bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of opioid-free anesthesia on the quality of recovery after gynecological laparoscopy: study protocol for a prospective randomized controlled trial
Authors: Song Jae Yen , Choi Hoon , Chae Minsuk , Ko Jemin , Moon Youg Eun 
Published: October 2020

Abstract
Background: Because of the indiscriminate use of opioids during the perioperative period, opioid-free anesthesia (OFA) has been increasingly required. Nevertheless, the studies on the detailed techniques and effects of OFA are not sufficient. The Quality of Recovery-40 (QoR-40) questionnaire is a validated assessment tool for measuring recovery from general anesthesia. However, no study has used the QoR-40 to determine if OFA leads to better recovery than standard general anesthesia. Therefore, we aim to perform this study to determine the effects of OFA using dexmedetomidine and lidocaine on the quality of recovery as well as the various postoperative outcomes. Methods: The participants (n=78) will be allocated to one of the two groups; Study group will receive bolus and infusion of dexmedetomidine and lidocaine and Control group will receive remifentanil infusion during general anesthesia for gynecological laparoscopy. The other processes including anesthetic and postoperative care will be performed similarly in two groups. Intraoperative hemodynamic, anesthetic, and nociceptive variables will be recorded. Postoperative outcomes such as QoR-40, pain severity, opioid-related side effects will be assessed. Additionally, ancillary cytokine study (inflammatory cytokine, stress hormone, and reactive oxygen species) will be performed during study period. Discussion: This will be the first study to determine the effect of OFA, using the combination of dexmedetomidine and lidocaine, on the quality of recovery after gynecological laparoscopy compared with standard general anesthesia using remifentanil. The findings from this study will provide scientific and clinical evidence on the efficacy of OFA.Trial registration: ClinicalTrials.gov: NCT04409964. Registered on 28 May 2020.
Anti-Warburg effect by targeting HRD1-PFKP pathway may inhibit breast cancer progression
Authors: Fan Ya , Wang Jia , Xu Yuemei , Wang Yipin , Song Tao , Liang Xiubin , Jin Feng , Su Dongming 
Published: October 2020

Abstract
Background: Our previous studies have shown that the E3 ubiquitin ligase of HMG-CoA reductase degradation 1 (HRD1) functions as a tumor suppressor, as overexpression of HRD1 suppressed breast cancer proliferation and invasion. However, its role in breast cancer cell glucose metabolism was unclear. Here, our aim was to uncover the role and molecular mechanisms of HRD1 in regulating aerobic glycolysis in breast cancer. Methods: The effect of HRD1 on robic glycolysis in breast cancer cells were assessed. Then the proliferation, colony formation ability, invasion and migration of breast cancer cells were evaluated. The relationship between HRD1 and PFKP was validated by Mass spectrometry analysis, immunofluorescence and co-immunoprecipitation. The level of PFKP ubiquitination was measured using ubiquitylation assay. Furthermore, the tumor growth and metastasis in mice xenografts were observed. Results: We found that upregulation of HRD1 clearly decreased aerobic glycolysis, and subsequently inhibited breast cancer proliferation and invasion. Mass spectrometry analysis results revealed a large HRD1 interactome, which included PFKP (platelet isoform of phosphofructokinase), a critical enzyme involved in the Warburg Effect in breast cancer. Mechanistically, HRD1 interacted and colocalized with PFKP in the cytoplasm, targeted PFKP for ubiquitination and degradation, and ultimately reduced PFKP expression and activity in breast cancer cells. HRD1 inhibited breast cancer growth and metastasis in vivo through a PFKP-dependent wayConclusions: Our findings reveal a new regulatory role of HRD1 in Warburg effect and provide a key contributor in breast cancer metabolism.
A realistic evaluation of evidence-based therapeutic processes in mental health services– Context-Mechanisms-Outcomes
Authors: Badu Eric , O’Brien Anthony Paul , Mitchell Rebecca , Osei Akwasi 
Published: October 2020

Abstract
Background

Evidence-based clinical practice is an inherent component of developed countries mental health professional practice, however, little is known about Ghana mental health professional perspectives on evidence-based practice. This paper outlines the processes involved in the delivery of best practice in Ghana. The paper describes a realistic evaluation of mental health nurses and allied health opinions regarding the evidenced-based therapeutic process in Ghana mental health facilities.
Methods

A purposive sample of 30 Mental Health Professionals (MHPs) was recruited to participate in semi-structured in-depth interviews. Thematic analysis was used to analyse the data. A programme theory of Context + Mechanism = Outcome (CMO) configuration was developed from the analysis.
Results

The thematic analysis identified two CMO configurations: 1) technical competency stimulates evidence-based mental health services; and, 2) therapeutic alliance-building ensures effective interaction. The study demonstrated that contextual factors (technical competencies and therapeutic alliance building) together with mechanisms (intentional and unintentional) help to promote the quality of mental health services. However, contextual factor such as the lack of sign language interpreters yielded an unintended outcome such as consumer-provider communication barrier for consumers with hearing impaired and those from linguistically minority background.
Conclusion

We conclude that government stakeholders and policymakers should prioritize policy documents, periodic monitoring and adequate financial incentives to support the on-going mechanisms that promote mental health professional technical competence and therapeutic alliance building.
Induced in vivo transdifferentiation of vertebrate muscle into early endoderm-like cells
Authors: Dong P. Duc , Lancman Joseph , Campbell Clyde , Espin-Palazon Raquel , Matalonga Jonatan , He Jiaye , Graves Alyssa , Mishra Rashmi , Yin Jun , Zhao Chengjian , Zeng Xin-Xin , Huisken Jan , Traver David 
Published: October 2020

Abstract
The extent to which differentiated cells, while remaining in their native microenvironment, can be reprogrammed to assume a different identity will reveal fundamental insight into cellular plasticity and impact regenerative medicine. To investigate in vivo cell lineage potential, we leveraged the zebrafish as a practical vertebrate platform to determine factors and mechanisms necessary to induce differentiated cells of one germ layer to adopt the lineage of another. We discovered that ectopic co-expression of Sox32 and Oct4 in several non-endoderm lineages, including skeletal muscle, can specifically trigger an early endoderm genetic program in a cell-autonomous manner. Gene expression, live imaging, and functional studies reveal that the endoderm-induced muscle cells lose muscle gene expression and morphology, while specifically gaining endoderm organogenesis lineage markers, such as the pancreatic specification genes, hhex and ptf1a, via a mechanism resembling normal development. Endoderm induction by a pluripotent defective form of Oct4, endoderm markers appearing prior to loss of muscle cell morphology, and a lack of mesoderm, ectoderm, dedifferentiation, and pluripotency gene activation, together, suggests that reprogramming is endoderm specific and occurs via direct transdifferentiation. Our work demonstrates that within a living vertebrate animal, differentiated cells can be induced to directly adopt the identity of a completely unrelated cell lineage, while remaining in a distinct microenvironment, suggesting that differentiated cells in vivo may be more amenable to lineage conversion than previously appreciated. This discovery of extensive lineage potential of differentiated cells, in vivo, challenges our understanding of cell lineage restriction and may pave the way towards new in vivo sources of replacement cells for degenerative diseases such as diabetes.
Definition of Acute Respiratory Distress Syndrome in Plateau of Xining,Qinghai: Verification of Berlin Definition Plateau Criteria
Authors: Liu Xiaoqin , Pan Chun , Si Li-Ning , Tong Shijun , Niu Yi , Qiu Haibo , Guifen Gan 
Published: October 2020

Abstract
BackgroundAcute respiratory distress syndrome（ARDS） is a common respiratory critical illness. The high altitude hypoxic environment has a great influence on its occurrence and development. Now we lack clear diagnostic definition of high altitude acute respiratory distress syndrome.To verify the application value of Berlin Definition plateau criteria of Acute Respiratory Distress Syndrome in Xining , Qinghai ( 2261m).MethodsRetrospective analysis of the clinical data of ARDS patients admitted to the Department of Critical Care Medicine of the Affiliated Hospital of Qinghai University from January 2018 to December 2018. The severity was divided according to the Berlin definition, the plateau standard, and the Zhang standard, and the differences of three standards were compared.ResultsIn this study, 512 patients with mechanical ventilation were selected. 229 patients who met the criteria of Berlin Definition plateau criteria , including 107 patients with mild ARDS (46.72%), 84 moderate patients (36.68%) and 38 severe ARDS patients (16.59%). Among 253 meet Berlin definition patients , 49(19.77%) were mild,148(58.50%) were moderate,and 56 (22.13%) were severe ARDS. There are 204 patients that meet Zhang criteria, among the 204 enrolled patients, 87(42.65%) were ALI and 117(57.35%) were ARDS. The AUROC of the Berlin Definition, the Plateau criteria and Zhang criteria were 0.6675 (95% CI 0.5866-0.7484), 0.6216 (95%CI 0.5317-0.7116) and 0.6050 (95% CI 0.5084-0.7016).ConclusionFor Xining, Qinghai, the Berlin Definition Plateau oxygenation index correction criteria can distinguish the severity of ARDS , but it needs to be enlarged and confirmed by multicenter clinical studies.
Study on optimization and stability of a single dose streptozotocin-induced diabetic modeling in rats
Authors: Zhang Yao , Zhang jiao , Hong Ming , Huang Jingyi , Wang Rui , Tan Bo , Huang Ping , Cao Hongying 
Published: October 2020

Abstract
BackgroundOptimization of experimental conditions in streptozotocin induced diabetic model in Sprague Dawley (SD) rats to evaluate the stability of the model.MethodsMale and female SD rats were randomly divided into control group, STZ 45 group (STZ: 45 mg / kg), STZ 65 group (STZ: 65 mg / kg), STZ 85 group (STZ: 85 mg / kg), high fat diet with STZ 45 group (STZ: 45 mg / kg), high fat diet with STZ 65 group (STZ: 65 mg / kg), high fat diet with STZ 85 group (STZ: 85 mg / kg). N = 6 in each group. The changes of body weight and blood glucose were observed dynamically.ResultsThere was no significant difference in blood glucose or body weight between the STZ 45 group and the control group in both male and female rats, whether or not they were on a high-fat diet. However, there were significant differences in blood glucose between the high-dose STZ group and the control group in both male and female rats, regardless of whether the rats were on a high-fat diet or not (P < 0.05 or P < 0.01). Compared with the control group, there were significant differences in blood glucose levels (P < 0.05 or P < 0.01) and higher blood glucose levels in the male rats fed with the normal diet than that in those fed with the high-fat diet.ConclusionsIn this study, male rats fed with ordinary feed and injected STZ dose of 65 mg / kg were the most stable and ideal diabetic rat.
Applying high throughput and comprehensive immunoinformatics approaches to design a trivalentsubunit vaccine forinduction of immune response against human emerging coronaviruses SARS-CoV, MERS-CoV and SARS-CoV2
Authors: Rahmani Abolfazl , Baee Masoud , Saleki Kiarash , Moradi Saead , Nouri Hamid Reza 
Published: October 2020

Abstract
Background

Coronaviruses (CoV) cause diseases such as severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS) and Coronavirus disease 2019 (COVID-19). Therefore, this study was conducted to contrast a trivalent subunit vaccine against SARS, MERS and COVID-19. The CTL, HTL, MHC I, and IFN-γ epitopes were predicted. Moreover, to stimulate strong helper T lymphocytes (HTLs) responses, Pan HLA DR-binding epitope (PADRE) was used. Also, for boosting immune response, β-defensin 2 was added to the construct as an adjuvant. Furthermore, TAT was applied in the vaccine to facilitate the intracellular delivery.
Results

Based on the predicted epitopes, a trivalent multi-epitope vaccine with a molecular weight of 74.8 kDa as a strong antigen, a non-allergenic, and soluble protein was constructed. Furtheremore, analyses validated the stability of the proposed vaccine. The binding affinity of the vaccine construct with the TLR3 was confirmed by molecular docking and, stability of the docked complex was simulated. The predicted epitopes demonstrated strong potential to stimulate T and B-cell mediated immune responses. Furthermore, codon optimization and in silico cloning guaranteed increased expression.
Conclusions

In this work, immunoinformatics investigations demonstrated that this next-generation approach may provide a new horizon for the development of a highly immunogenic vaccine against SARS-CoV, MERS‐CoV, and SARS-CoV-2.
Enhance Image Classification Performance Via Unsupervised Pre-trained Transformers Language Models
Authors: Shen Dezhou 
Published: October 2020

Abstract
Image classification and categorization are essential to the capability of telling the difference between images for a machine.
As Bidirectional Encoder Representations from Transformers became popular in many tasks of natural language processing recent years,
it is intuitive to use these pre-trained language models for enhancing the computer vision tasks, \eg image classification.
In this paper, by encoding image pixels using pre-trained transformers, then connect to a fully connected layer,
the classification model outperforms the Wide ResNet model and the linear-probe iGPT-L model,
and achieved accuracy of 99.60%～99.74% on the CIFAR-10 image set and accuracy of 99.10%～99.76% on the CIFAR-100 image set.
Profile of Patients with Heart Failure: A Multi-Site Thailand Heart Failure Snapshot Study
Authors: Tankumpuan Thitipong , Sindhu Siriorn , Perrin Nancy , Commodore-Mensah Yvonne , Budhatthoki Chakra , Padula William , Himmelfarb Cheryl Dennison , Davidson Patricia M. 
Published: October 2020

Abstract
Background: The prevalence of heart failure (HF) is increasing in many low- and middle-income countries but the limited availability of data on the patient profile and clinical outcomes of patients with HF challenges health services planning. Methods: The Thai HF Snapshot Study was a multi-site, observational study conducted in Thailand to document demographic, clinical and sociodemographic characteristics, and to compare clinical outcomes by the level of the hospital. Results: A total of 512 participants: mean age 64.9±15.3 years; female (55.9%) were recruited across Thailand. The most frequently identified admitting diagnosis was ischemic heart disease (45.1%). Most patients (70.3%) were classified as New York Heart Association class II at discharge. Patients in super tertiary care settings were frailer (3.2 vs. 2.9; p=0.015), had more depressive symptoms (8.1 vs. 5.7; p<0.001) and had lower functional status (66.2 vs. 73.3; p<0.001) than patients in tertiary care. Conclusion: Although HF patients admitted to super tertiary centers have access to advanced technology and healthcare specialists, clinical outcomes were worse. Interventions are urgently needed to ensure improved HF management considering the psychosocial determinants of health in Thailand.
Minimizing Guidewire Unwilling Passage and Related Perforation: Prevention is Better Than Cure
Authors: Yang Hongbo , Cao Jiatian , Zhang Feng , Zhang Meng , Li Chenguang , Dai Yuxiang , Song Yanan , Huang Zheyong , Yao Kang , Wang Xiangfei , Qian Juying , Ge Junbo 
Published: October 2020

Abstract
Background: Current guidewires for transradial coronary angiography had defects of passage difficulty or branch injury. This study sought to investigate the safety and efficiency of a novel method of active knuckle angle 0.035-inch hydrophilic guidewire in transradial coronary angiography.Methods: Patients who underwent a transradial coronary procedure from August 2015 to June 2020 were consecutively noted. Of them, 1457 patients were allocated into the Traditional group, while the following 1322 patients were allocated into the Knuckle group to investigate the safety. In addition, 239 patients were randomly divided to evaluate its efficiency. Results: Unwilling passage of guidewire into branches occurred more in Traditional group than in Knuckle group (9.5% vs. 0.08%, p<0.001). Of them, 2 patients experienced guidewire associated perforation in Traditional group. Covered stent was used for 1 patient with internal mammarian artery perforation, and the other was treated with compression for brachial branch perforation. Furthermore, duration of guidewire advancement from the sheath to aortic root significantly decreased in the Knuckle group (22.6±8.0s vs. 33.4±16.9s, p<0.001). Conclusions: Active knuckle angle guidewire was a novel method to prevent unwilling passage and associated perforation, which also improved the efficiency and reduced radiation exposure.
Ultrastructural analysis of cardiomyocytes shows that loss of left ventricular desmosomes leads to shortening of ST segment time in patients with arrhythmogenic cardiomyopathy
Authors: Chang Yuan , Hua Xiumeng , Hu Yiqing , Liu Wendao , Chen Xiao , Fan Xuexin , Menghao Tao. , Chen Shi , Song Jiangping , Hu Shengshou 
Published: October 2020

Abstract
Background: Arrhythmogenic cardiomyopathy (AC) is an inherited myocardial disease affecting the both ventricles. It shows large heterogeneity on its clinical, genetic, and pathological manifestations. The intercalated disc remodeling has been investigated in right ventricle (RV) of AC, however, the ultrastructural features in left ventricle (LV) and among different genotypes remain unknown.Methods: The ultrastructure characters of both ventricles from 24 AC who fulfilled the international Task Force diagnostic and 10 normal donor hearts were studied by transmission electron microscope. We applied Pearson correlation analysis to identify the relationship between D structure and electrocardiogram changes.Results: These 24 patients were divided into two subtypes based on whether they carried desmosome (D) gene mutation. We found that more D structures in LV than that in the right ventricles (RV) in the normal hearts (LV vs. RV, 10.82 ± 3.12% vs. 6.75 ± 1.11%, p=0.001), but the density (AC vs. Control, 3.77 ± 1.58 per 10 μm vs. 4.21 ± 1.76 per 10 μm, p=0.001) and proportion (AC vs. Control, 6.65 ± 2.77% vs. 10.82 ± 3.12%, p=0.001) of D was declined in LV of AC compared with that in normal hearts. The width (AC vs. Control, 21.38 ± 2.31 nm vs. 18.09 ± 0.98 nm, p=0.001) and length (AC vs. Control, 0.17 ± 0.05 μm vs. 0.14 ± 0.01 μm, p=0.002) of D was increased in RV of AC compared with that in normal hearts. Destroyed D structures were found in all AC patients, regardless of carrying a D gene mutation or not. The proportion of D in LV are positively correlated with ST segment time in AC patients. The ultrastructure of mitochondria was not different between AC and normal hearts.Conclusions: The D remodeling patterns had no correlation with the type of mutation. The D of LV mainly showed a decrease in density and proportion, but the D of RV were mainly manifested as compensatory widening and lengthening. The D loss in LV may cause ST segment shortening. From the perspective of ultrastructure, we concluded that increased output power of heart may accelerate the desmosome remodeling or disintegration.
Antimicrobial Resistance Genes and Bacteria Detected in Hospital Sewage May Provide Valuable Information in Clinical Antimicrobial Resistance
Authors: Cai Leshan , Sun Jiayu , Yao Fen , Zhang Qiaoxin , Yuan Yumeng , Xie Qindong , Wang Shiwei , Wang Zhen , Jiao Xiaoyan 
Published: October 2020

Abstract
Aim: Clinical antimicrobial resistance (AMR) is a significant threat to public health, which is often unclear due to representative data from human populations that are challenging to obtain. Study the associations between consumption of antibiotics and antimicrobial resistance bacteria or genes (ARB or ARGs) that will benefit from elucidating the AMR. Methods: The details of antibiotics usage were calculated based on the actual consumption in the target hospital, ARB was detected by culture method, and ARGs were evaluated by metagenomics. Results: Our study revealed that culture-based single-indicator-strain approaches only capture the AMR in 16.17% infectious samples. 1573 bacterial species and 885 types of ARGs were found in the hospital sewage. The consumption of antibiotics influences the resistance profiles that were significant in E.coli, but the strength varies among bacteria. In all ARGs group, ARGs of aminoglycosides was the most common, followed by sulfonamide, tetracycline, phenicol, macrolides, and quinolones, comprising to 82.6% of all ARGs. Five hundred nineteen pairs of ARGs and bacterial species showed a significant correlation (r > 0.8). The co-occurrence patterns of bacteria- ARGs mirrors the AMR of the clinic. Antibiotic usage will affect the abundance of ARG in sewage, with a hysteresis effect. Conclusion: The ARGs- bacteria co-occurrence patterns from wastewater could be a valuable bio-indicator to reflect the emergence of ARB in the future. Developing a predictive risk model of AMR on this basis will facilitate the rational use of antibiotics.
The Possibility of Analyzing Endometrial Receptivity Using Cells From Embryo Transfer Catheters
Authors: Goto Kaori , Kawano Yasushi , Utsunomiya Takafumi , Narahara Hisashi 
Published: October 2020

Abstract
Background: Endometrial receptivity issues represent a potential source of implantaion failure. It is very important to investigate the expression of endometrial receptive markers in the endometrium during implantation. Therefore, we examined whether it would be possible to analyze endometrial receptivity using cells from embryo transfer catheters. In addition, we analyzed the relationship between the gene expression profile associated with pregnancy from endometrial cells taken during embryo transfer.Methods: A total of 88 cycles from 88 consenting patients were enrolled in this study. The tip of the embryo transfer (ET) catheter was cut and immersed in a dedicated reagent. Confirmation of cell distribution was carried out using a Papanicolaou stain (n=6) and immunocytochemistry (n=3). Protein expression was carried out by immunocytochemistry (n=12). Total RNA was extracted, and the expression of endometrial receptive markers (estrogen receptor α, progesterone receptor, and homeobox A10) were analyzed using quantitative reverse transcription polymerase chain reaction (n=67). we analyzed the relationship between the gene expression profile associated with pregnancy from endometrial cells. Results: Samples collected from the ET catheter showed clear staining for endometrial cells. Most of the cells were endometrial epithelial cells. Cervical cells were not included. The protein expression of endometrial receptive markers in cells was also confirmed. Three genes were analyzed that are associated with endometrial receptivity. Progesterone receptor expression was 1.5-fold and homeobox A10 expression was 2-fold higher in patients who became non-pregnant group, compared to the pregnant group. Both increases were statistically significant (p < 0.05). Estrogen receptor α expression tended to be higher in the non-pregnant group, but there was no significant difference. Conclusion: Our results suggest that endometrial receptivity can be evaluated using cells obtained from the ET catheter. This method may be useful for elucidating the cause of implantation failure by comparing a receptive and non-receptive endometrium at the time of ET.