bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of sevoflurane and propofol on tourniquet-induced endothelial damage: a pilot randomized controlled trial for knee-ligament surgery
Authors: Maldonado Felipe , Morales Diego , Gutiérrez Rodrigo , Barahona Maximiliano , Cerda Oscar , Cáceres Mónica 
Published: May 2020

Abstract
Background
The glycocalyx layer is a key structure in the endothelium. Tourniquet-induced ischemic periods are used during orthopedic surgery, and the reactive oxygen species generated after ischemia-reperfusion may mediate the shedding of the glycocalyx. Here, we describe the effects of tourniquet-induced ischemia-reperfusion and compare the effects of sevoflurane and propofol on the release of endothelial biomarkers after ischemia-reperfusion in knee-ligament surgery.

Methods
This pilot, single-center, blinded, randomized, controlled trial included 16 healthy patients. After spinal anesthesia, hypnosis was achieved with sevoflurane or propofol according to randomization. During the perioperative period, five venous blood samples were collected for quantification of syndecan-1, heparan sulfate, and thrombomodulin from blood serum by using ELISA assays kits. Sample size calculation was performed to detect a 25% change in the mean concentration of syndecan-1 with an alpha of 0.05 and power of 80%.

Results
For our primary outcome, a two-way ANOVA with post-hoc Bonferroni correction analysis showed no differences in syndecan-1 concentrations between the sevoflurane and propofol groups at any time point. In the sevoflurane group, we noted an increase in syndecan-1 concentrations 90 min after tourniquet release in the sevoflurane group from 34.6 ± 24.4 ng/mL to 47.9 ± 29.8 ng/mL (Wilcoxon test, p < 0.01) that was not observed in patients randomized to the propofol group. The two-way ANOVA showed no intergroup differences in heparan sulfate and thrombomodulin levels.

Conclusions
Superficial endothelial damage without alterations in the cell layer integrity was observed after tourniquet knee-ligament surgery. There was no elevation in serum endothelial biomarkers in the propofol group patients. Sevoflurane did not show the protective effect observed in in vitro and in vivo studies.

Trial registration
The trial was registered in www.clinicaltrials.gov (ref: NCT03772054, Registered 11 December 2018).
Rno-microRNA-30c-5p promotes myocardial ischemia reperfusion injury in rats through activating NF-κB pathway and targeting SIRT1
Authors: Chen Jianfeng , Zhang Mingming , Zhang Shouyan , Wu Junlong , Xue Shufeng 
Published: May 2020

Abstract
Background
This study aimed to investigate the regulatory effect of rno-microRNA-30c-5p (rno-miR-30c-5p) on myocardial ischemia reperfusion (IR) injury in rats and the underlying molecular mechanisms.

Methods
A rat model of myocardial IR injury was established. The infarct size was detected by 2,3,5-triphenyltetrazolium chloride staining. The pathologic changes of myocardial tissues were detected by hematoxylin-eosin staining. The apoptosis of myocardial cells was measured by TUNEL staining and flow cytometry. The mRNA expression of rno-miR-30c-5p and Sirtuin 1 (SIRT1) was detected by quantitative real-time PCR. The levels of IL-1β, IL-6 and TNF-α were detected by enzyme linked immunosorbent assay. The protein expression of Bax, Bcl-2, caspase-3, p-IκBα, IκBα, p-NF-κB p65, NF-κB p65 and SIRT1 was detected by Western blot. The interaction between rno-miR-30c-5p and SIRT1 was predicted by TargetScan, and further identified by dual luciferase reporter gene and RNA immunoprecipitation assay.

Results
The myocardial IR injury model was successfully established in rats. IR induced the myocardial injury in rats and increased the expression of rno-miR-30c-5p. Overexpression of rno-miR-30c-5p enhanced the inflammation, promoted the apoptosis, and activated NF-κB pathway in IR myocardial cells. SIRT1 was the target gene of rno-miR-30c-5p. Silencing of SIRT1 reversed the effects of rno-miR-30c-5p inhibitor on the apoptosis and NF-κB pathway in IR myocardial cells.

Conclusions
Rno-miR-30c-5p promoted the myocardial IR injury in rats through activating NF-κB pathway and down-regulating SIRT1.
Mean platelet volume: a new predictor of ischaemic stroke risk in patients with nonvalvular atrial fibrillation
Authors: Zheng Meifang , Chen Shean , Zhu Ye , Gu Xiang 
Published: May 2020

Abstract
Background
Mean platelet volume (MPV) has been identified as an individual risk factor for stroke and thrombosis. Concurrently, ischaemic stroke caused by nonvalvular atrial fibrillation (AF) has attracted increasing attention. The aim of this study was to investigate the association between MPV and the risk of ischaemic stroke in AF patients not receiving anticoagulant therapy.

Methods
A total of 370 patients with nonvalvular AF were enrolled. Patients were divided into a control group and a stroke group according to the presence of ischaemic stroke.

Results
The MPV level and CHA2DS2-VASc scores of the stroke group were higher than those of the control group (all p < 0.001). The ischaemic stroke event rates were significantly increased in the highest MPV tertile when compared to the lowest MPV tertile (56.9% vs. 30.3%, p < 0.001). Multivariate logistic regression analysis showed that CHA2DS2-VASc, MPV and D-dimer (D2) were predictors of ischaemic stroke [all p < 0.05]. The receiver operating characteristic (ROC) curve analysis indicated that an MPV value of 11.65 fL could predict ischaemic stroke with a sensitivity of 67.3% and specificity of 58.5%, while a CHA2DS2-VASc score cutoff value 3.5 had a sensitivity of 52.1% and specificity of 87.3%. The predictive value of the combined model of CHA2DS2-VASc+MPV was higher than others (comparison calculated by using MedCalc software). The sensitivity of the CHA2DS2-VASc score combined with MPV for predicting ischaemic stroke was 72.1%, and the specificity was 81.5%.

Conclusions
MPV could be a new predictor of ischaemic stroke risk in patients with AF. Moreover, the CHA2D2S2-VASc combined with MPV can improve predictive value with higher sensitivity and it could be a powerful tool for stratifying patients in terms of ischaemic stroke risk.
Optimal, minimax and admissible two-stage design for phase II oncology clinical trials
Authors: Qin Fei , Wu Jingwei , Chen Feng , Wei Yongyue , Zhao Yang , Jiang Zhiwei , Bai Jianling , Yu Hao 
Published: May 2020

AbstractBackgroundThe article aims to compare the efficiency of minimax, optimal and admissible criteria in Simon’s and Fleming’s two-stage design.MethodsThree parameter settings (p1-p0 = 0.25–0.05, 0.30–0.10, 0.50–0.30) are designed to compare the maximum sample size, the critical values and the expected sample size for minimax, optimal and admissible designs. Type I & II error constraints (α,β) vary across (0.10, 0.10), (0.05, 0.20) and (0.05, 0.10), respectively.ResultsIn both Simon’s and Fleming’s two-stage designs, the maximum sample size of admissible design is smaller than optimal design but larger than minimax design. Meanwhile, the expected samples size of admissible design is smaller than minimax design but larger than optimal design. Mostly, the maximum sample size and expected sample size in Fleming’s designs are considerably smaller than that of Simon’s designs.ConclusionsWhenever (p0,p1) is pre-specified, it is better to explore in the range of probabilityq, based on relative importance between maximum sample size and expected sample size, and determine which design to choose. Whenqis unknown, optimal design may be more favorable for drugs with limited efficacy. Contrarily, minimax design is recommended if treatment demonstrates impressive efficacy.
Meningococcaemia causing necrotizing cellulitis associated with acquired complement deficiency after gastric bypass surgery: a case report
Authors: Pletschette Zoe , De Groote Elodie , Mattheus Wesley , Waxweiler Charlotte , Creteur Jacques , Grimaldi David 
Published: May 2020

Abstract
Background
Neisseria meningitidis has rarely been described as an agent of necrotic soft tissue infection.

Case presentation
We report a case of a septic shock with necrotizing cellulitis due to Neisseria meningitidis serogroup W, treated by urgent extensive surgical debridement followed by skin grafts. The invasive meningococcal disease occurred together with a complement deficiency, possibly acquired after bypass surgery that took place 1 year before.

Conclusions
Necrotic tissue infections should be considered part of the invasive meningococcal diseases spectrum and should prompt clinicians to look for complement deficiencies. Gastric bypass surgery associated malnutrition may be implicated but further verification is needed.
Carriage rate of Neisseria meningitidis, antibiotic susceptibility pattern and associated risk factors among primary school children in Gondar town, Northwest Ethiopia
Authors: Tefera Zelalem , Mekonnen Feleke , Tiruneh Moges , Belachew Teshome 
Published: May 2020

AbstractBackgroundGlobally, in 2012, about 1.2 million estimated cases were reported with ~ 135,000 deaths annually. In Ethiopia, specifically in our study area, limited information is found on the oropharyngeal carriage, antimicrobial resistance pattern, and associated risk factors forN. meningitidisamong school children. So, the aim of this study was to assess oropharyngeal carriage rate ofN. meningitidis,antibiotic susceptibility pattern and associated risk factors among primary school children in Gondar town, Northwest Ethiopia.MethodsA cross sectional study was conducted from January to April, 2019 in Gondar town. Multi stage simple random sampling technique was used. A total of 524 oropharyngeal swabs were collected using sterile plastic cotton swabs. Modified Thayer Martin media was used for primary isolation. Antimicrobial susceptibility pattern was done based on Kirby-Bauer method on Muller-Hinton agar supplemented with 5% sheep blood. Multidrug resistance was defined as resistance of an isolate to two or more antimicrobial classes tested. Logistic regression model was used to see the association between dependent variables (Carriage rate ofNeisseria meningitidis, Serogroups ofNeisseria meningitidis andAntimicrobial susceptibility patterns) and independent variables (Socio-demographic data and risk factors). Variables with aP- value ≤0.2 during bivariable analysis was taken to multivariable analysis to check significant association of meningococcal carriage with risk factors. Finally, aP-value < 0.05 was considered as statistically significant. Data was summarized using numbers, percentages and tables.ResultsA total of 53(10.1%) (CI: 7.6–12.8)N. meningitidisisolates were identified. Serogroup A 13 (24.5%) was the most prevalent followed by Y/W135 11(20.7%) whereas serogroup B 4(7.6%) was the least identified serotype. Meningococcal isolates were resistant to ciprofloxacin (45.3%) and trimethoprim-sulfamethoxazole (73.6%). Overall, most of meningococcal isolates showed about 32(60.4%) multidrug resistance. Meningococcal carriage rate was significantly associated with family size, tonsillectomy, passive smoking, number of students per class, sharing utensils, history of visiting healthcare institutions, and indoor kitchen.ConclusionThis study highlights the need for reinforcement of case-based, laboratory confirmed surveillance ofN. meningitidiscarriage in Ethiopian elementary school students to enable mapping of distribution of serotypes of the causative organisms across the country and determine the current potential necessity of vaccination.
Feasibility of pulmonary MRI for nodule detection in comparison to computed tomography
Authors: Yu Nan , Yang Chuangbo , Ma Guangming , Dang Shan , Ren Zhanli , Wang Shaoyu , Yu Yong 
Published: May 2020

Abstract
Background
To assess the feasibility of various magnetic resonance imaging (MRI) sequences for the detection of pulmonary nodules by comparing the detection rate of computed tomography (CT).

Methods
Forty-two patients with pulmonary nodules detected by multi-slice CT (MSCT) were prospectively enrolled in the present study between November 2016 and February 2017. Chest MRI was acquired within 24 h of CT. The MRI protocol included free-breathing radial VIBE (r-VIBE) and a conventional breathhold T1-weighted VIBE (C-VIBE) were analyzed by two independent radiologists. Both detection and morphology results of each MRI image were recorded. Subjective image evaluation in terms of overall nodule morphology on the MRI images was carried out using the 4-point scoring criteria. The MRI results were compared with those from CT, with the results of MSCT serving as the reference standard.

Results
Two hundred and fifty-eight solid pulmonary nodules in 42 patients were detected by CT. The r-VIBE correctly detected 94% of the pulmonary nodules as compared with CT. The detection rate increased to 100% for lesions ≥6 mm. The C-VIBE had a lower overall detection rate (64.3%) of pulmonary nodules. The difference in the subjective image evaluation scores between the two sequences was statistically significant (p < 0.001).

Conclusion
Significantly increased detection rates were obtained with free-breathing r-VIBE as compared with C-VIBE for the detection of pulmonary nodules and also provided more information when evaluating the nodules as compared with C-VIBE.
Practical value of three-dimensional high resolution magnetic resonance Vessel Wall imaging in identifying suspicious intracranial vertebrobasilar dissecting aneurysms
Authors: Zhu Xianjin , Qiu Hancheng , Hui Ferdinand K. , Zhang Yiqun , Liu Yun-e , Man Fengyuan , Jiang Wei-Jian 
Published: May 2020

Abstract
Background
Direct evidence of intimal flaps, double lumen and intramural haematomas (IMH) is difficult to detect on conventional angiography in most intracranial vertebrobasilar dissecting aneurysms (VBDAs). Our purpose was to assess the value of three-dimensional high-resolution magnetic resonance vessel wall imaging (3D HRMR VWI) for identifying VBDAs.

Methods
Between August 2013 and January 2016, consecutive patients with suspicious VBDAs were prospectively enrolled to undergo catheter angiography and VWI (pre- and post-contrast). The lesion was diagnosed as definite VBDA when presenting direct signs of dissection; as possible when only presenting indirect signs; and as segmental ectasia when there was local dilation and wall thickness similar to adjacent normal artery’s without mural thrombosis.

Results
Twenty-one patients with 27 lesions suspicious for VBDAs were finally included. Based on findings of VWI and catheter angiography, definite VBDA was diagnosed in 25 and 7 lesions (92.6%, vs 25.9%, p <  0.001), respectively; possible VBDA in 0 and 20 (0 vs 74.1%), respectively; and segmental ectasia in 2 and 0 (7.4% vs 0%), respectively. On VWI and catheter angiography, intimal flap was detected in 21 and 7 lesions (77.8% vs 25.9%, p = 0.001), respectively; double lumen sign in 18 and 7 (66.7% vs 25.9%, p = 0.003), respectively; and IMH sign in 14 and 0 (51.9% vs 0), respectively.

Conclusions
3D HRMR VWI could detect direct dissection signs more frequently than catheter angiography. This may help obtain definite diagnosis of intracranial VBDAs, and allow accurate differentiation between dissecting aneurysm and segmental ectasia as well. Further prospective study with larger sample was required to investigate the superiority of HRMR VWI for definite diagnosis of intracranial VBDAs than catheter angiography.
Environmental tobacco smoke exposure during pregnancy affects complications and birth outcomes in women with and without asthma
Authors: Fazel Nasrin , Kundi Michael , Kazemzadeh Asghar , Esmaily Habibollah , Akbarzadeh Roya , Ahmadi Raheleh 
Published: May 2020

AbstractBackgroundIt is known that environmental tobacco smoke (ETS) has adverse effects on pregnancy and birth outcomes. We aimed to assess the impact of ETS in pregnant women with and without asthma.MethodsA cohort study was conducted from August 2014 to June 2015 enrolling 1603 pregnant women during their 2nd trimester. Data on tobacco exposure were collected at first visit and women were followed through pregnancy till postpartum.ResultsOf the 1603 women, 231 reported passive smoking, 223 non-asthmatics and 8 asthmatics. Women exposed to ETS during pregnancy were more likely to have an infant admitted to the pediatric ward (10.8% vs. 6.5%,p = 0.026) and to have low one- and five-minute Apgar scores (1 min: 6.1% vs. 2.6%,p = 0.011; 5 min: 2.2% vs. 0.7%,p = 0.039). Complications of pregnancy were also elevated in women exposed to ETS (53.7% vs. 42.3%,p = 0.002). Asthma had no additional effect beyond the impact of ETS except for cesarean sections that were more frequent in women with asthma exposed to ETS.ConclusionsDue to the small number of women with asthma exposed to ETS, combined effects of asthma and ETS were only found for cesarean sections. Still counseling of pregnant women about adverse effects of ETS should consider women’s asthma as an additional reason to avoid ETS.
Does growth hormone supplementation improve oocyte competence and IVF outcomes in patients with poor embryonic development? A randomized controlled trial
Authors: Li Jingyu , Chen Qiaoli , Wang Jiang , Huang Guoning , Ye Hong 
Published: May 2020

Abstract
Background
Many studies have demonstrated the benefits of the addition of growth hormone (GH) to the controlled ovarian stimulation protocol in vitro fertilization (IVF) cycles in poor-respond patients, but the effect of GH on patients with poor embryonic development remain unclear. This paper was designed to investigate the efficacy of GH co-treatment during IVF for the patients with poor embryonic development.

Method
A randomized controlled trial including 158 patients with poor embryo development was conducted between July 2017 and February 2019. One hundred and seven patients were randomized for GH treatment (GH group) and 51 patients for untreated (control group). The primary end-points were the clinical pregnancy and live birth rates in the two groups. The oocyte competence were assessed through calculating the mitochondrial DNA (mtDNA) copy number in corresponding cumulus granulosa cells (CGCs). Quantitative PCR were used for calculation of mtDNA copy number.

Results
Relative to the control group, GH co-treatment resulted in a significantly higher number of retrieved oocytes (10.29 ± 5.92 versus 8.16 ± 4.17, P = 0.023) and cleaved embryos (6.73 ± 4.25 versus 5.29 ± 3.23, P = 0.036). The implantation rate, clinical pregnancy rates per cycle, and live birth rate per cycle were higher in the GH group than in the control group (36.00% versus 17.86%, P = 0.005; 43.93% versus 19.61%, P = 0.005; 41.12% versus 17.65%, P = 0.006). CGCs of the GH group had significantly higher mtDNA copy numbers than CGCs of the control group (252 versus 204, P < 0.001).

Conclusions
These data provided further evidence to indicate that GH supplementation may support more live births during IVF, in patients with poor embryonic development. It also appears that oocytes generated under GH co-treatment have a better developmental competence.

Trial registration
ChiCTR1900021992 posted March 19, 2019 (retrospectively registered).
Ovarian hyperstimulation syndrome in a frozen-thawed embryo transfer pregnancy: a rare case report
Authors: Yang Lihua , Wang Rong , Wang Fang , Wang Feifeng , Zou Libo 
Published: May 2020

AbstractBackgroundOvarian hyperstimulation syndrome (OHSS) is an iatrogenic complication of ovarian stimulation. Prevention and early recognition of OHSS are important to ensure patient safety.Case presentationIn this case, we reported a patient who underwent controlled ovarian hyperstimulation (COH) and in vitro fertilization (IVF). All embryos were cryopreserved to reduce possible OHSS. However, OHSS still occurred after the patient had a frozen-thawed embryo transfer (FET) with hormone replacement therapy (HRT) and obtained a dichorionic diamniotic triplet pregnancy. After multifetal pregnancy reduction (MFPR) and supportive treatment, all the symptoms regressed.ConclusionsPrompt recognition of OHSS, especially in patients who have no history of ovulation induction and fresh embryo transfer, is very important. Multiple pregnancies may lead to severe OHSS because of the high level of human chorionic gonadotropin (hCG) in the early stages. We suggest that a single embryo transfer may be necessary and beneficial for patients.
Factors affecting tracheostomy in critically ill paediatric patients in Japan: a data-based analysis
Authors: Ishihara Tadashi , Tanaka Hiroshi 
Published: May 2020

Abstract
Background
There has been an increasing number of children surviving with high medical needs, for whom tracheostomy and/or home ventilation is part of their chronic disease management. The purpose of this study was to describe the indications, epidemiology, frequency, and associated factors for tracheostomy in critically ill paediatric patients using the data available in the Japanese Registry of Paediatric Acute Care (JaRPAC).

Methods
This multicentre epidemiologic study collected data concerning paediatric tracheostomy from the JaRPAC database. Patients were divided into two groups: those with or without tracheostomies when they were discharged from the Intensive Care Unit (ICU) or Paediatric Intensive Care Unit (PICU). Consecutive patients aged ≤16 years who did not undergo tracheostomy when admitted to ICU or PICU between April 2014 and March 2017 were included.

Results
A total of 23 hospitals participated, involving 6199 paediatric patients registered in the JaRPAC database during the study period. Of the registered paediatric patients, 5769 (95%) patients were admitted to the ICUs or PICUs without tracheostomies. Among the patients, 181 patients (3.1%) had undergone tracheostomies. There were significant differences in chronic conditions (134, 74.0% versus 3096, 55.4%, p <  0.01), chromosomal anomalies (19, 10.5% versus 326, 5.8%, p <  0.01), urgent admission (151, 83.4% versus 3093, 55.4%, p <  0.01). More tracheostomies were performed on patients who were admitted for respiratory failure (61, 33.7% versus 926, 16.1%, p <  0.01) and for post-cardiac pulmonary arrest (CPA) resuscitation (40, 22.1% versus 71, 1.1%, p <  0.01).

Conclusions
This is the first report to use a large-scale registry of critically ill paediatric patients in Japan to describe the interrelated factors of tracheostomies. Chronic conditions (especially for neuromuscular disease), chromosomal anomaly, admission due to respiratory failure, or treatment for post-CPA resuscitation all had the possibility to be risk factors for tracheostomy.