bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of the effectiveness and safety of intravenous and topical regimens of tranexamic acid in complex tibial plateau fracture: a retrospective study
Authors: Wang Zhimeng , Lu Yao , Wang Qian , Song Leilei , Ma Teng , Ren Cheng , Li Zhong , Yang Jiarui , Zhang Kun , Zhang Bing 
Published: October 2020

Abstract
Background Previous studies have demonstrated the effectiveness and safety of tranexamic acid (TXA) in orthopedic surgery. However, no study has investigated TXA in complex tibial plateau fracture surgery. Therefore, the purpose of this study was to confirm the safety and effectiveness of i.v. (intravenous) TXA and topical TXA.Material and methods This was a retrospective analysis of prospectively collected data. The control group received an equal amount of placebo (physiological saline solution); the i.v. group received 1.0 g TXA by intravenous injection before the tourniquet was inflated and before the surgical incision was closed, and the topical group received 3.0 g TXA in 75 mL of physiological saline solution 5 minutes prior to the final tourniquet release. Perioperative blood loss, vascular events, wound complications, and adverse reactions were compared among the three groups. The pain, knee function, and quality of life (QoL) assessments were based on their corresponding scoring systems.Results Baseline data were comparable for all groups. The i.v. group showed the best results for total blood loss (TBL) and hidden blood loss (HBL) (424.5 ± 49.4 mL and 219.3 ± 33.4 mL, respectively, all P values < 0.001). Patients in the i.v. group had lesser real Hb decrease than those in the control group (0.9 vs 1.5, P＜0.001) and topical group (0.9 vs 1.2, P = 0.026). The blood coagulation level as measured using fibrinolysis (D-dimer) was lower in the i.v. group than in the control and topical groups on POD1 and POD3; however, this difference was not significant; the fibrin-degradation products also showed a similar trend. Patients in the topical group experienced less pain than those in the control group on POD2, POD4, and PO6W. The VAS pain score was 3.6 vs. 4.4 (POD2, P＜0.05), 2.8 vs 3.3 (POD4, P＜0.05), and 2.1 vs. 2.6 (PO6W, P＜0.001) in the topical group vs control group, respectively. No significant differences were identified in vascular events, wound complications, adverse reactions, knee function, and QoL among the three groups.Conclusion To our knowledge, this is the first study that showed both i.v. TXA and topical TXA are safe and effective for complex tibial plateau fractures. The i.v. regimen effectively reduced blood loss during the perioperative period, whereas patients under the topical regimen had less vascular events, wound complications, and a lower incidence of adverse reactions compared to those in the i.v. group.
hPMSCs protects against D-galactose-induced oxidative damage of CD4+ T cells through activating Akt-mediated Nrf2 antioxidant signaling&nbsp;
Authors: Xiong Yanlian , Wang Yueming , Zhang Jiashen , Zhao Nannan , Zhang Hengchao , Zhang Aiping , Zhao Dongmei , Yu Zhenhai , Yin Yancun , Song Lele , Xiong Yanlei , Luan Xiying 
Published: October 2020

Abstract
Background: Mesenchymal stem cells (MSCs) was considered as regenerative therapeutic approach in both acute and chronic diseases. However, whether MSCs regulate the antioxidant metabolism of CD4+ T cells and weaken immunosenescence remains unclear. Here, we reported the protective effects of hPMSCs in aging-related CD4+ T cell senescence and identified the underlying mechanisms using a D-gal induced mouse aging model.Methods: In vivo study, 40 male C57BL/6 mice (8 weeks) were randomly divided into four groups: control group, D-gal group, hPMSC group and PBS group. In in vitro experiment, human naive CD4+ T (CD4CD45RA) cells were prepared using a naive CD4+ T cell isolation kit II and pretreated with the Akt inhibitor LY294002 and Nrf2 inhibitor ML385. Then, isolated naive CD4+ T cell were cocultured with hPMSCs for 72 h in the absence or presence of anti-CD3/CD28 Dynabeads and IL-2 as a mitogenic stimulus. Intracellular ROS changes were detected by flow cytometry. The activities of the antioxidant enzymes superoxide dismutase, glutathione peroxidase and catalase were measured by colorimetric analysis. The senescent T cells were detected SA-β-gal stain. The expression of aging related proteins were detected by Western blotting, RT-PCR and confocal microscopy.Results: We found that hPMSC treatment markedly decreased the ROS level, SA-β-gal positive cells number, senescence-associated secretory phenotype (IL-6 and OPN) expression and aging-related protein (P16 and P21) expression in senescent CD4+ T cells. Furthermore, hPMSC treatment effectively upregulated Nrf2 nuclear translocation and the expression of downstream target genes (HO-1, CAT, GCLC and NQO1) in senescent CD4+ T cells. Moreover, in vitro studies revealed that hPMSCs attenuated CD4+ T cell senescence by upregulating the Akt/GSK-3β/Fyn pathway to activate Nrf2 functions. Conversely, the antioxidant effects of hPMSCs were blocked by the Akt inhibitor LY294002 and Nrf2 inhibitor ML385 in senescent CD4+ T cells.Conclusions: Our results indicate that hPMSCs attenuate D-gal induced CD4+ T cell senescence by activating Nrf2-mediated antioxidant defenses and that upregulation of Nrf2 by hPMSCs is regulated via the Akt/GSK-3β/Fyn pathway.
Development and launch of the first Obstetrics and Gynaecology Master of Medicine residency training programme in Botswana
Authors: Luckett Rebecca , Nassali Mercy , Melese Tadele , Moreri-Ntshabele Badani , Moloi Thabo , Hofmeyr Justus , Chobanga Kudra , Masunge Japhter , Makhema Joe , Pollard Maisie , Ricciotti Hope , Ramogola-Masire Doreeen , Bazzett-Matabele Lisa 
Published: October 2020

Abstract
Background: Sub-Saharan Africa (SSA) faces a severe shortage of Obstetrician Gynaecologists (OBGYNs). While the Lancet Commission for Global Surgery recommends 20 OBGYNs per 100,000 population, Botswana has only 40 OBGYNs for a population of 2.3 million. We describe the development of the first OBGYN Master of Medicine (MMed) training programme in Botswana to address this human resource shortage.Methods: We developed a 4-year OBGYN MMed programme at the University of Botswana (UB) using the Kern's approach. In-line with UB MMed standards, the programme includes clinical apprenticeship training complemented by didactic and research requirements. We benchmarked curriculum content, learning outcomes, competencies, assessment strategies and research requirements with regional and international programmes. We engaged relevant local stakeholders and developed international collaborations to support in-country subspecialty training.Results: The OBGYN MMed curriculum was completed and approved by all relevant UB bodies within ten months during which time additional staff were recruited and programme financing was assured. The programme was advertised immediately; 26 candidates applied for four positions, and all selected candidates accepted. The programme was launched in January 2020 with government salary support of all residents. The clinical rotations and curricular development have been rolled out successfully. The first round of continuous assessment of residents was performed and internal programme evaluation was conducted. The national accreditation process was initiated.Conclusion: Training OBGYNs in-country has many benefits to health systems in SSA. Curricula can be adjusted to local resource context yet achieve international standards through thoughtful design and purposeful collaborations.
The Relationship between QT Interval Indices with Cardiac Autonomic Neuropathy in Diabetic Patients- A casecontrol_ study
Authors: vasheghani maryam , Sarvghadi Farzaneh , Beyranvand Mohammad Reza , Emami Habib 
Published: October 2020

Abstract
Background: Long QT interval (QT) and abnormal QT dispersion (QTd) are associated with sudden death. The relationship between cardiac autonomic neuropathy (CAN) and QT indices in type 2 diabetic patients were investigated. Methods: Totally 130 diabetic subjects (mean age 50.87 ± 13.9 years) were included (70 individuals with and 60 individuals without CAN). All participants had sinus cardiac rhythm. The patients who had diseases or take drugs that cause orthostatic hypotension (OH), cardiac arrhythmia and QT prolongation were excluded. After interview and examination, standard and continuous ECG was taken in supine position with deep breathing and standing up position. CAN diagnosis was based on Ewing’s tests. QT, QT corrected (QTc), minimum QT (QT min), maximum QT (QT max) and mean ± SD of QT (QT mean) and QTd were assessed from standard ECG. QTc was calculated by Bazett’s formula from V2 lead. QTc > 440 msec in men and QTc > 0.46 msec in women and QTd > 80 msec were considered abnormal.Results: In patients with CAN, 21.5% were symptomatic. The prevalence of abnormal QTc and QTd was 11.3% and 28.7%, respectively. There was no significant difference between the patients with or without CAN in terms of long QTc and abnormal QTd. However, the mean ± SD of QT max, QT mean and QTd was higher in the patients with CAN (P value <0.03). The used cut points for QTc and QTd have high specificity (79% for both) and low sensitivity (30% and 37%, respectively). To use QTc and QTd as screening test for CAN in T2DM patients, the cutoff points 380 and 550 msec are suggested, respectively. Conclusion: The prevalence of asymptomatic CAN was 3.7 times that of symptomatic CAN. In patients with CAN the QT max, QT mean and QTd were higher than those without CAN .There was no association between CAN and long QTc and abnormal QTd.
Circular RNA MCTP2 inhibits cisplatin resistance in gastric cancer by miR-99a-5p-mediated induction of MTMR3 expression
Authors: Sun Guangli , Li Zheng , He Zhongyuan , Wang Weizhi , Wang Sen , Zhang Xing , Cao Jiacheng , Xu Penghui , Wang Haixiao , Huang Xiaoxu , Xia Yiwen , Lv Jialun , Xuan Zhe , Jiang Tianlu , Fang Lang , Yang Jing , Zhang Diancai , Xu Hao , Xu Ze-Kuan 
Published: October 2020

Abstract
Background: Cisplatin (CDDP) is the first-line chemotherapy for gastric cancer (GC). The poor prognosis of GC patients is partially due to the development of CDDP resistance. Circular RNAs (circRNAs) are a subclass of noncoding RNAs that function as microRNA (miRNA) sponges. The role of circRNAs in CDDP resistance in GC has not been evaluated.Methods: RNA sequencing was used to identify the differentially expressed circRNAs between CDDP-resistant and CDDP-sensitive GC cells. qRT-PCR was used to detect the expression of circMCTP2 in GC tissues. The effects of circMCTP2 on CDDP resistance were investigated in vitro and in vivo. Pull-down assays and luciferase reporter assays were performed to confirm the interactions among circMCTP2, miR-99a-5p, and myotubularin-related protein 3 (MTMR3). The protein expression levels of MTMR3 were detected by western blotting. Autophagy was evaluated by confocal microscopy and transmission electron microscopy (TEM).Results: CircMCTP2 was downregulated in CDDP-resistant GC cells and tissues compared to CDDP-sensitive GC cells and tissues. A high level of circMCTP2 was found to be a favorable factor for the prognosis of patients with GC. CircMCTP2 inhibited proliferation while promoting apoptosis of CDDP-resistant GC cells in response to CDDP treatment. CircMCTP2 was also found to reduce autophagy in CDDP-resistant GC cells. MiR-99a-5p was verified to be sponged by circMCTP2. Inhibition of miR-99a-5p could sensitize GC cells to CDDP. MTMR3 was confirmed to be a direct target of miR-99a-5p. Knockdown of MTMR3 reversed the effects of circMCTP2 on the proliferation, apoptosis and autophagy of CDDP-resistant GC cells. CircMCTP2 was also confirmed to inhibit CDDP resistance in vivo in a nude mouse xenograft model.Conclusions: CircMCTP2 sensitizes GC to CDDP through the upregulation of MTMR3 by sponging miR-99a-5p. Overexpression of CircMCTP2 could be a new therapeutic strategy for counteracting CDDP resistance in GC.
The effect of preoperative chemotherapy on liver regeneration after portal vein embolization/ligation or liver resection in patients with colorectal liver metastasis: a systematic review protocol
Authors: Pavel Mihai-Calin , Casanova Raquel , Estalella Laia , Memba Robert , Llàcer-Millán Erik , Achalandabaso Mar , Julià Elisabet , Geoghegan Justin , Jorba Rosa 
Published: October 2020

Abstract
Introduction: Liver resection (LR) in patients with liver metastasis from colo-rectal cancer remains the only curative treatment. Perioperative chemotherapy improves prognosis of these patients. However, there are concerns regarding the effect of preoperative chemotherapy on liver regeneration, which is a key event in avoiding liver failure after LR. The primary objective of this systematic review is to assess the effect of neoadjuvant chemotherapy on liver regeneration after (LR) or portal vein embolization (PVE) in patients with liver metastasis from colo-rectal cancer. The secondary objectives are to evaluate the impact of the type of chemotherapy, number of cycles and time between end of treatment and procedure (LR or PVE) and to investigate whether there is an association between degree of hypertrophy and postoperative liver failure.Methods: The design of this systematic review will follow the current recommendations of PRISMA. After an exhaustive literature search with pre-established criteria, two researchers will individually screen the identified records, according to a list of inclusion and exclusion criteria. Primary outcome will be future liver remnant regeneration rate. All data will be registered in a predesigned database. In the event of a substantial heterogeneity of selected articles, a narrative systematic review will be performed.Discussion: The results of this systematic review may help to better identify the patients affected by liver metastasis that could present low regeneration rates after neoadjuvant chemotherapy. These patients are at risk to develop liver failure after extended hepatectomies and therefore are not good candidates for such aggressive procedures.Systematic Review Registration: PROSPERO registration number: CRD42020178481 (July 5th 2020).
Regular consumption of soft drinks is associated with type 2 diabetes incidence in Mexican adults: findings from a prospective cohort study.
Authors: Torres-Ibarra Leticia , Rivera-Paredez Berenice , Hernández-López Rubí , Canto-Osorio Francisco , Sánchez-Romero Luz María , Lopez-Olmedo Nancy , González-Morales Romina , Ramírez Paula , Salmerón Jorge , Barrientos-Gutiérrez Tonatiuh 
Published: October 2020

Abstract
Background: Although high consumption of soft drinks has been associated with excess of type 2 diabetes risk, the strength of this association in the Mexican population, where a type 2 diabetes genetic susceptibility has been well established, has been scarcely studied. This study aimed to estimate the risk of type 2 diabetes due to soft drinks consumption in a cohort of Mexicans. Methods: We used data on 1,445 participants from the Health Workers Cohort Study, a prospective cohort conducted in Cuernavaca, Mexico. Soft drinks consumption was assessed with a semi-quantitative 116-item food frequency questionnaire. Incident type 2 diabetes was defined as self-report of physician-diagnosed type 2 diabetes, fasting glucose >126 mg/dl, or hypoglycemic medication at any examination. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard models.Results: With a total of 9,526.2 person-years of follow-up, 109 incident cases of type 2 diabetes were observed. Type 2 diabetes incidence rate was 7.6, 11.0, and 17.1 per 1,000 person-years across levels of soft drinks consumption of <1, 1-4, and ³5 servings/week, respectively (p<0.001 for trend). The intake of ≥5 soft drinks/week was significantly associated with an increased risk of type 2 diabetes (HR 1.9 95% CI:1.0-3.5) compared with consumption of <1/week (p-trend=0.040). The HR was attenuated by further adjustment for body mass index (HR 1.5 95%CI:0.8-2.8) and abdominal obesity (HR 1.6 95%CI:0.8-3.0). Conclusions: The consumption of soft drinks was associated with a higher risk of type 2 diabetes in a cohort of Mexican adults. Our results further support recommendations to limit soft drinks intake to address the growing diabetes epidemic in Mexico.
Circ-CCDC66 upregulates REXO1 expression to aggravate cervical cancer progression via restraining miR-452-5p
Authors: Zhang Yan , Li Xing , Zhang Jun , Mao Lin 
Published: October 2020

Abstract
Background: Cervical cancer is one most common cancer types among females over the world. While its underlying mechanisms remain unclear. Circ-CCDC66 has been revealed to participate in multiple biological functions, and contribute to various diseases’ progression. In the current study, we aimed to demonstrate the role of circ-CCDC66 in cervical cancer progression. Methods: Real-time quantitative PCR (RT-qPCR) was conducted to measure the expression of circ-CCDC66, miR-452-5p, and REXO1 mRNA. Cell fractionation assay and RNA fluorescence in situ hybridization (FISH) were performed to locate circ-CCDC66 in cells. Cell account kit 8 (CCK-8) was used to detect cell proliferation ability. Transwell assay was applied to evaluate cell migration or invasion ability. Bioinformatics analysis, biotinylated RNA pull-down, RNA immunoprecipitation, and dual-luciferase reporter assays were conducted to assess the association between miR-452 and circ-CCDC66 or REXO1. Western blot was applied to measure the protein expression of REXO1. The animal tumor model was used to assess the effect of circ-CCDC66 in vivo . Results: The expression of circ-CCDC66 was upregulated in cervical cancer tumor tissues in comparison with normal tissues, and correlated with later tumor stage and larger tumor size. Downregulated circ-CCDC66 inhibited cervical cancer cell proliferation, migration, and invasion. Circ-CCDC66 was an efficient molecular sponge for miR-452-5p, and negatively regulated miR-452-5p expression. MiR-452-5p directly targeted to REXO1. Circ-CCDC66 regulated REXO1 expression to modulate cervical cancer progression via miR-452-5p. Moreover, downregulated circ-CCDC66 was found to suppress tumor growth in vivo. Conclusion: Our results demonstrated the role of circ-CCDC66/miR-452-5p/REXO1 axis in cervical cancer progression, we might provide novel therapeutic targets for cervical cancer clinical intervention.
Screening of subclinical P300 event-related potentials changes in childhood acute lymphoblastic leukemia survivors: comparison of different treatment protocols.
Authors: Kroczka Slawomir , Stepien Konrad , Skoczen Szymon 
Published: October 2020

Abstract
Background: Modern treatment protocols in childhood acute lymphoblastic leukemia (ALL) resulted in high cure rate and improved long-term survival. However, due to their high intensity, they are also associated with many side effects, including central nervous system toxicity. The aim of our study was to evaluate the use of screening of subclinical P300 event-related potentials changes in childhood ALL survivors.
Methods: A group of 136 patients, 66 males (48.5%), aged 4.9 to 27.9 years who have completed ALL therapy, were screened for subclinical P300 potentials changes. ALL therapy was conducted according to modified New York (NY) (30 patients) and subsequent revisions of modified Berlin-Frankfurt-Münster (BFM): previous BFM protocols (pBFM) (32 patients) and BFM95 (74 patients). The control group consisted of 58 patients, 34 males (58.6%), aged 6 to 17 years after a syncope episode (n=29) as well as healthy subjects (n=29).
Results: The total group of ALL survivors had significantly prolonged the mean latency of P300 (331.31±28.71 vs 298.14±38.76 ms, P<0.001) and reaction time (439.51±119.86 vs 380.11±79.94 ms, P=0.002) compared to the control group. Abnormalities in endogenous evoked potentials were observed in 10 (33.33%) NY, 5 (15.63%) pBFM and 21 (28.38%) BFM95 patients. The mean latency time was significantly longer compared to the control group in all analyzed protocols and the highest values were observed in pBFM patients (NY: 329.13±28.07 ms, P=0.001; pBFM: 332.97±23.97 ms, P<0.001; BFM95: 331.47±31.05 ms, P<0.001). The reaction time was similarly prolonged compared to the control group. The largest and also significant prolongation was recorded in the NY group (461.8±140.3 vs 380.1±78.04 ms, P=0.039).
Analyzing the effect of radiotherapy on P300 potentials, a significantly higher frequency of prolonged reaction time in non-irradiated BFM95 patients was found (21.62 vs 15.85%, P=0.007). Radiotherapy methods used in NY and pBFM protocols have also significantly reduced the P300 wave amplitude (mean values: 10.395±5.727 vs 12.739±6.508 ms, P=0.027).
Conclusions: Endogenous P300 event-related potentials may be useful in screening assessment of late subclinical cognitive changes in ALL survivors. The type of treatment protocol significantly modulates the individual parameters of the registered P300 potentials.
Prevalence of delirium, depression, anxiety, and post-traumatic stress disorder among COVID-19 patients: protocol for a living systematic review
Authors: Shi Jiyuan , Gao Ya , Zhao Liang , Li Yuanyuan , Yan Meili , Mingming Niu , Chen Yamin , Song Ziwei , Zhang Ruixing , Zhang Lili , Tian Jinhui 
Published: October 2020

Abstract
Background Previous studies on the impact of corona virus disease 2019 (COVID-19) on the mental health of the patients has been limited by the lack of relevant data. With the rapid and sustained growth of the publications on COVID-19 research, we will perform a living systematic review (LSR) to provide comprehensive and continuously updated data to explore the prevalence of delirium, depression, anxiety, and post-traumatic stress disorder (PTSD) among COVID-19 patients.Methods We will perform a comprehensive search of the following databases: Cochrane Library, PubMed, Web of Science, Embase, and Chinese Biomedicine Literature to identify relevant studies. We will include peer-reviewed cross-sectional studies published in English and Chinese. Two reviewers will independently assess the methodological quality of included studies using the Joanna Briggs Institute Prevalence Critical Appraisal tool and perform data extraction. In the absence of clinical heterogeneity, the prevalence estimates with a 95% confidence interval (CI) of delirium, depression, anxiety, and post-traumatic stress disorder (PTSD) will be calculated by using random-effects model to minimize the effect of between-study heterogeneity separately. The literature searches will be updated every three months. We will perform meta-analysis if any new eligible studies or data are obtained. We will resubmit an updated review when there were relevant changes in the results, i.e. when outcomes became statistically significant (or not statistically significant anymore) or when heterogeneity became substantial (or not substantial anymore).Discussion This LSR will provide an in-depth and up-to-date summary of whether the common neuropsychiatric conditions observed in patients hospitalized for severe acute respiratory syndrome (SARS-CoV) and Middle East respiratory syndrome (MERS) are also prevalent in a different stage of COVID-19 patients.Systematic review registrationPROSPERO CRD42020196610