bluuebunny/crossref_metadata_2025_split huggingface dataset:
Shock Severity and Hospital Mortality In Out of Hospital Cardiac Arrest Patients Treated With Targeted Temperature Management
Authors: Tabi Meir , Burstein Barry J. , Ahmed Abdelrahman , Dezfulian Cameron , Kashani Kianoush B. , Jentzer Jacob C. 
Published: August 2020

ABSTRACT

Background:
Shock in patients resuscitated after out of hospital cardiac arrest (OHCA) is associated with an increased risk of mortality. We sought to determine the associations between lactate level, mean arterial pressure (MAP), and vasopressor/inotrope doses with mortality.

Methods:
Retrospective cohort study of adult patients with OHCA of presumed cardiac etiology treated with targeted temperature management (TTM) between December 2005 and September 2016. Multivariable logistic regression was performed to determine predictors of hospital death.

Results:
Among 268 included patients, the median age was 64 (55, 71.8) years, including 27% females. OHCA was witnessed in 89%, OHCA rhythm was shockable in 87%, and bystander CPR was provided in 64%. Vasopressors were required during the first 24 h in 60%. Hospital mortality occurred in 104 (38.8%) patients. Higher initial lactate, peak Vasoactive-Inotropic Score (VIS), and lower mean 24-h MAP were associated with higher hospital mortality (all P < 0.001). After multivariable regression, both higher initial lactate (adjusted OR 1.15 per 1 mmol/L higher, 95% CI 1.00–1.31, P = 0.03) and higher peak VIS (adjusted OR 1.20 per 10 units higher, 95% CI 1.10–1.54, P = 0.003) were associated with higher hospital mortality, but mMAP was not (P = 0.92). However, patients with a mMAP < 70 mm Hg remained at higher risk of hospital mortality after multivariable adjustment (adjusted OR 9.30, 95% CI 1.39–62.02, P = 0.02).

Conclusions:
In patients treated with TTM after OHCA, greater shock severity, as reflected by higher lactate levels, mMAP < 70 mmHg, and higher vasopressor requirements during the first 24 h was associated with an increased rate of hospital mortality.
Fibrinolysis Shutdown and Thrombosis in a COVID-19 ICU
Authors: Creel-Bulos Christina , Auld Sara C. , Caridi-Scheible Mark , Barker Nicholas A. , Friend Sarah , Gaddh Manila , Kempton Christine L. , Maier Cheryl L. , Nahab Fadi , Sniecinski Roman 
Published: August 2020

ABSTRACT
The coronavirus disease (COVID-19) pandemic has threatened millions of lives worldwide with severe systemic inflammation, organ dysfunction, and thromboembolic disease. Within our institution, many critically ill COVID-19-positive patients suffered major thrombotic events, prompting our clinicians to evaluate hypercoagulability outside of traditional coagulation testing.
We determined the prevalence of fibrinolysis shutdown via rotational thromboelastometry (ROTEM, Instrumentation Laboratories, Bedford, Mass) in patients admitted to the intensive care unit over a period of 3 weeks. In 25 patients who had a ROTEM test, we found that 11 (44%) met criteria for fibrinolysis shutdown. Eight of 9 (73%) of the VTE patients met criteria for fibrinolysis shutdown.
Given the high rate of fibrinolysis shutdown in these patients, our data support using viscoelastic testing to evaluate for the presence of impaired fibrinolysis. This may help identify patient subsets who might benefit from the administration of fibrinolytics.
Mid-term Outcomes of Laparoscopic Total Cystectomy Versus Open Surgery for Complicated Liver Hydatid Cysts
Authors: Maitiseyiti Abulaihaiti , Ma Zhigang , Meng Yuan , Tian Guanglei , Kalifu Baheti , Lu Shuang , Chen Xiong 
Published: August 2020

Background:
Total cystectomy is a challenging procedure in patients with complicated liver hydatid cysts (HCs). This study aimed to evaluate the feasibility and safety of laparoscopic total cystectomy in patients with complicated liver HCs.

Methods:
Prospectively collected clinical data of 50 consecutive patients, who underwent laparoscopic procedures for complicated liver HCs between January 2017 and January 2019, were retrospectively analyzed. One hundred patients who underwent open procedures were compared with the laparoscopic group in terms of perioperative outcomes during the 1-year follow-up period.

Results:
Conversion to open surgery occurred in 1 (2%) case. The number of single and multiple lesions and the size of HCs were similar between the 2 groups (P>0.05). Sixty-six percent of patients underwent total cystectomy, 10% subtotal cystectomy, and 24% hepatectomy in the laparoscopic group (P>0.05). Decompression and hepatic inflow occlusion were performed in high-risk cases. No differences were noted in average blood loss volume, and transfusion rate between the 2 groups. Postoperative recovery in the laparoscopic group was significantly shorter than that in the open group. There was no difference in the incidence of postoperative complications between the laparoscopic and open groups. No recurrence or death was observed in either group during this period.

Conclusions:
Laparoscopic total cystectomy was a curative and safe surgical approach to the treatment of complicated HC with favorable mid-term outcomes. Subtotal cystectomy combined with decompression is the preferred option for patients with high surgical risk(s). However, long-term outcomes need to be validated in prospective studies with larger sample sizes and prolonged follow-up.
Laparoscopic Complete Mesocolic Excision Versus Noncomplete Mesocolic Excision: A Systematic Review and Meta-analysis
Authors: Dai Qiaoqiong , Tu Shiliang , Dong Quanjin , Chen Bingchen 
Published: August 2020

Background:
Complete mesocolic excision (CME) emphasizes sharp dissection along the mesocolon plane and ligation of the supplying vessels at their origin. Although laparoscopic CME is reported to be feasible and safe, the benefit of laparoscopic CME over noncomplete mesocolic excision (NCME) remains unclear. This meta-analysis aimed to compare the safety, quality, and effect of laparoscopic CME with NCME.

Materials and Methods:
A systematic literature search with no limits was performed in PubMed, Embase, and Web of Science on March 27, 2020. Studies comparing laparoscopic CME with NCME were enrolled. Outcomes of interests included intraoperative, pathologic, postoperative, and survival outcomes.

Results:
Seven studies (5 articles and 2 conference abstracts) published between 2015 and 2020 with a total of 1595 patients (742 by CME and 853 by NCME) were enrolled. Compared with NCME, laparoscopic CME was associated with less intraoperative blood loss [P<0.001, weighted mean difference (WMD)=−12.01, 95% confidence interval (CI): −13.56 to −10.45, I
2=44%], more harvested lymph nodes (P<0.001, WMD=6.50, 95% CI: 3.57-9.42, I
2=89%), longer length of specimens (P=0.004, WMD=3.57, 95% CI: 1.12-6.03, I
2=93%), longer distance from tumor to high tie (P<0.001, WMD=1.36, 95% CI: 0.87-1.85, I
2=76%), and longer distance from nearest bowel wall to high tie (P<0.001, WMD=1.36, 95% CI: 0.87-1.85, I
2=85%). No differences were observed in terms of operative time, postoperative complications, wound infection, ileus, proximal, and distal resection margin or disease-free survival between 2 groups.

Conclusions:
The currently limited evidences suggest that laparoscopic CME can slightly decrease intraoperative blood loss and improve specimen quality, but its safety and survival benefits need to be further studied. High-quality evidences are needed before laparoscopic CME can be recommended as the standard procedure for colon cancer surgery.
Magnetic Sphincter Augmentation: Poor Consensus Among Experts Regarding Key Technical Aspects of Implantation
Authors: Leeds Steven G. , Ward Marc A. 
Published: August 2020

Background:
Magnetic sphincter augmentation (MSA) of the lower esophageal sphincter is an effective alternative to Nissen fundoplication for the treatment of gastroesophageal reflux disease. Surgeons must be certified in patient selection, adequate mediastinal dissection, device sizing, and device implantation. This certification process is intended to ensure optimal outcomes and patient safety; however, for many key technical aspects of MSA, proper performance has not been clearly defined. The purpose of this study is to determine how often surgical experts agree on the technical aspects of the MSA procedure.

Materials and Methods:
A 12-question survey investigated various technical aspects of the MSA procedure. The survey was sent to all certified MSA surgical proctors. Consensus on individual questions was defined as ≥70% agreement among the responding surgeons.

Results:
The survey was sent to 37 certified MSA surgical proctors, 24 of whom responded (65%). The mean number of MSA procedures performed by the responders was 210. There was consensus on 4 of the 12 questions. The consensus was achieved indicating it is safe for MSA implantation in any size hiatal hernia, and that tension on the hiatal repair is not a factor to implant the MSA device. There was no consensus for 3 mediastinal dissection questions and only consensus on 2 of the 5 questions regarding MSA implantation. Once the device is implanted, there was no consensus for the appearance of the MSA device.

Conclusions:
There is a need for procedure standardization to improve teaching and to maintain excellent efficacy and safety outcomes when the device is used in the community.
Radioactive Stent Insertion for Inoperable Malignant Common Biliary Obstruction
Authors: Yang Shan , Liu Yi , Teng Fei , Wu An-Le , Lin Jia , Xian Yu-Tao , Xu Yuan-Shun 
Published: August 2020

Purpose:
The purpose of this study was to assess the clinical efficacy and long-term outcomes of radioactive stent insertion in patients with malignant common biliary obstruction (MCBO).

Materials and Methods:
This was a retrospective study conducted at a single-center. Consecutive patients with MCBO were treated by normal or radioactive stent insertion between January 2014 and December 2019. The baseline data, instant efficacy records, and the long-term outcome results of these 2 groups were compared.

Results:
During the experimental duration, at our center 71 patients with inoperable MCBO underwent normal (n=40) or radioactive (n=31) stent insertion. Rates of technical success of normal and radioactive stent insertions were both 100%. No patients exhibited procedure-related complications. All patients achieved improvements in their liver functions at 2 weeks after stent insertion. Stent dysfunction was recorded in 11 and 6 patients from the normal and radioactive stent groups, respectively (P=0.425). The median stent patency was 165 and 222 days with the normal and radioactive stents, respectively (P<0.001). All patients died due to tumor progression at the follow-up. Patients survived for a respective median of 182 and 242 days in the normal and radioactive stent groups (P<0.001). The complication rates were comparable between the 2 groups.

Conclusion:
Radioactive stent insertion may provide longer patency and overall survival in those exhibiting inoperable MCBO than normal stent insertion.
An Addition of U0126 Protecting Heart Grafts From Prolonged Cold Ischemia-Reperfusion Injury in Heart Transplantation: A New Preservation Strategy
Authors: Zheng Hao , Su Yale , Zhu Cuilin , Quan Douglas , Skaro Anton I. , McAlister Vivian , Lacefield James C. , Jiang Jifu , Xue Peng , Wang Yefu , Zheng Xiufen 
Published: August 2020

Background.
Ischemia-reperfusion injury (IRI) is the major cause of primary graft dysfunction in organ transplantation. The mitogen-activated protein kinase/extracellular signal-regulated kinase (ERK) signaling pathway plays a crucial role in cell physiological and pathological processes including IRI. This study aims to investigate whether inhibition of ERK signaling with U0126 can prevent prolonged cold IRI in heart transplantation.

Methods.
Rat cardiac cell line H9c2 cells were treated with U0126 before exposure to hypothermic hypoxia/reoxygenation (H/R) conditions. The effect of U0126 on H9c2 cells in response to H/R stress was determined by measuring cell death, reactive oxygen species production, mitochondrial membrane potential, and ERK signaling activation. Mouse syngeneic heterotopic heart transplantation was conducted, where a donor heart was preserved in the University of Wisconsin (UW) solution supplemented with U0126 for 24 hours at 4°C before transplantation. Heart graft function, histopathologic changes, apoptosis, and fibrosis were measured to assess IRI.

Results.
Phosphorylated ERK was increased in both in vitro H/R-injured H9c2 cells and in vivo heart grafts with IRI. Pretreatment with U0126 inhibited ERK phosphorylation and prevented H9c2 cells from cell death, reactive oxygen species generation, and mitochondrial membrane potential loss in response to H/R. Preservation of donor hearts with U0126-supplemented solution improved graft function and reduced IRI by reductions in cell apoptosis/death, neutrophil infiltration, and fibrosis of the graft.

Conclusions.
Addition of U0126 to UW solution reduces ERK signal activation and attenuates prolonged cold IRI in a heart transplantation model. ERK inhibition with U0126 may be a useful strategy to minimize IRI in organ transplantation.
Outcomes of Renal Transplant Recipients With SARS-CoV-2 Infection in the Eye of the Storm: A Comparative Study With Waitlisted Patients
Authors: Mohamed Ismail H. , Chowdary Prashanth B. , Shetty Shraddha , Sammartino Cinzia , Sivaprakasam Rajesh , Lindsey Ben , Thuraisingham Raj , Yaqoob Muhammad M. , Khurram Muhammad A. 
Published: August 2020

Background.
Patients with chronic kidney disease stage 5 and those on immunosuppression are particularly vulnerable and are shielded as per public health strategy. We present our experience of coronavirus disease 2019 (COVID-19) transplant patients in one of the most affected parts of the UK with direct comparison to waitlisted patients.

Methods.
A single-center prospective study of symptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive waitlisted and transplant patients was undertaken to compare these groups and assess clinical outcomes.

Results.
A total of 60 consecutive symptomatic SARS-CoV-2 positive patients were identified with 32 active waitlisted patients and 28 functioning renal transplants. Demographics were similar. The incidence of symptomatic COVID-19 in the waitlisted group was 9.9% compared to 1.9% in renal transplant patients (P < 0.001). Immunosuppression did not influence initial symptomology. Fifteen percent of patients in the waitlisted and 32% in the transplant groups died (P = 0.726). Mortality as proportion of total waitlisted (321 patients) and transplant population (1434 patients) of our centre was 1.5% and 0.6% (P < 0.001), respectively. C-reactive protein (CRP) at 48 h and peak CRP were associated with mortality in both groups while quick sequential organ failure assessment score at 48 h (P = 0.036) was associated with mortality for transplant patients.

Conclusions.
Incidence of COVID-19 is higher in the waitlisted population but transplant patients have more severe disease, reflected by higher mortality. CRP at 48 h can be used as a predictive tool. In the absence of effective treatments, the current strategy of shielding is arguably the most important factor in protecting patients while resuming transplantation.
Aprepitant as a combinant with Dexamethasone reduces the inflammation via Neurokinin 1 Receptor Antagonism in severe to critical Covid-19 patients and potentiates respiratory recovery: A novel therapeutic approach
Authors: Mehboob Riffat , Ahmad Fridoon Jawad , Qayyum Ahad , Rana Muhammad Asim , Gilani Syed Amir , Tariq Muhammad Akram , Akram Javed 
Published: August 2020

AbstractBackgroundCorona virus infection is a respiratory infection, compromising the normal breathing in critical patients by damaging the lungs. Researches are ongoing to find an efficient treatment strategy for this disease by either inactivating the virus or boosting the immune system of patient or by managing the cytokine storm.AimTo evaluate the clinical outcomes of Substance P receptor Neurokinin 1 antagonist in Covid-19 patients against the usual treatments as controls.Patients and MethodsIt is a randomized clinical trial, open label, having two arms, one receiving normal management and care while other receiving Neurokinin-1 Receptor antagonist, Aprepitant, in addition. Dexamethasone, a corticosteroid is also administered orally to both the groups. PCR positive, hospitalized patients with more than 18 years of age, both genders, moderate to critical phase were included. 18 patients were randomly allocated in both arms, having 10 in group A and 8 in group B. Lab investigations were performed in both the groups before and after the intervention. We report preliminary results for the comparison of Aprepitant 80 mg given once daily for 3-5 days vs routine management. The primary outcome was total in hospital days and duration of disease.ResultsMean age of patients in group A was 47.63 ±12.07years while 60.90± 9.75 years in group B. There were 3/8 males in group A and 8/10 in group B. There were 2 critical patients in group A and 5 in group B. Biochemical and hematological parameters in both groups didn’t show much difference except the C-reactive protein reduction in the intervention group, indicative of a reduced inflammation. Oxygen saturation also improved but more patients should be enrolled to get a statistically significant data. One patient was discharged from each group within 5 days and one patient expired in each.ConclusionsIt is a pilot study but the findings give a strong clue for the therapeutic potential of Aprepitant. Patients who received a combination therapy of Aprepitant and Dexamethasone were recovered earlier and showed improved clinical outcomes, laboratory findings and reduced C-reactive protein which is an inflammatory marker. We suggest here a study on larger sample size to get a deeper insight of its potential and efficacy. It may be more effective in severe to critical patients having respiratory difficulties.
Effects of Starter Feeds of Different Physical Forms on Rumen Fermentation and Microbial Composition for Pre-weaning and Post-weaning Lambs
Authors: Li Yong , Guo Yanli , Zhang Chengxin , Cai Xiaofang , Liu Peng , Li Cailian 
Published: August 2020

ABSTRACTThis study aimed to evaluate the effects of starter feeds of different physical forms on rumen fermentation and microbial composition for lambs. Twenty-four eight-day-old male Hu lambs (5.04 ± 0.75 kg body weight) were fed either milk replacer (MR) and pelleted starter feed (PS), or MR and textured starter feed (TS) in pre-weaning (day 8 to 35) and post-weaning (day 36 to 42) lambs. And the MR was fed by bottles to lambs at 2% of body weight at day 8 divided as three equal amounts at 08:00, 14:00 and 20:00 in pre-weaning. And the lambs were readily availed starter feeds and clean fresh water in the whole experiment. Six lambs for each treatment were euthanized at day 21 or 42 for sampling. The results showed the total volatile fatty acids, propionate and butyrate of rumen liquid in TS groups were all higher than them in PS groups respectively for pre-weaning and post-weaning lambs (P< 0.05), and the pH of rumen liquid in TS group was lower than it in PS group for post-weaning lambs (P< 0.05). Moreover, the pH of rumen and OTUs in TS group had trends to lower than them in PS group for pre-weaned lambs (P= 0.061,P= 0.066). TS established the predominant Phylum,Bacteroidetes, earlier than PS, and increased significantly the relative abundances ofSharpeacompared to PS at level of genus (P< 0.05) for pre-weaning and post-weaning lambs. TS were more benefits to trigger rumen development for lambs.IMPORTANCEEarly use of starter feed could trigger rumen fermentation and establishment of dominant flora, which were in favour of growth and development of rumen for ruminants. The physical form of starter feed is one of the important factors to promote rumen fermentation and establishment of dominant flora for ruminants of transition. However, limited study on effects of physical forms of starter feeds, especially the texturized starters containing steam-flaked grains, to rumen fermentative pattern and microbial composition for pre-weaning and post-weaning lambs to date. It was necessary to investigate the effects of physical form of starter feed on rumen fermentation and microbial composition for lambs. The significance of our research showed TS were better benefits to promote the rumen fermentation and establishment of dominant flora for lambs, which will greatly enhance our understanding of physical forms of starter feeds, leading to broader studies on rumen development for lambs.
An immobilization technique for long-term time-lapse imaging of explantedDrosophilatissues
Authors: Bostock Matthew P. , Prasad Anadika R. , Chaouni Rita , Yuen Alice C. , Sousa-Nunes Rita , Amoyel Marc , Fernandes Vilaiwan M. 
Published: August 2020

AbstractTime-lapse imaging is an essential tool to study dynamic biological processes that cannot be discerned from fixed samples alone. However, imaging cell- and tissue-level processes in intact animals poses numerous challenges if the organism is opaque and/or motile. Explant cultures of intact tissues circumvent some of these challenges, but sample drift remains a considerable obstacle. We employed a simple yet effective technique to immobilize tissues in medium-bathed agarose. We applied this technique to study multipleDrosophilatissues from first-instar larvae to adult stages in various orientations and with no evidence of anisotropic pressure or stress damage. Using this method, we were able to image fine features for up to 18 hours and make novel observations. Specifically, we report that fibers characteristic of quiescent neuroblasts are inherited by their basal daughters during reactivation; that the lamina in the developing visual system is assembled roughly 2-3 columns at a time; that lamina glia positions are dynamic during development; and that the nuclear envelopes of adult testis cyst stem cells do not break down completely during mitosis. In all, we demonstrate that our protocol is well-suited for tissue immobilization and long-term live imaging, enabling new insights into tissue and cell dynamics inDrosophila.
Analysis of Structure and function by the LysR-Type Transcriptional Regulator CbbR of Nostoc sp. PCC 7120
Authors: Xu Hao-Xi , Han Shu-Jing , Jiang Yong-Liang , Zhou Cong-Zhao 
Published: August 2020

ABSTRACTThe LysR-type Calvin–Benson–Bassham cycle transcriptional regulator CbbR plays an important role in CO2fixation in carbon metabolism in nature, which regulates the gene expression of the key enzyme RibisCO in the Calvin–Benson–Bassham (CBB) cycle. In this study, we optimized the conditions for the transformation, expression, and purification of CbbR in the model algae Nostoc sp. PCC 7120, obtained nick-DNA fragments that could tightly bind to CbbR_7120, and finally obtained CbbR protein crystals. These findings provide great assistance for the final crystallization of CbbR to solve the crystal structure of CbbR, and lay the foundation for understanding the mechanism of CO2fixation in the CBB cycle.