bluuebunny/crossref_metadata_2025_split huggingface dataset:
Indocyanine green fluorescence imaging to assess bowel perfusion during totally laparoscopic surgery for colon cancer
Authors: Su Hao , Wu Hongliang , Mandula Bao , Luo Shou , Wang Xuewei , Zhao Chuanduo , Liu Qian , Wang Xishan , Zhou Zhixiang , Zhou Haitao 
Published: April 2020

Abstract
Aim: To retrospectively evaluate the feasibility and safety of intraoperative assessment of bowel perfusion in totally laparoscopic surgery for colon cancer using indocyanine green fluorescence imaging (IGFI).Methods: From October 2017 to June 2019, consecutive patients with colon cancer who underwent totally laparoscopic surgery were enrolled retrospectively and grouped into the IGFI group (n=84) and control group (n=105). In the IGFI group, indocyanine green (ICG) was injected intravenously, and the bowel perfusion was observed using a fluorescence camera system prior to and after completion of the anastomosis.Results: The two groups were demographically comparable. The IGFI group exhibited a significantly shorter operative time (p=0.0374) while intraoperative blood loss did not significantly differ among the groups (p=0.062). In the IGFI group, average time to perfusion fluorescence was 48.4±14.0 s after ICG injection, and four patients (4.8%) were required to choose a more proximal point of resection due to the lack of adequate fluorescence at the point previously selected. There were no differences in terms of pathological outcomes, postoperative recovery and the postoperative complication rates between the groups (p＞0.05). Conclusion: IGFI shows promise as a safe and feasible tool to assess bowel perfusion during a totally laparoscopic surgery for colon cancer and may reduce the operative time.
Health system’s readiness to provide cardiovascular, diabetes and chronic respiratory disease related services in Nepal: analysis using 2015 health facility survey
Authors: Ghimire Umesh , Shrestha Nipun , Adhikari Bipin , Meheta Suresh , Pokharel Yashashwi , Mishra Shiva Raj 
Published: April 2020

Abstract
Background: The burgeoning rise of non-communicable diseases (NCDs) is posing serious challenges in resource constrained health facilities of Nepal. The main objective of this study was to assess the readiness of health facilities for cardiovascular diseases (CVDs), diabetes and chronic respiratory diseases (CRDs) services in Nepal. Methods: This study utilized data from the Nepal Health Facility Survey 2015. General readiness of 940 health facilities along with disease specific readiness for CVDs, diabetes and CRDs were assessed using service availability and readiness assessment manual of the World Health Organization (WHO). Health facilities were categorized into public and private facilities. Results: Out of a total of 940 health facilities assessed, private facilities showed higher availability of items of general service readiness, except for standard precautions for infection prevention, compared to public facilities. The multivariable adjusted regression coefficients for CVDs (β=2.87, 95%CI: 2.42-3.39), diabetes (β =3.02, 95%CI: 2.03-4.49) and CRDs (β=15.95, 95%CI: 4.61-55.13) at private facilities were higher than the public hospitals. Health facilities located in hills had higher readiness index for CVDs (β=1.99, 95%CI: 1.02 - 1.39). Service readiness for CVDs (β=1.13, 95%CI: 1.04-1.23) and diabetes (β=1.78, 95%CI: 1.23-2.59) were higher in the urban municipalities than in rural municipalities. Finally, disease related services readiness index was sub-optimal with some degree of variation at the province level in Nepal. Compared to province 1, Province 2 (β=0.83, 95%CI: 0.73-0.95), and province 4 (β =1.24, 95%CI: 1.07-1.43) and province 5 (β =1.17, 95%CI: 1.02-1.34) had higher readiness index for CVDs.Conclusions: This study found sub-optimal readiness of services related to three NCDs at the public facilities in Nepal. Compared to public facilities, private facilities showed higher readiness score for CVDs, diabetes and CRDs. To cope up with the growing burden of NCDs, urgent improvement in health services, particularly in public facilities are critical to manage common NCDs.
Sedative and analgesic validity and administration routes of dexmedetomidine and fentanyl combined with ketamine in awake fiberoptic intubation: An exploratory randomized controlled trial
Authors: Li Chunzhu , Peng Jiali , Sun Yu , Hu Rong , Wang Hao , Yan Jia , Jiang Hong 
Published: April 2020

Abstract
Background: Awake fiberoptic bronchoscope intubation (AFOBI) is the gold standard technique for the management of patients with difficult airways. Adequate sedation and analgesia are essential for successful AFOBI. The aim of this study was to evaluate the sedative and analgesic validity and administration routes of dexmedetomidine and fentanyl combined with ketamine in awake fiberoptic intubation.Methods: Patients undergoing head and neck surgery under general anesthesia with predicted difficult airways were included. Participants were randomly assigned to 6 different groups (n = 6): groups 1-3 were intravenous (IV), while groups 4-6 were intranasal (IN) (group 1: dexmedetomidine (DEX) 1 μg/kg + fentanyl (FEN) 1 μg/kg; groups 2-3: DEX 1 μg/kg + FEN 0.7 μg/kg + ketamine (KTM) 0.1/0.2 mg/kg; group 4: DEX 1.5 μg/kg + FEN 1.4 μg/kg; and groups 5-6: DEX 1 μg/kg + FEN 1 μg/kg + KTM 0.4/0.6 mg/kg). The visual analog scale (VAS) score during intubation, time required for the modified observer’s assessment of alertness/sedation scale (OAA/S) score to reach above 2 and for the bispectral index (BIS) to decrease to 60-80, motor activity assessment scale (MAAS) score, changes in vital signs and adverse effects were recorded.Results: Among the IV groups, the VAS score of group 1 (5.65 ± 2.11) was higher than those of group 2 (1.89 ± 2.16, P = 0.012) and group 3 (1.15 ± 0.98, P = 0.001). Among the IN groups, the VAS score was lower in group 6 (0.86 ± 1.27) than in group 4 (7.20 ± 2.70, P < 0.001) and group 5 (3.93 ± 2.73, P = 0.031). Participants in group 5 and group 6 were less likely to cough when intubated than those in group 4 (P = 0.002), while the differences among IV groups were not significant. There were no significant differences in the other endpoints.Conclusions: Our study indicates that the addition of subanesthetic doses of ketamine, either intravenous or intranasal, could reduce the fentanyl and dexmedetomidine consumption used in AFOBI and provide better sedative and analgesic effects.Trial registration: Chinese Clinical Trial Registry (www.chictr.org.cn; ChiCTR1900021185), prospectively registered on February 1st, 2019.
Nobiletin Down-regulates SKP2-p21/p27-CDK2 Axis to Inhibit Tumor Progression and Shows Synergistic Effect with Palbociclib on Renal Cell Carcinoma
Authors: Chen Tingting , Liu Liu , Hu Xiaoyan , Wang Kai , Zhou Tao , Luo Xi , Li Longkun , Fu Weihua , Xu Jie 
Published: April 2020

Abstract
Background: Natural extracts can enhance the efficacy and sensitivity of chemotherapeutic drugs, including nobiletin. However, the possible role and underlying mechanisms of nobiletin in cancer including Renal cell carcinoma (RCC) are still unclear.Methods：Cell proliferation, cell cycle and apoptosis analysis, colony-forming assays, immunoblotting analysis and qRT-PCR analysis were performed to investigate how nobiletin inhibits RCC cell proliferation in vitro. Nude mouse model was used to measure in vivo efficacy of nobiletin and its combination with palbociclib.Results：Nobiletin induced G1 phase cell cycle arrest, apoptosis, and proliferative inhibition in RCC Cells. Mechanistically, nobiletin inhibited activation of oncogene SKP2, leading to the accumulation of tumor suppressors and apoptosis-inducing substrates such as p21 and p27 to inhibit cell proliferation, eventually inhibit tumor formation. Intriguingly, we further found that sensitivity of palbociclib was associated with SKP2 protein level. Furthermore, in vitro and vivo results, dual inhibition of nobiletin and palbociclib showed synergistic lethality.Conclusion：Combination nobiletin and palbociclib may serve as a potential therapeutic strategy for renal cancer.
Detect it so you can treat it: a case series and proposed checklist to detect neurotoxicity in checkpoint therapy
Authors: Bolz Saskia , Ramakrishnan Thivyah , Fleischer Michael , Livingstone Elisabeth , Stolte Benjamin , Thimm Andreas , Kizina Kathrin , Ugurel Selma , Kleinschnitz Christoph , Glas Martin , Zimmer Lisa , Hagenacker Tim 
Published: April 2020

Abstract
Background: Checkpoint inhibitors show impressive and durable responses in various cancer types and provide new avenues for cancer immunotherapy. However, these drugs have a variety of adverse events. Common autoimmune-related adverse effects include fatigue, hepatitis, skin rash, endocrine deficiencies, and colitis. Neurotoxicity has been reported, but its incidence and course remain unclear.Methods: To illustrate the broad spectrum of neurotoxicity, we exemplarily report the neurological adverse events of five patients with melanoma and one patient with differentiated thyroid cancer who received checkpoint inhibitors at Essen University Hospital (Essen, Germany).Results: After treatment with ipilimumab, nivolumab or pembrolizumab, neurotoxic effects included hypophysitis-associated neck pain and headache, Guillain-Barré syndrome, transverse myelitis, acute brachial plexus neuritis, and ocular myasthenia gravis.Conclusions: Checkpoint inhibitor therapy remains a success story; however, neurological immune-related adverse events may cause severe life-threatening conditions. We propose a checklist for the early detection of neurological adverse events during routine clinical treatment to prevent more severe courses of checkpoint inhibitor-induced neurotoxicity.
Neutral Polysaccharide from Panax notoginseng enhanced cyclophosphamide antitumor efficacy in hepatoma H22-bearing mice
Authors: Liu Yanhong , Qin Huayan , Zhong Yuanyuan , Li Shuang , Wang Huajing , Wang Hong , Chen Liling , Tang Xiang , Li Yalin , Qian Zhongyi , Li Huaiyu , Zhang Lei , Chen Tong 
Published: April 2020

Abstract
Background: Our previous studies demonstrated that the administration of crude Polysaccharide from Panax notoginseng (CPPN) can effectively prolong the lifespan of tumor-bearing mice via boosting host immune system as well as a weak cytotoxicity against hepatocellular carcinoma (HCC). In the present study, Neutral Polysaccharide (NPPN) were further purified from crude polysaccharide isolated from panax notoginseng. The effects of NPPN on the immune function and hematopoietic function of mice with low immunity and myelosuppression induced by cyclophosphamide (CTX) were investigated. The effect of NPPN combined with CTX on the tumor inhibition rate of the H22 tumor-bearing mice and the impact of NPPN on the proliferation of H22 liver cancer cells in vitro were investigated.Methods: CPPN was obtained by water extraction and alcohol precipitation method, and further purified by DEAE Sepharose Fast Flow ion exchange resin column. NPPN was added to the immunosuppressed with myelosuppression mice induced by CTX. Thymus index, spleen index, lymphocyte proliferation stimulation index by adding of concanavalin A, determination of serum hemolysin, NK cell activity assay, mice carbon clearance experiment, blood count tests were detected. The tumor inhibition rate of the H22 tumor-bearing mice treated with NPPN combined with CTX was recorded.Results: NPPN and 4 kinds of acid polysaccharide from Panax notoginseng (APPN) were successfully isolated from the CPPN by DEAE Sepharose Fast Flow ion exchange resin column. NPPN inhibited the growth of H22 cells and significantly increase the tumor inhibition rate of the H22 tumor-bearing mice combined with CTX. The elevation of the cellular and humoral immunity levels as well as a variety of blood count tests indicators of immunosuppressive with myelosuppression mice may contribute to the antitumor activity of NPPN.Conclusion: NPPN has potential antitumor activity for the treatment of liver cancer combined with cyclophosphamide.
The concept of a cementless isoelastic monoblock cup made of highly cross-linked polyethylene infused with vitamin E: Clinical outcome and radiological analyses of migration and wear using EBRA at mid-term follow-up
Authors: Afghanyar Yama , Joser Sebastian , Tecle Jonas , Drees Philipp , Dargel Jens , Rehbein Philipp , Kutzner Karl Philipp 
Published: April 2020

Abstract
Background The newest generation of cementless titanium coated, isoelastic monoblock cup with vitamin E-blended highly cross-linked polyethylene (HXLPE) has been introduced to the market in 2009. Aim of the present study was to obtain mid-term data including the analyses of migration and wear. Methods The present prospective study investigated 101 primary total hip arthroplasty (THA) cases in 96 patients at a single institution. Patients were allowed full weight-bearing on the first day postoperatively. Harris hip score (HHS) as well as pain and satisfication on visual analogue scale (VAS) were assessed during a mean follow-up of 79.0 months. Migration and wear were assessed using Einzel-Bild-Roentgen-Analyse (EBRA) software. Additionally, radiological alterations in the acetabular bone and complications were documented. Results At mid-term follow-up (mean 79.0 months (range: 51.8 – 101.7)), HHS was 91.1 (range 38.0 – 100.0), satisfaction on VAS was 9.6 (range 6.0 – 10.0), rest pain on VAS was 0.2 (range 0.0 – 4.0), and load pain on VAS was 0.6 (range 0.0 – 9.0). Mean migration was 0.86 mm (range: 0.0 – 2.56) after 24 months and 1.34 mm (range: 0.09 – 3.14) after 5 years. Mean annual migration rate was 0.22 (range: -0.24 – 1.34) at 5 years. Mean total wear was 0.4 mm (range: 0.03 – 1.0) at 5 years. The mean annual wear rate was 0.06 mm per year (range: 0.0 – 0.17). Radiographic analysis showed osteolysis in none of the cases and no revision surgeries had to be performed. Conclusion The concept of vitamin-E blended HXLPE in cementless isoelastic monoblock cups prevents osteolysis, aseptic loosening and the need of revision surgery at mid-term. Values for cup migration and wear stay well below the benchmarks which are considered predictive for potential future failure.
MiRNA-6089 inhibits rheumatoid arthritis fibroblast-like synoviocytes proliferation and induces apoptosis by targeting CCR4
Authors: Lin Suxian , Zhang Zhiyong , Wang Shengnan , Lu Yang , Yang Meilv , Chen Ping , Wang Mudan 
Published: April 2020

Abstract
Background: Growing data have indicated that fibroblast-like synoviocytes (FLS) and miRNAs are implicated in the pathogenesis of rheumatoid arthritis (RA). This study was aimed to evaluate the function of miR-6089 in the regulation of RA-FLSs. Methods: The expression of miR-6089 was measured by quantitative real time PCR (qRT-PCR). The RA-FLSs were transfected with si-CCR4 plasmids or miR-6089 mimic, and subjected to CCK-8 and flow cytometry to analyze proliferation and apoptosis. The concentrations of MMP-1, TNF-α and IL-6 in RA-FLSs supernatant were detected using ELISA. The protein expression of caspase-3, -8 and -9 was detected using western blot.Results: The levels of miR-6089 were detected to be significantly lower in the synovial tissues and FLSs of RA than in the synovial tissues and FLSs of healthy controls. The miR-6089 up-regulation in RA-FLSs significantly inhibited the proliferation and promoted cell apoptosis accompany with an increase protein expression of caspase-3, -8 and -9. Furthermore, CCR4 was determined to directly target miR-6089, and its expression was significantly increased in the synovial tissues of RA than in the synovial tissues of healthy controls. Moreover, CCR4 overexpression effectively reversed the effect on proliferation and apoptosis induced by miR-6089 in RA-FLSs. Conclusion: Our results revealed that miR-6089 may be a potential target for RA prevention and therapy of RA.
Hypertrophic adipocyte-derived exosomal miR-802-5p contributes to insulin resistance in cardiac myocytes through targeting HSP60
Authors: Wen Zhongyuan , Li Junfeng , Fu Yalin , Zheng Yuyang , Ma Mingke , Wang Changhua 
Published: April 2020

Abstract
Epicardial adipose tissue (EAT) is implicated in insulin resistance, which has been recognized as a strongest predictor of the development of diabetic cardiomyopathy and subsequent heart failure. However, the underlying mechanism remains incompletely understood. Herein, we investigated the effect of hypertrophic adipocytes on cardiac insulin resistance. We found that hypertrophic adipocyte-derived exosomes (h-Exo) induced insulin resistance in NRVMs. Furthermore, h-Exo high-expressed miR-802-5p. Insulin sensitivity of NRVMs was impaired by miR-802-5p mimic but improved by its inhibitor. TargetScan and luciferase reporter assays revealed that heat shock protein 60 (HSP60) was a direct target of miR-802-5p. Both h-Exo and miR-802-5p mimic could downregulate HSP60 protein levels. In addition, HSP60 silencing induced insulin resistance and mitigated the insulin-sensitizing effects of adiponectin. HSP60 depletion also significantly increased the expression levels of CHOP, a marker of the unfolded protein response (UPR), and enhanced oxidative stress, accompanied by the increased phosphorylation of JNK and IRS-1 Ser307. Inhibition of both miR-802-5p and endocytosis abolished the impacts of HSP60 knockdown on the UPR and oxidative stress. In summary, hypertrophic adipocyte-derived exosomal miR-802-5p caused cardiac insulin resistance in NRVMs through downregulating HSP60. These findings provide a novel mechanism by which EAT impairs cardiac function.
The use of pre-operative virtual reality to reduce anxiety in women undergoing gynaecological surgeries: a prospective cohort study
Authors: Chan Jason Ju In , Yeam Cheng Teng , Kee Hwei Min , Tan Chin Wen , Sultana Rehena , Sia Alex Tiong Heng , SNG Ban Leong 
Published: April 2020

Abstract
Background: Virtual reality (VR) is a promising new technology that offers opportunities to modulate patient experience and cognition. There is limited work on VR effectiveness during the preoperative period in the local setting. We investigated the feasibility and practicability of employing VR in anxiety management for patients undergoing minor gynaecological surgery, with the primary outcome being the changes in preoperative anxiety levels before and after the VR experience. Methods: A prospective cohort study was conducted in the KK Women’s and Children’s hospital between March 2019 and January 2020. Female patients undergoing gynaecological surgeries were recruited after obtaining informed consent. Patients were given a VR headset accompanied with a handphone loaded with VR experiences comprising sceneries, background meditation music and breathing exercises. The VR experience was administered for 10 mins and pre- and post-VR psychological assessments surveys were conducted. Results: Data analysis from 108 patients showed that our patient population had moderate state anxiety (39.6 (SD 11.14) and trait anxiety 40.1 (9.07) on the State-Trait Anxiety Inventory (STAI). The use of VR before surgery could reduce both Hospital Anxiety and Depression Scale (HADS) anxiety (7.2 ± 3.3 down to 4.6 ± 3.0; p<0.0001) and depression (4.7 ± 3.3 down to 2.9 ± 2.5; p<0.0001) scores. EQ-5D-3Lshowed no significant change in dimensions of ‘mobility’ and ‘self-care’ but significant changes to reported ‘usual activities’, ‘pain/discomfort’ and anxiety/ depression’ dimensions. Level 1 for ‘usual activities’ (“no problems with performing usual activities”) increased from 102 (94.4%) to 107 (99.1%) (p= 0.0253), ‘pain/discomfort’ (“I have no pain/discomfort”) increased from 72 (66.7%) to 84 (77.8%) and ‘anxiety/ depression’ (“I am not anxious/ depressed”) increased from 62 (57.4%) to 90 (83.3%) between pre- and post-VR experience. About 82% of patients rated the VR experience as ‘Good’ or ‘Excellent’.Conclusions: Our study showed significant reduction in preoperative anxiety after VR experience and has positive patient satisfaction. The use of VR may be suitable for patients with high anxiety preoperatively without the use of anxiolytics. Future work could include implementation studies upon adoption in clinical practice and the use in other surgical populations. Trial registration: Clinicaltrials.gov NCT03685422. Registered 26Sep2018 https://clinicaltrials.gov/ct2/show/NCT03685422?term=NCT03685422&draw=2&rank=1
Psychometric properties of women’s satisfaction with the childbirth education class questionnaire for Iranian population
Authors: Hassanzadeh Robab , Jafarabadi Mohammad Asghari , Abbas-Alizadeh Fatemeh , Meedya Shahla , Mohammad-Alizadeh-Charandabi Sakineh , Mirghafourvand Mojgan 
Published: April 2020

Abstract
Background: Childbirth preparation classes can reduce pregnant women’s anxiety and fear levels by providing them with training supports. The importance of mothers’ participation in these classes, evaluation of their satisfaction with these classes, and lack of a standard instrument in Iran led to the necessity of conducting this study for the translation and psychometric analysis of the women’s satisfaction with the childbirth education class questionnaire for the population of Iranian women. Methods: The questionnaire was translated from English into Persian through the forward-backward translation method. The cluster sampling method was employed to select 205 pregnant women with gestational age of 35-37 weeks from all health complexes of Tabriz, Iran. The face, content, and construct validity of the research instrument were assessed through exploratory and confirmatory factor analyses. Internal consistency and test-retest reliability were measured to evaluate the overall reliability of the questionnaire. Results: The impact scores of all items were above 1.5. The content validity index (CVI) and content validity ratio (CVR) of the questionnaire were 0.88 and 0.94, respectively. The convergent construct validity of the whole questionnaire and those of its three subscales were confirmed through the exploratory factor analysis (EFA). The factor loadings of no items were below 0.3, and the X2⁄df ratio was smaller than 5. In addition, the RMSEA was smaller than 0.08; therefore, the overall model validity was confirmed. Cronbach’s alpha and intra-class correlation coefficient (ICC) were 0.93 and 0.96, respectively, indicating the acceptable reliability of the questionnaire. Conclusion: The Persian version of this questionnaire, entitled "Women’s Satisfaction with Childbirth Education Class" is a valid and reliable instrument for measuring Iranian women’s satisfaction with childbirth education classes.