bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of sevoflurane anesthesia and abdominal surgery on the systemic metabolome: a prospective observational study
Authors: Wei Yiyong , Zhang Donghang , Liu Jin , Ou Mengchan , Liang Peng , Zuo Yunxia , Zhou Cheng 
Published: March 2021

Abstract
Background
Metabolic status can be impacted by general anesthesia and surgery. However, the exact effects of general anesthesia and surgery on systemic metabolome remain unclear, which might contribute to postoperative outcomes.

Methods
Five hundred patients who underwent abdominal surgery were included. General anesthesia was mainly maintained with sevoflurane. The end-tidal sevoflurane concentration (ETsevo) was adjusted to maintain BIS (Bispectral index) value between 40 and 60. The mean ETsevo from 20 min after endotracheal intubation to 2 h after the beginning of surgery was calculated for each patient. The patients were further divided into low ETsevo group (mean − SD) and high ETsevo group (mean + SD) to investigate the possible metabolic changes relevant to the amount of sevoflurane exposure.

Results
The mean ETsevo of the 500 patients was 1.60% ± 0.34%. Patients with low ETsevo (n = 55) and high ETsevo (n = 59) were selected for metabolomic analysis (1.06% ± 0.13% vs. 2.17% ± 0.16%, P < 0.001). Sevoflurane and abdominal surgery disturbed the tricarboxylic acid cycle as identified by increased citrate and cis-aconitate levels and impacted glycometabolism as identified by increased sucrose and D-glucose levels in these 114 patients. Glutamate metabolism was also impacted by sevoflurane and abdominal surgery in all the patients. In the patients with high ETsevo, levels of L-glutamine, pyroglutamic acid, sphinganine and L-selenocysteine after sevoflurane anesthesia and abdominal surgery were significantly higher than those of the patients with low ETsevo, suggesting that these metabolic changes might be relevant to the amount of sevoflurane exposure.

Conclusions
Sevoflurane anesthesia and abdominal surgery can impact principal metabolic pathways in clinical patients including tricarboxylic acid cycle, glycometabolism and glutamate metabolism. This study may provide a resource data for future studies about metabolism relevant to general anaesthesia and surgeries.

Trial registration
www.chictr.org.cn. identifier: ChiCTR1800014327.
School-based surveillance on visit-to-visit blood pressure variability and high blood pressure in children and adolescents
Authors: Wang Jiaxiang , Shen Hui , Liu Jieyu , Xiao Chengqi , Chen Cailong , Teng Haoyue , Hu Jia , Yin Jieyun 
Published: March 2021

Abstract
Background
The predictive importance of visit-to-visit blood pressure variability (VVV) for high blood pressure (HBP) in a pediatric population has been largely unsettled. We aimed to evaluate it based on Health Promotion Program for Children and Adolescents (HPPCA), a school-based surveillance conducted from 2012 to 2018 in Suzhou, China.

Methods
A total of 330,618 participants had BP measurement in 2018 and ≥ 3 BP records during 2012–2017, were recruited from HPPCA. Absolute BP values (in mmHg) were converted into age-, sex- and height- normalized z-scores. VVV was expressed as standard deviation (SD), coefficient of variation (CV) or average real variability (ARV) of BP z-scores during 2012–2017. Logistic regression models were used to assess the associations between VVV and HBP in 2018.

Results
In 2018, 42,554 (12.87%) subjects were defined as HBP. VVV, except for SBP-CV and DBP-CV, was significantly higher in the HBP group than normotensives group. After adjusting for covariates including mean BP values from 2012 to 2017, SBP-SD, SBP-ARV, DBP-SD and DBP-ARV, increased the risk of HBP by 5.70 [95% confidence interval (95% CI) 5.54–5.87], 4.10 (95% CI 4.01–4.20), 4.70 (95% CI 4.50–4.90) and 3.39 (95% CI 3.28–3.50) times, respectively. Notably, SBP-SD significantly improved risk discrimination of HBP based on other risk variables (c-statistics, net reclassification index and integrated discrimination improvement significantly increased).

Conclusions
Higher SD or ARV of BP, was independently related with higher probability of HBP in Chinese pediatric population. SBP-SD could be potentially helpful for detecting HBP. Future researches investigating the predictive value of VVV are warrant.
Patient perceptions of oral health care following stroke: a qualitative study
Authors: Ajwani Shilpi , Ferguson Caleb , Kong Ariana C. , Villarosa Amy R. , George Ajesh 
Published: March 2021

Abstract
Background
Stroke is a serious cerebrovascular disease and is one of the world’s leading causes of disability. Maintaining good oral health is a challenge among those hospitalised after stroke. A multidisciplinary approach to oral care involving non-dental professionals can be beneficial in improving oral health outcomes for patients. The aim of this study was to understand the perceptions of stroke survivors regarding oral healthcare across acute and rehabilitation settings.

Methods
A descriptive qualitative approach was used. Face-to-face semi-structured interviews were conducted. A framework analysis was employed to analyse the data. Patients who had recently experienced a stroke were purposively recruited across both acute and rehabilitation settings, at two metropolitan hospitals in Sydney, Australia. In total, 11 patients were interviewed.

Results
Although participants recognised the importance of oral health, few understood the link between oral and general health. Regular oral hygiene practices varied since having stroke, with a few receiving oral care assistance from nurses. Time, cost and lack of information were some barriers to accessing dental services, while supportive measures such as coordination of oral care, financial subsidy and nurse assistance were strategies proposed to support oral care practices amongst stroke survivors.

Conclusions
There is scope to improve current models of oral care in stroke. While stroke survivors understand the importance of oral care, an integrated oral health model with a multidisciplinary approach could improve health outcomes.
A program evaluation reporting student perceptions of early clinical exposure to primary care at a new medical college in Qatar
Authors: Kane Tanya , Chivese Tawanda , Al-Moslih Ayad , Al-Mutawa Noora A. M. , Daher-Nashif Suhad , Hashemi Nehdia , Carr Alison 
Published: March 2021

Abstract
Background
Though common practice in Europe, few studies have described the efficacy of early clinical exposure (ECE) in the Middle East. The barriers to clinical learning experienced by these novice medical students have not been reported. This evaluation reports on introducing ECE in primary care, supported by Experiential Review (ER) debriefing sessions. The evaluation explores students’ experiences of their acquisition of clinical and non-technical skills, sociocultural issues commonly encountered but underreported and barriers to clinical learning experienced.

Methods
We conducted a cross-sectional study of three student cohorts in 2017–19: All second and third-year students at the new College of Medicine were invited to participate. The primary outcome was students’ perceptions of the aims of the Primary Health Centre Placement (PHCP) programme and how it facilitated learning. Secondary outcome measures were students’ perceptions of their learning in ER sessions and perceived barriers to learning during PHCPs. Student perceptions of the PHCPs were measured using a Likert scale-based questionnaire.

Results
One hundred and fifty-one students participated: 107 in year 2 and 44 in year 3; 72.3% were female. Overall, most students (> 70%) strongly agreed or agreed with the purposes of the PCHPs. Most students (71%) strongly agreed or agreed that the PCHPs allowed them to learn about patient care; 58% to observe doctors as role models and 55% to discuss managing common clinical problems with family physicians. Most students (year 2 = 62.5% and year 3 = 67%) strongly agreed/agreed that they were now confident taking histories and examining patients. Student barriers to clinical learning included: Unclear learning outcomes (48.3%); faculty too busy to teach (41.7%); lacking understanding of clinical medicine (29.1%); shyness (26.5%); and finding talking to patients difficult and embarrassing (25.8%). Over 70% reported that ER enabled them to discuss ethical and professional issues.

Conclusions
Overall, our Middle Eastern students regard ECE as beneficial to their clinical learning. PHCPs and ER sessions together provide useful educational experiences for novice learners. We recommend further exploration of the barriers to learning to explore whether these novice students’ perceptions are manifesting underlying cultural sensitivities or acculturation to their new environment.
CircFAM73A promotes the cancer stem cell-like properties of gastric cancer through the miR-490-3p/HMGA2 positive feedback loop and HNRNPK-mediated β-catenin stabilization
Authors: Xia Yiwen , Lv Jialun , Jiang Tianlu , Li Bowen , Li Ying , He Zhongyuan , Xuan Zhe , Sun Guangli , Wang Sen , Li Zheng , Wang Weizhi , Wang Linjun , Xu Zekuan 
Published: March 2021

Abstract
Background
Circular RNAs (circRNAs) have emerged as a new subclass of regulatory RNAs that play critical roles in various cancers. Cancer stem cells (CSCs), a small subset of cancer cells, are believed to possess the capacities to initiate tumorigenesis and promote progression. Although accumulating evidence has suggested that cells with CSC-like properties are crucial for the malignancy of gastric cancer (GC), it remains unclear whether circRNAs are related to the acquisition of CSC-like properties in GC.

Methods
CircFAM73A expression was analyzed by GEO datasets and verified in GC samples. The roles of circFAM73A in GC cell proliferation, migration, cisplatin resistance, and CSC-like properties were determined by a series of functional experiments both in vitro and in vivo. RNA pulldown was used to explore the miRNAs and proteins binding to circFAM73A. Bioinformatic analysis and experimental verification confirmed the downstream targets of circFAM73A. The regulation of circFAM73A by HMGA2 was verified by ChIP and RIP assays.

Results
Elevated circFAM73A expression was confirmed in GC tissues, and higher circFAM73A predicted poor prognosis in GC patients. The upregulation of circFAM73A enhanced CSC-like properties in GC, thus facilitating cell proliferation, migration, and cisplatin resistance. Mechanistically, circFAM73A promoted GC malignancy by regulating miR-490-3p/HMGA2 in a positive feedback loop and recruiting HNRNPK to facilitate β-catenin stabilization. Moreover, HMGA2 further enhanced E2F1 and HNRNPL activity, which in turn promoted circFAM73A expression.

Conclusions
Our work demonstrates the crucial role of circFAM73A in the CSC-like properties of GC and uncovers a positive feedback loop in circFAM73A regulation that leads to the progression of gastric cancer, which may provide new insights into circRNA-based diagnostic and therapeutic strategies.
Enhanced hydrogen production of Rhodobacter sphaeroides promoted by extracellular H+ of Halobacterium salinarum
Authors: Ye Jiang-Yu , Pan Yue , Wang Yong , Wang Yi-Chao 
Published: March 2021

Abstract
Purpose
This study utilized the principle that the bacteriorhodopsin (BR) produced by Halobacterium salinarum could increase the hydrogen production of Rhodobacter sphaeroides. H. salinarum are co-cultured with R. sphaeroides to determine the impact of purple membrane fragments (PM) on R. sphaeroides and improve its hydrogen production capacity.

Methods
In this study, low-salinity in 14 % NaCl domesticates H salinarum. Then, 0–160 nmol of different concentration gradient groups of bacteriorhodopsin (BR) and R. sphaeroides was co-cultivated, and the hydrogen production and pH are measured; then, R. sphaeroides and immobilized BR of different concentrations are used to produce hydrogen to detect the amount of hydrogen. Two-chamber microbial hydrogen production system with proton exchange membrane-assisted proton flow was established, and the system was operated. As additional electricity added under 0.3 V, the hydrogen production rate increased with voltages in the coupled system.

Results
H salinarum can still grow well after low salt in 14% NaCl domestication. When the BR concentration is 80 nmol, the highest hydrogen production reached 217 mL per hour. Both immobilized PC (packed cells) and immobilized PM (purple membrane) of H. salinarum could promote hydrogen production of R. sphaeroides to some extent. The highest production of hydrogen was obtained by the coupled system with 40 nmol BR of immobilized PC, which increased from 127 to 232 mL, and the maximum H2 production rate was 18.2 mL−1 h−1 L culture. In the 192 h experiment time, when the potential is 0.3 V, the hydrogen production amount can reach 920 mL, which is 50.3% higher than the control group.

Conclusions
The stability of the system greatly improved after PC was immobilized, and the time for hydrogen production of R. sphaeroides significantly extended on same condition. As additional electricity added under 0.3 V, the hydrogen production rate increased with voltages in the coupled system. These results are helpful to build a hydrogen production-coupled system by nitrogenase of R. sphaeroides and proton pump of H. salinarum.

Graphical abstract
A novel approach for the isolation and long-term expansion of pure satellite cells based on ice-cold treatment
Authors: Benedetti Anna , Cera Gianluca , De Meo Daniele , Villani Ciro , Bouche Marina , Lozanoska-Ochser Biliana 
Published: March 2021

AbstractSatellite cells (SCs) are muscle stem cells capable of regenerating injured muscle. The study of their functional potential depends on the availability of methods for the isolation and expansion of pure SCs with preserved myogenic properties after serial passages in vitro. Here, we describe the ice-cold treatment (ICT) method, which is a simple, economical, and efficient method for the isolation and in vitro expansion of highly pure mouse and human SCs. It involves a brief (15–30 min) incubation on ice (0 °C) of a dish containing a heterogeneous mix of adherent muscle mononuclear cells, which leads to the detachment of only the SCs, and gives rise to cultures of superior purity compared to other commonly used isolation methods. The ICT method doubles up as a gentle passaging technique, allowing SC expansion over extended periods of time without compromising their proliferation and differentiation potential. Moreover, SCs isolated and expanded using the ICT method are capable of regenerating injured muscle in vivo. The ICT method involves minimal cell manipulation, does not require any expertise or expensive reagents, it is fast, and highly reproducible, and greatly reduces the number of animals or human biopsies required in order to obtain sufficient number of SCs. The cost-effectiveness, accessibility, and technical simplicity of this method, as well as its remarkable efficiency, will no doubt accelerate SC basic and translational research bringing their therapeutic use closer to the clinic.
Neddylation regulation of mitochondrial structure and functions
Authors: Zhou Qiyin , Zheng Yawen , Sun Yi 
Published: March 2021

AbstractMitochondria are the powerhouse of a cell. The structure and function of mitochondria are precisely regulated by multiple signaling pathways. Neddylation, a post-translational modification, plays a crucial role in various cellular processes including cellular metabolism via modulating the activity, function and subcellular localization of its substrates. Recently, accumulated data demonstrated that neddylation is involved in regulation of morphology, trafficking and function of mitochondria. Mechanistic elucidation of how mitochondria is modulated by neddylation would further our understanding of mitochondrial regulation to a new level. In this review, we first briefly introduce mitochondria, then neddylation cascade, and known protein substrates subjected to neddylation modification. Next, we summarize current available data of how neddylation enzymes, its substrates (including cullins/Cullin-RING E3 ligases and non-cullins) and its inhibitor MLN4924 regulate the structure and function of mitochondria. Finally, we propose the future perspectives on this emerging and exciting field of mitochondrial research.
Stakeholder analysis of childhood obesity prevention policies in Iran
Authors: Taghizadeh Shahnaz , Zarnag Rahim Khodayari , Farhangi Mahdieh Abbasalizad 
Published: March 2021

Abstract
Background
Childhood obesity is one of the most serious health challenges and risk factors for various diseases. International health organizations, such as the World Health Organization (WHO), recommend more stakeholder engagement to discuss this health problem. Therefore, this study aims to identify and analyze the stakeholders of childhood obesity prevention (COP) policy making process in Iran.

Methods
In this study, semi-structured interviews were conducted with 24 Iranian stakeholders in the field of COP from February 2019 to May 2020. PolicyMaker V.4 and MAXQDA V.10 software were used for the analysis of stakeholders.

Results
Out of 24 interviewed stakeholders, 17 were active and seven were inactive. The most powerful and supportive stakeholders were the Ministry of Health and Medical Education (MoHME) and the national and regional Offices of Community Nutrition Improvement. Although stakeholders like the Ministry of Sports and Youth, the municipalities, the Secretariat of the Health and Food Safety, the Islamic Republic of Iran Broadcasting (IRIB), and Student Organization were among powerful bodies, they showed the least support for COP policies. The remaining stakeholders showed medium or low support and power in the policy making process.

Conclusions
Disconnect between stakeholders, less attention to prevention strategies, and high advertising of unhealthy foods were among the main challenges facing the COP policies in Iran and worldwide. Insufficient financial resources, little attention to the young people under 18, non-aligned policies of the Student Organization and the IRIB, and insufficient support of COP policies were among the key challenges to be handled.
Incidence of and improvement in inappropriate parental behaviors of mothers with young children: a retrospective cohort study conducted in collaboration with a local government
Authors: Arai Takehiro , Goto Aya , Komatsu Mitsuko , Yasumura Seiji 
Published: March 2021

Abstract
Background
Inappropriate parental behaviors of mothers toward young children require further study; few epidemiological studies have utilized longitudinal analysis of region-based cohorts. This study examined the frequency of incidence of and improvements in inappropriate parental behaviors of mothers with young children and related factors.

Methods
Among the mothers who underwent a checkup in Fukushima City in 2017, 586 mothers with data from 4-, 18-, and 42-month-old checkups were included in analysis. In this retrospective cohort study, an anonymous database was created by transcribing and matching health checkup records with questionnaires stored at the city health center. Data were analyzed using chi-square tests and logistic regression analysis, using the SPSS Ver.20.0.

Results
In 28.5% of mothers, inappropriate parental behaviors were not reported in the 18-month-old data but were reported in the 42-month-old data. In 3.8%, inappropriate parental behaviors were reported in the 18-month-old data but were not reported in the 42-month-old data. The most common inappropriate parental behavior reported was “yelling at the child using emotional words” (18-month-old data, 16.2%; 42-month-old data, 39.5%). Mothers with financial difficulties were 2.19 times (95%CI: 1.13–4.26) more likely to begin inappropriate parental behaviors between 18 and 42 months. Improvements in parental behaviors were significantly higher in mothers under 30 years old (p = 0.03).

Conclusions
It is necessary to identify mothers with financial difficulties early and to examine how to provide childcare and financial support from a local government at the time of child health checkup.
COVID-19 case management strategies: what are the options for Africa?
Authors: Waya Joy Luba Lomole , Ameh David , Mogga Joseph Lou K. , Wamala Joseph F. , Olu Olushayo Oluseun 
Published: March 2021

AbstractThe ongoing coronavirus disease 2019 (COVID-19) pandemic has put a strain on health systems globally. Although Africa is the least affected region to date, it has the weakest health systems and an exponential rise in cases as has been observed in other regions, is bound to overwhelm its health systems. Early detection and isolation of suspected and confirmed COVID-19 cases are pivotal to the prevention and control of the pandemic. The World Health Organization (WHO) recommends that all laboratory-confirmed cases should be isolated and treated in a health care facility; however, where this is not possible due to the health system capacity, patients can be isolated in re-purposed facilities or at home. An already very apparent future challenge for Africa is facility-based isolation of COVID-19 cases, given the already limited health infrastructure and health workforce, and the risk of nosocomial transmission. Use of repurposed facilities requires additional resources, including health workers. Home isolation, on the other hand, would be a challenge given the poor housing, overcrowding, inadequate access to water and sanitation, and stigma related to infectious disease that is prevalent in many African societies. Conflict settings on the continent pose an additional challenge to the prevention and control of COVID-19 with the resultant population displacements in overcrowded camps where access to social services is limited. These unique cultural, social, economic and developmental differences on the continent, call for a tailored approach to COVID-19 case management strategies. This article proposes three broad case management strategies based on the transmission scenarios defined by WHO, and the criteria and package of care for each option, for consideration by policy makers and governments in African countries. Moving forward, African countries should generate local evidence to guide the development of realistic home-grown strategies, protocol and equipment for the management of COVID-19 cases on the continent "Image missing".