bluuebunny/crossref_metadata_2025_split huggingface dataset:
Canagliflozin Attenuates Lipotoxicity in Cardiomyocytes and Protects Diabetic Mouse Hearts by Targeting the mTOR/HIF-1α Pathway
Authors: Sun Pengbo , Ding Yipei , Luo Jingyi , Zhong Jin , Xie Weidong 
Published: December 2020

Abstract
BackgroundLipotoxicity plays an important role in the development of diabetic cardiomyopathy and heart failure (HF). Canagliflozin (CAN), a marketed sodium-glucose co-transporter 2 inhibitor, has significant beneficial effects on HF. However, the potential pharmacological mechanism is still unknown.MethodsIn this study, we evaluated the protective effects and mechanism of CAN in the hearts of a C57BL/6J diabetic mouse model induced by a high-fat diet/streptozotocin (HFD/STZ) for 12 weeks in vivo and using HL-1 cells (a type of mouse cardiomyocyte line) induced by palmitic acid (PA) in vitro.ResultsCAN could significantly alleviate lipid accumulation and inflammatory responses in the hearts of the HFD/STZ-induced diabetic mice. Furthermore, CAN significantly attenuated the inflammatory injury induced by PA in the HL-1 cells. In addition, CAN bound to the mammalian target of rapamycin (mTOR) and significantly inhibited mTOR phosphorylation and hypoxia inducible factor-1α (HIF-1α) expression.ConclusionCAN attenuated lipotoxicity in cardiomyocytes and protected diabetic mouse hearts by targeting the mTOR/HIF-1α pathway.
Anesthesia and Surgery Induce a Functional Decrease Selectively in Excitatory Synaptic Transmission in Mouse Prefrontal Cortex Neurons
Authors: Matsumoto Yu , Fujino Yuji , Furue Hidemasa 
Published: December 2020

Abstract
Postoperative delirium (POD), a syndrome of confusion and inattention, frequently occurs after anesthesia and surgery. However, the neuropathogenesis of POD remains mostly unknown. The prefrontal cortex (PFC) plays an essential role in cognitive processes. We therefore investigated how anesthesia and surgery induce neurofunctional changes in the PFC, and assessed whether intraoperative administration of dexmedetomidine, an alpha-2 agonist, could prevent the functional changes in the PFC. Laparotomy was performed in mice under isoflurane anesthesia. After a battery of behavioral tests measuring natural behaviors and learning and anxiety levels, PFC neuronal activities were recorded using whole-cell patch-clamp recordings. Effects of intraoperative dexmedetomidine were also examined. In the anesthesia/surgery group, the frequency of excitatory synaptic responses in PFC pyramidal neurons was decreased after the surgery without any changes in the response kinetics. On the other hand, neuronal intrinsic properties and inhibitory synaptic responses were not changed. Intraoperative dexmedetomidine or glutamate receptor antagonists, prevented the excitatory synaptic dysfunction induced by anesthesia and surgery. These findings suggest that anesthesia and surgery induce functional reductions selectively in excitatory synaptic responses in PFC pyramidal neurons, and intraoperative dexmedetomidine inhibits the plastic change in the PFC synaptic transmission.
Matching Ethical Climate to Nurses’ Service Behaviors in Public and Private Hospitals: A Cross-Sectional Study
Authors: Zhang Na , Li Jingjing , Bu Xing , Gong Zhenxing 
Published: December 2020

Abstract
Background: Workplace climate is great significant element that has impact on nurses’ behavior and practice; moreover, nurses’ service behavior contributes to the patients’ satisfaction and subsequently to the long-term success of hospitals. Few studies explore how different types of organizational ethical climate encourage nurses to engage in both in-role and extra-role service behaviors, especially in comparing the influencing process between public and private hospitals. This study aimed to compare the relationship between the five types of ethical climate and nurses’ in-role and extra-role service behaviors in public and private hospitals.Methods: This study conducted a cross-sectional survey on 559 nurses from China. All participants were investigated using the Ethical Climate Scale and Service Behavior Questionnaire. SPSS 22.0 was used for correlation analysis, t-test and analysis of variance test, and Mplus 7.4 was used for group comparison.Results: The law and code climate has a much greater influence on nurses’ in-role service behavior in private hospitals than on that in public hospitals (β = -.277; CI 95% = [-.452, -.075]; p < .01), and the instrumental climate has a stronger influence on nurses’ extra-role service behavior private hospitals than on that in public hospitals (β = -.352; CI 95% = [-.651, -.056]; p < .05). Meanwhile, the rules climate has a greater effect on nurses’ extra-role service behavior in public hospitals than it does in private hospitals (β = .397; CI 95% = [.120, .651]; p < .01). Conclusions: As the relationship between the five types of ethical climate and nurses’ in-role and extra-role service behaviors in public and private hospitals were different, the strategies used to foster and enhance the types of ethical climate are various from public to private hospitals. The caring and instrumental climate are the key to promote extra-role service behavior for nurses in private hospitals. And independent climate has great effect on extra-role service behaviors for nurses in public hospitals.
Utilizing Network Pharmacology to Explore the Possible Mechanism of Coptidis Rhizoma in Kawasaki Disease
Authors: Fan Xue , Guo Xin , Li Ying , Xu Mingguo 
Published: December 2020

Abstract
Background: Kawasaki disease (KD) is an acute self-limiting systemic vasculitis. In study, a randomized controlled trial regarding berberine (main component of Coptidis Rhizoma) function in treating KD was carried out and possible pharmacological mechanisms of Coptidis Rhizoma (CR) on KD therapy were investigated using an integrated network pharmacology approach. Methods: A total of 58 children with KD, younger than 5 years old, were enrolled in the study from October 2018 to May 2019. The patients were randomly divided into control group and BBR treatment group. The therapeutic indicators of the 2 groups before and after treatments were compared. Then, compounds and drug targets of CR from the Traditional Chinese Medicine Systems Pharmacology (TCMSP) database, the SWISS database, the SEA database and the STITCH database were collected, and targeted KD genes were retrieved from the DisGeNET databases, the DrugBank databases and the GeneCards databases. The network pharmacology approach involved network construction, target prediction, and module analysis. KEGG pathway and GO enrichment analysis were performed to investigate the molecular mechanisms and pathways related to CR for KD treatments. Results: The berberine group was able to reduce the values of CRP, NLR and PLR significantly. Also, the effect of berberine improved the resistance rate of intravenous injection of gamma globulin significantly. In total, 9 compounds and 369 relative drug targets were collected from TCMSP, SWISS, SEA and STITCH database and 624 KD target genes were collected in DisGeNET, DrugBank and GeneCards database. The network analysis revealed that 41 targets might be the therapeutic targets of CR on KD, among which ATK1, RELA, SRC, CASP3 and MTOR ranked in top 5. Gene ontology enrichment analysis revealed that the reaction to bacteria-derived molecules and to lipopolysaccharide and the apoptosis process were the key biological procedures for CR treating KD. The KEGG pathway enrichment analysis pointed out that the four signaling pathways closely related to CR treating KD including age-rage signaling pathway, fluid shear stress and atherosclerosis, TNF signaling pathway and Toll-like receptor signaling pathway in diabetic complications. Conclusions: we concluded that the introduction of routine treatment combined with berberine in treating KD has advantages than routine treatment and can be considered as a preferred approach in KD. Network pharmacology showed that CR exerted the effect of prevention KD by regulating multi-targets and multi-components.
ACE2-like carboxypeptidase B38-CAP protects from SARS-CoV-2-induced lung injury
Authors: Minato Takafumi , Hoshizaki Midori , Yamaguchi Tomokazu , An Jianbo , Niiyama Mayumi , Nirasawa Satoru , Asaka Masamitsu N , Chan Jasper Fuk-Woo , Imai Masaki , Takahashi Saori , Utsumi Daichi , Poon Vincent Kwok-Man , Yasuhara Atsuhiro , Chan Chris Chung-Sing , Motoyama Satoru , Nagata Satoshi , Penninger Josef M. , Kamada Haruhiko , Yuen Kwok-Yung , Kawaoka Yoshihiro , Yasutomi Yasuhiro , Imai Yumiko , Kuba Keiji 
Published: December 2020

Abstract
Angiotensin-converting enzyme 2 (ACE2) is a receptor for cell entry of SARS-CoV-2, and recombinant soluble ACE2 protein inhibits SARS-CoV-2 infection as a decoy. ACE2 is the carboxypeptidase to degrade angiotensin II (Ang II) to angiotensin 1-7 and improves the pathologies of cardiovascular disease and acute lung injury. To address whether the carboxypeptidase enzymatic activity of ACE2 is protective against COVID-19, we investigated the effects of B38-CAP, an ACE2-like enzyme, on SARS-CoV-2-induced lung injury. Expression of ACE2 protein was significantly downregulated in the lungs of SARS-CoV-2-infected hamsters. Recombinant S1 domain or receptor-binding domain (RBD) of the SARS-CoV-2 Spike protein also directly downregulated ACE2 expression and elevated Ang II levels and considerably worsened acid-induced lung injury in hamsters. Treatment with B38-CAP downregulated Spike RBD-induced high Ang II levels, severe inflammation and pulmonary edema through its ACE2-like enzymatic activity. Consistently, elevated cytokine mRNA levels and impaired lung functions were improved by B38-CAP treatment. Moreover, in SARS-CoV-2-infected humanized ACE2 transgenic mice, B38-CAP significantly improved the pathologies of lung injury, alleviated the cytokine storms and downregulated viral RNA levels. These results provide the first experimental in vivo evidence that increasing ACE2-like enzymatic activity is a potential and powerful therapeutic strategy for lung pathologies in COVID-19.
Routine Point of Care Ultrasound (POCUS) Assessment of Gastric Antral Contents in Traumatic Emergency Surgical Patients for Prevention of Aspiration Pneumonitis: A Randomized Clinical Trial&nbsp;
Authors: Shorbagy Mohamed S. , Kasem Amr A. , Eldin Ahmed A. Gamal , Mahrose Ramy 
Published: December 2020

Abstract
Background: Polytrauma patients are at a higher risk of delayed gastric emptying. To assess gastric volume, a reliable diagnostic tool is needed to prevent the occurrence of aspiration pneumonia, which remains a serious complication associated with anesthesia. Gastric antral ultrasound can provide reliable information about the size of the gastric antrum in traumatized patients undergoing emergency surgery.Methods: A prospective observational study of 45 polytrauma patients undergoing emergency surgery under general anesthesia. Prior to induction of anesthesia in the emergency department, gastric ultrasound was performed to allow qualitative and quantitative assessment of gastric antrum in a supine position and right lateral decubitus (RLD) position. Followed by routine placement of nasogastric tube to aspirate and calculate the volume of the stomach contents.Results: Forty-five polytrauma patients who underwent gastric ultrasound examination showed that the risk assessment of aspiration and anesthesia technique changed in 14 patients (31.1%) after the ultrasound examination.A very good relationship existed between the expected stomach volume at the RLD position and the suction volume in the nasogastric tube. In all cases, no aspirations were documented.Conclusion: Ultrasound examination of the stomach in polytrauma patients allows assessing the size and type of stomach contents. The data obtained can influence the choice of anesthesia technique while inducing anesthesia and reduce the risk of aspiration pneumonia.Trial registration: This trial was registered at ClinicalTrials.gov. Registry number: NCT04083677.
The Efficacy and Safety of Nabufen and Sufentanil in the Prevention of Visceral Pain After Gynecological Laparoscopic Surgery: A Randomised Controlled Trial
Authors: Gu Xiaoxia , Wang Jingjing , Liao Huihua , Mo Jian , Huang Weiming , Lu Yue , Pang Ping , Tan XiuJuan , Zhang Liangqing 
Published: December 2020

Abstract
Background: To compare the efficacy and safety of different compatibility schemes in the prevention of visceral pain after gynecological laparoscopic surgery. Methods: from April 2019 to April 2020, patients undergoing elective gynecological laparoscopic surgery in our hospital were randomly divided into four groups: group A: sufentanil 3 μ g / kg; group B: low-dose nalbuphine group: 0.1 mg / kg of nabufen + 3 μ g / kg of sufentanil; group C: medium dose of nabufen group: 1 mg / kg of nabufen + 2 μ g / kg of sufentanil; group D: high-dose nabufen 2 There were 30 cases in each group. The degree of pain and the number of adverse reactions at 2, 4, 8, 12, 24 and 48 hours after operation were observed and recorded. The number and dosage of morphine used as a remedial analgesic were recorded. The pain degree was assessed by visual analogue scale (VAS). The total amount of analgesic pump used, the total number of times of pressing and the effective times of pressing were recorded. The adverse reactions included respiratory depression, nausea and vomiting, drowsiness, restlessness and skin The skin itches. Results: the analgesic effect of group B was similar to that of group A, and there was no significant difference in the number of invalid pressing, total pressing times and rescue analgesia rate (P > 0.05), while the invalid pressing times, total pressing times and remedial analgesia rate of group C and group D were significantly lower than those of group A (P < 0.05). There was no significant difference between group C and group D in the number of invalid compressions, the total number of compressions and the rate of remedial analgesia (P > 0.05), suggesting that increasing the dose of nalbuphine could not significantly increase the analgesic effect. The incidence of postoperative nausea and vomiting, skin pruritus, lethargy and Ramsay Sedation score in group B and group C were significantly lower than those in group A (P < 0.05). Ramsay Sedation score and incidence of drowsiness were lower than those in group D, which indicated that the incidence of adverse reactions was higher in group D than group B and group C.Conclusion: the combination of 1 mg / kg nabufen and 2 μ g / kg sufentanil is a safe and effective combination scheme for the prevention of visceral pain after gynecological laparoscopic surgery with small adverse reactions.Trial registration: http://www.chictr.org.cn/showproj.aspx?proj=40635Registration number：ChiCTR1900025076 . Prospectively registered on 10 August 2019.
DDX23 is a Metabolic Regulator in Hepatocellular Carcinoma
Authors: Zhou Jianlong , Wang Xiaoming , Liang Jing , Tan Chaohui , Chen Changnan , Lin Yunxiao , Xie Feng , Chen Zhong , Huang Wenhua 
Published: December 2020

Abstract
Background: Although biochemical activities of RNA helicases have been well-studied, physiological meaning of those factors in both normal and disease condition remained to be clarified.Methods: RNA sequencing (RNA-seq) in HCC cells indicated DDX23 are highly expressed in HCC and high expression of DDX23 is responsible for poor survival of HCC patients. Next, The expression of DDX23 was establish for subsequent investigation. The roll of DDX23 in HCC was identified by RNA-seq, RT-qPCR, LC-MS, OCR, ECAR. The effect of DDX23 on proliferative, Cloning information as well as tumorigenicity of transfected cells in mice was examined using loss-of-function experiments.Results: Here, we investigated a new role of RNA helicase in a member of the DEAD box protein family, DDX23 in hepatocellular carcinoma (HCC). RNA level of DDX23 are highly expressed in HCC and high expression of DDX23 is responsible for poor survival of HCC patients. In addition, we demonstrated that DDX23 expression is important for in vitro and in vivo tumorigenesis. RNA sequencing (RNA-seq) in HCC cells indicated that metabolism is the most affected pathway by the DDX23 and most abundant DDX23-interacting RNA are involved in metabolism in HCC, especially glycolysis. Conclusions: These findings provide new insights on the unexpected HCC-related role of DDX23, an opportunities for the development of the therapeutic target which is a master regulator of genes involved in HCC-favorable metabolic reprogram at the RNA level.
Energy Delivery Guided by Indirect Calorimetry in Critically Ill Patients: a Systematic Review and Meta-analysis
Authors: Duan Jing-Yi , Zheng Wen-He , Zhou Hua , Xu Yuan , Huang Hui-bin 
Published: December 2020

Abstract
Background: The use of indirect calorimetry (IC) is increasing due to its precision in resting energy expenditure (REE) measurement in critically ill patients. Thus, we aimed to evaluate the clinical outcomes of an IC-guided nutrition therapy compared to predictive equations strategy in such a patient population.Methods: We searched PubMed, EMBASE, and Cochrane library databases up to Oct 25, 2020. Randomized controlled trials (RCTs) were included if they focused on energy delivery guided by either IC or predictive equations in critically ill adults. We used the Cochrane risk-of-bias tool to assess the quality of the included studies. Short-term mortality was the primary outcome. The meta-analysis was performed with the fixed-effect model or random-effect model according to the heterogeneity. Results: Eight RCTs with 991 adults met the inclusion criteria. The overall quality of the included studies was moderate. Significantly higher mean energy delivered per day was observed in the IC group, as well as percent delivered energy over REE targets, than the control group. IC-guided energy delivery significantly reduced short-term mortality compared with the control group (risk ratio=0.77; 95% CI, 0.60 to 0.98; I2=3%, P=0.03). IC-guided strategy did not significantly prolong the duration of mechanical ventilation (mean difference [MD]=0.61 days; 95% CI, -1.08 to 2.29; P=0.48), length of stay in ICU (MD=0.32 days; 95% CI, -2.51 to 3.16; P=0.82) and hospital (MD=0.30 days; 95% CI, -3.23 to 3.83; P=0.87). Additionally, adverse events were similar between the two groups. Conclusions: This meta-analysis indicates that IC-guided energy delivery significantly reduces short-term mortality in critically ill patients. This finding encourages the use of IC-guided energy delivery during critical nutrition support. But more high-quality studies are still needed to confirm these findings.
Outcomes of Combined Percutaneous Tracheostomy and Endoscopic Gastrostomy Tube Placement in COVID-19 Patients
Authors: Oberg Catherine , Keyes Colleen , Panchabhai Tanmay , Ali Sajawal , Oh Scott , Grogan Tristan , Mojica James , Auchincloss Hugh , Pulido Natalie , Brait Kelsey , Folch Erik 
Published: December 2020

Abstract
Background:A significant number of patients with severe respiratory failure related to COVID-19 require prolonged mechanical ventilation. Minimal data exists regarding the timing, safety, and efficacy of combined bedside percutaneous tracheostomy and endoscopy gastrostomy tube placement in these patients. The safety for healthcare providers is also in question. This study’s objective was to evaluate the effectiveness and safety of combined bedside tracheostomy and gastrostomy tube placement in COVID-19 patients.Methods:This is a single arm, prospective cohort study in patients with COVID-19 and acute respiratory failure requiring prolonged mechanical ventilation who underwent bedside tracheostomy and percutaneous endoscopic gastrostomy tube placement. Detailed clinical and procedural data were collected. Descriptive statistics were employed and time to event curves were estimated and plotted using the Kaplan Meier method for clinically relevant pre-specified endpoints.Results:Fifty-eight patients were included. Nearly 90% of the patients received pronation therapy and 52% of patients underwent extracorporeal membrane oxygenation evaluation. The median total intensive care unit length of stay was 29 days (24.7-33.3) with a median of 10 days (6.3-13.7) post-procedure. Nearly 88% of patients were weaned from mechanical ventilation post-procedure at a median of 9 days (6-12); 94% of these were decannulated. Sixty-day mortality was 10.3%. Almost 90% of patients were discharged alive from the hospital. No transfer out of the intensive care unit was required and a median of 3 healthcare personnel per procedure were present.Conclusions:This study shows that survival of critically ill COVID-19 patients after tracheostomy and gastrostomy was nearly 90%. The time-to-event curves are encouraging regarding time to weaning, downsizing, decannulation and discharge. A combined procedure minimizes the risk of virus transmission to healthcare providers in addition to decreasing the number of anesthetic episodes, transfusions, and transfers patients must undergo.
Awake Prone Positioning in Non-intubated Patients With Acute Hypoxemic Respiratory Failure Due to COVID-19: a Systematic Review and Meta-analysis
Authors: Pavlov Ivan , He Hangyong , McNicholas Bairbre , Perez Yonatan , Tavernier Elsa , Trump Matthew W. , Jackson Julie A. , Zhang Wei , Rubin Daniel S. , Spiegel Thomas , Hung Anthony , Estrada Miguel Ángel Ibarra , Roca Oriol , Vines David L. , Cosgrave David , Mirza Sara , Laffey John G. , Rice Todd W. , Ehrmann Stephan , Li Jie 
Published: December 2020

Abstract
Background: Awake prone positioning (APP) has been advocated to improve oxygenation and prevent intubations of patients with acute hypoxemic respiratory failure due to coronavirus disease 2019 (COVID-19). This paper aims to synthesize the available evidence on the efficacy of APP. Methods: We performed a prospective systematic review and meta-analysis of observational studies to compare in-hospital intubation and mortality rates in patients treated with APP or with standard care.Results: A total of 46 published and 4 unpublished observational studies that included 2994 patients were included. The intubation rate was 27% (95%CI, 19 to 37%) in the 870 patients treated with APP, as compared to 30% (95%CI, 20 to 42%) in the 852 patients treated with usual care (p=0.71). The mortality rate was 11% (95CI%, 6 to 20%) in the 767 patients treated with APP, as compared to 22% (95%CI, 13 to 36%) in those treated with usual care. This difference was not statistically significant (p=0.10). APP was associated with significant improvement of various oxygenation parameters in 19 studies (n=381) that reported this outcome.Conclusions: In this prospective meta-analysis of observational studies of patients with acute hypoxemic respiratory failure due to COVID-19, APP did not result in lower intubation or mortality rates, despite reported improvements in oxygenation parameters. Data from randomized controlled trials are needed. Routine implementation of APP outside of a clinical trial is not supported by current evidence. Registered on PROSPERO on August 3d, 2020, CRD42020201947.