bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gradient local anesthesia for percutaneous endoscopic interlaminar discectomy at the L5/S1 level: a feasibility study
Authors: Feng Wan-Li , Yang Jun-Song , Wei Dongmei , Gong Han-Lin , Xi Yong , Lv Hui-Qiang , Wang Xin-Gang , Xia Bin , Wei Jian-Min 
Published: August 2020

Abstract
Background

During the process of shearing the ligamentum ﬂavum, rotating the working channel, and manipulating the annulus fibrosis, the sinuvertebral nerve and the spinal nerve root can be irritated, inducing intolerable back and leg pain. Thus, GA is recommended and well accepted by most surgeons when performing PELD via the interlaminar approach. The aim of our study was to explore the efficacy and safety of percutaneous endoscopy interlaminar lumbar discectomy with gradient LA in patients with L5/S1 disc herniation.

Methods

This retrospective study was conducted between December 2017 and June 2018. The study included 50 consecutive patients who met the study criteria, had single-level L5/S1 disc herniation, and underwent PELD via the interlaminar approach under gradient LA. Different concentrations of LAC were injected into different tissues inside and outside the ligamentum flavum to complete gradient LA. The evaluation criteria included the intraoperative satisfaction score, VAS score, ODI, complications and adverse reactions.

Results

The intraoperative satisfaction score was consistently over 7, with an average score of 9.3±0.7, indicating that LAC can achieve satisfactory pain control throughout the PELD operation without additional anesthesia. The postoperative VAS score and ODI were dramatically improved at each follow-up interval (P < 0.001, respectively). There was no serious complication such as dural rupture caused by puncture, dural laceration caused by manipulation under endoscopy, total spinal anesthesia, iatrogenic nerve root injury, epidural hematoma, infections or local anesthetic-related adverse reactions. Three patients experienced transient postoperative dysesthesia of the lower limbs that gradually recovered within 24 hours.

Conclusions

Gradient local anesthesia can satisfactorily and safely control intraoperative pain during the PELD via the interlaminar approach. It can not only improve intraoperative satisfaction, but also reduce local anesthesia-related adverse reactions and surgery-related complications.
A Network Pharmacology-Based Study on Active Ingredients of Corydalis Rhizoma on Coronary Heart Disease
Authors: Li Ying , Wei Guhang , Zhuang Zhenkun , Chen Mingtai , Lin Haidan , Li Meihuan , Wu Yanhui , Yuan Changjian , Chen Hongyu , Zhang Zhong , Cheng Hong 
Published: August 2020

Abstract
Background. Corydalis Rhizoma(CR) showed a high efficacy for coronary heart disease (CHD). However, the interaction between the active ingredients of CR and the targets of CHD has not been unequivocally explained in previous researches. To study the active components and potential targets of Corydalis Rhizoma and to determine the mechanism underlying the exact effect of Corydalis Rhizoma on coronary heart disease, a method of network pharmacology was used. Materials and Methods. The active components of CR and targets corresponding to each component were scanned out from Traditional Chinese medicine systems pharmacology database and analysis platform (TCMSP), and target genes of CHD were searched on GeneCards database and Online Mendelian Inheritance in Man(OMIM) database. The active components and common targets of CR and CHD were used to build the “CR-CHD” network through Cytoscape (version 3.2.1) software as well as protein-protein interaction(PPI) network on String database. Gene Ontology (GO) enrichment and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway enrichment analysis was executed by clusterProfiler(version 3.8) and DOSE(version 3.6) package on R platform. Results. 49 active ingredients and 394 relevant targets of CR and the 7173 CHD-related genes were retrieved. 40 common genes were selected for subsequent analysis. Crucial biological processes and pathways were obtained and analyzed, including DNA-binding transcription activator activity, RNA polymerase II-specific, RNA polymerase II transcription factor binding, kinase regulator activity, ubiquitin-like protein ligase binding, fluid shear stress and atherosclerosis, TNF signaling pathway, apoptosis, MAPK signaling pathway and PI3K-Akt signaling pathway. Conclusions. Overall, CR could alleviate CHD through the mechanisms predicted by network pharmacology, laying the foundation for future development of new drugs from traditional Chinese medicine on CHD.
Burnout and Depression Among Psychiatry Residents During COVID-19 Pandemic
Authors: Alkhamees Abdulmajeed A. , Assiri Hatem , Alharbi Hatim Yousef , Nasser Abdullah , Alkhamees Mohammad A. 
Published: August 2020

Abstract
Very few studies have assessed the impact of an infectious outbreak on burnout among health care workers, especially non-frontline health care workers, such as psychiatrists. The role of psychiatrists and other mental health providers in such instances as a source of psychological support to the public and frontline workers is indispensable and valuable. This study aims to assess the prevalence of burnout and depression, and their correlation, during the COVID-19 pandemic among psychiatry residents in Saudi Arabia. A total of 121 out of 150 psychiatry residents in Saudi Arabia completed the Maslach Burnout Inventory and Patient’s Health Questionnaire for the assessment of burnout and depression. Around 27.3% reported having burnout and depression, with a significant relationship between them. Participants in the first two years of training and having a history of receiving mental health treatment in the past two years were at higher risk. The need is urgent to increase investment in mental health services or risk a massive increase in mental health conditions in the coming months. Hence, the need to construct a plan to reduce this risk of burnout and depression among psychiatrists by developing preventative strategies to prevent burnout and promote wellness is more important than ever.
Efficacy and Safety of Propofol combined with different doses of Remifentanil for gastroscopy: A-randomized controlled trial
Authors: Zhong Chaochao , Qin Yi-bin , Miao Hai-hang , Huang Xin-chong 
Published: August 2020

Abstract
Background Propofol is used to induce sadation or general anesthesia for procedures. Adjuvants, such as remifentanil characterized by a rapid onset of analgesia and a very short duration of action, which was proved to be an effective opioid receptor agonist considering its effective inhibition of autonomic nervous reflex during endoscopy. Meanwhile, it brings respiratory depression and hypoxia in particular, but there is few reports to explore the optimal dose of remifentanil during gastroscopy so far. So we design this randomized controlled trial (RCT) to identify an optimal remifentanil dosage in patients receiving gastroscopy. Methods A total of 200 patients were recruited and randomly assigned to receive one of four doses of remifentanil: 0 (control group), 1.25μg/ml (PR1 group), 2.5μg/ml (PR2 group), 5μg/ml (PR3 group) combined with propofol anesthesia. The primary outcome is the incidence of hypoxia. The secondary outcomes are the dosage of propofol, patients’ awakening time, and perioperative adverse reactions such as hypotension, hypertension, bradycardia, tachycardia, body movements, nausea and vomiting.Results The onset time of PR2 (19 ± 2 s) and PR3(18 ± 4 s) group were shorter than control group (21 ± 3 s). Awaking time in PR2 (1.6 ± 0.4 min) and PR3 (1.7 ± 0.6 min) groups were significantly less than control group (4.1± 1.1min). The dose of propofol in PR2(90 ± 11 mg) and PR3(87±12 mg) groups were also significantly less than control group( 180 ± 20 mg)。The incidence of hypoxia and increase the flow of oxygen and jaw lift in PR2 group were significantly decreased from 38% to 14% and 32% to 10% compared with the control group, respectively (p<0.01).While the incidence of hypoxia in PR3 group was increased to 46%, higher than other groups (p<0.01). Total number of Sedation-related adverse events in PR2 was significantly decreased from 32% to 8% (p=0.03).Conclusions Both 2.5μg/ml (PR2) and 5μg/ml (PR3) remifentanil combined with propofol used in gastroscopy can reduce the onset time、awaking time and the amount of propofol. But the incidence of hypoxia and total number of sedation-related adverse events in PR2 group were significantly decreased compared with other groups. In our study, 2.5μg/ml remifentanil combined with propofol in gastroscopy is an optimal remifentanil dosage.Trial registration: ClinicalTrials.gov, ChiCTR2000029216.
Morphological Neurite Changes Induced by Porcupine Inhibition Are Rescued by Wnt Ligands
Authors: Godoy Juan A. , Espinoza-Caicedo Jasson , Inestrosa Nibaldo C 
Published: August 2020

Abstract
Background: Wnt signaling plays key roles in cellular and physiological processes, including cell proliferation, differentiation and migration during development and tissue homeostasis in adults. This pathway can be defined as Wnt/β-catenin-dependent or β-catenin-independent or "non-canonical", both signaling are involved in neurite and synapse development/maintenance. Porcupine (PORCN), an acylase that o-acylates Wnt ligands, a major modification in secretion and interaction with its receptors. We use Wnt-C59, a specific PORCN inhibitor, to block the secretion of endogenous Wnts in young hippocampal neurons (DIV 4). Under these conditions, the morphology and length of the neurites and the complexity of the dendritic tree and axonal polarity were evaluated. Methods: Cultured primary young hippocampal neurons obtained from Sprague-Dawley rat fetuses (E18), were cultured until day in vitro (DIV) 4 (according to Banker´s protocol) and treated with Wnt-C59 for 24h, Wnt ligands were added to the cultures on DIV 3 for 24h. Dendritic arbors and neurites were analysis by fluorescence microscopy. Transfection with Lipofectamine 2000 on DIV 2 of plasmid expressing eGFP and KIF5-Cherry and neurons were fixed on DIV 4. Immunostaining was performed with MAP1B and Tau protein. Immunoblot analysis was carried out with Wnt3a, b-catenin and GSK-3b (p-Ser9). Quantitative analysis of dendrite morphology was carried out with ImageJ (NIH) software with Neuron J Plugin.Results: We report, here, that Wnt-C59 treatment changed the morphology of the dendritic arbors and neurites of young hippocampal neurons, with decreases -catenin and Wnt3a and an increase in GSK-3 (p-Ser9) levels No effect was observed on axonal polarity. In sister cultures, addition of exogenous Wnt3a, 5a and 7a ligands rescued the changes in neuronal morphology. Wnt3a restored the length of neurites to near that of the control, but Wnt7a increased the neurite length beyond that of the control. Wnt5a also restored the length of neurites relative Wnt concentrations. Conclusions: Our results indicated that all 3 Wnt ligands restored dendritic arbor complexity with recovery of secondary and tertiary projections in young hippocampal neurons. We proposed that PORCN is an emerging molecular target of interest in the search for preclinical options to study and treat neurological diseases.
Pulmonary Benign Metastasizing Leiomyomas: a Case Series of 23 Patients at a Single Facility
Authors: Fan Rong , Feng Fengzhi , Yang Hua , Xu Kaifeng , Li Shanqing , You Yan , Wan Xirun , Zhu Lan 
Published: August 2020

Abstract
Background: Pulmonary benign metastasizing leiomyoma (PBML) is a rare disease characterized by leiomyoma of benign histopathology existing in the lungs. Because of its rarity, limited literature with a single case or small number of cases has been regarding to the clinical course, pathology or management of PBML. Methods: A retrospective study was performed of all PBML cases diagnosed and managed at Peking Union Medical College Hospital (PUMCH) from 2001 to 2019. The clinical characteristics, pathology, treatment and outcomes of each case were studied. Results: There were 25 PBML patients identified in the 19-year period in PUMCH, and 23 patients’ data was analyzed. The median age at diagnosis was 46 years. There were 7 patients (30.4%) diagnosed with postmenopausal status. 2 patients (8.7%) had no uterine leiomyoma, and 3 patients (13.0%) had no gynecologic surgery history. Immunohistochemistry of most lesions demonstrated positive for desmin, SMA and Estrogen/Progesterone Receptors; and negative for S-100 were shown in 7 cases. After curative or diagnostic surgeries for the PBML, several treatments from observation to medical or surgical castration were performed. 9 premenopausal patients preserved their ovaries at first. At a median follow-up of 8 years, 3 patients finally had oophorectomy.Conclusions: PBML is a disease that not only be found in premenopausal women. Treatment should be individualized. Curative surgery for patients with limited lesions can achieve the complete response. For patients that are young and asymptomatic, close observation is recommended as the first choice. All patients should undergo long-term surveillance.
Association between polypharmacy and the persistence of delirium: a retrospective cohort study
Authors: Kurisu Ken , Miyabe Daisuke , Furukawa Yoshiko , Shibayama Osamu , Yoshiuchi Kazuhiro 
Published: August 2020

Abstract
Background: Although the association between polypharmacy and the occurrence of delirium has been well studied, the influence of polypharmacy on the persistence of delirium remains unclear. We aimed to explore the effect of polypharmacy on the persistence of delirium.Methods: This retrospective cohort study was conducted at a tertiary hospital. The medical records of patients diagnosed with delirium who were referred to the Department of Psychosomatic Medicine were reviewed. Presentation with delirium on day 3 was set as the outcome in this study. We counted the number of drugs prescribed on the date of referral, excluding general infusion fluids, nutritional or electrolytic products, and psychotropics. To define polypharmacy, we developed a classification and regression tree (CART) model and drew a receiver operating characteristic (ROC) curve. The odds ratio (OR) of polypharmacy for the persistence of delirium on day 3 was calculated using a logistic regression model with the propensity score as a covariate.Results: We reviewed the data of 113 patients. The CART model and ROC curve indicated an optimal polypharmacy cutoff of six drugs. Polypharmacy was significantly associated with the persistence of delirium both before [OR, 3.02; 95% confidence interval (CI), 1.39–6.81; P = 0.0062] and after (OR, 3.19; 95% CI, 1.32–8.03; P = 0.011) propensity score adjustment.Conclusion: We discovered an association between polypharmacy and worsening courses of delirium and suggest that polypharmacy is a prognostic factor for delirium.
Medical Students' Perception Towards E-learning During COVID 19 Pandemic in a high Burden Developing Country
Authors: AWADALLA MOHAMED DAFFALLA , MOHAMED MOHAMED Soud , Ibrahim Omaima , Elhassan Moawia , MOHAMMED MOHAMMED 
Published: August 2020

Abstract
Background: In High-income countries, many academic institutions are using e-learning during COVID 19 Pandemic. However, in limited resource countries, like Sudan, shifting towards E-learning require many adjustments to be made in order to make sure the e-learning is held in a proper manner, as best as possible. This study was undertaken to assess medical students’ perception towards implementing E-learning during COVID 19 Pandemic and to highlight difficulties of E-learning implementation in a limited-resource setting. Methods: A cross-sectional descriptive study was conducted between 10 to 25 May 2020 among the undergraduate medical students at the Faculty of medicine, University of Gezira, Sudan. A predesigned online-based questionnaire was used for data collection. Results: The total numbers of 358 medical undergraduate students responded to the survey and completely fill the electronic questionnaire. The majority (87.7%) of student agreed that, the closure of university is an essential decision to control spread of the COVID-19 infection. Approximately two-third (64%) of student perceived that E-learning is the best solution during COVID 19 lockdown. Level of student in the university and residence has strong relation to students’ opinion regards start the online education. Internet bandwidth and connectivity limitation, Unfamiliarity with E-learning system, Technical support limitation and time flexibility in case of technical problems during online exams and Lack of face-to-face interaction were the factors considered by medical students to be against the E-learning implementation.Conclusion: Majority of medical students had a positive perception towards E-learning. However, there are many challenges considered as inhibitory factor for utilizing electronic technologies for medical education. We recommend that challenges of E-learning in our setting should be systematically evaluated and that effective strategies should be developed to overcome their inhibitory effects.
Clinical Efficacy of Short-Term Pre-Operative Halo-Pelvic Traction in the Treatment of Severe Spinal Deformities Complicated With Respiratory Dysfunction
Authors: Qi Longtao , Xu Beiyu , Li Chunde , Wang Yu 
Published: August 2020

Abstract
Background Halo traction has been used as an adjunctive method in the treatment of severe spinal deformities. But there are few reports on the clinical efficacy of halo-pelvic traction (HPT) in the treatment of severe spinal deformities complicated with respiratory dysfunction. This study was to evaluate the clinical efficacy and complications associated with pre-operative HPT in the treatment of severe spinal deformities with respiratory dysfunction.Methods Thirty patients with severe spinal deformities complicated with respiratory dysfunction treated with short-term pre-operative HPT were retrospectively reviewed. Inclusion criteria were: (1) patients with severe kyphoscoliosis (coronal Cobb angle or kyphosis angle ≥100°) and respiratory failure, (2) patients undergoing HPT until posterior fusion surgery. All patients underwent general anesthesia for HPT application, which the pelvic ring used in this study was a half-ring, and the rods were all placed on the anterolateral side of the truck. Results The major coronal curve scoliosis averaged 116.00 ± 16.70° and was reduced to 63.23 ± 14.00° after HPT, 46.33 ± 10.70° after surgery. The major kyphosis was 102.40 ± 27.67° and was reduced to 52.23 ± 14.16° after HPT, 42.0 ± 11.92° after surgery. A signiﬁcantly increased FVC was observed after HPT (p<0.001), with a signiﬁcantly improved FVC% (p<0.001). Similarly, a signiﬁcantly increased FEV1 was also observed (p <0.001), with a signiﬁcantly improved FEV1% (p<0.001).Conclusion This study indicated that the modified HPT could be used to help patients with severe spinal deformities complicated with respiratory dysfunction achieve significant correction in both the coronal and sagittal deformities during the pre-operative treatment period along with improved respiratory function and in the absence of severe complications.
Evaluation of international continuing education on neurorehabilitation for rehabilitation health workers in Honduras: a pretest-posttest design
Authors: Angarita-Fonseca Adriana , Lovo Stacey , Gomez-Diaz Isabel Cristina , Busch Angela J , Hijuelos-Cardenas Martha Liliana , Basualdo Maria Laura , Premkumar Kalyani , Bidonde Julia 
Published: August 2020

Abstract
BackgroundRehabilitation therapies are still in the early stages of development in Honduras. At the present time there are no formal training opportunities in Honduras to support the learning needs of health professionals and healthcare workers who specialize in neurological rehabilitation. Support and development of those delivering rehabilitation services from community engaged academic collaborations outside of Honduras can enhance the learning and knowledge of healthcare workers. The purpose of this study was to evaluate reaction and learning linked to two continuing educational workshops for rehabilitation workers in northern Honduras. MethodsThe study design was a pretest-posttest design. The workshops were conducted in a rehabilitation center and a family support organization located in northern Honduras in September 2017.Faculty from Canada and Colombia, together with health professionals from Honduras, facilitated two workshops. Seventeen participants attended the ‘Acquired brain injury/spinal cord injury workshop’ (adult workshop); 15 attended the ‘Rehabilitation for children with impaired neuromotor development workshop’ (pediatric workshop). Participants completed three questionnaires: sociodemographic, knowledge, and Modified Stages of Learning Questionnaires (MSLQ), and three after: Modified Kirkpatrick, knowledge, MSLQ. ResultsWorkshop participants were physiotherapists, physicians, nurses, educational professionals and other non-physiotherapists. Most agreed that the workshops had positive effects in reaction (engagement, relevance, satisfaction), and learning (skills, attitude, confidence and commitment). Stages of Learning changed from scanning/evaluation to learning/experience (p<0.05) in three out of six topics in the pediatric workshop. Three of the knowledge questions showed important learning effects. ConclusionsWorkshops offered to the neurological rehabilitation healthcare workers in Honduras through an international collaboration resulted in enhanced learning and knowledge of participants. This has the potential to improve quality of care for people with neurological conditions in the region.