national airways management training program for anesthesia residents.
Prenatal ultrasound diagnosis of fetal pelvic tumors. II. Fetal ovarian
cysts – what does really matter? Literature review
Authors: I.V. Tsikhanenka , A.N. Chukanov
Published: January 2020

Literature review of prenatal ultrasound and MRI-diagnosis of fetal ovarian cyst is presented. Cysts evolution,
ultrasound features and related risk of complications and postnatal surgical intervention are reviewed. Authors
analyzed data of publications in aspects of time of diagnosis, complications and outcomes of antenatal diagnosed
ovarian cysts. Antenatal and postnatal management are discussed.
Pathology of chest organs in the fetus: review of literature and own
observations
Authors: V.N. Demidov, N.V. Mashinets
Published: January 2020

The article presents various nomological forms of malformations of the chest organs and their population
frequency. The ultrasound and differential diagnostic features are described, such as cystic adenomatoid
malformations of the lung, pulmonary sequestration, bronchogenic cyst and such rare diseases as congenital
high-airway obstruction syndrome and bronchial atresia, pulmonary hypoplasia and pulmonary agenesis,
mediastinal cystic lymphangioma. The timing of detection and accuracy of diagnosis of various malformations
of the chest is reported. Data on the nature of concomitant abnormalities and chromosomal pathology are given.
Considerable attention has been paid to resolving the issue of the advisability of maintaining or terminating a
pregnancy, the most rational tactics of managing patients with this pathology, the timing and methods of delivery,
as well as the selection of optimal methods for treating newborns in the postnatal period and the prognosis of
their further development.
The first experience of prenatal successful diagnosis of 22q11.2 deletion
syndrome
Authors: I.V. Komarova, A.A. Nikiforenko, E.F. Khmeleva et all
Published: January 2020

Two cases of prenatal diagnosis of a deletion syndrome 22q11.2 are presented. They are includes the cardiovascular defects in combination with hypoplasia of the thymus. In first case the pregnancy was aborted due
to the heart disease, adverse for life (aortic arch interruption). In second case (right aorta arch and left aberrant
subclavial artery) the pregnancy was prolonged, the chromosomal pathology was diagnosed at the age of 3 months.
Modern data on clinic, diagnosis and outcome of a syndrome at the fetus, children and adults are analyzed. The
possibility of the aim prenatal diagnosis of syndrome on the basis of the characteristic conotruncal abnormalities
in combination with hypoplasia of thymus is presented.
Prenatal diagnosis of pseudoisodicentric chromosome 18
Authors: E.I. Golovataya , T.A. Plevako , I.N. Motsiuk
Published: January 2020

Two cases of prenatal diagnosis of pseudoisodicentric chromosome 18 (i(18)(p11.3)) are presented. The data
of ultrasound and cytogenetic studies are presented, comparison with literature data is given.
Experience in prenatal ultrasound and MRI diagnosis of 49 fetal ovarian
cysts
Authors: I.V. Tsikhanenka , Y.Y. Buchel
Published: January 2020

Analysis of 49 cases of prenatally diagnosed ovarian cysts are presented. The outcomes of prenatally
diagnosed ovarian cysts were studied on their antenatal ultrasound and MRI images. Outcomes analysis of fetal
ovarian cysts depending on their ultrasound and MRI features are presented. Prenatal features, complications
of pregnancy, cysts evolution, outcomes and postnatal surgical intervention on 49 cases of fetal ovarian cysts
are presented. 1/3 of the ovarian cysts were visualized partly or completely in the abdomen, 1/3 — laterally
from the bladder. Simple cysts were of less dimension compared to complex lesions. Increase in size is
presumably of higher risk of complications. Spontaneous regression by the time of delivery was in 34.7%.
100% of lesions  2 cm disappeared, the rate of regression of simple and complex cysts was equal, the lowest
rate of regression was seen in cysts  4 cm. The frequency of surgical treatment was in 26.5%.
Aortic valve stenosis and fibroelastosis of the left ventricle of the heart:
prenatal ultrasound diagnosis, observation, outcome
Authors: I.I. Ryabov
Published: January 2020

The case of prenatal ultrasound diagnosis of aortic valve stenosis and fibroelastosis of the left ventricle of
the heart is presented. The child was successfully operated after birth.
Гетероструктуры на основе нитрида галлия на подложках кремния для мощных СВЧ-транзисторов
Authors: Езубченко И. С. , Черных М. Я. , Андреев А. А. , Грищенко Ю. В. , Черных И. А. , Занавескин М. Л.
Published: January 2020

Предложен и реализован уникальный метод формирования гетероструктур на основе нитрида галлия на подложках кремния при пониженных температурах роста (менее 950°С). Сформированная гетероструктура обладает атомарно-гладкой поверхностью со средней квадратичной шероховатостью 0.45 нм и высоким кристаллическим качеством. Среднее слоевое сопротивление канала двумерного электронного газа составило 415 Ом/квадрат при концентрации электронов 1.65 · 1013 см–2 и подвижности 920 см2 /В · с. Максимальная величина тока насыщения стока для транзисторов с шириной затвора 1.2 мм составила 930 мА/мм, что соответствует лучшим мировым результатам для нитрид-галлиевых транзисторов на подложках кремния.
Влияние модифицирования наноалмаза на смачиваемость поверхности оптического кислородного датчика и биологическое обрастание при длительных измерениях in situ
Authors: Александровская А. Ю. , Мельников П. В. , Сафонов А. В. , Абатурова Н. А. , Спицын Б. В. , Наумова А. О. , Зайцев Н. К.
Published: January 2020

Предложен способ управления смачиваемостью поверхности фторированного материала и контроля биообрастания за счет внедрения в структуру модифицированного наноалмаза. На примере сенсора молекулярного кислорода с помощью комплекса методов определены оптимальные условия модифицирования, не приводящие к изменению прочих функциональных свойств материала, таких как градуировочная зависимость и время отклика. Испытания in vitro показали, что небольшое количество аминированных наноалмазов придает поверхности бактерицидные свойства, но при большом содержании, напротив, наблюдается улучшенная адгезия биоматериала за счет уменьшения гидрофобности. Длительные испытания in situ в условиях, симулирующих биореактор с активно растущей биомассой, продемонстрировали практически полное отсутствие биологического обрастания у модифицированного материала и значительное обрастание сенсора из традиционно применяемого полистирола.