bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chidamide combined with doxorubicin induced p53-driven cell cycle arrest and cell apoptosis reverse multidrug resistance of breast cancer
Authors: CAO Lixia , Zhao Shaorong , Yang Qianxi , Shi Zhendong , Liu Jingjing , Pan Teng , Zhou Dongdong , Zhang Jin 
Published: September 2020

Abstract
Background: The multidrug-resistant (MDR) phenotype is usually accompanied by an abnormal expression of histone deacetylase (HDAC). Given that HDAC is vital in chromatin remodeling and epigenetics, inhibiting the role of HDAC has become an important approach for tumor treatment. However, the effect of HDAC inhibitors on MDR breast cancer has not been elucidated. This study aimed to evaluate the resistance of two MDR breast cancer cell lines to the HDAC-selective inhibitor chidamide (CHI).Methods: Cell viability, cell cycle and apoptosis were detected by CCK8, crystal violet staining, EDU staining, TUNEL assay, flow cytometry. The expression of HDAC1, H3K9, H3K18, p53, p21, caspase3/7/9 and the Bcl family was analyzed by western blotting and Quantitative real-time PCR. MDR breast cancer growth suppression by CHI and/or doxorubicin (DOX) in vivo was investigated in a tumor xenograft mouse model.Results: The results showed that, CHI combined with DOX showed significant cytotoxicity to MDR breast cancer cells in vitro and in vivo compared with the CHI monotherapy. The cell cycle distribution results showed that CHI caused G0/G1 cell cycle arrest and inhibited cell growth regardless of the addition of DOX. At the same time, Annexin V staining and TUNEL staining results showed that CHI enhanced the number of cell apoptosis in drug-resistant cells. The western blot analysis found that p53 as a tumor suppressor was in a silent state in drug-resistant cells. However, p53 was activated in the CHI-treated and combined treatment groups, which, in turn, activated the p53 up-regulated apoptosis regulator recombinant protein (Puma) and pro-apoptotic protein Bax, downregulated the apoptotic proteins Bcl-xL and Bcl-2, and activated the caspase cascade to induce apoptosis. ﻿Conclusion: The irreversible cell stress induced by CHI combined with DOX reduced the expression of HDAC1 and activated caspase-dependent apoptosis and p21-mediated growth arrest pathway, which might have been driven by the activation of p53. This provided a strong theoretical basis for exploring the treatment strategy of the combined use of CHI in patients with breast cancer who did not respond to chemotherapy or had cancer progression.
A New Surgical Technique of Laparoscopic Retrograde Inguinal Lymph Node Dissection: Our Initial Experience
Authors: Zhao Qinxin , Han Hu , Lei Hongen , Li Yajian , Tian Long , Xing Nianzeng 
Published: September 2020

Abstract
Background To explore the clinical efficacy of a new laparoscopic inguinal retrograde lymph node dissection (LND) in treating penile cancer and scrotal Paget’s disease. Methods 12 patients with penile cancer and 1 with scrotal Paget’s disease admitted and treated with laparoscopic retrograde inguinal LND in two medical centers from July 2018 to September 2020 were retrospectively analyzed. Thereafter, the basic clinical data, operation time, intraoperative blood loss, number of harvested lymph nodes and postoperative complications were evaluated. Results 13 patients were performed laparoscopic retrograde inguinal LND successfully under general anesthesia. Among them, 4 cases received pelvic lymph node dissection (PLND) simultaneously through the same incision. The operation time was (220.00±33.73) min, and the intraoperative blood loss was (15.38±13.76) ml. (8.92士4.00) lymph nodes were harvested in the left groin, (8.54士5.04) lymph nodes were dissected in the right groin. Meanwhile, (5.00士1.00) lymph nodes were harvested in the left pelvic cavity, and (8.50± 6.46) lymph nodes were dissected in the right pelvic cavity. All the 13 cases were successfully operated without conversions to open surgery. One case developed mild blister in subcutaneous skin, two had mild lower limb swelling, and one had lymph leakage; all these patients recovered favorably after symptomatic treatment, with no other surgery-related complications. The drainage tube removal time lasted for (13.23士3.83) days. The postoperative follow-up time ranged from 2.5 to 19.5 months, and no primary lesion, inguinal or pelvic lymph node relapse or metastasis was reported. Conclusion Laparoscopic retrograde inguinal LND can be applied to treat penile cancer and scrotal Paget’s disease, and it is safe and effective. Moreover, inguinal LND and PLND can be performed through the same incision, which is worthy of being promoted in clinic.
Clinical Characteristics of Severe Covid Pneumonia: Exploring New Trends in ICU
Authors: Akhtar Aftab , Bano Sheher , Iqbal Ahtesham , Ramzan Moazma , Qadeer Aayesha , Hussain Syed Waqar , Saleem Anam , Lodhi Omair-ul-Haq , Zubair Sana , kiani Abdul Hameed 
Published: September 2020

Abstract
Background: In late December 2019, Covid-19 emerged as clusters of pneumonia of unknown cause in a province of china, Wuhan. Etiological agent was identified as novel coronavirus that resembles severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East Respiratory syndrome coronavirus (MERS-CoV) and has zoonotic transmission. Covid pneumonia can remain asymptomatic, present as mild infection, severe pneumonia or respiratory failure. Diagnosis is based on rRT-PCR carried out on respiratory secretions. Covid related mortality exceeds 50% once patient requires ICU admission. Objective: To study the characteristics of ICU population admitted to ICU of Shifa International hospital.Results: we prospectively analysed 74 patients which included 43.3% females and 56.7% males. Commonest symptoms were shortness of breath (94.5%), fever (74.3%) and cough (74.3%). Most of our study population consisted of non-smokers (79.7%) and had hypertension (59.4%) followed by diabetes (47.2%). Hydroxychloroquine (HCQ) and azithromycin combination is superior to hydroxychloroquine and doxycycline in reducing mortality (p=0.023) whereas Doxycycline alone resulted in increased mortality (p=0.009). Those who did not require antibiotics or required only narrow spectrum antibiotics had increased survival and reduced requirement of invasive mechanical ventilation (p=< 0.0001). in our study population, (44.9%) developed acute kidney injury, 2.7% needed re-intubations 10.8% developed surgical emphysema and 2.7 % thromboembolic events despite full anticoagulation. ICU mortality was 41.8% and was higher in females (59.4%, p=0.008), those who had SOFA score > 3.5 at time of admission, raised D-Dimers > 931 ng/ml, NLR > 9.2. It was further high in those who required invasive mechanical ventilation and vasopressor support (58.1% mortality p=< 0.001). ICU stay was more prolonged in those requiring invasive mechanical ventilation as compared to those who did not. (23 days vs 6 days, p=0.001). Mean plateau pressure was 19.6 ± 7.6; mean Driving pressures 14.4 ± 4.6; mean PaO2/FiO2 150.7 ± 73.9; mean SPO2/FiO2 173.9 ± 106.9; mean PEEP was 8.2 ±4.33.Conclusion: We concluded that severe covid pneumonia is common amongst males, non-smokers those who had comorbid. HCQ and azithromycin combination is superior to combination of HCQ and doxycycline or doxycycline alone and QT prolongation is a rare complication. Baseline NLR, APACHI II, SOFA, SAPS II, NUTRIC scores, D-Dimers, invasive ventilation and vasopressor support are important tools to predict ICU mortality. Invasive mechanical ventilation carries higher mortality and associated with more prolonged ICU stay. AKI is most common complication followed by shock and surgical emphysema. CRP, Ferritin levels has no impact on outcome.
Usefulness of Cardiac Magnetic Resonance Images for Prediction of Sudden Cardiac Arrest in Patients with Mitral Valve Prolapse: A Multicenter Retrospective Cohort Study
Authors: Lee Jae-Hyuk , Uhm Jae-Sun , Suh Young Joo , Kim Min , Kim In-Soo , Jin Moo-Nyun , Cho Min Soo , Yu Hee Tae , Kim Tae-Hoon , Hong Yoo Jin , Lee Hye-Jeong , Shim Chi Young , Kim Young Jin , Kim Jun , Kim Jong-Youn , Joung Boyoung , Hong Geu-Ru , Pak Hui-Nam , Nam Gi-Byoung , Choi Kee-Joon , Kim You-Ho , Lee Moon-Hyoung 
Published: September 2020

Abstract
Background: An association has been identified between mitral valve prolapse (MVP) and sudden cardiac arrest (SCA), and ventricular arrhythmias (VA). This study aimed to elucidate risk factors for SCA or VA in MVP patients.Methods: MVP patients who had undergone cardiac magnetic resonance (CMR) were retrospectively included. Patients with other structural heart disease or causes of aborted SCA were excluded. Clinical characteristics (sex, age, body mass index, histories of diabetes, hypertension, coronary artery disease, and dyslipidemia), electrocardiographic (PR interval, QRS duration, corrected QT interval, bundle branch block, and atrial fibrillation), echocardiographic [mitral regurgitation grade, prolapsing mitral leaflet, and right ventricular systolic pressure (RVSP)] and CMR [both ventricular ejection fractions, both ventricular end-diastolic and systolic volume indexes, presence of late gadolinium enhancement (LGE), LGE volume and proportion] parameters were analyzed.Results: Of the 85 patients [age, 55.0 (41.0–65.0) years; 46 men] included, 7 experienced SCA or VA. Significantly young age and wide QRS complex were observed in the SCA/VA group compared to the no-SCA/VA group. The patients in the SCA/VA group had significantly lower RVSP, more presence of LGE, greater LGE volume, and higher LGE proportion than those in the no-SCA/VA group. A high risk for SCA or VA was observed in patients with LGE (odds ratio, 45.525; 95% confidence interval, 2.558–810.140; P = .009).Conclusions: Presence of LGE on CMR is a risk factor for SCA or VA in MVP patients. High LGE volume and LGE proportion may provide additional information for prediction of SCA or VA.
CONSENSUS: A Shiny application of Dementia evaluation and reporting for the KU ADC Longitudinal Clinical Cohort Database.
Authors: Sharma Palash , Montgomery Robert N. , Graves Rasinio S. , Meyer Kayla , Hunt Suzanne L , Vidoni Eric D. , Mahnken Jonathan D. , Swerdlow Russell H. , Burns Jeffrey M. , Mudaranthakam Dinesh Pal 
Published: September 2020

Abstract
Background: The University of Kansas Alzheimer’s Disease Center (KU ADC) maintains several large databases to track participant recruitment, enrollment, and capture various research related activities. It is challenging to manage and coordinate all the research related activities. One of the crucial activities involves capturing the data and maintaining high data quality, which ensures data reusability and reproducibility.Methods: To effectively manage the cohort, the KU ADC utilizes a combination of open source Electronic Data Capture (EDC) (i.e. REDCap), along with other homegrown data management and visualization systems developed using R-studio and Shiny.Results: In this manuscript, we describe the method and utility of the user-friendly dashboard that was developed for the rapid reporting of dementia evaluations along with data visualization, which allows clinical researchers to summarize recruitment metrics, automatically generate letters to both participants and health care providers, and depict other key metrics, which ultimately help optimize workflows. Conclusions: We believe this general framework would be beneficial to any institution for capturing and maintaining similar longitudinal databases for reporting and summarizing key metrics pertaining to their research.
Lipopolysaccharide-Induced Chorioamnionitis Induces Fetal Intestinal Injury and Affects Gut Colonization in Rats
Authors: Qingmei Huang , Siliang Lu , Yunlei Zhu , Bingmei Wei , Chen Yujun , Faming Bai 
Published: September 2020

Abstract
Background: Chorioamnionitis is associated with an increased risk of multiple adverse outcomes in offspring, especially neonatal necrotizing enterocolitis (NEC), which is one of the serious gastrointestinal diseases in neonates. However, the underlying mechanism remains undefined. We hypothesize that lipopolysaccharide (LPS)-induced chorioamnionitis causes intestinal injury in offspring, thereby affecting the composition of the intestinal microbiome.Methods: Pregnant Sprague Dawley rats were received intraperitoneal injections with 700 μg/kg Lipopolysaccharide (LPS) or saline at 15 days of gestation. Pups were allowed to deliver naturally, and euthanized at days 0,3 and 7 after birth. Intestinal tissue and faeces samples from offspring were collected to evaluate the effects of intrauterine infection on intestinal flora colonization and intestinal mucosal development. Results: Significant intestinal injury of the offspring induced by prenatal LPS exposure was observed at day 0 and 3 after birth.. In addition, prenatal LPS exposure also induced significant changes in the intestinal microbiome of the offspring with a significant increase in Proteobacteria (Escherichia-Shigella) and a decrease in Firmicutes at 7 days after birth . Conclusions: Thus, our findings suggest that LPS-induced chorioamnionitis induces intestinal injury in offspring and subsequently leads to NEC-like changes in the composition of the intestinal microbiome.
Harm reduction via online platforms for people who use drugs in Russia: A qualitative analysis of web outreach work
Authors: Davitadze Arsen , Meylakhs Peter , Lakhov Aleksey , King Elizabeth J. 
Published: September 2020

Abstract
Background
Harm reduction services to people who use drugs (PWUD) in Russia are insufficient in terms of quantity, government endorsement, and accessibility. The situation has recently deteriorated even further because of social distancing measures of the COVID-19 pandemic. Recently several harm reduction organizations have started to provide some harm reduction services via online platforms by web outreach. However, little is known on how online outreach services are organized and implemented. Drawing on the example of St. Petersburg-based NGO “Humanitarian Action” we explored web outreach work in Telegram instant messenger.
Methods
4 semi-structured interviews with the NGO staff and 301 cases of web outreach work with PWUD comprised the dataset. The process of web outreach, service provision to PWUD, and PWUD’s needs were thematically analyzed.
Results
Three stages of the process of web outreach work were determined: clients initiating communication, NGO workers addressing clients’ needs, and NGO workers receiving clients’ feedback. Communication proceeded either in group chat or in direct messages. Challenges in addressing clients’ needs happened when clients turned for help in nighttime, sent recorded voice messages, sent unclear messages, and/or were unwilling to transition to telephone communication. All web outreach workers reported receiving only positive feedback on their work. PWUD’s needs were categorized into two major themes, depending on whether they can be addressed fully or partially online. In cases of online only provision of services, web outreach workers helped PWUD treat minor injection drug use complications, obtain verified harm reduction information and receive general psychological support. In instances of partial online services provision, PWUD were assisted in getting treatment of severe injection drug use complications, overdoses, and in accessing offline medical, psychological, social, legal and harm reduction services.
Conclusions
Our research demonstrated that web outreach work is a convenient tool for delivering some harm reduction services to PWUD either partially or completely online and recruiting new clients (including hard-to-reach PWUD that avoid attending brick-and-mortar facilities). It indicates that harm reduction organizations should consider incorporating online harm reduction services into their activities. However, more research is needed to explore relative advantages and disadvantages of online harm reduction services delivery.
Meal frequency and associated factors among children 6-23 months in Tahtay michew district, northern Ethiopia, 2018
Authors: Brhane Ermyas , Grum Teklit , Abraha Teklehaymanot Huluf , Aregawi Gebrekiros 
Published: September 2020

Abstract
BackgroundThe term meal frequency is used to describe the adequacy of complementary feedings among children. In the absence of adequate meal frequency young children are susceptible to malnutrition like stunting, wasting, micronutrient deficiencies and associated morbidity and mortality. More half of Ethiopian children did not receive age appropriate minimum meal frequency. Therefore, the aim of this study is to determine minimum meal frequency and associated factors among children 6–23 months in Tahtay Michew district, Northern Ethiopia.MethodsA community based cross sectional study was conducted among systematically selected 981 mothers with index children 6–23 month. An interviewer- administered structured questionnaire was used to collect data. 24 hours dietary recalls was used to determine minimum meal frequency. Crude and Adjusted Odds Ratio with the corresponding 95% confidence interval were computed. In the multivariable analysis, variables with less than 0.05 P-value were considered statistically significant.ResultsMinimum meal frequency was 68% [95% CI: 64.9, 70.9%]. Wealth index (AOR = 1.69, 95% CI = 1.09, 2.61), growth monitoring follow up (AOR = 1.98, 95% CI = 1.41, 2.79) and mothers knowledge (AOR = 2.15, 95% CI = 1.51, 3.04) were factors significantly associated with minimum meal frequency.Conclusion and recommendationThe proportion of children who received the minimum meal frequency was found low. Improving the wealth status of families and encouraging all mothers to attend growth monitoring follow ups are important for improving meal frequency and dietary diversity.
Evaluation of demographic, clinical characteristics, and the prescribing practice of guideline-directed medical therapy among chronic heart failure outpatients in multidisciplinary clinics in a large tertiary hospital: a retrospective audit of 1186 patients from 12 years
Authors: Parajuli Daya Ram , Shakib Sepehr , Eng-Frost Joanne , McKinnon Ross , Caughey Gillian , Whitedhead Dean 
Published: September 2020

Abstract
BackgroundAdherence to guideline-directed medical therapy (GDMT) remains low particularly in elderly despite several approaches. Previous studies showed that heart failure (HF) patients who receive pharmacist-involved multidisciplinary care may have better clinical outcomes. We evaluated patient characteristics and the practice of receiving individual GDMT in chronic HF patients who attended multidisciplinary clinics.MethodsA retrospective audit of data of chronic HF patients presenting to two multidisciplinary outpatient clinics at a tertiary hospital between March 2005 and January 2017 was performed. Data were obtained from two clinics, a Multidisciplinary Ambulatory Consulting Service (MACS) clinic which uses a pharmacist-involved model of multidisciplinary care, and a General Cardiology Heart Failure Service (GCHFS) clinic which does not have the active involvement of a pharmacist.ResultsHF with mid-range ejection fraction (HFmrEF) subjects resembled the HF with preserved ejection fraction (HFpEF) patients in terms of age, heart rate (HR), systolic blood pressure (SBP) and having higher prevalence of polypharmacy whereas resembled with the HF with reduced ejection fraction (HFrEF) for the proportion of male distribution and prevalence of ischemic heart disease (IHD). Both the clinics had similar prescribing rates of GDMT and achieved maximal tolerated doses of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARB) in HFrEF, but significantly higher prescription of ACEIs/ARBs (70.5% v. 56.2%) was found in HFpEF patients in the MACS clinic. There was significantly lower rates of β-blockers and mineralocorticoid receptor antagonists (MRAs) prescription in HFrEF and HFpEF patients in both clinics. Use of digoxin in chronic atrial fibrillation (AF) was significantly higher in HFrEF patients (82.5% v. 58.5%), but number of people anticoagulated in presence of AF and prescription of diuretics were significantly lowered in MACS clinic in HFpEF patients. Age, anemia, chronic renal failure, SBP, HR and comorbidities were the significant predictors in a multivariate binary logistic regression for the utilization of GDMT.ConclusionsOur study concludes that pharmacist is an important member of a multidisciplinary team in the management of chronic heart failure. The other roles of the pharmacist within a multidisciplinary team, including continuity of care, medication compliance and prevention of adverse reactions need further research.
Treatment of Metformin Decreases the Risk of Varicose Vein: A Mendelian Randomization Study
Authors: Chen Qinchang , Li Lingling , Wu Ridong , Wang Shenming , Yao Chen 
Published: September 2020

Abstract
Background Varicose vein is a common illness of the vascular system which affects life quality and social function of patients. We aimed to assess the causality between metformin and varicose vein using a two-sample Mendelian randomization（MR）analysis based on genome-wide association study (GWAS) summary data.Methods Twenty-five single nucleotide polymorphisms (SNPs) were selected from the GWAS summary data from Neale Lab and MRC-IEU Consortium available on the MR-base platform. Inverse variance weighted (IVW), MR-egger method, weighted median method and weighted mode were adopted. Results were evaluated by pleiotropy test using an Egger regression method and sensitivity analysis preforming a leaving-one-out (LOO) method. Analyses were performed using R package “TwoSampleMR”.Results The result of IVW method showed that one SD increased treatment of metformin was linked with approximately 10% lower risk of varicose vein (OR,0.90; 95%CI, 0.85-0.96; P, 6.99e-04). It was similar to that measured by other methods in the aspect of effect size and direction. There is no evidence to supporting genetic pleiotropy in the MR-Egger regression method (intercept=2.5e-04, P=0.33). No single SNP was detected to be strongly driving the overall causal effect in a LOO sensitivity analysis. The genetically predicted treatment of metformin was negatively casually associated with varicose veins.Conclusions This study suggested that treatment of metformin was a casual protective factor of varicose vein. Further researches are required to confirm our findings and explore the potential mechanisms of metformin on varicose vein.