bluuebunny/crossref_metadata_2025_split huggingface dataset:
Protective and Therapeutic Effects of Nanoliposomal Quercetin on Acute Liver Injury in Rats
Authors: Liu Xiangyan , Zhang Yang , Liu Ling , Pan Yifeng , Hu Yu , Yang Pu , liao mingmei 
Published: October 2019

Abstract
Background Quercetin, a pigment (flavonoid) found in many plants and foods, has good effects on protecting liver function but poor solubility and bioavailability in vivo. A drug delivery system can improve the accumulation and bioavailability of quercetin in liver. Objective In this study, we used liposomal nanoparticles to entrap quercetin and evaluated its protective and therapeutic effects on drug-induced liver injury in rats. Design The nanoliposomal quercetin was prepared by a thin film evaporation-high pressure homogenization method and characterized by morphology, particle size and drug content. Acute liver injury was induced in rats by composite factors, including carbon tetrachloride injection, high-fat corn powder intake and ethanol drinking. After pure quercetin or nanoliposomal quercetin treatment, liver function was evaluated by detecting serum levels of glutamic-pyruvic transaminase (GPT), glutamic-oxal acetic transaminase (GOT) and direct bilirubin (DBIL). Histology of injured liver tissues was evaluated by hematoxylin and eosin staining. Results and discussion On histology, liposomal nanoparticles loading quercetin were evenly distributed spherical particles. The nanoliposomal quercetin showed high bioactivity and bioavailability in rat liver and markedly attenuated the liver index and pathologic changes in injured liver tissue. With nanoliposomal quercetin treatment, the serum levels of GPT, GOT and DBIL were significantly better than treated with pure quercetin. Using liposomal nanoparticles to entrap quercetin might be an effective strategy to reduce hepatic injury and protect hepatocytes against damage. Conclusions Liposomal nanoparticles may improve the solubility and bioavailability of quercetin in liver. Furthermore, nanoliposomal quercetin could effectively protect rats against acute liver injury and may be a new hepatoprotective and therapeutic agent for patients with liver diseases.
Gene signature characteristic of elevated stromal infiltration and activation is associated with increased risk of hematogenous and lymphatic metastasis in serous ovarian cancer
Authors: Yue Huiran , Wang Jieyu , Chen Ruifang , Hou Xiaoman , Li Jun , Lu Xin 
Published: October 2019

Abstract
Background The clinical significance of hematogenous and lymphatic metastasis in ovarian cancer has been increasingly addressed, as it plays an imperative role in the formation of both intraperitoneal and distant metastases. Our objective is to identify the key molecules and biological processes potentially related to this relatively novel metastatic route in serous ovarian cancer.Methods Since lymphovascular space invasion (LVSI) is considered as the first step of hematogenous and lymphatic dissemination, we developed a gene signature mainly based on the transcriptome profiles with available information on LVSI status in the Cancer Genome Atlas (TCGA) dataset. We then explored the underlying biological rationale and prognostic value of the identified gene signature using multiple public databases.Results We observe that primary tumors with increased risk of hematogenous and lymphatic metastasis highly express a panel of genes, namely POSTN, LUM, THBS2, COL3A1, COL5A1, COL5A2, FAP1 and FBN1. The identified geneset is characterized by enhanced deposition of extracellular matrix and extensive stromal activation. Mechanistically, both the recruitment and the activation of stromal cells, especially fibroblasts, are closely associated with lymphovascular metastasis. Survival analysis further reveals that the elevated expression of the identified genes correlates to cancer progression and poor prognosis in patients with serous ovarian cancer.Conclusions Our findings indicate that tumor stroma supports the hematogenous and lymphatic spread of ovarian cancer, increasing tumor invasiveness and ultimately resulting in worse survival. Thus stroma-targeted therapies may improve the clinical outcomes in combination with cytoreductive surgery and chemotherapy.
Acupuncture for patients with insomnia disorder protocol for a resting-state functional magnetic resonance imaging study
Authors: Guo Jing , Yu Siyi , Liu Chunhong , Wang Guiling , li Bin 
Published: October 2019

Abstract
Background Insomnia is among the most prevalent sleep-related disorders. Previous researches suggest insomnia disorder is associated with brain hyperarousal state manifested as abnormal regional brain activity and resting-state functional connectivity (rs-FC). Acupuncture is considered to be beneficial to improve sleep quality and modulate hyperarousal state. Its underlying neurobiological bases remain poorly understood. The purpose of the trial is to investigate the effectiveness and potential neural mechanism in acupuncture treatment for insomnia disorder using neuropsychological measurements and resting-state functional magnetic resonance imaging (rs-fMRI). Methods /Design This study is a randomized, patient-assessor-blinded trial. A total of 60 eligible patients with insomnia disorder will be randomized in a ratio of 1:1 to the real acupuncture group and sham acupuncture group. Acupuncture intervention will be administered to all patients three times a week for 4 weeks, followed up for 8 weeks. 30 age- and sex-matched healthy good sleepers will be recruited as healthy control group without any treatment intervention. All participants will undergo neuropsychological and rs-fMRI evaluations. The primary outcome includes the change of Pittsburgh Sleep Quality Index (PSQI) scores. The secondary outcome includes Hyperarousal scale (HAS),rs-fMRI measurements, Fatigue scale-14 (FS-14), Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA), a sleep diary, and actigraph test. All outcomes will be evaluated at baseline, post-treatment period and follow-up. The main analyses will be carried out on the basis of the intention-to-treat principle. Discussion The results of the trial will contribute to the efficacy and central mechanism of acupuncture treating insomnia disorder.
Magnesium sulfate reduces the rocuronium dose needed for satisfactory double lumen tube placement conditions in patients with myasthenia gravis
Authors: Fei Shoujun , Xia Hengfu , Chen Xiaowei , Pang Dazhi , Xu Xuebing 
Published: October 2019

Abstract
Background: Using a minimum dose of neuromuscular blockade (NMB) to achieve intubation condition is one of the goals in anaesthesia management of patients with myasthenia gravis (MG) for thoracoscopic (VATS) thymectomy. However, tracheal intubation with double lumen tube (DLT) could be challenging if intubation condition is not optimal. This double-blind randomised controlled study was designed to investigate whether magnesium sulfate would reduce the rocuronium dose needed for DLT intubation and improve the DLT placement condition for patients with MG who were scheduled for video-assisted thoracoscopic (VATS) thymectomy.
Methods: Recruited patients were randomly assigned to receive magnesium sulfate 60mg.kg -1 or normal saline (control) prior to the administration of NMB. Titrating dose of rocuronium was administered to achieve train of four (TOF) ratio less than 10% before DLT intubation. The primary outcome was the rocuronium dose required to achieve TOF ratio less than 10%. The secondary outcome was intubation condition for DLT placement.
Results: Twenty-three patients had received magnesium sulfate and 22 patients had received normal saline before rocuronium administration. The required rocuronium dose[mean (standard deviation)] were 0.10 (0.05) mg.kg -1 and 0.28(0.17) mg.kg -1 in patients who had magnesium sulfate and normal saline respectively( P <0.0001). With a similar depth of neuromuscular blockade and depth of anaesthesia, 100% of patients in the magnesium sulfate group and 72.7% of patients in the control group showed excellent intubation condition ( P = 0.027) respectively. The patients in both groups had similar emergence characteristics.
Conclusions: Magnesium sulfate is associated with a decrease in rocuronium requirement for an optimal DLT intubation condition in patients with MG for VATS thymectomy.
Trial registration: Clinical Trial Registry of China (http://www.chictr.org.cn ) identifier：ChiCTR-1800017696, retrospectively registered on August 10, 2018.
Key words : Magnesium sulfate; double lumen tube; myasthenia gravis; intubation; rocuronium
The DREAM Initiative: study protocol for a randomized controlled trial testing an integrated electronic health record and community health worker intervention to promote weight loss among South Asian patients at risk for diabetes
Authors: Lim Sahnah , Wyatt Laura C , Mammen Shinu , Zanowiak Jennifer M , Mohaimin Sadia , Goldfeld Keith S , Shelley Donna , Gold Heather T , Islam Nadia S 
Published: October 2019

Abstract
Background: Electronic health record (EHR)-based interventions that use registries and alerts can improve chronic disease care in primary care settings. Community health worker (CHW) interventions also have been shown to improve chronic disease outcomes, especially in minority communities. Despite their potential, these two approaches have not been tested together, including in small primary care practice (PCP) settings. This paper presents the protocol of Diabetes Research, Education, and Action for Minorities (DREAM) Initiative, a 5-year randomized controlled trial integrating both EHR and CHW approaches into a network of PCPs in New York City (NYC) in order to support weight loss efforts among South Asian patients at risk for diabetes.

Methods: The DREAM Initiative was funded by the National Institute of Diabetes and Digestive and Kidney Diseases (National Institutes of Health). A total of 480 individuals at risk for type 2 diabetes will be enrolled into the intervention group, and an equal number will be included in a matched control group. The EHR intervention components include the provision of technical assistance to participating PCPs regarding prediabetes-related registry reports, alerts, and order sets. The CHW intervention components entail group education sessions on diabetes prevention, including weight loss and nutrition. A mixed-methods approach will be used to evaluate the feasibility, adoption, and impact (≥5% weight loss) of the integrated study components. Additionally, a cost effectiveness analysis will be conducted using outcomes, implementation costs, and healthcare claims data to determine the incremental cost per person achieving 5% weight loss.

Discussion: This study will be the first to test the efficacy of an integrated EHR-CHW intervention within an underserved, minority population and in a practical setting via a network of small PCPs in NYC. The study’s implementation is enhanced through cross-sector partnerships, including the local health department, a healthcare payer, and EHR vendors. Through use of a software platform, the study will also systematically track and monitor CHW referrals to social service organizations. Study findings, including those resulting from cost-effectiveness analyses, will have important implications for translating similar strategies to other minority communities in sustainable ways.
Prevalence and causes of visual impairment and blindness in three ecological regions of Nepal
Authors: Shrestha Mohan Krishna , Sun Sunjuri Zhi Yu , Limbu Ben , Poudel Manish , Khanal Shankar Prasad , Pradhan Bandana , Shrestha Mangala 
Published: October 2019

Abstract
Background: Visual impairment and blindness are significant public health issues worldwide. The study aims to explore is the prevalence and causes of moderate to severe visual impairment and blindness across three ecological regions of Nepal. Methods: A comparative cross-sectional study was conducted in three districts covering all ecological regions of Nepal. Intensive training for health workers was provided to conduct door-to-door visits for visual acuity testing using Snellen chart and refer the abnormal cases for comprehensive ocular examination by technicians and ophthalmologists to diagnose and treat ocular morbidities. Collected data were analyzed using Statistical Package for Social Sciences and Stata software. Results: Altogether 5234 participants were enrolled in the study. The overall prevalence of moderate to severe visual impairment was 9.5% (4.7% in the Mountain district, 11.2% in the Hill district and 21.2% in the Tarai district), though the prevalence of MSVI was 1.5% in participants aged 15-49 years and 25.1% in those aged ≥50. The overall prevalence of blindness was 0.9%, and the prevalence of blindness in the 15-49 and ≥50 age groups was 0.2% and 2.3% respectively. Most cases of visual impairment and blindness (95.5%) were an avoidable cause, of which 93.7% were treatable and 1.8% were preventable. Overall, cataract was the leading cause of visual impairment and blindness (53.5%), followed by uncorrected refractive error (39.5%). Conclusion: The prevalence of visual impairment and blindness varied significantly with age, ethnicity and locality. The correction of refractive error and cataract surgery would reduce nine in ten cases of moderate to severe visual impairment and blindness. Key words: Epidemiology, Public health, visual, Optic and refraction
Comparison of anterior segment changes after femtosecond laser LASIK and SMILE using a dual rotating Scheimpflug analyzer
Authors: Kim Bu Ki , Mun Su Joung , Yang Young Hoon , Kim Ji Sun , Moon Jun Hyung , Chung Young Taek 
Published: October 2019

Abstract
Background: To compare the changes in the anterior segment after femtosecond laser in situ keratomileusis (FS-LASIK) and small incision lenticule extraction (SMILE) using a dual rotating Scheimpflug (DRS) analyzer (Galilei®; Ziemer Ophthalmology, Port, Switzerland).Methods: A total of 218 eyes of 109 patients who underwent FS-LASIK or SMILE for myopic correction were retrospectively studied. Ninety-eight eyes of 49 patients who underwent FS-LASIK were compared to 120 eyes of 60 patients treated with SMILE. A DRS analyzer was used for preoperative and 6-month postoperative anterior segment analyses. Measured variables included the central corneal thickness (CCT), anterior chamber depth (ACD), anterior and posterior keratometry (K), anterior and posterior best-fit sphere radius, and maximum posterior elevation (MPE).Results: After the procedure, the amount of CCT decrease was higher in the SMILE group than in the FS-LASIK group, but it was not statistically significant. The MPE was significantly increased after both procedures (p < 0.001 and p = 0.001 in the FS-LASIK and SMILE groups, respectively), with the amount of elevation being higher after FS-LASIK than after SMILE even though it was not statistically significant. And there was a significant change in the steep and average posterior K in the FS-LASIK group (p = 0.006 and 0.001, respectively), but not in the SMILE group.Conclusions: Regarding changes in the MPE and posterior K, changes in the posterior corneal surface were greater after FS-LASIK than after SMILE.
Intensive Phase Treatment Outcome and Associated Factors among Patients Treated for Multi Drug Resistant Tuberculosis in Ethiopia: A retrospective cohort study
Authors: Molie Teklu , Teklemariam Zelalem , Klinkenberg Eveline , Dessie Yadeta , Kumsa Andargachew , Mohammed Hussen , Debebe Adisalem , Assefa Dawit , Habte Abebe , Bedru Ahmed , Fiseha Daniel , Seyoum Berhanu 
Published: October 2019

Abstract
Background : Multi-drug resistant Tuberculosis (MDR-TB) is a strain of Mycobacterium tuberculosis that is resistant to at least Rifampicin and Isoniazid drugs. The treatment success rate for MDR-TB cases is lower than for drug susceptible TB. Globally only 55% of MDR-TB patients were successfully treated. Monitoring the early treatment outcome and better understanding of the specific reasons for early unfavorable and unknown treatment outcome is crucial for preventing the emergence of further drug-resistant tuberculosis. However, this information is scarce in Ethiopia. Therefore, this study aimed to determine the intensive phase treatment outcome and contributing factors among patients treated for MDR-TB in Ethiopia.

Methods : A 6 year retrospective cohort record review was conducted in fourteen TICs all over the country. The records of 751 MDR-TB patients were randomly selected using simple random sampling technique. Data were collected using a pre-tested and structured checklist. Multivariable multinomial logistic regression was undertaken to identify the contributing factors.

Results: At the end of the intensive phase, 17.3% of MDR-TB patients had an unfavorable treatment outcome, while 16.8% had an unknown outcome with the remaining having a favorable outcome. The median duration of the intensive phase was 9.0 months (IQR 8.04-10.54). Having an unfavorable intensive phase treatment outcome was found significantly more common among older age [ARRR= 1.047, 95% CI (1.024, 1.072)] and those without a history of hypokalemia [ARRR=0.512, 95% CI (0.280, 0.939)]. Having an unknown intensive phase treatment outcome was found to be more common among those treated under the ambulatory care [ARRR=3.2, 95% CI (1.6, 6.2)], rural dwellers [ARRR= 0.370, 95% CI (0.199, 0.66)], those without a treatment supporter [ARRR=0.022, 95% CI (0.002, 0.231)], and those with resistance to a limited number of drugs.

Conclusion: We observed a higher rate of unfavorable and unknown treatment outcome in this study. To improve favorable treatment outcome more emphasis should be given to conducting all scheduled laboratory monitoring tests, assignment of treatment supporters for each patient and ensuring complete recording and reporting which could be enhanced by quarterly cohort review. Older aged and rural patients need special attention. The sample referral network should be strengthened.
Cross-resistance of the pathogenic fungus Alternaria alternata to fungicides with different modes of action
Authors: Yang Li-Na , He Meng-Han , Ouyang Hai-Bing , Zhu Wen , Pan Zhe-Chao , Sui Qi-Jun , Shang Li-Ping , Zhan Jiasui 
Published: October 2019

Abstract
Background: Cross-resistance, a phenomenon that a pathogen resists to one antimicrobial compound also resists to one or several other compounds, is one of major threats to human health and sustainable food production. It usually occurs among antimicrobial compounds sharing the mode of action. In this study, we determined the sensitivity profiles of Alternaria alternata , a fungal pathogen which can cause diseases in many crops to two fungicides (mancozeb and difenoconazole) with different mode of action using a large number of isolates (234) collected from seven potato fields across China. Results: We found that pathogens could also develop cross resistance to fungicides with different modes of action as indicated by a strong positive correlation between mancozeb and difenoconazole tolerances to A. alternata . We also found a positive association between mancozeb tolerance and aggressiveness of A. alternata , suggesting no fitness penalty of developing mancozeb resistance in the pathogen and hypothesize that mechanisms such as antimicrobial compound efflux and detoxification that limit intercellular accumulation of natural/synthetic chemicals in pathogens might account for the cross-resistance and the positive association between pathogen aggressiveness and mancozeb tolerance. Conclusions: The detection of cross-resistance among different classes of fungicides suggests that the mode of action alone may not be an adequate sole criterion to determine what components to use in the mixture and/or rotation of fungicides in agricultural and medical sects. Similarly, the observation of a positive association between the pathogen’s aggressiveness and tolerance to mancozeb suggests that intensive application of site non-specific fungicides might simultaneously lead to reduced fungicide resistance and enhanced ability to cause diseases in pathogen populations, thereby posing a greater threat to agricultural production and human health. In this case, the use of evolutionary principles in closely monitoring populations and the use of appropriate fungicide applications are important for effective use of the fungicides and durable infectious disease management.
Missense mutations in a transmembrane domain of the Komagataeibacter xylinus BcsA lead to changes in cellulose synthesis
Authors: Salgado Luis , Blank Silvia , Esfahani Reza Alipour Moghadam , Strap Janice L. , Bonetta Dario 
Published: October 2019

Abstract
Background Cellulose is synthesized by an array of bacterial species. Komagataeibacter xylinus is the best characterized as it produces copious amounts of the polymer extracellularly. Despite many advances in the past decade, the mechanisms underlying cellulose biosynthesis are not completely understood. Elucidation of these mechanisms is essential for efficient cellulose production in industrial applications. Results In an effort to gain a better understanding of cellulose biosynthesis and its regulation, cellulose crystallization was investigated in K. xylinus mutants resistant to an inhibitor of cellulose I formation, pellicin. Through the use of forward genetics and site-directed mutagenesis, A449T and A449V mutations in the K. xylinus BcsA protein were found to be important for conferring high levels of pellicin resistance. Phenotypic analysis of the bcsAA449T and bcsAA449V cultures revealed that the mutations affect cellulose synthesis rates and that cellulose crystallinity is affected in wet pellicles but not dry ones. Conclusions A449 is located in a predicted transmembrane domain of the BcsA protein suggesting that the structure of the transmembrane domain influences cellulose crystallization either by affecting the translocation of the nascent glucan chain or by allosterically altering protein-protein interactions.
Genitourinary menopausal syndrome: diagnosis and treatment principles
Authors: Ermakova E. I. 
Published: October 2019

Aim: Presentation of basic clinical scientific data based on modern evidence of anatomical and physiological changes in the urogenital tract in periand postmenopause and the principles of management of women with genitourinary menopausal syndrome.Material and methods: The review of domestic and foreign sources devoted to prevalence, modern diagnostics and methods of vaginal atrophy treatment was carried out.Results: the present article contains modern terminology, data on etiopathogenesis, clinic, diagnostics and treatment methods of VVA, clinical examples.