bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of sugammadex in the prevention of postoperative residual curarisation and related complications in patients over 65 years of age undergoing general anaesthesia.
Authors: Pietraszewski Piotr , Gaszynski Tomasz 
Published: February 2020

Abstract
Background. Neuromuscular blocking drugs have contributed to advances in anaesthesiology. The first agent blocking neuromuscular transmission was curare. Alarming respiratory complications in patients recovering from anaesthesia were reported from the very beginning of curare use. The currently used non-depolarizing muscle relaxants are regarded as safe. However, postoperative residual curarisation may be associated with the risk of complications in the first few days after general anaesthesia, especially in patients older than 65 years. This study aims to investigate the effect of sugammadex on the incidence of postoperative residual curarisation, postoperative critical respiratory events, and postoperative cognitive dysfunction. Although recommended, neuromuscular monitoring is still not standard practice during general anaesthesia with the use of muscle relaxants. Methods. Overall, 351 patients aged 65-91 years were included in the observational study. Patients were anaesthetised at the M. Kopernik Provincial Multispeciality Centre of Oncology and Traumatology in Lodz. Spirometry and MMSE (Mini-Mental State Examination) were performed in patients one day before the surgery and one day postoperatively. Neuromuscular blockade was not monitored intraoperatively. One measurement was taken during recovery from anaesthesia. Anaesthetists made a decision to administer either a dose of 2mg/kg sugammadex (group S) or 0.05 mg/kg of neostigmine iv (group N) during recovery from anaesthesia. Results. There were significant differences (p<0.001) between the groups in postoperative TOF ratios. The percentage of patients with TOF ratios >0.9 was significantly higher in the S group than in the N group (83% vs 49%). The incidence of critical respiratory events was significantly lower in the S group compared to the N group (7.6% vs 17%). The study demonstrated significant differences in the postoperative scores of MMSE. Conclusions. Sugammadex effectively prevents postoperative residual curarisation in patients over the age of 65. It reduces the incidence of critical respiratory events in elderly patients. The study revealed a slight trend that full reversal of the neuromuscular blockade may correspond with the improvement of postoperative cognitive functions. Trial registration: Trial ID: ISRCTN17481425 Date registered: 27/01/2020, Link: https://www.isrctn.com/ISRCTN17481425
Characteristics of prescriptions and costs for acute upper respiratory tract infections in Chinese outpatient pediatric patients: a nationwide cross-sectional study
Authors: Wang Shan , Liu Lihua , Liu Jianchao , Miao Likun , Zhuang Qian , Guo Ning , Zhao Jing , Li Quanzheng , Ren Guoquan 
Published: February 2020

Abstract
Background To understand the characteristics of prescriptions and costs in pediatric patients with acute upper respiratory infection (AURI) is important for the regulation of outpatient care and reimbursement policy. This study aims to provide evidence on these issues that was in short supply. Methods We conducted a retrospective cross-sectional study based on data from 138 hospitals across the country. All pediatric patients aged 0-14 years diagnosed with uncomplicated AURI visiting hospital ambulatory departments from 1 January 2015 to 31 December 2017 were included. We reported characteristics of pediatric patients diagnosed with AURI, the average number of medications prescribed per encounter, the categories of medication used and their percentages, the cost per visit and prescription costs of drugs. For these measurements, discrepancies among diverse groups of age, regions, insurance types, and AURI categories were compared. Kruskal-Wallis nonparametric test and Student-Newman-Keuls test were performed to test differences among subgroups. Results A total of 1,002,687 clinical records with 2,682,118 prescriptions were collected and analyzed. The average number of drugs prescribed per encounter was 2.8. The most frequently prescribed medication was Chinese traditional patent medicines (CTPM) (36.5% of overall prescriptions) followed by antibiotics (18.1%). It showed a preference of CPTM over western drugs. The median cost per visit was 119.97 CNY. The median drug cost per visit was 92.70 CNY. The expenditures of antibiotics and CTPM per visit (40.54CNY and 39.35CNY) were among the three highest categories of drugs. The percentage of out-of-pocket patients reached 65.9%. Disparities have been showed among subgroups of different ages, regions, and insurance types. Conclusions The high volume of CPTM usage is the typical feature in outpatient care of AURI pediatric patients in China. The rational and cost-effective use of CPTM and antibiotics still faces challenges. The reimbursement for child AURI cases needs to be enhanced.
Assessing the risk factors of preterm births in Kurdistan, Iran: a case-control study
Authors: Hemmatpour Siros , Mansori Majid , Moradi Ghobad , Sheikhahmadi Shobo , Bagheri Batoul 
Published: February 2020

Abstract
Background: Preterm birth is one of the most common causes of mortality in infants. Despite advances in health care and better access to health services in many countries, preterm birth has increased over the past two decades. Methods: This case control study was conducted on two groups with 100 participants including 100 preterm infants (case) and 100 term infants (control) with gender match in Kurdistan Province-Iran in 2018. The required information was collected from medical files and interviewing the mothers as to demographical information, midwifery specifications, background diseases, disease over pregnancy term, and infants’ information. Conditional logistic regression test was used to estimate the final model and compute the risk ratio. Results: Multivariate regression analysis showed that the risk of preterm birth in individual with AB blood type was higher (OR=5.04; 95%; CI 1.40-18.08). In addition, the risk of preterm birth was higher in the mothers with a history of stillbirth (OR=13.63; 95% CI 1.39-133.5). Preterm birth was significantly related to the history of birth diseases, history of pregnancy diseases, and using medicine for specific diseases during pregnancy. Conclusions: Blood type of mother, history of still birth, history of birth disease, history of pregnancy diseases, using medicines for specific diseases, and history of preterm birth were the risk factors of preterm birth. These factors need to be taken into account before and during pregnancy. Paying more attention to these factors attenuates the rate of preterm birth and premature infants and in turn the mortality rate of infants and mothers.
Egyptian Patients’/guardians’ experiences and perception about clinical informed consent and its purpose: Cross Sectional Study
Authors: metwally ammal , Amer Hala Abdalla , Salama Hend , Hady Safaa Abd El , Alam Raefa , Aboulghate Ahmed , Mohamed Hanan , Badran Hanan , Eltokhy Hanan , SaadAllah Amal , Eldali Abdelmoneim , El-Sonbaty Marwa , Eltahlawy Eman , Saad Walaa , Deeb Sherif El , Fathy Asmaa , Mohsen Amira , Abdel-Latif Ghada , Elmosalami Dalia , Saleh Rehan , Rabah Thanaa , Naga Mai , Hassanain Amal 
Published: February 2020

Abstract
Background: Informed consent (IC) is a healthcare standard emphasizing the meaning of human dignity as clarified in The Universal Declaration of Human Rights. Data about IC practices in Egypt is insufficient. This study aimed to describe the Egyptian patients ‘or guardians ‘experience about IC and their expectations about its meaning in general and according to type of healthcare facility. Methods: Self-administered questionnaire to 1092 participants who had undergone or were scheduled to a procedure requiring an IC at three types of Egyptian health care facilities. Ten statements were ranked twice by the participants to reflect their perception of IC purpose as per what is currently practiced then as per what they believe should be practiced. Results: Informed consent implementation varies across the different levels of health care facilities in Egypt; being implemented the most at the non-governmental health facilities (in 85.9 % of procedures) followed by the governmental health care facilities (77.8 %) and the least at the university hospitals (63.8 %). Current practice was perceived to: “Help patient/guardian decide”, “Document patient’s/guardian’s decision”, and “Have shared decision” (ranked 1–5 by 64.9%, 59.3 %, and 57.3% of respondents, respectively). The perceived purpose of IC was to: “Inform the patient/guardian”, “Make sure patient/guardian understand” and “Document patient’s/guardian’s decision” (ranked 1–5 by 68.4%, 65.3 %, and 65.1% of respondents, respectively). Conclusion: The use of IC is common in Egyptian medical practice but varies across healthcare facilities. Participants believe that the current purpose of IC is to help in decision making, and its main purpose should be information disclosure. There is consensus agreement that both documenting the patient’s/guardian’s decision and informing the patient /guardian is considered as important current as well as preferred practices. IC should be an integral part of any procedure with more emphasis on seeking assent children whenever appropriate. Keywords: Informed consent, Arab Culture, Norm perception, Current practice.
Anlotinib can overcome acquired resistance to EGFR-TKIs via FGFR1 signalling in non-small cell lung cancer without harboring EGFR T790M mutation
Authors: Lian Zengzhi , Du Wenwen , Zhang Yang , Fu Yulong , Liu Ting , Wang Anqi , Cai Tingting , Zhu Jianjie , Zeng Yuanyuan , Liu Zeyi , Huang Jian-an 
Published: February 2020

Abstract
Background Although many studies have defined mechanisms of resistance to EGFR-TKIs, acquired resistance remains the major limitation of monotherapy with EGFR-TKIs. Therefore, there is an urgent need to develop effective therapeutic interventions to overcome acquired resistance. Methods Cell viability was analysed using CCK‐8 assay. EGFR T790M mutation was sequenced on a HiSeq 4000 platform. mRNA from HCC827 and HCC827 gefitinib-resistant (GR) cells was analysed by genome analyser-based deep sequencing. The effect of anlotinib on apoptosis and cell cycle arrest of HCC827 GR was detected by fluorescence-activated cell sorting (FACS) analysis. A mouse xenograft model was used to assess the killing effect of anlotinib on HCC827 GR cells. Results Here we found the T790M mutation in the PC-9 gefitinib-resistant (GR) cell line but not in the HCC827 GR cell line. Interestingly, anlotinib could suppress the growth of HCC827 GR cells by inhibiting FGFR1 in vitro and in a mouse xenograft model. Moreover, FGFR1 was overexpressed in HCC827 GR cells, and the knockdown of FGFR1 reversed gefitinib resistance in HCC827 GR cells. Furthermore, anlotinib induced apoptosis and cell cycle arrest in HCC827 GR cells by increasing the activity of Caspase-3 and decreasing the expression of Cyclin D1. Conclusion FGFR1 overexpression is one of the mechanisms of EGFR-TKI acquired resistance and anlotinib can suppresses the growth of EGFR-TKI-resistant NSCLC cells without T790M mutation.
circRNA-UBAP2 promotes the proliferation and inhibits apoptosis of ovarian cancer though miR-382-5p/PRPF8 axis
Authors: Xu Qin , Deng Bo , Li Manlin , Chen Yang , Zhuan Li 
Published: February 2020

Abstract
Objective: circular RNAs (circRNAs) have been reported to be essential regulators of multiple malignant cancers. However, the functions of circRNAs in ovarian cancer need to be further explored. The aim of our study is to explore the role of circRNA-UBAP2 in ovarian cancer and its mechanism. Results: circRNA-UBAP2 was upregulated in ovarian cancer tissues and cell lines. Knockdown of circRNA-UBAP2 inhibited cell proliferation and promoted cell apoptosis, but circRNA-UBAP2 overexpressed got opposite results. In addition, circRNA-UBAP2 targeted miR-382-5p and downregulated its expression, PRPF8 was a target gene of miR-382-5p. Furthemore, circRNA-UBAP2/miR-382-5p/PRPF8 axis affected the proliferation, apoptosis and cell cycle of ovarian cancer through the mechanism of competing endogenous RNAs (ceRNA). Conclusion: circRNA-UBAP2 acted as a ceRNA to sponged miR-382-5p, increased the expression level of PRPF8, and prompted proliferation and inhibited apoptosis in ovarian cancer cells.
Economic Evaluation of Carbetocin as Prophylaxis for Postpartum Hemorrhage in the Philippines
Authors: Briones Jamaica Roanne , Talungchit Pattarawalai , Thavorncharoensap Montarat , Chaikledkaew Usa 
Published: February 2020

Abstract
Background: Cost-effectiveness and budget impact of carbetocin was evaluated as an alternative to oxytocin for postpartum hemorrhage (PPH) prophylaxis in the Philippines.Methods: A model-based economic evaluation was employed to assess cost-effectiveness of carbetocin compared to oxytocin for PPH. Population of interest were women undergoing either vaginal delivery (VD) or cesarean section (CS) in a public hospital setting with costs and outcomes evaluated in six weeks. Cost-utility was analyzed using a government and societal perspectives while the budget impact was determined using a third party payer’s perspective. Incremental Cost Effectiveness Ratio (ICER) was evaluated using the set threshold in the country of 150,000 PhP per QALY gained.Results: Carbetocin was not cost-effective in the Philippines. Deterministic results in a government perspective for CS was at 724,081 PhP while for VD was over 2 million PhP. Deterministic and probabilistic results in the societal perspective for CS and VD were near these respective ICER values and did not also favor carbetocin use. Moreover, the treatment effects of carbetocin in reference to oxytocin were identified as the most sensitive parameter used. On budget impact, if 50% of deliveries would switch to carbetocin for the fiscal years assessed, additional incremental cumulative costs of 1.08 billion PhP for VD and 1.86 billion PhP for CS would be needed.Conclusion: The incremental benefit of carbetocin does not justify the additional costs incurred from purchasing the drug given a Philippine context. Price reduction of carbetocin is recommended if the drug would be publicly reimbursed in the country.
Early hemoglobin status is predictive of outcomes and long-term mortality of sepsis
Authors: Qi Desheng , Peng Milin 
Published: February 2020

Abstract
Background: Hemoglobin change plays a critical role in progress of sepsis. However, the contribution of hemoglobin change to outcomes of patients with sepsis is still unknown. The aim of our study is to investigate the effect of early hemoglobin level within 48h after admission to Intensive Care Unit (ICU) on long term prognosis for sepsis. Methods: In this single centered, cohort study, we included patients from different ICU departments of Xiangya hospital from 2016 to 2018. Out of 1800 ICU patients, 199 patients with sepsis matched inclusion criteria. All 199 patients were divided into three groups according to 70, 80, and 90 g/L hemoglobin statuses, respectively. Results: Our study showed seventy-nine patients (39.7%) with ≤90g/L hemoglobin, forty-seven patients (23.6%) with hemoglobin ≤80g/L, and twenty-five (12.6%) with hemoglobin ≤70g/L at 48h after admission. Compared to survival group, there were higher rates of patients with hemoglobin ≤80g/L (33.7% vs. 15.1%, P=0.003), hemoglobin ≤70g/L (18.5% vs. 7.5%, P=0.031) in non-survival group, but similar rate of hemoglobin ≤90g/L patients (46.7% vs. 34.0%, P=0.081). Kaplan-Meier survival analysis showed that significant difference occurred among all three groups with total one-year survival rates. Furthermore, multivariate cox proportional hazards regression analysis showed that serum hemoglobin concentration ≤ 80g/L at 48h admission (Hazard Ratio HR 1.736, 95% CI 1.131-2.665, P=0.012), the occurrence of ARDS (HR 1.814, 95% CI 1.184-2.778, P=0.006), the use of CRRT (HR 1.569, 95% CI 1.030-2.390, P=0.036), and septic shock (HR 1.776, 95% CI 1.124-2.804, P=0.014) were independent risk predictors for one-year mortality in septic patients. Whereas the infection site from abdomen (HR 0.281, 95% CI 0.113-0.697, P=0.006) was the only independent protective factor for mortality in septic patients. Conclusion: ≤80 g/L hemoglobin within 48h after admission to ICU was the independent risk factor for mortality for patients with sepsis. Attention should be raised up to target early hemoglobin level in course of sepsis to achieve better outcomes of sepsis. Future larger researches and randomized controlled trials are needed to validate our results.
Nosocomial Infections Due to Multidrug-Resistant Bacteria in Cancer Patients: A Seven-Year Experience of an Oncology Center in Western China
Authors: Jiang Ai-Min , Shi Xin , Liu Na , Gao Huan , Ren Meng-Di , Zheng Xiao-Qiang , Fu Xiao , Liang Xuan , Ruan Zhi-Ping , Yao Yu , Tian Tao 
Published: February 2020

Abstract
Background: Bacterial infections are the most frequent complications in patients with malignancy, and the epidemiology of nosocomial infections among cancer patients has changed over time. This study aimed to evaluate characteristics, antibiotic-resistant patterns, and prognosis of nosocomial infections caused by multidrug-resistant bacteria (MDR) in cancer patients. Methods: This retrospectively analyzed cancer patients with MDR bacteria caused nosocomial infections from August 2013 to May 2019 and was conducted to explore the risk factors, clinical features, outcomes, and antibiotic-resistant patterns of these infections. Results: Overall, 257 cancer patients developed nosocomial infections caused by MDR bacteria. Extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae was the most frequently isolated multidrug-resistant Gram-negative bacteria (MDRGNB), followed by ESBL-producing Klebsiella pneumonia, and Acinetobacter baumannii. Cancer patients with liver disease, received intrapleural/abdominal infusion within 30 days, length of hospitalization, hemoglobin, and albumin were independent factors for 30-day mortality in the study population. The isolated MDR bacteria were highly sensitive to amikacin, meropenem, imipenem, tigecycline, and piperacillin/tazobactam. Conclusions: Cancer patients with prolonged hospitalization was an independent predictor of a favorable outcome. However, cancer patients with liver disease, received intrapleural/abdominal infusion within 30 days, anemia, and hypoproteinemia were independent risk factors of 30-day mortality.
Systematic surveillance and meta-analysis on the prevalence of Metallo-β-Lactamase producers among carbapenem resistant clinical isolates in Pakistan
Authors: Ain Noor ul , Abrar Samyyia , Khan Rehan Ahmad , Hannan Abdul , Imran Namrah , riaz saba 
Published: February 2020

Abstract
Background: Rapid emergence of carbapenem resistance (CR) is a health concern of pertinent importance. Epidemiological surveillance of CR at global and indigenous level (Pakistan) can help to improve infection control strategy and establish pharmacovigilance programs. This study evaluate the prevalence of clinically significant CR isolates, and its genetic variant distribution among different geographical regions of Pakistan. Methods: A meta-analysis was conducted to present the current rate of CR infections and prevalence of Metallo-β-lactamases (MBLs). The proposed subject was researched using robustic electronic databases a) PubMed b) PubMed Central® (PMC), and c) Google Scholar to identify the available literature. Thereafter, relevant data was extracted and statistical analysis was performed using STATA version 14. Result: A total of 110 relevant studies were identified with 19 meeting the inclusion criteria for the meta-analysis of CR, while 22 for MBLs. Pooled rate for carbapenem resistance was determined to be 0.28 (95% CI: 0.26-0.31) with overall significant heterogeneity (I 2 =99.61%, p<0.001) and significant estimated score ES=0 (Z=22.65, p<0.001). In case of Pakistan, the overall pooled proportion of MBL producers was 0.34 (95% CI: 0.29-0.39) with overall heterogeneity significance (I 2 =99.62%, p<0.001) and respective significant ES=0 (Z=13.17, p<0.001). Conclusively, diverse variants of carbapenemases (VIM, IMP, NDM, KPC, GIM, SIM) along with other co-existing β-lactamase variants (OXA, TEM, SHV, CTX-M) have been reported across the country. However, New Delhi Metallo-β-lactamase (NDM)-variants were reported in predominant literature. Conclusion: The prevalence of CR isolates in Pakistan is alarming, associated with MBL production primarily evident from the studies. The study emphasizes the need for regular surveillance, pharmacovigilance and antibiotic stewardship programs to ensure the availability of data to the authorities for preemptive measures of infection control.
The Interactive Association between Sodium Intake, Alcohol Consumption and Hypertension among Elderly in Northern China
Authors: Wang Xuemei , Nan Xi , Lu Haiwen , Wu Jing , Xue Mingming , Qian Yonggang , Wang Wenrui 
Published: February 2020

Abstract
Background The study examined the interactive association between sodium intake, alcohol consumption and hypertension among elderly in Inner Mongolia in Northern China. Methods This was a cross-sectional study which came from the National Survey Data for Nutrition and Adult Chronic Disease in Inner Mongolia. Sodium intake and alcohol consumption were estimated by 24-hour recalls and a weighing method. Participants were categorized into 6 subgroups according to the sodium intake status and drinking levels. Multivariate logistic regression were used to determine the interactive effects. Results 820 elderly were included in the study, of whom 523 (63.80%, standardized rate 62.33%) had been diagnosed with hypertension. The mean sodium intake was 4.88g among the residents in Inner Mongolia. Adjusting for confounders, there was interaction between sodium intake and alcohol consumption, the risk of hypertension was highest among sodium intake excessively with alcohol consumption excessively group, with odds ratio (OR) of 3.639 (95% Confidence interval [ 95% CI ]: 1.666 - 7.947). Conclusions The study highlights the interactive association between sodium intake and alcohol consumption with hypertension. Measures which reduce the intake of sodium and consumption of alcohol aimed at preventing hypertension, and improving the quality of life and health among elderly in Inner Mongolia.