bluuebunny/crossref_metadata_2025_split huggingface dataset:
Meta-regression analysis of the effect of lifestyle interventions on mediators of inflammation in postmenopausal breast cancer women with cardiovascular risk factors
Authors: Milambo Jean Paul Muambngu , Kotze Maritha , Rajiv Erasmus , Akudugu John , Jacques Tamuzi Lukenze 
Published: December 2019

Abstract
Background: Chronic inflammation is associated with obesity, dyslipidemia, and different types of malignancies that may play a complex role in the risk of breast cancer (BC) recurrence and therapy related side effects. The purpose of this review was to determine the effects of lifestyle interventions on mediators of inflammation (C-reactive protein (CRP), interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α)) and other therapy related adverse events in postmenopausal BCS with cardiovascular related risk factors. Methods: A systematic search for relevant articles was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis criteria using available databases (PubMed, Scopus, The Cochrane Library, OpenGrey, Google Scholar and CENTRAL). Results: Twelve eligible randomized controlled trials (RCT) met the inclusion criteria. The mean ages of postmenopausal BC women ranged from 49 to 56 years. The meta-regression revealed that there was moderate evidence that MSE decreased the mean difference (MD) of inflammatory markers in BCS, with CVD risk factors (MD: 0.31; 95% CI: 0.05 to 0.57, P=0.02; heterogeneity: Tau² = 0. 12; Chi² = 106.30, df = 19, I² = 0. 50.4%). Conclusion: There is a moderate level of evidence on the effects of MSE on mediators of inflammation in postmenopausal BCS with cardiovascular risk factors. A number of shared risk factors between postmenopausal status and CVD should be considered, while treating postmenopausal BCS.
Strengthening the quality of paediatric primary care: A process evaluation of a complex health systems intervention in South Africa
Authors: Curran Robyn Leigh , Murdoch Jamie , Cornick Ruth Vania , Picken Sandra , Bachmann Max , Bateman Eric , Simelane Makhosazana Lungile , Fairall Lara Rosemary 
Published: December 2019

Abstract
BACKGROUND: Innovative strategies like WHO’s Integrated Management of Childhood Illness (IMCI) have resulted in progress in addressing infant and child mortality. However, the needs of children continue to present a burden upon primary healthcare services. The capacity of services and quality of care offered require greater support to address these needs and extend integrated curative and preventive care, specifically, for the well child, the child with a long-term health condition and the child older than 5 years, not included in IMCI. In response to these needs, the PACK Child intervention was developed, based on a similar successful approach in adults, that expands the scope and reach of integrated management and training programmes for paediatric primary care. We report findings from the process evaluation of the integration of PACK Child intervention within the existing primary health care system. METHODS: A mixed methods process evaluation was completed in ten primary health care facilities in the Western Cape province in South Africa, where clinicians were trained to integrate PACK Child into routine practice. Qualitative data included interviews with managers, clinicians, caregivers and policymakers; observations of training, consultations and clinic flow. Quantitative data included training logs and clinicians’ questionnaires. RESULTS: Impact of PACK Child on clinical practice: Longer consultations, improved clinical knowledge and practice, better teamwork, strengthening of appropriate referrals and inclusion of psychosocial risk screening. Implementation fidelity of PACK Child was hindered by over-reliance on documentation and embedded checklist approach to consultations limited to acute episodic illnesses. PACK Child increased caregiver participation during consultations. CONCLUSIONS: The PACK Child intervention has strengthened primary care for children despite institutionalised care provided by a limited number of clinicians focusing on acute illness with little participation of the caregiver. With refinement of the programme, there is potential for PACK Child to strengthen paediatric care in low-resource settings.
Iron Overload contributes to General Anesthesia-induced Neurotoxicity and Cognitive Deficits
Authors: Wu Jing , Yang Shuofei , Cao Yan , Li Huihui , Zhao Hongting , Yang Jian-Jun , Li Kuanyu 
Published: December 2019

Abstract
Background Increasing evidence suggests that exposure to general anesthesia (GA) could be detrimental to cognitive development in young subjects, and might also contribute to accelerated neurodegeneration in the elderly. Iron is essential for normal neuronal function and excess iron in brain is a hallmark of neuroinflammation and is implicated in several neurodegenerative diseases. However, the role of iron in GA-induced neurotoxicity and cognitive deficits has not been studied.Methods We used the primary hippocampal neurons and rodents including young rats and aged mice to examine whether GA impacts iron metabolism and whether the impact contributed to neuronal outcomes. In addition, a pharmacological suppression of iron metabolism was performed to explore the molecular mechanism underlying GAs-mediated iron overload in the brain.Results Our results demonstrated that GA, induced by intravenous ketamine or inhalational sevoflurane, disturbed iron homeostasis and caused iron overload in both in vitro hippocampal neuron culture and in vivo hippocampus. Interestingly, ketamine or sevoflurane-induced cognitive deficits, very likely, result from a novel regulated iron-dependent cell death, ferroptosis. Notably, iron chelator deferiprone attenuated the GA-induced mitochondrial dysfunctions, ferroptosis, and further cognitive deficits. Moreover, we found that GA-induced iron overload was activated by NMDAR-RASD1 signalling via DMT1 action in the brain.Conclusion We conclude that disturbed iron metabolism may be involved in the pathogenesis of GA-induced neurotoxicity and cognitive deficits. Our study provides new insights into a potential novel therapy for prevention in GA-associated neurological disorders.
Cytokine levels and fatigue in patients with depression: A case-control study
Authors: Petrozzi Bruno Pedraz , Neumann Elena , Sammer Gebhard 
Published: December 2019

Abstract
1. AbstractBackground: Depression represents a highly disabling disease. A relationship between augmented cytokine concentrations and depression has been suggested. Fatigue, frequently being part of depressive symptoms and being associated with infectious diseases and autoimmune diseases, could constitute a link between inflammation mechanisms and depression. The aim of this work was to show the pattern of relationships between depression, fatigue, and inflammation. Methods: A case-control study with 27 patients and 33 matched controls was conducted. IL-6, IL-1β, TNF-α, IFN-γ and CRP were assessed in venous blood samples. Fatigue was assessed behaviorally with a sustained attention task (SAT) and subjectively with a questionnaire (FIS-D). Depression scores were assessed using a questionnaire (BDI-FS). Results: IL-6 was higher in the patient group (U test = 304.00; p = 0.045). For the whole sample size, IL-1β concentration differences were found between BDI-FS categories (H (3) = 11.34, p = 0.01). In patients, correlations were found between BDI-FS categories and IL-1β (ρ = 0.409, p = 0.038), psychosocial fatigue and IL-6 (ρ = 0.437, p = 0.029), and somatic fatigue and TNF-α (ρ = 0.390, p = 0.049). However, correlations failed p = 0.05 threshold for controls. Finally, the total number of omitted responses in the SAT and TNF-α were positively correlated in the patient group (ρ = 0.488, p = 0.011) as well as in the control group (ρ = 0.454, p = 0.008). Conclusions: The results suggest the presence of inflammation in both depression and fatigue. However, each correlates with different pro-inflammatory parameters, indicating potential biological heterogeneity.
Cytokeratin-positive cells in the bone marrow from patients with pancreatic, periampullary malignancy and benign pancreatic disease show no prognostic information
Authors: Hugenschmidt Harald , Labori Knut Jørgen , Brunborg Cathrine , Verbeke Caroline Sophie , Seeberg Lars Thomas , Schirmer Cecilie Bendigtsen , Renolen Anne , Borgen Elin , Naume Bjørn , Wiedswang Gro 
Published: December 2019

Abstract
Background: Pancreatic and periampullary carcinoma are aggressive tumours where preoperative assessment is challenging. Disseminated tumour cells (DTC) in the bone marrow are associated with impaired prognosis in a variety of epithelial cancers. For a cohort of patients with presumed resectable pancreatic and periampullary carcinoma, we evaluated the frequency and the potential prognostic impact of the preoperative presence of DTC, defined as cytokeratin-positive cells detected by immunocytochemistry (ICC). Methods: Preoperative bone marrow samples from 242 patients selected for surgical resection of presumed resectable pancreatic and periampullary carcinoma from 09/2009 to 12/2014, were analysed for presence of CK-positive cells by ICC. The median observation time was 21.5 months. Overall survival (OS) and disease-free survival (DFS) were calculated by Kaplan-Meier and Cox regression analysis. Results: Successful resection of malignant tumours was performed in 179 (74.0%) of the cases, 30 patients resected (12.4%) had benign pancreatic disease based on postoperative histology, and 33 (13.6%) were deemed inoperable during laparotomy due to advanced disease. Overall survival for patients with resected carcinoma was 21.1 months (95% CI: 18.0-24.1), for those with benign disease OS was 101 months (95% CI: 69.4-132) and for those with advanced disease OS was 8.8 months (95% CI: 4.3-13.3). The frequency of CK-positive cells was 6/168 (3.6%) in resected malignant cases, 2/31 (6.5%) in advanced disease and 4/29 (13.8%) in benign disease. The presence of CK-positive cells was not correlated to OS or DFS, neither in the whole cohort nor in the subgroup previously tested negative for circulating tumour cells in blood. Conclusions: The results indicate that CK-positive cells may be present in patients with both malignant and benign diseases of the pancreas. CK-positive cell presence was not associated with differences in prognosis for any patient group. Trial registration: clinicaltrials.gov (NCT01919151)
Analgesic effect of preoperative intravenous administration of paracetamol on post-cesarean pain: A randomized clinical trial
Authors: Moghadam Seyyed Hamid Pakzad , Pourparizi Masoud , Goujani Reza , Khalilabadi Tayyebeh Mirzaei , Ravari Ali , Askari Shayesteh , Khalilabadi Sakineh Mirzaei 
Published: December 2019

Abstract
Background Pain control after every surgery, especially cesarean is highly important, and physicians are striving to discover pain control methods using the least amount of opioid and Paracetamol is a non-opioid analgesic with few complications. The present study was aimed to investigate the analgesic effect of preoperative intravenous administration of paracetamol on post-cesarean pain.Methods This randomized double-blind clinical trial was conducted on 240 pregnant women under spinal anesthesia who were candidate for elective cesarean. The patients’ weight, height, age and body mass index (BMI) were recorded, and patients were randomly divided into two equal groups (n=120). In the first group, 10 mg/kg paracetamol in 100cc normal saline (paracetamol group) and in the second group 100cc normal saline (control group) administered 15 minutes before surgery intravenously. Blood pressure, pulse rate, chills and nausea were recorded during and 1 hour after surgery, and pain visual analogue scale (VAS) and need for additional analgesic were recorded 1, 2, 4, 6, 12 and 24 hours after surgery.Results No significant difference was found between the two groups in frequency of chills and nausea (p>0.05). Mean pethidine consumed was lower in paracetamol group than control group but not significantly. Systolic blood pressure of both groups during surgery and one hour after surgery did not show a significant difference, but diastolic blood pressure was significantly lower in paracetamol group 15 minutes (p=0.046) and 60 minutes after surgery (p=0.042) than control group. The mean scores of pain were significantly lower in paracetamol group than control group 6 hours (0.008) and 24 hours (p=0.038) after surgery.Conclusions Within the limitations of the current study, preoperative intravenous administration of paracetamol significantly reduced post-cesarean pain within 24 hours.
Home-based Palliative Intervention to Improve Quality of Life in Children with Cancer: A Randomized Controlled Trial
Authors: Andriastuti Murti , Halim Pricilia G , Tunjungsari Elnino , Widodo Dwi P 
Published: December 2019

Abstract
Background: In these last few years, an integrated approach between palliative care (PC) and chronic and/or life-threatening conditions care have been widely used. Home-based PC service is developed to meet the needs of the patients at home, but hasn’t been applied widely. This study is aimed to determine the benefit of integrated home-based PC in the quality of life (QOL) and symtomps intensity of Indonesian children with malignancies. Method: A randomized controlled trial to compare the quality of life between patients who were given PC (a 3-month home visit) and those who were not (intervention vs control group) was conducted, each group containing 30 children with cancer aged 2-18 years old who were consulted to palliative team. Participants were randomly assigned into each group. In the first and twelfth week of the intervention, all patients were assessed with the Pediatric Quality of Life Inventory (PedsQLTM) questionnaire cancer module 3.0 (report by proxy or self-report). Symptoms intensity (pain, anorexia, sleep disturbance) were scored by using Edmonton Symptoms Assessment Scale (ESAS). Mean score and each dimension score of both group were compared and analyzed using bivariate analysis. Results: A total 50 participants were included in analysis. Significant difference was found between two groups with average total score in control group 62.39 and intervention group 81.63 (p<0.001). In the intervention group QoL tends to improve, whereas in the control group, those did not get palliative intervention, quality of life tends to decrease as the disease progress. The most improved aspect in QoL is pain and nausea (p<0.001), followed by procedural anxiety (p=0.002), treatment anxiety (p=0.002), and worry (p=0.014). Palliative intervention was found to be able to reduce sleep disturbances (p=0.003) and anorexia (p<0.001) significantly. Conclusion: Home-based PC improved several aspects of the QOL and provide better symptoms management of children with malignancies. An early intervention concurrent with the underlying treatment is believed to be able to improve their quality of life. Trial Registration: This study has been retrospectively registered in ClinicalTrials.gov ID: NCT04067687 (August, 22nd 2019).
QTL and transcriptomic analyses for ammonia tolerance in the Pacific white shrimp (Litopenaeus vannamei)
Authors: Zeng Digang , Yang Chunling , Li Qiangyong , Zhu Weilin , Chen Xiuli , Peng Min , Chen Xiaohan , Lin Yong , Wang Huanling , Liu Hong , Liang Jingzhen , Liu Qingyun , Zhao Yongzhen 
Published: December 2019

Abstract
Background: Ammonia is one of the most common toxicological environment factors affecting shrimp health. Although ammonia tolerance in shrimp is closely related to successful industrial production, few genetic studies of this trait are available. Results: In this study, we constructed a high-density genetic map of the Pacific white shrimp (Litopenaeus vannamei) using specific length amplified fragment sequencing (SLAF-seq). The constructed genetic map contained 807,505 polymorphic markers spanning 44 linkage groups, with a total distance of 6,360.12 centimorgans (cM) and an average distance of 0.37 cM. Using this genetic map, we identified a quantitative trait locus (QTL) that explained 7.41–8.46% of the phenotypic variance in L. vannamei survival time under acute ammonia stress. We then sequenced the transcriptomes of the most ammonia-tolerant and the most ammonia-sensitive individuals from each of four genetically distinct L. vannamei families. We found that 7546 genes were differentially expressed between the ammonia-tolerant and ammonia-sensitive individuals. Using QTL analysis and the transcriptomes, we identified one candidate gene (annotated as an ATP synthase g subunit) associated with ammonia tolerance. Conclusions: In this study, we constructed a high-density genetic map of L. vannamei and identified a QTL for ammonia tolerance. By combining QTL and transcriptome analyses, we identified a candidate gene associated with ammonia tolerance. Our work provides the basis for future genetic studies focused on molecular marker-assisted selective breeding.
Circulating betatrophin/ANGPTL8 levels correlate with body fat distribution in individuals with normal glucose tolerance but not those with glucose disorders
Authors: Zheng Jing , Liu Juan , Hong Beverly S , Li Yanbing 
Published: December 2019

Abstract
Background: The relationship between betatrophin/ANGPTL8 and obesity has been investigated using body mass index (BMI); however, since BMI reflects overall adiposity rather than body fat distribution, it remains unclear whether fat deposition in different areas of the body affects betatrophin expression. Here, we investigated the correlation between circulating betatrophin levels and body fat distribution in patients with different glucose tolerance. Methods: In 128 participants with impaired glucose tolerance (IGT; n = 64) or normal glucose tolerance (NGT; n = 64), we measured circulating betatrophin levels by enzyme-linked immunosorbent assay and body fat distribution (subcutaneous, visceral, and limb fat) using magnetic resonance imaging (MRI) and a body fat meter. Results: After controlling for age, sex, and BMI, betatrophin was correlated positively with visceral adipose tissue-to-subcutaneous adipose tissue ratio ( VAT/SAT ratio; r = 0.339, p = 0.009) and negatively with body fat ratio (BFR; r = -0.275, p = 0.035), left lower limb fat ratio (LLR; r = -0.330, p = 0.011), and right lower limb fat ratio (RLR; r = -0.288, p = 0.027) in the NGT group, with these correlations remaining after controlling for triglycerides. VAT/SAT ratio (standardized β = 0.419, p = 0.001) was independently associated with serum betatrophin levels; however, betatrophin was not associated with body fat distribution variables in the IGT group. Conclusions: Circulating betatrophin levels correlated positively with VAT/SAT ratio and negatively with lower limb fat, but not subcutaneous or upper limb fat, in individuals with normal glucose tolerance. Thus, betatrophin may be a poten­tial biomarker for body fat distribution in individuals without glucose disorders.
Rescue Therapy in Endovascualr Treatment for Acute Ischemic Stroke Due to Large Artery Atherosclerosis
Authors: Liu Mingli , Chen Minghui , Liu Yang , Lin Lin , Li Yongli , Feng Yan , Cai Jinquan , Li Ruiyan 
Published: December 2019

Abstract
Background and purpose Safety and predictors of rescue therapy in patients with acute ischemic stroke due to large artery atherosclerosis still remain unclear. This study aimed to test safety of rescue therapy and evaluate predictors of it after failed mechanical thrombectomy.Methods This retrospective study enrolled consecutively 245 patients with acute ischemic stroke treated by endovascular treatment from March 2016 to April 2019 in a single stroke center. We analyzed the clinical data and laboratory test for safety and predictors of rescue therapy. Binary logistic analysis was applied to confirm the independently relationship.Results There were totally 145 patients enrolled among 245 patients. Rescue therapy was independently associated with the excellent outcome [p=0.048, adjusted OR: 2.655, 95%CI: 1.008 – 6.989] and longer procedure time of endovascular treatment [p=0.004, adjusted OR: 3.722, 95%CI: 1.519-9.122], but there was no significance on complications and mortality. Prestrike incidence [p=0.004, adjusted OR:4.427, 95%CI:1.618-12.114], use of rt-PA [p=0.003, adjusted OR:4.792, 95%CI:1.688-13.602], tandem occlusion [p=0.001, adjusted OR:0.021, 95%CI:0.002-0.194], PLT [p=0.012, adjusted OR:3.234, 95%CI:1.289-8.113], P-LCR>42.3% [p=0.031, adjusted OR:0.132, 95%CI:0.021-0.827] were independent predictors of rescue therapy.Conclusions Rescue therapy for acute ischemic stroke due to large artery atherosclerosis costs more procedure time of endovascular treatment, but it can successfully recanalize the occlusive large artery and is independently related to the excellent clinical outcome without increasing ICH, sICH, reocclusion and others. Prestroke incidence, use of rt-PA, tandem occlusion, PLT and P-LCR may be independent predictors of rescue therapy in acute ischemic stroke due to large artery atherosclerosis.
Randomized, Placebo-controlled, Double-blind, Pilot Trial to Investigate Safety and Efficacy of Cerebrolysin in Patients with Aneurysmal Subarachnoid Hemorrhage
Authors: Woo Peter Yat-Ming , Lam Sandy , (Dr.) Joanna WK Ho , Ko Natalie MW , Li Ronald PT , Jian Leo , Chu Alberto CH , Kwan Marco CL , Chan Yung , Wong Alain KS , Wong Hoi-Tung , Chan Kwong-Yau , Kwok John CK 
Published: December 2019

Abstract
Background There are limited treatment options for aneurysmal subarachnoid hemorrhage (SAH)-induced delayed cerebral ischemia, a major determinant of mortality and morbidity. Cerebrolysin, a brain-specific pleiotropic neuroprotective agent, has been suggested to improve functional outcomes in ischemic stroke. We investigated the efficacy, safety and feasibility of Cerebrolysin for conferring such benefits in SAH patients. Methods This was a prospective, randomized, double-blind, placebo-controlled, single-center, parallel-group pilot study. 50 patients received either daily Cerebrolysin (30ml/day) or a placebo (saline) for 14 days (25 patients per study group). The primary endpoint was a favorable Extended Glasgow Outcome Score (GOSE) of 5 to 8 (moderate disability to good recovery) at six-months. Secondary endpoints included the occurrence of adverse effects, six-month mortality, the occurrence of cerebral vasospasm, delayed cerebral ischemia and infarction. Results No severe adverse effects or mortality attributable to Cerebrolysin were observed. No significant difference was detected in the proportion of patients with favorable six-month GOSE in either study group (odds ratio (OR): 0.53; 95% confidence interval (CI): 0.43-5.17). Secondary functional outcome measures for good six-month recovery indicated by a modified Rankin Scale of 0 to 2 (OR: 0.53; 95% CI 0.43-5.17) and a Barthel Index of 70 or more (OR: 0.52; 95% CI: 0.29-12.72) were also similar for both groups. There was a significantly lower risk of three- and six-month mortality for patients that received Cerebrolysin (OR: 0.46; 95% CI: 0.33-0.63). There were no deaths in the Cerebrolysin group, but the morality rate for the control group was 16% (4/25). The commonest cause of death was due to delayed cerebral ischemia. There were no differences in the overall incidence of delayed cerebral ischemia (p-value: 0.78), cerebral vasospasm (p-value: 0.16) and infarction (p-value: 0.77) between the two groups. Conclusions Use of Cerebrolysin in addition to standard-of-care management of aneurysmal SAH is safe, well tolerated and feasible. Results suggest a benefit in reducing three- and six-month mortality. Due to the exploratory nature of this study and its small sample size, these findings should be confirmed in a larger-scale clinical trial.