bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Mini-fluid Challenge of 200 mL Predicts fluid Responsiveness Using Pulmonary Artery Catheter in Septic Shock Patients an Observational Study
Authors: Yang Ting , Weng Li , Jiang Wei , Wang Chunyao , Peng Jingmin , Hu Xiaoyun , Li Shan , Du Bin 
Published: August 2020

Abstract
Background: Mini-fluid challenge may predict fluid responsiveness and limit fluid overload. This study was designed to explore the minimal infusion volume in effectively predicting fluid responsiveness in septic shock patients.Methods: ICU septic shock patients with indwelling pulmonary artery catheter received five sequential intravenous boluses of 100 mL 4% gelatin. Cardiac output was measured with thermodilution before fluid challenge (baseline) and three minutes after each bolus. Fluid responsiveness (FR) was defined as an increase in CO greater than 10% after 500 mL fluid infusion. The smallest volume which can perform an effective fluid challenge was analyzed. Results: Forty-seven patients were included in this prospective study. After 500 mL volume expansion, thirty-six patients presented with FR (77%) and 11 patients were fluid nonresponders. A mini fluid of 100 mL colloid had a poor predictive value (AUC = 0.67, p > 0.05). The minimal volume required to predict FR in a mini fluid challenge was 200 mL. An increase in CO greater than 5.2% after 200 mL colloid infusion was able to predict FR with a sensitivity of 83.3% and specificity of 90.9%. The AUC under the ROC curve was 0.93 (95% CI: 0.84 – 1, p < 0.05). Conclusion: In septic shock patients, a minimal volume of 200 mL 4% gelatin could reliably detect fluid responders and nonresponders.Trial registration: ClinicalTrial.gov (NCT01941472). Registered on 13 September 2013.
Maternal and Fetal Outcomes of Patients with Liver Cirrhosis:A Case-Control Study
Authors: Gao Xiang , Zhu Yunxia , Liu Haixia , Yu Hongwei , Wang Ming 
Published: August 2020

Abstract
Objective:We aimed to describe the characteristics and outcomes in pregnant women with liver cirrhosis, and identify the predictors of negative outcome of the mother and fetus.Methods: Retrospectively collect the mothers with liver cirrhosis in our center from 6/2010 to 6/2019. Women without liver cirrhosis were selected as a control in a 1:2 ratio. The primary assessment was the frequency of negative maternal and fetal outcomes. The secondary assessment was the negative outcomes between patients continuing the pregnancy or not and the factors to predict the severe negative outcomes.Results:Of 126 pregnancies enrolled, 29 pregnancies were discontinued for worrying the disease progression and 97 pregnancies were continued. 194 pregnancies without liver cirrhosis were selected as control. At baseline, patients with liver cirrhosis have a lower level of platelet, hemoglobin, Prothrombin activity, and a higher level of ALT, Total Bilirubin, Creatinine. Compared to control, patients with liver cirrhosis have a higher frequency of negative outcomes, including bleeding gums(7.2 %vs. 1.0%), TBA elevation (18.6 %vs.3.1%), infection (10.3 %vs.0.5%), cesarean section (73.6 %vs.49.5%), postpartum hemorrhage(13.8% vs 2.1%), blood transfusion (28.9% vs 2.1%), new ascites or aggravating ascites(6.2% vs.0%), MODS(7.2% vs.0.5%) and intensive care unit admissions(24.1% vs 1.1%). The incidence of severe maternal negative outcomes was also higher (32.0% vs 1.5%). Women who chose to discontinue the pregnancy had less severe negative outcomes (3.4% vs.32.0%).A higher frequency of fetal/infants complication were observed in liver cirrhosis population than control, including newborn asphyxia(10.2% vs1.1%), Low birth weight infant(13.6% vs. 2.6%) .In those patients who progressed into the third trimester, multivariable regression demonstrated that severe negative outcomes were associated with a higher CTP scores (OR 2.128, 95% CI[ 1.002, 4.521] ,p=0.049). Wilson’s disease related liver cirrhosis has a better prognosis (OR= 0.009, 95% CI[0, 0.763], p=0.038).Conclusions:The incidence of the negative outcomes was significantly increased in pregnancies complicated by cirrhosis. The predictor of severe negative outcomes is higher CTP score and Wilson’s disease induced liver cirrhosis have a better prognosis. Timely terminate the pregnancy during the first trimester may avoid the incidence of severe negative outcomes.
The carbon dioxide signal from the COVID-19 lock-down
Authors: Reid John 
Published: August 2020

Abstract
Two unintended experiments provide insight into the role of anthropogenic emissions in the global carbon cycle. One was the temporary reduction in emissions during the COVID-19 lock-down. The other was the emission of a radioactive isotope of carbon during the testing of nuclear weapons in the 1950s and the abrupt cessation of these tests in 1963. Together they imply the existence of two distinct reservoirs which exchange carbon with the atmosphere, viz.: the mixed layer and the deep ocean. Exchanges with the former are noisy because they are influenced by sea surface temperature which, in turn, depends on local weather conditions. They completely mask any variations caused by the COVID-19 lock-down. Exchanges with the latter are steady, long-term and uninfluenced by the weather. They result in half the carbon content of the atmosphere and mixed layer being replaced every eleven years.
Psyllium Supplementation is Associated with Changes in the Fecal Microbiota of Horses
Authors: Mienaltowski Michael J. , Belt Ashley , Henderson John D. , Boyd Tannah N. , Marter Nicole , Maga Elizabeth A. , DePeters Edward J. 
Published: August 2020

Abstract
Objective
Prophylactic supplementation of psyllium husk is recommended to enhance passage of ingested sand from the gastrointestinal tracts of horses. We hypothesized that psyllium supplementation would increase fecal sand passage and favorably alter bacterial populations in the hindgut. Six yearlings and six mature mares were fed a psyllium supplement in the diet daily for seven days. Voluntarily-voided feces were collected over the course of 29 days, prior, during, and after treatment. Feces were analyzed for acid detergent fiber (ADF) and acid detergent insoluble ash analyses. Microbial DNA was also isolated, and the V3/V4 region of the 16S ribosomal RNA gene was PCR-amplified and sequenced using MiSeq technology.
Results
Fecal ADF concentration was greater in adults while silica concentration was greater in yearlings. Mature mare fecal ADF decreased during and just after supplementation but thereafter increased. No changes in silica levels were noted in either group over time. Fecal microbial population phylogenetic diversity was greatest mid-supplementation and lowest at 11 days post-supplementation. Functional profiles of the microbial communities presented some benefits for psyllium supplementation. These findings provide compelling evidence for further detailed studies of prophylactic psyllium supplementation.
Chemotherapy Increases the Risk of Developing Severe Illness in Breast Cancer Patients with COVID-19: A Multi-Center Retrospective Study in Hubei, China
Authors: Wei Jielin , Wu Mengjiao , Liu Jing , Wang Xu , Yang Hua , Xia Pengfei , Peng Ling , Huang Yu , Liu Cuiwei , Xia Zihan , Chen Chuang , Zhao Yanxia 
Published: August 2020

Abstract
Background: The COVID-19 pandemic is a significant worldwide health crisis. Patients with malignancy are considered at substantially increased risk of infection and poor outcomes. Breast cancer patients with COVID-19 represent an urgent clinical need. This study aimed to identify clinical characteristics of breast cancer patients with COVID-19 and risks associated with anti-cancer treatment.Methods: This multicenter retrospective cohort study included 45 breast cancer patients with laboratory-confirmed COVID-19 at seven designated hospitals in Hubei, China. The medical records of breast cancer patients were collected from the records of 9559 COVID-19 patients from 13th January, 2020 to 18th March, 2020. Univariate and multivariate analyses were performed to assess risk factors for COVID-19 severity.Results: Of 45 breast cancer patients with COVID-19, 33 (73.3%) developed non-severe COVID-19, while 12 (26.7%) developed severe COVID-19, of which 3 (6.7%) patients died. The median age was 62 years, and 3 (6.7%) patients had stage IV breast cancer. Most patients developed fever (37, 82.2%), and most had bilateral lung involvement on chest CT (36, 80.0%). Univariate analysis showed the age over 75 and Eastern Cooperative Oncology Group (ECOG) score were associated with COVID-19 disease severity (P<0.05). Multivariate analysis showed patients received chemotherapy within 7 days had a significantly higher risk for severe COVID-19 (logistic regression model: RR=13.886, 95% CI 1.014-190.243, P=0.049; Cox proportional hazards model: HR=13.909, 95% CI 1.086-178.150, P=0.043), with more pronounced neutropenia and higher LDH, CRP and procalcitonin levels than patients else (P<0.05).Conclusions: The severity of COVID-19 in breast cancer patients was associated with baseline factors of the age over 75 and ECOG score, but not with tumor characteristics. Chemotherapy within 7 days before symptom onset was a risk factor for severe COVID-19, reflected by neutropenia and elevated LDH, CRP and procalcitonin levels.
Lactic acidosis associated with metformin in diabetic patients with chronic kidney disease: a multicentre case-control study using electronic health records
Authors: Ávila Mónica , Videla Sebastian , Gómez-Lumbreras Ainhoa , Manriquez Marcela , Prat Oriol , Morros Rosa , Pedrós Consuelo 
Published: August 2020

Abstract
Background

Several studies have assessed the risk of lactic acidosis with metformin use. However, data of this association in patients with renal impairment are still scarce and controversial. Our aim was therefore to assess the association between metformin and lactic acidosis in Spanish type 2 diabetic patients with chronic kidney disease.
Methods

A case-control study (ALIMAR-C2) was performed using the electronic health records from hospitals linked to their corresponding primary healthcare regions. The cases were adult (≥ 18 years) diabetic patients with chronic kidney disease, admitted to seven Spanish hospitals from 2010 to 2016. Ten controls (≥ 18 years, diabetic patients with chronic kidney disease) per case were selected from the population within the same primary healthcare region of the hospital cases. The patients’ hospital health records were linked to their corresponding primary healthcare information. Analyses included multivariable logistic regression and adjustment for potential confounders.
Results

Our study included 126 cases and 1,260 matched controls. The current use of metformin and administration at high doses (> 2 g) were associated with lactic acidosis (adjusted OR: 1.92, 95% CI: 1.21–3.03; OR: 3.13, 95% CI: 1.63–6.01, respectively). The estimated case fatality rate was 46.8% (95% CI: 38.3–55.5%). An increased risk of lactic acidosis was observed in patients with mild to moderate renal impairment (OR: 3.41, 95% CI: 1.48–7.85). As an unexpected finding, diuretic drugs use was also associated with lactic acidosis (OR: 2.73, 95% CI: 1.67–4.46).
Conclusions

Metformin was associated with an increased risk of lactic acidosis in patients with type 2 diabetes mellitus and chronic kidney disease. New data is needed to confirm the association between diuretic drugs and lactic acidosis in this group of patients.
Production of common carp donor-derived offspring from goldfish surrogate broodstock
Authors: Franěk Roman , Kašpar Vojtěch , Gela David , Pšenička Martin 
Published: August 2020

Abstract
Background: Common carp is the fourth most-produced species in worldwide aquaculture. Significant efforts are invested in breeding and preservation of genetic integrity of this important species. However, maintaining carp gene bank in situ can be considered as demanding due to its big body size. Recent progress in reproductive biotechnologies in fish allows improving some unfavourable characteristics of a target species using surrogate reproduction. Germ stem cells (gamete precursors) from one species are transplanted into different surrogate species with small body size. After maturation, surrogates are producing donor-derived progeny. Efficient protocols for cryopreservation of carp male and female germ stem cells have been developed lately. Thus, the next logical goal was to assess the potential of goldfish surrogate to produce donor-derived gametes of common carp after intraperitoneal transplantation of testicular cells. Results: High transplantation success was achieved when 44% of the surviving goldfish produced pure donor-derived gametes of common carp. More importantly, both viable eggs and sperm giving rise to pure common carp progeny were produced, witnessing sustainability of the presented method. Donor-derived identity of the offspring was confirmed by genotyping and typical phenotype corresponding to the donor species. Reproductive performance of chimeras was similar to goldfish controls. Assessment of gamete characteristics showed that the size of donor-derived eggs is between control carp and goldfish eggs. Interestingly, flagellum length in donor-derived spermatozoa was comparable to common carp flagellum and significantly shorter than goldfish flagellum. Conclusions: In this study, we succeeded in the production of pure common carp progeny from surrogate goldfish recipients transplanted intraperitoneally by testicular germ cells. Here we reported production of viable eggs between most distant species up to date. Good reproductive performance of goldfish germline chimeras gives a promising prospect for further analysis about the long-term reproductive performance of surrogates, recovery of cryopreserved germ cells or production of monosex stocks. Presented technology is ready to ease needs for carp breeds preservation and their recovery using many times smaller goldfish surrogates.
Neurological Complications and Noninvasive Multimodal Neuromonitoring in Critically ill COVID-19 Patients
Authors: Battaglini Denise , Santori Gregorio , Chandraptham Karthikka , Iannuzzi Francesca , Bastianello Matilde , Tarantino Fabio , Ball Lorenzo , Giacobbe Daniele Roberto , Vena Antonio , Bassetti Matteo , Rocco Patricia Rieken Macedo , Patroniti Nicolò , Brunetti Iole , Pelosi Paolo , Robba Chiara 
Published: August 2020

Abstract
Background: The incidence and clinical presentation of neurological manifestations of coronavirus disease 2019 (COVID-19) remain unclear. No data regarding the use of neuromonitoring tools in this group of patients are available. Methods: This is a retrospective study of prospectively collected data. The primary aim was to assess the incidence and type of neurological complications in critically ill COVID-19 patients and their effect on survival, as well as on hospital and intensive care unit (ICU) length-of-stay. The secondary aim was to describe cerebral hemodynamic changes detected by noninvasive neuromonitoring modalities such as transcranial doppler (TCD), optic nerve sheath diameter (ONSD), and pupillometry. Results: Ninety-four patients with COVID-19 receiving mechanical ventilation and admitted to an ICU from February 28 to June 30, 2020, were included in this study. Fifty-three patients underwent noninvasive neuromonitoring. Neurological complications were detected in 47/94 patients (50%), with delirium as the most common manifestation. Patients with neurological complications, compared to those without, had longer hospital (36.8±25.1 vs. 19.4±16.9 days, p <0.001) and ICU (31.5±22.6 vs. 11.5±10.1 days, p <0.001) stay. The duration of mechanical ventilation was independently associated with risk of developing neurological complications (OR 1.100, 95%CI 1.046-1.175, p=0.001). Patients with increased intracranial pressure (ICP) measured by ONSD (19% of the overall population) had longer ICU stays. Conclusions: In conclusion, neurological complications are common in critically ill patients with COVID-19 receiving invasive mechanical ventilation and are associated with prolonged ICU length-of-stay. Multimodal noninvasive neuromonitoring systems are useful tools for early detection of cerebrovascular changes in COVID-19. Registration number: 163/2020
Challenges Encountered by Family Caregivers of Prostate Cancer Patients: A Qualitative Inquiry
Authors: Owoo Benedicta , Ninnoni Jerry Paul , Ampofo Evelyn Asamoah , Seidu Abdul-Aziz 
Published: August 2020

Abstract
BackgroundIn Ghana, prostate cancer is more prevalent than all other cancers with a mortality rate of 75% partly as a result of late presentation to the health care facilities. Limited health services provision across the country and shortages of skilled nurses place a significant demand on family caregivers who are often ill-equipped for the caring role resulting in a lot of challenges. As they are expected to provide complex care at home with little resources, information, and support, yet, the healthcare system rarely addresses the challenging needs of these family caregivers. This study explored the Challenges encountered by family caregivers of people with prostate cancer. MethodsA qualitative phenomenological descriptive study was adapted using a semi-structured interview guide to conduct in-depth interviews with twelve (12) family caregivers of prostate cancer patients selected through a purposive sampling technique at the Cape Coast Teaching Hospital. All interviews were recorded, transcribed, and analyzed thematically.Findings The significant statement extracted from verbatim transcripts (analysis of transcripts) produced three main themes as key challenges relating to; Education and Training needs, Resources and Caregiver-nurse relationship issues with seven (7) sub-themes that collectively hindered the family caregivers ability to effectively perform their caring role. Thus making it difficult for them to meet the care demands. Sub-themes that emerged were; lack of preparedness towards the caring role, lack of knowledge about condition/ treatment, misconception about the condition, lack of accommodation facilities, financial constraints, poor communication and poor staff attitude.ConclusionCaregiving is associated with significant challenges that hinder family caregiver’s ability to effectively care for the patient; further diminishing caregiver’s quality of life and quality of patient care. Healthcare professionals especially nurses should, therefore, consider these challenges faced by family caregivers and put in measures to obviate them through education, preparation, and support.
Network Pharmacology Revealed the mechanism of Platycodon grandiflorum in Lung Cancer Treatment
Authors: Chen Xiang-Jing , Zhang Ran , Wang Ren-Zhong , Yao Cheng-Fang 
Published: August 2020

Abstract
Background: Traditional Chinese Medicine has demonstrated increasingly unique advantages in the treatment of lung cancer. Through literature review, it was found out that Platycodon grandiflorum had immunomodulatory and anti-inflammatory effects, and it had a special targeting effect on the lung. Purpose：In order to determine the molecular mechanism of Platycodon grandiflorum in lung cancer treatment. Network pharmacology theory was used to do a systematic study.Methods: The active compounds of Platycodon grandiflorum were screened from TCMSP database. Then, compounds targets were predicted with the assistance of Swiss Target Prediction and STITCH. The targets of lung cancer were screened form TTD and DisGeNET database. The common targets of compounds and lung cancer were screened out for following analysis. A Protein-Protein Interaction (PPI) Network was constructed by STRING. Subsequent to topological analysis, the hub targets were screened out for KEGG pathway and GO Enrichment. Molecular docking by AutoVina was performed to investigate the binding ability between the hub targets and compounds. Results: There were 4 active compounds screened out, including Acacetin, Spinasterol, cis-Dihydroquercetin and Luteolin. There were 80 targets screened as the common target of compounds and lung cancer. After topological analysis TP53, AKT1, VEGFA, CASP3, IL6, EGFR and MAPK1 were identified as hub targets. The 7 hub targets might be involved in 81 biological annotation and in the regulation of 23 pathways to intervene lung cancer. The main functional annotation was negative regulation of apoptotic process. Almost all of the pathways were directly or indirectly associated with the PI3K-Akt signal pathway and MAPK signal pathway. According to Affinity score of molecular docking the best binding protein for Luteolin was EGFR, and the best binding protein for Acacetin was CASP3. This meant that the Platycodon grandiflorum was easier to combine these two targets than other targets.Conclusion: Our study affirmed the effectiveness of Platycodon grandiflorum in treatment of lung cancer from molecular level. And we found that EGFR and CASP3 were the most likely targets for the direct action of Platycodon grandiflorum. The most important pathways that Platycodon grandiflori might interfere with were PI3K-Akt signaling pathway and MAPK signaling pathway.
Dosimetric comparison between helical tomotherapy, volume modulated arc-therapy and Fixed-Field intensity modulated radiation therapy in postoperative adjuvant radiotherapy for cervical cancer
Authors: Yu Deyang , Wang Lei , Hu Xueyuan , Li Xin , Bai Yanling , Yang Shanshan 
Published: August 2020

Abstract
Background: To evaluate the dosimetric parameters among three different radiotherapy techniques in patients with postoperative cervical cancer, including the Helical Tomotherapy (HT), the Volume Modulated Arc-Therapy (VMAT), and the Fixed-Field intensity modulated radiation therapy (FF-IMRT). Methods: Fifteen cervical cancer patients treated with postoperative radiotherapy were re-planning with HT, VMAT and FF-IMRT. The prescribed target dose of the patients was 1.8/45Gy. The paired-samples t-test was used to compare the dosimetric parameters of the planning target and OARs (Organs at risk), and the efficiency of radiation delivery. Results: Compared with the VMAT and FF-IMRT, the HT plans showed significant improvement in the conformity index (CI) and the homogeneity index (HI). In addition, the HT plans also significantly reduced the volume of high-dose region of the OARS, especially in the V30, V40 of small bowel, rectum and bladder. Meantime, the advantage of VMAT is that it reduced the treatment time and improved the efficiency of radiation delivery obviously, compared with the HT (293.8 ± 12.8s Vs. 557.6 ± 51.9s, P < 0.001) and FF-IMRT (293.8 ± 12.8s Vs. 581.8 ± 26.1s, P < 0.001). Conclusion: Our result reveals that HT showed better CI and HI for the target and reduced high dose volumes to OARs compared with VMAT and FF-IMRT, but the lower dose volumes to OARs increased slightly. As for the benefit of VMAT, it demonstrated the shortest treatment time. Our results could provide guidance for selecting the appropriate radiation technologies for cervical cancer patients who undergoing postoperative adjuvant pelvic radiotherapy.