bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emergency laparotomies under spinal anesthesia: a retrospective, facility based observational study, in Kabul, Afghanistan
Authors: Farda Wais , Nawazish Ahmad Bashir 
Published: August 2020

Abstract
Background Laparotomy is most commonly performed under general anesthesia, but spinal anesthesia (SA) is considered an alternative to in the context of limited resources. The safety and efficacy of using SA as substitute for GA has not been explored in Afghanistan. Methodology We conducted an observational study in the general surgery department of Isteqlal hospital in Kabul, Afghanistan on 196 adult patients undergoing emergency laparotomy under spinal anesthesia between April 2018-April 2020. Results The mean age of patients was 41.5 years (SD=19.4), the ratio of males to females was 1.9:1 and almost half (44.4%) had comorbidities. 21% were classified as ASA grade III and IV with a similar pattern among males and females. 11 (5.6%) cases were converted to GA. Conversion pattern to GA was similar among males and females (P=0.71), ASA grade (P=0.432) and age group (P=0.642). The mean length of stay after operation was 6.5 days (SD=4.1). 32 (16.3%) patients suffered SA complications with no significant difference in according to sex (P=0.134). Hypotension and headache accounted for 97% of complications. Complication rates were similar in terms of intervertebral level (P=0.349), type of abdominal incision (P>0.1) and average length of stay (P=0.156). 18 patients (9.2%) died due to MOF, sepsis, respiratory failure, thromboembolism and cardiogenic shock.Conclusion SA is considered a safe and effective anesthesia for emergency laparotomies, even for those with comorbidities. Based on our findings we would recommend SA as an alternative to GA in emergency laparotomy in Afghanistan.
Age-related Impairment of Navigation and Strategy in Virtual Reality Star Maze
Authors: Zhang Jiaxin , Wang Lin , Hou Haiyan , Yue Chunlin , Wang Liang , Li Huijie 
Published: August 2020

Abstract
BackgroundAlthough it is well known that aging impairs navigation performance, the underlying mechanisms remain largely unknown. Previous study suggested that the egocentric strategy was relatively unimpaired during aging. In this study, we aimed to examine strategy use and the underlying cognitive supporting mechanisms in older adults with the virtual reality star maze.MethodsThirty young adults and thirty-one older adults participated in the study. During the learning trials, participants were required to reach a fixed destination in a virtual reality star maze task. In an additional probe trial, the distal landmarks around the maze were removed, and the strategy using was classified into egocentric and non-egocentric according to whether participants could reach the destination directly.ResultsThe results revealed that older adults adopting egocentric strategy completed the navigation task as accurate as young adults, whereas older adults using non-egocentric strategy were selectively impaired. The relatively well-maintained egocentric strategy in older adults was related to better visuo-spatial ability.ConclusionsVisuo-spatial ability might play an important role in navigation accuracy and navigation strategy of older adults. This study demonstrated the potential value of the virtual reality star maze in evaluating navigation strategy and visuo-spatial ability in older adults.
Relationship of Femoral Offset and Clinical Outcomes of Femoral Neck Fracture Patients Following Bipolar Hip Arthroplasty
Authors: Kim Sung Soo , Kim Hyeon Jun , Lee Seung Yup 
Published: August 2020

Abstract
Background

This study aimed to investigate the relationship between femoral offset(FO) and clinical outcomes of patients with femoral neck fracture following bipolar hip arthroplasty(BHA).
Methods

A hospital registry-based retrospective study, involving 520 patients who underwent BHA for femoral neck fracture and with a minimum follow-up of one year, Dong-A university hospital, from December 1, 2003, to September 31, 2018, was carried out. Excluding those with unclear medical records, a previous surgical history on the affected or contralateral hip, a congenital deformity and preoperative trauma history of the hip, high-energy multiple trauma, a history of neurodegenerative disease or cerebrovascular disease, a total of 77 patients were included in the analysis. The subjects were 54 females and 23 males. The mean age of patients was 74.6(65–95) years old and the mean follow-up period was 30.5 (12–136) months. For clinical assessment, postoperative pain visual analogue scale(VAS) and Harris hip score (HHS) were analyzed at each follow-up period. For radiological assessment, the difference in leg length discrepancy (LLD) and FO was measured. FO nearest to the real value was calculated using the values corrected for magnification and rotation errors on the anteroposterior view of plain radiographs taken at the first year of follow-up. In statistical analyses, the statistical significance between FO and clinical outcomes was analyzed using the Pearson correlation tests with SPSS v. 25.0. A value of p < 0.05 was considered statistically significant.
Results

The difference in mean FO postoperatively was 6.7(± 4.8) mm, and the difference in mean postoperative LLD was 4.9 (± 3.4). The mean HHS was 77.1(± 7.7), 82.3(± 8.6), 83.4(± 7.7), and 86.4(± 6.7) at 1st, 3rd, 6th and 12th postoperative months, respectively. In the analysis using the Pearson correlation coefficient, the correlation coefficient between FO and HHS in 1-year follow-up was − 0.38, and a significant outcome was found (p = 0.001). Of HHS domain, the correlation coefficient for function in 1-year follow-up was − 0.42, revealing a significant outcome (p = 0.0001).
Conclusions

There was a stastically significant correlation between clinical oucomes and FO difference at 1 year after BHA in patients with femoral neck fractures older than 65 years.
Using thrombin time to evaluate the efficacy of anticoagulant therapy for acute cerebral infarction
Authors: Li Qianqian , Liu Tingjiao , Yang Shanshan 
Published: August 2020

Abstract
Background

Although intravenous thrombolysis therapy has been considered as a significant progress in the treatment of acute ischemic stroke, there are limited effective treatments for patients with onset ischemic symptom that beyond six hours during acute ischemic stroke. In this study, we investigated the effectiveness of the intravenous argatroban therapy in acute ischemic stroke patients who cannot be treated with intravenous thrombolysis due to the limited time window.
Methods

One hundred and eighty patients with acute ischemic stroke that had beyond six hours ischemic symptom were admitted to our hospital and were analyzed retrospectively. Levels of activated partial thromboplastin time (aPTT), prothrombin time (PT) and thrombin time (TT) in peripheral blood of these patients were measured by ELISA at 24 hours post initial therapy.
Results

We found that plasma TT was significantly prolonged after 24 hours of argatroban treatment. aPTT showed slightly increased prolongation after 24 hours of argatroban treatment. PT also showed slightly prolonged after treatment, however, there was no difference from the basal line. We further investigated the relationship between the level of TT and the clinical effectiveness and safety of intravenous argatroban therapy. We found that when TT was between 40 and 80 seconds, intravenous argatroban effectively promoted the complete recovery rates without increasing the risk of hemorrhage.
Conclusion

Our study implies that TT assay might be useful for guiding regular dose of agratroban for therapy.
A New Monoclonal Antibody that Blocks KIT Dimerisation and Inhibits Gastrointestinal Stromal Tumour Growth
Authors: Bai Chen Guang , Xu Yi , Qiu Cen 
Published: August 2020

Abstract
Gastrointestinal stromal tumour (GIST) is the most common sarcoma of the gastrointestinal tract, and arises owing to oncogenic mutations in c-kit that result in constitutive auto-phosphorylation of KIT in the absence of ligand binding. Small-molecule tyrosine kinase inhibitors have shown good clinical activity by inhibiting ATP binding to the receptor. Unfortunately, majority of patients eventually develop drug resistance, which limits the long-term benefits of the tyrosine kinase inhibitors and poses a significant challenge in the clinical management of GIST. Here, we demonstrate c-kit mutation-driven KIT auto-dimerisation prior to tyrosine kinase phosphorylation as same as the procedure in ligand-dependent signalling pathway and describe a monoclonal antibody, KITMAb, with strong affinity to the dimerisation domain of KIT that blocks the important step in both the KIT signalling pathways. Treatment of KIT-dimer-expressing cells with the KITMAb slowed down cell growth. Furthermore, KITMAb reduced the proportion of cells in the proliferative phase (S+G2-M). Finally, we also demonstrate that KITMAb treatment accelerated cell apoptosis. These results indicate that KITMAb strongly inhibits KIT receptor dimerisation-mediated signalling pathway and cell growth responses in vitro. Further, the results suggest that treatment with KITMAb may be potentially therapeutic in imatinib-resistant GIST.
An Epidemiologic Study of the Process of Changes in Anthropometric Indices in Children Under 24 Months Based on Gender Differences in Kohgiluyeh and Boyer Ahmad Province, Southwest Iran 2017-18: an Incidental Phenomenon or a Gender Inequality?
Authors: Pourmahmoudi Azizollah , Mousavizadeh Ali , dastoorpoor maryam , Tabeshfar Zibane , Hosseinikia Mahboobe , kousari raana 
Published: August 2020

Abstract
Background:An assessment of the process of changes in growth indices of children basaed on gender differences not only does provide the required information of the child's growth pattern, rather it also prepares the ground for a dynamic comparison of gender differences as a sensitive indicator of gender discrimination. The current research has been designed and implemented for depicting the growth patterns of children under two years old.Methods:Through a secondary analysis based study, the health files of 1336 children under 2 years old (700 boys and 636 girls) in the maternal and child health care system in Kohkiluyeh and Boyer Ahmad Province in 2017 were analyzed in terms of the nutritional status and in view of underweight and skinniness (wasting) and stunting (stunted growth) based on WHO standardization indicators.Results:The average difference of weight, height and head circumference of male and female children in the early days of their birth were respectively 67 g, 0.36 and 0.37 cm. Although z standardized score charts for average weight, height, and head circumference did not show a significant difference in the course of two-year period among boys and girls, the percentage ratio of boys as compared to girls in low weight at birth, six months, one year and two years old are respectively 0.98, 1.7, 12.4 and 1.5 for weight loss index 2.4, 1.73, 2.9 and 1.9, and for the short height (stunted growth) indexes 1.3, 1.48, 1.4 and 1.6, and for the head circumference index 0.48, 2.27, 1.56 and 1.6, and these indicate a constant gap between the boys with low weight, skinny and low head circumference measure and girls.Discussion and conclusion:In spite of the closeness of weight, height and head circumference differences in newborn girls and boys, their growth difference over the two-years period was associated with boys' superiority. In other words, boys had a more desirable growth trend than girls in terms of averaging indices. On the other hand, the percentage of male children with low weight, wasting and short height in the whole course of the study was more than female subjects. The research findings not only lay an emphasis on the gap between boys and girls in view of the studied indices, but also underlines the fact that in epidemiological studies, comparisons of averages are not an appropriate approach for comparing populations, and this in turn reveals the urgent need to pay more attention to frequency-based indicators. The recent attitude shift that has occurred among Iranian familes in terms of giving much care to girls as compared to boys against the previous inverted approach seems to be one of the most important justifications for this difference in growth trend.
Duodenal Stump Reinforcement with Purse-string Suture in Distal Gastrectomy under Laparoscope Combined with Uncut Roux-en-Y Reconstruction in Patients with Gastric Cancer
Authors: Li Fengyuan , Xu Jianghao , Xu Hao , Wang Weizhi , Zhang Caidian , Yang Li , Wang Linjun , Ge Yugang , Xia Yiwen , Shi Liang , Wang Lu , Xu Zekuan 
Published: August 2020

Abstract
Objective: This study aimed to compare patient outcomes after laparoscopic distal gastrectomy with uncut Roux-en-Y reconstruction for gastric cancer between a group who underwent a duodenal stump reinforcement procedure and those who did not.Methods: Data from 233 patients with gastric cancer (GC) undergoing distal gastrectomy under laparoscope combined with uncut Roux-en-Y reconstruction were retrospectively investigated. Patients were divided into two groups. The non-reinforcement group (NR) underwent surgery from June 2014 to March 2015 with no reinforcement of the duodenal stump (n=54) and the reinforcement group (R) underwent surgery from April 2015 to June 2018 with reinforcement of the duodenal stump (n=179). In group R, the duodenum was divided using an endoscope-assisted linear stapler, which was reinforced by a purse-string suture along the duodenal staple line. Results: Duodenal stump leakage was observed in 2 patients from group NR (3.7%), while no duodenal stump leakage or fistula was detected in group R. In addition, no significant difference was observed in the patient characteristics between group NR and R.Conclusions: The incidence of duodenal stump leakage can be reduced by reinforcement with a purse-string suture.
Propofol Ameliorates Ischemic Brain Injury by Blocking Toll-like Receptor 4-dependent Pathway and Suppressing Consequent Inflammatory Cytokine Production
Authors: Mitsui Kazuha , Kotoda Masakazu , Hishiyama Sohei , Takamino Ayasa , Morikawa Sho , Ishiyama Tadahiko , Matsukawa Takashi 
Published: August 2020

Abstract
BackgroundIschemic stroke is one of the leading causes of mortality and morbidity worldwide. Accumulated evidence suggests that the consequent excessive inflammation plays detrimental roles in the pathogenesis of secondary injury after cerebral infarction and exacerbates the brain tissue damage. Although regulation of the inflammation would be the potential strategy for the novel treatment option, effective methods that control the cerebral inflammation have not yet been established. Recent studies have suggested that propofol, a sedative agent widely used for management of patients with acute stroke, suppresses excessive inflammation and may have neuroprotective effects against ischemic brain injury. However, the available evidence is still limited and controversial, and the underlying mechanism remains unclear. This study aimed to investigate the neuroprotective effects of propofol against ischemic brain injury, with a specific focus on Toll-like receptor 4 (TLR4), the critical mediator of inflammation in the ischemic brain.ResultsTreatment with propofol significantly reduced infarct volume in wild-type mice (7.9 ± 1.4 vs. 12.6 ± 1.1 mm3, n = 10 each, p < 0.05). The propofol-treated mice exhibited lower levels of pro-inflammatory cytokine expressions compared with the control mice (IL-6: 0.57 ± 0.23 vs. 1.00 ± 0.39, p < 0.05, IL-1β: 0.53 ± 0.24 vs. 1.00 ± 0.36, p = 0.087, n = 15 each). The neuroprotective effect of propofol was abrogated by TLR4 gene knockout. Propofol treatment had no significant effects on hemodynamic parameters.ConclusionsPropofol attenuates brain injury by blocking the TLR4-dependent pathway and suppressing pro-inflammatory cytokine production. This insight into the mechanism underlying the neuroprotective effect of propofol against ischemic brain injury may lead to a new strategy for preventing exacerbation of cerebral infarction.
Computational analyses decipher the primordial folding coding the 3D structure of the beetle horn
Authors: Matsuda Keisuke , Gotoh Hiroki , Adachi Haruhiko , Inoue Yasuhiro , Kondo Shigeru 
Published: August 2020

Abstract
The beetle horn primordium is a complex and compactly folded epithelial sheet located beneath the larval cuticle. Only by unfolding the primordium the complete 3D shape of the horn appears, suggesting that the morphology of beetle horns is coded in the primordial folding pattern. To decipher the folding pattern, we have developed a method to manipulate the primordial local folding, reproduced it on a computer, and clarified the contribution of the folding of each primordium region to transformation. We found that the three major morphological changes (branching of distal tips, proximodistal elongation, and angular change) were caused by the folding of different regions, and that the folding mechanism was also different depending on the region. The computational methods we used are applicable to the morphological study of other exoskeletal animals.
Mobile Small RNAs Are Predominately Accumulated via Long-Distance Movement Rather than Local Biogenesis
Authors: Li Shuai , Wang Xutong , Xu Wenying , Xu Tong , Cai Chunmei , Chen Liyang , Clark Chancelor , Ma Jianxin 
Published: August 2020

Abstract
Long-distance RNA movement is important for plant growth and environmental responses; however, the extent to which RNAs move between distant tissues, their relative magnitude and functional significance remain to be elucidated on a genomic scale. Using a soybean (Glycine max)/common bean (Phaseolus vulgaris) grafting system, we identified 100 shoot-root mobile miRNAs and 32 shoot-root mobile phasiRNAs, which were predominantly produced in shoots but transported to roots, some of which enabled cleavage of their mRNA targets or their precursors. In contrast, most of the mobile mRNAs were transcribed in both shoots and roots and were truncated fragments, with the transported copies accounting for only a tiny portion of all copies accumulated in the recipient (shoots or roots) tissues. These findings suggest that the regulatory mechanisms for sRNAs movement are different from those for mRNA movement, and that the earlier is more strictly regulated, and likely, more functionally significant than the latter.
The Effect of Screening and Treatment of Ureaplasma Urealyticum Infection on Semen Parameters in Asymptomatic Leukocytospermia: A Case Control Study
Authors: Zhang Qi-Feng , Zhang Yu-Ji , Wang Sheng , Wei Yu , Li Feng , Feng Ke-Jian 
Published: August 2020

Abstract
Background: Ureaplasma urealyticum (UU) infection, as well as asymptomatic leukocytospermia, whether it has effect on semen parameters and whether it needs screening and treatment is still a confusing and controversial topic for clinicians.Methods: Among 1,530 adult males who visited Guilin People's Hospital due to infertility, 295 were diagnosed with asymptomatic leukocytospermia, and 95 were further screened for UU-positive. 81 UU-positive asymptomatic leukocytospermia patients received 7-day or 14-day treatment plan with doxycycline, and 70 cases were cured. The semen parameters of non-leukocytospermia, leukocytospermia, UU-positive leukocytospermia and UU-negative leukocytospermia groups were compared, and the differences between the two treatment plans and the semen parameters before UU treatment and 1 month after UU-cured were compared.Results: Compared with non-leukocytospermia patients, the sperm concentration, progressive motility (PR), and normal morphology of patients with leukocytospermia decreased, while those with UU-positive leukocytospermia performed more significantly. The PR, total motility, and normal morphology of UU-positive leukocytospermia patients were significantly lower than those of UU-negative leukocytospermia patients (all p<0.001). The UU cure rates of the 7-day and 14-day treatment plan with doxcycline was 84.62% and 89.66% (p=0.738), respectively, and the sperm concentration, PR, total motility, and normal morphology of the cured UU-positive leukocytospermia patients were all increased after 1 month (p=0.001, p=0.022, p=0.004 and p=0.008, respectively).Conclusions: It is significant to screen and treat UU infection in asymptomatic leukocytospermia for improving sperm quality. Where appropriate, the 7-day treatment plan with doxycycline may be a good choice.
Glycaemia and Hand Grip Strength in Aging People: Guangzhou Biobank Cohort Study
Authors: Liang Xue , Jiang Chao Qiang , Zhang Wei Sen , Zhu Feng , Jin Ya Li , Cheng Kar Keung , Lam Tai Hing , Xu Lin 
Published: August 2020

Abstract
Background
There is a link between hyperglycemia and mechanical functions of muscle. However, existing evidence of the association between hyperglycemia and weaker muscle strength is limited and inconsistent. We examined whether glycemic status was associated with relative grip strength (RGS) in older Chinese.
Methods
In 2008–2012, 9180 participants (2516 men and 6664 women) from the Guangzhou Biobank Cohort Study had fasting and 2-hour post-load glucose measured. Glycemic status was categorized as normoglycaemia, prediabetes (i.e., impaired fasting glucose and/or impaired glucose tolerance) and diabetes. RGS was assessed using a Jamar Hydraulic Hand Dynamometer divided by body mass index. General linear model was used to assess the association of glycemic status with RGS.
Results
After adjusting for age, smoking status, alcohol use, physical activity, health status, body fat percentage and waist circumference, in men, hyperglycemia was associated with a lower RGS, with the RGS being 1.38 (95% confidence interval (CI) = 1.34, 1.42) in normoglycaemia, 1.35 (95% CI = 1.30, 1.39) in prediabetes, 1.33 (95% CI = 1.29, 1.38) in newly diagnosed diabetes and 1.32 (95% CI = 1.27, 1.37) in known diabetes (P for trend < 0.001). The association of glycemic status with RGS was non-significant in women. Among the normoglycaemic group, no association was found between fasting glucose and RGS in men, whereas a significantly inverse association was found in women, with adjusted β for RGS per mmol/l increase in fasting glucose being − 0.05 to -0.04 (P values from 0.002 to 0.03).
Conclusions
Higher fasting glucose was associated with reduced grip strength in a dose-response manner, and the association was significant even in women with normoglycaemia. Our findings suggest that lowering glucose across the whole range might be important in preserving muscle strength, especially in aging women.