bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of acute cardiovascular events following acute exacerbation period for patients with COPD: a nested case-control study
Authors: Hu Weiping , Lhamo Tsokyi , Zhang Feng-ying , Hang Jing-qing , Zuo Yi-hui , Hua Jian-lan , Li Shan-qun , Zhang Jing 
Published: November 2020

Abstract
BackgroundFor patients with chronic obstructive pulmonary disease (COPD), the incidence of acute cardiovascular events (CVEs) increases during acute exacerbation (AE) period, causing increased inpatient mortality. Thus, we try to identify predictors of acute CVEs in patients with AECOPD via a nested case-control study.MethodsA total of 496 cases hospitalized for AECOPD were included into analysis, and followed-up for 6 months after discharge. Acute CVEs in the AE period were defined as the new or worsening acute coronary syndrome (ACS), arrhythmia, left ventricular disfunction (LVD). Predictors were selected from several variables, including baseline characteristics and treatments in the stable period as well as symptoms, laboratory tests, complications and treatments in the AE period.ResultsThirty cases (6.05%) had acute CVEs, including 2 with ACS, 13 with LVD and 19 with arrhythmia. Four deaths were observed in the CVE group, with significantly increased death risk compared with the non-CVE group (P=0.001, OR=5.81). Moreover, patients who have had CVEs were vulnerable to have re-exacerbation within 3 months. Multivariate analysis showed that previous LVD history (P=0.004, OR=5.06), 20% increase in heart rate (HR) (P=0.003, OR= 10.19), electrolyte disturbance (P=0.01, OR= 4.24) and diuretics (P=0.002, OR = 6.37) were independent predictors. In addition, usage of theophylline, fluoroquinolone and inhaled beta agonists in the AE period were not statistically associated with acute CVEs.ConclusionsOur study preliminarily indicated that patients hospitalized for AECOPD with previous LVD history or increased HR need close observation and diuretics should be cautiously used with electrolyte monitoring. These findings needs to be confirmed in a large cohort.
Atorvastatin combined with dexamethasone in chronic subdural haematoma (ATOCH II): study protocol for a randomised controlled trial
Authors: Jiang Rong Cai , Wang Dong , Zhao Shi Guang , Wang Ren Zhi , Kang De Zhi , Zhu Xin Gen , Zhao Zong Mao , Wei Jun Ji , Huang Ying , Qu Yan , Sun Xiao Chuan , Ji Hong Ming , Jiang Xiao Chun , Liu Jin Fang , De Zhu Xi , Wang Jian Jun , Tian Ye , Gao Chuang , Wei Hui Jie , Zhang Shu , Quan Wei , Yue Shu Yuan , Lei Ping , Li Xian , Song Li Li , Anderson Craig S , Zhang Jianning 
Published: November 2020

Abstract
Background
Chronic subdural haematoma (CSDH) is a common condition in the elderly that often requires neurosurgical management. For small CSDH, evidence has emerged that statins may reduce haematoma volume and improve outcomes, presumably by reducing local inflammation and promoting vascular repair. We wish to extend this evidence in a study that aims to determine the efficacy and safety of atorvastatin combined with low-dose dexamethasone in patients with CSDH.
Methods
The second ATorvastatin On Chronic subdural Hematoma (ATOCH-II) study is a multi-center, randomized, placebo-controlled, double blind trial which aims to enroll 240 adult patients with a conservative therapeutic indication for CSDH, randomly allocated to standard treatment with atorvastatin 20 mg combined with low-dose dexamethasone (or matching placebos) daily for 28 days, and with 152 days of follow-up. The primary outcome is a composite good outcome defined by any reduction from baseline in haematoma volume and survival free of surgery at 28 days. Secondary outcomes include functional outcome on the modified Rankin scale (mRS) and modified Barthel Index at 28 days, surgical transition, and reduction in haematoma volumes at 14, 28 and 90 days.
Discussion
This multi-centre clinical trial aims to provide high-quality evidence on the efficacy and safety of the combined treatment of atorvastatin and low-dose dexamethasone to reduce inflammation and enhance angiogenesis in CSDH.
Trial registration:
ChiCTR, ChiCTR1900021659. Registered 3 March 2019, http://www.chictr.org.cn/showproj.aspx?proj=36157
Effect of cyclic wetting-drying on tensile mechanical behavior and microstructure of clay-bearing sandstone
Authors: guo Pingye , Juan Gu , Yi Su , Wang Jiong , Ding Zhanwen 
Published: November 2020

Abstract
The understanding of the weakening mechanism of tensile strength of rock subjected to cyclic wetting-drying is critical for rock engineering. Tensile strength tests were conducted on a total of 35 sandstone specimens with different wetting-drying cycles. The crack propagation process and acoustic emission characteristics of the tested samples were obtained through a high-speed camera and acoustic emission system. The results indicate that the tensile strength is observably reduced after cyclic wetting-drying, and the extent of the reduction is not only related to the number of wetting-drying cycle, but also closely related to the clay mineral content of the sample. In addition, as the cycles of wetting-drying increase, the effect of each single cycle on tensile strength get reduced until it becomes constant.. Moreover, the crack initiation and penetration time is prolonged as the number of wetting-drying cycle increases, which indicates that cyclic wetting-drying weakens the rock stiffness and enhances the ductility of sandstone. Meanwhile, the acoustic emission characteristics of the tested samples further confirmed the ductile behaviour of the sandstone samples with increasing wetting-drying cycle. Furthermore, through the analysis of the microstructure and mineral composition of the samples with different wetting-drying cycles, it is concluded that the main weakening mechanisms of sandstones containing clay minerals are frictional reduction, chemical and corrosive deterioration.
Impact of Previous Abdominal Surgery on Robotic-Assisted Rectal Surgery in Patients with Locally Advanced Rectal Adenocarcinoma: A Propensity Score Matching Study
Authors: Huang Ching-Wen , Su Wei-Chih , Chang Tsung-Kun , Ma Cheng-Jen , Yin Tzu-Chieh , Tsai Hsiang-Lin , Chen Po-Jung , Chen Yen-Cheng , Li Ching-Chun , Hsieh Yi-Chien , Wang Jaw Yuan 
Published: November 2020

Abstract
Background: The application of minimally invasive surgery in patients with colorectal cancer (CRC) and a history of previous abdominal surgery (PAS) remains controversial. This retrospective study with propensity score matching (PSM) investigated the impact of PAS on robotic-assisted rectal surgery outcomes in patients with locally advanced rectal adenocarcinoma undergoing preoperative concurrent chemoradiotherapy (CCRT).Methods: In total, 203 patients with locally advanced rectal adenocarcinoma who underwent preoperative CCRT and robotic-assisted rectal surgery between May 2013 and December 2019 were enrolled. Patients were categorized into PAS and non-PAS groups based on the PAS history. The PSM caliper matching method with 1-to-3 match was used to match PAS patients with non-PAS.Results: Of the 203 enrolled patients, 35 were PAS patients 168 were non-PAS patients. After PSM, 32 PAS patients and 96 non-PAS patients were included for analysis. No significant between-group differences were noted in the perioperative outcomes, including median console time [165 min (PAS) vs 175 min (non-PAS), P = 0.4542)] and median operation time [275 min (PAS) vs 290 min (non-PAS), P = 0.5943)] after PSM. Postoperative recovery and overall complication rates were also similar (all P > 0.05). Moreover, the between-group differences in pathological or short-term oncological outcomes were also nonsignificant (all P > 0.05). No 30-day postoperative deaths were observed in either group.Conclusion: The current results indicate that robotic-assisted surgery is safe and feasible for PAS patients with locally advanced rectal adenocarcinoma undergoing preoperative CCRT. However, future prospective randomized clinical trials are required to verify these findings.
Real-World Clinical Outcomes of Pembrolizumab as Second-Line Therapy for Advanced Urothelial Carcinoma
Authors: Kadono Yoshifumi , Kawaguchi Shohei , Nohara Takahiro , Shigehara Kazuyoshi , Izumi Kouji , Kamijima Taiki , Seto Chikashi , Takano Akinobu , Yotsuyanagi Satoshi , Nakagawa Ryunosuke , Miyagi Tohru , Aoyama Shuhei , Asahi Hideki , Fukuda Rie , Mizokami Atsushi 
Published: November 2020

Abstract
Background: Pembrolizumab is currently considered the standard second-line treatment for advanced urothelial carcinoma (UC). This study aimed to investigate the efficacy and safety of pembrolizumab in patients with advanced UC in real-world data, which is not well-reported.Methods: The study included 98 patients with advanced UC who were treated with pembrolizumab after platinum-based chemotherapy at eight hospitals. The efficacy, safety, and risk factors for prognosis were evaluated. Results: The median age was 73 years. Nineteen patients (19%) with performance status (PS) 2-4 were included. The percentages of liver, lung, bone, and lymph node metastasis were 18%, 27%, 19%, and 76%, respectively. The best response was complete response in nine patients (9%) and partial response in 16 patients (17%). The median progression-free survival and overall survival were 3.7 months (95% confidence interval [CI]: 2.8–4.7) and 11.8 months (95% CI: 6.7–17.0), respectively. Poor PS, liver metastasis, and higher C-reactive protein were poor prognostic factors. Hyperprogression was observed in nine patients (9%), who were mostly of poor PS and had high-volume lesions. Severe adverse events (AEs) were observed in 18 patients (19%), and five patients died because of AEs (5%). Atypical AEs, such as pneumocystis pneumonia and acute myeloid leukemia, were observed in our cohort. Conclusion: The efficacy of pembrolizumab for advanced UC in our cohort was better than a previous phase III trial (KEYNOTE-045), possibly owing to lower cancer volume and fewer visceral metastases in our patients.
Dietary Isoleucine Improved Flesh Quality, Muscle Antioxidant Capacity, and Muscle Growth Associated with AKT/TOR/S6K1 and AKT/FOXO3a Signaling in Hybrid Bagrid Catfish (Pelteobagrus vachelli ♀ × Leiocassis longirostris♂)
Authors: Jiang Qin , Yan Ming-Yao , Zhao Ye , Zhou Xiao-Qiu , Yin Long , Feng Lin , Liu Yang , Jiang Wei-Dan , Wu Pei , Wang Yan , Chen De-Fang , Yang Shi-Yong , Huang Xiao-Li , Jiang Jun 
Published: November 2020

Abstract
Background: Muscle is the complex and heterogeneous tissue, which comprises the primary edible part of the trunk of fish and mammals. Previous study has shown that dietary isoleucine (Ile) exerts beneficial effects on animals’ growth. However, limited studies have evaluated the benefits of Ile on fish muscle and their effects on flesh quality and muscle growth. Thus, this study was conducted to explore whether dietary Ile had affected flesh quality and muscle growth in hybrid bagrid catfish (Pelteobagrus vachelli × Leiocassis longirostris). Results: In the current study, we demonstrated that Ile significantly: (1) increased muscle protein and lipid contents and the frequency distribution of muscle fibers with ≤ 20 and ≥ 50 µm of diameter; (2) improved pH value, shear force, cathepsin B and L activities, hydroxyproline content, resilience, cohesiveness, and decreased cooking loss, lactate content, hardness, springiness, gumminess, and chewiness; (3) decreased reactive oxygen species (ROS), malondialdehyde (MDA), and protein carbonyl (PC) contents, GCLC and Keap1 mRNA levels, and up-regulated CuZnSOD, CAT, GST, and Nrf2 mRNA levels; (4) up-regulated the insulin-like growth factor 1, 2 (IGF-1, IGF-2), insulin-like growth factor 1 receptor (IGF-1R), proliferating cell nuclear antigen (PCNA), Myf5, MyoD, MyoG, MRF4, and MyHC mRNA levels, and decreased MSTN mRNA level; (5) increased muscle protein deposition by activating AKT-TOR-S6K1 and AKT-FOXO3a signaling pathways. Conclusion: These results revealed that Ile improved flesh quality, which might be due to increasing nutritional content, physicochemical, texture parameters, and antioxidant ability; promoting muscle growth by affecting myocytes hyperplasia and hypertrophy, and muscle protein deposition associated with protein synthesis and degradation signaling pathways. Finally, the quadratic regression analysis of chewiness, ROS, and protein contents against dietary Ile levels suggested that the optimal dietary Ile levels for hybrid bagrid catfish was estimated to be 14.19, 12.36, and 12.78 g Ile kg-1 diet, corresponding to 36.59, 31.87, and 32.96 g kg-1 dietary protein, respectively.
A Review Of The Clinical Outcomes In Idursulfase-Treated And Untreated Filipino Patients With Mucopolysaccharidosis Type II: Data From The Local Lysosomal Storage Disease Registry
Authors: Racoma Marie Julianne Castillo , Calibag Maria Kristina Karizza B. , Chiong Mary Anne D. , Abacan Mary Ann R. , Cordero Cynthia 
Published: November 2020

Abstract
Background: Mucopolysaccharidosis type II (MPS II; Hunter syndrome) is an X-linked multisystem disorder characterized by glycosaminoglycan (GAG) accumulation, caused by a deficiency of iduronate-2-sulfatase (I2S). Enzyme replacement therapy (ERT) with recombinant I2S, the standard of care, was started in the Philippines in 2017. This study reviewed the clinical outcomes in idursulfase-treated and untreated Filipino MPS II patients who were included in the local Lysosomal Storage Disease (LSD) registry of the Institute of Human Genetics-National Institutes of Health (IHG-NIH) from January 1999 to December 2019.Methods: A retrospective audit of records of MPS II patients listed in the registry was done. Qualified patients were divided into two cohorts: idursulfase-treated group (patients on enzyme replacement therapy, ERT, for >6 months) and untreated group. Baseline characteristics, including demographic data, biochemical results, neurocognitive classification, respiratory involvement, mortality, and adverse events, were recorded. Height, weight, cardiac pathology, liver and spleen sizes, six-minute walk test (6MWT), joint mobility, were determined at baseline and at year 1 and 2 of follow up.Results: Forty male patients were included in this review, with 8 receiving ERT since 2017. The mean age at diagnosis was 6.99 years (SD 4.15; 0.75-20) and mean age at start of ERT was 14.03 years (SD 7.1; 4-21.5), more delayed than previous reports. Eighty percent have early progressive phenotype which was higher than reported average. The early growth pattern differed in our Filipino cohort, but was followed by the expected slowed growth in later years. Improvements in the following endpoints were observed in the treated cohort: height and weight, cardiac disease, liver and spleen sizes, and joint mobility. There were also positive effects on respiratory involvement and mortality rate. Adverse events were consistent with previous reports.Conclusions: ERT is generally well tolerated and effective in reducing GAG storage and improving clinical endpoints among our Filipino MPS II patients. In untreated patients, typical disease progression was observed.
Parent-Child-Agreement on Health-Related Quality of Life and its Determinants in Patients Born with Esophageal Atresia – A Swedish-German Cross-Sectional Study
Authors: Witt Stefanie , Dellenmark-Blom Michaela , Kuckuck Susanne , Dingemann Jens , Abrahamsson Kate , Dingemann Carmen , Chaplin John Eric , Ure Benno , Bullinger Monika , Gatzinsky Vladimir , Jönsson Linus , Quitmann Julia Hannah 
Published: November 2020

Abstract
Background The aim was to compare parent and child reported health-related quality of life (HRQOL) of children born with esophageal atresia (EA) and to determine factors that affect the level of parent-child agreement. Methods We included 63 parent-child dyads of children born with EA aged 8-18 from Germany and Sweden. The generic PedsQL questionnaire and the condition-specific EA QOL questionnaire were used to assess children’s HRQOL from parents- and child’s perspective. The Peds QL Family Impact Module was used to assess parental HRQOL and Family Functioning.Results On an individual level, intra-class correlation coefficients indicated strong levels of parent-child agreement (.61-.97). At the group level, the analyses showed no significant differences between the responses of parents and children. In cases where disagreement occurred, parents were more likely to rate generic HRQOL lower than the children (19-35%) and condition-specific HRQOL higher than the children (17-33%). Findings of the multiple regression analysis showed that the country (Germany vs. Sweden) was found to be a significant predictor of parent-child agreement in generic HRQOL and parental HRQOL to be a significant predictor of parent-child agreement in condition-specific HRQOL.Conclusion The parent-child agreement is mostly good, suggesting that parent-reports are a reliable source of information. However, discrepancies may occur and cannot be explained by the child's age and gender, nor severity of the disease or Family Functioning, but solely by country respectively parental HRQOL. Clinicians should therefore not only observe the pediatric patient but also the parents.
Psychometric Properties of ‘Attitudes to Health Professionals Questionnaire’ (AHPQ) in Iranian Context
Authors: Najafi Maryam , Motlagh Maryam Karbasi , Najafi Minoo , Kajeazad Mojtaba , Zarghi Nazila , Shirazi Mandana 
Published: November 2020

Abstract
Background: The professional life has been frequently made by social interactions in which different forms of professional collaboration appear. Everybody has different attitudes through his/her life that could influence on choosing profession and probably the approach towards inter professional work. In order to study the current attitude towards planning educational courses and assess efficiency of the ongoing educational courses, the present study has normalized the Persian version of the ‘Attitudes to Health Professionals Questionnaire’ (AHPQ).Method: After permission from questionnaire developers, in order to confirm face and content validity, the process of translation and back translation was performed. Then it was sent to ten scholars (Delphi Technique) and their comments were considered for providing the final copy. The questionnaire was back translation from Persian into English. The final version was compared with the original questionnaire in terms of concepts. Reliability confirm by test-retest and internal consistency (intra class correlation and Cronbach alpha coefficient).The construct validity was confirmed by exploratory factor analysis. Results: According to the first phase (67 participants), wide range has caused unnecessary variations in answers; so reliability has been confirmed in larger sample size (104 participants) after decreasing the extent of scale from 10 to 5 points. Exploratory factor analysis was used by main construct and rotation of maximum variance. Final reliability was confirmed by Cronbach alpha as 0. 899. Three underlying constructs of professional ethics, professional autonomy and patient-centered care had been revealed in the questionnaire.Conclusion: In addition to confirmation of AHPQ construct validity, reveals that such a tool is able to specify the attitude of health team members based on their perceived importance towards the basis of inter professional collaboration. Thus, recognizing and directing priorities of health care team in inter professional collaboration enables us to manage establishment, integrity, sustainability and coordination of group activities.
Geranylgeranylacetone Attenuates Cerebral Ischemia-reperfusion Injury in Rats Through the Augmentation of HSP&nbsp;27 Phosphorylation: A Preliminary Study
Authors: Matsuo Kazuya , Hosoda Kohkichi , Tanaka Jun , Yamamoto Yusuke , Imahori Taichiro , Nakai Tomoaki , Irino Yasuhiro , Shinohara Masakazu , Sasayama Takashi , Kohmura Eiji 
Published: November 2020

Abstract
BackgroundWe previously reported that heat shock protein 27 (HSP27) phosphorylation plays an important role in the activation of glucose-6-phosphate dehydrogenase (G6PD), resulting in the upregulation of the pentose phosphate pathway and antioxidant effects against cerebral ischemia-reperfusion injury. The present study investigated the effect of geranylgeranylacetone, an inducer of HSP27, on ischemia-reperfusion injury in male rats as a preliminary study to see if further research of the effects of geranylgeranylacetone on the ischemic stroke was warranted.MethodsIn all experiments, male Wistar rats were used. First, we conducted pathway activity profiling based on a gas chromatography-mass spectrometry to identify ischemia-reperfusion-related metabolic pathways. Next, we investigated the effects of geranylgeranylacetone on the pentose phosphate pathway and ischemia-reperfusion injury by real-time polymerase chain reaction (RT-PCR), immunoblotting, and G6PD activity, protein carbonylation and infarct volume analysis. Geranylgeranylacetone or vehicle was injected intracerebroventricularly 3 h prior to middle cerebral artery occlusion or sham operation.ResultsPathway activity profiling demonstrated that changes in the metabolic state depended on reperfusion time and that the pentose phosphate pathway and taurine-hypotaurine metabolism pathway were the most strongly related to reperfusion among 137 metabolic pathways. RT-PCR demonstrated that geranylgeranylacetone did not significantly affect the increase in HSP27 transcript levels after ischemia-reperfusion. Immunoblotting showed that geranylgeranylacetone did not significantly affect the elevation of HSP27 protein levels. However, geranylgeranylacetone significantly increase the elevation of phosphorylation of HSP27 after ischemia-reperfusion. In addition, geranylgeranylacetone significantly affected the increase in G6PD activity, and reduced the increase in protein carbonylation after ischemia-reperfusion. Accordingly, geranylgeranylacetone significantly reduced the infarct size (median 31.3% vs 19.9%, p = 0.0013).ConclusionsAs a preliminary study, these findings suggest that geranylgeranylacetone may be a promising agent for the treatment of ischemic stroke and would be worthy of further study. Further studies are required to clearly delineate the mechanism of geranylgeranylacetone -induced HSP27 phosphorylation in antioxidant effects, which may guide the development of new approaches for minimizing the impact of cerebral ischemia-reperfusion injury.