bluuebunny/crossref_metadata_2025_split huggingface dataset:
Moderate and deep sedation for non-invasive paediatric procedures in tertiary maternity and children’s hospitals in China: A questionnaire survey from China
Authors: Li Bo , Zhang Ruidong , Huang Yue , Zhang Kan , Wat Chun Yin , Bai Jie , Zhang Mazhong , Zheng Jijian 
Published: December 2019

Abstract

Background : Moderate and deep sedation are well-established techniques in many developed countries, and several guidelines have been published. However, they have received attention in China only in recent years. The aim of this study is to investigate current paediatric sedation practices in tertiary children’s hospitals and tertiary maternity and children hospitals in China. Methods : All tertiary children’s hospitals and tertiary maternity and children hospitals registered with the National Health Commission of the People’s Republic of China were invited to participate in an electronic survey, which included information on the sedation caseload, facility availability, staff structure, clinical skill requirements for sedation providers, fasting guidelines, patient-monitoring practices, and choice of sedatives. Results : Fifty-eight of the 63 hospitals that completed the survey (92.1%) provided moderate and deep sedation. Dedicated sedation rooms and post-sedation recovery rooms were found in 14 (24.1%) and 19 (32.8%) hospitals, respectively. Sedation for non-invasive procedures was primarily performed by anaesthesiologists (69.0%); however, 75.9% of the sedation providers had not received paediatric basic or advanced life-support training. Children were asked to fast from clear liquids for at least 2 hours in 44.8% of hospitals and up to 6 hours in 5.2% of hospitals; they were asked to fast from solid food/milk for at least 4 hours in 27.6% of hospitals and more than 8 hours in 1.7% of hospitals. The most commonly used sedative in all groups was chloral hydrate. For rescue, propofol was the most widely used sedative, particularly for children older than 4 years. Conclusions : Moderate and deep sedation practices vary widely in tertiary children’s hospitals and tertiary maternity and children hospitals in China. Optimised practices should be established to improve the quality of moderate and deep sedation.
Analyzing preferences for family doctor contract services in rural China: a study using discrete choice experiment
Authors: Fu Peipei , Wang Yi , Liu Shimeng , Li Jiajia , Gao qiufeng , Zhou Chengchao , Meng Qingyue , Sylvia Sean 
Published: December 2019

Abstract
Background: Preliminary evaluations have found that family doctor contract service has significantly controlled medical expenses, better managed chronic diseases, and increased patient satisfaction and service compliance. In 2016, China proposed the establishment of a family doctor system to carry out contract services, but studies have found uptake and utilization of these services to be limited. This study aimed to investigate rural resident preferences for FDCS from the public perspective in China. Methods: A discrete choice experiment (DCE) was performed to elicit respondent preferences towards FDCS among rural residents in China. Attributes and levels were established based on literature review and qualitative methods. Five attributes consisted of cost, medicine availability, reimbursement rate, competence of the family doctor, and attitude of the family doctor were evaluated using mixed logit model. Results: A total number of 609 residents were included in the main DCE analysis. Respondents valued high competence (coefficient 2.44, [SE 0.13]) and good attitude (coefficient 1.42, [SE 0.09]) of the family doctor most. Cost was negatively valued (coefficient -0.01, [SE 0.01]) as expected. The preference heterogeneity analysis was conducted after adjusting the interaction terms, we found that rural residents with higher educational attainment prefer good attitude than those with lower educational attainment counterparts. The estimated willingness to pay (WTP) for “high” relative to “low” competence was 441.13 RMB/year and WTP for a provider with a “good” relative to a “poor” attitude was 255.77 RMB/year. Conclusion: This present study suggested priorities should be given to strengthen and improve the quality of primary health care including family doctors’ competence and attitudes so as to increase the uptake of signing FDCS. The contract service package including annual cost, insurance reimbursement rate and individualized services should be redesigned and become congruent with residents with different health status and their stated preferences.
Neuromuscular shoulder activity during exercises with different combinations of stable and unstable weight mass
Authors: Baritello Omar , Khajooei Mina , Engel Tilman , Kopinski Stephan , Quarmby Andrew , Mueller Steffen , Mayer Frank 
Published: December 2019

Abstract
Background:Recent shoulder injury prevention programs have utilized resistance exercises combined with different forms of instability, with the goal of eliciting functional adaptations and thereby reducing the risk of injury. However, it is still unknown how an unstable weight mass (UWM) affects the muscular activity of the shoulder stabilizers. Aim of the study was to assess neuromuscular activity of dynamic shoulder stabilizers under four conditions of stable and UWM during three shoulder exercises. It was hypothesized that a combined condition of weight with UWM would elicit greater activation due to the increased stabilization demand.
Methods:Sixteen participants (7 m/9 f) were included in this cross-sectional study and prepared with an EMG-setup for the: Mm. upper/lower trapezius (U.TA/L.TA), lateral deltoid (DE), latissimus dorsi (LD), serratus anterior (SA) and pectoralis major (PE). A maximal voluntary isometric contraction test (MVIC; 5 sec.) was performed on an isokinetic dynamometer. Next, internal/external rotation (In/Ex), abduction/adduction (Ab/Ad) and diagonal flexion/extension (F/E) exercises (5 reps.) were performed with four custom-made-pipes representing different training conditions. First, the empty-pipe (P; 0.5 kg) and then, randomly ordered, water-filled-pipe (PW; 1 kg), weight-pipe (PG; 4.5 kg) and weight + water-filled-pipe (PWG; 4.5 kg), while EMG was recorded. Raw root mean square values (RMS) were normalized to MVIC (%MVIC). Differences between conditions for RMS%MVIC, scapular stabilizer (SR : U.TA/L.TA; U.TA/SA) and contraction (CR : concentric/eccentric) ratios were analyzed (paired t-test; a = 0.05; Bonferroni adjusted a = 0.008).
Results:PWG showed significantly greater muscle activity for all exercises and all muscles except for PE compared to P and PW. Condition PG elicited muscular activity comparable to PWG (p> 0.008) with significantly lower activation of L.TA and SA in the In/Ex rotation. The SR ratio was significantly higher in PWG compared to P and PW. No significant differences were found for the CR ratio in all exercises and for all muscles.
Conclusion:Higher weight generated greater muscle activation whereas an UWM raised the neuromuscular activity, increasing the stabilization demands. Especially in the In/Ex rotation, an unstable weight mass increased the RMS%MVIC and SR ratio. This might improve training effects in shoulder prevention and rehabilitation programs.
Diverse biological processes coordinate the transcriptional response to nutritional changes in a Drosophila melanogaster multiparent population
Authors: Ng'oma Enoch , Williams-Simon Patricka A. , Rahman Aniqa , King Elizabeth G. 
Published: December 2019

Abstract

Background: Environmental variation in the amount of resources available to populations challenge individuals to optimize the allocation of those resources to key fitness functions. This coordination of resource allocation relative to resource availability is commonly attributed to key nutrient sensing gene pathways in laboratory model organisms, chiefly the insulin/TOR signaling pathway. However, the genetic basis of diet-induced variation in gene expression is less clear. Results: To describe the natural genetic variation underlying nutrient-dependent differences, we used an outbred panel derived from a multiparental population, the Drosophila Synthetic Population Resource. We analyzed RNA sequence data from multiple female tissue samples dissected from flies reared in three nutritional conditions: high sugar (HS), dietary restriction (DR), and control (C) diets. A large proportion of genes in the experiment (19.6% or 2,471 genes) were significantly differentially expressed for the effect of diet, 7.8% (978 genes) for the effect of the interaction between diet and tissue type (LRT, P adj. < 0.05). Interestingly, we observed similar patterns of gene expression relative to the C diet, in the DR and HS treated flies, a response likely reflecting diet component ratios. Hierarchical clustering identified 21 robust gene modules showing intra-modularly similar patterns of expression across diets, all of which were highly significant for diet or diet-tissue interaction effects (false discovery rate, FDR P adj. < 0.05). Gene set enrichment analysis for different diet-tissue combinations revealed a diverse set of pathways and gene ontology (GO) terms (two-sample t-test, FDR < 0.05). GO analysis on individual co-expressed modules likewise showed a large number of terms encompassing a large number of cellular and nuclear processes (Fisher exact test, P adj. < 0.01). Although a handful of genes in the IIS/TOR pathway including Ilp5 , Rheb , and Sirt2 showed significant elevation in expression, known key genes such as InR , chico , insulin peptide genes, and the nutrient-sensing pathways were not observed. Conclusions: Our results suggest that a more diverse network of pathways and gene networks mediate the diet response in our population. These results have important implications for future studies focusing on diet responses in natural populations.
Survival and mortality of elderly men with localized prostate cancer managed with primary androgen deprivation therapy or by primary observation
Authors: Seikkula Heikki , Boström Peter J. , Seppä Karri , Pitkäniemi Janne , Malila Nea , Kaipia Antti 
Published: December 2019

Abstract
Background: Androgen deprivation therapy (ADT) remains a primary treatment for localized prostate cancer (PCa) even though there is no evidence that its use is beneficial in the absence of curative treatment.
Methods: Men aged ≥70 years ( n = 16534) diagnosed with localized PCa from 1985 to 2014 and managed either with primary observation or ADT in the absence of curative treatment were included. The cases were identified from the population-based Finnish Cancer Registry. We estimated the standardized mortality ratios (SMR) for overall mortality by treatment group. We determined the relative risk (RR) of PCa-specific mortality (PCSM) and other-cause mortality between the two treatment groups. Survival was determined using the life table method. Two age groups (70–79 years and ≥80 years) and three calendar time cohorts (1985–1994, 1995–2004, and 2005–2014) were compared following adjustment of propensity score matching between the treatment groups with four covariates (age, year of diagnosis, educational level, and hospital district). Follow-up continued until death or until December 31, 2015.
Results: Patients in the observation group had lower overall SMRs than those in the ADT group in both age cohorts over the entire study period. PCSM was higher in men aged 70–79 years undergoing primary ADT compared to those managed by observation only (RR: 1.70, 95% confidence interval [CI]: 1.29–2.23 [1985–1994]; RR 1.55, 95% CI: 1.35–1.84 [1995–2004]; and RR 2.71, 95% CI: 2.08–3.53 [2005–2014]); p = 0.005 for periodic trend. A similar trend over time was also observed in men aged >80 years; ( p for age–period interaction = 0.237). Overall survival was also higher among men in their 70’s managed by observation compared to those undergoing ADT.
Conclusions: Primary ADT is not associated with improved long-term overall survival or decreased PCSM compared to primary conservative management for men with localized PCa. However, this observational study’s conclusions should be weighted with confounding factors related to cancer aggressiveness and comorbidities.
The combination of transversus abdominis plane block and rectus sheath block reduced postoperative pain after splenectomy
Authors: Zhu Jingli , Wang Xue-ting , Gong Jing , Sun Hai-bin , Zhao Xiao-qing , Gao Wei 
Published: December 2019

Abstract
Background: Splenectomy performed with a curved incision results in severe postoperative pain. The aim of this study was to evaluate the effect of transversus abdominis plane block and rectus sheath block on postoperative pain relief and recovery.Methods: A total of 150 patients were randomized into the control (C), levobupivacaine (L) and levobupivacaine/morphine (LM) groups. The patients in the C group received only patient-controlled analgesia. The patients in the L and LM groups received transversus abdominis plane block and rectus sheath block with levobupivacaine or levobupivacaine plus morphine. The intraoperative opioid consumption; postoperative pain score; time to first analgesic use; postoperative recovery data, including the times of first exhaust, defecation, oral intake and off-bed activity; the incidence of postoperative nausea and vomiting and antiemetics use; and the satisfaction score were recorded.Results: Transversus abdominis plane block and rectus sheath block reduced intraoperative opioid consumption. The patients in the LM group showed lower postoperative pain scores, opioid consumption, postoperative nausea and vomiting incidence and antiemetic use and presented shorter recovery times and higher satisfaction scores.Conclusions: The combination of transversus abdominis plane block and rectus sheath block with levobupivacaine and morphine can improve postoperative pain relief, reduce the consumption of analgesics, and partly accelerate postoperative recovery.
Responses of the photosynthetic characteristics and chloroplast ultrastructure of Welsh onion (Allium fistulosum L.) to different LED light qualities
Authors: Gao Song , Liu Xuena , Liu Ying , Cao Bili , Chen Zijing , Xu Kun 
Published: December 2019

Abstract
Background: The optimized illumination of plants using light-emitting diodes (LEDs) is beneficial to theirphotosynthetic performance. Because of this, in recent years LEDs have been widely used in horticultural facilities. However, there are significant differences in the responses of different crops to light quality. The influence of light quality on photosynthesis needs to be further explored to provide theoretical guidance for the adjustment of the light environment in industrial crop production. This study tested the effects of different qualities of LED lighting (white, W; blue, B; green, G; yellow, Y; and red, R) with the sama photon flux density (300 μmol/m2·s) on the growth and development, photosynthesis, chlorophyll fluorescence characteristics, leaf structure, and chloroplast ultrastructure of Welsh onion (Allium fistulosum L.) plants.
Results: The results showed that the plant height, leaf area, and fresh weight of plants in the W and B treatments were significantly higher than those in the other treatments. The photosynthetic pigment content and net photosynthetic ratein the W treatment were significantly higher than those in the monochromatic light treatments, while the transpiration rate (E) and stomatal conductance (Gs) were the highest in the B treatment, and the intercellular CO2 concentration (Ci) was the highest in the Y treatment. Among the chlorophyll fluorescence characteristics tested, the non-photochemical quenching coefficient (NPQ) was the highest in the Y treatment, while the maximum photochemical efficiency of photosystem II (PSII) under dark adaptation (Fv/Fm), maximum photochemical efficiency of PSII under light adaptation (Fv'/Fm'), photochemical quenching coefficient (qP), actual photochemical efficiency (ΦPSII), and apparent electron transport rate (ETR) all differed among treatments in the following order: W > B > R > G > Y. Both leaf structure and chloroplast ultrastructure showed the most complete development in the B treatment.
Conclusions: In summary, in addition to W light, B light significantly improved the photosynthetic efficiency of Welsh onion, whereas Y light significantly reduced the photosynthetic efficiency of this plant.
Clinical effect analysis and radiographic outcomes of Isobar TTL system for two-segmental lumbar degenerative disease: a retrospective study
Authors: ji zhisheng , Ji Zhi-Sheng , Yang Hua , Yang Yu-Hao , Li Shao-Jin , Luo Jian-Xian , Zhang Guo-Wei , Lin Hong-Sheng 
Published: December 2019

Abstract
Background: Non-fusion fixation is an effective way to treat lumbar degeneration. The present study evaluated the clinical effect analysis and radiographic outcomes of Isobar TTL system for two-segmental lumbar degenerative disease. Method: Forty-one patients with two-segmental lumbar degenerative disease who underwent surgical treatment by Isobar TTL dynamic stabilization system (n=20) and rigid system (n=21) from January 2013 to June 2017. The mean follow-up period was 23.6 (range 15–37) months. Clinical outcomes were evaluated by oswestry dysfunction index (ODI), visual analogue score (VAS) and modified Macnab. Radiographic evaluations included the height of intervertebral space and range of motion (ROM) of the operative segments and proximal adjacent segment. The intervertebral disc signal change was classified by the modified Pfirrmann grade and University of California at Los Angeles (UCLA) system. Results: The clinical outcomes including the ODI and VAS were significantly improved in two groups after operation, but the difference between two groups was not significant. In addition, the clinical efficacy of modified Macnab in two groups was similar too. Radiologic outcomes include height of intervertebral space, lumbar mobility and intervertebral disc signal. The height of intervertebral space of upper adjacent segments of L2/3 in the rigid group were significantly lower than those in the Isobar TTL group at the last follow-up. Furthermore, the number of fixed segment ROM of L3/4 in Isobar TTL group was significantly lower than pre-operation, suggesting that fixed segment ROMs in Isobar TTL group were limited. And, the ROM of upper adjacent segments of L2/3 in the last follow-up of rigid group increased significantly, while the ROM of L2/3 in Isobar TTL group haven’t changed after operation. At last, the incidence of adjacent segment degeneration was significantly greater in the rigid group than the Isobar TTL group according to modified Pfirrmann grading system and the UCLA system. Conclusion: Isobar TTL system could get a good clinical effect for treatment of two-segmental lumbar degenerative disease. Compared with rigid fixation, Isobar TTL system can get better radiographic outcomes and maintain the mobility of the stabilized segments with less influence on the proximal adjacent segment.
Risk factor analysis for progressive spinal deformity after resection of intracanal tumors─ a retrospective study of 272 cases
Authors: Wang Pangbo , Ma Kang , Chen Tunan , Xue Xingsen , Ma Dada , Wang Shi , Chen Xin , Meng Hui , Cui Gaoyu , Gao Boyuan , Lin Jiangkai , Feng Hua , Chu Weihua 
Published: December 2019

Abstract
Background: Progressive spinal deformity has become a well-recognized complication of intracanal tumors resection. However, the factors affecting post-operative spinal stability remain to be further research. Here, we described the current largest series of risk factors analysis for progressive spinal deformity following resection of intracanal tumors. Methods: We retrospectively analyzed the medical records of the patients with resection of intracanal tumors between January 2009 and December 2018. All patients who underwent resection of intracanal tumors performed regular postoperative follow-up were identified and included in the study. Clinical, radiological, surgical, histopathological, and follow-up data were collected. The incidence of postoperative progressive kyphosis or scoliosis was calculated. The statistical relationship between postoperative progressive spinal deformity and radiographic, clinical, and surgical variables was assessed by using univariate tests and multivariate logistic regression analysis. Results: Two hundred seventy-two patients (mean age 42.56 ± 16.18 years) with median preoperative modified McCormick score of 3 met the inclusion criteria. Among them, 7（2.6%）patients were found to have spinal deformity preoperatively, and the extent of spinal deformity in these 7 patients deteriorated after surgery. 36 (13.2%) were new cases of postoperative progressive deformity. The mean duration of follow-up was 21.8 months (median 14 months, range 6–114 months). In subsequent multivariate logistic regression analysis, age≤18 years (p=0.027), vertebral levels of tumor involvement (p = 0.019) and preoperative spinal deformity(p=0.008) was the independent risk factors (p < 0.05), increasing the odds of postoperative progressive spinal deformity by 3.94- , 0.69- and 27.11-fold, respectively. Conclusions: The incidence of postoperative progressive spinal deformity was 15.8%, mostly in these patients who had younger age (≤18 years), tumors involved in multiple segments and preoperative spinal deformity. The risk factors of postoperative progressive spinal deformity warrants serious reconsideration that when performing resection of spinal cord tumors in these patients with such risk factors, the surgeons should consider conducting follow-ups more closely, and when patients suffering from severe symptoms or gradually increased spinal deformity, surgical spinal fusion may be a more suitable choice to reduce the risk of reoperation and improve the prognosis of patients.
Iodine concentration and content measured by dual-source computed tomography are correlated to thyroid hormone levels in euthyroid patients: a cross-sectional study in China
Authors: Li ZhengTeng , Zhai Rui , Liu HongMei , Wang Min , Pan Dongmei 
Published: December 2019

Abstract
Background: The aim of this study was to investigate the correlation of the dual energy CT measured iodine concentration and total iodine content with blood measured thyroid parameters. Methods: 43 patients with normal thyroid function at our hospital from August 2017 to October 2019 were included in this retrospective study. Dual energy CT was used to scan the neck of thyroid patients. The mean iodine concentration and thyroid tissue volume were measured to calculate the total iodine content of the thyroid. Relevant tests of triiodothyronine (FT3), total triiodothyronine (TT3), total thyroxine (TT4), free thyroxine (FT4), and thyroid hormone (TSH) were conducted. The correlation of the thyroid mean iodine concentration and total iodine content with blood-measured thyroid function was analysed. Result: The total iodine content in the thyroid was positively correlated with FT3 but negatively correlated with TSH. The mean iodine concentration of the thyroid was positively correlated with both FT3 and TT3. Conclusion : The thyroid iodine content measured by dual energy CT can be used to determine the human iodine nutritional status and evaluate thyroid function, which will facilitate the diagnosis and treatment of thyroid diseases.