bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is There A Renoprotective Value to Leukodepletion During Heart Valve Surgery? A Randomized Controlled Trial (ROLO)
Authors: KHOSHBIN Espeed , SPENCER Sally , SOLOMON Laurence , TANG Agustine , CLARK Stephen , STOKES Elizabeth , WORDSWORTH Sarah , DABNER Lucy , EDWARDS Julia , REEVES Barnaby , ROGERS Chris 
Published: July 2020

Abstract
Background: Acute Kidney Injury (AKI) adversely affects outcomes after cardiac surgery. A major mediator of AKI is the activation of leukocytes through exposure to the cardiopulmonary bypass circuit. We evaluate the use of leukodepletion filters throughout bypass to protect against post-operative AKI by removing activated leukocytes during cardiac surgery. Methods: This is a single-centre, double-blind, randomized controlled trial comparing the use of leukodepletion versus a standard arterial filter throughout bypass. Elective adult patients undergoing heart valve surgery with or without concomitant procedures were investigated. The primary clinical outcome measured was the development of AKI according to the KDIGO criteria. Secondary measures included biomarkers of renal tubular damage (urinary Retinol Binding Protein and Kidney Injury Molecule-1), glomerular kidney injury (urinary Micro Albumin and serum Cystatin C) and urinary Neutrophil Gelatinase Associated Lipocalin, as well as the length of hospital stay and quality of life measures through EQ-5D-5L questionnaires. Results: The ROLO trial randomized 64 participants with a rate of recruitment higher than anticipated (57% achieved, 40% anticipated). The incidence of AKI was greater in the leukodepletion filter group (44% versus 23%, risk difference 21%, 95% CI -2% to 44%). This clinical finding was supported by biomarker levels especially by a tendency toward glomerular insult at 48 hours, demonstrated by a raised serum Cystatin C (mean difference 0.11, 95% CI 0.00 to 0.23, p=0.068) in the leukodepleted group. There was however no clear association between the incidence or severity of AKI and length of hospital stay. On average, health related quality of life returned to pre-operative levels in both groups within 3 months of surgery. Conclusions: Leukocyte depletion during cardiopulmonary bypass does not significantly reduce the incidence of AKI after valvular heart surgery. Other methods to ameliorate renal dysfunction after cardiac surgery need to be investigated.Trial registration: The trial was registered by the International Standard Randomized Controlled Trial Number Registry ISRCTN42121335. Registered on the 18 February 2014. The trial was run by the Bristol Clinical Trials and Evaluation Unit. This trial was financially supported by the National Institute of Health Research (Research for Patient Benefit), award ID: PB-PG-0711-25090.
WITHDRAWN: Combination of Paeoniflorin and Calycosin-7-glucoside Promotes Ischemic Stroke Recovery via the PI3K/AKT Signaling Pathway
Authors: Wang shengxin , Yan Xiangli , He Yingying , Zheng Haozhen , Wang PengCheng , Shi Xuguang , Tan Yongheng , Wang Lisheng 
Published: July 2020

Abstract
Background
Paeoniflorin (PF) and calycosin-7-glucoside (CG) play a role in protecting against brain damage following cerebral ischemia. However, the mechanism of action of PF in combination with CG (PF + CG) against ischemia/reperfusion injury remains unclear.
Methods
The aim of this study was to investigate the protective role of PF + CG on ischemia/reperfusion injury in vivo and in vitro, as well as its potential mechanism of action indicating that PF + CG attenuates middle cerebral artery occlusion (MCAO) /oxygen-glucose deprivation reperfusion (OGD/R) injury via the PI3K/AKT pathway. MCAO rat model was prepared by modified suture method, and behavioral scoring, cerebral infarction area, brain tissue water content measurement, using PI3K, p-PI3K, AKT, p-AKT, Bcl-2, Bax, GSK-3β protein expression as indicators, observe the effect of PI3K / AKT signaling pathway inhibitor LY294002 on the anti-ischemia-reperfusion effect of PF + CG. Oxygen deprivation method was used to prepare the OGD/R model, CCK-8 was used to determine the survival rate of HT22 cells, the contents of SOR, ROS, MDA, and LHD were determined, and apoptosis was detected by flow cytometry and mitochondrial membrane potential, using PI3K, p-PI3K, AKT, p-AKT, Bcl-2, Bax, GSK-3β protein expression as indicators, observe the effect of PI3K/AKT signaling pathway inhibitor LY294002 on the anti- oxidative and glucose deprivation effect of PF + CG.
Results
The animal studies showed that PF + CG significantly decreased neurobehavioral deficits, cerebral infarct volume, and brain edema; ameliorated histopathological damage in model rats; increased levels of PI3K, AKT, p-PI3K, p-AKT, and Bcl-2; and reduced BAX and GSK-3β expression. After treatment with PF + CG, the morphology and number of cells in brain tissue were restored to normal, demonstrating a therapeutic effect in cerebral ischemia-reperfusion injury. Results of further studies revealed that, in vitro, PF + CG has a therapeutic effect to enhance cell vitality; elevate levels of superoxide dismutase (SOD); reduce levels of reactive oxygen species (ROS), lactate dehydrogenase (LDH), and malondialdehyde (MDA); decrease apoptosis rate; increase levels of PI3K, AKT, p-PI3K, p-AKT, and Bcl-2; and reduce BAX and GSK-3β expression.
Conclusion
These results demonstrate that PF + CG has a positive therapeutic effect on ischemia/reperfusion and OGD/R injury, and the mechanism is attributed to activation of the PI3K/AKT signaling pathway.
Lacrimal Sac Bacteriology and Susceptibility Pattern in Infants with Congenital Nasolacrimal Duct Obstruction in the 1st Year of Life: A Cross-Sectional Study
Authors: Zheng Xiaoyu , Choy Bonnie Nga Kwan , Zhou Mingming , Shi Caiping , Zhao Zhengyan 
Published: July 2020

Abstract
Background
Congenital nasolacrimal duct obstruction (CNLDO) is one of the main causes of epiphora in infants, and antibiotics are usually used as a conservative therapy in the first year. Yet, little is known about the bacteriology of the occluded lacrimal drainage system in this group of patients. The aim of this study was to evaluate the microbiology of lacrimal sac (LS) in Chinese children with CNLDO in their first year of life.
Methods
Patients with CNLDO between May 1, 2017 and August 31, 2018 at a tertiary care children’s hospital were enrolled. The study recruited infants who received lacrimal probing under 1 year old, and refluxed discharge from LS was collected. Samples were cultured and susceptibility test was performed for positive culture.
Results
Thirty-two patients with CNLDO were included. The ratio of male to female was 1.5 : 1. The mean age was 6.6 ± 2.3 (1.7–12) months. Positive cultures was identified in 87.5% of the sample, and presented 38 strains of bacteria. Mixed infection was identified in 10 (35.7%) children. Gram-positive bacteria accounted for 60.5% of all the strains, with Streptococcus (50%) being the most frequent species, whereas Haemophilus (21.1%) and Neisseriae (13.2%) were most common isolates for Gram-negative organisms. Methicillin-resistant Staphylococcus aureus (MRSA) was detected in 2 infants whose symptoms resolved by a routine probing. No difference of bacteriology pattern was detected between patients under 6 months old and those beyond. The pathogens were highly sensitive to chloramphenicol (88%) and levofloxacin (84%), but resistant to erythromycin (40%) and sulfamethoxazole (32%).
Conclusions
Infants with CNLDO under 1 year of age presented predominance of Streptococcus as Gram-positive organism, and Haemophilus as Gram-negative organism. Levofloxacin was an active topical antibiotic agent with few chance of resistance. These findings could help clinicians choose optimal medicine for CNLDO as the conservative treatments.
The Effect of Foetal And Early Childhood Growth on Metabolic Derangements of Sri Lankan Children
Authors: Wickramasinghe Vithanage Pujitha , Arambepola C. 
Published: July 2020

Abstract
Background
Studies have shown that accelerated postnatal growth plays a significant role on the onset of adult metabolic diseases. The aim of this study was to identify the effects of intrauterine and later growth on metabolic derangements among children in Colombo, Sri Lanka
Materials:
A school-based cross-sectional study was conducted among 5–15 year old children selected using a two-stage probability-proportionate-to-size cluster sampling technique. Birthweight (BW) was extracted from records to denote prenatal growth; and body mass index (BMI) and fat mass (FM) measured to denote the current growth of children. As metabolic parameters, fasting and random blood glucose, lipid profile and blood pressure (BP) were measured. The sample was stratified by age (5–10 years and 11–15 years); and each age group further categorized into tertiles of BW and BMI. Based on these two parameters, metabolic parameters were evaluated within each age category.
Results
The sample comprised 833 (494 boys). Metabolic parameters did not significantly differ by sex or across BW tertiles of each BMI tertile. However, significant increases were noted in all except FBS across the BMI tertiles of each BW tertile. Children belonging to the lowest BW and highest BMI tertiles had worst metabolic profiles, while those in the lowest BW as well as BMI tertile were protected. Changes were more significant in the older age category. Irrespective of BW, fat deposition rather than nutritional growth seemed to move children to higher BMI tertiles.
Conclusion
Poor prenatal growth is not the sole risk factor for abnormal metabolic profile found in childhood. Those who gain weight during early childhood are at higher risk than those who remain small. This favours the accelerated postnatal growth hypothesis.
Cognitive development of children with Kawasaki Disease and the parenting stress of their caregivers
Authors: Wang Liang-Jen , Tsai Zi-Yu , Chang Ling-Sai , Kuo Ho-Chang 
Published: July 2020

Abstract
Background

Kawasaki disease (KD) is an acute form of febrile vasculitis that occurs in early childhood. The multi-systemic vasculitis common in KD patients may influence blood perfusion in the brain, and thus caregivers of KD children may feel stress with regard to caring for them. Intravenous immunoglobulin (IVIG) infusion is the standard treatment for acute KD, and the most serious complication of KD is coronary artery aneurysms (CAL). This study aimed to investigate the relationships between KD heterogeneity and the risk of patients’ cognitive impairment or caregivers’ parenting stress.
Methods

This cross-sectional study consisted of 176 patients with KD (mean age: 5.5 years, 60.8% male) and 85 healthy children (mean age: 6.4 years, 54.1% male). Based on the children’s age, each KD patient and control subject was administered an assessment using the Mullen Scales of Early Learning or the Wechsler Intelligence Scale, and parenting function of their caregivers was assessed using the Parenting Stress Index-Short Form (PSI).
Results

We observed no significant differences in any developmental index, cognitive function, or parenting stress between KD patients and controls. Among the KD children, IVIG administration nor CAL was associated with children’s cognitive scores. However, the caregivers of patients who had CAL suffered from greater PSI total scores than those of patients without CAL (p = 0.019). Furthermore, the caregivers who had education levels of a master’s degree or above showed less parenting stress than those who had an education level of college (p = 0.010) or lower (p = 0.021).
Conclusion

No significant differences in developmental index, cognitive function or parenting stress between KD patients and controls. In KD patients, neither IVIG response nor CAL appear to have a relationship with development milestones or cognitive function. However, caregivers’ education is associated to parenting stress, and caregivers of KD patients who developed CAL may feel stress about the unpredictable sequela caused by CAL for their children. Such caregivers may require support to fulfill their parenting roles.
Human levator veli palatini muscle: A novel source of mesenchymal stem cells for use in the rehabilitation of patients with congenital craniofacial malformations
Authors: Bueno Daniela Franco , Kabayashi Gerson Shigueru , Pinheiro Carla Cristina Gomes , Tanikawa Daniela Y S , Raposo-Amaral Cassio Eduardo , Rocha Diogenes Laercio , Ferreira José Ricardo Muniz , Hokugo Ashigue , Jarrahy Reza , Zuk Patricia A , Bueno Maria Rita Passos 
Published: July 2020

Abstract
Background. Bone reconstruction in congenital craniofacial differences, which affect about 2-3% of newborns, has long been the focus of intensive research in the field of bone tissue engineering. The possibility of using mesenchymal stem cells in regenerative medicine protocols has opened a new field of investigation aimed at finding optimal sources of multipotent stem cells that can be isolated via non-invasive procedures. Here we analysed whether levator veli palatini muscle fragments, which can be readily obtained in non-invasive manner during surgical rehabilitation of cleft p­­atients during palatoplasty, represent a novel source of MSCs with osteogenic potential. Methods. We obtained levator veli palatini muscle fragments, in non-invasive procedure during surgical rehabilitation of 5 unrelated cleft palate patients (palatoplasty surgery). The levator veli palatini muscle fragments was used to obtain the mesenchymal cells using pre-plating technique in a clean rooms infrastructure and all procedures were performed at good practices of manipulation conditions. To prove that levator veli palatini muscle are mesenchymal stem cells they were induced to flow cytometry analysis and to differentiation into bone, cartilage, fat and muscle. To demonstrate the osteogenic potential of these cells in vivo a bilateral full thickness calvarial defect model was made in immunocompentent rats.Results. Flow cytometry analysis showed that the cells were positive for mesenchymal stem cell antigens (CD29, CD73, CD90), while negative for hematopoietic (CD45) or endothelial cell markers (CD31). Moreover, these cells were capable of undergoing chondrogenic, adipogenic, osteogenic and skeletal muscle cell differentiation under appropriate cell culture conditions characterizing them as mesenchymal stem cell. Defects treated with CellCeramTM scaffolds seeded with levator veli palatini muscle cells showed significantly greater bone healing compared to defects treated with acellular scaffolds. Conclusion. We have demonstrated that cells derived from levator veli palatini muscle have phenotypic characteristics similar to other mesenchymal stem cells, both in vitro and in vivo. Our ﬁndings suggest that these cells may have clinical relevance in the rehabilitation of patients with cleft palate and other craniofacial anomalies characterized by significant bone deficit.
Pathogenesis Clues from the Early Clinical Presentation of 300 Hospitalized COVID-19 Patients
Authors: Yu Feng , Deng Xuemei , Ni Li , Li Wei , Yan Ping , Huang Mian , wang xiongbiao 
Published: July 2020

Abstract
Background: The global spread of the 2019 coronavirus disease (COVID-19) has lasted more than half a year. Except for the gene sequence and viral structure of SARS-CoV-2, its clinical characteristics, pathological mechanisms and corresponding measures have not been fully revealed. We aimed to speculate about the possible pathological mechanism from the early clinical manifestations of patients with COVID-19. Methods: The onset symptoms, laboratory examinations and CT findings on admission of 300 patients in two wards of Wuhan Third Hospital from January 28 to March 15 were analyzed retrospectively. Results: There was no difference in incidence between men and women, but women were hospitalized later after onset. Upper respiratory symptoms and sputum were rare. The incidence of fever was 71%. Blood lymphocyte counts were decreased significantly on admission and were related to the severity of the disease. In moderate patients without hypoxia, thrombocytopenia occurred in 12.37%, CRP rose in 64.43%, BUN was elevated in 20.62%, creatinine rose in 17.53%, D-dimer was elevated in 74.74%, and creatine kinase and α-hydroxybutyrate dehydrogenase were elevated in 45.36% and 54.12% of patients, respectively. Early CT showed a small amount of infiltration in the subpleural and lateral zones of the lung and thickening of the interlobular septum. Approximately 5 days later, infiltration was worse in some of the patients, and the proportion of involvement of the affected lung was negatively correlated with the lymphocyte count. Conclusions: There was no sex difference in patients with SARS-CoV-2 infection. Alveolar cells and T lymphocytes may be the main targets of the virus, and apoptosis may be the primary mechanism of pathogenesis. The virus entering the lung may be transmitted through lymph or blood vessels rather than directly dispersing through the respiratory tract. Early damage to multiple organs may be caused by the immune response.
Assessment of self-medication practices in the context of Covid-19 outbreak in Togo
Authors: Sadio Arnold J , Gbeasor-Komlanvi Fifonsi A , KONU Rodion Y , Bakoubayi Akila W , Tchankoni Martin K , Bitty-Anderson Alexandra , Gomez Iris M , Denadou Claudia P , Anani Joël , Kouanfack Harold R , Kpeto Innocent K , Salou Mounerou , Ekouevi Didier K 
Published: July 2020

Abstract
Background: To date, there is no effective treatment for Covid-19 which is a pandemic due to a new coronavirus called SARS-CoV-2. In Togo where four people in five practice self-medication, the absence of a cure for Covid-19 and its constant progression requires an assessment of self-medication patterns in the context of the pandemic. This study aimed to estimate the prevalence of self-medication to prevent Covid-19 and its associated factors in Lomé, Togo. Methods: A cross-sectional study was conducted in Lomé, capital city of Togo, from April 23rd to May 8th, 2020 in a random sample of participants from five sectors: healthcare, air transport, police, road transport and informal. Participants were invited to give information about their self-medication practices to prevent Covid-19 within the two weeks preceding the survey. Results: A total of 955 participants (71.6% of men) with a median age of 36 (IQR 32–43) were included. Around 22.1% were in the air transport sector, 20.5% in police, and 38.7% in the health sector. The overall prevalence of self-medication to prevent Covid-19 was 34.2% (95CI%: 31.2-37.3%). Most commonly used products were vitamin C (27.6%) and traditional medicine (10.2%). Only 2.0% of participants reported using Chloroquine/Hydroxychloroquine. Female sex (aOR=1.90; p<0.001), working in the health sector (aOR=1.89; p= 0.001), secondary education level (aOR= 2.28; p= 0.043) and university education level (aOR= 5.11; p<0.001) were associated with self-medication. Conclusion: Prevalence of self-medication was high in high-risk populations in Lomé. Intensifying awareness campaigns is crucial to fight misinformation about alleged Covid-19 prevention products on social media.
Preservation of Swallowing in Resected Oral Cavity Squamous Cell Carcinoma: Examining Radiation Volume Effects (PRESERVE): Study Protocol for a Randomized Phase II Trial
Authors: Lang Pencilla , Contreras Jessika , Kalman Noah , Paterson Claire , Bahig Houda , Billfalk-Kelly Astrid , Brennan Sinead , Rock Kathy , Read Nancy , Venkatesan Varagur , Sathya Jinka , Mendez Lucas C. , MacNeil S. Danielle , Nichols Anthony C. , Fung Kevin , Mendez Adrian , Winquist Eric , Kuruvilla Sara , Stewart Paul , Warner Andrew , Mitchell Sylvia , Theurer Julie A. , Palma David 
Published: July 2020

Abstract
Background Patients with resected oral cavity squamous cell carcinoma (OCSCC) are often treated with adjuvant radiation (RT) ± concomitant chemotherapy based on pathological findings. Standard RT volumes include all surgically dissected areas, including the tumour bed and dissected neck. RT has significant acute and long-term toxicities including odynophagia, dysphagia, dermatitis and fibrosis. The goal of this study is to assess the rate of regional failure with omission of radiation to the surgically dissected pathologically node negative (pN0) hemi-neck(s) compared to historical control, and to compare oncologic outcomes, toxicity, and quality of life (QoL) profiles between standard RT volumes and omission of RT to the pN0 neck. Methods This is a multicentre phase II study randomizing ninety patients with T1-4 N0-2 OCSCC with at least one pN0 hemi-neck in a 1:2 ratio between standard RT volumes and omission of RT to the pN0 hemi-neck(s). Patients will be stratified based on overall nodal status (nodal involvement vs. no nodal involvement) and use of concurrent chemotherapy. The primary endpoint is regional failure in the pN0 hemi-neck(s); we hypothesize that a 2-year regional recurrence of 20% or less will be achieved. Secondary endpoints include overall and progression-free survival, local recurrence, rate of salvage therapy, toxicity and QoL. Discussion This study will provide an assessment of omission of RT to the dissected pN0 hemi-neck(s) on oncologic outcomes, QoL and toxicity. Results will inform the design of future definitive phase III trials. Trial Registration: Clinicaltrials.gov identifier: NCT03997643. Date of registration: June 25, 2019, Current version: 2.0 on July 11 2020. URL: https://clinicaltrials.gov/ct2/show/NCT03997643
Evaluation of OAR sparing and plan robustness of beam-specific PTV in lung cancer IMRT treatment
Authors: Chang Yu , Xiao Feng , Quan Hong , Yang Zhiyong 
Published: July 2020

Abstract
Purpose: Margins are employed in radiotherapy treatment planning to mitigate the dosimetric effects of geometric uncertainties for the clinical target volume (CTV). We propose a margin concept that takes the beam direction into consideration, generating a beam-specific PTV (BSPTV) on a beam entrance view. The total merged BSPTV was considered as target using for optimization. We investigated the impact of this novel approach when applied to lung IMRT treatments, and compared the treatment plans generated using BSPTV with conventional PTV. Methods and Materials: We margin the BSPTV by expanding the CTV perpendicularly to the incident beam direction using the 2D version of van Herk’s margin concept. The BSPTV and conventional PTV margin were first analyzed in digital phantom simulation. Then, fifteen lung cancer patients were used in this planning study. First, all patient targets were performed with the CTV projection area analysis to select the suitable beam angles. Then, BSPTV were margined according to the selected beam angles. IMRT plans were optimizted with the conventional PTV and BSPTV as the target volumes, respectively. The dosimetry metrics were calculated and evaluated between these two plans. The plan robustness of both plans for setup uncertainties was evaluated with worst-case analysis. Results: Both conventional PTV and BSPTV plans satisfied the CTV coverage. The BSPTV plans improved the sparing of high doses to target-surrounding lung tissues much better than the conventional PTV plans. Both Dmean of Ring PTV and Ring BSPTV were significantly lower in BSPTV plans (38.89Gy and 39.43Gy) than that in the conventional PTV plans (40.27Gy and 40.68Gy). The V20, V5 and mean lung dose of the affected lung were significant lower in BSPTV plans (16.20%, 28.75% and 8.93Gy) than that in the conventional PTV plans (16.69%, 29.22% and 9.18Gy). About 80% of target coverage in all uncertainty scenarios could be achieved for both conventional PTV and BSPTV plans. Conclusions: The results suggested that the plan robustness can be guaranteed in both the BSPTV and conventional PTV plans. However, the BSPTV plans can spare the normal tissues such as lungs significant better than the conventional PTV plans.