bluuebunny/crossref_metadata_2025_split huggingface dataset:
Elevated levels of serum urokinase plasminogen activator predict poor prognosis in hepatocellular carcinoma after resection
Authors: Tsai Ming-Chao , Yen Yi-Hao , Chang Kuo-Chin , Hung Chao-Hung , Chen Chien-Hung , Lin Ming-Tsung , Hu Tsung-Hui 
Published: November 2019

Abstract
Background: Urokinase plasminogen activator (uPA) is an extracellular matrix-degrading protease that is involved in the invasiveness and progression of cancer. There is good evidence that uPA expression is a clinically relevant biomarker in some solid tumors, but its role in hepatocellulcar carcinoma (HCC) is uncertain. We evaluated the prognostic value of serum uPA before surgery in HCC patients receiving curative resection. Methods: Serum uPA levels were determined by enzyme-linked immunosorbent assay in 282 HCC patients who received complete liver resections at Kaohsiung Chang Gung Memorial Hospital. Overall survival (OS) curves were constructed using the Kaplan-Meier method and compared using the log-rank test. A Cox proportional -hazards regression model was used to identify independent prognostic factors. The median follow-up time was 52 months. Results: Patients with higher pretreatment serum uPA (≥1 ng/ml) had significantly shorter OS (p = 0.002). Patients with liver cirrhosis, hypoalbuminemia, and thrombocytopenia were significantly more likely to present with elevated uPA levels. Multivariate Cox regression analyses indicated that high pretreatment serum uPA [hazard ratio (HR), 1.848, p = 0.006], vascular invasion (HR, 2.940, p <0.001), and pathology stage III/IV (HR, 3.517, p<0.001) were independent prognostic factors for OS. In further stratified analyses, the combination of serum uPA and AFP had more capacity to predict OS. Conclusions: We conclude that uPA is a clinically relevant biomarker in HCC patients receiving curative resection, with higher expression of uPA being associated with higher mortality. This also highlights the potential utility of uPA as a therapeutic target for improved treatment strategies.
Molecular Dynamics simulations of TREM2 variants R47H and R62H show structural alterations at key binding regions leading to possible implications for mechanisms in Alzheimer’s disease.
Authors: Menzies Georgina Elizabeth , Sims Rebecca , Williams Julie 
Published: November 2019

Abstract
Background There is strong evidence supporting the association between Alzheimer’s disease (AD) and protein-coding variants, R47H and R62H in triggering receptor expressed on myeloid cells 2 (TREM2). The TREM2 protein is an immune receptor protein found in brain microglia. These two variants are in a similar position in the protein but cause a different functional outcome. A structural alteration caused by the variants could be having a large effect on the protein. A crystallised structure was used to investigate structural differences. Both variants were inserted into the protein structure and these were subjected to 300ns of molecular dynamic simulation (MD) in order to investigate the link between structural change and AD risk.Results Results suggest structural alterations in both variant models of TREM2 which could be causing the reduced functional outcome. A large change was noted in the R47H model in the complementarity-determining region two (CDR2) loop, a proposed binding site for ligands such as APOE, a smaller change was observed in the R62H model in this same loop. The overall structure remained stable, possibly accounting for the reduced, not missing, function of TREM2 in disease.Conclusions These differing levels of structural impact could explain the in vitro observed differences in TREM2-ligand binding when the mutations are present. Further studies to investigate this binding loop could help not only a better understanding of TREM2’s role in the onset of dementia but also possibly provide a target for therapeutics.
Assessment of Asymptomatic Bacteriuria and Sterile Pyuria among Antenatal Attendants in hospitals in Northern Ghana
Authors: Karikari Akosua Bonsu , Saba Courage Kosi Setsoafia , Yamik David Yembilla 
Published: November 2019

Abstract
Background Asymptomatic bacteriuria (ASB) and sterile pyuria (SP) are complexities of UTI whose prevalence are not known in the northern sector of Ghana. Our aim was to determine the occurrence of sterile pyuria and asymptomatic bacteriuria among pregnant women accessing antenatal care at a secondary and tertiary care hospitals in Tamale, northern Ghana.Methods A cross sectional study was conducted by screening 530 pregnant women with no signs of acute urinary tract infection attending antenatal clinic for a period of 6 months. Midstream urine was collected for microscopy, quantitative urine culture and antibiotic susceptibility testing. Data analysis was carried out using the Statistical Package for Social Sciences version 20.Results Of the 390 and 90 women screened for ASB, prevalence was 20% and 35.5% respectively at Tamale Central and Tamale Teaching Hospital. Sterile pyuria was found among 66% of the 50 women presenting at Tamale Central Hospital. More than 64% of isolates recovered from ASB patients were S. aureus and coagulase negative Staph. ( CoNS ). Escherichia coli was the dominant species among members of the enterobacteriaceae isolated. Highest susceptibility was recorded against gentamicin and amikacin while most resistance was to Ampicillin, cotrimoxazole, chloramphenicol and nitrofurantoin. Resistance to imipenem and vancomycin were 28.8% and 52%, with strains showing multiple drug resistance of between 81-92%.Conclusion The prevalence of asymptomac bacteriuria is appreciably higher (20-35.5%) than documented rates in the southern sector of the country. The presence of sterile pyuria which may be an indication of asymptomatic renal impairment and most often overlooked in antenatal management is 66%. Empirical treatment of UTIs at the Tamale Central and Teaching Hospital without confirmation of susceptibility may result in treatment failure. It is necessary to screen and treat pregnant women for ASB and SP due to the complications associated with these conditions.
Bioinformatic Analysis of Peripheral Blood miRNA of Breast Cancer Patients in Relation With Anthracycline Cardiotoxicity
Authors: Yadi Wang , Shurui Chen , Tong Zhang , Suxian Chen , Qing Tong , Dongning He 
Published: November 2019

Abstract
The current diagnostic methods and treatments still fail to lower the incidence of anthracycline-induced cardiotoxicity effectively. In this study, we aimed to (1) analyze the cardiotoxicity-related genes after breast cancer chemotherapy in gene expression database and (2) carry out bioinformatic analysis to identify cardiotoxicity-related abnormal expressions, the biomarkers of such abnormal expressions, and the key regulatory pathways after breast cancer chemotherapy. Cardiotoxicity-related gene expression data (GSE40447) after breast cancer chemotherapy was acquired from the GEO database. The biomarker expression data of women with chemotherapy-induced cardiotoxicity (group A), chemotherapy history but no cardiotoxicity (group B), and confirmatory diagnosis of breast cancer but normal ejection fraction before chemotherapy (group C) were analyzed to obtain the mRNA with differential expressions and predict the miRNAs regulating the differential expressions. The miRanda formula and functional enrichment analysis were used to screen abnormal miRNAs. Then, the gene ontology (GO) analysis was adapted to further screen the miRNAs related to cardiotoxicity after breast cancer chemotherapy. The data of differential analysis of biomarker expression of groups A, B, and C using the GSE40447-related gene expression profile database showed that there were 30 intersection genes. The differentially expressed mRNAs were predicted using the miRanda and TargetScan software, and a total of 2978 miRNAs were obtained by taking the intersections. Further, the GO analysis and targeted regulatory relationship between miRNA and target genes were used to establish miRNA-gene interaction network to screen and obtain 7 cardiotoxicity-related miRNAs with relatively high centrality, including hsa-miR-4638-3p, hsa-miR-5096, hsa-miR-4763-5p, hsa-miR-1273g-3p, hsa-miR6192, hsa-miR-4726-5p and hsa-miR-1273a. Among them, hsa-miR-4638-3p and hsa-miR-1273g-3p had the highest centrality. The PCR verification results were consistent with those of the chip data. There are differentially expressed miRNAs in the peripheral blood of breast cancer patients with anthracycline cardiotoxicity. Among them, hsa-miR-4638-3p and hsa-miR-1273g-3p are closely associated with the onset of anthracycline cardiotoxicity in patients with breast cancer. Mining, integrating, and validating effective information resources of biological gene chips can provide a new direction for further studies on the molecular mechanism of anthracycline cardiotoxicity.
Effectiveness of early postoperative oral hydration after colorectal surgery with general anesthesia: A prospective randomized controlled trial
Authors: Yin Xiaorong , Yang Lei , Xiang Shunju , Wu Yixuan , Li Qian 
Published: November 2019

Abstract
BACKGROUND: Over the last decades, studies have already demonstrated that early feeding in patients after elective colorectal surgery yielded a shorter length of hospital stay and did not cause additional risk for adverse events. However, the optimal timing for beginning oral hydration after colorectal surgery under general anesthesia remains controversial. Therefore, we conducted the study to evaluate the effects of early oral hydration (EOH) versus traditional oral hydration (TOH) on thirst and clinical safety outcomes after colorectal surgery under general anesthesia. METHODS: This prospective randomized controlled trial of 1,000 patients with American Society of Anesthesiologists I–III who underwent colorectal surgery under general anesthesia were randomly assigned to the EOH group (given 0.5 ml/kg water after recovery from general anesthesia) or TOH group (fasting and water deprivation until postoperative intestine function recovery). The primary outcome was thirst scale, and secondary outcomes were discomfort score, nausea and vomiting score, and safety outcomes. RESULTS: Of the 1,000 patients who underwent randomization at initial stage, 27 were excluded in EOH group because of refusal (n=22) or nausea and vomiting before hydration (n=5). Demographic and operative data were similar, but not statistically significant (P>0.05). Patients who received EOH were associated with lower thirst score than with TOH (EOH 45.70±24.51 vs. TOH 62.20±23.99; P<0.001) and oropharyngeal discomfort scale (EOH 3.71±8.49 vs. TOH 6.18±11.89, P<0.0001) 30 min after drinking. No significant differences were found for the time of intestinal movements (EOH 73.37±34.49 h, TOH 70.56±31.71, P=0.187) and for EOH and TOH for the risk of nausea and vomiting at the postoperative period (P>0.05) and other complications (P>0.05). CONCLUSIONS: The findings suggested the safety outcomes for mild EOH on patients after colorectal surgery under general anesthesia. Patients who received EOH could have significantly reduced degree of thirst scale and oropharyngeal discomfort scale 30 min after drinking. Trial registration: CHiCTR, CHiCTR-TRC-13003097. Registered 11 March2013, http://www.chictr.org.cn/showproj.aspx?proj=6462.
Nalmefene to prevent Epidural morphine-induced pruritus after Caesarean delivery: a randomized, placebo-controlled clinical trail
Authors: Zhong Chaochao , Xu Xingguo , Zhu Xiang , Qin Yibin , Miao Haihang , Huang Xinchong , Cao Su 
Published: November 2019

Abstract
Background. Epidural morphine provides an effective analgesic effect on cesarean section patients, while epidural morphine-induced pruritus is a very common side-effect that is difficult to prevent or treat. The aim of this study was to determine whether a μ-opioid antagonist with central and peripheral effects could reduce morphine-induced pruritus. Methods. Eighty patients who underwent elective cesarean delivery under spinal aesthesia with epidural morphine 3mg were divided into two groups of 40 each in this prospective, randomized study. After delivery, participants received either intravenous nalmefene hydrochloride 50μg( Nalmefene group, n=40) or saline(Placebo group, n=40). Pruritus, nausea, pain, and side-effects were assessed at 2, 4, 8, 12, 24h after epidural morphine administration. Results. Eighty women completed the study. Compared to IV saline , the total incidence of pruritus within the first 24 hours was reduced in IV nalmefene group (37.5% vs 65%, P=0.003). IV nalmefene also reduced the severity of pruritus. There was no significant difference in the incidence of nausea and vomiting. Remarkably, although the pain scores were significantly higher at 8, 12 and 24h(all P<0.05) in the nalmefene groups, but there was no difference between two groups in the number of patients who needed analgesic treatment(P=0.37). Conclusions. A single dose of IV nalmefene 50μg can reduce the overall severity and incidence of epidural morphine-related pruritus without adversely affecting the quality of postoperative analgesia. TRIAL REGISTRY: ChiCTR1900022268. Registered on 2 April 2019
Ureteric stenting versus non-stenting following uncomplicated ureteroscopic lithotripsy: A Prospective randomized trial.
Authors: Demour Saddam Al , Alrabadi Adel , AlSharif Abedallatif , Ababneh Mera , Melhem Motaz , Mansi Hammam , Aljamal Sa’id , Abufaraj Mohammad 
Published: November 2019

Abstract
Background: There is no consensus about whether a double-J ureteric stent (DJ-US) should be placed following uncomplicated ureteroscopy for stone retrieval. This study aimed to compare three groups of patients who underwent uncomplicated ureteroscopic lithotripsy (URSL) and to evaluate whether stents could be eliminated after the procedure. Methods: A total of 105 patients underwent uncomplicated URSL for ureteric stones were prospectively randomized into three groups: group 1 (34 patients) with DJ-US, group 2 (35 patients) with DJ-US on extraction string, and group 3 (36 patients) with no DJ-US after the procedure. The outcomes measured were; postoperative Visual Analog Score (VAS) for flank pain and dysuria score, urgency, frequency, suprapubic pain, hematuria, analgesia requirement, operative time, re-hospitalization, and return to normal physical activity.Results: Mean operative time was significantly longer in groups 1 and 2 compared to group 3 [mean time ± SD, 22.2 ± 9.1 min, 20.2 ± 6 min, 15.1 ± 7.1 min respectively, p<0.0001]. The results of the VAS for flank pain and dysuria scores, urgency, frequency, hematuria, and suprapubic pain showed a significant difference at all time points of follow-up, with significantly higher in groups 1 and 2 compared to group 3. Further analysis showed that measured outcomes, and analgesia need for groups 1 and 2 were similar, at all time points except at week 1 and 1 month where group 2 patient’s had less symptoms.Conclusion: DJ-US placement appear to be unnecessary in procedures considered uncomplicated by operating urologists during surgery. The advantages of DJ-US with extraction string over DJ-US only include earlier and easy removal with earlier relief of symptoms, and less analgesia requirements.
Chicken avian β-defensin 8 modulates immune response via the mitogen-activated protein kinase signaling pathways in a chicken macrophage cell line
Authors: Hong Yeojin , Pham Thu Thao , Lee Jiae , Lillehoj Hyun S. , Hong Yeong Ho 
Published: November 2019

Abstract
Background Defensins are antimicrobial peptides composed of three conserved disulfide bridges, a β-sheet, and both hydrophobic and cationic amino acids. In this study, we aimed to demonstrate the immunomodulation role of avian β-defensin 8 (AvBD8) in a chicken macrophage cell line.Results Chicken AvBD8 stimulated the expression of proinflammatory cytokines (interleukin (IL)-1β, interferon-γ, and IL-12p40) and chemokines (CCL4, CXCL13, and CCL20) in macrophages. Furthermore, by western blotting and immunocytochemistry, we confirmed that AvBD8 activated the mitogen-activated protein kinase (MAPK) signaling pathway via extracellular regulated kinases 1/2 (ERK1/2) and p38 signaling molecules.Conclusion Overall, AvBD8 plays a crucial role in host defense as not only an antimicrobial peptide, but also an immunomodulator by activating the MAPK signaling pathway and inducing the expression of proinflammatory cytokines and chemokines.
Evaluation of the expression of Notch1 and related proteins in lung carcinoma cells
Authors: Hassan Wael Ahmed Maher Abdou Abdou , Ito Takaaki 
Published: November 2019

Abstract
Introduction Notch signaling pathway has different roles in many human neoplasms, being either tumor-promoting or anti-proliferative. In addition, Notch signaling in carcinogenesis could be tissue dependent.Aim To study the relation between Notch1 protein expression in lung cancer cells to the following Notch related proteins: Hes1, c-Myc, Jagged1 and Jagged2.Materials and methods Notch1 and its related proteins were detected in human lung cancer cell lines and in 54 surgically resected different lung carcinoma tissues. Then, we used small interfering RNA (siRNA) technology, to down-regulate the expression of Notch1 in H69AR and SBC3 small cell lung carcinoma (SCLC) cells. Also, we transfected venus Notch1 intracellular domain (v.NICD) plasmid into human SCLC lines; H69. Result s: The expression of Hes1, c-Myc and Jagged2 is affected by Notch1 in SCLC.Conclusion There is a strong association between the expression of Notch1 protein and the expression of Hes1, c-Myc and Jagged2 proteins, which could aid in better understanding the tumorigenesis in SCLC.
Lung-protective ventilation suppresses systemic and hepatic vein levels of cell-free DNA in porcine experimental post-operative sepsis
Authors: Nyberg Axel , Larsson Alexander , Jylhävä Juulia , Hurme Mikko , Sperber Jesper , Lipcsey Miklós , Castegren Markus 
Published: November 2019

Abstract
Background: Plasma levels of cell-free DNA (cf-DNA) are known to be elevated in sepsis and high levels are associated with a poor prognosis. Mechanical ventilation affects systemic inflammation in which lung-protective ventilation attenuates the inflammatory response.

Aim: To study the effect of tidal volume and PEEP on arterial and organ-specific venous blood as well as on trans-organ differences in cf-DNA levels in a porcine post-operative sepsis model.

Method: One group of anaesthetised, domestic-breed, 9-12 weeks old, pigs were ventilated with protective ventilation (VT 6mL x kg-1, PEEP 10 cmH2O) n=20. Another group, ventilated with a medium high tidal volume and lower PEEP, served as a control group (VT 10 mL x kg-1, PEEP 5 cm H2O) n=10. Blood samples were taken from four sources: artery, hepatic vein, portal vein and, jugular bulb. A continuous endotoxin infusion at 0.25 µg x kg-1 x h-1 for 5 h was started following 2 h of laparotomy, which simulated a surgical procedure. Inflammatory cytokines and cf-DNA in plasma were analysed and trans-organ differences calculated.

Results: The protective ventilation group had lower levels of cf-DNA in arterial (p=0.02) and hepatic venous blood (p=0.03) compared with the controls. Transhepatic differences in cf-DNA were lower in the protective group, compared with the controls (p=0.03). No differences between the groups were noted as regards the transcerebral, transsplanchnic or the transpulmonary cf-DNA differences.

Conclusions: Protective ventilation suppresses arterial levels of cf-DNA. The liver seems to be a net contributor to the systemic cf-DNA levels, but this effect is attenuated by protective ventilation.
Analysis of risk factors for the development of a post-bronchoscopy respiratory infection in lung cancer patients
Authors: Shimoda Masafumi , Yamana Kazunari , Yano Ryozo , Saitou Masaoki , Fujiwara Keiji , Furuuchi Koji , Osawa Takeshi , Uesugi Fumiko , Arakawa Kenichi , Morimoto Kozo , Tanaka Yoshiaki , Kokutou Hiroyuki , Okumura Masao , Uchiyama Takashi , Ohta Ken , Yoshimori Kozo 
Published: November 2019

Abstract
Background: The development of pneumonia following bronchoscopy is very important as a post-bronchoscopy complication. Most patients with post-bronchoscopy respiratory infections show typical pneumonia, and lung abscesses are rare. However, bronchoscopic techniques have advanced, and recently, we have observed patients with lung abscess after bronchoscopy. Therefore, the risk factors might vary from those in past reports. This study aims to identify the incidence of and risk factors for post-bronchoscopy respiratory infections. Methods: We retrospectively studied adult patients diagnosed with lung cancer by bronchoscopy at Fukujuji Hospital between January 2017 and June 2019. Patients in the infection and noninfection groups were compared. The incidence of lung abscess was compared between recent periods and 2013, when endobronchial ultrasonography with a guide sheath (EBUS-GS) was not yet used in our hospital. Results: We reviewed 327 patients, including 20 patients (6.1%) in the infection group. The risk factors for infection were necrosis and/or a cavity in the tumor (p<0.001), large tumor diameter (≥30 mm) (p=0.003), and low serum albumin (<4.0 g/dL) (p=0.012). We developed a predictive score that included these risk factors, and the area under the curve of the score was 0.737 (95% Cl: 0.610-0.864). Conversely, no significant differences in age, current smoking status, or abnormal bronchoscopic findings were observed, even though these factors were reported as risk factors in past reports. Other risk factors for infection were a high white blood cell count (p=0.007), high C-reactive protein level (p=0.014), and expression of programmed death-ligand 1 expression in the tumor cells (p=0.033). In total, 12 patients had lung abscesses (3.7%), which represents a higher incidence than that in 2013 (0.8%). Other types of infection were post-obstructive pneumonia in four patients (1.2%) and typical pneumonia in four patients (1.2%). Conclusions: The risk factors for developing post-bronchoscopy respiratory infection in our study varied from those in past reports, possibly because of the advancement of bronchoscopic techniques such as EBUS-GS.
Survival analysis of asthma patients attended to at Chitungwiza Central Hospital in Zimbabwe
Authors: Ndarukwa Pisirai , Chimbari Moses John , Sibanda Elopy 
Published: November 2019

Abstract
Background Asthma is one of the leading global public health problems with an estimated 300 thousand deaths occurring annually worldwide. Deaths due to asthma in Zimbabwe reached 1 301 or 1.02% of total deaths in 2014. The association between asthma survival and socio-demographic and pathologic factors has not been done in Zimbabwe. We aimed to determine the survival of asthma patients at Chitungwiza Central Hospital in Zimbabwe over a period of 20 years. Methods Records for 158 asthma patients were analysed in this retrospective cohort study. The patient records were sampled from the computerised health information department at the hospital. Data were collected using a patient record checklist which was divided into four sections: (i) demographic information, (ii) clinical characteristics of asthma patients, (iii) health service utilization and (iv) asthma self-management. Descriptive data analysis was performed using the Kaplan Meier survival function curves. The Kaplan Meier survival curves were differentiated by the log-rank test, median survival times and mortality rates. Significant hazard ratios were used for multivariate cox regression model and a test on proportional hazards assumption based on Schoenfeld residuals was conducted. Results The total follow-up time was 2208 person years. The majority of the participants (60.7%) were female. The mortality rate was 61.4%. The median age at death was 25.5 years (IQR; 21-34). Smoking history [p=<0.001], presence of respiratory disease and cardiovascular disease [p=0.002] were significantly associated with higher mortality. Having an income level