bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rationale and design of influence of volatile anesthesia versus total intravenous anesthesia on chronic postsurgical pain after cardiac surgery using Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials criteria assessment: study protocol for a prospective randomized controlled trial
Authors: Yu Hong , Zheng Jianqiao , Hua Yusi , Ren Shuofang , Yu Hai 
Published: October 2019

Abstract
Background Many patients develop chronic postsurgical pain (CPSP) after cardiac surgery, which interferes with sleep, mood and quality of life. Studies have suggested that propofol improved postoperative analgesia compared with volatile anesthetics, but the prevention effect on CPSP following cardiac surgery is still unknown. This study has been designed to compare the incidence in CPSP following cardiac surgery receiving volatile anesthesia compared to propofol-based total intravenous anesthesia (TIVA) using Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) criteria assessment.
Methods This is a prospective randomized controlled trial. Five hundred adult patients undergoing cardiac surgery will be randomly allocated to the volatile or the TIVA group. The volatile group will receive sevoflurane or desflurane during surgery to provide general anesthesia. The TIVA group will receive propofol-based intravenous agents and no volatile agents during surgery. The primary outcome will be the frequency of CPSP at 3 months, 6 months and 1 year after surgery. CPSP is defined as two ways: sternal and/or thoracic pain: (1) numeric rating scale, NRS >0; (2) meets all six IMMPACT criteria for CPSP assessed using validated pain instruments.
Discussion To our knowledge, this is the first prospective randomized protocol investigating the prevention of CPSP following cardiac surgery receiving volatile anesthesia compared to propofol-based TIVA using validated pain instruments in accordance with the IMMPACT recommendations. This study will provide important information on whether the choice of these two anesthetic regimens might influence CPSP after cardiac surgery.
Trial registration: Chictr.org.cn, ID ChiCTR1900020747. Registered on 16 January 2019.
Angiographic Features of Drug-Induced Bilateral Angle Closure and Transient Myopia with Ciliochoroidal Effusion
Authors: Kang Yong Koo , Son Byeong Jae , Park Dong Ho , Shin Jae Pil 
Published: October 2019

Abstract
Background: To report five cases of acute drug-induced bilateral angle closure and transient myopia with ciliochoroidal effusion, and to suggest a pathogenesis for this condition based upon angiography. Methods: This study is an observational case series. Five patients with acute drug-induced angle closure with ciliochoroidal effusion were examined by ultrasound biomicroscopy, fluorescein angiography, and indocyanine green angiography (ICGA). Results: Five patients presented with bilateral visual impairment and ocular pain after treatment with mefenamic acid, phendimetrazine tartrate, topiramate, or methazolamide. All patients presented a shallow anterior chamber and elevated intraocular pressure in both eyes. They showed a myopic shift from -0.5 to -17.0 diopters. Ultrasound biomicroscopy revealed annular ciliochoroidal effusions with diffuse thickening of the ciliary body in all cases. Rapid clinical improvement occurred in all patients after discontinuing the suspected drugs. ICGA findings were classified into two major signs (hypofluorescent dark spots and hyperfluorescent pinpoints) and three minor signs (early choroidal stromal vessel hyperfluorescence and leakage, diffuse hyperfluorescence of the choroid, and tortuous and dilated retinal vessels). Conclusions: The basic mechanism of pathogenesis involved an idiosyncratic reaction in uveal tissue to systemic drugs. Angiography showed that accumulation of extravascular fluid in the ciliochoroidal layer had a major role in pathogenesis. Angiography could therefore be a useful method to examine the pathophysiology of this condition by imaging of the choroidal layer.
Reducing shoulder complaints in employees with high occupational shoulder exposures: study protocol for a cluster-randomised controlled study (The Shoulder-Café Study)
Authors: Trøstrup Jeanette , Mikkelsen Lone Ramer , Frost Poul , Dalbøge Annett , Høybye Mette Terp , Casper Sven Dalgas , Jørgensen Lene Bastrup , Klebe Thomas Martin , Svendsen Susanne Wulff 
Published: October 2019

Abstract
Background: In Denmark, exercise therapy in combination with work modifications is the first choice treatment for persons with shoulder complaints and high occupational shoulder exposures. To obtain this treatment they must visit several healthcare providers, which makes usual care fragmented and uncoordinated. Therefore, we developed a new intervention which unifies the expertise that is needed. The main hypotheses are that a group-based Shoulder-Café intervention will more effectively reduce (I) shoulder complaints and (II) occupational shoulder exposures than an individual-based Shoulder-Guidance intervention (active control – enhanced usual care).
Methods: A cluster-randomised trial is conducted including 120 employees with high occupational shoulder exposures. Companies (clusters) are randomised to either Shoulder-Café or Shoulder-Guidance with a 1:1 allocation ratio. Participants are 18–65 years old and have an Oxford Shoulder Score (OSS) ≤ 40. Both interventions include a home-based shoulder exercise programme, assessment of shoulder exposures by technical measurements and self-report, and general information on how to reduce shoulder exposures. The Shoulder-Café course also includes three café meetings with physiotherapist-supervised exercises, clinical shoulder evaluation, education on shoulder anatomy, workplace-oriented counselling, and an opportunity for a workplace visit by a health and safety consultant. The primary outcomes are the OSS at 6 month follow-up (hypothesis I), and the mean number of minutes/day with the arm elevated > 60° shortly after end of intervention (hypothesis II). We will use mixed model analysis that allows for company clustering, and data will be analysed according to the intention-to-treat principle.
Discussion: Persons with shoulder complaints and high occupational shoulder exposures are an obvious target group for secondary prevention efforts. We developed the Shoulder-Café to reduce shoulder complaints and shoulder exposures while unifying the expertise that is needed to evaluate and treat shoulder complaints. If the intervention is effective, it would warrant widespread implementation.
Trial registration: The trial was registered at Clinicaltrials.gov on 18 May 2017 (ID: NCT03159910).
A Call for Consensus in Defining Efficacy in Clinical Trials for Opioid Addiction: Combined Results from a Systematic Review and Qualitative Study in Patients Receiving Pharmacological Assisted Therapy for Opioid Use Disorder
Authors: Dennis Brittany B. , Sanger Nitika , Bawor Monica , Naji Leen , Worster Andrew , Baptist-Mohseni Natasha , Hillmer Alannah , Rice Danielle , Corace Kim , Hutton Brian , Tugwell Peter , Thabane Lehana , Samaan Zainab 
Published: October 2019

Abstract
Background Given the complex nature of opioid addiction treatment and the rising number of available opioid substitution and antagonist therapies (OSAT), there is no ‘gold standard’ measure of treatment effectiveness, and each successive trial measures a different set of outcomes which reflect success in arbitrary or opportune terms.We sought to describe the variation in current outcomes employed across clinical trials for opioid addiction, as well as determine whether a discrepancy exists between the treatment targets that patients consider important and how treatment effectiveness is measured in the literature. Methods We searched nine commonly used databases (e.g. EMBASE, MEDLINE) from inception to August 1, 2015. Outcomes used across trials were extracted and categorized according to previously established domains. To evaluate patient reported goals of treatment, semi-structured interviews were conducted with 18 adults undergoing methadone treatment. Results We identified 60 trials eligible for inclusion. Once outcomes were categorized into eight broad domains (e.g. abstinence/substance abuse), we identified 21 specific outcomes with furthermore 53 subdomains and 118 measurements. Continued opioid use and treatment retention were the most commonly reported measures (46%, n=28). The majority of patients agreed that abstinence from opioids was a primary goal in their treatment, however they also stressed goals under-reported in clinical trials. Conclusion There is inconsistency in the measures used to evaluate the effectiveness of OSATs. Individual and population level decision making is being guided by a standard of effect considered useful to researchers yet in direct conflict with what patients deem important. PROSPERO ID CRD42013006507
Peripapillary retinal artery in first diagnosed and untreated normal tension glaucoma
Authors: RONG XIN , Cai Yu , Li Mei , Fang Yuan , Tian Tian , Pan Yingzi 
Published: October 2019

Abstract
Background Glaucoma, an important cause of visual impairment in many countries, remains a common eye condition due to difficulties in its early diagnosis. We analyzed the characteristics of retinal arteries to add a valuable technology for helping the normal tension glaucoma (NTG) diagnosis.
Methods This study included 51 patients with newly diagnosed NTG with hemifield defects and 60 age-matched controls. Peripapillary retinal arteriolar calibers (PRACs) photoed by non-mydriatic retinal camera were measured using ImageJ by two masked readers. We also performed spectral-domain optical coherence tomography to evaluate retinal nerve fiber layer thickness (RNFLT) and optic disc parameters. Their relations to retinal arteriolar calibers were investigated by univariate and multivariate linear regression. The area under the receiver operating characteristic curve (AUROC) was used to confirm the powers to detect NTG by PRACs.
Results PRACs in four quadrants were significantly reduced in individuals with first diagnosed NTG (82 ± 15.1 μm, 80 ± 13.6 μm, 71 ± 11.6 μm, and 64 ±10.0 μm) compared with those in age-matched controls (101 ± 9.8 μm, 105 ± 8.7 μm, 90 ± 7.5 μm, and 82 ± 9.8 μm). Superotemporal and inferotemporal PRACs in the visual field-affected hemifield were narrower than those in the unaffected hemifield in NTG group ( P ≤0.004). Temporal PRACs in the RNFL unaffected hemifield were significantly narrower than in healthy eyes ( P <0.001). Superotemporal PRAC showed a significant correlation with superior RNFLT (β=0.659, P <0.001), and a similar relationship was found between inferotemporal PRAC and inferior RNFLT (β=0.227, P =0.015). The diagnostic capability of temporal PRACs was satisfactory (superotemporal PRAC; AUROC 0.983, cut-off value 84.7 μm, inferotemporal PRAC; AUROC 0.946, cut-off value 94.2 μm).
Conclusions PRAC and infero temporal PRAC are valid parameters for discriminating patients with NTG.
Functional versus functional and anatomical criteria-guided ranibizumab treatment in patients with neovascular age-related macular degeneration – results from the randomized, phase IIIb OCTAVE study
Authors: Staurenghi Giovanni , Garweg Justus G. , Gerendas Bianca S. , Macfadden Wayne , Gekkiev Boris , Margaron Philippe , Dunger-Baldauf Cornelia , Kolář Petr 
Published: October 2019

Abstract
Background

To evaluate the efficacy and safety of two individualized ranibizumab retreatment schemes in neovascular age-related macular degeneration.Methods

Patients (N=671) were randomized (1:1) to receive three initial monthly ranibizumab 0.5 mg injections, then retreatment guided by either best-corrected visual acuity (BCVA) loss (Group I) or BCVA loss and/or signs of disease activity on optical coherence tomography (OCT; Group II). The study was terminated prematurely, as OCT-guided disease activity monitoring became a recommended retreatment criteria. Efficacy analyses were performed on patients who completed 12 months of the originally planned 24-month study. Safety analyses are presented for all safety analyzable patients.Results

Of 671 randomized patients, 305 completed 12 months of the study. For the 12-month completers, baseline mean (standard deviation) BCVA and reading-center evaluated central subfield thickness (CSFT) were comparable [Group I: 60.9 (13.10) letters and 517.7(201.79) µm; Group II: 60.2 (12.21) letters and 515.3 (198.37) µm]. The change from baseline at Month 12 in BCVA was 6.7 (13.48) letters in Group I and 8.3 (13.53) letters in Group II and the change in CSFT was −161.3 (163.48) µm and −175.3 (170.45) µm, respectively. The mean number of ranibizumab injections was 8.2 in Group I and 8.4 in Group II.Conclusion

Ranibizumab treatment resulted in visual and anatomic gains at 12 months for both retreatment strategies, with a trend in favor of OCT-guided vs BCVA loss guided retreatment. No new safety signals were seen.
Evaluating the Cerebrospinal Fluid ctDNA detection by Next-Generation Sequencing in the diagnosis of Meningeal Carcinomatosis
Authors: Zhao Yue , He Jun-Ying , Zou Yue-Li , Guo Xiao-Su , Cui Jun-Zhao , Guo Li , Bu Hui 
Published: October 2019

Abstract
Background

Meningeal carcinomatosis (MC) is the most severe form of brain metastasis and causes significant morbidity and mortality. Currently, the diagnosis of MC is routinely confirmed on the basis of clinical signs and symptoms, positive cerebrospinal fluid (CSF) cytology, and/or neuroimaging (contrast-enhanced brain MRI and/or CT) features. However, negative rate of CSF cytology and neuroimaging findings often result in a failure to diagnose MC from the patients who actually have the disease.Methods

A total of 35 CSF samples were collected from 35 patients with MC for CSF cytology examination, CSF tumor-derived circulating tumor DNA (ctDNA) extraction and cancer-associated gene mutations detection by next-generation sequencing (NGS) at the same time.Results

The most frequent primary tumor in this study was lung cancer (26/35, 74%), followed by gastric cancer (2/35, 6%), breast cancer (2/35, 6%), prostatic cancer (1/35, 3%), parotid gland carcinoma (1/35, 3%) and lymphoma (1/35, 3%) while no primary tumor could be found in the remaining 2 patients in spite of using various inspection methods. Twenty-five CSF samples (25/35; 71%) were found neoplastic cells in CSF cytology examination while all of the 35 CSF samples (35/35; 100%) were revealed having detectable ctDNA in which cancer-associated gene mutations were detected. All of 35 patients with MC in the study underwent contrast-enhanced brain MRI and/or CT and 22 neuroimaging features (22/35; 63%) were consistent with MC. The sensitivity of the neuroimaging was 88% (95% confidence intervals [95% CI], 75 to 100) (p=22/25) and 63% (95% CI, 47 to 79) (p=22/35) compared to those of CSF cytology and CSF ctDNA, respectively. The sensitivity of the CSF cytology was 71% (95% CI, 56 to 86) (n=25/35) compared to that of CSF ctDNA.Conclusions

This study suggests a higher sensitivity of CSF ctDNA than those of CSF cytology and neuroimaging findings. We find cancer-associated gene mutations in ctDNA from CSF of patients with MC at 100% of our cohort, and utilizing CSF ctDNA as liquid biopsy technology based on the detection of cancer-associated gene mutations may give additional information to diagnose MC with negative CSF cytology and/or negative neuroimaging findings.
Integrated mRNA and miRNA transcriptome analysis reveals a regulatory network for tuber expansion in Chinese yam (Dioscorea opposite)
Authors: Zhou Yun-Yi , Luo Shuzhen , Hameed Saba , Xiao Dong , Zhan Jie , Wang Aiqing , He Longfei 
Published: October 2019

Abstract
Background
Yam tuber is a storage organ, derived from the modified stem. Tuber expansion is a complex process, and depends on the expressions of genes that can be influenced by environmental and endogenous factors. However, little is known about the regulatory mechanism of tuber expansion. In order to identify genes and miRNAs involved in tuber expansion, we examined the mRNAs and small RNAs in Dioscorea opposite (Chinese yam) cv. Guihuai 16 tuber during its initiation and expansion stages.
Results
A total of 14238 differentially expressed genes in yam tuber at its expansion stage were identified by using RNA sequencing technology. Among them, 5723 genes were up-regulated, and 8515 genes were down-regulated. Functional analysis revealed the coordination of tuber plant involved in processes of cell events, metabolism, biosynthesis, and signal transduction pathways at transcriptional level, suggesting that these differentially expressed genes are somehow involved in response to tuber expansion, including CDPK, CaM, CDL, SAUR, DELLA, SuSy, and expansin. In addition, 541 transcription factor genes showed differential expression during the expansion stage at transcriptional level. MADS, bHLH, and GRAS were involved in cell differentiation, division, and expansion, which may relate to tuber expansion. Noteworthy, data analysis revealed that 22 known tuber miRNAs belong to 10 miRNA families, and 50 novel miRNAs were identified. The integrated analysis of miRNA-mRNA showed that 4 known miRNAs and 11 genes formed 14 miRNA-target mRNA pairs were co-expressed in expansion stage. miRNA160, miRNA396, miRNA535 and miRNA5021 may be involved in complex network to regulate cell division and differentiation in yam during its expansion stage.
Conclusion
The mRNA and miRNA datasets presented here identified a subset of candidate genes and miRNAs that are putatively associated with tuber expansion in yam, a hypothetical model of genetic regulatory network associated with tuber expansion in yam was put forward, which may provide a foundation for molecular regulatory mechanism researching on tuber expansion in Dioscorea species.
Study on availability of groundwater resources in Selangor state of Malaysia for an efficient planning and management of water resources
Authors: Mridha Goutam Chandra , Hossain M. Monowar , Uddin Mohammad Salah , Masud Md. Sohel 
Published: October 2019

Abstract
Groundwater has become an important source of water to meet the increasing requirement for domestic, industrial, and agricultural needs. The study was formulated to assess the availability of groundwater resources in Selangor State, Malaysia. An integrated MIKE SHE and MIKE 11-based surface water–groundwater interaction model was developed to fulfill the study objectives. Model results illustrated that groundwater flows from the eastern part of the hilly region to the western part and ultimately discharges into the sea. The study also revealed that Sungai Langat, Sungai Klang, and Sungai Selangor receive water from groundwater and do not feed the groundwater. Approximate potential groundwater resources based on water balance study varies from 860–960 million liter per day (MLD), 630–690 MLD, 810–870 MLD to 630–690 MLD for Langat basin, Klang basin, Selangor basin, and Bernam basin, respectively. Impacts due to extreme dry condition showed that groundwater table declined about 0.5–3 m in most of the area. However, groundwater level for the major portion of Selangor State will drop to about 0–1 m for increased abstraction due to changed land-use pattern. Study findings may be used for a holistic and comprehensive management of groundwater resources for sustainable development in Selangor State, Malaysia.
Treatment for high-concentration liquid crystal wastewater with a novel Fenton–SBR–microwave pyrolysis integrated process
Authors: Li Jincheng , Zhao Baoxiu , Ji Qingpeng , Zhang Yanqing , Zhang Kaixin , Gou Tianshuo , Xia Wenxiang , Liu Jie 
Published: October 2019

Abstract
A novel Fenton–SBR–microwave pyrolysis integrated process is developed to treat liquid crystal wastewater possessing complex components, high toxicity and strong stability. In this integrated process, Fenton–SBR and microwave pyrolysis are for the removal of chemical oxygen demand (COD) and disposal of iron mud generated in the Fenton process respectively. The effects of H2O2:Fe2+ molar ratio and Fenton dosage on COD removal were optimized. The experimental results revealed that the removal efficiencies for COD and total organic carbon (TOC) were 99.8% and 99.2%, and the values for MLSS and SVI were stable at 4,500 mg L–1 and 65%, respectively. Microscopic examination proved that there were rotifer, Epistylis galea, Opercularia coarctata, vorticella and mormon genus which are indicative microbes for good water quality. Iron mud waste produced in the Fenton reaction was handled with microwave pyrolysis, producing ɑ-Fe2O3 commercial byproduct. The estimated cost including chemical reagents and electricity for this integrated process is about $320 T–1, without consideration of the added value of the ɑ-Fe2O3 byproduct. TOC removals in the Fenton and SBR processes both fit well with pseudo-first-order kinetics and the corresponding half-life times are 0.15 and 7 h, respectively.
Extracellular Vesicles as Therapeutics for Brain Injury and Disease
Authors: Upadhya Dinesh , Shetty Ashok K. 
Published: October 2019

:
Extracellular vesicles (EVs) are gaining tremendous importance in comprehending central nervous
system (CNS) function and treating neurological disorders because of their role in intercellular communication
and reparative processes, and suitability as drug delivery vehicles. Since EVs have lipid membranes, they cross
the blood-brain barrier easily and communicate with target neurons and glia even deep inside the brain. EVs from
various sources have been isolated, characterized, and tailored for promoting beneficial effects in conditions, such
as brain injury and disease. Particularly, EVs isolated from mesenchymal stem cells and neural stem cells have
shown promise for alleviating brain dysfunction after injury or disease. Such properties of stem cell-derived EVs
have great importance for clinical applications, as EV therapy can avoid several concerns typically associated
with cell therapy. This minireview confers the competence of EVs for improving brain function by modulating
CNS injury and disease.